Part 18

4. For the Attack.--Take calomel one-sixth grain tablets; one every fifteen minutes until six are taken, and then follow with two to four teaspoonfuls of epsom salts.

JAUNDICE (Icterus).--A symptom consisting in discoloration by bile pigment of the skin, whites of the eyes, other mucous membranes and secretions.

Causes.--Obstruction of the gall ducts, from gall stones, inflammation, tumor, strictures, from pressure by tumors, and other enlarged abdominal organs.

Symptoms.--The skin and the conjunctiva (red membrane of the eyes) are colored from a pale lemon yellow to a dark olive or greenish black. The itching may be intense, especially in a chronic case. The sweat may be yellow. The stools are a pale slate color, from the lack of bile, and are often pasty and offensive. The pulse is slow. Recovery depends upon the cause. Plain, simple jaundice cases recover in a few days or weeks.

MOTHERS' REMEDIES.--1. Jaundice, Sweet Cider Sure Cure for.--"New cider before it ferments at all. Drink all you can." This is a very simple remedy, but a sure one if taken in the early stages of jaundice. It causes the bowels to move freely and carries off any impurities in the system.

2. Jaundice, Lemon Juice for.--"Take a tablespoonful of lemon juice several times a day." This disease is produced by congestion of the liver, and as lemon is excellent as a liver tonic it is known to be an excellent remedy for jaundice.

3. Jaundice, Peach Tree Bark for.--"Take the inner bark of a peach tree, and make a strong tea, and give a teaspoonful before each meal for five days, then stop five days, and if the patient's indications do not warrant a reasonable expectation that a cure is effected repeat the medicine as above. I never knew of a case in which the above medicine failed to cure. Keep the bowels open with sweet oil."

MOTHERS' REMEDIES for Liver Complaint. Mandrake Root for.--1. "Dry and powder the mandrake root (often called may-apple) and take about one teaspoonful." This dose may be repeated two or three times a day, according to the requirements of the case. This is a stimulant, a tonic and a laxative, and is especially good when the liver is in a torpid and inactive condition.

[128 MOTHERS' REMEDIES]

2. Liver Trouble, Dandelion Root Tea for.--"Steep dandelion root, make a good strong tea of it; take a half glass three times a day." This is a very good remedy as it not only acts on the liver, but the bowels as well. This will always cure slight attacks of liver trouble.

3. Torpid Liver, Boneset Tea for.--"Drink boneset tea at any time during the day and at night. It is also good for cleansing the blood." This is a very good remedy, especially for people who live in a low damp region.

4. Liver Trouble, Mandrake Leaves for.--"A very good remedy to use regularly, for several weeks, is to use from one to three grains of may-apple (mandrake) seed, night and morning, followed occasionally by a light purgative, as seidlitz powder or rochelle salts." This is sure to give relief if kept up thoroughly.

5. Liver Trouble, Mullein Leaf Tea for.--"Mullein leaves steeped, and sweetened. Drink freely." This acts very nicely upon the liver.

PHYSICIANS' TREATMENT for Liver Trouble.--1. For the itching, hot alkaline baths with baking soda in water, or dust on the following:--

Starch 1 ounce Camphor, powdered l-1/2 drams Oxide of Zinc 1/2 ounce

Mix and use as a powder, or use carbolic vaselin locally. Move the bowels with salts and do not give much food for a few days. Use nothing but milk.

2. The following is good to move the bowels when the stool is yellow and costive in a child one year old:

Sulphate of Magnesia 2 ounces Cream of tartar 2 ounces

Mix and give one-half teaspoonful in water every three hours until the bowels move freely. Phosphate of soda in one dram doses every three hours is good.

3. Severe Type and Epidemic Form.--Give one to two drops of tincture myrica cerifera (barberry) every two hours for an adult. This I know to be very good.

4. The common simple kind of jaundice will get well readily by moving the bowels freely and keeping the patient on light food.

CATARRHAL JAUNDICE. (Acute catarrhal angiocholitis).--Jaundice caused by obstruction of the terminal portion of the common duct, by swelling of the mucous membrane.

Causes.--This occurs mostly in young people. It follows inflammation of the stomach or bowels, also from emotion, exposure, chronic heart disease. It may be epidemic.

[DIGESTIVE ORGANS 129]

Symptoms.--Slight jaundice preceded by stomach and bowel trouble. Epidemic cases may begin with chill, headache and vomiting. There may be slight pain in the abdomen, the skin is light or bright yellow, whites of the eyes are yellowish, pain in the back and legs, tired feeling, nausea, clay colored stools. Pulse is rather slow, liver may be a little enlarged. It may last from one week to one to three months.

PHYSICIANS' TREATMENT for Catarrhal Jaundice.--1. Restrict the diet if the stomach and bowels are diseased. Sodium phosphate may be given one teaspoonful every three hours to keep the bowels open. Drink large quantities of water and with it some baking soda one-half to one teaspoonful in the water.

2. If you have calomel you may take one-tenth of a grain every hour for four hours, and then follow with the sodium phosphate in one-half teaspoonful doses every two to three hours, until the bowels have fully moved, or epsom salts, two to four teaspoonfuls. Keep in bed if there is a fever or a very slow pulse say of forty to fifty.

GALL STONES. (Biliary Calculi, Cholelithiasis).--Cases of gall stones are rare under the age of twenty-five years. They are very common after forty-five, and three-fourths of the cases occur in women. Many people never know they have them. Sedentary habits of life, excessive eating and constipation tend to cause them. They may number a few, several, or a thousand, or only one.

Symptoms.--There are usually none while the stones are in the gall bladder, but when they pass from the gall bladder down through the (channel) duct into the bowel they often cause terrific pain, especially when the stone is large. Chill, fever, profuse sweating and vomiting, which comes in paroxysms or is continuous. The pain may be constant or only come on at intervals. The region of the liver may be tender, the gall bladder may be enlarged, especially in chronic cases and very tender. In some cases the pain comes every few weeks and then may be scattered, sometimes seeming to be in the stomach, and then in the bowels, or in the region of the liver. When a person has such pains and locates them in the stomach or bowels, and they come periodically, every week or two or more, he ought to be suspicious about it being gall stones, especially if the symptoms do not show any stomach trouble. If the stone is large and closes the common duct, jaundice occurs; the stools are light colored; the urine contains bile. The attacks of pain may cease suddenly after a few hours, or they may last several days or recur at intervals until the stone is passed. The stones may be found in the bowel discharges after an attack. Death may occur from collapse during an attack.

MOTHERS' REMEDIES.--1. Gall Stones, Sweet Oil for.--"Massaging the part over the region of the liver lightly night and morning is very good, following by drinking a wineglassful of sweet oil at bedtime." The patient should take some good cathartic the next morning, such as a seidlitz powder or cream of tartar. Teaspoonful in glass of water each morning. This treatment should be continued for several weeks and is very effective.

[130 MOTHERS' REMEDIES]

2. Gall Stones, Tried and Approved Remedy for.--"Drink about a wineglass of olive oil at bedtime followed in the morning by a cathartic, as seidlitz powder, or cream of tartar and phosphate of soda; teaspoonful each morning in wineglass of water. This treatment to be pursued several weeks. Massage the part over the liver lightly night and morning. If the suffering is intense use an injection of thirty drops of laudanum to two quarts of water." In many cases the cathartic may not be needed as the olive oil will move the bowels freely. Massaging the parts over the liver will cause it to work better and has proven successful in many cases.

PHYSICIANS' TREATMENT for Gall Stones.--1. For the pain. Morphine must be used and by the hypodermic method; one-fourth grain dose and repeated, if necessary, and chloroform given before if the pain is intense, until the morphine can act. Fomentations can be used over the liver.

2. Soda.--The bowels must be kept open by laxatives, Sodium Phosphate or Sodium Sulphate, (Glauber's) salt.

3. Olive Oil.--Olive oil is used very extensively. I do not know whether it does any good; some people think it does. From two to ten ounces daily, if possible. The phosphate or sulphate of sodium should be taken daily in one to two teaspoonfuls doses each day. Some claim these salts prevent formation of gall stones.

4. Powder for the Itching.--For the intolerable itching you may use the following powder, dust some of it over the skin:

Starch 1 ounce Zinc Oxide 1/2 ounce Camphor 1-1/2 drams

Mix into a powder.

Diet.--This must be thoroughly regulated. The patient should avoid the starchy and sugar foods as much as possible. He or she should also take regular exercise. If a person afflicted with gall stones keeps the stomach and bowels in good condition, they will be better. Pure air, sunshine, exercise, and diet are big factors in the treatment of chronic diseases. A woman so afflicted should not wear anything tight around the stomach and liver, corsets are an abomination in this disease; olive oil if taken must be continued for months.

Surgery.--The operation is indicated when the patient is suffering most of the time from pain in the liver region or when the person is failing in health, or during an acute attack. When there are symptoms of obstruction or when there is fever, sweating shows that there is pus in the gall bladder. Also an operation is then necessary, and in most cases it results satisfactorily.

[DIGESTIVE ORGANS 131]

CANCER OF THE GALL BLADDER, AND BILE DUCTS. Causes.--It usually occurs between forty and seventy years of age. The cases that originate here show no percentage in either sex; but those that appear here as secondary cancers are three times as frequent in women as in men. Chronic irritation by gall stones is an important cause. They are hard to diagnose and, of course, fatal in the secondary kind. For the primary kind early complete removal may cure if you can get at them.

CIRCULATORY DISTURBANCES OF THE LIVER. (Acute Hyperemia or Congestion).--This occurs normally after meals, and in acute infections, diseases, etc.

CHRONIC CONGESTION OR NUTMEG LIVER.--This is due to an obstruction of the blood circulation in the liver by chronic valvular heart disease with failure of heart action. Lung obstruction in the trouble called Emphysema, Chronic Pneumonia, etc., may cause it. The cut section of a liver shows an appearance like a nutmeg, due to a deeply congested central vein and capillaries. In a later stage the liver is contracted, central liver cells are shrunk and the connective tissue is increased.

ACUTE YELLOW ATROPHY. (Malignant Jaundice).--This is fortunately a rare disease. There is rapid progress, and it is fatal in nearly all cases. The liver is very small and flabby. The symptoms are many and are hard to differentiate. You must depend upon your physician. The only thing for him to do is to meet the symptoms and relieve them if possible.

CIRRHOSIS OF THE LIVER. (Sclerosis of the Liver, Hobnail Liver, Gin Drinkers Liver, Hard Liver).--This occurs most often in men from forty to sixty years old. It is not uncommon in children.

Cause.--It is usually due to drinking of alcohol to excess, especially whisky, brandy, rum or gin. The liver is small and thin; hard, granular, white bands run through it and press on the liver cells and destroy them.

Symptoms.--These are few as long as proper circulation in the heart is maintained. Fatty cirrhosis is often found in post-mortems. The first symptoms are the same as those accompanying chronic gastritis, dyspepsia, They are:--Appetite is poor, nausea, retching and vomiting, especially in the morning; distress in the region of the stomach, constipation or diarrhea. These increase and vomiting of blood from the stomach may occur early and late. Bleeding from the stomach and bowels, etc., cause the stools to look like tar. Nosebleed and piles are common and profuse; bleeding may cause severe lack of blood. The epigastric and mammary veins are enlarged. Ascites (dropsy in the abdomen) usually occurs sooner or later and may be very marked, and it recurs soon after each tapping. The feet and genital organs may be oedematous (watery swelling), jaundice is slight and does not occur until late. During the late stage the patient is much shrunken, face is hollow, the blood vessels of the nose and cheeks are dilated, abdomen is greatly distended. Delirium, stupor, coma or convulsions may occur at any time.

[132 MOTHERS' REMEDIES]

PHYSICIANS' TREATMENT for Cirrhosis of the Liver.--It is usually fatal; sometimes even after temporary improvements. No coffee or alcohol; simple diet, bitter tonics, keep bowels open, A physician must handle such a case.

ABSCESS OF THE LIVER. Hepatic Abscess: Suppurative Hepatitis.--This is a circumscribed collection of pus in the liver tissue. If there is only one abscess it is in the larger lobe in seventy per cent of the cases. The amount of fluid contained in such an abscess may be two or three quarts and its color varies from a grayish white to a creamy reddish-brown; when the abscess is caused by a type (amebic) of dysentery, there is generally only one abscess, occurring more often in the right lobe, whereas other forms due to septic infection give rise to many abscesses.

Causes.--This disease is rare even in tropical climates. When it is excited by gall stones, it is invariably septic in character and the infecting material reaches the interior through the liver vessels or bile passages. Stomach ulcers, typhoid fever, appendicitis, may bring on such an abscess. Pus wounds of the head are sometimes followed by a liver abscess. The most common method of infection is through the portal vein. Other causes that may be mentioned are foreign bodies traveling up the ducts, as round-worms and parasites.

Symptoms.--Hectic temperature, pain, tenderness, and an enlarged liver, and often slight jaundice. In acute cases the fever rises rapidly, reaching 103 or 104 in twenty-four hours. It is irregular and intermittent, and it may be hectic, that is, like the fever of consumption. Shakings or decided chills frequently are present with the rise of fever and when the fever declines there may be profuse sweating. The skin is pale and shows a slight jaundice, the conjunctiva being yellowish. Progressive loss of strength with disturbance of the stomach and bowels is present. The bowels are variable and constipated and loose. Dropsy of the abdomen (Ascites) may develop, on account of pressure on the big vein, inferior vena-cava. Lung symptoms, severe cough, reddish-brown expectoration are often present.

THE ABSCESS.--May break into the pleural cavity, bronchial tubes, lungs and stomach, bowels, peritoneum or through the abdominal wall.

Recovery.--The result is unfavorable as it generally goes on to a rapid termination. The abscess should be opened and evacuated when its location can be detected. The death rates ranges from fifty to sixty per cent.

Treatment.--Open it if you can, Sponge liver region with cool water. For the pain, mustard poultices, turpentine stupe or hot fomentations prove beneficial. Keep up strength by stimulation and quinine.

[DIGESTIVE ORGANS 133]

Diet in Liver Troubles sent us from Providence Hospital (Catholic), Sandusky, Ohio:

May Take--

Soups--Vegetable soups with a little bread or cracker, light broths.

Fish--Boiled fresh cod, bass, sole or whiting, raw oysters.

Meats--Tender lean mutton, lamb, chicken, game, (all sparingly).

Farinaceous--Oatmeal, hominy, tapioca, sago, arrowroot (well cooked), whole wheat bread, graham bread, dry toast, crackers.

Vegetables--Mashed potato, almost all fresh vegetables (well boiled), plain salad of lettuce, water-cress, dandelions.

Desserts--Plain milk pudding of tapioca, sago, arrowroot or stewed fresh fruit (all without sugar or cream), raw ripe fruits.

Drinks--Weak tea or coffee (without sugar or cream), hot water, pure, plain or aerated water.

Must Not Take--

Strong soups, rich made dishes of any kind, hot bread or biscuits, preserved fish or meats, curries, red meats, eggs, fats, butter, sugar, herrings, eels, salmon, mackerel, sweets, creams, cheese, dried fruits, nuts, pies, pastry, cakes, malt liquors, sweet wines, champagne.

ACUTE GENERAL PERITONITIS. (Inflammation of the Peritoneum, Lining of the Abdominal Cavity).--Causes. Primary; Occurs without any known preceding disease, and is rare. Secondary; Occurs from injuries, extension from inflamed nearby organs, such as appendicitis or infection from bacteria, without any apparent lesion (disease of the bowel). Perforation causes most of the attacks of peritonitis. Peritonitis may accompany acute infections or accompany chronic nephritis, rheumatism, pleurisy, tuberculosis and septicemia. Peritonitis occurs from perforation of the bowel in typhoid fever also, and it frequently occurs after appendicitis and sometimes after confinement.

Symptoms.--This is often the history of one of the causes mentioned above, followed in cases with perforation or septic disease by a chill or chilly feeling and pain, varying at first, with the place where the inflammation begins. The patient lies on his back, with the knees drawn up, and the body bent so as to relax the muscles of the abdomen, which are often rigidly contracted,--stiff at first on the side where the pain starts. The pain may be absent. The abdomen becomes distended, tympanitic (caused by gas). An early symptom is vomiting and it is often repeated. There is constipation; occasionally diarrhea occurs. The temperature may rise rapidly to 104 or 105 and then become lower; it is sometimes normal. The pulse is frequent, small, wiry and beats 100 to 150 per minute; the breathing is frequent and shallow. The tongue becomes red and dry and cracked. Passing the urine frequently causes pain; sometimes there is retention of urine. The face looks pinched, the eyes are sunken, the expression is anxious, and the skin of the face is lead colored or livid. Hiccoughs, muttering, delirium or stupor may be present.

[134 MOTHERS' REMEDIES]

Recovery, Prognosis, etc.--The action of the heart becomes weak and irregular, respiration is shallow, the temperature taken in the rectum is high, the skin is cold, pale and livid, death occurs sometimes suddenly, usually in three to five days; less often thirty-six to forty-eight hours; or even after ten days. The results depend mainly upon the cause of the inflammation, and the nature of the infection, infectious disease that produces it, being usually very bad after puerperal sepsis (after confinement), induced abortion, perforation of the bowel or stomach, or rupture of an abscess.

LOCAL PERITONITIS.--This may come from local injury, but it is usually secondary to empyema, tuberculosis, or cancer, abscess, perforation of the stomach or bowel, ulcer, etc.

Symptoms.--Onset is usually sudden. There is sudden local pain, increased by any movements; tenderness, and vomiting; then chills, irregular fever, sweating, difficult breathing, emaciation.

TREATMENT OF THE ACUTE PERITONITIS.--There must be absolute rest, morphine by hypodermic method, one-fourth to one-half grain to relieve the pain. Ice cold and hot fomentations with some herb remedy like hops, smartweed, etc.; or cloths wrung out of hot water with five to ten drops of turpentine sprinkled on them. This is very good when there is much bloating from gas.

The turpentine should be stopped when the skin shows red from it. The cloths should not be heavy or they will cause pain by their weight. Ice water can be used when cold cloths are needed.

For vomiting.--Stop all food and drink for the time and give cracked ice.

Diet.--Should be hot or cold milk with lime water or peptonized milk if necessary. If the feeding causes vomiting, you must give food by the rectum. For the severe bloating enemas containing turpentine should be given, one to two to six ounces of water used with ten to thirty drops of turpentine in it; sometimes it is necessary to resort to surgery.

TUBERCULAR PERITONITIS.--This may occur as a primary trouble or secondary to tuberculosis of the bowels, lungs, and Fallopian tube. It is most frequent in males between twenty and forty.

[ DIGESTIVE ORGANS 135]

Symptoms.--These are variable. It may occur like acute peritonitis with sudden onset of high fever, pain, tenderness, bloating, vomiting and constipation; these symptoms passing into those of chronic peritonitis. Often there are gradual loss of strength and flesh, low and irregular fever; frequently the temperature goes below normal with a little ascites tympanites, constipation, diarrhea and masses in the abdomen which consist of the omentum (apron covering the bowels) rolled up and matted into a sausage-shaped tumor in the upper part of the abdomen, or of thickened or adherent coils of the bowel, enlarged mesentric lymph nodes, etc. Spontaneous recovery may occur, or the course of the disease may resemble that of a malignant tumor.

Treatment.--If there is effusion and few adhesions, cutting in and removing the fluid may help. In other cases good nourishing diet with cod liver oil is best.

ASCITES. (Hydroperitoneum. Abdominal Dropsy).--This is an accumulation of serous fluid in the peritoneal cavity. It is but a symptom of disease.

Local Causes.--Chronic peritonitis, obstruction of the portal (vein) circulation as in cirrhosis of the liver, cancer or other liver disease, from heart disease, tumors, as of the ovaries or enlarged spleen. All these mentioned may produce this dropsy.

General Cause.--Heart disease, chronic nephritis, chronic malaria, cancer, syphilis, etc.

Symptoms.--Gradual increasing distention of the abdomen, causing sometimes a sense of weight, then difficulty of breathing from pressure. The abdomen is distended, flattened at the sides unless it is very full. The skin may be stretched tense, superficial veins are distended. The navel may be flat or even protrude and around it the vessels may be greatly enlarged. There is fluctuation when you tap sharply at one side, while holding your hand on the other side you feel a wavy feeling.

PHYSICIANS' TREATMENT for Ascites.--First treat the disease causing it. Sometimes it is necessary in order to prolong life to repeatedly tap the patient as in cirrhosis of the liver. When it is caused by the heart or kidneys, give cathartics that carry away much liquid, hydragogue cathartics. One dram of jalap at night followed by a big dose of salts before breakfast. Cream of tartar and salts are good, equal parts. Or cream of tartar alone, one to two drams, with lemon juice in water in repeated doses. Digitalis and squill, of each one grain to cause great flow of urine. Infusion of digitalis is also good to increase flow of urine, when the heart is the real cause of the ascites. These treatments take the liquids away through the proper channels, the bowels and kidneys.

[136 MOTHERS' REMEDIES]