Part 10

TRICHINIASIS (Trichinosis).--The disease is caused by the trichina spiratis, a parasite introduced into the body by eating imperfectly cooked flesh of infected hogs. The "embryos" pass from the bowel and reach the voluntary muscles, where they finally become "encapsulated larvae,"--muscle trichinae. It is in the migration of these embryos that the group of symptoms known as trichiniasis is produced.

When the flesh containing the trichinae is eaten by man or by any animal in which the development can take place, the capsules are digested and the trichinae are set free. They pass into the small intestine and about the third day attain their full growth and become sexually mature. The young produced by each female trichina have been estimated at several hundred. The time from the eating of the flesh containing the muscle trichinae to the development of the brood of embryos in the intestines (bowels) is from seven to nine days. The female worm penetrates the intestinal wall and the embryos are probably discharged into the lymph spaces, thence into the venous system, and by the blood stream to the muscles, which constitutes their seat of election. After a preliminary migration in the inter-muscular connective tissue, they penetrate the primitive muscle- fibres and in about two weeks develop into the full grown muscle form. In this process interstitial inflammation of the muscle is excited, and gradually an ovoid capsule develops about the parasite. Two, and occasionally three or four, worms may be seen within a single capsule. This process of encapsulation has been estimated to take about six weeks. Within the muscles the parasites do not undergo further development. Gradually the capsule becomes thicker and ultimately lime salts are deposited within it. This change may take place in man within four or five months. The trichinae may live within the muscles for an indefinite period. They have been found alive and capable of developing as late as twenty or twenty-five years after their entrance into the system. These calcified capsules appear as white specks in the muscles. In many instances however these worms are completely calcified. In the hog the trichinae cause few if any symptoms. An animal, the muscles of which are swarming with living trichinae, may be well nourished and healthy looking. An important point also is the fact that in the hog the capsule does not readily become calcified, so that the parasites are not visible as in the human muscles.

Modes of Infection.--The danger of infection depends entirely upon the mode of preparation of the flesh. Thorough cooking, so that all parts of the meat reach the boiling point, destroys the parasites; but, in larger joints, the central portions are not often raised to this temperature. The frequency of the disease in different countries depends largely upon the habits of the people in the preparation of pork. In North Germany, where raw ham and wurst are freely eaten, the greatest number of instances have occurred. In South Germany, France, and England cases are rare. Salting and smoking the flesh are not always sufficient, and the Havre experiments showed that animals are readily infected when fed with portions of the pickled or the smoked meat as prepared in this country.

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Symptoms.--The eating of trichinous flesh is not always followed by this disease.

In the course of a few days after eating the infected meat there are signs of disturbance of the stomach and bowels, and pain in the abdomen, loss of appetite, vomiting and sometimes diarrhea; and yet, these preliminary symptoms do not always occur, for in some of the large epidemics cases have been observed in which they have been absent. Pain in different parts of the body, general debility and weakness have been noted in some of the epidemics. In some instances the stomach and bowel disturbances have been so marked from the outset that the attack resembled our cholera. The invasion symptoms develop between the seventh and tenth day. Sometimes not until the end of the second week, and they are marked by fever, a chill in some cases and pain and swelling and tenderness along the muscles involved. The migration of the parasites into the muscles excites a more or less intense inflammation of these muscles, which is characterized by pain on pressure and movement, and by swelling and tension of the muscles, over which the skin may be swollen. The limbs are placed in some position in which these muscles are more at rest. Difficulty in chewing and swallowing is caused by the involvement of the muscles controlling these acts. In severe cases the involvement of the diaphragm and intercostal muscles may lead to difficult breathing (Dyspnoea) which sometimes proves fatal. Watery swelling, a feature of great importance, may be seen early in the face, particularly about the, eyes. Later it develops in the extremities when the swelling and stiffness of the muscles are at their height. Profuse sweats, tingling and itching of the skin and in some instances hives (Urticaria) have been described.

There are emaciation and anemia. In the severe cases the appearance may be like that in the third week of typhoid fever. In mild cases the fever and muscular symptoms subside in ten to fourteen days, in others only after two or three months. The mortality, from one to thirty per cent, seems to depend upon the virulence and number of parasites.

PHYSICIANS' TREATMENT.--If discovered within twenty-four to thirty-six hours, thoroughly empty the bowel with purgatives. Rhubarb and senna, or an occasional dose of calomel may be given. Relieve the pains afterwards and support the strength.

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DISEASES OF THE SKIN.

The skin is divided into three layers. Beginning with the outer one and naming inward, they are named as follows: The outer layer is called the epidermis or cuticle (near or upon the skin). The second layer is called the corium, derma cutis vera, or true skin. The third layer is called the sub-cutaneous (under the skin) (fatty or connective) tissue. This last layer contains the sweat glands, the lower end of the deep-seated hair follicles, (little sacs containing the roots of the hair) and larger branches of the lymphatics, blood vessels and nerves, and serves in general as a bed for the true skin to rest upon, and by which the true skin is connected with the deeper parts, muscles, etc. The appendages of the skin are the hair, nails, sebaceous and sweat-glands. The discharge from the sweat-glands form a little or larger tumor. The contents of a wen are from sebaceous glands--fat secretions--fat tumor. The following names are frequently mentioned in the skin diseases:

Macule. (Spots, patches). Skin is altered in color, but the skin is not raised or depressed; freckle, etc.

Papule. (Pimple). Elevated piece of skin, varying in size from a pin-head to a coffee bean.

Tubercle. (Node-lump). A solid elevation of the skin, varying in size from a pea to a cherry.

Tumors. These are soft or firm elevations of the skin, like a wen or hard lump. They are always deep-seated.

Wheel. A round flat, white or pink elevation of the skin; such as hives, mosquito bites, etc.

Vesicle. This is a pin-head or pea-sized elevation of the outer layer (epidermis) filled with a watery fluid.

Bleb. (Bulla). A circumscribed elevation of the skin and contains a watery fluid, such as a burn, etc.

Pustule. A rounded elevation of the outer layer (epidermis) of varying size, containing pus (matter).

A vesicle, bleb, and pustule are hollow; macule, papule, and tubercle are solid.

Scale. (Squama). This is a dry attached or unattached thin piece from the skin as a result of disease of the skin.

Crust. This is a dried mass as a result of fluid oozing from a diseased skin.

Excoriation. Like a scratch mark.

Fissures. This is a crack, like that found on chapped hands.

Ulcer. (Sore). Eating away of the parts.

Scar. Ulcer healed leaving a mark, like from a healed cut.

Pigmentation. Discoloration.

ACNE. (Simple Acne).--This is an inflammation of the sebaceous (fatty, cheesy) glands. It forms these pimples or pustules and these are intermingled with black-heads (comedones), flesh-worms. They vary from a pin-head to a split-pea in size, and are of a bright or dark red color. They occur for the most part on the face; also on the back, neck and chest.

Condition.--An over secretion, or alteration and retention of the fatty (sebaceous) matter, and this is followed by inflammation involving the glands, ducts of the glands, and hair follicles. Pus often forms and tissue may be destroyed.

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Causes.--These skin glands are active at the time of puberty. The active cause may be the stomach troubles, constipation, womb disorders, and poor general nutrition.

PHYSICIANS' TREATMENT for Acne.--All stomach troubles, constipation, and womb troubles should be looked into and remedied. The diet and hygiene must be regulated. Food that stimulates and is hard to digest should be prohibited. When there is dyspepsia and constipation, bitter tonics, like compound tincture of gentian, one dram before meals, or pepsin (five grains) and loosening medicines like salts should be given.

Tincture of Nux Vomica is a good stomach and bowel tonic given in doses of one to two drops before meals.

Calomel, one-half grain at night for a few nights, followed in the morning by epsom salts or some mineral water like Abilena or Hunjadi is useful. The following is a good combination by Dr. Schalek:

Tincture of Nux Vomica 2 drams Dilute Nitro Muriatic Acid 4 drams Sherry Wine enough for 3 ounces

Mix and take one teaspoonful three times a day.

Diet.--See diet for dyspepsia and constipation. All fatty, greasy, rich foods are prohibited.

Local Treatment.--If the skin is quite red and tender, mild soothing applications should be used. Most cases require vigorous treatment. First wash the parts with warm water and the best soap, rinse with hot water and then dry carefully. Remove the black-heads by careful pressure of the fingers, or with black-head extractor; the pimples and pustules should be freely cut, to allow the matter to escape and all the matter taken out.

External Medication, Ointment and Lotions.--Lotions are to be preferred in cases of oily discharge. If the skin becomes rough and chapped, soap should not be used in washing, and a soothing ointment should be applied. Drugs used are for stimulating the skin and healing the lesions.

1. Soothing Ointment.--

Precipitated Sulphur 1 dram Benzoinated Lard 1/2 ounce Lanolin 1/2 ounce

For local use but not in oily cases. (Dr. Schalek.)

2. The following used as a soothing lotion:

Washed Sulphur 2-1/2 drams Spirits of Camphor 3 drams Biborate of Sodium 2 drams Glycerin 6 drams Distilled water enough for 4 ounces

Mix and shake well and apply freely so as to leave a film on the face. (Dr. Schalek.)

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3. Dr. Duhring's Lotion, following:

Precipitated Sulphur 2 drams Glycerin 2 drams Alcohol 1 ounce Lime water 1 ounce Rose water 2 ounces

Mix and shake before using and apply.

4. Kummerfield's Lotion. "Oriental Lotion."

Precipitated Sulphur 4 drams Powdered Camphor 10 grains Powdered Tragacanth 20 grains Lime water 2 ounces Rose water 2 ounces

Mix; shake well and apply every few hours.

5. Stimulating preparations.

Corrosive sublimate 1/2 to 2 grains Emulsion bitter almonds 4 ounces

Mix thoroughly and use to stimulate the skin.

6. Ointment of white precipitate (five to fifteen per cent strength) can be used in place of one above.

7. The Following Hebra Lotion (I give as written).

Hydrarg. Bichlor 1 dram Aqua Distill 4 drams Ov. Albuminis 3 drams Succi Citri 3 drams Sacchari 1 ounce

Mix and apply as directed.

Caution.--Sulphur and mercury preparations should not be used at the same time, nor immediately succeeding each other, as they will stain the skin.

BALDNESS. (Alopecia). Causes.--Hereditary and diseases. Congenital and senile (old age) baldness is incurable. Congenital (born without hair) baldness is rare.

MOTHERS' REMEDIES. 1. Baldness, Well Recommended for.--"A first class hair restorative is made of sage tea and whisky in equal parts with a dash of quinine in the bottle."

2. Baldness, Vaselin and Quinine for.--

"Vaselin 1 ounce Quinine 1/2 ounce"

Mix together and apply to the scalp.

3. Baldness, Good Canadian Remedy for.--"Strong sage tea. Rub the scalp frequently. I have used this with great success."

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PHYSICIANS' TREATMENT for Baldness.--Persons who have an hereditary tendency to baldness should pay close attention to the hygiene of the scalp, as this is very important. The hair should be shampooed two or three times a week, to remove sebaceous accumulations and other foreign materials. After the scalp has been thoroughly rinsed with clean water and dried, some oil or (tube) vaselin should be rubbed in, Fine-toothed combs should never be used, The daily wetting of the hair is injurious, Rats should be light and well aired, When the hair begins to fall, stimulating applications should be used, in the form of ointments or lotions. The following are among the best with the author's name given but in English instead of Latin.

Dr. Schalek. 1.

Bichloride of Mercury 3 grains Tinct. of Cantharides 1/2 ounce Oil of Sweet Almonds 1 dram Spirits of Rosemary 1 ounce Rectified Spirits of Wine 2 ounces Distilled water enough to make 6 ounces

Mix; shake bottle well; rub thoroughly into the scalp every morning.

2. Carbolic add 15 grains Glycerin 2 drams Cologne water 1 ounce

Mix, and apply to the scalp once daily.

3. Precipitated Sulphur 1 dram Lanolin 2-1/2 drams Glycerin 2-1/2 drams Rose water enough to make 1 ounce

Mix well. Part the hair in different places and rub ointment into the scalp.

4. Ihle's Mixture.--

Resorcin 1-1/2 drams Castor Oil 1-1/2 ounces Spirits of Wine 5 ounces Balsam Peru 10 drops

Mix. Rub into the scalp daily with a piece of flannel.

5. Bulkley's Lotion.--

Tincture Cantharides 1/2 ounce Tincture Capsicum 1/2 ounce Castor Oil 1 dram Cologne Water 1 ounce

Mix and apply daily to the scalp.

6. Lassar's Ointment.--

Pilocarpine Muriate 30 grains Vaseline 5 drams Lanolin 2 ounces Oil of Lavender 20 drops

Mix and apply to the scalp.

BALD PATCHES. (Alopecia Areata).--These appear rather suddenly. They are circular bald patches which may appear on any hairy part of the body, but more frequently on the scalp. It is considered a chronic trouble, but tends to final recovery.

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Cause.--Occurs usually between the ages of ten and forty. It may be from a parasite.

PHYSICIANS' TREATMENT.--Cod-liver oil, elixir quinine, iron and strychnine one dram three times daily. Arsenic, Fowler's solution, four drops three times daily.

Local Treatment.--Stimulating remedies, like sulphur, tar, tincture of cantharides, capsicum, in various strength in combination such as given for baldness. In old persons it may become permanent.

ANIDROSIS. (Lessened Sweat Secretion).--This means a diminution of the sweat secretion. The patient does not sweat enough, especially in certain skin diseases like psoriasis, etc.

Treatment.--Hot water, vapor baths, friction, massage, etc., should be used to increase the sweat secretion. Treat the accompanying skin disease.

FOUL SWEATING. (Bromidrosis). Symptoms.--The odor may be very disagreeable, or resemble the odor of certain flavors or fruits. It is generally found in the arm-pit and genital organs.

MOTHERS' REMEDIES. 1. Offensive Sweating, Alum Water for.--"A wash made with a teaspoonful of alum and a quart of water will prevent offensive sweating. We all know how disagreeable it is to sit near a person in a street car or any crowded place, who has an odor of perspiration about them, How easy it would be to use this wash and rid yourself of this difficulty,"

2. Sweaty Feet, Borax and Alcohol for.--"Dissolve a tablespoonful of powdered borax in half a pint of diluted alcohol (half alcohol, half water) and rub the feet at night, You will find this a splendid remedy." I

3. Sweating, Simple Home Remedy to Produce.--"Place a rubber sheet or blanket under the patient. Have a simple blanket soaking in hot water and when all is ready, wring blanket as dry as possible and wrap about the patient up to the neck. After this a dry blanket is wrapped around the patient. Care should be taken not to have the blanket hot enough to burn the patient, but not too cool. After a few minutes the patient is taken out, rubbed dry gently and left to rest and sleep." This treatment will be found very beneficial and inexpensive.

PHYSICIANS' TREATMENT for Foul Sweating.--Frequent bathing, dressing powders of boric and salicylic acids, etc.

1. Salicylic Acid 1/2 ounce Powdered Starch 1/2 ounce

Mix and dust on the parts.

2. Boric acid powdered may also be used.

3. Powdered Boric Acid and Salicylic Acid; Equal parts.

To be used as a dusting powder on the sweating parts.

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3. One per cent solution of potassium permanganate or permanganate of potash is good applied to the parts.

CALLOSITY or Callositas.--This is circumscribed yellowish-white, thickened and horny patches of one of the layers of the cuticle (epidermis).

Causes--They come as the result of the occupation or pressure, and sometimes without any seeming cause.

Symptoms.--They occur mostly on the hands and feet and are usually sensitive.

PHYSICIANS' TREATMENT, for Callosity or Callositas.--Remove the cause of the horny masses. The latter is done by soaking them with prolonged hot water baths and scraping off the mass afterwards. This should be continued and done frequently.

Salicylic Acid 30 grains Collodion 4 ounce

Mix and apply with a camel's hair pencil.

CORNS. (Calvus).--A small, flat, deep-seated, horny growth, mostly on or between the toes.

Cause.--Usually the result of too tight or too loose shoes. Due to pressure and rubbing.

MOTHERS' REMEDIES.--Corns, one of the Surest Remedies.--"Take salicylic acid, make a thick paste with flour, put on absorbent cotton and apply, leaving same on several days; soak well and corn will come out." This is a thoroughly tried remedy and a good one. This is about as good a cure as there is for corns. After this paste has been on the corn for three days, it should be removed and the feet soaked well, and the corn scraped off.

2. Corns, Turpentine and Kerosene for.--"A very simple remedy is to apply turpentine or kerosene oil to the affected part on going to bed." It is always a good plan to soak the feet well before treating the corn, as the turpentine will penetrate more quickly.

3. Corns, to Remove Without Pain.--

"Alcohol 1/2 ounce Muriatic Acid 1 dram Nitric Acid 1 dram Oil of Rosemary 1 dram Chloroform 2 drams Tincture Iron 2 drams

Mix the above, and apply freely to the corn with little brush or feather until it can be removed with thumb lance. It may require several applications."

4. Corns, Onion a Cure for.--"Soak a small onion in vinegar four hours, then cut in two and bind on the corn at night. In the morning (if the onion has remained over the corn) the soreness will be gone and you can pick out the core. If not cured in first application repeat."

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5. Corns, Castile Soap an Effective Remedy for.--"Rub the corn night and morning with castile soap, as often as possible shave it, being careful not to cut deep enough to make it bleed." Be faithful in soaping it thoroughly night and morning for several days until it disappears. This is a very simple but effective remedy.

6. Hard Corns, Iodine a Successful Remedy for.--"Paint the corns with iodine every night for three nights, stop three nights, then apply three nights again, and so on for two weeks." Have tried this and know it to be very successful, especially good for hard corns.

7. Corns, Castor Oil for.--"Apply castor oil; rub it thoroughly, then soak feet. It will soften and remove corns."

8. Corns, Vinegar and Bread for.--"Take bread and soak in vinegar for twenty-four hours, put a plaster on for three or four nights. If not cured on first application, repeat."

PHYSICIANS' TREATMENT for Corns.--Remove the cause; soften them by prolonged soaking in hot water, and then gently scrape off the softened particles, continue this for several days; then put a narrow strip of rubber or salicylated plaster (adhesive plaster) over to protect them from pressure. The following is good to soften them:

1. Salicylic Acid 1-1/2 dram Extract of Cannabis indica 10 grains Collodion 1 ounce

Mix and paint on the corn for several days and after soaking corn scrape it off with a sharp knife.

2. A Good but Weaker Remedy:-

Salicylic Acid 30 grains Extract of Cannabis indica 5 to 10 grains Collodion 1/2 ounce

Both of these prescriptions are good, the first being stronger with salicylic acid.

3. When the corns are soft with inflammation, wash and dry the foot and apply a solution of nitrate of silver, sixty to one hundred and twenty grains to the ounce of water, to every part every four or five days.

Ulcerating Corns.--Cauterize with nitrate of silver in stick form.

CARBUNCLE. (Anthrax).--A carbuncle is an acute circumscribed inflammation of the skin and tissues beneath, of the size of an egg, orange, or larger. It is a hard mass and ends in local death of some of the tissue and formation of pus, which empties upon the surface through several sieve-like openings.

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Symptoms.--There is a feeling of general sickness, chilliness and some fever. The skin over the sore part is hot and painful. The several dead parts may run together until the entire mass separates in a slough. In favorable cases it proceeds to heal kindly, but in severe cases it may spread to the surrounding tissues and end fatally, sometimes by the absorption of putrid materials, or by the resulting weakness. It runs usually from two to five weeks.

Causes.--It comes in middle or advanced life, usually oftener in men than in women. It occurs frequently in patients suffering from diabetes, in whom it is usually fatal.

MOTHERS' REMEDIES. Carbuncles, Poppy Leaves to Draw and Ripen.--"A poultice of poppy leaves is very efficacious to draw or ripen a carbuncle." A poultice made from these leaves is very quieting and soothing, and at the same time will cause the carbuncle to ripen.

2. Carbuncle, Slippery Elm and Sassafras Root for.--"Sassafras root and slippery elm bark boiled together and the decoction thickened with cornmeal." This should be changed as often as it becomes cool.

3. Carbuncle, Sheep Sorrel Poultice for.--"Gather a bunch of sheep sorrel leaves, wrap them in a cabbage leaf and roast in the oven. Apply to the carbuncle, and it will soon ripen and break."

4. Carbuncle, Bread and Milk Poultice for.--"Keep warm bread and milk poultice on until the core comes out, then put on salve or vaselin and keep covered until all healed."

5. Carbuncle, the Common Scabious for.--"Take scabious, the green herb and bruise it. Apply this to the affected part. This has been found a very effectual remedy." The common field scabious have many hairy, soft, whitish green leaves, some of which are very small and rough on the edges, others have hairy green leaves deeply and finely divided and branched a little. Flowers size of small walnut and composed of many little ones. Sometimes called "Morning Bride," "Devil's Bit," etc.

6. Carbuncle, Snap Bean Poultice for.--"Apply snap bean leaves beat up fine. Bruise the leaves until they are real fine, then apply as a poultice."

PHYSICIANS' TREATMENT for Carbuncles.--Keep up the strength by a nourishing diet and in some cases, stimulants.

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