6>1 Li~Zfr )drU8I,v~101W THT,'BR A So A. JONES. M. D C.,II/ THE HOM(EOPATHIC TREATMENT OF THE DISEASES OF FEMALES AND CHILDREN. LONDON*. PRINTED BY J. WERTHEIMIER AND CO., CIRCUS PLACE, FINSBURY CIRCUS.' THE HOM(EOPATHIC TREATMENT OF THE DISEASES OF FEMALES AND CHILDREN. BY WALTER WILLIAMSON, M.D. OF PHILADELPHIA. LONDON: J. LEATH, 5, ST. PAUL'S CHURCH YARD, M.DCCC.XLIX. ON THE ADMINISTRATION OF THE,MEDICINES., THaE Homoeopathic Medicines are used in the form of Tinctures, and Globules. A dose of the Tincture of any of the medicines is from one-eighth to one-fourth of a drop. A convenient way of obtaining a suitable dose is to mix a drop with one ounce, two table-spoonfuls) of pure soft water, and take "a dessert-spoonful for a dose for an adult, or. "a tea-spoonful for an infant. Of the Globules, two or three for an adult, or one for an infant. In chronic cases, they may be taken dry on the tongue; but in acute cases they are better dissolved in water. With regard to the repetitiont of the dose, it will be sufficient for the present purpose to observe, that it must depend chiefly on the urgency of the case. In vi severe acute diseases, the dose may be repeated every three, four, or six hours. Some medicines, such as Aconite and Ipecacuanha, may be repeated every hour or two, if the symptoms are very urgent. DIET. Whilst using the medicines, the patient should, as much as possible, avoid everything possessing medicinal or stimulating properties, as well as everything which experience has shewn to disagree with the patient. Abstinence from cofee and from camphorated dentifrice is particularly enjoined ENGLISH ED. LIST OF THE MEDICINES REFERRED TO IN THIS WORK, WITH THEIR COMMON NAMES. Aconitum Napellus.-Aconite, Monkshood. Antimonium Crudum.-Crude Autmony. Arnica Montana.-Arnica, Leopard's Ban~e. Arsenicum Album.- Arsenic. Aurum Metallicum.-Aurum, Gold. Belladonna.-iDeadly Night Shade. Bryonia Alba,.-Bryonia, White Bryoriy. Calcarea Carlionica.- Carbonate of Lime. Carbo Vegetabilis.-Wood Charcoal. Chamomilla.-Wild Chamomile. China, or Cinchona.-Yellow Bark. Cina.-Worm Secd. Cocculus.-Cocculus Indicus. Coffea Arabica.-Coffea Cruda, Coffee. Colocynthlis.-Colocynth, Bitter Cucumber. Conium-Maculatunm.-Conitum, Spotted Hemlock. Cuprum, Aceticum.- Acetate of Copper. Dulcamara.-Bitter Sweet. Euphrasia Officinalis.-E uphrasia, Eyebright. Ferrum Metallicum.-Ferrum, Iron. Graphites.-Plumbago, Black Lead. Hepar Sulphuris.-Liver of Sulphur. Hyoscyam-us Niger.- Hyoscyamus, Henbane, Ignatia' A mara.- Ignatia., St. Ignatia's Bean. LIST OF ME DICINES. Ipecacuanlia.-Ipecacuanuha Root. Kali Carbonicum.-Carbonate of Potash. Lachesis.-Poison of the Lance-Headed Viper. Lycopodium.- Club Moss. Mercurius Vivus.-Quick silver. Natrum, Muriaticum..,-,Common Salt. Nux Vomica.. Opium. Phosphorus. Phosphori Acidum.-Phosphoric Acid. Platina.-Platinum. Pulsatilla Niger.-Meadow Anemone. Rheum or Rhabarbarum. -Rhubarb. Rhus Toxicodendran.-Poison Oak, Sambucus. -Elder. Sepia.-Inky juice of the Guttle Fish. Silicea, Silica, Silex. Staphysagria.-Stavesacre. Stramon ium. -Thorn Apple. Sulphur. Veratrum.-Whitc Hellebore. istras of femalu s anb ~(ilbren. PART I. DISEASES OF FEMALES. THE female constitution, especially after puberty, possesses distinctive peculiarities, independent of the influence of habits and of education. And these peculiarities extend to the moral as well as the physical being. The particular organisation of the female subjects her to many diseases, as well as physiological changes not of a morbid character, from which the male is exempt. The object of this portion of the work is to treat of some of the most common of those diseases, derangements, and changes. MENSTRUATION. When this function is performed in a healthy manner, no change of consequence is percepB 2 PART I. tible in the general feelings; although increased susceptibility of the nervous system sometimes attends it. The first approach of this change is generally marked by a reserve in the manners; a more erect carriage; a change in the voice; expansion of the chest; enlargement of the breasts, etc. The quantity differs very much in different individuals; the average quantity is perhaps from four to six ounces. When perfectly healthy it does not coagulate, and the stain is very difficult to wash out. In quite young females, or those who menstruate too soon, the quantity is generally smaller, and more mixed with mucus; sometimes nearly white, and merely streaked with red. The duration of a menstrual period varies in different persons from two to seven days; the average is about five days. It usually returns with great regularity in a state of health, every twenty-eight days; except in girls who menstruate precociously and again when approaching the period of its final cessation, or the " change of life," as this stage is called. The above account may be considered a brief outline of healthy menstruation, and any considerable deviation therefrom, especially if 'DISEASES OF FEMALES.3 3 it affect the general health, should be corrected by appropriate medical treatment. Derangements of menstruation are generally referable to insufficient clothing, fault in regimen, or improper arction of the mind. Too TARDY APPEARANCE OF THE MENSES. The absence of this discharge alone, so long as the general health does not suffer, is not a sufficient reason for' the administration of medici-ne. It is sometimes delayed in our latitude uni teigteenth year without any evil cn sequences resulting. It generally, however, occurs at the age of fourteen or fifteen years. Carefully avoid taking all nostrums, herb teas, essential oils, or other forcing medicines, for the purpose of bringing it on. But when all the visible signs of womanhood have appeared, with the mental and moral changes that usually take place at the period of puberty, and the menses do not yet show themselves, especially if periodical pains in the hips, loins, and back occur, attended with a sensation of weight and fulness in the lower part of the abdomen with bearing-down, the aid of medicine may with propriety be called in to relieve the sufferer. 4 PART 1. A long catalogue of additional symptoms occasionally occurring at this period might be enumerated as calling for treatment: such as fulness about the head, giddiness, flushed face or sallowness, bleeding at the nose, buzzing, in the ears, palpitation of the heart, constriction of the chest, shortness of breath on going up stairs, hardness and soreness in the breasts, drawing and numbness in the lower limbs, lassitude, feeble pulse, fainting fits, hysterical symptoms, coldness of the limbs, swelling of the ankles, swelling of the abdomen, nausea, colic, constipation, leucorrhcea, etc. The causes which impede menstruation may be very remote and obscure, or they may be immediate and apparent. As the notices of disease in the present treatise are necessarily short and confined to the most prominent points, the cases treated of under this head will be selected from those of the most frequent occurrence and of the simpler forms; recommending those arising from occult causes, or depending on some organic- derangement, to the management of a judicious homoeopathic physician. When the general health is but slightly affected by the apparent delay of this important DISEASES OF FEMALES. 5 function, a well-ordered regimen is frequently all that is necessary to bring about the" change." Let the diet be simple but nutritious; consisting of easily digestible articles in due proportion from the animal and vegetable kingdoms: avoiding compounded cookeries, high seasoning and spices, as.well as the use of tea and coffee, and all stimulating drinks, such as cider, porter, beer, wine, spirits, etc. Let her pursue a regular course of exercise: such as walking in the open air in suitable weather; riding on horseback or in an open carriage; taking a share in the duties of housekeeping, etc.; being careful to avoid fatigue or excessive exercise, and exposure to a draft of air when in a state of perspiration. Sedentary habits and too close application to study are very injurious. Cultivate cheerfulness of disposition, and endeavour to promote it by choosing such pastimes as will at once amuse and divert the mind. Pay proper attention to dress: let the clothing be seasonable, and changed to suit the variations of the weather; protect the feet and lower limbs against cold, and carefilly avoid exposure to wet and dampness. The medicines chiefly employed in the cases alluded to above, are, Arsenicum, Bellcalonna, B3 6 PART I. Bryonia, Coccidus, Cuprum, Lachesis, Lycopodium, Phosphorus, Pulsatilla, Sepia, Sulphur, and Veratrum. Arsenicum, if the face is pale and swelled in the morning on rising, with swelling of the feet in the evening, and a sensation of heat in the circulation, with prostration of strength. Belladonna, if bleeding of the nose, redness of the face, injected eyes attended with dread of light, or if there be a full pulse, dark redness of the face, and giddiness after stooping. Aconite may be given alternately with Belladonna. Bryonia, if, in place of menstruation, bleeding of the nose occurs, give Bryonia two mornings in succession. Lachesis and Lycopodium may also be given in similar cases. Cocculus, if there should be a complication of nervous affections; contracting pinching pains in the lower part of the abdomen, with oppressed respiration and groaning. Give it for two or three nights in succession., Cuprum is indicated when the patient is threatened with spasms; or has cramps in the lower limbs, with screaming, nausea, and vomiting. Lachesis is applicable when symptoms of DISEASES OF iEMALAS. 7 suffocation attend, and all the sufferings are aggravated after sleep; also if there be fainting fits and convulsions. Phosphorus, in females of a delicate form, with light complexion and lively disposition, weak chest, and a predisposition to disease of the lungs; expectoration of blood in. small quantities, or dyspeptic symptoms alternating with rheumatic pains. This remedy should not be given in such cases more than once or twice a week. Pulsatilla, if there be pain in the abdomen and across the back, giddiness, fulness about the head and eyes, paleness of the face with occasional flashes of heat; roaring in the ears, or partial deafness; coldness of the hands and feet, with predisposition to general coldness; hysterical symptoms, alternate laughing and crying; nausea and vomiting; sour taste in the mouth after eating; discouragement and sadness; palpitation of the heart; soreness of the breasts; loss of appetite, with desire for acids; and aversion to exercise. - The unpleasant sensations frequently change from one place to another, or are felt on but one side of the body at a time. She feels better during exercise, and in the open air; generally worse 8 PART I. in the evening and before midnight, and is fatigued in the morning. Give the medicine at four o'clock in the afternoon for two days in succession, and if better, wait as long as the improvement continues; but if the symptoms return, and the menses do not appear, repeat the Pulsatilla once more. The medicine is particularly adapted to young ladies of a mild character. Sepia, if, in addition to many of the above symptoms, there should be a yellow streak across the nose and on the cheeks in the form of a saddle. It should be given at night, twice in succession. Sulphur, if neither of the above remedies should answer the purpose, and there be a sensation of heat in the interior of the brain; great religious depression; emaciation; want of appetite, with sickness after eating; vertigo; palpitation of the heart, and shortness of breath on going up-stairs; worse when standing; to be given at night, as above directed for the other remedies. Veratrum, if there be cold hands and feet, with a tendency to diarrhea. DISEASES OF FEMALES. 9 CHLOROSIS, OR GREEN SICKNESS. On account of the very common occurrence of this disease about the period of puberty in females, and the uniform attendance of suppressed or vitiated menstruation consequent upon it, the affection itself is frequently looked upon as the result of such derangement. This state of the system, however, has been witnessed in females of mature age, and even sometimes in males having -a lymphatic temperament and delicate constitution. Any of the causes which so frequently produce derangement of the female economy may give rise to this disease. The most common exciting causes are cold and exposure to dampness:,,sedentary habits, want of exercise and fresh air; powerful emotions of the mind, disappointment and chagrin; errors in diet, food not sufficiently nourishing, and the too free use of acids and stimulating drinks. As the disease under consideration is a complicated one, and one of very serious import, involving the all of health, none but a qualified physician should attempt its treatment, if the services of one can be obtained. The medicines that are generally sufficient 10 PART I. in this affection, are, Bryonia, China, Conium Ferrum, Kali carbonicum, Lycopodium, Natrum muriaticum, Pulsatilla, Sepia, and Sulphur. But on account of the difficulty of any one but a physician treating this disease, when the services of one can be procured, the special application of each remedy need not be pointed out; as all practical purposes, in a domestic point of view, will be answered by referring to what is said under the heads of " Too Tardy Appearance," and " Suppression." SUPPRESSION OF THE MENSES. By suppression of the menses, is understood the suspension or temporary cessation of this discharge, after it has been well established, by some incidental cause. Cold is the most common cause of this obstruction, as it is the one to which females are the most liable, on account of the little care they take of themselves at the menstrual period. Sudden and powerful emotions of the mind, particularly grief and despondency may also produce it, but next after the first-mentioned cause is the pernicious practice of eating pickles, drinking vinegar, and putting the feet in cold water, DISEASES OF FEMALES. 11 during the flow, for the purpose of arresting it. Disease of the chest and of the liver, rheumatism, and inflammation of the organs concerned, may also give rise to suppression. Any of these causes may act so as to produce the result during the flow, when the menses are about to appear, or during the interval. If the menses are suddenly suppressed during the flow, or just as they are about to appear, especially if cold be the cause, the symptoms are apt to be much more violent, than if the obstructing cause were applied in the interval. In the worst cases are seen frightful attacks of spasmodic pains in the stomach and bowels, often attended with retching to vomit, headache, flushed face, wild delirium, convulsions, hysteria, palpitation of the heart, difficulty of breathing, etc. This state of things is sometimes followed by fever and local inflammations. When suppression of the menses is the effect of causes operating in the interval, the evil consequences do not arise so suddenly nor are they so alarming; yet, after the lapse of two or three months, the enfeebled state of health evinces the no less certain result. The subject becomes pale, languid, and debilitated; loses her appetite and ambition; looks sickly and dejected; is affected 12 PART I. with swelling of the feet and ankles; nervous symptoms set in, palpitation of the heart, shortness of breath, flatulency, etc., and leucorrhcea winds up the unhappy train. In persons predisposed to consumption, and some other serious diseases, suppression is particularly prejudicial and demands the earliest attention. The medicines generally required in the treatment of this affection are, Aconite, Bryonia, Pulsatilla, Sepia, and Sulphur. But Belladonna, Chamomilla, Graphites, Kali carbonicum, Lycopodiumn, Platina, and Veratrum are sometimes necessary. Aconite if the suppression be the result of the direct application of cold, and be attended by congestion to the head, or chest; redness of the cheeks; sickness, faintness, or giddiness on rising from a recumbent position; shooting and beating pains in the head, with delirium or stupefaction; fulness of the pulse; impatience; worse from motion; cold gives relief, but heat aggravates the sufferings. Bryonia if there be swimming in the head, with heaviness and pressure towards the forehead; worse after stooping, and aggravated by motion; bleeding of the nose; dry cough; shivering during the pains; heat on the head; DISEASES OF FEMALES. 13 pain in the pit of the stomach after eating; bitter and sour eructations; regurgitation of food after eating with a good appetite; constipation; drawing pains in the lower part of the abdomen; pain in the back; the sufferings are increased by motion and by touching; this remedy is particularly adapted to unmarried females. Pulsatilla is the principal remedy in this disease, especially when it has been caused by exposure to dampness, or cold air, and the subject have an amiable disposition with a tendency to sadness and tears; the headache is generally on one side only, with shooting pains extending to the face, ears and teeth; palpitation of the heart; suffocation; coldness of the -hands and feet; flashes of heat; nausea and vomiting; tendency to diarrhea; pressure in the lower part of the abdomen; frequent urination; and leucorrhoea. Sepia is also a very important remedy, especially in females of a delicate constitution and sallow complexion; the symptoms are often relieved by exercise and aggravated by rest; great liability to take cold; disposed to melancholy; morning headache; throbbing in the head; vertigo; bearing-down in the lower part c 14 PART I. of the abdomen, with heat and sensitiveness; leucorrhoea; colic; pains in the limbs as if they had been beaten; pain in the loins. Sulphur if the person has been subject to eruptions; disposition to stiffness in all parts of the body; want of strength; faintness; exhaustion from conversation; sensitiveness to the open air; disposition to sleep; the heat of the bed aggravates the pains at night; confusion of the head; vertigo on rising up; headache on one side, or over the eyes, or in the back part of the head, extending to the back of the neck; heat in the head; heaviness of the head; dimness of sight; sourness of the stomach; waterbrash; pressure in the stomach; voracious appetite; constipation, with ineffectual efforts at stool; abdominal pains; leucorrhoea with itching; pain in the loins; weariness and fatigue in the limbs. If menstruation has been checked by fright, vexation, or other emotions of the mind, give Aconite, Coffea, or Lycopodium. If the suppression have connexion with rheumatic pains about the shoulders and chest, and the subject be predisposed to consumption, send for a physician without delay. DISEASES OF FEMALES. PAINFUL MENSTRUATION. Women are liable to this disease during every part of their life between the commencement and the cessation,of menstruation. Cold, and the improper treatment of other diseases, are the most prolific sources of this derange"ment. The pain sometimes begins several hours or even days before the flow commences. At other times the evacuation comes on regularly and continues for a few hours, then diminishes, or ceases entirely, with a great deal of suffering. The pains may continue for a longer or shorter period; frequently under appropriate treatment the flow returns, and continues to the end of the period without interruption; sometimes the pains continue to the end of the period without shortening the time, or lessening the quantity. At other times the pains continue until a membranous substance is expelled, and a healthy discharge continues, or the evacuation ceases with the expulsion of the membranous.body. In some cases, through sympathy, the breasts become sensitive, tumid, and occasionally extremely painful. The pains of difficult menstruation are of two kinds, viz.-the interS mitting expulsive pains, resembling those. of 16 PART I. labour, and the constant aching pains in the loins, hips, and limbs, like those which often precede regular menstruation. The remedies are Aconite, Belladonna, Calcarea, Chamomilla, Cocculus,. Coffea, Nux vomica, Pulsatilla and Veratrum. Aconite. See the symptoms requiring this remedy under " Suppression." Dissolve twelve globules in six teaspoonfuls of water, and take a teaspoonful every hour until the sufferings are relieved. Belladonna, if the pains precede the flow, with violent congestion to the head, and confusion of sight; frightful visions; screaming; disposition to bite and tear every thing; redness and bloatedness of the face; pain in the back; strong bearing-down in the lower part of the abdomen as if the parts would fall out. Calcarea, if there be boring headache which is aggravated by every moral emotion; coldness on the head; toothache; breasts swollen and painful; colic with shiverings; cuttings in the abdomen; leucorrhcea; spasmodic pains in the loins. After the period is past, if the membranous substance spoken of above should have been discharged, give a dose of Calcarea on two successive evenings, and again four or five days DISEASES OF FEMALES, 17 before the return of the next menstrual period, give two doses more in the same way. Chamomilla may be given if the pains resemble labour pains, with pressure from the small of the back towards the front of the abdomen and downwards; colic, with tenderness of the abdomen when touched; discharge of a dark colour and coagulated. Cocculus, if there be abdominal spasms; flatulency; nausea and faintness; pressive colic; and cramps in the chest. Coffa, if there be great nervous excitement, and anguish with the sufferings; exceedingly painful colic, with fulness and pressure in the bowels, with spasms which extend to the chest; delirium; wringing of the hands; grinding of the teeth; screaming; coldness over the.whole body; numbness and stiffness; groaning and difficulty of breathing. Nux vomica relieves the writhing pains in the abdomen when accompanied with nausea; pain as if bruised in the bones in front; spasms in the womb with pressure downwards and heat; nausea and fainting; restlessness; stitches in the right side; frequent desire to urinate. Nux vomica is indicated when the menses are preceded by drawing pains in the muscles of -,- c3 / -/ ~ -. / Z '- " 7)" P 18 PART 1. the back of the neck, and, in excitable or passionate persons. Pulsatilla will remove a heaviness resembling a stone in the abdomen, with violent pressure in the lower part, and in the small of the back, attended with drawing and numbness down the thighs; vomiting of sour mucus; shiverings, with paleness of the face; pressure to stool with ineffectual efforts; frequent desire to pass water; and leucorrhea. Veratrum, when the menses are preceded by headache and attended with diarrhcea; excessive weakness; humming in the ears; constrictive sensation in the throat; icy coldness of the nose, hands and feet. MENSTRUATION TOO SOON. Belladonna, when the evacuation comes on before the time, is too copious, and is of a bright red colour; discharge of fetid coagule; nocturnal sweat on the chest; thirst; confusion of the sight; beating headache; puffiness of the face; colic and violent bearing-down pains. Calcarea carb. is appropriate when the evacuation is preceded by swelling and sensitiveness of the breasts, headache, colic, shiverings, DISEASES OF FEMALES. 19 and leucorrhoea; during the flow there are cuttings in the abdomen, toothache, bearingdown, leucorrhoea, and enlargement of the veins. Ignatia is very effectual where the menses return every two weeks, and are attended with hysterical symptoms; nausea and fainting; general chilliness; paleness of the face; failing of the sight; the patient cannot bear the light, nor noise; the abdomen is distended and hard; the pains are of the cramp-like compressing kind. Ipecacuanha is suitable where the patient is excessively weak, uneasy, and has a dislike to all food; the discharge copious, bright red, and coagulated. Natrum mur. should be given when the monthly period is preceded by moroseness and irritability; the evacuation is too profuse and continues too long; is attended with sadness, headache, and an inclination to lie down. MENSTRUATION TOO LATE. Kali carb. may be given, when there is constant bearing down and still the menses do not appear, in young girls. 20 PART I. Lachesis, when the commencement of the flow is attended with violent pains in the small of the back, and subsequent spasms in the abdomen and beatings in the head. Phosphorus, if the patient has a delicate form, is predisposed to disease of the chest, and is troubled with dyspeptic symptoms; during menstruation, lancinating headache, spitting of small portions of blood, shiverings, lassitude and fever. Pulsatilla, where the menses are very irregular, sometimes coming too soon, at other times too late, and frequently too feebly; sometimes the discharge is too dark or mixed with mucus, again it is pale and watery; the sufferin'gs also are various: nausea and vomitings, shiverings and paleness of the face, shooting pains, bearing-down, constipation, etc., are frequently met with, before, during, and after the period. Sulphur is frequently necessary when other remedies fail, and where sick headache precedes, attends, or follows menstruationi. The reader is referred to the preceding sections on " tardy appearance" and " suppression" for many of the symptoms of this important medicine. DISEASES OF FEMALES. "-21 MENSTRUATION TOO SCANT. The remedies recommended for this particular irregularity, are Kali carb. Lachesis, Nux vomica, Pulsatilla, and Sulphur. Inasmuch as the characteristic symptoms of these remedies are to be found in the preceding sections of this Part, it is not necessary to repeat them here. The reader is respectfully referred to them there. The remedy which corresponds most accurately with the whole group of symptoms, is always the most appropriate one. MENSTRUATION TOO COPIOUS. Belladonna, when the catamenia are too copious, and return too soon, with violent pressure downwards, as if something would escape, accompanied with pain in the small of the back; where the immoderate flow has been caused by exertion, or lifting something during the period. Arnica also, may be given when that is the cause. For other symptoms of Belladonna, see what is said under it when the menses return too soon. Calcarea carb., after other remedies appa 22 PART I. rently well adapted to the case have been given without effect, give Calcarea carb. for two mornings in succession at the next period. See some of the symptoms of this remedy under " Menstruation too soon." Chamomilla will prove beneficial if the discharge is dark and clotted; flowing at intervals, accompanied by pain, and dull griping, which passes from the small of the back towards the abdomen; to which symptoms may be added, thirst, coldness of the extremities, and fainting. China, sallowness; general weakness, with great tendency to perspire; dulness; swelling of the lower extremities; confusion of the head with buzzing in, the ears; faintness; the discharge may be either watery, or coagulated, gushing out at intervals, accompanied with cramp-like pains in the lower part of the abdomen. Ipecacuanha, where the discharge is profuse and continued; attended with paleness, thirst, and constant desire to lie down, with great prostration. Nux vomica, when menstruation is too copious and returns before the twenty-eighth day; when it lasts longer than four days, stops and returns. In such cases allow no coffee, DISEASES OF FEMALES. 23 wine, cider or brandy; no mince pies, or anything stimulating for several months. MENSTRUATION TOO SHORT. Most of the remedies mentioned under " Menstruation too soon" and " too scant" may be given with advantage in this aberration, when the attending symptoms correspond. When the period of menstruation is rendered too short by accidental causes, look under " Suppression" for the remedy. Bryonia, Lachesis, Phosphorus, Platinum, and Pulsatilla are the principal remedies in this irregularity. MENSTRUATION TOO LONG. Aconite, when there are congestions to different parts of the body with shooting pains, especially about the heart and in the head; full and hard pulse; desire to be in the cool air; the patient is worse in a warm room; the discharge is bright red and for the most part fluid, but coagulates readily. China, paleness of the face; dark-coloured under the eyes; obscuration of sight, or black 24 PART I. spots before the eyes; roaring in the ears; pulsations in the head and neck; nocturnal headache; sleeplessness or disturbed sleep; nervous excitability; frequent desire to pass water; pains like labour; weakness and heaviness in the limbs; swelling of the feet. Ignatia is serviceable if the discharge continues too long and the next period is attended with hysterics, yawning, and choking. The medicine should be given on the fourth day of menstruation, and repeated in a day or two; and again on the third day of the next period. Nux vomica, when the menses return too soon. and continue too long; giddiness; constipation; nausea and faintness; the symptoms are generally worse in the morning; dragging about the loins with bearing-down in the pelvis; cramp-like pains in the abdomen, extending downwards to the thighs. Platina, discharge thick and black or slimy; pressure on the lower parts, with increased sensibility. Sulphur will frequently change this state of the system by giving a few doses of it after menstruation is over, and repeating it again a few days before the next period. DISEASES OF FEMALES. 25 CESSATION OF THE MENSES. The " change of life," or the " critical stage," as the period of the decline of the menses is called, generally occurs at or about the age of forty-five years. With ladies who have indulged themselves at the table, and been fond of their ease generally, this change is apt to take place a little earlier; while with those who have led more industrious and even laborious lives, it may not come quite so soon. It sometimes occurs as early as thirty-six and even earlier; and, on the other hand, it has been postponed in some instances until the woman has passed fifty, and even much later. When this period of life is approaching, the menses become more or less irregular, both as to the time of their recurrence and the quantity discharged-they may either return too soon, or the interval be more protracted than usual. The quantity discharged may likewise vary from the regular amount-be very small, by itself or largely mixed with mucus, or be very profuse, amounting to a true haemorrhage. The flow frequently appears suddenly, at an unexpected moment, continues for an hour or D 26 PART I. two, and then stops, without any of the ordinary symptoms of suppression following. Sometimes the progressive course of this change in the female economy is so gradual, and free from constitutional disturbance, that the woman passes through it before she is aware of her altered condition; until she realizes that her menses have ceased, and with them many of the frailties incidental to menstruation have disappeared. Her health is confirmed, and frequently she becomes more fleshy than she ever was before. Others, less fortunate, are afflicted with vertigo; headachc; flashes of heat; nervousness; paleness and debility; frequent passage of limpid urine in large quantities, or high coloured in small quantities; pain in the lower part of the abdomen, back, and hips, running down the thighs with a kind of creeping sensation; heat in the lower part of the stomach and back; piles are apt to be troublesome, and sometimes take on a vicarious office; swelling of the lower limbs; tumidity of the abdomen, which subsides from time to time without the ordinary symptoms of flatulency. Pruritus (violent itching of the private parts) is not uncommon at this period. (See p. 44.) DISEASES OF FEMALES..27 Not every case of slight irregularity at this period of life should be interfered with by medicine, especially if the discharge be diminishing in quantity. A well-ordered regimen, however, is important in every case -the diet should be simple and digestible, consisting chiefly of vegetable articles; total abstinence from every thing stimulating should be strictly observed; exercise in the open air in suitable weather, bathing, and the use of the fleshbrush, should be duly attended to. Sleeping in heated rooms should generally be avoided, and a mattress is better than a feather bed. In many instances it would be proper to wear flannel or silk next the skin; in all cases avoid unnecessary exposure, and guard against the injurious effects of the common vicissitudes of the weather, by suitable attention to dress. Tonics, and the so-called strengthening medicines, are always injurious at this period; and, therefore, should be assiduously avoided. Lachesis and Pulsatilla are the principal homoeopathic remedies for the disorders of the " critical stage of life." If one of them should not be sufficient to correct the symptoms, they may be taken alternately, at intervals of a week between the doses., 28 PART I. Bryonia, Cocculus, Ignatia, Sepia, or Sulphur, may be required in some cases. LEUCORRH(EA. This disease (frequently called " Whites") consists of a discharge of unhealthy mucus from the private parts, and is most liable to affect females between the age of puberty and the final cessation of the menses. Occasionally we observe it in little children, and sometimes also in women who have passed the change of life. Women of a nervous temperament, with a relaxed habit of body, weak chest, and hereditary predisposition to it, are the most frequent subjects of this disease. The exciting causes of this complaint generally are difficult labours; irregularity of the menses; the employment of purgative medicines; tight lacing; late hours the immoderate use of tea, coffee, and spices; limited exercise; and sometimes the neglect of necessary ablutions. In children the most common exciting causes are neglect of cleanliness, seat-worms, and the local application of some irritating matter. Those who are subject to it at all, are liable to have the discharge DISEASES OF FEMALES. 29 most abundant before and after menstruation, and during pregnancy. The secretion may be small or very abundant, and may vary just as much in quality.as it does in quantity; in the beginning, it frequently seems to be nothing more than an increase of healthy transparent mucus, but after a while it assumes a more dense consistency, and gelatinous appearance, or becomes thin, milky, and acrid; after longer continuance it may become purulent, and acquire a yellow colour; it is often greenish, and sometimes has a brownish hue. The discharge does not always pass away continuously, but often irregularly, by emissions. After this discharge has continued for a -longer or shorter time, the concomitant symptoms make their appearance, such as constant pain in the back and loins; bearing-down in the abdomen; aching in the hips; coldness of the extremities; paleness of the face; dejection of the spirits; loss of appetite; eructations; nervous symptoms; neuralgies; etc. Leucorrhosa is so often complicated with serious diseases of the womb and adjacent parts, that the best interests of the sufferer require the earliest attention to its treatment, %and the most diligent use of the means calcuD 3 30 PART I. lated to remove it. Many now mourn with fruitless grief over their unfortunate neglect of. this disease in its incipient and more manageable state. On the first intimation of the approach of the complaint, the subject of it should endeavour to correct the predisposing causes, and as far as in her power lies avoid all the exciting causes. The remedies recommended in this place are, Aconite, Calcarea carbonica, Cocculus, Pulsatilla, Sepia, and Sulphur. Aconite, if the discharge be excessive, viscous, or yellowish; heat and a sense of fulness in the parts internally; the application of any tlhing cold gives relief; especially if the patient have been subject to acute attacks of rheumatism. Calcarea carbonica, with itching and burning; coming on before the menses; the discharge is milky, and often passes when making water; attended with shooting through the parts and falling of the womb; leucorrhcea after lifting; whitish corrosive leucorrhcea of young children; especially applicable to females of a lymphatic constitution, light complexion, and inclined to be fat, and who are subject to copious menstruation which returns too soon.. DISEASES OF FEMALES. 31 Cocculus, leucorrhcea before and after menstruation; discharge of sanguineous mucus during pregnancy; leucorrhoea like the washings of meat; with colic and flatulency. Pulsatilla, when the discharge is thick, like cream; sometimes corrosive; attended with pruritus near the change of life; before, during, and after menstruation; when occasioned by fright; and in young girls before menstruation is well established. Sepia, leucorrhoea with excoriation of the parts; bearing-down; frequent urination; yellew or greenish fetid discharge; inflation of the abdomen; yellowness of the face; this remedy is not always admissible during pregnancy. Sulphur, in obstinate cases of leucorrhoea with scalding urine; whitish or yellowish and corrosive; after repelled eruptions or imperfectly cured rheumatism. PROLAPSUS UTERI. (Falling of the Womb.) The chief predisposing cause of this displacement is a relaxed condition of the sytem, C PART 1. which may be natural, or induced by habits of indulgence and high living. The immediate causes of the mischief may be various; as getting up too soon after confinement; leucorrhoea; falls; injuries from lifting heavy weights; long-continued coughs; severe pukings; tight lacing; etc. An eminent physician remarked, in 1831--" I will venture to say, that of late years, since the preposterous custom of pressing the waist into as narrow a space as cords and steel springs can bring it, has been so general, there are more instances of prolapsus and leucorrhoea among young females than at any former period, when the abdomen was a little better accommodated'with room" (Eberle). But as fashion has changed the mode of dress considerably for the better in.this particular, since the doctor wrote the above, we may expect to see fewer cases of the diseases mentioned arising from that cause in the future. The symptoms may be mild for a long time in the commencement of the disease, and be considered rather as an annoyance than the occasion of much suffering. There is generally more or less bearing-down, dragging about the groins, pain in the back and loins, pressure DISEASES OF FEMALES. 33 low down in the pelvis, a benumbing sensation shooting down the limbs, nervous feelings, with a sense of faintness, and many other exceedingly distressing symptoms. Every case does not present this long catalogue of ailments, but many cases d6 present them in great numbers, and in an aggravated form. In some severe cases the woman has great difficulty in rising to her feet, and if she attempts to walk has to lean forwards and support herself by placing her hands on her thighs. A very obscure and troublesome symptom, of pain in the left side close under the ribs, sometimes attends this disease. The sufferings are aggravated by the erect position, and nearly all of them subside after lying down. To the above enumeration of difficulties must be added the constant discharge of mucus more or less unhealthy, and very generally a more abundant and frequent discharge of the menses. These two drains upon her system, in conjunction with the general weakness consequent upon uninterrupted suffering, reduces the woman's strength very much, and unless relieved, will destroy her health entirely. For the cure of this disease we have very frequently to employ mechanical means, namely, PART I. the " supporter," or the " pessary." But in many cases we can succeed with medicine and a well-regulated regimen. The affection itself is sometimes symptomatic of other curable diseases, Let the patient avoid the provoking causes as far as she can, adhere to the homceopathic diet, and take one of the following remedies every night for a week, namely, Belladonna, Calcarea carbonica, Nux vomica, and Sepia. After taking one remedy, and then suspending all medicine for a week or more, still adhering to the diet, if the symptoms have not abated, take one of the other remedies named, in the same way and wait as before. But if the symptoms do improve, take nothing so long as they are better, and if they return, take the last medicine once or twice more. In order to discriminate between the remedies recommended as well as you can, compare the symptoms under leucorrhoea. REGIMEN DURING PREGNANCY. During the period of gestation, a woman should consider that her most trifling actions iay exert a great influence on the future phy DISEASES OF FEMALES. 35 sical, and we may add, moral and intellectual condition of a being bound to her by the most endearing ties - a being that has a right to expect from her as its parent, so far as it lies in her power to give, a sound constitution. Therefore, to realise such an object, it becomes the duty of a mother to pay every possible attention to her diet, dress, and exercise. DIET.-With regard to diet, she should observe the greatest simplicity, and abstain from all stimulating food and drinks, as well as everything else that has a tendency to increase the irritability of the system; such as the immoderate use of coffee, tea, etc. She should also avoid taking too large an amount of nourishment of any kind; for nature seems to have instituted nausea and vomiting for the purpose, in part, of preventing excessive fulness. The occasion of pregnancy ought not to be made the apology for the free indulgence of a wayward or a voracious appetite; as indigestion, colic, and even convulsions in some instances, have been the sad consequences of such indulgence. The unnatural use of chalk, magnesia, charcoal, roasted coffee, etc., is to be deprecated. DREss.-The dress should be strictly suited to the season, and so arranged as not to pro 36 PART IL duce unnecessary pressure on any part of the body; even the garters should be worn loosely. Tight lacing is very hurtful; it must be evident to the plainest understanding, that serious injury to the health of both mother and child, must often result from a continual and forcible compression of the abdomen, while nature is at work in gradually enlarging it for the accommodation and development of the fcetus; and no doubt, there are many who owe their deformities to the vanity or fastidiousness of their mothers. EXERCISE.-With regard to exercise, here let us say, that it is indispensably necessary to health, during the term of pregnancy. The most useful kind of exercise is walking in the open air, for this calls into action more of the muscles of the body, than any other exercise suited to the state of pregnancy. Such exercise must not, however, interfere with the process of digestion, and therefore the most suitable time for it is two or three hours after a moderate dinner, or during warm weather, towards. evening; care being taken to avoid the dampness of the night air by returning home early. The passive exercise of riding in a carriage, falls short of the object in view and the violent DISEASES OF FEMALES. 37 exercise of riding on horseback exceeds it, besides the liability to fright and accident which besets this mode and renders it objectionable. Too long walks, going out in slippery weather, dancing, hastily running up stairs, lifting heavy weights, etc., should be carefully avoided. Abortion and premature delivery are frequently the consequences of imprudence. The air she breathes should be pure, and therefore, if. possible, she ought to select a large and well-ventilated bedroom. Intense anxiety about anything, severe study, and night watchings are decidedly injurious. DISORDERS OF PREGNANCY. Although the state of pregnancy is perfectly natural and perfectly healthy, yet in consequence of the existence of latent diseases in some constitutions naturally, the artificial disorders produced in others by improper medical treatment, and sometimes from accidental causes, it often happens that this condition is attended by many deviations from health, which it may be well to notice, together with the best means of removing them. Notwithstanding the universally admitted E 38 PART I. tendency to plethora, and general fulness of the system during gestation, the preposterous idea of depletion being necessary to get rid of that fulness must not be entertained. Hear what Dr. Dewees says on the subject of bleeding in certain cases: " To women who are in the habit of miscarrying, this proscription of indiscriminate bleeding is particularly important; especially as it is the remedy almost universally resorted to for its relief; than which, in very many instances, nothing can be more preposterous or improper. We know ourselves to be justified in saying, it has very often produced the evil it was intended to prevent."-Dewees on Children, p. 28. The state of nervous excitation incident to pregnancy is susceptible of successful treatment; and, under judicious management, the storm which sometimes seems to threaten the safety of the patient can be so directed as to give a new impetus to the current of life, and render the woman more healthy than before. We shall now proceed to notice some of the disturbances which take place during pregnancy, and point out the treatment of such of them as call for medicine. DISEASES OF FEMALES. 39 VERTIGO AND HEADACHE. Sometimes as early as the second week, but generally in the third week after conception, a strange sensation of fulness, or heaviness, is felt in the head, attended with dulness, and a disinclination to active employment. If these feelings increase, the sensation of lightness of the head follows, with vertigo, especially in the morning; giddiness, with blindness after stooping; scintillations before the eyes; sleepiness, or its opposite; headache, with weight on the head, or in the back of the neck; disposition to fall forwards when stooping; palpitation of the heart; general nervousness, etc. With the above symptoms in many cases at this early period may be noticed a fastidious state of the stomach; variable, and on the whole, diminished appetite; the smell of food while it is cooking becomes disgusting; provisions, as they are exhibited in market, excite nausea; articles of diet in common use, of which the patient may have been fond, become offensive; and articlep that she could not eat before, are now taken with avidity. It is remarkable that these likes and dislikes are not the result of actual experiment, but arise from a capriciousness of 40 PART I taste, which decides the matter before the article has been tasted at all. The tongue is occasionally coated yellow, with slightly increased redness along the middle towards the point, or the whole tongue is whitish, and enlarged. The mouth fills with tasteless saliva. Perhaps no single case of pregnancy is attended with all the unpleasant symptoms above mentioned, a few only being present in each case, and even those may be so mild as to attract but little notice; and in some instances the woman enjoys uninterrupted health throughout the period of gestation. 'Aconite, vertigo on rising from a seat, often as if intoxicated, causing one to fall; faintness on rising from a recumbent posture, with dimness of vision; congestion of blood to the head, with throbbing, and pressure in the forehead; stupefying pains in the head; eyes red and sparkling, with intolerance of light; black spots before the eyes. This remedy is chiefly applicable to plethoric persons with a florid complexion and nervous temperament. Belladonna, vertigo, with staggering and trembling; stupor, with loss of consciousness; fulness of the head, with whizzing in the ears, and danger of falling; intolerance of noise; DISEASES OF FEMALES. 41 heaviness and pressure on the head, or in the forehead, above the eyes; expansive pains in the head, with violent beating of the carotid arteries;_ injected eyes, quivering of the lids, and redness of the face; sparks before the eyes; objects appear double. The symptoms requiring the use of Belladonna are generally worse in the morning, and the patient dislikes to move. Nux vomica, vertigo, and bewildered feeling in the head; giddiness, with cloudiness of the eyes, and buzzing in the ears; tearing, drawing, and jerking pains in the head; periodical pains; sufferings about the head of almost every description during pregnancy, accompanied with constipation, disgust of food with insipidity, or acid, bitter and putrid taste in the mouth. Well suited to persons of a quick, hasty disposition, and especially to such as lead sedentary lives and are addicted to the use of coffee. The sufferings are generally worse in the morning, after exercise, and on coming in from the open air. Opium, vertigo on rising up; vertigo with stupidity, as after a debauch; imperfect sleep, with lethargy and puffed face; illusions of the imagination. E3 42 PART I. Platina, head-ache that increases gradually and then diminishes in the same way; headache caused by vexation or a fit of passion; spitting of tasteless or sweetish saliva. Sufferings of nervous and hysterical females, which are aggravated during repose and relieved by motion. Pulsatilla, vertigo, worse after stooping, with momentary blindness, staggering, and danger of falling; one-sided headache; pulsating and shooting pains in the head; sympathetic headache, arising from the stomach; headache every other day; the sufferings are frequently attended with numbness of the limbs, are generally worse in the evening and before midnight. Pulsatilla is particularly adapted to the sufferings of good-natured people of a gentle disposition. MORNING SICKNESS, ETC. This common but oftentimes very distressing concomitant of pregnancy, usually begins aboutsix weeks after conception, and continues with more or less violence until the sixteenth week. After this time it generally abates, but in some instances it "returns from slight pro DISEASES OF FEMALES. 43 vocations to the end of gestation. Nausea and vomiting commonly take place as soon as the patient rises from her bed, and very often continue to harass her for two or three hours through the morning. After considerable straining a mouthful of tough mucus is thrown up, which at times is so sour, as to set the teeth on edge. There is rarely any food ejected, but occasionally bile is discharged in considerable quantities. In this connexion may also be. noticed the spitting of frothy saliva, and the more profuse salivation, which sometimes attends pregnancy. The frothy saliva which causes the spitting is very white and tenacious. In some cases, the salivation is very profuse and attended by heartburn and waterbrash. Arsenicum is useful, when there is excessive vomiting after eating or drinking, with attacks of fainting, great weakness, and emaciation. Ipecacuanha, violent vomiting with pains in the pit of the stomach; coated tongue; vomiting of bile; vomiting with thirst; loss of appetite; and, looseness of the bowels. Natrum mur., in obstinate cases with waterbrash; clawing in the pit of the stomach, which is painful to the touch; acidity of - ^..~ <*l'r, `-- 44 PART I. the stomach; salivation; loss of taste and appetite. Nux vomica, vomiting with vertigo, restlessness and ill humour; vomiting of sour mucus; bitter taste in the mouth; continual nausea; heartburn, waterbrash; hiccups; painful sensibility, with pressure in the pit of the stomach as if caused by a stone. Pulsatilla, tongue coated white; insupportable nausea, with desire to vomit; vomiting of sour mucus and food; nausea rising into the throat and mouth; eructations, acid, bitter or with the taste of food; bitter or sour taste in the mouth after eating; nausea after eating; salivation; waterbrash; hiccups; pulsations in the pit of the stomach; frequent inclination to pass water, &c. PRURITUS. During the early months, but sometimes not until a later period of pregnancy, women are subject to a very troublesome and distressing itching of the vulva or private parts. In almost every case of pregnancy there is an increase of the secretion of mucus of those parts, and in some instances there is an acridity of thle secre DISEASES OF FEMALES. 45 tion, which gives rise to this complaint. An aphthous efflorescence similar to the thrush of infants, occasionally incrusts the inner surfaces of the labia and adjacent parts in this disease: sometimes the affection penetrates to considerable depth in the direction of the womb. In other instances the aphthous condition is not present, but in place of it, there is a great deal of irritation of the same parts which assume a copper colour, and present a number of slight abrasions. From the whole of the parts labouring under this peculiar irritation, a vitiated watery discharge seems to be almost constantly oozing; the accumulation of which is attended with the most indomitable itching. This disease is not confined to the state of pregnancy, but may attack a female at any time: she is most liable to it however during gestation, and at the decline of the menses. Frequent ablutions with water are very important for the comfort of the patient and at the same time conducive to her recovery. The principal remedies are Bryonia, Carbo veg., Lycopodium, Pulsatilla, Sepia and Silicea. In the aphthous variety, preference should be given to Carbo veg. or Silicea. 46 PART I. Bryonia and Lycopodium are applicable in case of dryness and heat in the parts. Lycopodium is also applicable when there is a milky ichorus discharge with or without the expulsion of wind from the parts. Pulsatilla is suited to every variety of the disease, especially if it occur at the period of the decline of the menses. Sepia, violent itching with inflammation and swelling of the labia; corrosive leucorrhoea with bearing down; and excoriation about the parts. A wash made of a solution of borax in water applied locally two or three times a day will generally remove the troublesome symptom of itching in a short time. HEARTBURN AND WATERBRASH. These affections generally go together, and may attack a woman during any part of the period of gestation. They may come on in the early months, and accompany the morning sickness, &c., but generally they come on later in the term, and are most troublesome after quickening. The patient complains of heat in the stomach DISEASES OF FEMALES. 47, extending upwards; it is frequently attended with very acid eructations. There is usually a cramp-like sensation in the pit of the stomach; a rising out of a tasteless or bitter fluid, which is sometimes hot and so acrid as to excoriate the throat and mouth. The symptoms are worse after eating, and water frequently turns sour and is regurgitated immediately after drinking. Nux vomica, Phosphoric acid, Pulsatilla and Sulphur are the remedies best adapted to this state of the stomach. For further information see the symptoms under the remedies for morning sickness, &c. Phosphoric acid is especially useful. CONSTIPATION. Constipation is a very frequent attendant upon pregnancy. Exercise, a diet composed chiefly of vegetables, and drinking freely of cold water will generally relieve it. But if these are not sufficient, give Bryonia, Lycopodium, Nux vomica, Pulsatilla, Opium or Sulphur, for particular indications for each remedy, see any of the domestic words under the head " Constipation." 48 PART I. DIARRH(EA. Diarrhoea is not so common as constipation during pregnancy, but is much more injurious. It should not be suffered to continue long, lest it lead to something more serious. It frequently depends on some accidental cause, on the removal of which the diarrhoea ceases spontaneously. The best remedies are Antimonium crud., Dulcamara, Lycopodium and Sulphur. TOOTHACHE. Toothache is most common in the early months of pregnancy, and is sometimes one of its first symptoms. It is liable to occur at any time during the term, and usually comes on in paroxysms after longer or shorter intervals. It may attack one or more decayed teeth, or a perfectly sound tooth, or shoot along the jaw without locating in any particular tooth. The pain partakes of the nature of neuralgia. Consult a physician before having teeth extracted under such circumstances. The most successful remedies are, Aconite, Belladonna, Calcarea, Chamomilla, Nux vomica, DISEASES OF FEMALES. 49 Pulsatilla and Staphlysagria. For the particular indication for each medicine see any of the domestic formula. VARICOSE VEINS. This disease consists of a dilatation and distension of the veins. It is not confined to a state of pregnancy, but may exist at any time in the female, and occasionally is met with in the male sex. Still the disease is so frequently met with in women during pregnancy that it may be considered as a disease almost peculiar to this state. It rarely occurs in a first pregnancy, and when -it appears for the first time it does not commonly occur until after the period of quickening; but in subsequent pregnancies it is apt to take place in the early months. Varicose veins generally appear first about the ankle, and are frequently confined to the leg below the knee, but occasionally the veins of the entire lower extremity are involved. The affection may be confined to one limb, or both may be included. (Edema or general swelling of the feet and lower limbs may attend this complaint or exist without it. F 50 PART I. The enlarged veins are generally superficial, and at first assume a reddish hue, but afterwards a bluish or leaden colour, and the larger ones become very much knotted; they get larger when the patient stands on her feet or suffers the limb to hang down; and the swelling decreases when she lies down. When moderate it is not painful, but if it continues to increase it may become so, and ultimately the veins may burst and the blood be effused beneath the skin, or poured out externally. As the disease is produced by a mechanical cause, after delivery, the pressure being removed, the veins very soon regain their natural size, and the swelling disappears. If the distension is great, and the disease be very painful, rest in the recumbent posture will be necessary. If the woman is obliged to be on her feet much, she will find great relief from having the limb bandaged, or wearing the laced stocking. If the bandage or laced stocking is used, it should be applied in the morning, when the veins are least distended, beginning at the toes and progressing upwards. In addition to the above mechanical means the following medicines may be given with great advantage, namely- Arnica, Lycopodium, Nux vomica, and Pulsatilla. DISEASES OF FEMALES. 51 HEMORRHOIDS OR PILES. Although this disease is not by any means peculiar to pregnancy alone, yet it often arises in persons while in this state who are not subject to it at any other time, from the pressure of the gravid uterus and a torpid condition of the abdominal viscera. Piles consist of one or more small vascular tumours about the. anus. When severe they enlarge to the size of marbles, and form a cluster like a compact bunch of grapes, of a purplish hue, are very painful and sensitive to the touch. When they occupy the lower part of the rectum within the anus, they are called inward piles, and when they protrude they are called external piles. If there is no discharge from them they are called blind piles, and when there is a discharge from them they are called bleeding piles. A patient who is liable to piles or somewhat afflicted with them should neither sit too much nor stand on her feet long at a time, but take plenty of exercise, drink freely of cold water, and abstain from all rich food and stimulating drinks. During a paroxysm of suffering from them 52 PART I. it will be expedient for her to lie down and choose for herself the easiest position. As a local application, place a folded napkin wet in cold water next to them, and,lay 'a dry one folded in like manner over it, and repeat the process as occasion may require. Any animal oil, or a mucilage made by soaking quince seeds in water and applied, will frequently give temporary relief, but for more permanent benefit we must resort to one or more of the following medicines, according to the symptoms, namely-Aconite, Belladonna, Ignatia, Nux vomica, and Sulphur. Aconite is applicable when there is bleeding, with cutting or pricking pains, and pressure at the anus; fulness in the abdomen, with tightness and colic; and pain in the small of the back as if it was broken. Belladonna, when the bleeding continues for several days, with itching of the anus, and soreness when walking; tumours large, with bearing-down; pain in the back as if it would break. Belladonna is especially indicated if the patient have taken sulphur in large doses under old-school treatment in previous attacks. Ignatia, constipation, with ineffectual efforts at stool; body comes down; protrusion of the DISEASES OF FEMALES. 53 piles, during a laxative evacuation with discharge of bloody mucus; painful pressure after stool; contractive feeling in the anus; itching and crawling in the anus. Nux vomica is applicable for both blind and bleeding piles, attended by constipation and frequent ineffectual efforts at stool, with a sensation as if the anus were contracted, or closed; burning and pricking pain in the tumours; itching in the anus; colicky pains in the abdomen; determination to the head; frequent painful urination; worse after mental labour and after a meal. Particularly adapted to persons of sedentary habits, and who use much coffee. Sulphur, when there is alternate constipation and diarrhoea; sensation of excoriation, with itching and burning at the anus; frequent protrusion of the tumours; fulness of the head; sour stomach; dyspepsia; painful urination; morning diarrhoea, with bearing-down and protrusion of the rectum. In obstinate cases, give Nux vomica and Sulphur, alternately, night and morning. F3 54 PART I. CRAMPS. This very annoying affection is mostly worse about the fourth and fifth months, and again towards the end of pregnancy. Cramps may attack the muscles of the abdomen, the back, the hips, and the lower extremities. For cramps in the muscles of the abdomen take Belladonna, Hyoscyamus, Nux vomica, or Pulsatilla. When they attack the back take Ignatia, Opium, or Rhus Tox. Hips, Colocynth, Graphites, or Stramonium. Thighs, Hyoscyamus. Legs, Calcarea carb., Chamomilla; Nux vomica, if after midnight; or Sulphur, if in the evening. Feet, Calcarea carb. INCONTINENCE OF URINE. This very distressing complaint may occur at any time during pregnancy; but perhaps is most common during the early months. If the inclination is not attended to immediately, the urine is discharged involuntarily. The urine DISEASES OF FEMALES. 55 is frequently very acrid, and possessed of a strong odour. The best remedies are Belladonna, Cina, Pulsatilla, Silicea, and Stramonium. PAINFUL URINATION. This concomitant of pregnancy is relieved by Cocculus, Phosphoric acid, Pulsatilla, Nux vomica or Sulphur. SLEEPLESSNESS. Towards the latter end of pregnancy, many women, to use their own expression, become so fidgety at night, that they cannot sleep. This condition is often attended with sleepiness, but just as sleep is approaching, the limbs jerk or restlessness suddenly comes over the patient, and she is obliged to move, which dissipates for a little time the disposition to sleep. Some can sleep well enough in the day-time. Air and exercise, not carried to the extent of producing fatigue, are the best preventives. Belladonna, Coffea, Hyoscyamus, Lycopodium, Nux vomica, and Opium are the best remedies. 56 PART I. MELANCHOLY. Under this head may also be included, Despondency, Hypochondriasis, Lowness of Spirits, etc. The unfortunate subject of this unhappy state of mind always looks on the dark'side of the picture, and sees everything through an unfavourable medium. She seems to realise in her own feelings every unpropitious symptom she ever heard of, and is even afraid that something still worse awaits-her. Gossips and injudicious friends frequently unwittingly contribute to this morbid state of feeling, by relating an account of accidents and unhappy issues which perhaps never occurred. Aconite, if the fear of death be predominant, and if the unhappy state of mind have been caused by fright. Aurum, melancholy, with desire for death; irresistible desire to weep; anguish of mind, which prompts one to commit suicide; despondency; weakness of the memory and intellectual faculties. Belladonna, great agitation and' inquietude at night; fearfulness, with inclination to run away or hide; fear of ghosts; involuntary laughter; disposition to laugh and sing, or to DISEASES OF FEMALES. 57 become furious with rage; dread of exertion; illusions of the senses, frightful visions, etc. Pulsatilla, sadness and tears; oppressed with a multitude of cares; distress in the pit of the stomach; sleeplessness, headache, and heartburn; she sits in a taciturn mood, folds her hands upon her lap. and says foolish things; moroseness, with repugnancy to conversation. Sulphur, depression of spirits, with great concern on the subject of religion; despair of salvation; forgetfulness of proper names, and especially of words when about to speak them; disposition to get angry. FAINTING AND HYSTERIC FITS. These affections may take place at any time during the period of gestation; but they are most apt to occur about the time of quickening. Robust women may have them, but such attacks are generally confined to the nervous and delicate. The patient first feels a sensation of languor, with inclination to yawn; everything appears to turn round; her sight becomes obscure; buzzing and ringing in the ears; her face turns pale; she sighs and becomes insensible. There are no convulsive motions, no 58 PART I. choking with noise in the throat, and no biting of the tongue, as in epileptic fits. They may be caused by fright, anger and alarm of any kind, and sometimes they occur without any external exciting cause. Aconite, Chamomilla, or Ignatia, if they are caused by a fit of passion or fright. Belladonna, when there is determination of blood to the head, with flushed face; heat of the head, with coldness of the extremities. Ignatia, when there is severe headache; nausea and fainting; chilliness, with paleness of the face; the patient can bear neither light nor noise; distension of the abdomen. If the attacks are protracted, or recur repeatedly, dissolve afew globules of Ignatia in water, andgive the patient a teaspoonful every ten minutes until she is better. Pulsatilla, when there is a disposition to shed tears; and in persons of great nervous susceptibility. MISCARRIAGE AND FLOODING. On account of the very intimate association of these two diseases of pregnancy, I have concluded to give their treatment conjointly. If DISEASES OF FEMALES. 59 they were treated of separately, there would be frequent repetitions of the same symptoms. Abortion may frequently be prevented even after flooding and labour pains have commenced; and, in cases where this cannot be done, the sufferings of the patient may be very much mitigated, and the evil consequences partially avoided. It may occur at any period of gestation, but is most frequent at the third month. If it occurs after the sixth month, it is called premature labour. It may result from accidental causes, constitutional predisposition, or some latent disease. Arnica, if it is caused by a blow, lifting heavy weights, overreaching, a fall, or any other violent concussion; when pains which bear down heavily, or real labour-pains make their appearance, with a mixed discharge from the vagina. Belladonna, when there are violent pressing pains, with tension in the whole abdomen, particularly low down, with the feeling as if the private parts would fall out, which is characteristic for Belladonna; pain in the small of the back, as if it would break; the patient is pale and restless, or her face is flushed, and she is stupid; heat about the head; thirst; 60 PART I. palpitation; the discharge is neither very dark, nor. very bright red. Bryonia, if the discharge is of a dark colour, in large quantities, with pain in the small of the back; headache, particularly in the temples, as if the head would burst; especially if constipation attend. Chamomilla, when there are violent pains going from the back around the stomach, resembling an inclination to evacuate the bowels, or water; the pains are periodical, like labour pains, and each one is followed by a dark and coagulated discharge; much thirst; and coldness of the extremities. China is very important in the most dangerous cases of flooding; when heaviness of the head, giddiness, loss of consciousness, and drowsiness appear; sudden weakness; coldness of the extremities; fainting; paleness of the face; convulsions of the mouth; contortions of the eyes; the face and hands turn blue; single jerks pass through the whole body; the discharge passes by starts, and may be either thin and bright red, or dark and coagulated; the cramp-like contraction is attended with a painful sensation of bearing-down towards the anus, and the discharge is increased at every pain. DISEASES OF FEMALES. 61 During the administration of this remedy cloths dipped in vinegar and water may be applied to the lower part of the stomach. Afterwards a little wine and water may be given. China always answers well for the debility, and other troublesome symptoms which sometimes remain, after the flooding has ceased. Should there be colicky pains, with frequent inclination to pass water, and sore tension of the abdomen afterwards, give Aconite. Hyoscyamus, when there are spasmodic affections of the whole body or jerking of single limbs, sometimes followed by stiffness of the joints, and loss of consciousness, attended with a light red discharge, which is worse during the spasms and at night. The pains resemble labour pains, with drawing in the thighs, and small of the back; heat over the whole body, with quick, full pulse, with fulness of the veins on the backs of the hands and in the face; great uneasiness; excessive liveliness; trembling over the whole body; numbness of the limbs; darkness before the eyes; delirium; "and twitching of the sinews at the wrists. Ipecacuanha, when the threatened miscarriage is attended with spasmodic affections, without loss of consciousness; copious flooding; the G 62 PART IL discharge flows without interruption but is worse during motion with cutting pains around the navel, and great pressure downwards; chills, and coldness of the' body; internal heat rising towards the head: great weakness, and inclination to lie down. Nux Vomica, threatened abortion, particularly about the third month; spasmodic pains, accompanied with ineffectual urging to stool; the pains are accompanied with nausea, and sometimes faintness; strong bearing-down, with frequent inclination to pass water; and, heat in the private parts. Discharge of mucus. Platina, when the discharge is dark, thick, and sometimes coagulated; the pain in the back draws towards the groins with pressing down internally to the private parts, which are excessively sensitive. Particularly applicable where mental emotions are the cause. Administration. On the first appearance of the premonitory symptoms of miscarriage, the patient should keep quiet or go to bed, release her mind from care, avoid exciting conversation, and live on a light diet. Select the remedy according to the symptoms, and if no better in a few hours or the next day after taking the first dose, repeat it again. But if DISEASES OF FEMALES. 63 no improvement follow the second dose, select another remedy. If better, take nothing more so long as the improvement continues; if the symptoms return, repeat the last remedy once More, before selecting another. If the symptoms are urgent or the flooding severe, dissolve about ten globules in a wineglass full of water and take a teaspoonful every half hour, or not so often, according to the necessity of the case, increasing the interval as the symptoms improve, and discontinue the medicine when the flooding ceases. BREASTS. A great deal of suffering from sore breasts after delivery, may be saved by paying a little attention to them for a few months previous to confinement. Women are most liable to suffer in this way, with first children. During the progress of gestation, especially with first children, and in quite young women, the breasts increase very much in size, the areolfe assume a darker colour, and the nipples become enlarged, and project more than they had done previously. This change in the size and condition of the nipples is often attended with 64 PART I. some pain, and a great deal of tenderness. Excoriation, inflammation, cracks, branny exfoliations, and very minute abscesses around them, are the most common diseases to which the nipples are liable during pregnancy. For two or three months in the latter part of pregnancy, the whole breasts should be well bathed with cold water every morning, and rendered perfectly dry afterwards, with towels. For simple excoriation, or tenderness of the nipples, they may be washed two or three times a day with water containing a few drops of the tincture of Arnica, or with brandy. In some instances a little tincture of myrrh may be added to the brandy with advantage. For the other diseases of the nipples above mentioned, the following medicines should be administered internally, according to the indications. Chamomilla, if the nipples be highly inflamed, and ache like toothache. Also Silicea and Sulphur. Sulphur, for burning, itching, swelling, cracks, branny eruption, and the minute abscesses or pimples around the nipples; Graphites, Lycopodium, and Mercurius viv. also are sometimes necessary. DISEASES OF FEMALES. 65 LABOUR. The process of giving birth to a child is called labour. The average duration of gestation, is thirty-nine weeks. There are three cardinal points from which if they occur at the usual time, and in regular succession, a correct "reckoning" may be kept, and the time of labour fixed with considerable certainty. 1. The time of the last period of menstruation. 2. The commencement of morning sickness -six weeks after conception. 3. Quickening, at half way-one hundred and thirty-five days from quickening to labour. Moreover, the stomach gets lower after the eighth month, and the woman is smaller around the waist, the last month of her pregnancy, than she had been for six weeks previously. Labour is ushered in by a few premonitory signs. One very common and very good one, is looseness of the bowels, sometimes for a day or two before. Various nervous symptoms, such as agitation without apparent cause, disposition to shed tears without distress; in other instances lowness of spirits occasionally G3 66 PART I. precedes labour. Flying pains through the stomach, with frequent inclination to pass water, and finally a discharge of mucus tinged with red, technically called "a show" takes place. Then come pains at intervals of longer or shorter duration, and frequently rigors or trembling without coldness. Were it not for the acquired habits of civilised life, the process of child-bearing would be divested of much of the suffering and danger, which now so commonly attend it as almost to lead us to consider them natural concomitants. It is almost unattended with pain among savages. It would not be wise, neither is it necessary to return to savage life in order to get rid of the ills of childbearing; but let the women in civilised life pay more attention to the natural means, both moral and physical of developing their whole being-live more usefully and less artificially, than they now do, in deforming themselves in order to make what they call a 1" fine figure," and in a few generations, many of the difficulties which now exist will have disappeared. It is not intended here to go into a minute description of the process of labour, nor to give any specific directions for its management, DISEASES OF FEMALES. 67 as I cannot suppose that any sensible person who is not qualified, would have the temerity to undertake the care of a case unless placed under very peculiar circumstances. Some of the deviations from the natural course, however, may be noticed with their appropriate treatment. INEFFECTUAL PAINS. Chamomilla, when there is over-excitement, and excessive sensibility to pain; and anguish, and discouragement with tossing about. Co.fea, if the pains are excessively violent, with great mental and general nervous excitement, and over-sensitiveness. Nux Vomica, when the pains are irregular, and the labour does not seem to progress; drawing in the back and thighs with pressure downward, and constant inclination to evacuate the bowels, and to pass water. Opium, is especially suitable in women of a full habit, if the pains suddenly cease, and determination to the head, with redness and fulness of the face, with a state of stupor take place..Pulsatilla, if the pains are too weak, and too far apart, or if they become weaker, as from inactivity of the womb. 68 PART I. AFTER DELIVERY. A patient should not be disturbed immediately after delivery, except so far as is absolutely necessary in the application of the bandage and to render her situation as comfortable otherwise, as circumstances will admit of. She should be allowed to rest for an hour or two, and then if no unfavourable symptoms be present to forbid it, she may be "put to bed." If she complain of general soreness from violent, or long-continued exertion, give her two doses of Arnica internally, three or four hours apart, or if that should not be sufficient give Rhus Tox in the same way. If she complain of much soreness or pain locally, Arnica may be applied externally, in the form of lotion, prepared by mixing twenty drops of the tincture in a tumbler full of tepid water. Cofea, if she cannot sleep from nervous excitement with restlessness and tossing about. FLOODING AFTER DELIVERY. Belladonna, when the flooding is attended with violent pressure downwards in the internal organs, as if they would be forced out, and pain in the small of the back. DISEASES OF FEMALES. 69 Chamomilla, if the discharge take place at intervals with pains running round the abdomen; constant thirst; paleness of the face; and coldness of the extremities. China, when the same symptoms exist as are enumerated under Chamomilla, and in addition thereto; vertigo; dulness of the senses; desire for fresh air, and fainting. This remedy is also suitable for the debility and want of energy, after the flooding has ceased. Ipecacuanha, when the discharge is bright red and constant, with cutting pains in the middle of the abdomen; bearing-down; nausea with great prostration of strength, and a desire to be fanned. AFTER-PAINS. After-pains rarely occur with first children, and generally, they are but slight until the third or fourth. Some women never have them of any account, and others have them severely in every confinement. Something may be done towards preventing them by patience and a little judicious management on the part of the practitioner during labour; 70 PART I. but frequently they occur after the most skilful management. Arnica, if a sensation of soreness accompanies the pains, with pressure on the bladder, and retention of urine. Belladonna, for the kind of bearing-down so characteristic for Belladonna and so often mentioned, with fulness about the head and strong inclination without the ability to sleep; also, tenderness and fulness of the abdomen. Chiamomilla or Coffea, if nervous excitement with restlessness and tossing about, prevail. Nux Vomica, when the pains are aching, and more of the colicky kind, with violent contractions in the womb, and sometimes followed by nausea. This remedy is always suitable for excitable and hasty persons. Pulsatilla, in persons of a mild temperament; severe colicky pains, extending to the back; desire to vomit; sour taste; bearing down; nervousness with disposition to shed tears. In severe cases, Nux Vomica and Pulsatilla may be given alternately in water, with very good effect. Pulsatilla is very important, when the placenta is retained too long. DISEASES OF FEMALES. 71 OF THE LOCHIA. The discharges which take place after delivery, are called lochia. If the quantity be excessive, it is similar to haemorrhage or flooding, and, in that case see the remedies for flooding, after delivery. After the first day or two, until about the tenth day, these discharges in appearance and quantity are something like the discharge of menstruation. In a majority of cases, the red colour leaves about the tenth day, and a yellowish discharge follows for a few days, which is often succeeded in its turn, by a whitish or mucous discharge. After the woman begins to move about the house, the lochial discharge is apt to be renewed for a few days, and, then take its final leave. If the lochia continue too long, or should be too profuse and full red: give Aconite il water, night and morning for two days. But, if that should not be sufficient, give Calcarea carb. twice, dry. If it still continue, consult the remedies for flooding, after delivery. Bryonia, for suppression of the lochia with headache; fulness and heaviness of the head, with pressure in the forehead, and temples; throbbing pains in the head, increased by 72 PART I. motion; back-ache, with scanty emission of hot urine. Give one dose of the medicine; then wait twelve hours; and, if no better, repeat it, once. Platina, if the suppression be the result of some mental emotion, with dryness, and over-sensitiveness of the sexual organs. Pulsatilla, if the suppression be sudden, from any accidental cause with feverish excitement, with or without thirst; one sided head-ache; oppression of the chest; partial heat of the upper part of the body, with coldness of feet; frequent inclination to pass water; the symptoms being worse in the evening, and better in the morning. This remedy is also suitable for a diminution, if there be not an entire suppression of the discharge. Rhus Tox, for a variety of unhealthy lochiae, if the discharge be offensive, black and watery, with shootings up the rectum; sharp pains shooting through the head, which feels as if it were too large; the head is worse when lying, and better after rising. COMING OF THE MILK. Except in very few instances, the mother has DISEASES OF FEMALES. 73 no milk, at the time of the birth of the child. Milk generally makes its appearance on the third day, sometimes earlier and sometimes later. Previous to the formation of milk, the breasts enlarge more or less, and sometimes to such an extent as to give rise to a great deal of suffering, especially with first children. Care should be taken not to bruise the breasts, at this time by rudely rubbing them, or officiousness in drawing them, in order to get out the " caked" milk. The state of turgescence which precedes the secretion of milk, is widely different, and must be distinguished from the state of distention of the breasts, which follows the secretion. Aconite, if the breasts be hard and knotted; dry and hot skin; redness of the face; the patient is restless and discouraged. Give the medicine in water every four hours, until the symptoms are relieved, and then stop it. Bryonia, should be given after Aconite, if that remedy mitigates the symptoms, but does nbt remove them, or, if some of them disappear and others remain. Belladonna, may be given after Bryonia, or alternately with it, if a portion of the same group of symptoms, still continue. H 74 PART 1. Calcarea carb., is especially suitable if there be a deficiency in the secretion of milk in the out-set, or fulness and enlargement of the breasts, with tardiness in the formation of milk. This remedy is also most important when the milk runs out too easy. Chamnomilla, is suitable if there be excessive sensibility of the nervous system, with restlessness; tenderness of the breasts; and, inflammation of the nipples, so that the milk cannot run out. Pulsatilla, when the secretion of milk is interrupted, or entirely suppressed; threatening symptoms of child-bed fever. This medicine exercises a healthful influence over the female constitution, in almost every deviation from the natural course, during the entire period of nursing. It is also very effectual in re-establishing the equilibrium of the organism at the time of weaning. Rhus Tox, in painful distention of the breasts, with rheumatic pains throughout the system; swelling, heat and hardness of the breasts, causing headache, stiffness of the joints, and other constitutional disturbance. Rhus Tox is very serviceable in warding off the ill consequences of a suppression of milk, and also at the time of weaning. DISEASES OF FEMALES. 75 As local applications, I frequently direct the breasts to be bathed with hot lard, and then enveloped in raw cotton. SORE NIPPLES. Arnica, in the form of lotion, made by dissolving five drops of the tincture in a wineglassful of water, and bathing the nipples several times a day, is very effectual in removing the tenderness and excoriation consequent upon the first few applications of the child's mouth. Be careful to moisten the nipple with saliva or mucilage, before giving it to the child. Chamomilla, for inflammation, swelling, and ulceration of the nipples. Graphites, for burning, aching, cracking and tenderness of the nipples. Sulphur, when the nipples are sore and deeply chapped; the chaps bleed, and burn like fire; deep fissures around the base of the nipples. In difficult cases one of the following medicines may be given alternately with Sulphur, night and morning, viz: Calcarea, Lycopodium, Mercurius, viv. or Silicea. 76 PART I. GATHERED BREASTS. During the entire period of lactation, the breasts are more or less liable to inflammation, and suppuration. Abscesses sometimes form, from mechanical injuries, and needless exposure, in the breasts of unmarried women. Belladonna, is indicated if the breasts be swollen and hard, with shooting and tearing pains, and redness which radiates from a central point. Bryonia, when the breasts are too full of milk, hard, and feel heavy, like the weight of a stone, with shooting pains; dry skin and other feverish symptoms. Bryonia and Belladonna can frequently be given alternately, with very great advantage. Hepar, after the administration of Belladonna and Bryonia, if the swelling continue, and especially if throbbings make their appearance. Phosphorus, when the foregoing remedies have not been sufficient to arrest the progress of the inflammation, but suppuration having established itself, the abscess is discharged through fistulous openings which are not disposed to heal. DISEASES OF FEMALES. 7 77 Sulphur, if the discharge of matter be profuse, with chilliness through the forenoon, and feverish heat with flushed cheeks in the afternoon. STATE OF THE BOWELS. It is perfectly natural for the bowels to remain without being moved, for a few days after delivery. In a majority of cases, the bowels move about the fifth day. In no case should purgative medicine be given during confinement. If headache, pain in the bowels, or other symptoms of costiveness appear, give one dose of Bryonia in the evening and another in the morning. Should there be no change by the following evening give a dose of Nux vomica in water, and a dose of Sulphur next morning. Should these remedies not procure an evacuation, and the unpleasant symptoms remain, give an injection of luke warm water. If diarrhcea should occur during confinement Dulcamara, Phosphorus acid, or Rheum, will be found to control it without difficulty. "n3 78 PART I. RETENTION OF URINE. In retention and painful emission of urine after delivery, Arnica, Belladonna, Nux vomica, or Pulsatilla, will generally suffice to procure a free emission; sitting over a chamber which contains warm water is sometimes useful. DURATION OF CONFINEMENT. For the first four or five days after delivery a woman should remain quiet in bed, keep her mind free from excitement, and live on gruel, panada, toast and black tea, or other similar articles, and drink cold water. Afterwards should no untoward symptoms be present, she may rise daily to have her bed made, and gradually return to her ordinary diet. The first two weeks should be chiefly spent in bed, or at least in the recumbent posture; during which time visitors ought not to be admitted. A woman ought not to leave her room before three weeks, and never go up or down stairs before four weeks after her confinement. 79 PART II. TREATMENT OF CHILDREN. RECEPTION AT BIRTH. IN case a child is born before the arrival of the accoucheur, some person should place it in a proper position to breathe; and if the cord be coiled round the neck, body or limbs of the child, it should be disengaged, in order that the circulation between the mother and child may not be interrupted before respiration is fully established, in the latter. Remove the child a little out of the discharges, so that the face at least may be free, and if the mouth or nostrils are obstructed by mucus, cleanse them with a napkin or piece of fine linen wrapped round the little finger. When these things are attended to, if the child be healthy and robust it will cry lustily; and its skin will change from a light, or leaden hue, to a pink, or rose colour. There is now no further cause for alarm as both mother and child may remain in this situation for an hour or two without danger. If however, the child 80 PART II. should be feeble, or have been delayed long in the birth, or either of the causes above mentioned have operated to prevent it from breathing, and after the above directions shall have been followed, respiration do not yet take place, wrap the child's body and limbs in warm flannel or napkins, and apply cold water, or cold spirits to its breast with the palm of the hand; should this not succeed, place your mouth over the child's mouth and gently blow so as to inflate the lungs, closing the childs nostrils at the same time between your thumb and finger, to keep the air from passing out through its nose. If pulsation be felt in the cord, and the beating of the child's heart be perceptible, have a little patience and all will be well. After respiration is fully established with the child, and, pulsation have ceased in the cord and not before, the child may be removed. In order to do this, take a string made of sewing thread doubled and twisted, which is best, or in place of that a piece of narrow tape or round bobbin of sufficient strength will answer. Wrap the string once round the cord about an inch and a half from the child's stomach and tie it securely in a hard knot,, TREATMENT OF CHILDREN. 81 cut off the loose ends of the string, and tie one of them round the cord three quarters of an inch fxrther up, and then cut the cord with a pair of scissors, between the two ligatures. The child may be received in a blanket or sheet which should be warmed, for the purpose. WASHING THE CHILD. The body of almost every new-born babe is more or less covered with a white umctuous matter, which adheres to it with great tenacity.* The best method of removing it is by rubbing the covered parts of the child, freely with hog's lard, until the two substances become completely incorporated, when they are easily removed by a piece of flannel which should always be used as a wash rag. When the skin is freed from the unctuous matter, a little fine soap may be used to get rid of the grease. After the child has been carefully washed which should be well done the first time, its * Lukewarm water and bran, will be much better than lard and soap, the washing ought to be done with a very soft sponge, as flannel is too irritating for the tender skin of a new born infant.-ENG. ED. 82 PART II. skin should be rendered perfectly dry with a fine napkin. The reprehensible practice of bathing children in spirits should always be prohibited. DRESSING OF THE NAVEL. This is to be done by folding a piece of linen or muslin until it is about six inches long, and three wide, consisting of four or six thicknesses, in which a hole- is to be cut and the cord passed through. The cord is then to have another strip of linen or muslin wrapped round it as you would wrap up a sore finger. The first piece of linen or muslin lying lengthwise of the child's body, the end of the cord now wrapped is to be laid up towards the child's breast, and the lower end of the first piece is to be folded over it, and the whole secured by the belly-band, which should always be made of a strip of flannel, without either hemming or lining. The navel usually comes off from the fifth to the eighth day. OF THE MECONIUM. In most cases the child's bowels are moved TREATMENT OF CHILDREN. 83 a few hours after birth. The substance discharged is of a dark bottle green colour and is called Meconium. To aid the discharge of the meconium and to clear the throat of mucus it is allowable to give the child two or three teaspoonfuls of warm water sweetened with brown sugar. The first milk has a tendency to promote the object. The colour of the stools generally changes to yellow about the fifth day. If the bowels should not be moved as freely or as frequently in the few first days as they ought to be and the child be restless, give a dose of Nux vomica at night, and if necessary a dose of Chamomilla the next day. PUTTING THE CHILD TO THE BREAST. After the lapse of ten or twelve hours or sooner if the mother have milk, the child may be put to the breast, after carefully moistening the nipple as before directed. In a majority of cases it is best to comply with the above direction for the reasons, [that it teaches the child to suck, softens the nipple, and invites an early flow of milk. The mother's milk is the most natural food for the child, but when 84 PART II. this cannot be procured and a substitute becomes necessary, we ought to imitate it as near as we can. For this purpose take fresh milk from one cow, add one third warm water and sweeten it with a little loaf sugar. Of this a child may take a few teaspoonfuls at a time, as often as may be necessary. Never give a new born infant cracker victuals, gruel, pap, panada, or other cooked food. Every infant should have a teaspoonful or two of cold water given to it every day, or several times a day, if the water agrees with it. ELONGATION OF THE HEAD. In first children and after other tedious and protracted labours it is common to find a tumor on the back of the child's head, giving it the appearance of being elongated. The repeated application of cold water with a few drops of the tincture of Arnica dissolved in it will remove the trouble in a few days. INFLAMMATION OF THE EYES. Very young infants are subject to inflammation of the eyes; sometimes the lids only TREATMENT OF CHILDREN. 85 are affected, at other times the lids and eyeballs are both involved. The eyes should not be exposed to too strong a light, and the child should be kept out of every draught of air, as light and cold are the most common, although not the only causes of the disease. Aconite, when cold or exposure to the light is the cause; when the whole eye is very red, and runs a great deal. Belladonna, when the whites of the eyes are very red, and present a blood-shot appearance, or there is bleeding from the eye-lids; and the child cannot bear the light. Chamomilla, if the eyes bleed, are swelled, and, are closed in the morning. Euphrasia, when the eyes are very much gummed up and run acrid yellow water; and, the child cannot bear the light. Rhus Tox,.is very important in scrofulous children, and where the lids are principally affected. SNIFFLES. Infants are often attacked with a kind of catarrh, or obstruction of the nose, which prevents them from breathing whilst they are I 86 PART II. sucking. Give Nux vomica at night and if this does not give relief by the next morning, give Sambucus, and repeat it every six or eight hours, until relief follows. If the nose runs water, give Chamomilla. SORE MOUTH. Baby's sore mouth is also called Thrush and Aphthea. It runs in families, and is apt to make its appearance towards the latter end of the second week. Much may be done to prevent this troublesome complaint by proper attention to cleanliness. A child should be thoroughly washed every day, in slightly tepid water, and the mouth cleansed with cold water on a piece of fine linen rag, and afterwards the child should be allowed to suck the rag wet with the cold water. Give two doses of Mercurius viv., twelve hours apart and wait a couple of days and if it does not disappear give Sulphur in the same way. Bryonia and Nux vomica, are also called for in some cases. The common domestic remedy is equal parts of Borax and loaf sugar finely pulverised, and a pinch of it put into the child's mouth three TREATMENT OF CHILDREN. 87 or four times a day. In many cases it answers very well, but it should not be pushed too far. JAUNDICE. The skin of children for some time after birth, being very delicate and vascular, is consequently much redder than it is when they are more advanced. During the transition from the red to a paler colour, the skin often assumes a yellowness, somewhat resembling jaundice; but this does not constitute the disease. This yellow tint may continue for a few days, without being attended by any other symptom, and then disappear spontaneously. Although the skin be yellow, if the child is not sick, and the secretions be natural, there is no need of medicine. But, if in addition to the yellowness of the skin, the whites of the eyes, the secretion of tears and urine be yellow, and the evacuations from the bowels be paler than natural, or of a clay colour; if, the abdomen swell; if, the child be fretful and moan frequently, there need be no further delay: the child is sick, and requires treatment. Give a dose of Chamo 88 PART II. milla in the evening, and a dose of Mercurius viv. in the morning, then wait twenty-four hours, and if the child is not better, send for a homoeopathic physician. RETENTION OF URINE. Young infants are frequently the subjects of this complaint. Dissolve a few pellets of Aconite in a wine-glass full of water, and give the child a portion of it, every two or three hours until relief is obtained. Should this fail give, Nux vomica or Pulsatilla in the same way. PROFUSE URINATION. Occasionally young children have frequent and profuse emissions of colourless and inodorous urine. They are apt to be pale and fretful during its continuance. Phosphoric acid or Silicea are the appropriate remedies. CONSTIPATION. If the evacuations have the natural colour - TREATMENT OF CHILDREN. 89 and consistency, although they should not occur so frequently as would be desirable, it is not always the part of wisdom to interfere, by giving medicine. If left to themselves they will often return to the natural state, but if collateral symptoms arise, we must give medicine. Bryonia, Calcarea, Nrux vomica, and Opium are oftener indicated than other remedies, and will generally produce a change. It often happens that the constipation or diarrhoea of a child depends upon the mother or the nurse, and in that case the medicine should be given to them, so as to operate on the child, through the medium of the milk. DIARRHOEA. The diarrhoea of infants will not always yield to the medicines which are successful at other periods. Belladonna, if the child sleeps a great deal, but is uneasy; paleness of the face; every time the child is changed, the napkin is found to be soiled by a small greenish discharge. Chamomilla, when the evacuations are watery, and greenish, or like beaten-up eggs, and worse at night; the stools are attended with 13 90 PART II. straining, and redness of the child's face; frequent small green stools with restlessness. Rheum, in diarrhcea arising from acidity, attended with cries, colic and straining; bearing down without stool; the evacuations are frothy, sometimes slimy, and smell sour; the child smells sour notwithstanding the greatest attention to cleanliness. COLIC. Infants and especially those of feeble constitutions are troubled with colic. It may arise from constitutional peculiarity, or, from improper feeding of the child and from improprieties on the part of the mother-either errors of diet, exposure to cold, or suffering of any kind that will interfere with the healthy secretion of milk. If the child's food disagrees with it, it is apt to exhibit signs of pain soon after feeding it. The attacks may be so severe and frequent as almost to wear out both mother and child. Diarrhcea frequently attends it. There is another species of colic, to which some of the most robust and otherwise healthy children, are subject. It is periodical in its TREATMENT OF CHILDREN. 91 attacks which usually occur at five or six o'clock in the afternoon. This species is often attended with costiveness, but frequently the state of the bowels is unchanged. The complaint does not interfere with the growth or general health of the child, and usually stops when the child is about three months old. Whatever may be the cause of colic in children, it should be sought out, and if possible, removed. Chamomilla, if the pain be attended with looseness of the bowels; yellowish green and watery discharges; distention of the abdomen, writhing pain, constant crying and drawing up of the legs with coldness of the feet. The medicine may be given in water, and frequently repeated until the child is relieved. China, when the pains come on late in the afternoon, with hardness of the abdomen; the child screams, and laughs immediately afterwards; the bowels may be in a healthy state, or the stools may be whitish and curdled. Ipecacuanha, when the cries of the child are sharp, as if the pains were of the cutting kind; fermented stools of a putrid odour. This medicine is well adapted to the various ailments of the stomach and bowels of young children. 92 PART II. Pulsatilla, is very useful in flatulent colic, especially if it occur in the evening or every other day accompanied with shiverings, and paleness of the face; rumbling of wind through the bowels with tenderness of the abdomen. CRYING OF INFANTS. An infant is not always in pain when it cries. This is the language by which it makes known its wants. It may be hungry or need changing. Young infants should never be obliged to lie in one position longer than an hour or two at a time. They should be placed on the side to sleep, and turned over occasionally. Although the above be true, we are not to think that children never have pain when they cry. An experienced ear can generally perceive a difference in the tone, and in that way determine whether the child have pain or not. If a child continue to cry and will not be pacified, the cause should be diligently sought for - a pin may be pricking it, or its clothes may be too tight or it may have pain somewhere. Belladonna, if the child continues to cry for a long time without any apparent cause, or TREATMENT OF CHILDREN. 93 starts out of its sleep and cries. If Belladonna should not succeed, and there be uneasiness with heat, give a dose of Aconite or Coffea. Chamomilla, when the child cries, and is restless, with frequent startings, or there is reason to believe it has ear-ache or head-ache, and cries when it is moved. RESTLESSNESS AND' WAKEFULNESS. Restlessness and inability to sleep are generally produced by injurious food being given to the child, or by the mother drinking green tea, and coffee, or using other improper articles of diet. * Belladonna, if the child seems inclined to sleep and cannot sleep, but starts up and cries. Chamormilla, if the sleeplessness be attended with flatulency, with starts and jerkings of the limbs; or, feverish heat with redness of one cheek. Coffea, if there be increased heat of the body with great nervous excitability. If this does not answer, and the face be red, give Opium. 94 PART II. SWELLING OF THE BREASTS. At birth or very soon afterwards, the breasts of infants are sometimes found to be swollen. A common opinion prevails among nurses and others, that this swelling and inflammation is owing to the presence of milk which must be squeezed out before they can get well. This opinion is not true-there is no milk there, neither do the breasts require squeezing. By rude handling, the inflammation is sometimes urged on to suppuration-matter is formed, and in some instances the breasts have been destroyed, and females deprived of their usefulness for ever. In most cases there is nothing more necessary than to apply a piece of linen dipped in sweet oil to them. In a few severe cases it may be necessary to apply a bread and milk poultice, and renew it as occasion may require. At the same time, give a dose or two of Chamomilla, and follow it by Belladonna. If matter be formed, give a dose or two of Hepar, and in a day or two afterwards give a single dose of Silicea. EXCORIATIONS. Unless there be a strong predisposition to TREATMENT OF CHILDREN. 95 excoriations, proper attention to cleanliness, and care being taken to dry all the creases in fat children, after washing, they will very generally be prevented. A child that is kept so warm as to make it perspire a great deal, is very liable to excoriations. When they do take place, the child should be washed in luke warm water (without soap) and dried by the repeated application of a fine linen handkerchief without rubbing. Afterwards it should be powdered with finely pulverised wheaten starch. Although excoriations are sometimes bad to look at, they are not dangerous, and a little patience and close attention will overcome them. While the above directions are being followed externally, one or more of the following medicines may be administered internally, namely: Carbo veg., Chamomilla, Lycopodium, Mercurius viv. or Sulphur. SCURF ON THE HEAD. Children that are kept too warm, or that are a little neglected, are liable to have an unsightly dirty-looking incrustation formed on the top of the head. On removing any part 96 PART H. of the crust the skin beneath will be found red and inflamed. It annoys the child by its itching, and others by its offensiveness. The forcible removal of it by the fine tooth comb will not effect a cure, for so long as the diseased state of the scalp remains, it will be speedily reproduced. It can be prevented by washing the child's head regularly every morning, and after drying fit properly, using a suitable hair brush. If a tendency to this formation be noticed, give the child Staplhysagria two nights in succession. After the crust has formed, it can be removed by anointing it well with lard at night, and washing it off next morning with a solution of Borax and water. The application may have to be repeated three or four times. DENTITION.* The two middle lower front teeth make their appearance generally when the child is about * Those who wish for more information on the treatment of this important natural process will do well to consult "Becker, on Dentition." TREATMENT OF CHILDREN. 97 six months old. In three or four weeks afterwards the middle incisors of the upper jaw come through the gums, then come the two lateral incisors below, which are soon followed by the two lateral incisors above. In about two months after these, the first four jaw teeth are cut, two below and two above; and after another little respite the two stomach teeth and the two eye teeth show themselves, and finally at the age of from two years to two and a half the four back jaw teeth, two above and two below, make their appearance, which completes the first dentiton, consisting of twenty teeth. Every child does not cut its teeth with so much regularity as is indicated above, for some deviate variously from the rule which governs the majority. The process of teething gives rise to a variety of sympathetic affections in children, many of which, cause great suffering, and some of them are attended with considerable danger. In order to save the child as much suffering as possible, if it still nurse, the mother should abstain from all stimulating and indigestible articles, as well as every thing else which she knows from experience will cause her milk to disagree with the child. And if the child K 98 PART II. be weaned let its diet be of the most mild and unirritating kind-allow no coffee, tea or malt liquors-no candies or other confectionaries. On account of the known tendency to heat in the head, sore ears, &c. during dentition, it is better for the child to sleep without a nightcap. Some children pass through the whole process without the least sickness. Before the teeth come through, the gums usually become broader, more angular and frequently show the shape of the coming teeth; the veins running parallel with the teeth, become enlarged and look like little red strings. The mouth becomes hot and the child seems uneasy, particularly at night; its face is alternately flushed and pale; puts its fingers in its mouth; frequently seizes the nipple, bites, and then jerks its head away; the gums swell and become painful; the child drivels at the mouth and the bowels become loose. When there is much constitutional disturbance, the child leans its head on the nurse's shoulder, becomes feverish, the skin is hot, with burning in the palms of the hands; the head is hot and the feet cold, nausea and vomiting, with rubbing of the nose, and frequent cough at night during sleep. When the gums are swollen and inflamed, TREATMENT OF CHILDREN. 99 and if the above enumerated sympathetic and constitutional symptoms be present, and especially if watery vesicles form over the teeth giving the gums a rounded and bluish appearance, there is no valid objection to lancing. To perform this very simple but useful operation properly, a gum lancet should be used; place the instrument over the tooth, and cut through the gum until the tooth is felt. The operation of lancing the gums is but seldom called for, as in a majority of instances a little timely recourse to one or more of the following medicines will remove all the unpleasant symptoms. Aconite, when there is fever with much restlessness, sleeplessness and suffering of pain, as evinced by the child's crying and starting. Belladonna, when convulsions are caused by teething; the convulsion is followed by sound sleep, which continues for a long time or until another paroxysm comes on. The child starts suddenly from its sleep, as if frightened and looks around as if terrified, with an altered expression of countenance; the pupils of the eyes are enlarged, and the child stares at a particular spot; the whole body becomes stiff; with burning heat in the palms of the hands and in the temples. 100 PART II. Calcarea carbo, when the process of dentition is retarded, in children of light complexion, and inclined to be fat. Give the medicine once a week for three or four weeks. Chamomilla is particularly adapted to the various diseases of children generally, during the period of dentition, and especially when a child is very uneasy at night; tosses about; wants drink often; has spasmodic jerks and twitches of the limbs during sleep; starts from the slightest noise; general heat; redness of the one cheek and of the eyes; moaning; groaning; agitation; short, quick, noisy respiration and oppression of the chest; hacking cough; mouth dry and hot; diarrhaea, with watery, slimy and greenish evacuations, worse at night. Cina, may be given to children who wet the bed at night and grit their teeth during sleep and at other times; have hardness and distention of the abdomen; rub their nose, and have a dry cough, resembling hooping-cough. Coffea, when the child is very excitable; does not sleep; is sometimes fretful and at other times too lively, with some fever. Ignatia, when there is convulsive jerkings of single limbs; frequent flushes of heat, sometimes followed by perspiration; the child rouses TREATMENT OF CHILDREN. 101 from a light sleep with piercing cries and trembles all over. Ipecacuanha is very useful in nausea and vomiting with diarrhoea; the stools are mixed, of different colours. Mercurius viv. is applicable in cases of copious driveling, redness of the gums, and green evacuations from the bowels, with straining. Sulphur may be given when the stools are whitish, or hot and sour; and, excoriate the nates. SPASMS OR CONVULSIONS. Children from the period of their birth, until they attain their fourth year, are exceedingly liable to suffer from this disease. Between the ages specified, the nervous system of a child is more susceptible of the action of morbific agents, as well as influences of every kind; than it is in after life; hence judicious surgeons do not perform operations on very young children when they can be postponed to a later period. A knowledge of this fact should deter physicians from bleeding and blistering at such an early age; and experience teaches all who witness K 3 102 PART 1. such things and wish to learn, that the constitution of a young child, cannot bear such treatment, without being injured by it. The circulation of the blood, and every vitalizing process is carried forward with greater rapidity than at any subsequent time; and, hence accidental and mechanical injuries, such as cuts, fractures and the like, are repaired in shorter time than they can be in after life. So long as this susceptible and excitable state continues, just so long will the liability to convulsions remain and the danger of an attack will be proportionate to the degree of excitability. Another predisposing cause, is the tendency to such diseases inherited from parents. The children in large and crowded cities are also more disposed to have such diseases than children in the country, who are favoured with a purer atmosphere, and enjoy greater opportunities for exercise. Among the exciting causes may be enumerated, dentition, the fever attending eruptive diseases, repelled eruptions, worms, errors in diet, falls upon the head and mental emotions. When a child is attacked with convulsions, let those having charge of it endeavour to be calm, and first of all, try, to ascertain the ex TREATMENT OF CHILDREN. 103 citing cause, and then become acquainted with the mode of attack. As upon these, in many instances, mainly depend, the certainty and success of the treatment. In a majority of cases the convulsions of young children are not dangerous, unless they occur during the advanced stage of some of the diseases incidental to childhood. For the purpose of giving temporary relief, the child's feet and legs may be placed in warm water, and after being kept there for five or ten minutes, wiped dry and wrapped in flannel -the child's head should be sponged with cold water or have the cold water poured on it through the spout of a teapot from a height of three feet. If the child be costive, or it be suspected that there are some irritating matters in the bowels, give an injection of warm water or molasses and water. If the child has eaten something that has disagreed with its stomach and there be retching and vomiting, put a large mustard poultice over the stomach. If the child be cutting teeth, and the gums over the teeth next due, be swollen, lance them. If the convulsions are caused by a fall, after the spasms are relieved give Arnica and apply it externally if any, part is bruised. 104 PART n. But for the purpose of curing the spasms and preventing their return, we must administer one or more of the following medicines successively, according to the symptoms. The most favourable time for giving the medicine is just as the fit is going off, but when the paroxysm lasts a long time, or one succeeds another with rapidity, the medicine must be given immediately, without waiting for the fit to terminate. If the first dose produces no change, repeat it in ten minutes, but if the child improve after the first dose, give nothing more so long as the improvement continues; when the symptoms get worse or another paroxysm comes on, repeat the same medicine. If the remedy first given does not remove the disease, select another according to the symptoms. Belladonna, if the paroxysm terminate in a state of stupor, or the child wakes suddenly, as if from fright, with staring eyes, fixed look, and dilated pupils; bending backwards; rigidity and coldness of the whole body, with burning in the hands and forehead; involuntary passing of fieces and urine. Chamomilla, if there be convulsive jerkings of the arms and legs; twitchings of the eye TREATMENT OF CHILDREN. 105 lids and muscles of the face, with involuntary movements of the head from side to side, followed by drowsiness, with the eyes half open and loss of consciousness; redness of one cheek, and paleness of the other; moaning, and frequent desire for drink; great restlessness and excitability. If the Chamomilla be not sufficient alone, it may be given alternately with Belladonna. Cina, in children who are subject to worms and are in the habit of wetting the bed, with spasms in the chest, convulsive movements of the limbs; distention and hardness of the abdomen, itching in the nose and of the anus, with loose cough at night. Coffea, in weakly, nervous children, who are frequently attacked by convulsions without any apparent cause. Hyoscyamus, when twitchings of the muscles of the face, and frothing at the mouth, are the prominent symptoms. Ignatia, may be considered the principal remedy in the treatment of convulsions of children, in as much as it is more generally applicable than any other medicine, especially in the outset of the disease, when the cause is unknown. It is applicable when particular 106 PART II. parts or limbs are convulsed, or when the flesh here and there is affected by spasms, with frequent heat; light slumber with violent starts, screams and trembling of the whole body; perspiration; in children that are subject to fits; when the fits return every day, or every second day, at about the same hour and are followed by heat and perspiration. Ignatia may be repeated several times. Chamomilla is often suitable after Ignatia. Ipecacuanha, when the child is asthmatic, sick at the stomach, with retching and vomiting, and has diarrhoea; and, stretches itself out before, during or after the paroxysm. This remedy may be repeated frequently in water. Mercurius viv., if worms be the cause; saliva runs out of the mouth; green, watery stools; hard and distended abdomen; eructations; the child's skin is hot and moist; great weakness and exhaustion after the fits. Opium, when there is much trembling over the whole body, tossing of the arms and legs, loud screaming during the paroxysm; the child lies unconscious as if stunned; the abdomen is swelled; suppression of urine and faeces. This remedy is particularly applicable if the fit have been caused by nursing, after TREATMENT OF CHILDREN. 107 the mother had been frightened, or fallen into a passion. Stramonium, if the convulsions arise from repelled eruptions, or occur during the fever of eruptive diseases, or in consequence of eruptions not coming out; attended with involuntary evacuations of faeces and urine; much groping about with the hands, and opening and shutting of the fingers. SUMMER COMPLAINT. Cholera infantum as this disease is technically called, is generally owing to improper diet either on the part of the mother or child, atmospheric changes, improper clothing, teething, and want of fresh air. In some instances the disease begins like a simple diarrhoea, and is then frequently ascribed to the teeth alone, and very improperly neglected. In its more aggravated forms, it commences with vomiting, first of the food and afterwards of mucus or mere gagging with efforts to vomit. The child's flesh becomes soft, it loses its appetite, has fever with evening exacerbations; the eyes look languid, and when the child sleeps, are but half closed. 108 PART II. The thirst for cold water becomes very urgent, and all drink is immediately rejected by the stomach. The head and abdomen are hot, while the extremities are cold. The evacuations from the bowels are very frequent and assume various appearances. Sometimes consisting of a mere looseness, at other times they are greenish or yellow and watery, or they may be slimy and tinged with blood. The most common colour, however,' is white; the odour is very peculiar, and sometimes exceedingly offensive. The food frequently passes off without being digested. In bad cases the skin on the forehead is tight and shiny; the eyes are sunken; the cheeks fall in; the nose is sharp; the lips are shrivelled; and, the emaciation is extreme, so much so that the skin on the extremities hangs in folds. During the season in which children are most liable to the disease they should be kept cool and frequently taken into the fresh air. Small children in cities, are very much benefited by riding them out two or three miles into the country late in the afternoon to get ice cream, and then return before dark. A ride on the water by steamboat late in the TREATMENT OF CHILDREN. 109 afternoon in very warm weather, is also very serviceable. Never take them out in the morning for the sake of health, so as to be obliged to return in the middle of the day, when it is warmer than when you went out. Give the child no tea, coffee, and nothing sour or highly seasoned, no unripe fruit or pies made of it; neither ought the mother to indulge in any article which she knows from experience will cause her milk to disagree with the child. The diet should be of the simplest kind; if the child be still at the breast, it should take but little else, and the mother should live on beef, mutton and ham of animal food, and milk or cocoa, bread and butter, potatoes and other vegetables of the most unirritating kind. If the child be weaned, pay strict attention to its diet as above directed. Give it a portion of smoked herring two or three times a week, in the morning for breakfast. Antimonium crud. when the tongue is coated white or yellow; dryness of the mouth with thirst; nausea with vomiting, or gagging and cough; distension of the abdomen with flatulency; offensive, slimy stools; and, frequent passages of water. L 110 PART II. Arsenicum, if the child be very weak, pale and emaciated; inflation of the abdomen; cold extremities; loss of appetite; nausea and vomiting; intense thirst; yellow and watery, white or brownish offensive diarrhoea, which is worse after midnight, towards morning and after eating or drinking. Bryonia, when the diarrhoea comes on in hot weather, and is accompanied by much thirst; vomiting of food; nausea and vomiting after eating; diarrhoea with colic; the stools have a putrid smell, are white or brownish and lumpy. Carbo veg., if Bryonia afford but temporary relief, give Carbo veg., especially if the evacuations be very thin and offensive, and are attended with burning and much pain. Dulcamara. if the complaint return every time the weather gets cool, or takes place after drinking cold water while in a heat; burning thirst for cold water; diarrhcea of a greenish or brownish mucus, worse at night. Ipecacuanha, if given in the commencement of the disease will generally arrest its progress at once. The symptoms which indicate Ipecacuanha are chiefly, nausea and vomiting of ingesta or mucus and bile, attended with TREATMENT OF CHILDREN. 111 diarrhoea of fermented stools of white flocks or tinged with blood; coated tongue, dislike to all food, and raging thirst. Mercurius viv., when the diarrhoea is worse before midnight and is attended with colic, straining at stool, and perspiration; evacuations are scanty, greenish, sour, and attended with nausea and eructations. Nux vomica, if Ipecacuanha should-not be efficacious in arresting the disease at the outset, give one dose of Nux Vomica at night and another next morning. Veratrum, when the weakness from the nausea and vomiting is so great as almost to canse fainting; great exhaustion, vomiting, and diarrhoea; vomiting after swallowing the least liquid; the slightest movement excites vomiting; thirst for cold water; sensitiveness over the pit of the stomach; colic, with burning and cutting pains in the abdomen; loose, brownish, and blackish stools; and, small unnoticed evacuations of liquid faeces. RUPTURE OR HERNIA. Delicate children with feeble constitutions are most liable to this disease. If the child 112 PART II, cries much, and appears to suffer a great deal of pain; if the skin beeomes clammy and yet the child screams without apparent cause, examine its groins, and if swellings are discovered in one or both of them, which were not there before, give a dose of Nux vomica, and send for a homceopathic physician. Rupture of the navel is more common, but less painful, than the variety above mentioned. It can be successfully treated by placing an additional compress, under the belly band, containing in its folds some hard substance like a piece of sheet lead or thick pasteboard. SORENESS BEHIND THE EARS. This affection is a species of excoriation and should be treated in a similar manner. Apply water to the sores as seldom as possible; only washing them in warm water without soap, for purposes of cleanliness; and, mop them dry with a fine linen handkerchief, and powder them with wheaten starch finely pulverised, when there is too much moisture to be absorbed. Give the child, Calcarea carb., Graphites, or Sulphur internally. A dose each night, for TREATMENT OF CHILDREN. 113 two or three nights, and then wait three or four days; if no better, give one of the other remedies in the same way. RUNNING FROM THE EARS. Young children are subject to abscesses, and running from the internal ears. These gatherings are generally preceded by a great deal of pain; the child screams and rolls its head about; starts out of its sleep; sometimes there is considerable fever; it involuntarily puts its hands to the ears, and will not lie down. Chamomilla, Puzlsatilla, and Sulphur, are the appropriate remedies for the pain. Pulsatilla is also applicable, after the running is established. NOCTURNAL URINATION. Constant " wetting the bed," in a majority of instances is the result of disease, although in a few cases, it may be owing to the indulgence in filthy habits. Whipping is a remedy that is frequently applied, but I never knew it to cure a single case. Sepia, will sometimes remove it, but a few L3 114 PART Hf. doses of Silicea will generally effect a permanent cure, when it does not depend on some organic disease. PROLAPSUS ANI. The descent of the rectum, or the " body coming down," as it is termed in domestic language, is generally consequent upon some other disease. It is apt to follow upon long continued dialrrhcea, or an acute attack of dysentery: protracted costiveness also may give rise to it, or it may depend on a state of relaxation of the system, merely. When the bowel is protruded, it can easily be reduced, by lying the child across the lap, and making pressure on the protruded part, with a piece of fine linen cloth, anointed with fresh lard. When it is but an attendant upon another disease, of course that disease must be removed, before the prolapsus can be cured. But when it stands out as a disease by itself, Ignatia or Nux vomica will frequently cure it. TREATMENT OF CHILDREN. 115 WEANING. As a general rule, children should be weaned when they are about eighteen months old. If the mother is weakly, the supply of milk begins to diminish in quantity and deteriorate in quality, or the menses re-appear, the child may be weaned at an earlier period. The progressive development of a child's teeth, may be taken as a sign that the mother's milk may be dispensed with, and that its digestive organs are capable of managing more substantial food. But a child ought not to be weaned, while it is suffering very much from the irritation of teething, or other infantile diseases, unless there are considerations on the part of the mother, which render it necessary. As soon as the teeth begin to make their appearance, a child ought to be gradually accustomed to taking other kinds of nourishment; so that, by the time its jaw teeth come through, it may be able to eat a portion of animal as well as vegetable food. Let it have what is going at table, besides its bread and milk, which should be the staple food. 116 PART II. There is nothing gained to a healthy child by nursing it through the second summer, the say-so of our grandmothers to the contrary notwithstanding. The most suitable seasons of the year for weaning, are March or April, in the spring, and October or November, in the fall. After the process of weaning is decided upon, be not deceived by the plausibility of the theory of doing it gradually, nor of keeping the breast from the child through the day, and of giving it to it through the night; as such a course not only prolongs the sufferings of the child, but also renders the milk unfit for its stomach. Nothing ought to induce a mother except in case of sickness, to give her infant into the hands of another person, however competent she may be to perform the office for a child of her own, for the purpose of weaning. Neither ought a mother to absent herself from home during the trying period; if she really love her offspring, let her extend her sympathy while she maintains sufficient firmness to do what is best for the child. It is grieved at her absence, besides losing its favorite nourishment; and then is doomed to disappointment on her return, which is almost as painful as the first privation. TREATMENT OF CHILDREN. 117.The best, and easiest, method of weaning a child, is to take it to bed as usual, and in nothing depart from the common routine of management, except to withhold the breast. Once denied, let not the child have it again; and in forty-eight hours the whole process so far as the child is concerned will be completed. Give the child the food it is accustomed to, and do not pamper its stomach, with candies and other sweetmeats. After weaning, the child's diet should be simple but sufficiently nourishing; as intimated above, bread and milk should be the staple food, but the farinaceous articles; such as arrow root, tapioca, etc., or mashed potatoes, bread and butter, and occasionally a little beef, mutton, or chicken, may be allowed. After the child is taken from the breast, let the mother abstain from salted articles, to prevent thirst, and as far as she can from fluid nourishment of every sort, in order to diminish the secretion of milk; eat only the driest kind of food, drink nothing but water and that in small quantities. If the breasts be painfully distended with milk, rub them with hot lard, wrap them in raw cotton, and take a dose of Belladonna, or, if that should 118 PART II. not relieve, take a dose of Rhus Tox. In order to get rid of the distension, it is generally necessary, to have the breasts drawn, but let this be done only so far as is necessary to give present relief, and as seldom as possible; increasing the interval between each time of drawing, so as not to encourage the secretion of more milk. Pulsatilla and Rlius Tox, are the best medicines to stop the secretion of milk. LEUCORRHCEA OF CmLDREN. Little girls, from a little neglect, and some other incidental causes, are liable to a discharge of whitish mucus from the vagina, somewhat similar to the leucorrhoea of adults. Frequent ablutions with lukewarm water, will generally remove it in a short time; but if it should not, give a dose of Calcarea carb., two nights in succession, and continue the washings. VACCINATION. This is a purely homoeopathic means of preventing one of the most loathsome diseases, to which the human system is liable-the TREATMENT OF CHILDREN. 119 small pox. Vaccination alone has probably, within the last fifty years-since its general introduction, saved more human life than all other remedial means put together have done in twice that length of timo. It will answer well, to vaccinate a child, at almost any age, but probably about the sixth month, is the best time, as the child is as easy nursed at that age as at any other; and, is less liable to get the pustule broken, from accidental causes, or its own scratching, than when older. It is a matter of great importance, to obtain the virus from a healthy child-one that is free from scrofulous taint, and all other hereditary, and especially cutaneous diseases. When the vaccination is successful, the best means of preventing the development of eruptions after it, is to administer s dose of homceopathic Sulphur, on the evening of the eighth day. INDEX. Abortion, see miscarriage, 58. Acid stomach, 43; diarrhoea of children, 89. Acids, 10. After-pains, 69. Aphthm, 86. Birth, treatment after, 79. Bleeding of the nose, in place of menstruation, 12; of the eyes in children, 85. Blood, spitting of, 8. Body coming down (see prolapsus ani), 114. Bowels, state of, during confinement, 77; menstruation, 18; looseness of, during confinement, 77; in children, 89; costiveness of, during confinement, 77. Breasts, attention to, before confinement, 63; gathered, 76; inflamed,.76; swelling of, in infants, 94. Catarrh, of infants, 85. Cessation ofthemenses,25. Cheerfulness, 5. Children, treatment of, 79. Chlorosis (green sickness), 9. Cholera infantum (summer complaint), 107. Clothing, 5, 35. M Cold, exposure to, 5, 10. Coldness of extremities, 8, 18. Colic, 16, 18; of infants, 90. Confinement, duration of, 78; (see delivery), 65. Constipation, duringmenstruation, 14;' pregnancy, 47; confinement, 77; of children, 88. Convulsions of children, 101. Cookery, compound, 5. Cord (navel string), tying of, 80. Costiveness (see constipation). Cramps, during menstruation, 6,17; pregnancy, 54. Critical stage of life, 25. Crying of infants, 92. Delivery, treatment after, 68; flooding after, 68. Dentition, 96. Despondencyduringpregnancy, 56. Diarrhoea, during menstruation, 8, 18; pregnancy, 48; of children, 89. Diet, 5, 27; during pregnancy, 35; of children after weaning, 73. INDEX. Discharge of menses, dark, coloured and coagulated, 22; bright red, 18; copious, 21; profuse, 22; watery, 22; of a membranous body, 15. Discharge of lochia, 71. Disorders of pregnancy, 37. Dress, 5, 35. SDrinks, stimulating, 5. Ears, running from the, 112; soreness behind the, 113. Elongation of the head, 84. Emotions, mental, during menstruation, 9, 10; pregnancy, 58. Eruptions, on infants, 98; repelled, causing convulsions, 102. Excoriation of nipples, 64; of infants, 94. Exercise, 5; during pregnancy, 36. Eyes and eyelids, inflammation of, in infants, 84; yellowness of, 85. Fainting, during menstruation, 19; and hysteric fits during pregnancy, 57. Falling of the womb (see prolapsus uteri), 31. Fever, milk, 74. Fits, hysteric, 57; (see convulsions), 101. Flooding, after delivery, 68; and miscarriage, 58. Giddiness (vertigo), during menstruation, 6; pregnancy, 39. Green-sickness, (see chlorosis) 9. Griping, during menstruation, 18. Gum (see pimples and eruptions), 98. Head, elongation of, in infants, 84, Headache, during menstruation, 18; pregnancy, 39. Heartburn and waterbrash, 46. Hemorrhoids (piles), 51. Hernia (rupture), 70. Hypochondriasis, 56. Hysteric fits and fainting, during pregnancy, 57; menstruation, 19. Icterus (see jaundice), 87. Icy coldness of extremities, 9, 18. Incontinence of urine, 54, 71. Ineffectual labour pains, 67. Infants, treatment of, 79; reception of, at birth, 79. Inflammation of the eyes of infants, 84; of breasts, 76. Irregular menstruation, 18, 23. Irritability, 19. Itching of the anns, 105; of the nose, 105. Jaundice, 87. INDEX. Labour, 65. Leucorrhcea (whites), 28; of children, 118. Lochia, 71; character of, 71; too long continued, 71; profuse, 71; suppression of, 71. Loins, pain in the, 8. Looseness of the bowels, during menstruation, 8,18; confinement, 77; in children, 89. Lowness of spirits, 56. Meconium, 82. Melancholy, 10, 16, 56. Menses, 2; average quantity of the, 2; cessation of the, 25; dark coloured and coagulated, 18; suppression of the, 10. Menstruation, 1; diarrhoea during, 8, 18; discharge of a membranous body during, 15; painful, 13; too copious, 21; too fre - quent, 19; too late, 19; too long, 23; too scant, 21; too short, 23; too soon, 18; profuse, 19; retarded, too tardy, 3; watery, 20. Mental emotions, 9, 10, 58. Milk, coming of the, 72; fever, 74; profuse secretion of, 74; suppression of the, 74. Mind, emotions of, 9, 10, 58. Miscarriage and flooding, 58. Morning sickness, 42. Nausea, and fainting, during menstruation, 19; and vomiting, during pregnancy, 44. Navel, dressing of the, 82; string, tying of the, 81. Nervous affections during menstruation, 8,14; excitement during pregnancy, 38. Neuralgia during pregnancy, 48. Nipples, excoriated, 64. Nocturnal urination, 113. Noise, intolerance of, during pregnancy, 40. Odontalgia (see toothache, 48. Pain in right side, during pregnancy, 36; in the back and abdomen duringmenstruation, 7,16. Painful menstruation, 15; urination, 55. Piles (see hemorrhoids), 51. Pimples, red (sec gum), 98. Pregnancy, 34; regimen during, 34; diet, 35; dress, 35; exercise, 36; disorders of, 37; bleeding in, 38; toothache during, 48; vertigo and headache, 39. Prolapsus uteri (falling of the womb), 31. Pruritus (itching), 44. INDEX. Quickening, 65. Restlessness of infants, 93. Retention of urine, 55, 88. Ringing and buzzing in the ears, 57. Running from the ears, 113; from the eyes, 85. Rupture (hernia), 111. Sallow complexion, 19. Scurf on the head, 95. Sedentary habits, 5, 9. Show, a, at the beginning of labour, 66. Sleeplessness,during pregnancy, 55; of children, 93. Sniffles, 85. Sore mouth, baby's, 86; nipples, 75. Soreness behind the ears, 112. Spasms, during menstruation, 6; of children, 101. Spasms (see convulsions), 101. Suckling, 75, 83. Summer complaint, 107. Suppression of the menses, 10; of the lochial discharge, 71. Swelling of the lower limbs, 24, 26. Teething (see dentition), 96. Thrush, 86. Toothache during pregnancy, 48. Treatment of children, 79; after delivery, 68. Urine, incontinence of, 36; retention of, after delivery, 71. Urination, nocturnal,jl 13; painful, 55; profuse, of children, 88. Vaccination, 118. Varicose veins, 49. Veins swelled and knotted (see varicose veins), 49. Vertigo and headache, during pregnancy, 39. Wakefulness of infants, 93. Washing the child, 81. Weaning, 115. Wetting the bed, 113. Whites (see leuchorrhea), 28; of children, 18. Womb, falling of the,31. Yellowness of the skin (see jaundice), 87. UNIV. OF DEC 19192 A 575747 UNIVERSITY OF MICHIGAN 9015 05531 5306 s^,,, ý. 'ý, " " - -..-- -.--, - "i I.;:ý"Rý 11;4)-',, ",,t:ý,,-",: " ";::: -ý..- -.... 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