{"1": {"fulltext": "", "height": "4400", "width": "2748", "jp2-path": "humanmachineitsc00mcve_0001.jp2"}, "2": {"fulltext": "Qass 3\\\\C 6\\\\", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0002.jp2"}, "3": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0003.jp2"}, "4": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0004.jp2"}, "5": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0005.jp2"}, "6": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0006.jp2"}, "7": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0007.jp2"}, "8": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0008.jp2"}, "9": {"fulltext": "THE\\nH uman M achine\\nITS\\nCARE and REPAIR\\nOR HOW TO\\nDEVELOP THE BODY, PRESERVE THE HEALTH, MEET\\nEMERGENCIES, NURSE THE SICK\\nAND TREAT DISEASE\\nBY TWELVE AUTHORS\\nEdited by W. E. McVEY, B.S., M.D.\\nJHmUU\u00c2\u00a9TM\u00c2\u00aeTlEJn)\\nTopeka, Kansas\\nHERBERT S. REED\\n*%9", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0009.jp2"}, "10": {"fulltext": "EIVED.\\nLibrary of Congret*\\nOffice of t\\nfleglster of Copyrights\\nc\\n49864\\nEntered According to the Act of Congress in the Year 1899,\\nBy HERBERT S. REED,\\nIn the Office of the Librarian of Congress at Washington.\\nALL RIGHTS RESERVED.\\nTO BE SOLD BY SUBSCRIPTION.\\nSECOND COPY,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0010.jp2"}, "11": {"fulltext": "Introduction.\\nNATURE produces diseases and their antidotes. The pharmacist\\nprepares and compounds, but the physician alone interprets\\nsymptoms, seeks out their causes and devises the cure. Un-\\nless sure of his remedy, it is as criminal to give it to a beggar as to\\na prince.\\nMan is the epitome of nature, and has all its elements within\\nhim. Its forces are constantly acting upon him, but he may react\\nand make them subservient to his will. Observing the relations of\\ncause and effect, he is king; but, failing in this, they become his\\nmaster, inflicting as penalties all manner of diseases become a\\nmonster that accepts no excuses and knows no mercy, but for broken\\nlaw wreaks vengeance on the innocent and the vicious alike, making\\nthem victims of infinite ills and of the hordes of parasitic life.\\nThat wisdom is better than rubies has gone unchallenged for\\nthirty centuries, until to-day the proverb is doubly true, for the\\nwisdom of the present includes more perfect knowledge of the causes\\nand control of diseases than was attained in any age of all the past.\\nAs a correct use of the facts now known to science would prevent\\nmost cases of sickness, and annually save millions of lives, how\\nimportant that the masses be taught until everywhere the incanta-\\ntions of the voodoo shall give way to germicides, the darkness of\\nsuperstition to the light of biology flooding the world.\\nTo remain in the front rank of the world s benefactors, the physi-\\ncian, too, must add to the sum of useful knowledge in terms that can\\nbe understood. All that a man hath will he give for his life, and\\nhe should no longer be barred from knowing himself, from acquir-\\ning the best possible knowledge of physiology and hygiene, and from\\nlearning to outwit and destroy the micro-organisms that would make\\nhim their prey.\\nTo meet these demands is only a part of the purposes of this\\nbook, for it has also become imperative that the profession and the\\nlaity should better understand each other. The doctor has stood\\naloof from the people too long, to their anxious inquiries has replied\\nin an unknown tongue, and mystified what should have been made\\nplain, until it is not wholly his own fault that the average individual\\n3", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0011.jp2"}, "12": {"fulltext": "4 INTRODUCTION.\\nknows less of himself than of almost everything else. You may\\ndoubt this statement, or say that it is not true, but the trainloads of\\npatent dopes, the worse than worthless nostrums marketed annually,\\nand the golden harvests gathered all the year by advertising char-\\nlatans, prove that it is true; and that many of our commonwealths,\\nthough providing liberally for the quarantine of cattle and hogs,\\nproverbially fail to appropriate or legislate for the adequate protec-\\ntion of human life, emphasizes the density of the ignorance pre-\\nvailing, even among the generally well informed, as to the causes\\nof disease and premature death.\\nEducation is the only remedy. Encourage study. Disseminate\\nknowledge. Let all be informed upon sanitation and the nature of\\nthe more common maladies, and there will come ability to discern\\nbetween quackery and skill, between the false and the true. And\\nthe physician s usefulness will keep pace, always, with the advance.\\nIndeed, it is only where there is this intelligence that he can have the\\nunswerving confidence of the patient and his friends, that cooperation\\nin emergencies, so essential to the highest success in long and\\ndesperate combats with disease.\\nParents!. We also have a message for you. No longer assume\\nthat there is any virtue in ignorance. In a proper way teach the boys\\nand girls, while they are yet innocent and pure, the purposes of each\\norgan, the meaning of awakening instincts, the mysteries of pro-\\ncreation, and the fearful retributions following misuse of the\\nsexual powers, instead of leaving them to acquire fragmentary or\\nvicious ideas from impure companions, and, perhaps, to become\\nhelpless victims of the vile.\\nThe several departments have been prepared by separate authors\\nwho are well known to have had special experience in their chosen\\nfields. To these physicians our best thanks are due for their generous\\nand able assistance.\\nA strictly scientific classification has not been attempted. As far\\nas possible, plain, simple language has been used, and technical terms\\navoided. It is not expected that anyone, not possessed of special\\nknowledge and experience, will attempt to treat the more serious\\nforms of disease, but that the information here given will prove most\\nvaluable in preventing sickness, in accidents and other emergen-\\ncies, and by enabling all to better cooperate with the physician in his\\nbest efforts to save life. If the work adequately meets, as we\\ntrust it will, the needs of those for whom it was written, we shall not\\nconsider that our long and laborious task has been in vain.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0012.jp2"}, "13": {"fulltext": "Aatf)ors.\\nIda C. Barnes, A.B., M.D., member of the American Medical Association; Alumnae\\nAssociation of the Women s Medical College of Pennsylvania; Western Surgical\\nand Gynecological Association; Kansas Medical Society; Ex-President of the\\nTopeka Academy of Medicine and Surgery; Resident Physician of the Woman s\\nHospital of Philadelphia, 1S90-91; Surgical Lecturer to the Woman s Medical\\nCollege of Kansas City.\\nLouis C. Duncan, M.D., Professor of Anatomy, Kansas Medical College; Late Assis-\\ntant Surgeon U. S. Volunteers.\\nB. D. Eastman, M.D., State Superintendent of the State Insane Asylum, Topeka,\\nKansas; Professor of Materia Medica and Therapeutics and of Psychiatry,\\nKansas Medical College; member of the American Medico-Psychological\\nAssociation.\\nJoseph T. Lovewell, Ph.D., late Professor of Chemistry, Washburn College;\\nChemist of the Kansas State Board of Health.\\nRobert S. Magee, M.D., Secretary and Professor of Physiology, Kansas Medical\\nCollege; Secretary of the Topeka Academy of Medicine and Surgery.\\nJohn C. McClintock, A.M., M.D., President and Professor of Principles and Practice\\nof Surgery, Kansas Medical College; Surgeon-in-Chief Christ s Hospital, Topeka,\\nKansas.\\nRichard E. McVey, M.D., Professor of Dermatology and Venereal Diseases and of\\nClinical Medicine, Kansas Medical College.\\nWilliam E. McVey, B.S., M.D., Professor of Laryngology, Rhinology and Diseases\\nof the Chest, Kansas Medical College; Editor of the Medical Monograph;\\nformerly Editor of the Kansas Medical Journal; Secretary of the Kansas\\nMedical Society.\\nJohn E. Minney, A.M., M.D., Professor of Diseases of the Eye and Ear, Kansas\\nMedical College; member of the American Medical Association.\\nTheodore W. Peers, Ph.B., M.D., Professor of the Diseases of Children, Kansas\\nMedical College; member of Kansas Medical Society and of the Topeka\\nAcademy of Medicine and Surgery.\\nW. L. Schenck, A.M., M.D., Ex-Vice-President of the American Medical Association;\\nEx-President Kansas Medical Society; late Professor of Hygiene and Preven-\\ntive Medicine, Kansas City Medical University and Kansas Medical College.\\nAlfred C. Sloan, D.D.S., Professor of Oral and Dental Surgery, Kansas Medical\\nCollege.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0013.jp2"}, "14": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0014.jp2"}, "15": {"fulltext": "Contents.\\nSANITATION.\\nCHAPTER I.\\nThe Cell Heredity The Principles of Hygiene Camp Life\\nWhere to Camp How to Camp Personal Habits While\\nCamping\u00e2\u0080\u0094 Home Life Healthy Homes Where to Build or\\nChoose a Home How to Build How to Grade How to\\nOrnament 21\\nCHAPTER II.\\nExercise Its Purposes and Value Active Exercise Nerve\\nForce Will Force Passive Exercise Exercise in Child-\\nhood Its Best Forms Correct Positions The Gymnasium\\nRest L Tissue Building in Children Moral Trend of Exer-\\ncise Development of Heart and Lungs Exercise versus\\nCorsets Outdoor Life Bicycling, Its Advantages and Dis-\\nadvantages Proper Saddles and Adjustments Left-handed\\nPeople The Athlete College Athletics 30\\nCHAPTER III.\\nGerm Life and Its Relation to Disease Infections Contagions\\nHow Diseases Are Spread Air-borne Diseases Water-\\nborne Diseases The Meaning of Cleanliness Precautions\\nPreventives 49\\nCHAPTER IV.\\nAir Its Composition Nitrogen Oxygen Density, Humidity,\\nTemperature, Air Currents, Altitude, Climate Their Influ-\\nence Upon Health Atmospheric Contaminations Carbu-\\nretted Hydrogen Carbon Monoxide Sewer Gas Organic\\nand Inorganic Dusts Ventilation Quantity of Air Needed\\nby One Person Standard of Purity Sources of Supply\\nVentilating Shafts Ventilation of Schoolrooms Injuries\\n7", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0015.jp2"}, "16": {"fulltext": "8 CONTENTS,\\nWrought by Poisonous Air Novel Methods of Ventilating\\nRelation Between Ventilation and Fuel 52\\nCHAPTER V.\\nWater Importance of Pure Water Sources of Supply Sedi-\\nmentation Filtration Modern Sand Filters The Agency\\nof Bacteria in Purifying Water How Rapidly Water Can Be\\nFiltered Value of Filtered Water Filter Galleries Other\\nWays of Purifying Water Nitrification Oxidation Sun-\\nlight Heat Distillation Will Water Freeze Pure Worth-\\nless Filters How to Filter Drinking Water Rain Water\\nHow to Filter Rain Water How to Build Cisterns How to\\nTest Water for Impurities Bathing Extent of Bathing in\\nAncient Times The Roman Baths When and How to\\nBathe Drv Baths Vapor Baths Sea Baths Swimming.\\n65\\nCHAPTER VI.\\nDiet W r ays in Which Foods Serve the Body Why a Mixed Diet\\nIs Necessary to Health Nitrogenous Foods Non-nitrogen-\\nous Foods Inorganic Foods What Salt Does for the Body\\nWhat Magnesia and Lime Do Beverages Advantages\\nand Disadvantages of Alcoholic Drinks The Diet in Health\\nAmount of Food Needed Daily by the Average Man\\nVoight s Investigations Table Showing the Composition of\\nFoods Heat Producing Foods Tissue Producing Foods\\nTable Showing the Relative Cost of the Various Kinds of\\nFood Balanced Rations and Bills of Fare How Long It\\nTakes to Digest Food Beaumont s Table How to Aid Di-\\ngestion 80\\nCHAPTER VII.\\nThe Teeth Diseases of the Teeth Importance of Intelligent Care\\nof the Teeth How to Preserve the Temporary Teeth The\\nDental Arch Root Absorption The Causes of Deformed\\nTeeth Common Errors Regarding the First Teeth Should\\nLoose Teeth Be Extracted How to Secure to a Child a\\nFaultless Set of Perfect Teeth Tooth Powders Mouth\\nWashes Salivary Calculus or Tartar The Daily Care of the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0016.jp2"}, "17": {"fulltext": "CONTENTS. 9\\nTeeth The Teeth During Sickness and Pregnancy How to\\nControl Toothache 91\\nCHAPTER VIII.\\nStimulants and Narcotics Alcohol The General Effects of Alco-\\nholism Physiological Changes Wrought by It in the Stom-\\nach, Liver, Heart, Kidneys and Brain Tobacco The Ele-\\nments of Which It Is Composed Their Effects Upon the\\nVarious Organs Their Influence Upon the Mind Plow to\\nOvercome the Tobacco Habit Opium and Morphine\\nTheir Action and Effects Upon the Human Body The Cure\\nof the Opium Plabit 96\\nCHAPTER IX.\\nDisinfection and Disinfectants The Objects of Disinfection\\nDiscoveries by Pasteur The Causes of Disease When to\\nApply Disinfectants The Principles of Disinfection Dilu-\\ntion Changes in Temperature Sunlight Chemical Dis-\\ninfectants Carbolic Acid Cresol Solutol Tricresol and\\nCreolin Corrosive Sublimate Lime Chloride of Lime\\nSoap and Soda Sulphur Formaldehyde How to Make\\nDisinfecting Solutions What Disinfectants to Use How to\\nUse Them To Protect Homes To Disinfect Rooms Cot-\\nton and Linen Clothing Woolen Clothing Bedding Mat-\\ntresses Furniture Rugs and Carpets Furs and Skins\\nBoots and Shoes Excreta Privy Vaults Water Closets\\nSputa Corpses The Mouth and Throat of the Attendant\\nThe Clothing of the Nurses and Physician How to Make\\nHome Healthy Drainage Without Sewers Disposition of\\nRubbish Patent Disinfectants no\\nMATERIA MEDICA.\\nExplanations The Terms Employed General Tonics Heart\\nStimulants Antipyretics Antiseptics Emetics Diuretics\\nCathartics Purgatives Chologogues Hydrogogues\\nThe Safest Cathartics and How to Take Them Hypnotics\\nAnthelmintics Miscellaneous Remedies Weights and\\nMeasures The Administration of Medicines Medicinal", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0017.jp2"}, "18": {"fulltext": "10 CONTENTS.\\nDose List How to Ascertain Doses for Children of Differ-\\nent Ages 125\\nNURSING.\\nImportance of Good Nursing The Nurse The Physician s Or-\\nders Personal Care of the Patient How to Bathe the Sick\\nThe Care of the Bed How to Change Sheets The Draw-\\nsheet Bed Sores How to Prevent Them How to Cure\\nThem The Sick Room Its Location, Ventilation, Temper-\\nature and Furniture The Care of Infectious Diseases The\\nCare of Contagious Diseases The Disinfection of Corpses\\nWhen Public Funerals Are Unsafe How to Observe Symp-\\ntoms The Preparation of Foods The Degrees of Heat Re-\\nquired to Properly Cook Different Kinds of Food The Diet\\nin Wasting Diseases The Diet in Diseases of the Stomach\\nand Bowels The Administration of Food Rectal Feeding\\nBills of Fare for the Convalescent 155\\nEMERGENCIES.\\nCHAPTER I.\\nPoisoning Knowledge of Poisons Modern Uses of Poisons\\nClasses of Antidotes Quantity of Poison That Will Cause\\nDeath Special Poisons Sulphuric Acid Hydrochloric or\\nMuriatic Acid Nitric Acid The Alkalies: Caustic Soda\\nand Caustic Potash Ammonia Arsenic: Fowler s Solu-\\ntion, Rough on Rats, Fly Poisons, Paris Green, London Pur-\\nple, Arsenical Wall Papers, Arsenical Colored Candies, Im-\\npure Subnitrate of Bismuth Lead Lead Acetate or Sugar\\nof Lead, Lead Subacetate or Lead Water, Lead Carbonate or\\nWhite Lead Mercury: Mercuric Chloride, Mercurous\\nChloride, Bichloride of Mercury or Corrosive Sublimate, Red\\nOxide of Mercury or Red Precipitate, Sulphide of Mercury\\nor Vermilion Phosphorus 175\\nCHAPTER II.\\nAconite, Monk s Hood, Wolf s Bane, Blue Rocket Belladonna,\\nAtropine Stramonium, Thorn Apple, Jimson Weed\\nHyoscyamus, Hen s Bane Hydrocyanic Acid, Prussic", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0018.jp2"}, "19": {"fulltext": "CONTENTS. 11\\nAcid Conium, Poison or Spotted Hemlock Opium: Ex-\\ntract of Opium, Dover s Powder, Tincture of Opium, Pare-\\ngoric, Morphine, Codeine Cupric Sulphate or Blue Vitriol,\\nVerdigris or Copper Acetates Cocaine Nicotine Strych-\\nnia, Nux Vomica Digitalis, Foxglove Chloral, Chloral\\nHydrate Carbolic Acid Phenol. Zinc Chloride Iodine\\nPoison Ivy, Poison Oak Mushrooms The Ptomains Tur-\\npentine Objects Swallowed 184\\nCHAPTER III.\\nAccidents Drowning Asphyxia How Soon Death Occurs\\nHow to Get the Water Out the Lungs How to Restore\\nBreathing Satterthwaite s Method Sylvester s Method\\nStimulants Plow to Treat Suffocation Frost Bites Sun-\\nstrokes, Heatstrokes Burns and Scalds Extent to Which\\nOne May Be Burned and Recover Lightning and Electric\\nShocks Bites and Stings of Insects, Spiders, Tarantulas, Etc.\\nHow to Relieve the Pain The Bites of Serpents The\\nDangerous Snakes of North America Their Poison Appa-\\nratus How to Use Intoxicants in Treating Snake Bites\\nHydrophobia Its Symptoms in Dogs Its Symptoms in\\nMan Popular Errors The Dangers from Using a Mad-\\nstone What to Do When Bitten by a Rabbid Animal The\\nPasteur Treatment Principles Upon Which It Depends. 194\\nBACTERIA.\\nThe Discovery of Bacteria How They Grow and Multiply The\\nGerm Causation of Disease The Henle and Koch Laws\\nAntitoxin Treatments Definitions Spores and Their Tenac-\\nity of Life Universal Prevalence of Bacterial Germs How\\nBacteria Produce Disease The Causes of Fermentation and\\nPutrefaction How Wounds May Be Made to Quickly Heal.\\n209\\nMINOR SURGERY.\\nThe Triumphs of Modern Surgery Pus Germs Surgical Cleanli-\\nness\u00e2\u0080\u0094The Temporary Dressing of Wounds The Control\\nof Hemorrhage The Permanent Dressing of Wounds\\nFractures Sprains Dislocations Bruises Hernia or Rup-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0019.jp2"}, "20": {"fulltext": "12 CONTENTS.\\nture Hernia in Children Hernia in Adults How to Secure\\na Perfectly Fitting Truss Strangulated Hernia Rectal Pro-\\nlapsus and Procidentia 217\\nGENERAL DISEASES.\\nCHAPTER I.\\nIntroduction The Stomach, Its Construction, Size and Muscular\\nMovements Digestion and Its Processes Mastication\\nSaliva The Gastric Juices The Work Performed in the\\nDuodenum The Pancreatic Fluid The Bile How the\\nVarious Nutrients Find Their Way Into the Blood Indiges-\\ntion How to Find the Cause of a Digestive Trouble Im-\\nproper Methods of Eating and Drinking A Cause of Big\\nAbdomens Inaction of the Stomach Chronic Dyspepsia\\nUlcer of the Stomach Cancer of the Stomach Constipation\\nAcute Diarrhea Treatment for Adults Treatment for\\nInfants Chronic Diarrhea Dysentery Cholera Morbus\\nColic Intestinal Obstruction Sea Sickness Appendicitis\\nand Typhlitis Peritonitis, Inflammation of the Bowels. .235\\nCHAPTER II.\\nTyphoid Fever Malarial Fever Influenza, La Grippe, Grip\\nDiphtheria, Membranous Croup Variola, Small-pox Vac-\\ncinia, Cow-pox Yellow Fever 259\\nCHAPTER III.\\nThe Liver Its Size, Shape and Position What It Does for the\\nBody Its Mechanism, Sensitiveness and Liability to Disease\\nAcute Congestion of the Liver Chronic Congestion\\nBiliary Concretions, Hepatic Colic or Gall Stones Icterus or\\nJaundice 306\\nCHAPTER IV.\\nRheumatic Fever or Acute Rheumatism Chronic Rheumatism\\nMyalgia or Muscular Rheumatism\u00e2\u0080\u0094 Rheumatoid Arthritis or\\nDeforming Rheumatism Gout Diabetes Obesity or Cor-\\npulence Acute Nephritis or Bright s Disease Nephrolith-\\niasis, Gravel or Kidney Stone Contracted Kidney The\\nDropsies 317", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0020.jp2"}, "21": {"fulltext": "CONTENTS. 13\\nCHAPTER V.\\nThe Heart Anatomy and Physiology The Blood Of What It\\nIs Composed\u00e2\u0080\u0094 What Its Red Cells Do\u00e2\u0080\u0094 What Its White Cells\\nDo Incorrect Ideas Regarding the Heart Children Who\\nAre Born with Defective Hearts Pericarditis Endocarditis\\nMalignant Endocarditis Diseases of the Valves Hyper-\\ntrophy or Enlargement of the Heart Dilatation Heart\\nFailure Rupture of the Heart Degenerations of the Heart\\nTissues Palpitation Angina Pectoris Diseases of the\\nBlood and Blood Vessels Aneurism Varicose Veins Ar-\\nteriosclerosis-\u00e2\u0080\u0094 Anemia Chlorosis or Green Sickness. .342\\nCHAPTER VI.\\nThe Lungs Anatomy and Physiology Sighing, Hiccoughing,\\nCoughing, Sneezing Bronchitis, Cold in the Chest or Cold\\non the Lungs Chronic Bronchitis Asthma or Bronchial\\nAsthma Pneumonia or Lung Fever Broncho-pneumonia\\nConsumption, Consumption of the Lungs Pulmonary\\nConsumption, Phthisis, Pulmonary Phthisis or Tuberculosis\\nof the Lungs Pleurisy Empyema 358\\nCHAPTER VII.\\nThe Nose and Throat The Causes of Colds The Prevention of\\nColds Acute Rhinitis, Coryza or Cold Chronic Rhinitis or\\nCatarrh of the Nose The Catarrh of Childhood Catarrh in\\nAdults Dry Catarrh Common Catarrh Adenoid Growths\\nThe Pharynx, Palate, Uvula, Fauces and Tonsils Diseases\\nof the Pharynx Enlarged Tonsils Follicular Tonsilitis\\nPharyngitis, Sore Throat The Voice The Larynx or Voice\\nBox The Epiglottis The Vocal Cords How to Control\\nthe Voice in Singing or Public Speaking Diseases of the\\nLarynx 381\\nCHAPTER VIII.\\nThe Eye and Ear\u00e2\u0080\u0094 How We See and Hear The Eye Twitch-\\ning Eyelids Bright Flashes Lumps in the Eyelids Sties\\nConjunctivitis Contagious Diseases of the Eye Pterigium\\nCateract How to Find the Cause of an Eye Trouble\\nEpiphora Photobia Crabs Ulcers Infantile Sore Eyes", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0021.jp2"}, "22": {"fulltext": "14 CONTENTS.\\nSlight Ailments of the Eye Dirt, Pieces of Cinder or Steel,\\nor Other Foreign Bodies in the Eye Things Not to Be Done\\nto the Eye The Light of Schoolrooms How to Tell When\\nthe Eyes Need Glasses.\\nThe Ear The External, the Middle and the Inner Ear Can\\nDeafness Be Cured Incorrect Ideas About the Ear Ear-\\nache Boils in the Ear Ear Remedies How to Get Ker-\\nnels, Insects or Other Foreign Bodies Out the Ear Things\\nNot to Do 400\\nCHAPTER IX.\\nIntestinal Parasites The Tape Worm How It Reproduces Its\\nKind The Egg, Embryo, Larva, Cyst, Hydatid How to\\nProtect Domestic Animals How Tape W 7 orms Enter the\\nHuman Body Their Quick and Enormous Growth The\\nAge to Which They Live Their Wonderful Fecundity The\\nReal Danger Not from the Worms Ascaris Lumbricoides or\\nRound-worms The Most Common and Next to the Largest\\nIntestinal Parasites The Thread-worm, Seat-worm or Pin-\\nworm Trichina Spiralis The Bladder-worm The Gid-\\nworm Precautions How the Danger Is Increased by Rats\\nand Dogs Fertilizers Which Should Never Be Applied to\\nPastures and Gardens 418\\nDISEASES OF CHILDREN.\\nCHAPTER I.\\nInfancy A Healthy Child Color at Birth Size and Weight\\nShape and Proportions Maternal Impressions Malforma-\\ntions Birth-marks Training Age at Which Discipline\\nShould Begin Nursing Its Regularity and Frequency\\nQuantity of Milk Required How to Increase or Diminish\\nthe Mother s Milk How to Change Its Quality Where the\\nBaby Should Sleep How Much and in What Positions It\\nShould Sleep The Frequency, Temperature and Duration\\nof Its Bath How It Should Be Bathed Defecation Im-\\nportance of Regularity, and How It May Be Secured The\\nRight Temperature for a Baby Improper Ways of Warming\\na Child Exercise When and Where to Be Taken. .431", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0022.jp2"}, "23": {"fulltext": "CONTENTS. 15\\nCHAPTER II.\\nInfant Feeding Artificial Foods Why Cows Milk Is Unsuitable\\nfor an Infant s Food How to Modify It Artificial Diges-\\ntion Digestive Tablets Peptonizing Compounds Objec-\\ntion to the Use of Predigested Milk How to Find a Milk\\nthat Will Agree with the Baby Cereals and Lime Water\\nAge at Which an Infant Should First Have Starchy Food\\nCondensed Milk Its Defects The Dangers from Its Use\\nCereal Foods Partly Digested by Cooking Cooked Cereals\\nwith Condensed Milk Added Beef Juice W hite of Egg\\nWhey How to Feed to Aid Digestion How to Create a\\nRelish for Any Nutritious Food Sterilized Milk Pasteur-\\nized Milk Flints Upon the Preparation of Food Flow Long\\nan Infant Should Be in Taking Its Meals.\\nDentition Condition of the Teeth at Birth Disorders Associated\\nwith Teething Age at Which the Various Deciduous Teeth\\nAppear Precautions Required Early Care of the Teeth\\nThe Permanent Teeth 442\\nCHAPTER III.\\nStomatitis Its Catarrhal, Ulcerative, Aphthous and Gangerous\\nForms Thrush Spasmodic Croup Acute Dyspepsia\\nGastralgia or Gastric Fever Harmless Vomiting Danger-\\nous Vomiting Vomiting as a Symptom of Disease Evacu-\\nations of the Bowels Appearances of the Feces Indicating\\nDiseased Conditions of the Bowels Meaning of Blood in the\\nFeces Colic Constipation The Diarrheas Catarrhal In-\\nflammation of the Intestines Summer Complaint Cholera\\nInfantum 452\\nCHAPTER IV.\\nScarlet Fever Rubeola or Measles Rotheln or German Measles\\nVaricella or Chicken-pox Parotitis or Mumps Pertussis\\nor Whooping Cough Scrofula Richitis or Rickets 473\\nOBSTETRICS.\\nCHAPTER I.\\nPreliminary Considerations Who Should Not Marry Mental\\nand Physical Fitness Pelvic Anatomy Pelvic Deformities\\nThe Organs of Generation The Uterus, Fallopian Tubes,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0023.jp2"}, "24": {"fulltext": "16 CONTENTS.\\nOvaries The Relation of Ovulation and Menstruation Fer-\\ntilization of the Ovum Why the Child Partakes of the Char-\\nacteristics of Both Parents Stages of the Embryo and Fetus\\nDegree of Development in Each Month of Pregnancy 493\\nCHAPTER II.\\nThe Changes in the Maternal Organism Caused by Pregnancy\\nThe Diagnosis of Pregnancy The Relative Value of the\\nSigns of Pregnancy Maternal Impressions The Duration,\\nHygiene and Management of Pregnancy Conditions of the\\nUterus and Its Appendages Complications During Preg-\\nnancy^-Disorders of the Nervous System Nausea and\\nVomiting Infectious Diseases During Pregnancy 506\\nCHAPTER III.\\nAbortion Its Causes and How to Avoid Them Extra-uterine\\nPregnancy Diseases of the Fetus Management of the Fetus\\nNormal Labor Preparation of the Room Preparation of\\nthe Bed Preparation of the Patient Other Safety Meas-\\nures The Care of the Mother -The Care of the Child The\\nDiet of the Mother Nursing the Child Artificial Feeding\\nThe Child s Clothing 525\\nCHAPTER IV.\\nConvalescence Effects of Childbirth Puerperal Infection\\nChild-bed Fever Failure of the Uterus to Return to Its Nor-\\nmal Conditions Incontinence of Urine Nervous Compli-\\ncations Sore Nipples Abscess of the Breast Changes in\\nthe Milk When to Wean the Child Weight Respiration\\nDigestional Secretions Development of the Nervous\\nSystem Pathology 544\\nDISEASES OF WOMEN.\\nCHAPTER I.\\nHeredity Changes That Can Be Wrought by Physical Culture\\nThe Girl Her Diet Clothing Sexual Development\\nMental Development Menstruation Retarded Puberty\\nMalformation of the Ovaries Malformations of the\\nUterus Chlorosis 561", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0024.jp2"}, "25": {"fulltext": "CONTENTS. 17\\nCHAPTER II.\\nThe Active Period of Life Its Characteristics and Diseases Con-\\ntrasts in Masculine and Feminine Development The Femi-\\nnine Brain and Nervous System Woman s Recuperative\\nPower Sexual Instinct The Danger from Uncontrolled\\nPassion Natural and Sexual Selection The Relations of\\nthe Sexes 57 2\\nCHAPTER III.\\nGeneral Means Employed in the Treatment of Disease The Uses\\nof Water Electricity Exercise Rules for Muscular Exer-\\ncise for Failure of Menstruation Rules for Exercise for Dis-\\ncharges of Blood Between the Regular Periods Swedish\\nMovements Massage Diet in Disease Fluid Diet\\nForced Feeding Vegetable Diet The Spare Diet The\\nDiet for Obesity The Diet for the Aged The Power of\\nMind Over Disease 579\\nCHAPTER IV.\\nDerangements of Menstruation Hemorrhage Nervous Exhaus-\\ntion Derangements of the Sexual Functions Acute In-\\nflammation of the Pelvic Organs Chronic Inflammation of\\nthe Pelvic Organs Metritis Endometritis Cervicitis\\nCongestion of the Ovaries Chronic Ovaritis Inflammation\\nof the Fallopian Tubes 592\\nCHAPTER V.\\nDisplacements of the Uterus Anteversion Anteflexion Retro-\\nversion Retroflexion Prolapsus Diseases of the External\\nGenitals Vulvitis Pruritis or Itching of the Vulva Hyper-\\nesthesia Vaginitis Uterine Fibroids, or Tumors of the\\nUterus Cancer 606\\nCHAPTER VI.\\nDiseases of the Urinary Organs Neuralgia of the Bladder In-\\ncontinence, or Lack of Power to Retain Urine Paralysis of\\nthe Bladder Organic Diseases of the Bladder Congestion\\nof the Bladder Hemorrhage from the Bladder Cystitis, or", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0025.jp2"}, "26": {"fulltext": "18 CONTENTS.\\nInflammation of the Bladder Various Abnormal Conditions\\nThe Menopause Inflammation of the Uterus After the\\nChange in Life Falling of the Uterus Complete Prolapsus\\nDilatation of the Pelvic Veins .617\\nDISEASES OF THE SKIN.\\nCHAPTER I.\\nAnatomy of the Skin The Scarf Skin The Papulary and Retic-\\nular Layers of the True Skin Subdermic Tissue The Oil\\nGlands The Sweat Glands The Blood Vessels of the Skin\\nThe Muscles of the Skin Pigmentation Terms Em-\\nployed in Describing Skin Diseases 629\\nCHAPTER II.\\nDiseases of the Sebaceous Glands Comedo, Black Heads, Flesh\\nWorms Milium, Grutum Steatoma, Wens Seborrhea\\nAcne Vulgaris Psoriasis Lichen Planus Urticaria, Nettle\\nRash, Hives Flerpes Simplex, Fever Blisters Herpes Zos-\\nter, Shingles Miliaria Rubra, Prickly Heat Papilloma\\nVerruca, Warts Eczema, Tetter, Salt Rheum Dermatitis,\\nInflammation of the Skin Drug Eruptions Erythema Sim-\\nplex Erythema Intertrigo, Chafing Erythema Multiforma,\\nBlush Pediculosis, Louisness Head Lice Body Lice\\nCrabs Scabies, Itch Cimex Lectularius 633\\nCHAPTER III.\\nTinea Trichophytina, Ring-worm T. Capitis, Ring-worm of\\nthe Scalp, Scald Head T. Circinata, Ring-worm of the Body\\nT. Sycosis, Ring-worm of the Face, Barber s Itch T.\\nCruris, Ring-worm of the Crotch and Axilla T. Unguium,\\nRing-worm of the Nails Chilblains Clavi, Corns Bun-\\nions Onyxis, Ingrowing Nail Onychia, Run-around\\nWhitlow, Felon Nevus Pigmentosus, Mole Furuncles,\\nBoils Carbuncles Anthrax, Malignant Pustule Erysipe-\\nlas Lentigo, Freckles Chloasma, Liver Patches Disorders\\nof the Sweat Glands Anidrosis, Defective Sweat Hyperi-\\ndrosis, Excessive Sweat Bromidrosis, Offensive Sweat\\nPruritus Ani, Itching Piles 659", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0026.jp2"}, "27": {"fulltext": "CONTENTS. 19\\nCHAPTER IV.\\nThe Hair Its Component Parts The Follicle The Root\\nSheath Color Curl Care of the Plair Hair Tonics\\nHair Dyes- Alopecia, Baldness Premature Alopecia\\nSenile Alopecia Alopecia Areata 681\\nVENEREAL DISEASES.\\nIntroduction Syphilis, Pox Gonorrhea, Clap Masturbation,\\nOnanism, Self-abuse, Self-pollution Seminal Losses. .687\\nDISEASES OF THE NERVOUS SYSTEM.\\nCHAPTER I.\\nIntroductory Inanimate Machinery The Human Machine\\nThe Nervous System Gray and White Matter Cerebro-\\nspinal Axis, Cranial and Spinal Nerves\u00e2\u0080\u0094 Nerve Terminals-\\nSubdivisions of the Brain The Cerebrum The Cerebellum\\nThe Pons and the Oblongata Decussation of Nerves\\nMotor Nerves Sensory Nerves Surface of the Brain\\nNerve Trunks Cranial Nerves Spinal Nerves Centers of\\nNervous Action Brain Centers Spinal Centers Reflex\\nAction Investing Membranes and Blood Vessels Flow\\nNerves Are Formed 703\\nCHAPTER II.\\nRegeneration and Repair Malformations of Development In-\\nflammation Meningitis Degenerations Tumors and Ad-\\nventitious Products Vascular Disturbances Functional\\nDiseases Predisposing Causes Exciting Causes Develop-\\nmental Influences Habits and Social Condition 720\\nCHAPTER III.\\nDiseases of the Peripheral Nerves Neuralgia Neuralgia of the\\nHead Neuritis Multiple Neuritis Facial Paralysis. .728\\nCHAPTER IV.\\nDiseases of the Spinal Cord and Oblongata Myelitis, or Trans-\\nverse Inflammation of the Cord Infantile Spinal Paralysis\\nAcute Ascending Paralysis Spinal Hemorrhage Progres-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0027.jp2"}, "28": {"fulltext": "20 CONTENTS.\\nsive Muscular Atrophy, or Wasting Palsy Locomotor\\nAtaxia\u00e2\u0080\u0094 Traumatic Affections of the Cord Spinal Sclerosis\\nBulbar Paralysis Pseudo Hypertrophic Muscular Paraly-\\nsis Intracranial Hemorrhage, Embolism and Thrombosis.\\n739\\nCHAPTER V.\\nDiseases of the Cerebrum, or Larger Brain Cerebral Palsies of\\nChildren Tumor of the Brain Hydrocephalus, Dropsy of\\nthe Brain, or Water on the Brain.\\nDiseases of .the Cerebro-spinal System and Its Membranes\\nMeningitis Suppurative Meningitis Cerebro-spinal Menin-\\ngitis Tubercular Meningitis Lead Poisoning. 756\\nCHAPTER VI.\\nThe Neuroses Epilepsy, Falling Sickness, Fits Chorea, St.\\nAnthony s Dance, St. Vitus Dance Hysteria Somnambu-\\nlism, Trance, Catalepsy, Night Terrors, Hypnotism, Etc.\\nParalysis Agitans, or Shaking Palsy 764\\nCHAPTER VII.\\nNervous Diseases of Germ Origin Tetanus Hydrophobia.\\nNervous Symptoms Vertigo Headache Insomnia or Sleep-\\nlessness Coma Fainting 782\\nINSANITY.\\nCHAPTER I.\\nInsanity Caused by Defect in Brain Development Idiocy Im-\\nbecility Feeble-mindedness.\\nInsanity Caused by Brain Disease After Development Melan-\\ncholia Mania Paranoia Dementia Paretic Dementia\\nIllusions, Hallucinations and Delusions Distinguished from\\nInsanity General Considerations\u00e2\u0080\u0094 Prevention 795", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0028.jp2"}, "29": {"fulltext": "SANITATION.\\nBy W. L. Schenck, A.M., M.D.\\nCHAPTER I.\\nTHE CELL.\\nAll life reaches back through a past eternity, and forward\\nforever.\\nScience teaches that, since the first created pair, all life be-\\ngins in a cell evolved through the reproductive tissues of a\\nparent pair of the same or allied species. Wherever we find a cell,\\nwe know there was a pre-existent cell. Every embryonic cell,\\na cell formed by the union of a germ and sperm cell, if higher than\\nan ameba, is endowed with power to proliferate and differentiate\\nother cells, to produce cells like and unlike itself, until it has\\ndeveloped all the various types of cells found in the organism from\\nwhich it sprang.\\nPhysiological]}-, the purpose of all life is the reproduction and\\nperfection of life. All the functions of the body begin and end\\nin the microscopic entities out of which it is built, and, although\\nthere is division of labor, each works for the good of all and all\\nwork as a unit to effect a common purpose. For ages but one\\nlife was supposed to be in the body. Now we know that life is\\na sum of vital units, and that down among these little lives all\\nthe living matter of the body, its protoplasm, is prepared, or\\ncreated, and that each nucleus and nucleolus produces a protoplasm\\nof special chemical constitution and organic function changes\\ndead into living matter of special type for special purpose, each\\ncell doing its own work in its own way. Were other evidence re-\\nquired to demonstrate the existence of an individual life in each\\ncell it is found in the fact that every cell possesses the power to\\ncreate other cells like itself, and transmit to them both its improved\\nand debased conditions.\\nAs the reproduced cell is born of the varied activities of all\\nthe ceils of the body it must partake of their peculiarities. This\\n21", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0029.jp2"}, "30": {"fulltext": "22 SANITATION.\\npower of transmitting inherited and developed peculiarities is\\ncalled heredity.\\nHEREDITY.\\nAll developed peculiarities are hereditary, but changes\\nwrought by accident, or the surgeon s knife, are not. Thus the\\nJewish rite, performed ever since the age of the lawgiver on the\\neighth day after birth, has wrought no inherited change in the\\ncircumcised organ. Disease is not and cannot be inherited, but,\\nas we have seen, special tissue types are hereditary, and must\\ntherefore, under favoring circumstances, be predisposed to the\\ndiseases to which they yielded in the ancestor. Take courage,\\nthen, for by guarding against these tendencies and observing the\\nlaws of health, your chances for dying of old age are good, even\\nthough your parents were consumptives, but this fortune will\\nrequire greater care and prudence on your part than is needed by\\nthe average child of strong and vigorous parents.\\nIf, through the thousands of generations in which spirit has\\ndwelt in flesh, man had wisely used his intellectual and moral\\nfaculties, the millennium would no longer be the hope of a far-\\noff future. So constant, however, have been his violations of\\nthe laws of life that, but for his wonderful recuperative power,\\nhe would long ago have found a place among the extinct species\\nof the geologic past. Too often he has lived wholly in his animal-\\nisms, has neglected or disregarded the laws of development, or\\nbecome an ignorant slave of passion. He has carefully developed\\ngrasses and grains, flowers and fruits, and the animals that min-\\nister to his comfort and pleasure, but neglected the improvement\\nof his own race, perhaps, because such improvement required\\ngreater effort, self-denial and self-control.\\nEvery stock raiser knows that the improvement of his cattle\\nand horses lies in judicious mating, and gives to it careful thought.\\nWith man, too often, fancy, caste, money, lust, are the chief\\nconsiderations. The procreative act is the most momentous in\\nthe life of man, each new generation increasing the magnitude of\\nancestral errors, yet how many give to it as little intelligent\\nthought as wild beasts of the plains.\\nTHE PRINCIPLES OF HYGIENE.\\nThe laws of life and health date back to the creation of the\\nuniverse.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0030.jp2"}, "31": {"fulltext": "SANITATION. 23\\nHe who created life made laws for its procreation, develop-\\nment and preservation laws which, understood and obeyed, give\\nhealth and fullness of life disobeyed, whether ignorantly or know-\\ningly, disease, misery and premature death. Sanitary science\\nembraces all the means by which healthful life is preserved. Two\\nantagonizing forces are ever present, life and death. While the\\none is continually vitalizing the material out of which the body\\nis built, the other constantly destroys the vitalized atoms. In\\nperfect health there seems no antagonism between these ever\\nopposing processes; the new steadily replaces the old, in more\\npotential form, until development is perfect, when destructive\\ngradually trench upon constructive forces until the body comes\\nto the grave, like a sheaf of corn fully ripe, and the spirit soars\\non angel wings. This should not occur until man has reached\\nhis fivescore years, for the law of animal life is that it shall extend\\nto five times its developmental period.\\nA physiological balance between the building and destroying\\nactivities is the chief concern of hygiene. The cells destroyed\\nby the attrition of use must be replaced or there will be atrophy,\\nand, when destroyed, they must be remo\\\\^ed from the body or\\nthey will become toxines (poisons), deranging all the activities\\nof life. The toxines of these dead cells will vary as widely in\\ncharacter as the cells from which they came, and in effect, as\\nwidely as the cells upon which they act. Let the removal of dead\\ntissues be prevented and there will be auto-infection (poisoning\\nfrom within), and diseases of varied type, for disease is a logical\\nsequence of hindered or deranged action among the minute ele-\\nments of the body. Health lies in the physiological activity of\\nthese elements. Keep the body and every surrounding pure\\nthrough perfect cleanliness, and, with proper nutrition, healthful\\nexercise, regular habits and a cheerful mind, you need not fear\\ndisease.\\nCAMP LIFE.\\nCamp life was presumably man s first estate. How long\\nbefore written history the race had camped in caves and wigwams\\nno man knows. Permanent homes and city building are the\\nevolution of the ages. The hygiene of camp life, whether of those\\nwho dwell in tents for a summer outing, a camp meeting, a militia\\nservice, or of armies in the tented field, is based upon immutable\\nlaws, and is, therefore, much the same everywhere.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0031.jp2"}, "32": {"fulltext": "24 SANITATION.\\nThe selection of a camping place is of the first importance.\\nThe soil should be dry, clean and well drained. When practicable\\nthere should be a gravelly substratum, and a few large trees to\\nshield from sun and storm, but no underbrush to interfere with\\nthe free circulation of the air. There should be an abundance\\nof pure water and the camp must be so situated as not to re-\\nceive dampness out of line with winds that bear away the evap-\\noration of rivers, lakes and the like. Latrines should be made\\nat convenient distances from the camp, and where their odors\\nwill not reach it or their contents contaminate the water supply.\\nInto them a few shovelfuls of fresh earth, to cover all excrementi-\\ntious matter, should be thrown every morning and evening.\\nThe camp should be kept as clean as a lady s parlor. The\\nfire furnishes a fit place for the disposal of all waste, and should\\nbe kindled every morning and evening when the air is damp or\\nchilly. The tents should be well aired every day, their occupants\\nprotected from the chill of night by an abundance of proper\\nclothing, and, as night approaches, extra shawls and coats should\\nbe pressed into service. By a careful avoidance of the damp and\\nchill of night air there need be no fear of microbes or periodic\\ndiseases, neuralgias, etc.\\nThe food supply should be inspected every morning, and the\\ninspector should know that the cook employs the best methods.\\nFor drinks, aside from pure and sparkling water, iced tea, lemonade\\nand ginger ale are always acceptable, while coffee and camp life\\nare inseparable. It is well to have some alcohol in camp to be\\nused in cases of shock, to relieve the first sense of exhaustion, or\\nin case of snake bites, to check the poison, but, as a regular bev-\\nerage, it destroys the equilibrium of the organism and tends to\\nvarious diseases.\\nAll habits should be regular, and one-third of the time given\\nto sleep. This rule should be very carefully observed by those\\nwho are seeking health. There should be a daily bath, which, if\\ntaken in a lake or stream, should not be prolonged beyond fifteen\\nminutes, and should be followed by free friction with dry towels.\\nIt should never be taken within two hours after a full meal.\\nRegular hours should be set apart for exercise, which must never\\nbe excessive in hot weather, or at any time with those seeking\\nhealth. Let there be games, books, etc., to prevent ennui, and all\\nbusiness cares be left at home, or, more properly, in the business", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0032.jp2"}, "33": {"fulltext": "SANITATION. 25\\nhouse, where they belong. Remember that in an outing the chief\\nthought should be freedom from care and a full enjoyment of the\\npure environment and abandon of country life. A competent\\nperson, clothed with authority to command obedience to the laws\\nof health, should be appointed to select the camping place and\\nto daily inspect the camp.\\nIn the military service of regular armies all officers are pre-\\nsumed to comprehend their duties and to enforce obedience with\\nmilitary rigor, but in the summer camp of state troops there is\\noften a deplorable ignorance of all that pertains to health, and, in\\nconsequence, much unnecessary sickness. This was especially\\ntrue of the rapidly improvised armies of the Great Rebellion, and\\nin the late war with Spain, the fearful penalties suffered in the\\ncamps of our volunteers for being officered by men criminally\\nignorant upon sanitary matters, are too well known to require\\nmore than a mention here. Too often the colonel thought the\\nregiment belonged to him and that his straps made him equal to\\nits hygiene. While the work of the surgeon is very different from\\nthat of the commander, there will be no conflict of authority\\nwhen each understands his duties. Where no exigency exists the\\nsurgeon should always select the camping place, and supervise\\nall that pertains to its healthfulness, and his directions should be\\ncordially seconded by the commandant.\\nHEALTHY HOMES.\\nBy healthy homes we mean homes in which shall be built,\\nfor God and humanity, strong, useful, happy lives homes whose\\nenvironment shall keep away the gaunt arm of disease, secure\\nperfect physical development, and make of the body an instru-\\nment whose passions, appetites and desires are in subjection to\\nthe higher spiritual life. Such a home will not only be brightened\\nby the light of the sun, but illumined by intelligence, purity and\\nlove. The soil on which it is built will be thoroughly drained by\\nproper tiling, and its cellar will be dry and well ventilated. Sun-\\nlight will enter every room at some hour during the day, and trees\\nthat are so near the house as to prevent the free admission and\\ncirculation of air will be removed. Let beautiful trees surround\\nthe home, but not be so near as to interfere with sunlight and air.\\nThere must be pure water in abundance, and it must be used\\nnot only for drink, but to keep clean the person and all surround-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0033.jp2"}, "34": {"fulltext": "26 SANITATION.\\nings. Every home should have a bathroom, so appointed that\\nits use will be a luxury.\\nIt may cost something to secure a healthy home, but the\\njoy of rosy-cheeked, rollicking childhood, and the health and hap-\\npiness of the family, are not to be weighed against gold. The\\nanxiety and anguish that fill the home where the rose is sup-\\nplanted by the lily, where suffering and sadness displace the glee\\nand laughter of healthy, happy children, where doctor s, nurse s\\nand undertaker s bills take the place of those of the carpenter,\\nplumber and gardener, lead to the conclusion that healthy homes\\nare the cheapest.\\nLOCATION AND CONSTRUCTION OF THE HOME.\\nThe building spot must be well drained, not on a clay sub-\\nsoil, which is often damp, and never on made soil, which always\\ncontains death-dealing elements. Hilltops and hillsides are likely\\nto be well drained and dry, but valleys are usually damp. On the\\nfirst range of hills to the windward of rivers, lakes and ponds, con-\\nstant evaporation often settles. The occupants of homes built\\nupon such hills will suffer from palludal fevers, while those in the\\nvalley below may escape, the dampness passing over their heads.\\nThe neighborhood of swamps, lagoons and millponds should be\\navoided. If that cannot be, let the home be on the side from\\nwhich the prevailing winds blow.\\nWe quote the following from Bishop Haven because it shows\\nso plainly the importance of correct location\\nTwo brothers in Vermont, of strong and vigorous stock,\\nand giving equal promise of long and useful life, married wives\\ncorresponding in promise of future activity. They both had\\nchosen that healthiest of all callings farming. One of the broth-\\ners built his house in an open and sunny spot, where the soil and\\nsubsoil were dry; shade trees and embowering plants had a hard\\ntime of it, but the cellar was dry enough for a powder magazine;\\nthe house in all its parts was free from every trace of dampness\\nand mold; there was a crisp and elastic feeling in the air of the\\ndwelling. The farmer and all his family had that vigorous elas-\\nticity that reminds one of the spring and strength of steel. Health\\nand sprightly vigor were the rule, and sickness the rare exception.\\nThe farmer and his wife, though past threescore, have yet the\\nlook and vigor of middle life.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0034.jp2"}, "35": {"fulltext": "SANITATION. 27\\nThe other brother built his home in a beautiful, shady nook,\\nwhere the trees seemed to stretch their protecting arms in benedic-\\ntion over the modest home. Springs fed by the neighboring hills\\nburst forth near his house, and others by his barns; his yard was\\nalways green, even in the dryest time, lor the life-blood of the hills\\nseemed to burst out all about him in springs and tiny rivulets.\\nBut, the ground was always wet, the cellar never dry, the walls\\nof the rooms often had a clammy feel, the clothes mildewed in the\\nclosets, and the bread molded in the pantry. For a time their\\nnative vigor enabled them to bear up against these depressing in-\\nfluences children were born of apparent vigor and promise, but\\nthese one by one, under the touch of diphtheria and pneumonia,\\nsank into the arms of the dreamless twin brother of sleep. The\\nmother went into a decline and died of consumption before her\\nfiftieth birthday, and the father, tortured and crippled by rheuma-\\ntism, childless and solitary in that beautiful home, which elicits\\nthe praises of every passer-by, waits and hopes for the dawning\\nof that day which shall give him back wife and children, an un-\\nbroken family, and an eternal home.\\nIn the city choose a home as far as may be from the sources\\nof moral as well as physical pestilence, that there may be sound\\nmorals with a sound body, for the physical and the spiritual life\\nconstantly exercise reciprocal influences.\\nLet the home be away from pigsties and barns, cess pits, gar-\\nbage heaps and sewer openings, and, as much as possible, from\\nthe dust of the street, and let the saloon, gambling house and\\nbrothel be far removed. Locate the home near schools, and\\nchurches, far enough back on the lot to have a lawn, flowers and\\nsunshine, with parks and trees along the street, and make it an edu-\\ncator in all that is beautiful, ennobling and healthful. Whatever\\ndebases the intellect and morals tends to physical degeneration,\\nand vice versa.\\nThe evolution of man into higher and yet higher types of\\nmanhood involves the development, generation after generation,\\nnot only of the body, but of the spirit that molds it, to its noblest\\npossibilities. The home must be an educator in all that is man-\\nlike, god-like, and never inculcate shiftlessness or helplessness.\\nMuch of one s education will be obtained away from home, but the\\nhome should rectify and purify it all.\\nAs far as practicable, the home should be owned by those", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0035.jp2"}, "36": {"fulltext": "28 SANITATION.\\nwho occupy it, and day by day it should be made more attractive,\\nso that it will remain forever a green spot in memory its uplifting\\ninfluence always surrounding those who have known its peace\\nand joy.\\nIn building we must begin at the bottom, remembering that\\nthe foundation is the most important part of a permanent structure.\\nIf the location is not dry at all seasons, let the foundation be laid\\ndouble on a solid substratum of asphalt or Roman cement, to\\nprevent dampness from below and without. All the walls should\\nbe double, with an air space between. This space will secure both\\ndryness and warmth. Stone and brick houses should be lathed and\\nplastered, with an air space between the lathing and the wall.\\nIf the location be damp, place beneath the timbers a layer of slate,\\nimbedded in cement. The house should be at sufficient elevation\\nto have three feet of the cellar wall above the surrounding surface,\\nthat there may be proper cellar ventilation, light and dryness.\\nThe cellar floor should be laid in asphalt or cement. A damp,\\ndark, illy ventilated cellar under the home means pneumonia, rheu-\\nmatism, consumption, and all disease intensified. It means\\nacquaintance with doctors and undertakers. All cellars must be\\nkept clean, free from dust and decaying vegetables, and should\\nbe frequently whitewashed. Sanitary inspection should begin with\\nthe cellar. Too many cellars are dark and damp. Many have\\nrotting wood floors and rough walls whose interstices are deposi-\\ntories for all manner of dust and filth, and often, too, they are con-\\ntaminated by faultily constructed or leaking soil pipes. The\\ngrounds about the house should slope from it in every direction\\nsufficiently to carry away all moisture and they should also slope\\naway from the well and cistern.\\nAll outbuildings should be constructed in conformity with\\nthe laws of sanitary art and science, and before the home is occu-\\npied it should be inspected by a thoroughly competent sanitarian.\\nWhere there are no sewers, the privy vault should be made of iron\\nor water-tight cement, unless placed so far from the house and\\nwater supply that it cannot possibly contaminate them. It should\\nbe of moderate size and frequently cleaned. That it may be kept\\npure and aseptic it should receive daily a little dry earth and\\noccasionally a quart of the saturated solution of sulphate of iron.\\nNo cess pit should ever be within one hundred feet from the well\\nor cistern, and never on ground higher than the water supply, or\\nnear the dwelling.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0036.jp2"}, "37": {"fulltext": "SANITATION. 29\\nPaint, kalsomine, whitewash, all are preferable to paper, but\\nif the housewife must gratify her love for the artistic by papering\\nher walls with modern designs, let all old paper be removed\\nbefore the new is applied. The common practice of putting one\\ncoat of paper upon another until many thicknesses have been\\nplastered upon the walls to exhale poisons from decaying paste,\\nand other chemical reactions, cannot be too strongly condemned.\\nAll dwelling houses should be painted outside, for paint not only\\nbeautifies and preserves but helps to secure dryness.\\nIn no other part of the furnishings is there likely to lurk so\\nmuch danger as in carpets. They should be taken up frequently\\nand thoroughly cleaned and aired. Hardwood and painted floors,\\nrequiring only rugs which can be easily removed and cleaned, are\\nmuch more sanitary.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0037.jp2"}, "38": {"fulltext": "CHAPTER II.\\nEXERCISE.\\nExercise is any movement of the body tending to change its\\nmolecular elements. In all organic matter the present is the\\never-changing, eternal link that binds the future to the past. With\\nproperly regulated activities each new link should be better than\\nthe old. Evolution is the law of life, life through never-ending\\nchanges. Progress requires constant readjustment and renewal.\\nThis comes through exercise, and the Creator has ordained it\\nfor every organ of the body and faculty of the soul. We may be\\neither slaves or masters, worse or better, through the force of\\nhabit. New cells may be made superior to the old. The properly\\ntrained muscle gains strength and skill equal to any emergency,\\nand correct mental discipline well-regulated thought makes\\neach succession of brain cells better than those displaced, until\\nthe mind is enabled to reach out and up, and grasp and utilize\\nlaws governing the universe.\\nPhysiologically, exercise is the wisely regulated activity by\\nwhich, through one of those beautiful compensations so often ob-\\nserved in nature, both the force expended and the atoms de-\\nstroyed are renewed in more potential form. It is the application\\nof stored- up force to the generation of greater force. Whether\\nlife was created merely for the reproduction of species, or for the\\npurpose of changing and vivifying matter until a superadded\\nspirit shall find through it all its possibilities, up to that final step\\nbeyond which science cannot go, the continuous change incident\\nto exercise is essential to both physical and spiritual health and\\ndevelopment. The functional activity of the organism destroys\\nand removes its atoms while it provides material and stimulus for\\ncreating their successors.\\nWant of exercise, too much exercise, and deficient nutrition,\\nall result in defective development and tend to degeneration and\\natrophy. Any movement in an organ is exercise though it be\\ndeficient, defective or excessive, and exercise in some form is es-\\nsential to its life, health and efficiency, is an agency through\\n30", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0038.jp2"}, "39": {"fulltext": "SANITATION. 31\\nwhich nutrients are borne to a part, waste removed, and normal\\nactivity preserved or restored.\\nExercise is of two kinds Active and Passive.\\nActive Exercise may be defined as muscular movements\\ndirected by the will. What causes muscular movement, strength\\nand endurance? The muscles, as you know, are only a combina-\\ntion of cells, which, stripped of their sheaths, will hold little more\\nthan their own weight, yet the emaciated muscles of an enraged\\nmaniac are energized by some unseen force until they hold in\\nabeyance the strongest men. Though muscle cells are necessary\\nto muscular action, there is a power behind them through whose\\npotency they are energized. The mind acting upon the will im-\\npresses the cells of the gray matter of the brain in some unknown\\nway, transmits to the motor nerve centers the impulse which, borne\\nto the muscles, gives them power to act in direct proportion to\\nthe strength and endurance of the mental impression and volition.\\nIt is evident, then, that back of effective exercise lies the power of\\nmind, whose activities stimulate the generation of nerve influence,\\nnerve fluid, neurism, whatever that is. Violent or long-continued\\nexercise may exhaust the power of generating and disseminating\\nneurism, and be followed by atrophy, .paralysis, death, but, under\\nproper control and a well-directed will, its force is well nigh bound-\\nless. Taken with a little allowance, a man can do what he believes\\nhe can what he wills to do. Who pulls with a will wins the\\npennant, and who works with a will in any department of life\\ngenerally achieves success. The lazy lout may have plenty of\\nmuscle but it is never energized; he may have plenty of brain\\ncells, but lives and dies without causing even a ripple in the\\nmovements of the world. Will power makes the man by enabling\\nhim to control and energize all the activities of life. Upon it, more\\nthan upon anything else, depend strength of character and a\\nperfect life.\\nThe body is so marvelously constructed, so fitly joined, that\\nimpressions made upon any part are in touch with every other\\npart. The proper exercise of an organ not only increases its\\npossibilities, but more or less affects the whole organism. During\\nexercise more air is taken into the lungs over a third more oxy-\\ngen being then absorbed, and a still greater proportion of carbon\\ndioxide eliminated. Exercise also increases the frequency and\\nefficiency of the heart s action, so that the blood courses more", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0039.jp2"}, "40": {"fulltext": "32 SANITATION.\\nfreely to all parts of the body. As a direct result of muscle con-\\ntraction and relaxation there is glandular activity and vascular\\nmovement, and what is true of these organs applies with equal\\nforce to the nervous system, for muscular action not only increases\\nblood movement and blood supply, but increases nerve power, con-\\nverts stored up energy into force, furnishes the material to replace\\nthat consumed, and stimulates the replacement. Properly regu-\\nlated, it so invigorates the muscle cells, and their associate organs,\\nthat health and development follow. Improperly applied, either\\nexercise or rest may produce pathological changes in the acting\\norgan and in remote parts; thus, through well-regulated exercise\\nvision grows clear and strong, perception more acute, life more\\njoyous, and the vitality of the whole organism is increased but\\nimproperly used, the eye is injured, and diseases developed whose\\neffects are not confined to the injured organ. So, by proper use,\\nthe vocal organs develop until they convey in melodious tones\\nthe various emotions of the soul, but, improperly exercised,\\ncease to be its servants, and may produce far-reaching disease.\\nPassive Exercise. Of the various forms of passive exercise,\\nwe will mention only massage, which may be defined as a kneading\\nof the soft parts of the body a series of systematic passive manip-\\nulations. Instinctively we rub or press a part suffering from\\nnumbness, or other abnormal sensation. As a preventive and\\ncurative measure it is coextensive with the history of medicine.\\nPlutarch tells us that even great Caesar was pinched daily to cure\\nor prevent neuralgia. Galen was appointed physician to the\\nPergamos school of gladiators, who were rubbed before and after\\ntheir combats and every intelligent horseman makes his groom\\na masseur to his horses before and after racing. The artful bone-\\nsetter, who pretends special magnetic powers, has sometimes\\nacquired fame through judiciously applied massage. Although\\nit lacks will-force, that important element of all perfect exercise,\\nwhere active exercise is impracticable, passive exercise is essential.\\nIt promotes absorption, increases the volume of the circulation,\\nand relieves engorgement, stiffness and pain.\\nEXERCISE IN CHILDHOOD.\\nAs a rule, in childhood and youth, opportunity for exercise\\nis the only requirement, but, that each child may receive its full\\nbenefits, some approved method of physical training should be", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0040.jp2"}, "41": {"fulltext": "SANITATION. 33\\npracticed daily in every school. The playgrounds are often too\\nsmall, but even where ample, some students, usually those most\\nin need of exercise, idly stand during the time for recreation.\\nEvery form of exercise should be made attractive and joyous, that\\nthe pupils may enter into it heart and soul. We live in our nerve\\ncenters. Until they are energized, there can be no free action.\\nWhatever the form of exercise, it should be easily learned, readily\\npracticed, and call into action the whole body. That the im-\\nportant organs within the chest may have full development, all\\nconstriction should be removed.\\nPupils should first be taught to properly sit, to stand erect,\\nand to take such postures as will give grace and ease to all their\\nmovements. Some suppose they stand erect when the chest is\\nthrown forward and the back drawn in, so that a perpendicular\\nline that touches the chest is several inches in front of the face\\nand toes, and one that touches the nates, several inches behind\\nthe back of the head and heels. Others think they are erect when\\nthe abdomen is protruded, and a perpendicular line touching it is\\nin front of both face and feet while a line which touches the\\nshoulder is behind the head, nates and heels. Neither is right.\\nIn the erect position that gives ease in standing and freedom to\\nall the organs, a perpendicular line should touch the lips, chest\\nand toes, when the feet are at an angle of sixty degrees and a\\nperpendicular line passing through the body would pass through\\nthe shoulder, hip and ankle joint while one drawn behind the head,\\nshoulders and heels would touch only the nates. The head is\\nthus carried erect, and the perpendicular lines are nearly at right\\nangles with the collar bones. Observing this position for a time,\\nit will soon be taken and maintained without conscious effort.\\nIn sitting the body must also be maintained in an upright\\nposition by the muscles, and when bent it should be at the hips.\\nThe position must be changed when the muscles become fatigued,\\nbut the greater part of the time the body should be erect and\\nrest squarely upon the nates. Every position should give perfect\\nfreedom to the organs within the chest and abdomen.\\nIn walking or running, the step should be free and swinging,\\nthe head erect, the shoulders thrown back and the chest forward,\\nthus developing grace, comfort, strength and health. AYalking\\nand running, combined with a moderate amount of such indoor\\ngymnastics as the dumb-bell, Indian club and rowing machine,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0041.jp2"}, "42": {"fulltext": "34 SANITATION.\\nwill give a requisite degree of exercise to all parts of the body.\\nWhen a boy has a woodpile, ax and saw, he can find plenty of\\nuseful exercise, though it is likely to lack the mental diversion\\nessential to the best results.\\nRemember that proper exercise means the vigorous use of\\nevery part of the body, and for perfect results must be coupled\\nwith joyousness, and that exercise which unduly strains any or-\\ngan must be avoided. Hypertrophy and irregular action of the\\nheart are frequently caused by excessive exertion. This is espe-\\ncially liable to occur in competitive games, where the ambition\\nof the player, stimulated by the applause of the multitude, calls\\nforth the last ounce of force an illustration of the influence of\\nmind upon muscle. Daily labor, as well as exercise for health,\\nshould be so regulated that all over-strain shali be avoided. Be-\\nfore engaging in active exercise, we should be sure that there\\nare no forbidding conditions; e. g., those laboring under valvular\\ndisease of the heart must not run, row or exercise violently in\\nany way.\\nModel modes of exercise are found in walking, running, row-\\ning, skating, cricketing, horseback riding, etc. The gymnasium\\nhas the advantage of furnishing exercise in spite of wind and\\nweather, and in exciting all parts of the body. It should always\\nbe well ventilated.\\nREST.\\nRest forms an important part of all systems of exercise, and\\nbetween it and exercise there should be a well-established mean,\\ndiffering at different ages, and for different conditions and indi-\\nviduals. Exercise that wears out and removes the developed tis-\\nsues of all the organs, secures through rest and proper nutrition\\nperfection of form, gives elasticity and grace to every move-\\nment, and confers great power of endurance the fullness of both\\nphysical and spiritual life. In the overworked the parts are\\npressed together, from excessive cell destruction, and there is\\nloss in height and symmetry. Continued health, vigor and cheer-\\nfulness lie largely in joyous exercise, alternated with well-timed\\nrest, regardless of the feeling of fatigue, for, while that is a warn-\\ning against its continuance, we should not always wait for the\\nwarning.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0042.jp2"}, "43": {"fulltext": "SANITATION. 35\\nTISSUE-BUILDING IN CHILDREN.\\nThat all organs may be properly exercised from early life,\\nthe babe should be placed upon the floor and encouraged to kick\\nand roll. It should be taught to creep an exercise natural to\\nmost children and tending to the development of the trunk and\\nlimbs. The daintiness which keeps a child from the floor cannot\\nbe too strongly condemned. In infancy, childhood and youth,\\neven down to old age, the chest should be preserved as it is\\nfound at birth larger at the lower ribs than at the armpits.\\nWhen the limbs are strong enough to support the body without\\ninjury, the child should walk, run, romp and roll, both in the\\nnursery and upon the lawn. The nurse may find a fit exemplar\\nfor proper training in the playful puppy, and encouragement in\\nthe perfect development of all its organs.\\nBefore the child can walk, it should be given a daily airing\\nin the baby carriage, and kept out many hours, properly wrapped,\\nof course, in cold weather. It will soon learn to long for its out-\\ning, and, when old enough to go alone, it should spend most of\\nits waking hours in the open air.\\nAt the proper age, a portion of its time should be given\\nto work and study, but no work should ever be made a burden\\nand no teaching a task. Both should be joyous. Remember\\nthat: All work and no play makes Jack a dull jay. The boy\\nt-ires at the woodpile, long before he has had sufficient exercise.\\nThe sawing bee/ in which the boys go about helping each other,\\ndestroys monotony and makes the task more joyous. Work or\\nplay, to be healthful, should be pleasant. Good humor and a\\nwilling mind energize the nervous system and cause the genera-\\ntion and distribution of sufficient neurism to keep the muscles\\nwell oiled and free from fatigue.\\nOne of the best modes of exercise for students and those\\nengaged in sedentary occupations, is to keep a ball bounding from\\na wail. When vigorously played by two or more persons, each\\nalternately stopping the ball, it will bring all their muscles into\\nproper action.\\nTissue renewal and building are the physiological objects\\nof aM exercise. To accomplish this the material must be at hand,\\nand, that it may be of the right quantity and quality, digestion\\nmust be good. Like other organic activities, it requires nervous\\nenergy, which should not be exhausted by active exercise, either", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0043.jp2"}, "44": {"fulltext": "36 SANITATION.\\nphysical or mental, immediately before or after meals. For half\\nan hour both preceding and following a hearty meal, there should\\nnever be more than quiet, joyous recreation.\\nTHE MORAL TREND OF EXERCISE.\\nMental and moral exercise, properly directed, tends to de-\\nvelop and improve the brain as certainly as correct physical exer-\\ncise gives strength and vigor to the muscles. Cherish, then, pure\\nthoughts, noble ambitions and right aims, for As one thinketh\\nso is he, and the brain builds on what it feeds.\\nWe have occasional examples of learned men leaving the\\nstudy for the nursery, and there have been kings who played horse\\nwith their little ones, but in the hurry of American life parents\\ndo not find time to play as much as they should with their chil-\\ndren. This false economy of time is loss, both to the children\\nand the parents. By indulgence in their sports there comes oppor-\\ntunity, through an unseen authority and visible example, of forti-\\nfying them against the evils incident to all sports and ot wielding\\nan unconscious influence that will be a blessing throughout their\\nlives. Imbibing the spirit of youth, the parent grows young again\\nand keeps young, and, by mingling in their plays, strengthens\\nthe bonds of affection and acids to the joys of their early days\\nmemories that will never perish.\\nDEVELOPMENT OF THE HEART AND LUNGS.\\nMuscular development, as ordinarily understood, is only a\\nsecondary matter, for the muscles that form the outer coverings\\nof the skeleton, however important, are dependent upon the\\nhealth and development of internal organs. It is, therefore, of\\nthe first importance that we learn their correct use. So intimate\\nis the connection between heart and lungs that, however widely\\ndifferent their function, they seem but parts of a whole. The\\nheart sends the blood from its right side to the lungs for oxidation\\nand decarbonization, which, after it has been purified and vivified,\\nreturn it to the left heart for distribution to the organism. So\\nthese organs go band in hand and, although their action is largely\\ninvoluntary, they are amenable to education.\\nWhen we know that many athletes, whose fine muscular de-\\nvelopment and feats of strength have excited admiration, die sud-\\ndenly and in early life from failure of the heart or lungs, and that", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0044.jp2"}, "45": {"fulltext": "SANITATION. 37\\nvery many at a more advanced age die of heart or lung trouble,\\nwe recognize the importance of the question How should we\\nbreathe? Their training did not reach these important organs,\\nand the fine superstructure, being without a proper foundation,\\nsoon crumbled to decay.\\nThe diaphragmatic muscles assist the lungs in receiving and\\nexpelling air, and abdominal breathing is natural to both sexes,\\nbut we must not overrate its importance. It is only a part of this\\nvital act. In civilized life very few women breathe abdominally,\\nalthough many are healthy and long lived, yet were not both\\nabdominal and thoracic breathing essential to a perfect life, we\\nwould have been created without the one or the other.\\nBut how should we breathe? When in the proper attitude,\\nwith chest free from constriction, take a deep, long breath, con-\\ntinued until the lungs seem filled but not strained. By practicing\\nthis conscious breathing several times each day or hour, as you\\nthink of it, the lungs will become enlarged, and both respiration\\nand pulsation slower and stronger. If persistently practiced it\\nwill soon cease to be conscious breathing, for the habit of deep,\\nfull inspirations will become normal, and you will find by measure-\\nment that the expansive mobility of the chest has increased, not\\nby building up the muscles about its walls, but by an increase of\\nlung capacity and strength.\\nIn practice, breathing must be both abdominal and thoracic.\\nFor the former, breathe as if about to lift the body upward and\\nforward, and, to exercise the abundant cells of the lower portions\\nof the lungs, at the same time lift the abdomen forward. With\\nperfect breathing certain movements facilitate lung exercise and\\ndevelopment. Thus, as you take a ^ong, deep breath, keep the\\narms straight, raise the hands slowly above the head without\\nbending the body, and hold the breath while they are brought\\ndown, then slowly exhale. Another aid in lung development is\\nfound in bringing the elbows to the level of the shoulders, the\\nfingers touching in front of the sternum and on the same level,\\nthen, carrying them backwards, take in as much air as the lungs\\nwill hold, retain it while you return the hands to the chest position,\\nthen slowly empty the lungs. These movements should be made\\ndeliberately, say ten times a minute, practiced morning and even-\\ning, when partly disrobed, and stopped when there is a feeling of\\nfatigue.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0045.jp2"}, "46": {"fulltext": "38 SANITATION.\\nEXERCISE VERSUS CORSETS.\\nFor boys outdoor sports and work usually furnish abundant\\nexercise. With girls it is quite different. Their work is generally\\nin the house and outdoor sports are too often considered unsuit-\\nable, while careful mothers, even among the poor, anxiously re-\\nlieve their daughters from all burden bearing. Thus there is\\nfaulty development of the muscles and ligaments which are to\\nkeep in place the organs peculiar to their sex.\\nIn addition to this as soon as they begin to bud into woman-\\nhood, when the organs should have ample room for development,\\nthe fond mother begins to make them shapely with corsets, or\\nother chest constrictors, thus distressing the lungs, stomach, liver\\nand spleen, and pressing down the sexual organs into the cavity\\nof the pelvis. In the lives of most women, there come times when\\na tub, table, or other article needs lifting. The first act in all\\nefforts of this kind is compression of the walls of the abdomen, by\\ncontracting the abdominal muscles. The diaphragm, prevented\\nby the corset from moving upward, presses the contents of the\\nabdominal cavity downward, the poorly developed ligaments give\\nway, and there is uterine displacement, with all its varied aches\\nand pains, and the neuroses for which it stands.\\nBoth sexes are built out of similar combinations of vitalized\\nelements controlled from nerve centers, and, in the main, what\\nis good for the one is good for the other; but woman has some\\npeculiarities of structure, constitution and habit, that merit special\\nconsideration. While she may advantageously take physical\\ntraining, when she finds any form of movement impresses harm-\\nfully any part of her organism, it must be moderated until she\\nbecomes accustomed to it. It has generally been supposed that\\nwoman s power of endurance is not as great as that of man, but if\\nthat be true she is an exception in the animal kingdom. Her\\nmuscles are not as large, but they are energized by a more active\\nnervous system. She has been so dominated by the iron heel of\\nfashion that her physical system has been handicapped. Perfect\\ndevelopment requires the free play of all the organs. Though\\nGreek statuary shows the perfect conception of the ideal woman as\\npossessing strong and ideal proportions, wasp waists have been\\nthe fashion for centuries, and, among all civilized nations, have\\nbeen so assiduously cultivated that you can scarcely find a woman\\nwho breathes naturally, both thoracically and abdominally.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0046.jp2"}, "47": {"fulltext": "SANITATION. 39\\nAlthough there has been some amendment among women\\nof culture, the butterflies still fasten their corset cords to the\\nbed-post and throw their weight upon them to reduce their waists\\nto the smallest possible compass. Few physicians have failed to\\nnotice women whose floating ribs overlapped the stomach, until\\nforced to wonder where they kept that important organ and its\\nfellows of the same region the liver and the spleen and to mark\\ngrave disease as a consequence. Nature has assigned a place to\\neach organ, and an organ can be displaced only with injury to it-\\nself and such displacement of its fellow organs as to invite far\\nreaching disease. Most women become indignant when lacing is\\nsuggested, yet abdominal breathing has become so rare among\\ncivilized women that some supposedly learned physiologists have\\ntaught that only thoracic breathing is natural to woman. A little\\ninvestigation, however, shows that the latter is natural only to her\\nwho is civilized\\nThose accustomed to the corset complain that when it is left\\noff there is a sense of weakness, a lack of support that is uncom-\\nfortable. They want it to hold them up the best possible argu-\\nment against its use. Nature has provided muscles for the sup-\\nport of the body, and it is the corset that lias prevented their\\nproper growth. In slender, delicate women nothing secures de-\\nvelopment like freedom from constriction breathing so as to\\nsecure chest expansion and the proper use of chest muscles and\\nnothing so reduces obesity and prevents unseemly protrusion of\\nthe abdomen as this freedom and exercise. They promote in all\\nperfection of form, grace of movement and clearness of skin.\\nSallow complexions, hollow chests, spinal curvatures and pro-\\ntruding abdomens are the logical results of the corset. Do not\\nwear it.\\nOUTDOOR LIFE\\nNothing else so perfectly overcomes the irritability and nerv-\\nousness quite common to womankind as outdoor exercise, that\\ncalls into play all parts of the organism, followed by rest in the\\nhorizontal position, or so perfectly develops all portions of the\\nbody, giving grace to form and movement. The idea that work\\nis disgraceful is disreputable. The woman who takes pride in\\ndoing her own housework, who does it with a will, and enjoys\\nkeeping her home in order, will escape the wear and tear of soul\\nand body incident to the management of the average servant, and,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0047.jp2"}, "48": {"fulltext": "40 SANITATION.\\nin three hours in the morning and two in the afternoon, will do all\\nthe work of an ordinary house, kept neatly and plainly, and do it\\nsatisfactorily. Like Bridget, she may dawdle over it all day and,\\nfeeling it a hardship, soon grow tired and lose the joy and benefit\\nof the exercise it furnishes, but by energetic, hopeful, happy work,\\nfollowed by a refreshing bath, clean linen, rest and an afternoon\\nairing, she may enjoy perennial health and a form and complexion\\noutrivaling those of Venus.\\nIt has frequently been remarked that, in high, salubrious table-\\nland and mountain districts, men are healthier than women a\\ncondition due in part to the nervous irritation common to such\\naltitudes, but largely to the outdoor life of the men and the se-\\ncluded lives of the women. To get the full benefit of pure air\\none must spend much time outdoors. As a class, women lead too\\nsedentary lives.\\nWalking and running are among the best forms of exercise,\\nbut women get out of breath from lack of practice. Then, too,\\nthey have corns and bunions for pride in small feet is not pe-\\nculiar to the Chinese woman which greatly interfere with grace-\\nful movements and continued exercise on foot. The shoe should\\nbe large enough and, what is quite as important, should fit the foot.\\nIf the toes be well turned out in walking, the practice will tend to\\nprevent forward contraction of the pelvis.\\nBICYCLING.\\nAlthough the bicycle is very popular, and its swift, easy\\nmotion a fascination, it has positive demerits as used by the aver-\\nage rider, and conies far from furnishing a model exercise. It\\ncalls into action the pedal extremities, and may develop esthetic\\ncalves, but leaves many organs of the body only poorly exercised.\\nFew riders take the proper position for sitting or riding the head\\nis lowered, the face turned up, the neck unnaturally bent, the\\nshoulders and back humped,- the chest and abdomen drawn in, and\\nthe body bent at an acute angle at the thighs, pushing the pelvic\\norgans out of place and throwing the weight upon the prostate\\nor vulva. If the seat be too narrow, the soft hip bones of young\\ngirls are pressed together, the opposite condition from that pre-\\nvailing when the weight of the body rests naturally upon the\\nwidely separated heads of the thigh bones.\\nBicycling violates a fundamental law of correct exercise fair", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0048.jp2"}, "49": {"fulltext": "SANITATION. 41\\nplay to all organs but, if the wheel be ridden, the body should\\nbe maintained in an erect position, while the saddle should be easy,\\nfirm and elastic, and permit pedaling without friction. Many\\nsaddles in common use are adapted to the male rider, but the small-\\nest number recognize that the pelvic organs of the two sexes are\\nnot built after the same pattern. If the pommel is high it inter-\\nferes with the dress of the lady rider; if too low, she slides forward\\nand is uncomfortable if narrow, fleshy women chafe if broad,\\nthose who are thin complain. A saddle perfectly adapted to the\\nfemale rider has not yet been constructed.\\nAmong the good things for which the bicycle stands, is an-\\nother evil which must not be overlooked. Everyone, when first\\nriding the wheel, finds it prone to fall upon one side or the other,\\nand that constant watchfulness and effort are necessary to keep\\nit in balance, and an old rider, in rapid motion, more than the\\nlocomotive engineer, needs a watchful eye, for his track is often\\nfull of obstructions. As the rider gains mastery of his machine,\\nthe effort to keep it in balance seemingly disappears, but the rapid\\nmovement, at full speed, is so fraught with peril as to demand con-\\nstant attention and will-force, which, when long continued, bring\\nthe anxious expression, always a danger signal, seen in the face of\\nthe professional cyclist. Although the bicycle is beneficial to\\nthose who use it for short periods only, in proper position and\\nat moderate speed, and although it ministers to the American\\nhabit of haste, it is not as healthful to the sedentary as a walk to\\nand from the office.\\nCycling in any but the best way involves loss of pleasure and\\nprofit, and may cause both functional and organic injuries. We\\ntell the beginner to sit up straight, and he assumes a perfectly\\nerect position, perhaps bringing the coccyx in painful contact with\\nan improperly constructed saddle so that the spinal column suffers\\ninjurious jars, and making progress wholly dependent upon the\\nmuscular action of the legs. The would-be professional bends\\nthe body at a very acute angle at the hips, draws in the chest and\\nabdomen and humps the shoulders, compressing the vital organs\\nof the chest and pressing the contents of the abdominal cavity into\\nthe pelvis. This position is full of danger to every rider who\\nassumes it, and especially perilous to women and girls. It is void\\nof art and science, prevents continued action, injures health, and\\nis far from being esthetic.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0049.jp2"}, "50": {"fulltext": "42\\nSANITATION.\\nThe following excellent suggestions on the saddle, by Theo.\\nR. MacClure, were brought out at a recent sanitary convention\\nin Detroit:\\nThe bicycle seat should have the same relation to the rider as\\ndoes the properly constructed chair; it should be flat, rigid and\\nfixed in its shape, and at no time\\nshould any portion of the seat\\ncause undue pressure upon parts\\nin one of the most delicate re-\\ngions of the human economy.\\nTo better place this portion of\\nthe subject before the reader, we\\nhave, in connection herewith,\\nthree illustrations Figs. I, 2\\nand 3.\\nFig. 1 represents the bony\\npelvis of the human being. The\\ntwo prominences marked A are\\nthe ischial tuberosities upon\\nwhich the weight of the body\\nwhen riding a wheel should rest.\\nB exhibits the pubic arch,\\nwhich protects a portion of the\\nanatomy upon which the weight\\nof the body should never rest, for\\nany considerable time. The\\npubic arch is nature s protection\\nfor some of the more delicate and\\nsensitive parts, among which are\\nthe prostate gland, the bulb, ure-\\nthra, etc. Any condition which\\nshall interfere with nature s ar-\\nrangement will throw down the\\nbars of protection, and sooner or\\nlater result in permanent and se-\\nrious injury. The insidious way\\nin which these injuries gain a\\nfoothold misleads the one be-\\ning injured and, while there may\\nbe premonitory symptoms or", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0050.jp2"}, "51": {"fulltext": "SANITATION. 43\\nwarnings, they are not such as to be observed until too late, when\\nthe injury has occurred.\\nFig. 2 represents the bony pelvis seated upon the common\\nhammock saddle, the saddle against which we should guard.\\nIt will be seen that the weight of the body ceases to be supported\\nby the ischial tuberosities, but is supported by that portion of the\\nbody called the perineum.\\nFig. 3 exhibits the bony pelvis resting upon a flat rigid\\nseat, the weight of the body falling upon the two bony prominences\\nof the pelvis. The seat represented in this plate consists of two\\nseparate pads or cushions, between which is a groove or depres-\\nsion, about one inch across, for the better protection of the peri-\\nneum from pressure. Any bicycle seat made upon the plan ex-\\nhibited in this plate will be less likely to cause injury to the delicate\\nportions of the body situated in the region of the perineum. The\\nhorn should be free from sharp corners, and padded or cushioned\\nwhen practicable.\\nThe pelvic bones vary, so that in some, especially in females,\\nthe tuberosities are closer together than in others. The seat\\nshould be wide enough to permit these bony prominences to\\nrest comfortably upon the pads. It is equally important that the\\nseat be not too wide, in order that the pedaling can be ac-\\ncomplished without unnecessary friction or chafing by the edges\\nof the seat.\\nWhen the saddle is too far back or too low there is loss\\nof power, while the unduly bent knees become painful, the ankles\\nlack freedom of action, the shoulders are humped, and progress up\\nhill is barred. Fat persons prefer the low saddle because it\\nfacilitates mounting and dismounting, but the position is neither\\ngraceful nor healthful. The other extreme must also be avoided.\\nWhen the toe just reaches the pedal, it involves an injurious and\\nawkward twist of the back and sides, and a loss of power, es-\\npecially on up-grades. The saddle should be well over the pedal\\nand its height will be right for a person sitting upon it when he can\\nplace his foot under the pedal, the pedal resting upon the instep.\\nPersons of different heights should not use the same adjustment.\\nIt is important that the seat be neither too hard nor too soft.\\nW hen the body rests properly upon it the weight will be supported\\nsquarely upon the pelvic bones, with trunk at right angles to the\\ntilt of the saddle. If the handle bar is too high there is an un-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0051.jp2"}, "52": {"fulltext": "44 SANITATION.\\ncomfortable and unseemly bend of the elbows, and the position is\\nunsteady.\\nLEFT-HANDED PEOPLE.\\nThere is another subject that has not been sufficiently dwelt\\nupon by those who have discussed exercise. The Creator does no\\nunnecessary thing, and the work of the hygienist, and the true\\nphysician, is to see the work of the great Architect well done\\nrather than to make substitutions. In all vertebrate animals the\\nnerves and muscles are usually in pairs. Man is no exception to\\nthe rule. Children are born with both sides equal in form and\\nfunction. Heredity may in some instances make a difference, but\\nthat is the rule. They are also born weak and helpless and almost\\nwholly void of instinct. From the cradle to the grave all the\\nfaculties are developed by education. Nature yields to the teacher,\\nand the babe is hardly born before its education commences.\\nWhen or why man became right sided is not within the\\nscope of our discussion, but the exceptions are too numerous to\\nprove it a physiological law. Most persons are dexterous, right\\nhanded but whole tribes have been ambidextrous, left handed.\\nIn the earliest history of the race, Moses tells us the tribe of Benja-\\nmin was left handed, and adds They were mighty men of war.\\nFrom the fact that, in certain vocations, men use either hand with\\nequal facility and the more important fact, that man is born with\\nhis nerves and muscles equally paired, we conclude the Creator\\ndesigned that man should use with equal convenience the right\\nand the left hand, and that the employment of either alone is a\\nhuman innovation, but no improvement on the divine plan.\\nNinety per cent of the peripheral nerves cross each other as\\nthey pass to the nerve centers in the brain. As already stated,\\nthe properly directed exercise of an organ develops both its form\\nand function. The nerves are developed, not only in the acting\\nmuscles, but in the nerve trunks and centers as well. When the\\nright muscles are alone or largely used, the right brain is propor-\\ntionately functionless, while in the left are stored the results of our\\nactions, perceptions, and memories, and here the will is chiefly\\nfunctioned.\\nWe are not surprised to know that in such diseases as aphasia\\n(loss of word memory), there is usually softening in that portion\\nof the left brain where the record of words is kept, the third left\\nfrontal convolution. The exceptions to this rule are among the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0052.jp2"}, "53": {"fulltext": "SANITATION. 45\\nleft handed, and this theory of right handedness is confirmed by\\nsuch cases as that of Prof. Lourdet of Montpelier, France, who,\\nhaving lost both the power of speech and the use of the pen, taught\\nhimself the use of the left hand, and, letter by letter, and word by\\nword, learned again to write and speak.\\nBy exercising both sides of the brain, as by the use of both\\neyes, they are enabled to give to each other mutual assistance and\\nrest, and when, from injury or disease, one loses its function the\\nother may take up its work, but when either right or left sidedness\\nalone is developed one hemisphere of the brain is held in abeyance,\\nor dwarfed, and there can be no exchange. The health and de-\\nvelopment of the nerve centers and brain, the co-operation of the\\nperipheral nerves and the development and strength of the mus-\\ncles, in short, a full, harmonious and symmetrical development of\\nall the organs of the body, is involved in the equal training of both\\nits sides, and he who would possess complete control of all his\\norgans and faculties must continue such use through life.\\nTHE ATHLETE.\\nMan differs from other animals, only as he has a superadded\\nspiritual life controlling his will and directing his forces. We have\\njust begun to recognize the power of this will. By it man is able\\nto effect changes in his physical development in a few short years,\\nthat require generations in the brute. By careful training, the\\nwild horse has been changed into the fleet-footed Arabian, the\\nmassive Percheron and the tiny Shetland, but these results have\\n\u00e2\u0080\u00a2been the work of many generations, and are preserved only by the\\nmost careful breeding and continued judicious exercise.\\nSandow, the Prussian athlete, belonged to a family in nowise\\nremarkable for its physique, but through localizing muscle-build-\\ning, and associating with his training voluntary control, he reached\\nhis most wonderful development at twenty-six years of age. At\\neighteen he was in every way beneath mediocrity. By exercising\\nhis various muscles as they required, though only five feet eight\\nand one-half inches in height, he gained a measurement around the\\nchest of 46 inches, about the waist 29, with an expansive mobility\\nof 14 inches under the axilla, over the deltoid 17 inches, over\\nthe shoulder 21, over the biceps 19^, around the forearm 19,\\naround the thigh 27, and around the calf ij\\\\ inches. With ap-\\nparent ease and one hand, at arm s length, he lifted from the floor", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0053.jp2"}, "54": {"fulltext": "46 SANITATION.\\nstraight over his head a hollow dumb-bell with a man in each\\nglobe, together weighing 305 pounds, and as easily let it down\\nagain. With his feet and hands upon the floor he supported\\nthree horses, weighing 2,800 pounds, upon a platform resting\\nupon his chest and knees. Although through volitional control\\nover his muscles he secured this wonderful muscular power, he did\\nnot develop spiritual life and control, and was far from being an\\nintellectual giant.\\nSeeking the development of the whole man we must remem-\\nber that the methods that develop the mere animal organs do not\\nmaterially impress those through which the spirit acts. From\\nSamson, shorn of his strength by the seductions of Delilah, down\\nto the pugilists of the present day, neither athletes nor gymnasts\\nhave been distinguished for their mental or moral force. Many\\nmen with frail bodies, without muscles, have gained as dis-\\ntinguished conquests in the world of mind, as athletes without\\nmind have won in the world of muscle. Aim at neither extreme,\\nand remember that while a well balanced, healthy physical organ-\\nism is essential to life and intellectual growth, an excessive ani-\\nmal development is a hindrance to both.\\nIf sudden death does not come to the athlete for taxing\\nhis heart beyond its strength, his abnormal muscles, to preserve\\ntheir health, must be exercised in proportion to their development,\\nand to sustain this the digestive organs must be overtaxed to feed\\nthem, the circulatory to carry to them their nutrients, the respira-\\ntory to oxidize their blood, and the excretory to remove their\\nwaste.\\nFor him to stop this exercise is not less dangerous than to\\ncontinue it. The removal of unused and devitalized tissues is\\nalways full of danger. Use his organs as he may, sooner or later\\nhe will reach the down-hill grade, when the involution of his\\nmassive muscles will invite disease.\\nCOLLEGE ATHLETICS.\\nJust now a mania for muscular development is mani-\\nfest in our colleges. The learned professors in some of\\nour leading universities seem to have forgotten that while\\nmuscular efforts demand increased activity and development\\nof all the merely physical organs, the athlete does\\nnot gain either intellectual or moral force from punch-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0054.jp2"}, "55": {"fulltext": "SANITATION. 47\\ning bags, or kicking balls, and that a student with mind in-\\ntent on football, or anything else foreign to mental training, and\\nwho frequently interrupts his college course to give exciting ex-\\nhibitions of his muscular powers, is not pursuing the best educa-\\ntional methods and results.\\nThe development of man is in line with his activities. While\\nthe health of all the organs of the body should be preserved\\nthrough regular and moderate use, we think the college should\\nchiefly be a gymnasium for mental training for beneficent pur-\\nposes. It should not be dedicated to the forcing of the organs\\nof mere animalism. During student life, violent sports are in-\\njurious rather than beneficial, and the college contests at football,\\nas described by the press, are in every way demoralizing and differ\\nfrom the ring onlv in the character of the actors. Brutality pre-\\ndominates in both. We are aware that its friends claim that it\\ndevelops courage, determination, will-force, self-restraint, quick-\\nness of perception and decision. The same is claimed for the ring.\\nPurpose, determination and decision may be bad as well as good.\\nSurely the fruits of the ring are not the highest exponents of\\ncivilization, and may we not expect like results from a game where\\na half score of players fight with hands and feet, breaking noses,\\nribs and limbs, dislocating joints, slugging on the sly, and, in some\\ninstances, taking life?\\nExercise is essential to physical health, but we should under-\\nstand its laws, and develop those faculties which distinguish man\\nfrom the brute. Cultivating the merely animal organism does not\\ndevelop the cells through which the spirit acts, and much time\\nand thought given to exciting sports during a college course are\\nworse than lost. We reap what we sow. Physical exercise in\\nsome form is indispensable to health and longevity, and these, in\\nthe educated, are of incalculable value both to the individual and to\\nthe state, but, develop as he may, man cannot make his physical\\nstrength equal that of the ox, and he should not attempt it.\\nGod created him for other and nobler purposes. His mental and\\nmoral faculties should have precedence. His perfect development\\ndoes not mean transformation into a behemoth, but the symmetry\\nwhich secures the perfect health of all his organs, makes his body\\na fit instrument for the mentality which, laying hold of unseen\\nforces, compels them to drive his engines over land and sea, and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0055.jp2"}, "56": {"fulltext": "48 SANITATION.\\nperfects those still higher activities by which he reaches out and\\nup to the infinite.\\nGod alone creates, but to man is given recreative power, en-\\nabling him to utilize the varied creations, and, in so doing, to\\nbecome refined, noble and strong in mental and spiritual action.\\nOf all his capacities, our chief interest is in his will, reason, affec-\\ntions, character. We secure health and the power of endurance\\nto the physical organism that it may be a fit instrument for the\\nactivities of the spirit and subject to their control. Man is made\\nin the image of God, not physically but spiritually, and should seek\\nsuch physical culture as will secure a sound body, but, at the same\\ntime, conduce to highest spiritual power.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0056.jp2"}, "57": {"fulltext": "CHAPTER III.\\nGERM-LIFE AND ITS RELATION TO DISEASE, AS UN-\\nDERSTOOD BY THE BACTERIOLOGIST.\\nIn all the past, contagious and infectious diseases have been\\nthe world s most dreadful scourges, so resistless in their sweep\\nand deadly in results as to be generally regarded as vengeful work\\nof offended spirits, or inscrutable dispensations of Providence. But\\ntheir mysterious power has gone, for having learned their secrets\\nwe are able now to combat and overcome them. Of all the\\ndiscoveries of the present age, none is more wonderful or of more\\npriceless worth than that of the germ causation of disease.\\nIt has dispelled the terrors ol the plague, stayed the pestilence\\nand added to the years of human life. No class of diseases now\\nyields more readiiy to preventive measures than the contagious\\nones; while nearly all the infections have been found amenable to\\nsimple laws, and the remaining few are likely to soon be added to\\nthe list.\\nIn this revolution the bacteriologist has suddenly become the\\ngreat benefactor, worthless theories have given place to exact\\nscience, and in the medical world nearly all things have become\\nnew. It has been fully demonstrated to the satisfaction of the\\nmost critical that the causes of these diseases are micro-organisms\\nknown as bacteria; that of the very numerous varieties of micro-\\nscopic life only a few are pathogenic, or disease producing, and\\nthat these in almost every case are taken into the system with the\\nbreath, food or drinking water. Hence, air, food and water, as\\nthe media of infection, possess an interest never accredited them\\nbefore, and how to get them pure and keep them so has become the\\nmain problem of sanitary science the science of how to keep\\nwell.\\nThe infections or germs which float in the air and are carried\\ninto the system with the breath are called air-borne and the dis-\\neases thus disseminated are air-borne diseases. Consumption,\\npneumonia, diphtheria, whooping-cough, scarlet fever, yellow fever,\\n3 49", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0057.jp2"}, "58": {"fulltext": "50 SANITATION.\\nmeasles, mumps and influenza belong to this class. It will be\\nnoticed that most of them manifest themselves chiefly in ailments\\nof the throat and lungs.\\nAs the air is breathed by everybody in the same inclosure, the\\nonly safety lies in isolation of the patient, and prevention, as far as\\npossible, of the spread of germs into the common atmosphere.\\nThe air-borne germs are not always expelled from the diseased\\nperson in his breath, but may escape through the skin, and, in\\nthroat and lung diseases, are found in myriads in the sputum.\\nIf this be allowed to dry in the open air, the germs will be taken\\nup as dust, and some of them will reach the throats and lungs of\\nother people and be implanted there. This is the common method\\nby which consumption, pneumonia and diphtheria are dissem-\\ninated, and it is even more for this reason than to avoid the dis-\\ngusting filth that ordinances are made forbidding spitting in cars\\nand many other public places. Indeed, the dust from dried expec-\\ntorations in cars, hotels, stores, factories. schools, assembly halls, etc.,\\nis a constant source of danger, and suppression of the filthy habit\\nof indiscriminate spitting would be a most important step toward\\npublic safety.\\nWhen fully developed, pulmonary consumption is still gen-\\nerally regarded as an incurable disease, but it is no longer con-\\nsidered hereditary. One may inherit a physical weakness, a pecu-\\nliarity of cell, which predisposes to the attacks of its microbe, the\\nbacillus of tuberculosis, but weakness alone cannot bring the dis-\\nease. The specific seeds must be planted, and these must come\\nfrom another diseased person or animal, and may enter the system\\nin the food as well as with the breath, for cattle are frequently\\nafflicted with this disease, the microbes of which may be found\\nin their flesh, and, in extreme cases, in their milk.\\nTyphoid fever, malarial fever, cholera and some of the\\ndiarrheas are usually water-borne, but as they may be disseminated\\nby any means through which their germs can reach the stomach,\\nfood as well as water may be a medium of infection. It is, there-\\nfore, of the highest importance that both food and water be clean.\\nBy cleanliness, in this connection, is meant freedom from disease-\\nproducing germs. It is not enough that water should seem pure,\\nfor though pleasing to the taste, and clear and sparkling, it may\\nabound with death -producing germs.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0058.jp2"}, "59": {"fulltext": "SANITATION. 51\\nNECESSARY PRECAUTIONS.\\nAlthough freezing appears to have very little influence upon\\nmany of these germs, they are extremely sensitive to heat, few sur-\\nviving 158 degrees in streaming steam and none of them being able\\nto long withstand the temperature of boiling water. Hence, by\\nthoroughly cooking food, and carefully keeping it from contami-\\nnation thereafter, and by boiling all water used for drinking and\\nculinary purposes, and carefully cleansing with water thus ster-\\nilized all fruits and vegetables to be eaten raw, the danger of con-\\ntracting any of these diseases may be very largely overcome. But\\nthere are other points of attack which should also receive careful\\nattention. Such pets as cats and dogs often carry infection,\\nand, therefore, may be dangerous to children or others fondling\\nthem. Rats and mice, and, still more often, common house flies\\nmay become common carriers of these disease germs, hence, if for\\nno other reason, every precaution should be used to prevent them\\nfrom reaching human food.\\nXot only are careful personal habits essential to safety, but the\\namount of general infection should be reduced as much as\\npossible everywhere. To this end individual and municipal efforts\\nshould be united in intelligent and unceasing warfare against all\\nkinds of filth and accumulations of decaying organic matter for\\nmasses of putrefaction are ideal breeding places of disease-germs\\nfountains of infection, contaminating both air and water with\\nsubtle poisons causing misery and death. For the effectual treat-\\nment of these menaces to health see the department of Disin-\\nfection and Disinfectants.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0059.jp2"}, "60": {"fulltext": "CHAPTER IV.\\nAIR.\\nWe may live for a time without food or drink, but no one can\\nlive without air. Tfre supply is ample, for it surrounds the whole\\nearth, penetrates every crevice and extends above the highest\\nmountain tops, no one knows how far. but to an estimated height\\nof from 50 to 200 miles. Not only this, but provision is made for\\nits constant renewal and purification. Pure air is commonly said\\nto be one-fifth oxygen and four-fifths nitrogen, but absolutely pure\\nair is never found. It may be considered pure when composed as\\nfollows\\nOxygen 20 6.1 volumes\\nNitrogen -77-95 I In one hundred volumes\\nCarbonic acid gas. .04\\nAqueous vapor 1 40\\nof air.\\nIt will also contain traces of ammonia, nitric acid and car-\\nbureted hydrogen and, if in a city, traces of sulphureted hydro-\\ngen and sulphurous acid gas. While all the gases of the atmos-\\nphere differ in weight, by the law of diffusion they are never at\\nrest, and so intermingle that their proportion is maintained with\\ngreat regularity at all temperatures and altitudes.\\nWhatever other functions nitrogen may have, it is a necessary\\ndiluent of oxygen. When free or uncombined it is, as far as we\\nknow, negative in character. Variously combined it is an im-\\nportant element in the tissues of both animals and vegetables. Its\\nproportion in the air is not disturbed by the presence of carbon\\ndioxide or other deleterious gases. They are present at the ex-\\npense of the oxygen and, when in excess, they are dangerous both\\non account of their own action and by their displacement of\\nnecessary oxygen. Any considerable quantity of carbon dioxide\\nis injurious, but the atmosphere may contain four parts in 10,000\\nwithout appreciable influence upon health, and even in much\\nlarger quantities it is a measure of injurious contaminations rather\\nthan dangerous itself.\\n52", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0062.jp2"}, "61": {"fulltext": "SANITATION. 53\\nOxygen is the part essential to life. It is the most abundant\\nelement in nature, enters into all forms both of organic and inor-\\nganic matter, constitutes one-half the globe and, as we have already\\nstated, one-fifth of the air surrounding it. It is a colorless gas,\\nwithout taste or odor, and at ordinary temperatures is soluble in\\nwater to the extent of about two volumes in a hundred. It will\\nnot burn, but is the most powerful element of combustion. Apply\\na blazing match to the end of a tube filled with oxygen and you\\nwill obtain no results, but extinguish the flame and insert the in-\\ncandescent end of the match into the tube, and it will burst into\\na beautiful flame. It is by supporting combustion that it main-\\ntains the heat of the body taken into the lungs it is carried by the\\nblood to all the tissues and, by its contact with them, they are in\\npart burned up oxidized, the oxidation producing heat, force,\\nand, as a residuum, carbon dioxide. This residuum is carried in\\nthe blood back to the lungs, and by them thrown out to become\\nfood for plants. Decomposed in plant cells, through the action of\\nlight, its carbon becomes fixed, as a part of organic matter, while\\nthe liberated oxygen escapes to be breathed again. Thus the\\nanimal provides food for the plant and the plant for the animal,\\na beautiful example of one of the many wonderful laws of equiva-\\nlences found in God s handiwork.\\nThe contaminations of the air, also its density, humidity, tem-\\nperature currents and electrical conditions, have a constant in-\\nfluence upon health, imparting to seasons and localities many of\\ntheir hygienic characteristics.\\nThe Density or weight of the atmosphere at any given point is\\naffected by altitude, temperature and humidity. The rarified air\\nof high altitudes produces various impressions upon physical life,\\ncausing labored breathing from the difficulty in securing sufficient\\noxygen, excessive heart action to force a larger quantity of blood\\nto the lungs for oxidation, nausea, lowered temperature, convul-\\nsive trembling and ocular fatigue, with a sense of languor and\\nindifference. The diminished pressure upon the body often per-\\nmits the exudation of blood through the delicate membranes of\\nthe eyes, nose and ears, and sometimes from the lungs. These\\nconditions are increased by atmospheric movement, and are\\nknown as mountain sickness. Properly selected altitudes, by\\nswelling the capillary circulation of the surface, and correspond-\\ningly relieving the congestion in central organs, and by demanding", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0063.jp2"}, "62": {"fulltext": "54 SANITATION.\\nfull use of all the air cells of the lungs, may prevent the develop-\\nment of certain diseases or, if not too far advanced, may cure\\nthem.\\nBut in recommending altitude the sanitarian must consider\\nthe condition of all the organs of the body. Thus, however ad-\\nvantageous to the lungs, rarefied air increases cardiac effort and is\\nincompatible with various forms of heart disease. Altitude is but\\none factor of the climatic conditions essential to consumptives,\\nfor while, in the early stages of the disease, they need a rarefied at-\\nmosphere, they also require dry air, the absence of sudden and\\nextreme changes in temperature, and a climate that woos to\\nexercise and will enable them to spend much of their time out\\ndoors at all seasons. Man s adaptability to environment enables\\nhim to live in very high and very low altitudes, but idiosyncrasy\\nshould always be considered, and for those seeking health extreme\\nchanges must be gradual.\\nHumidity. Heat, by expanding or rarefying the air, makes\\nit lighter than cold air, and, since the hydrogen in aqueous vapor is\\nlighter than the oxygen and nitrogen it displaces, moist air is\\nlighter than dry air, the specific gravity of air saturated with mois-\\nture being less than two-thirds of that of dry air, or, more exactly,\\nas 623 is to 1,000. The warm, balmy air of coasts and sea-girt is-\\nlands near equatorial regions is hygienic in many respects, but\\ntends to enervate, and such localities are less favorable to the cure\\nof consumption and allied diseases than warm, high and dry table-\\nlands. Knowing that moist air encourages a tendency to con-\\nsumption, those afflicted with lung diseases should go to the mesas\\nof Arizona and New Mexico, where they will take full deep inspira-\\ntions and enjoy outdoor life and exercise, rather than to Northern\\nColorado and Wyoming, where the rainfall is greater and the win-\\nters more or less inclement. Cold, damp air produces chilliness,\\ncontraction of the capillaries and engorgement of central organs,\\nthus tending to congestions it also favors the development of\\nrheumatism and the like, while warm, high and dry air relieves such\\nconditions. Study to correctly interpret all the influences of the\\natmosphere upon health.\\nTemperature. In cities, and often in country homes, condi-\\ntions popularly attributed to high temperature are really due to\\ncauses which are largely dependent upon accumulations of filth,\\nbad drainage, poor ventilation, over-work, under -work, intemper-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0064.jp2"}, "63": {"fulltext": "SANITATION. 55\\nance. improper diet, etc. Thus cholera infantum, tropical dysentery\\nand yellow fever were long thought to be heat diseases, but are now\\npositively known to be due each to a specific germ, which upon\\nbeing taken into the system, especially if from violations of hygi-\\nenic rules, or for any other reason, the subject is in a debilitated\\ncondition, multiplies with astonishing rapidity and develops the\\nvirulent poison that produces the disease. In moist accumulations\\nof filth under high temperature these germs find excellent breeding\\nplaces, until, through the medium of food, water or air, some of\\nthem can effect an entrance into the human body. Asiatic cholera\\nand the Bubonic plague have been called heat diseases, but are due\\nto germs which multiply and flourish in the unspeakable filth of\\nthe degraded worshipers of Juggernaut, and are dependent upon\\nfilth to keep them alive. So with other diseases attributed to\\nheat high temperature is indeed a necessary accompaniment, but\\nother factors, preventable in nearly every case, are essential to their\\ndevelopment. Heat alone is very rarely a sufficient cause even\\nfor sunstroke, the debilitating influence of imperfect ventilation,\\nvicious habits, faulty diet, over-work, etc., being a usual ac-\\ncompaniment or prelude.\\nLow as well as high temperatures have their characteristic\\ndiseases those of the air passages, as influenza, tonsilitis, croup,\\nbronchitis and pneumonia, are some of them, especially when cold\\nis associated with great humidity. They are largely favored\\nby the abstraction of warmth and moisture. According to Dr.\\nBaker of the Michigan State Board of Health, each cubic foot of\\nair inhaled at zero contains only one-half grain of vapor, but when\\nexhaled at 98 degrees is nearly saturated and contains about 18 J\\ngrains of water, having abstracted its additional heat and moisture\\nfrom the air passages: Irritation, inflammation and suppuration\\nare incident to such drains, and are always facilitated by the de-\\npressing influence of cold upon the nervous system, the part first\\naffected depending largely upon the condition of the air passages.\\nThe lung substance is not usually involved until there has been\\nlong continued action. Hence, pneumonia does not generally\\nprevail until February, March and April. Cold, dampness and\\ndensity favor the development of pulmonary troubles, while the\\nopposite conditions, found in a warm, dry, rarilied atmosphere, are\\npreventives.\\nAir Currents are important agencies in purifying the atmo-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0065.jp2"}, "64": {"fulltext": "56 SANITATION.\\nsphere, but are sometimes factors of disease. Warm, clamp cur-\\nrents rising from the earth carry contaminating decompositions\\nand infections, and currents passing over bodies of water become\\nmoisture laden, causing enervation by day and chill at night.\\nCold draughts, especially when charged with moisture, tend to\\nrheumatism and neuralgia; and cold dry winds, as the northers\\nof Texas and the bora of the Alps, are followed by inflammation\\nof the air passages. Dry winds are filled with particles of matter,\\nreadily seen when passing through bright sun rays, and while we\\nconstantly inhale thousands of these tiny motes without harm, if\\ncomposed of infectious or contagious matter they may cause most\\nserious epidemics.\\nDusty country air is far less injurious than that taken up from\\nthe streets of villages and cities, laden with dried and pulverized\\ndroppings of cattle and horses, and sputa of consumptives and\\nother invalids. What condemnation can be too severe for\\nboards of health that permit butchers and grocers to make out-\\ndoor displays of beef, mutton, fowls, vegetables and fruits, thus\\nallowing them to become coated with such loathsome and danger-\\nous filth?\\nWinds often carry disease. W T e have known typhoid fever\\nto be borne by prevailing winds in a dry atmosphere from excre-\\nmentitious matter of typhoid patients, thrown upon the ground,\\nand to follow a track as clearly marked as when water-borne.\\nWhether the germs were carried by the unaided breezes, or by flies\\nwhose flight was guided by the air currents, we do not know the\\nresult was the same, though, if by the latter agency, good screens\\nmight have barred the dangers from the home.\\nHot, dry winds, as the harmattan of the West African coast,\\nare conducive to certain diseases, and the sirocco of Northern\\nAfrica and Southern Italy, whether dry or moist, has a depressing\\neffect. So, too, the simoon of India and the hot winds of Australia\\nare deleterious to both vegetable and animal life. Even in their\\nmilder form, as sometimes found on our western plains, they sap\\nhuman energy and may be injurious.\\nIn this latitude remittent fevers and diseases of the alimentary\\ncanal reach their acme during the heat of August, typhoid fever in\\nSeptember and October, diphtheria and croup in November, De-\\ncember and January, acute lung diseases in late winter and early\\nspring, and consumption, well nigh perennial, reaches its climax in\\nMarch.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0066.jp2"}, "65": {"fulltext": "SANITATION. 57\\nSudden changes tend to disease, but the human organism so\\nreadily adapts itself to new conditions as to soon become ac-\\nclimated. While the sanitarian recognizes the influence of seasons\\nand climates in the production of diseases, he attributes them more\\nto other causes, of which the chief are infection, ignorance and\\nneglect.\\nCarbureted Hydrogen. In mines a carbureted hydrogen\\noften accumulates which, though not serious to health, is danger-\\nously explosive when mixed with air. Carbon dioxide is one of\\nthe products of such explosions, and is what is known as after-\\ndamp. It may also be present without an explosion, in such\\nquantities as to asphyxiate as completely as though drowned in\\nwater, those exposed to its action. It is frequently found in pits\\nand wells. Xo one should enter such places, if they have been\\nlong unvisited, without first letting down a lighted lamp or candle.\\nIf it be extinguished, gas is there, and must be removed by heat\\nor some other means. As good a way as any is to slack lime in the\\npit or well, for the process creates a current by the generated heat,\\nand the slacking lime absorbs gas, so that a double action is ob-\\ntained.\\nBeing heavier than air it may also be drawn out by a cord\\nfastened to an inverted umbrella, much the same as drawing water\\nwith a bucket, repeating the process until on letting down a candle\\nit continues to burn.\\nCarbon Monoxide is one of the most common and most dan-\\ngerous gases with which we have to deal. It is the gas which\\nescapes from stoves when their draught is defective, or when they\\nare sufficiently heated to open the pores of the iron. It causes\\nmany deaths from the ignorant blowing out of gas lights, instead\\nof properly turning off of the gas. Turning down gas to produce\\nonly a slight light is always dangerous, for a sudden draught may\\nblow out the flame, and the gas will continue to escape. This\\ngas often poisons the air about coke and charcoal ovens, smelting\\nand gas-works, producing in the Avorkmen general debility, and\\ndiseases of the respiratory organs. The poisoning from it causes\\nheadache, dizziness, roaring in the ears, weakness, vomiting, un-\\nconsciousness, convulsions, diminished heart and lung action, and\\ncomplete asphyxia. At all works where injurious gases are\\ngenerated every precaution should be taken to supply good air\\nto the workmen.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0067.jp2"}, "66": {"fulltext": "58 SANITATION.\\nSewer Gas is a mixture of gases, vapors and solid particles,\\nderived chiefly from organic matter in a state of decomposition.\\nCarbon dioxide, sulphureted hydrogen, ammonia, etc., are usually\\npresent. The great danger lies in the germs which produce the\\ndecomposition of the particles of animal and vegetable matter.\\nThat sewer gas is itself capable of producing such diseases as\\nscarlet, yellow, typhoid and malarial fevers, cholera, etc., is no\\nlonger believed, but gas from sewers containing excreta from pa-\\ntients laboring under these diseases, if connected with houses by\\nimproper plumbing, or defective traps, may contaminate food or\\nwater left near sinks or other openings, especially if, from disuse\\nfor a few days or weeks in hot weather, the pipes and accumulated\\nmatter within them become dry, in which case it may also be\\npossible for germs to settle upon the lips of one breathing the gas\\nand be carried in the saliva to the throat or digestive tract, the\\nfields for their deadly work. It is certain, however, that gases\\nas poisonous as those that escape from sewers will, if long inhaled,\\nreduce the system to a susceptible condition for the easy con-\\ntraction of these diseases, and it is probably in this way that most\\nof the mischief is done. Wash basins and other conveniences with\\nsewer connections should never be in living or sleeping rooms,\\nno matter how perfect the plumbing. They are likely to be bad\\nenough in the kitchen and bath room where they can be shut\\nfrom the rest of the house and their dangers reduced by special\\nventilation.\\nDust containing organic matter, not septic, often produces\\nserious results. Workmen in tobacco factories usually suffer for a\\nfortnight after commencing work, from catarrh, nausea, nervous\\ntroubles and loss of appetite. In pregnant women there is a\\ntendency to abortion. The system soon accustoms itself to the\\naction of the poison, though it often leaves a permanent impress\\nupon the nerves, and an irregular action of the heart and lungs.\\nThe average life of the cigar maker is but 38 years. Millers,\\nthough often hearty and seemingly robust, frequently suffer from\\npulmonary diseases, and have an average life of but 46 years.\\nThose operating grain elevators and threshing machines suffer\\nfrom a very irritating dust which loads the pulmonary mucous\\nmembrane, often producing severe rigors after the first day s\\nwork but in a short time the system becomes accustomed to it\\nand suffers less.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0068.jp2"}, "67": {"fulltext": "SANITATION. 59\\nWe have known one season s work to destroy the lives of\\nall those who spent much of their time in a dust saturated room,\\nengaged in the manufacture of ochre brick by the dry process.\\nBrush makers, from the inhalation of sharp fragments of bristles,\\nare prone to lung diseases. Cotton-mill operatives, from breathing-\\nair iaden with cotton liber, suffer from various forms of bronchial\\nand pulmonary trouble, frequently ending in consumption while,\\nbecause of the oil in wool, consumption among woolen-mill opera-\\ntives is comparatively rare. Wool and rag sorters disease is prob-\\nably a form of anthrax, due to specific contamination, and its pre-\\nvention lies in properly steaming the stock before giving it to the\\npickers. The lungs are stained by coal dust, just as the skin is\\nstained when long kept in its solution. The lung tissues of an\\nold coal miner are a bluish black, though the occupation rarely\\ntends to pulmonary disease.\\nInorganic Dusts often produce grave results. Among file\\ncutters, 62.2 per cent contract phthisis needle polishers, 69.6 per\\ncent; grinders, 40.4 per cent, with an average life of 30.16 years.\\nIn grinding glass, cutting millstones, or any other occupation\\nthat fills the air with dust, there always is a tendency to serious\\nlung disease, the danger being in proportion to the sharpness of\\nthe dust, and the quickness of its chemical action. Prevention\\nlies in guarding against the admission of the dust to the air\\npassages.\\nVENTILATION.\\nBy ventilation we mean change of air by artificial methods,\\nwhereby that which is pure is made to displace that which has be 1\\ncome impure. It is essential to the health of all who live in en-\\nclosed spaces, and is of special importance in homes continuously\\noccupied. It is perfect when pure air, at an agreeable temperature\\nwith proper moisture, is distributed throughout an enclosure with-\\nout perceptible draught, in such quantity as to prevent its occu-\\npants from inhaling that which has been exhaled or otherwise con-\\ntaminated. Y\\\\ nen taken into the lungs, air iswarmed, moistenedand\\nmade lighter, so that when exhaled it rises, creates a current and\\ngives place to fresh air. In this way nature provides that we shall\\nbe ventilated, and never permitted to breathe air which we have ex-\\npired, if opportunity be given it to escape, but man, in his un-\\nwisdom, to economize fuel has applied every mechanic art to make\\nthe house tight, thus keeping in exhausted and contaminated air,\\nand keeping out that which is pure and invigorating.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0069.jp2"}, "68": {"fulltext": "60 SANITATION.\\nAs the average adult breathes 540 cubic inches of air every\\nminute, and in the same time throws out about 25 cubic inches of\\ncarbon dioxide which pollutes and makes unfit for breathing 5\\ntimes its volume of air, one can readily understand the importance\\nof ventilation. To breathe an atmosphere from which the oxygen\\nhas been exhausted is to starve in the midst of plenty, while to\\nbreathe contaminated air is suicidal. When, upon entering an oc-\\ncupied room, a musty odor is noticed, and there is a sensation of\\nfaintness, you may feel sure that it contains a much larger pro-\\nportion of carbon dioxide than the air without. Dr. Parks says:\\nImpurities may be detected in this way when there are 6 parts of\\ncarbon dioxide in 10,000, and when there are 10 parts the air is\\nmarkedly close and unpleasant to those coming from a pure\\natmosphere.\\nSanitarians generally agree that the standard of purity shall\\nbe about two parts of carbon dioxide in excess of that contained\\nin what is called pure air, which we have already seen is about\\n\u00e2\u0080\u00a2four parts in 10,000. Not only is the dioxide itself injurious, but,\\nwhen due to respiration, is a danger signal because of the poison-\\nous effete matter always associated with it. Ventilation must pre-\\nvent it from being present in larger quantity than six or seven parts\\nin 10,000. It may be detected by moistening a piece of blotting\\npaper with aqua ammonia and placing it within a cylinder of the\\nsame paper moistened with dilute muriatic acid. If present in\\ndangerous quantity there will be the white fumes of muriate of am-\\nmonia. The test should be made in the stratum that is being\\nbreathed and at the places of entrance and exit. If the above\\nstandard be accepted as the limit of impurity, about 750 cubic feet\\nof air per hour must be distributed to each occupant of a room.\\nWe should always consider the source from which air is re-\\nceived and guard against the admission of that already impure.\\nGround air and air contaminated by any kind of sewage or dust\\nmust be carefully avoided. The best air for ventilating purposes,\\nespecially in cities, is that taken from above contaminating in-\\nfluences, admitted through a shaft and forced downward by some\\nfanning process. All buildings occupied by many people should\\nbe ventilated in this way. By using ice in hot weather, buildings\\nthus equipped may be kept comfortably cool. In planning for\\nventilation we must consider the cubic space of the apartment, the\\nnumber of inmates, how long they will occupy it, the rapidity with", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0070.jp2"}, "69": {"fulltext": "SANITATION. 61\\nwhich the air may be changed without dangerous draft, and the\\nmode of heating and lighting. A room 25x30 feet, with a ceiling\\nof 13^ feet, will contain 10,000 cubic feet. If occupied by 40\\npersons each would have an air space of 250 cubic feet but, if oc-\\ncupied continously, each should have from 300 to 400 feet.\\nA school room, well ventilated and frequently flushed, occu-\\npied from six to eight hours daily, will be healthful with 240 cubic\\nfeet to each pupil. The average school room does not give half\\nthat. If the over-crowded apartment does not stupefy the brain\\nof both pupil and teacher, and develop actual disease, it will devital-\\nize until its occupants become easy victims to every type of dis-\\nease, especially the septic ones as scarlet fever, typhoid fever, diph-\\ntheria, measles, etc., the great destroyers of childhood and youth.\\nVery great care should be taken in the ventilation of all rooms\\ncontinuously occupied by many people, and this is especially\\ntrue of the school room. Large numbers of children are often\\ncrowded into apartments entirely too small and their little lives\\njeopardized by teachers not well informed on ventilation and the\\ndangers arising from breathing poisonous air.\\nTo ventilate with cold air the entrance and exit should both be\\nnear the ceiling but on opposite sides of the room, that the pure,\\ncold, heavy air descending may displace that which has become\\nimpure, warm and light, by crowding it through the exit. Xo\\none should sit under such an entrance, for a current of cold air\\nfalling upon the head is dangerous. This may be largely avoided\\nby such an arrangement of slats as will give the current an up-\\nward turn. Dust may be kept out by stretching thin flannel over\\nthe openings. There should always be a current passing through\\nthe room.\\nWhere windows must be used for ventilating and a large\\namount of air is not required, a good way. is to fit a board, five or\\nsix inches in width and as long as the window is wide, to the under\\nside of the lower sash so as to permit no air to pass under the win-\\ndow when raised but to admit a nice stream, with an upward turn,\\nbetween the lower and upper sashes. Two or more windows on\\nopposite sides, thus equipped, will do much toward keeping the\\nair of an ordinary room pure and healthful.\\nGood ventilating shafts for houses to be warmed by stoves\\nmay be cheaply obtained by building the chimneys large, say 18\\ninches square inside, then running the stove-pipes up inside them", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0071.jp2"}, "70": {"fulltext": "62 SANITATION.\\nto their tops, but a better plan is to build a separate ventilating\\nshaft close beside the smoke flue. In either arrangement two\\nregisters, one near the floor, the other near the ceiling, should open\\ninto the ventilating shaft from each room.\\nThe heat from the stoves will create strong drafts in the\\nshafts which will draw from the rooms opening into them. Open\\nfireplaces or grates are excellent ventilators.\\nAir must be admitted from a pure source. Cellar air, so\\ncommonly supplied to furnaces, is always dangerous. Pathogenic\\ngerms rarely rise above the lower strata, hence air taken from\\nabove the roof is usually the most desirable. When this cannot\\nbe admitted, the opening to the shaft should be as far above the\\nground as practicable and, when heated, should not be carried into\\nthe rooms through the floor, where the registers are liable to be-\\ncome clogged and fouled by sweepings and other contaminations,\\nbut through walls near the floor, and discharged near the same\\nlevel on the opposite sides. That it may be equally diffused\\nthroughout the room, without perceptible draft, it is better to\\nhave several points of entrance and exit. Unpleasant drafts may\\nbe corrected also by making the entrances larger than the exit but,\\nin every form of ventilation, let it always be remembered that\\nample provision must be made for the removal of foul air.\\nThe proper size for flues and registers can be found by divid-\\ning the number of cubic feet of air to be supplied per second by\\nthe velocity in feet, per second, of the air at the inlet. It is better\\nto have the openings, both inlets and outlets, made too large, rather\\nthan too small, as their size can be more readily reduced than en-\\nlarged. The velocity should never exceed six feet per second, and\\nif the registers are so placed that the admitted air strikes the occu-\\npants it should not exceed one and a half feet. The amount of\\nair to be supplied w r ill depend more upon the number of persons\\nthan upon the number of cubic feet the room contains, but a room\\nwarmed by hot air and equipped with proper exits will require\\nmore to keep it comfortable than is needed for respiration. The\\ncurrent may be stronger at the outlet than at the inlet without\\ncausing dangerous draft. If the shaft be built next to a warm\\nchimney, the velocity will be increased.\\nSome novel modes of ventilation have been patented, which\\nare even worse than the economy of corking every crack and\\ncrevice by which pure air may enter and foul air escape. Where", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0072.jp2"}, "71": {"fulltext": "SAX IT ATI ON. 63\\nbuilders, especially school boards, are not thoroughly posted in\\nscientific ventilation they should consult a disinterested expert, for\\nno feature of the building is more important.\\nDry water closets are rarely, if ever, satisfactory and should\\nnever be placed in either public or private houses. Sewage should\\nnever be permitted to accumulate in or about a building, and if\\ndried or cremated it must be done where it cannot contaminate the\\nair breathed by people, and every precaution should be used to\\nprevent sewer gas and other noxious air from entering ventilating\\nshafts, except as drawn from the rooms they ventilate.\\nWhere there are no arrangements for improved methods of\\nheating and ventilation, an equal diffusion of warmth and pure\\nair may be secured by surrounding the stove with zinc sheeting,\\nopen at the top, with an air space of a foot between it and the\\nstove. Pure air from outside the building must be admitted\\nthrough a pipe terminating beneath the stove and after being dif-\\nfused through the room, escape near the floor at the several sides\\ninto ventilating shafts.\\nIn every school room, and in all rooms occupied for many\\nhours by many people, there should be a few simple instruments.\\nA thermometer should be placed four feet above the floor, and\\nshould register 68 degrees Fahrenheit. To know that warmth\\nis equally diffused it should, from time to time, be placed in dif-\\nferent parts of the room. An air tester, indicating the purity of\\nthe air, is even more important. Wolpert s is a good one and\\neasily comprehended. A hygrometer, showing the percentage of\\nmoisture, is also useful. Danville s, Regnault s and Heddlestom s\\nare all good instruments.\\nThe greater the amount of air, whether warmed before or\\nafter its admission, the greater the amount of fuel required. Ven-\\ntilation and heating are interdependent. It is false economy to\\nsacrifice the former to the latter, for, although there can be no\\ncheap system, a perfect system is always worth more than it costs.\\nIf we can secure in the home and other buildings occupied by\\nhuman beings an abundant use of pure air, we shall have done more\\ntoward preserving health and prolonging life than we could by\\nthe solution of any other sanitary problem. The lowered vitality,\\nconsequent upon imperfect ventilation, may be gradual, at first\\ninappreciable, but it undermines the health, lessens the power to\\nresist infectious and contagious diseases, and tends to premature", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0073.jp2"}, "72": {"fulltext": "64 SANITATION.\\nage and death. Its influence upon some may for a time be un-\\nperceived. The power of adaptation to environment, always\\ngreat, varies greatly in different individuals, so that it is ever the\\nold story And two women shall be grinding at the mill, the one\\nshall be taken and the other left.\\nThe causes of disease, physical as well as mental, rarely occur\\nsingly, and it may sometimes be difficult to say which is responsi-\\nble, this or that. Scientific sanitation seeks not only to know all\\nthe causes of disease, but to remove them all, a consummation that\\nnever can be reached without the aid of ventilation and a con-\\nstant and liberal supply of pure air.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0074.jp2"}, "73": {"fulltext": "CHAPTER V.\\nWATER.\\nWe can live longer without water than without air. but as\\nthe body is from four to five sevenths water, from which, by excre-\\ntion and exhalation, there is constant loss, a frequent renewal of\\nthe supply is essential to life. Water is the medium by which the\\nnutrients and waste products of the body are held in solution or\\nsuspension, and borne to and from the various tissues and organs,\\nand the diseases consequent upon an inadequate supply of it cover\\nthe entire list of those caused by innutrition and the non-removal\\nof the waste incident to all activity. Nothing can atone .for in-\\nsufficient water.\\nIt is very important that water for domestic purposes be pure.\\nAll organic matter, undergoing or liable to undergo decomposi-\\ntion, renders water impure, and although it may contain no spe-\\ncific form of sepsis producing cholera, yellow fever, typhoid fever,\\nor the like, it gradually lowers vitality and systemic resistance,\\nthus tending to the ready inception of all forms of disease. Some\\nminerals in moderate amount are inert, or even healthful, while\\nothers in the smallest quantity are poisons. Absolutely pure\\nwater, H2O, does not exist in nature. Lake Loka in Sweden\\nis said to furnish the nearest approximation, and to contain but\\none twenty-eighth of a grain of solid matter per gallon. Decom-\\nposing algea and other water plants, and the leaves of most trees,\\nare less dangerous than decaying animal matter, which is less\\ndangerous than ordinary human excreta, and very much less dan-\\ngerous than the discharges from patients laboring under certain\\ndiseases.\\nIn all cities most homes are, and should be, provided with\\nhydrant water, the purity of which is likely to be measured in\\neach case by the degree of civilization possessed by the city, that\\ncivilization being highest which furnishes the purest and most\\nabundant water. In densely peopled localities no wells should\\nbe tolerated, for in cities and most villages, old or recent privy\\npits and cesspools honeycomb the ground, while leaking sewers\\n5 65", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0075.jp2"}, "74": {"fulltext": "66 SANITATION.\\nand made soil are common, furnishing constant contamination\\nand, often, a terrible death rate.\\nCountry wells, properly made, are usually healthy, though\\nwe have seen fearful epidemics of typhoid fever and diphtheria in\\nrural homes caused by wells being contaminated by privy pits\\nand other foulness. It is a rule that the privy should be one\\nhundred feet from the well. This is the minimum. When the\\nsoil is porous or the dip of the strata is from the privy toward\\nthe well, the distance should be very much greater. Always\\navoid the latter arrangement, if possible, by placing the privy on\\nthe lowest ground. Specific poisons, such as produce typhoid\\nfever, yellow fever, Asiatic cholera, malignant dysentery, etc., in\\nthe smallest possible quantities, are dangerous, and all danger\\nsignals should be regarded.\\nThe greed of gain characterizing too many water companies\\nshould not be allowed to hazard the lives of their patrons. The\\nwater supplies of cities taken from streams receiving city sewage,\\nand distributed without proper sedimentation and filtration, may\\nbe condemned without analysis; and so may wells, although their\\nwater be clear and sparkling, pleasing to the palate and compara-\\ntively free from organic matter, if they be in the neighborhood\\nof privy pits, or allied sources of pollution, especially if any water-\\nborne disease has followed their use. Taste and appearances may\\nbe very unreliable guides.\\nSEDIMENTATION.\\nSedimentation means permitting water to stand in basins\\nuntil its heavy inorganic matter falls to the bottom, carrying with\\nit a portion of the organic contents, while the remainder are more\\nor less perfectly disintegrated by the action of microbes. The\\nagency most relied upon for purifying water is filtration, but sup-\\nplies containing much solid matter in suspension must first be\\ntreated by sedimentation. In this process, properly conducted,\\nthe water is drawn from one basin to another until it is clear, the\\nnumber and size of the basins being regulated by the impurity\\nof the water and the amount required. An acre in extent is a\\nconvenient size. The basins at St. Louis emphasize their im-\\nportance. They each hold 18,000,000 gallons of water, and the\\nsediment, removed every four months, amounts to 2,000,000 cubic\\nyards per annum. To all water containing large quantities of\\nfinely powdered soil, a week should be given for sedimentation.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0076.jp2"}, "75": {"fulltext": "SANITATION. 67\\nFILTRATION.\\nFiltration is the passage of water through some substance\\nthat removes from it the solid particles. The bacteriologist con-\\ntends that, to be of any value, filtration must also deprive it of its\\nbacteria. Pursuant to this the following points were so clearly\\nmade by Prof. J. B. Johnson, of Washington University, in an\\naddress before a recent meeting held by our State Board of\\nHealth, that we quote by permission\\nIn general, there are but two sources of water for domestic\\nuse surface waters and ground waters. Since all surface waters,\\nwhether rivers or lakes, are composed of the run-off, they must\\ncontain the impurities washed from the surface by the cleansing\\nrains. These are carried either in solution or suspension, and,\\nalong with the inert organic or inorganic matter, there will always\\nbe found in every swallow of water some millions of bacterial\\norganisms. As most of these are entirely harmless, we suffer no\\ndetriment, but occasionally they include some of the disease-\\nproducing bacilli, and then, if the system is in a susceptible condi-\\ntion, sickness results. If in close communication with surface\\ndrainage, ground water is likely to be as fully contaminated as\\nsurface water, and often it is very much worse.\\nIt is only from deep wells, wholly cut off from surface con-\\ntamination, that water can be obtained absolutely free from bac-\\nterial life. Such a supply is that of Memphis, Tenn., where the\\nwater comes from a large deposit of pure quarcz sand several hun-\\ndred feet below the surface, from which it is separated by a thick\\nstratum of clay. While artesian waters are likely to be charged\\nwith inorganic matter in solution, they are quite free from all or-\\nganic pollution and from all forms of bacterial life but since\\nthese sources are very exceptional, few cities can be supplied in\\nthis way, and the chief reliance must be upon surface waters.\\nThese, to be entirely healthy, must be freed from their bacteria.\\nOne of the greatest triumphs of sanitary science is the ability to\\ndo this, and it can be proved beyond a reasonable doubt that this\\npurification is effected by filtration through fine sand.\\nEvidently this process does not consist of straining the\\nwater, for these organisms pass rapidly through the closest filter\\npaper, and probably wherever water can go, so far as any me-\\nchanical restriction is concerned. The action of a sand filter is\\nsomething very different. Indeed, the efficiency of a sand filter", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0077.jp2"}, "76": {"fulltext": "68 SANITATION.\\ndepends upon the presence in the water of certain microscopic\\nvegetable growths, which are collected on the sand grains on and\\nnear the top of the filter and there form a kind of porous blanket-\\ncovering, through which the water to be filtered must pass. This\\ngelatinous cover is of a thick, spongy nature, and is itself a grow-\\ning vegetable, furnishing enticing habitations for the innumerable\\nfamilies of water bacteria which here find a home. These in turn\\nattack and consume the organic matter in the water as it slowly\\nmoves down through this superficial blanket of living and hungry\\norganisms, so that, after passing through this film, not over a\\nquarter of an inch thick, the water is found to have lost not only\\nits bacteria but a very large portion of its other organic matter.\\nAll surface waters contain a sufficient number of vegetable\\nspores to form a protecting coat in a few days, after which it is\\nconstantly renewed from the oncoming water. As the vegetable\\nwhich forms the tough coating, and the all-consuming bacteria\\nhoused therein, die, they are at once consumed by the living gen-\\neration, which is ever increasing in numbers, until the passages\\nbetween the sand grains become clogged with them, when this\\nimpervious purifying cover has to be removed and a new one\\nallowed to form. In water containing a large amount of silt, like\\nthat of the Missouri river, which must first be settled to get rid\\nof the mud to prevent immediate clogging of the sand filter, we\\nfind that a large proportion of the organisms which form the\\nspongy cover, and also of the all-consuming bacteria, go down\\nwith the mud in the settling basins, and that it is likely to require\\na longer time and the passage of a larger quantity of such settled\\nwater through the filter to render it again effective, after a cleans-\\ning by removal of its top layer, than it does of water that was\\noriginally clear.\\nIt is thus seen that water, alive with micro-organisms, con-\\ntains within itself the elements for its own purification, and that\\nthe sand filter furnishes the means for making them effective.\\nThe process is a bacteriological, not a chemical one. Water may\\nbe chemically pure, yet contain so many disease germs as to be\\nvery dangerous. Upon no scientific subject has there been a\\ngreater change of views during the last few years than that of\\nwater purification. It has been but a little while since animal\\ncharcoal and some other forms of carbon were thought ideal ma-\\nterials for filters, because when fresh and in perfect condition", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0078.jp2"}, "77": {"fulltext": "SANITATION. 69\\nthey can strain out some colors from swamp waters and change\\nclaret into a colorless liquid, but it is now known that they can\\nremove scarcely anything of a disease-producing nature, and are\\nunable to promote any germicidal effects that asbestos filters\\nare also worthless, and that very little confidence can be placed\\nin any filter made from natural stone until that particular filter\\nhas been tested. At that time sand filters were thought of no\\nvalue, bcause they remove but a small proportion of dissolved\\ninorganic matter. Indeed, it was not until after the discovery\\nof bacteria in water, and their relation to disease, that the real\\nsignificance of water filtration began to be understood.\\nAlthough a sand filter may strain out solids and make water\\nclear, its most valuable service is that of destroying disease-pro-\\nducing bacteria by means of other bacteria, as already described.\\nTo do this most efficiently the filter must have been in opera-\\ntion several days, not only that the sand may become firmly set-\\ntled, but that the slimy, vegetable growth, swarming with bacterial\\nlife, may form over its surface. Let it be emphasized that it is\\nin this covering that its chief value lies that here the principal\\npurification of the water takes place and that when this film\\nhas been formed it will do good work until it and a thin layer\\nof sand next to it have become so clogged as to cause too scanty\\nflow, when a thin layer must be scraped from the top of the filter-\\nbed and a new film allowed to form. At some large filters it is\\ncustomary, as soon as the. clogged layer has been removed, to\\nspread over the surface some of the sand scraped off at a previous\\ncleaning, that its bacteria may hasten the growth of the new\\ncovering, and the period that the filter must remain idle thus be\\nshortened. Meantime, the outlet is closed, and the surface of\\nthe filter-bed is kept covered with filtered water let in from below.\\nMost of the purifying organisms require oxygen, hence, the\\nuse of the filter should be discontinued for an hour or two each\\nday, the water drawn off, and the surface of the bed exposed to\\nthe air. With long use a gradual growth of the surface bacteria\\nextends through the filter-bed, and so large a number of these\\norganisms then appear in the filtered water as to make it neces-\\nsary to renew all the sand.\\nAlthough nearly all water bacteria are harmless to the human\\nbody, and many of the common, vigorous forms rapidly destroy\\ndisease bacteria, such as the germs of typhoid fever, when brought", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0079.jp2"}, "78": {"fulltext": "70 SANITATION.\\ninto contact with them, water that contains more than ioo of any\\nkind of germs to the cubic centimeter (fifteen drops) is consid-\\nered unfit for use. When it is remembered that a filtrate of this\\ndegree of purity is likely to have contained many thousands of\\nbacteria per cubic centimeter when it entered the filter, it can\\nbe readiiy understood that the modern sand filter, properly con-\\ntrolled, silently but surely perforins a most priceless service.\\nAs already indicated, it is impracticable, if not impossible, to\\nmake a filter with spaces between its grains smaller than the\\nmicrobes. The medium sought is one with spaces so small that\\nthe microbes shall be retained by molecular attraction until they\\ncan attack and destroy each other. Sands of various dimensions\\nare used for this, but in general its grains should not exceed .015\\nof an inch in diameter, and a smaller size is usually preferred.\\nWith everything in perfect order, a filter-bed of such sand a few\\ninches in thickness is sufficient, but to guard against accidents\\nand to assure reliable service for a long time, the large filter-beds,\\nused in the purification of water supplies for cities, are usually\\ncomposed of from 30 to 60 inches of fine sand, resting upon a\\nfew inches of coarse sand, underlaid by a few inches of fine gravel,\\nwith a layer of coarse gravel under all, that the filtered water may\\nreadily percolate through it to the outlet.*\\nFor effective bacterial work, filtration must be a slow process,\\nand the efficiency of a filter will vary inversely with the quantity\\npassed through it in a given time. To secure good results, the\\nspeed of the water as it passes through the fine sand should not\\nexceed four inches per hour, under a pressure of three or four\\nfeet of water.\\nThe prevention of water-borne diseases by proper filtration\\nhas been so thoroughly demonstrated, we will pause to mention\\nonly one of very many convincing tests. Hamburg and Altona,\\nin Germany, lie closely, side by side, on the right bank of the\\nElbe, and both take their water-supplies from that stream\\nAltona from a point seven miles below the sewers of both cities,\\nHamburg from about seven miles above. The raw water of\\nAltona is thus polluted with the sewage of about 770,000 people,\\nRecent experiments with water excessively charged with bacteria indicate that\\ndeep filter-beds may sometimes be necessary, and emphasize the importance of sand\\naction in germ destruction, as distinguished from the action of the sediment layer, by\\nwhich it appears that while the surface film is the principal factor, it is not by any\\nmeans the only agency in sand filtration.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0080.jp2"}, "79": {"fulltext": "SANITATION. 71\\nand generally contains from 20,000 to 40,000, sometimes 100.000,\\nbacteria per cubic centimeter. The Hamburg supply, prior to\\n1893, received no filtration, but that of Altona was purified by\\nsand filters before delivery for domestic use.\\nIn August, 1892, some gypsies, among whom was a case of\\ncholera, camped on the bank of the river, above these cities. An\\nepidemic of the disease promptly broke out in Hamburg, causing\\nin August and September 16,748 cases and 8,605 deaths. No cases\\noccurred in Altona until December and January, when a slight\\nepidemic came, caused, as Professor Koch afterward demon-\\nstrated, by contaminated water that had passed through cracks\\nin the walls of the filter-beds, results of freezing. Although along\\na street forming the dividing line of the two cities, there were\\nnumerous cases on the Hamburg side in August and September,\\non the opposite side, among the residents supplied with the\\nAltona filtered water, not a case of cholera occurred. In like\\nmanner, because of the freezing of its filter-beds, Altona suffered\\nfrom typhoid fever during other winters, and, although the fever\\nwas constant in Hamburg, it appeared only at these times in\\nAltona. But Hamburg still further illustrates the value of pure\\nwater. Roused by its cholera scourge, the city adopted most\\nradical improvements, whereby its water supply, which is still\\ntaken from the same polluted stream, was so filtered that\\nits death rate from typhoid fever, which had always been very\\nlarge, has been reduced to only 6 in each 100,000 inhabitants.\\nFilter galleries are trenches sunk below low water mark, ex-\\ntending several feet to a reservoir, and filled with sand and gravel.\\nThey are very unreliable and likely to prove a source of danger\\nand disappointment.\\nFiltration by percolation is one of nature s chief methods of\\npurifying water, and is more or less perfect, according to the\\nmedium through which the water passes. When perfect, all sus-\\npended matter, alive or dead, is intercepted.\\nOTHER METHODS OF PURIFYING WATER.\\nNitrification, oxidation, sunlight, heat and cold are also\\nnature s methods.\\nNitrification is a sequent of germ action, which, as we have\\nseen, plays such an important part in the purification of water\\nby sand filtration as to constitute its main factor.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0081.jp2"}, "80": {"fulltext": "72 SANITATION.\\nOxidation is the action of atmospheric oxygen. Its power\\nto change organic matter has been greatly overestimated. No\\nriver is long enough to purify its water in this way. Even the\\nwaters of Niagara are little changed by their tremendous leap\\nthrough the air.\\nSunlight destroys many kinds of germs, and in this way is a\\npurifier.\\nHeat, as produced in nature, has little influence in purifica-\\ntion. Results sometimes attributed to it and to oxygen are due\\nto light.\\nCold cannot be relied upon to destroy many kinds of bacteria,\\nor as a means of purification, although alternate freezing and\\nthawing will diminish organic life, and cold hastens sedimenta-\\ntion. Ice may be very impure and is a frequent means of convey-\\ning disease. Water will not freeze pure. Many micro-organ-\\nisms are not injured at all by freezing, but on thawing out awake\\nto new activity, and, if taken into the alimentary canal, are liable\\nto do deadly work.\\nDistillation produces pure water, and though its expense pre-\\ncludes its use on a large scale, there are small stills in the market\\ncapable of furnishing supplies for family use without much extra\\nexpenditure for fuel. (See Beverages, page 82.)\\nBoiling is an easy method of destroying germs, thus rendering\\ninert organic matter. All suspected water should be boiled twenty\\nminutes before it is used for drink. The insipidity of boiled and\\ndistilled waters may be overcome by pouring several times\\nthrough a pure atmosphere or by other means of aeration. Fil-\\ntering through charcoal improves the taste.\\nDOMESTIC FILTERS.\\nA good domestic filter is needed in most households sup-\\nplied with either rain or hydrant water. Most of those on the mar-\\nket require constant care and intelligent supervision, and nearly\\nail of them have no bacteriological value, hence, are practically\\nworthless. A better one than most of those offered for sale can\\nbe made by placing a piece of thick, white flannel in the bottom\\nof a large flower-pot, previously cleansed by scalding, placing on\\nthat a couple inches of fine gravel, on that a thin layer of coarse\\nsand, then six or eight inches of fine sand over all, and well pressed", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0082.jp2"}, "81": {"fulltext": "SANITATION. ^3\\ndown. To be of any value it must operate slowly. A fruit jar, or\\nlarge bottle, with a funnel in its mouth, makes a good receiver for\\nthe filtered water.\\nRAIN WATER.\\nRain water includes all water that has been evaporated, con-\\ndensed and precipitated, whether as rain, snow, frost or dew. By\\nmany it is thought to be pure. But it is often very impure, for\\nin passing through the air it absorbs gases, especially carbon diox-\\nide and ammonia, and brings down with it various atoms, always\\nfloating in the air. As these atoms are chiefly organic, rain\\nwater containing three grains of solid matter per gallon is con-\\nsidered impure, although that amount in spring or well water\\nmight not be injurious.\\nIn cities, roofs are often covered with dust, containing a large\\namount of organic matter, and water collected from them may\\nbe very bad. A pure supply may be obtained by turning off the\\nfirst rain-fall and passing the rest through a good filter. It is\\nas difficult to obtain perfection in filters as in many other things,\\nbut a properly constructed sand filter, more nearly, perhaps, than\\nany other, fills all the requirements for purifying rain water before\\nit enters the cistern.\\nA brick and cement, water-tight reservoir, five feet in diam-\\neter (or as much larger as the size of the roof and cistern may\\ndemand) and about ten feet deep, should be constructed. A vitri-\\nfied pipe should form the outlet, and over its opening at the bot-\\ntom of the filter should be placed pieces of brick or stone, to\\nprevent the entrance of gravel. A six-inch layer of coarse gravel\\nshould then be spread over the bottom, over this a four-inch layer\\nof fine gravel, next four inches of coarse sand, then about forty-\\neight inches of fine sand. A few bricks may be placed below the\\nsupply pipe to prevent the incoming water from tearing up the\\nfilter-bed. The remaining space will form a reservoir for storing\\nthe water gathered during a shower, until it can pass down through\\nthe sand. The more slowly this process is performed, the more\\nefficient it is apt to be. Water will be less likely to pass down\\nbetween the sand and the wall, thus escaping filtration, if there\\nbe built in the wall, about thirty inches from the bottom, a hori-\\nzontal offset four or more inches wide, abruptly increasing the\\ndiameter, for the sand will pack more closely upon this horizontal\\nsurface than upon the vertical ones.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0083.jp2"}, "82": {"fulltext": "74 SANITATION.\\nOf course, the materials used must all be clean. It is not best\\nto heat the sand, but if dirty it should be thoroughly washed before\\nit is placed in the filter. When the surface of the fine sand\\nbecomes clogged, a thin layer should be scraped off, and replaced\\nby clean sand. After a time the entire filter-bed must be taken\\nout, and one made of fresh materials substituted. As much of\\nthe reservoir should be below the surface of the ground as the\\ndepth of the cistern into which it is to drain will permit. The top\\nis best left open to the air and light, but, during winter, a few\\nboards may be laid across, and the top and sides protected from\\nfrost by a covering of straw or similar material. If the filter-bed\\nbecomes frozen, water should not be admitted until the frost has\\nthawed out.\\nThe cistern must be so constructed that no seepage can pene-\\ntrate its walls and no vermin enter from the top. The surface\\nshould slope from it in every direction. If made of brick or stone,\\nthough laid in cement, it should be at a safe distance from all cess\\nand privy pits. The best material for it is iron, laid in sections\\nwith cement, and coated with tar. Probably the next best mate-\\nrial is vitrified brick, laid in cement. The cover should exclude\\nall contamination, and be equipped with a ventilator to admit pure\\nair. No lead, zinc or galvanized pipes should be used about it.\\nThe pump should not rest upon the bottom, but terminate a few\\ninches above it, suspended from the platform. The chain-pump\\nrigged with small buckets which carry air down into the water\\nevery time that water is brought up, is the best yet devised for\\ncistern use.\\nPure soft water is healthier than hard water, and is better\\nfor cleansing purposes, giving a fresher and more youthful appear-\\nance to the complexion and greater softness to the skin, but it\\ndissolves both organic and inorganic matter more readily, hence,\\nincreased care is required to preserve its purity.\\nTESTS FOR IMPURITIES.\\nOnly bacteriological tests conducted with great skill and care\\ncan certainly decide as to whether water contains disease germs,\\nand in some cases careful chemical analysis is required to detect\\nthe presence of injurious inorganic elements, but there are several\\ntests for impurities, so simple as to be made by anyone. In all\\nexaminations remember that the purity of the water in a well", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0084.jp2"}, "83": {"fulltext": "SANITATION. 75\\nor reservoir differs at different depths. The surface ma} be prac-\\ntically pure, while, from sedimentation, there is great impurity\\nat the bottom.\\nColor. Pure water, in a clean and clear glass bottle, when\\nlight shines through it on a dark background, will be clear and\\ncolorless. A faint blue tint is no evidence, however, of impurity,\\nbut a yellow tint is always suspicious.\\nOdor. Fill a bottle half full of the suspected water, cork and\\nplace it where it will keep warm a few hours, after which shake\\nit and remove the cork. If it emits any odor, especially an un-\\npleasant one, the water should be further tested.\\nTaste. Water fresh from the well is usually tasteless, al-\\nthough it may contain putrescible matter. If pure, it should\\nremain tasteless after it has been left in a warm place long enough\\nfor any organic matter it may contain to decompose. If any\\nunpleasant taste develops, the water should be subjected to anal-\\nysis.\\nFermentation. Into a clean glass bottle, filled with the sus-\\npected water, drop a pinch of pure white sugar, and put it in a\\nwarm place, leaving it uncorked. If in two days the water appears\\ncloudy, it is impure and unfit for use.\\nThe Permanganate Test. An excellent test may be made\\nby putting into a glass-stoppered bottle two tablespoonfuls of\\nwater, three grains of permanganate of potash, and twelve grains\\nof caustic potash. Y\\\\ nen the potash has been dissolved, add a\\ndrop of the liquid to eight tablespoonfuls of the water to be tested,\\nin a clear white bottle, and if the color changes to a brown, or\\nin a few hours disappears, the water is too impure for drinking.\\nIn all tests be careful that everything used, except the water, shall\\nbe strictly clean.\\nBATHING.\\nWater must also be used for other than potable purposes.\\nCleanliness is next to godliness, because it tends to health, hap-\\npiness and purity. This requires abundant water in every home,\\nand its free use by every individual. So marvelous have been the\\nresults of cleanliness, through the free use of pure water, that in\\nsurgery they led at first to erroneous conclusions. Scientists\\nbelieved the benefits were due to some specific germicide, and\\noperating rooms were therefore flooded with solutions of carbolic", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0085.jp2"}, "84": {"fulltext": "76 SANITATION.\\nacid, corrosive sublimate, and the like. Under the leadership of\\nLawson Tait, it was found that the rapid and healthy healings\\nwithout inflammation or pus were due to thorough cleanliness,\\nsecured as readily by aseptic water as by the use of drugs. What\\nis true of the prevention of disease in wounds, is true of its pre-\\nvention everywhere. If the body, within and without, and all\\nits surroundings, be kept pure, disease will be reduced to the\\nminimum.\\nThe skin encasing the body performs many important func-\\ntions. It is the most extensive membrane of the organism, and\\nnot only covers the body, but is reflexed, and lines all the cavities\\nwhich open on its surface for although this inner lining is called\\nmucous membrane, it is only skin turned in. The skin not only\\nforms a covering and protection, but, through a delicate network\\nof nerves, furnishes information as to the character of its sur-\\nroundings. The hardened cells of its outer covering are contin-\\nually loosening, and, if not removed as dead organic matter, will\\ndecompose and perhaps be absorbed, for the skin not only absorbs\\noxygen, but the excretions of the body and other deleterious mat-\\nter that remains in contact with it. Hence, we must wash and be\\nclean.\\nWe note progress in many lines of sanitary science, but in\\nwater supply we are behind the civilization of ancient Rome, which\\nled the ages. Pure water brought from far-away mountains by\\nits great aqueduct, literally flooded the city of seven hills, and its\\npeople understood its importance and use. Agrippa erected 177\\nelegant baths, where the poorest Roman could lave without a\\nfarthing, and provided yet more luxurious ones at the charge\\nof a penny, thus tempting to cleanliness every citizen. Rome had\\n856 public baths, receiving 400,000,000 gallons pure soft water\\nannually, and, as a corollary of this munificence, private wealth\\ncompeted in the construction of baths, of splendor almost beyond\\nmodern conception, with another yet more important consequent\\nPliny tells us that for six hundred years Rome needed no other\\nmedicine than her baths. She boasted then in the health and\\nstrength of her people. Her degeneration now finds a fitting\\nsequent in the filthy, dwarfed and ungainly Italian immigrants\\nthat crowd the huts of our mining camps and cities.\\nWould there were Agrippas in the great Christian cities of\\nthe modern world. W r hile we are doing much to ameliorate the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0086.jp2"}, "85": {"fulltext": "SANITATION. 77\\ncondition of those struggling in life s unequal contest, there is\\neverywhere failure to appreciate the importance of preventive\\nmedicine, especially in the supply and use of pure water. But the\\nlight is breaking slowly, and civilized nations are beginning to\\nawake. In every first-class hotel, in many private houses, and in\\nsome tenements, there are approved bathing apartments, and pub-\\nlic baths are scattered through most cities, but the price of the\\nluxury is still generally beyond the reach of the poor, and too\\nmany brownstone fronts have baths for the family and guests, but\\ndeny them to those who cook the food, serve at the tables and\\ncare for the children.\\nThe rain bath meets all requirements for a public bath, and\\nhas much to recommend it. It requires a minimum amount of\\nwater and serves it to each bather fresh and pure, warm or cold;\\nit occupies little space, is easily kept clean, and may be used in\\nall weather at all seasons. The falling water should break into\\nspray with just sufficient force to rapidly cleanse the body.\\nWhether warm or cold, or both alternately, it produces grateful\\nsensations, and, as it runs away, carries with it the impurities from\\nthe person.\\nThe necessary outlay for such baths is so small they should\\nbe supplied to every citizen at public cost. Any large establish-\\nment using steam can have them at little expense, where the\\nworkmen can quickly wash away the dirt and sweat, incident to\\ntheir toil, and with such renewal of vigor that, on resuming work,\\nthey will return their employer more than a quid pro quo. Such\\nbath houses should have a dozen or more rooms, each 6x8 feet,\\nand high enough for proper water-fall. There should be both\\ncold and warm water, admitted through easily managed faucets,\\nthe floor should be of stone, slightly sloping, and adjoining each\\nroom should be a small dressing room provided with hooks, towels,\\nbrushes, soap, etc. As these rooms practically clean themselves,\\nthey require little supervision.\\nFree public baths of this kind should be in every city, dif-\\nferent buildings for each sex, and located at convenient points.\\nWhile their establishment opens a wide field for private charity,\\nit should not be left for individual philanthropy, but be clone at\\npublic expense at all centers of population. Their prevention of\\ndisease, and the vigor and energy developed in the citizen, will\\nabundantly repay the outlay. That some of our cities are begin-\\nning to move in this matter is one of the hopeful signs of the times.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0087.jp2"}, "86": {"fulltext": "78 SANITATION.\\nAny house can have, at small expense, a satisfactory shower\\nbath. All that is needed is a tub in which to stand and a tin pail\\nwith straight sides, a perforated bottom and an air-tight cover\\nsoldered to its top, with a nozzle for receiving a cork. Fill the\\npail with water, hang it over your head and, by pulling a string\\nattached to the cork, admit air above the water. Use care that\\nthe shower shall not be cold enough to produce a shock.\\nThe home of everyone who can afford it should contain a bath-\\nroom, so equipped that its use will be a luxury. Its windows\\nshould open into the outdoor air, its ventilation and plumbing\\nbe as perfect as possible, and its supply of water soft and pure.\\nTHINGS TO BE REMEMBERED ABOUT THE BATH.\\nThe bath should never be taken within two hours after a\\nfull meal, or when you are very tired, greatly exhausted, or chilly.\\nThe reaction will be the most perfect in the morning, but only\\na strong, healthy person should indulge in either a shower or tub-\\nbath before breakfast. For early morning, the sponge bath is\\npreferable. The temperature should be regulated by individual\\nvigor and sensibility to that which is the most agreeable. Neither\\nwater nor air should produce chilliness, nor should the water be\\nvery hot. If there are chilly sensations, the bath should be very\\nbrief.\\nThose suffering from lesions of internal organs, especially of\\nthe heart or lungs, should avoid cold baths, or gradually educate\\nthemselves to their use. Aged people should always avoid them.\\nCold baths should not be taken during menstruation, but warm\\nbaths may then be beneficial, both by promoting cleanliness and by\\nstimulating the discharges. A bath should never be continued\\nuntil it enervates, or interferes with reaction. The average length\\nof a warm bath should be from a quarter to a half hour, that of a\\ncool bath less, that of a cold one much less. Never drink freely\\nof cold water just before a bath, and always rub after a bath until\\nboth dry and warm. In healthy persons reaction may be hastened\\nand a pleasant glow of warmth secured by a spray of cold water,\\nshowered over the body after the bath and followed by free fric-\\ntion with coarse towels. Violent exercise immediately after a\\nbath is not desirable, but the vigorous may be benefited by a\\nbrisk walk, or other movements, to quicken the circulation and\\nrestore a normal temperature. The whole body should be bathed\\nevery day, or at least two or three times a week.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0088.jp2"}, "87": {"fulltext": "SANITATION. 79\\nA little baking soda, ammonia or good soap added to the bath\\nmakes it more refreshing, since by cutting the oil and other excre-\\ntions, it leads to a more thorough cleansing oi the skin. Baths\\nof milk, koumiss, beer, wine and blood have all had their advocates,\\nbut the best authorities agree that none are better than those com-\\nposed of water. The special benefits derived from ocean baths,\\nmineral baths, etc., may be due in part to the stimulus of their\\nsalts and minerals, but their chief value is in the outing which\\ntheir use implies. The change in diet and surroundings, the rest\\nof body and mind, the cheerful and healthful environment, and the\\nhygienic effects of any kind of water properly used, are the impor-\\ntant factors.\\nThe dry bath a bath without water, is an approved method\\nof stimulating the peripheral circulation, hence, of removing rem-\\nora and recent congestions, and consists of free friction over the\\nwhole body, as by a dry towel, continued until the skin feels like\\npolished ivory. It is a logical and generally successful method\\nof equalizing the circulation and removing colds.\\nVapor or steam baths are often very useful, for by promoting\\nperspiration and other excretions, the} cleanse the whole system.\\nVarious devices and costly cabinets are offered the public, but, for\\nmost practical purposes, the following contrivance is as good as\\nany of them On two slats support a basin ot water just below\\nthe seat of a cane-bottomed chair, and beneath the basin place\\na lighted lamp (an alcohol lamp is best), then sit in the chair,\\ncover yourself, chair and all, with a large blanket, gathering it\\ntightly about the throat and letting its lower edge rest upon the\\nfloor. When steamed to your fancy, spray the body with cold\\nwater, rub thoroughly with dry towels, dress warmly and avoid\\ndraughts and other means of taking cold.\\nSwimming combines a general bath with vigorous exercise,\\nand, therefore, may be continued longer than would be safe in\\nwater of the same temperature in a tub. Under proper condi-\\ntions it is healthful and invigorating, but it should not be overdone.\\nYoung people, especially, are inclined to remain in the water too\\nlong. Unless the water is very warm, the stay should not be\\nover twenty minutes, even for the most vigorous. Entering- the\\nwater when exhausted by severe exercise is likely to cause con-\\ngestion, and is very dangerous, but heating the body by outside\\ninfluences, such as hot air, is good preparation for a bath, and\\npromotes healthy reaction at its termination.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0089.jp2"}, "88": {"fulltext": "CHAPTER VI.\\nDIET.\\nBy Louis C. Duncan, M.D.\\nFoods serve the human body in two ways, one of which is\\nthe replacement of the worn-out tissues. This might, at first,\\nseem their only use, but another service, equally important, is\\nthe furnishing of heat and force keeping the body warm and\\ngiving it strength. Before an engine can furnish power, fuel\\nmust be consumed and heat transformed to force and before the\\nbody can have energy, food must be consumed, resulting in a\\nsimilar production of heat and force. The first named service,\\nby replacing worn-out parts, enables the body to perpetuate itself;\\nthe second, by furnishing power, gives it strength to meet the\\nvarious demands thrust upon it.\\nThese two requirements are met by two classes of foods\\nThe nitrogenous, and the non-nitrogenous.\\nThe Nitrogenoiis Foods, so called because they contain nitro-\\ngen, meet the first demand that of replacing worn-out tissues\\nand building up the body. They are also known as albuminous\\nfoods and as proteids, the latter being their most common name.\\nLean meats, eggs, casein of milk, and gluten of grains, are of this\\nclass.\\nThe Non-nitrogenous Foods, those which contain little, if\\nany, nitrogen, meet the second demand, and are of two kinds\\nthe fats, including the oils, and the starches, including the sugars.\\nThe principal non-nitrogenous foods are the grains, flour, meal,\\nvegetables, rice, fruit, cream, butter, fat, meat and oils. They pro-\\nduce animal heat and energy, and may be stored up in the tissues\\nas superfluous fat. The starches and sugars are often called\\ncarbo-hydrates.\\nThe above classification must not be taken as absolute and\\nexact. When speaking of a class of foods as force producers,\\nwe do not mean that they may not also be of some use in the econ-\\nomy of repair, but that their chief function is the production of\\nforce. So, too, the tissue-building foods may also bear a small\\n80", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0090.jp2"}, "89": {"fulltext": "SANITATION. 81\\npart in the production of heat and energy. Most, if not all, foods\\ncontain both proteid and non-nitrogenous elements, their per-\\ncentages differing widely. Thus, the proportion of these parts\\nin beef, milk and wheat are as follows\\nWater and -r, j- Non-Nitrogenous\\nMinerals. *roteia*. Elements.\\nBeef 57-oo 27.60 15.30\\nMilk 87.52 4.48 8.00\\nWheat 15.60 14.60 59.58\\nFrom the foregoing it will be seen that a mixed diet is a\\nnecessity, because the body demands both nitrogenous and non-\\nnitrogenous food, and a little study of the above table will show\\nthat in general there is nothing to be gained by adhering to a\\nvegetable diet. Though in varying proportions, the great staples,\\nwheat, milk and beef, all contain the same elements. Thus, beef\\ncontains twice as much of the proteids as there is in wheat, but\\nonly about one-fourth as much non-nitrogenous matter (starch).\\nNow, as baked bread contains a little less than half as much of\\nthe proteids as there is in an equal weight of wheat, if we eat\\nbread alone we must take four times as much of it as we would\\nof beef to get an equal quantity of proteids, and in so doing would\\noverload the stomach with starch, getting about eight times as\\nmuch as we would m eating the beef; but, by eating beef only,\\nAve would have to take an excess of proteids in order to get\\nenough starch. Hence, we see that either bread or beef, as an\\nexclusive diet, is likely to do harm by overloading and derang-\\ning the digestive system with one food element if we would\\nget enough of the other. A judicious mixture of the two\\nclasses of foods will most economically secure the proper develop-\\nment of the body, and maintain good health and the maximum\\nenergy.\\nAs the starches and fats produce heat, it is evident that they\\nshould not be taken in fevers, but that the proteids, which restore\\nand maintain the tissues without evolving much heat, will then\\nbe indicated. The proteids, since they contain nutriment in more\\nconcentrated form, and, in general, are more easily digested, are\\nbest in nearly all kinds of sickness. On the other hand, a healthy\\nbody in cold weather will require fats and starches. Except in\\na few conditions, the fats are more easily digested and assimilated\\nthan the starches.\\n6", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0091.jp2"}, "90": {"fulltext": "82 SANITATION.\\nThe Inorganic Foods. Besides the two great classes of foods\\njust mentioned, there is another class, known as inorganic foods.\\nIt consists of water and the various salts, and, although, strictly\\nspeaking, these substances are not foods, they, nevertheless, fill\\nvery important places in the human diet. As it is water that\\ngives to the blood, serum, sweat, and other fluids of the body\\ntheir fluidity, and constitutes 76 per cent of the muscular tissues,\\nand is the common carrier which bears the nutrients to and the\\nwaste from the various parts, the reasons readily appear why it\\nis so indispensable to animal life.\\nThe salts pass into the blood, unchanged, hence it is only\\nnecessary that they be in a state of solution to be absorbed when\\nthey come in contact with the lining of the alimentary canal.\\nMany of them are already held in solution in the water we drink,\\nbut an additional amount is usually needed and is added to the\\nfood to render it palatable. The chief of them is common salt\\n(Na CI), and is a varying quantity. It does five things for us\\nand our food It renders it more palatable lessens putrefaction\\nstimulates the flow of some of the gastric juices; by its affinity for\\nwater promotes the flow of it into the intestinal canal, thus assist-\\ning in the liquefaction of the foods and, lastly, promotes osmosis,\\ni. e., the mucous membrane lining the stomach and intestines per-\\nmits a more complete and rapid passage through it of the liquefied\\nfoods, for being covered with a salty fluid. It is essential that food\\nfor the sick, as well as for the healthy, be properly salted. Certain\\nminerals, as magnesia and lime, assist in the building process,\\nand other articles besides salt, as acids, alcoholics and spices, are\\ntaken to stimulate the appetite, to render the food more palatable,\\nor to aid digestion, but cannot themselves be properly called foods.\\nBEVERAGES.\\nMilk. Of all beverages, milk is the best. Besides satisfying\\nthirst, it furnishes the body with real nutriment to the amount\\nof about 13 per cent of its bulk.\\nWater. Water, of course, is one of the best of drinks. Pure\\nwater simply quenches thirst, but absolutely pure water is never\\nfound in nature, and, as already seen, the various wholesome salts\\nusually held in solution in water serve a good purpose. Hence,\\nwater purified by proper filtration, or by boiling, is likely to be\\nbetter than distilled water for drinking purposes. Indeed, unless", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0092.jp2"}, "91": {"fulltext": "SANITATION. 83\\nit contains poisonous solutions, or wholesome salts in excess,\\ndrinking water should not be distilled, for distillation impairs the\\ntaste and removes the salts and minerals essential to health. The\\nvarious mineral waters are useful in many cases, but we have not\\nspace for their discussion.\\nCoffee and Tea. Though in almost universal use, coffee and\\ntea are not at all necessary to health and strength. The highest\\nmental and physical efforts are possible with no other beverage\\nthan water. Coffee and tea contain very little nourishment, but,\\nbecause of their stimulating effects, are very useful to soldiers\\nand others undergoing great fatigue. After a day of severe\\nphysical effort without food, there is nothing else as grateful as\\ngood strong coffee. It is slightly laxative, while tea is astringent.\\nThe habitual coffee drinker suffers from headaches when without\\nit, but soon becomes accustomed to the loss. It is claimed that\\nstrong coffee in the morning keeps off malaria; in the evening\\nit often keeps off sleep. Strong, black coffee is an antidote to\\nopium poisoning. It may safely be said that coffee and tea, of\\nmoderate strength and quantity, are not injurious, and may be\\nbeneficial by quieting the nervousness and mental unrest of\\nfatigue and anxiety. Persons traveling, or in any way subject\\nto great exposure and strain, should drink plenty of good coffee,\\nbut no alcoholics. Soldiers of the United States army, on travel\\nrations, are allowed twenty-one cents each per day for coffee.\\nCocoa and Chocolate. Cocoa contains much nutritious mat-\\nter of an oily nature, somewhat difficult to digest, and, as much\\nboiling separates its elements and makes them still harder to\\ndigest, it should never be allowed to boil longer than five minutes.\\nChocolate should never be allowed to boil at all. In cases of con-\\nsumption and other wasting diseases, either is an excellent drink,\\nand when possible should be included in the diet.\\nDeer, Ale and Porter. These are fermented liquors made\\nfrom malted grains, and contain from 2 to 6 per cent of alcohol.\\nThe mildest of all the alcoholics, a moderate amount of them\\nmay be taken daily without injury, unless a morbid desire be cre-\\nated by their use. They have very little nutritive value, but\\nincrease the appetite, and favor the formation of fat. In large\\nquantities they cause fatty degeneration of the organs, especially\\nof the liver and heart. The fat of the beer drinker is not a healthy\\nfat, and does not represent stored-up vitality. These drinks are", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0093.jp2"}, "92": {"fulltext": "84 SANITATION.\\nnot prescribed in acute diseases, but are useful in convalescence,\\nand in chronic wasting diseases; as consumption, protracted sup-\\npuration, long continued nursing, scrofula and diseases of the\\njoints.\\nWines. Wines are made by fermenting the juice of the\\ngrape, and contain from 5 to 25 per cent of alcohol. Some wines,\\nas Port, have alcohol, added during the process of manufacture;\\nsome such fortified wines containing as much as 30 or 40 per\\ncent. Wines usually contain from 3 to 25 per cent of sugar, but\\ndry wines are free from sugar. Foreign wines are in no way\\nsuperior to our native wines. A glass of either, taken during\\nthe course of a meal, often aids digestion. Wines do good in\\ndiarrhea and! dysentery, anemia and chlorosis, convalescence and\\nchronic wasting diseases in various acute diseases and conditions,\\nwith great weakness and feeble heart, they are highly useful.\\nSuch occasions are met in pneumonia, pleurisy, typhoid and other\\nfevers, profuse hemorrhage, severe injuries and surgical opera-\\ntions.\\nBrandy and Whisky. These liquors are distilled from the\\njuices of fruits and grains. Brandy contains from 40 to 47 per\\ncent alcohol, and whisky, from 45 to 50 per cent. Neither is\\nsuitable for a beverage, but both are useful in diseases and injuries.\\nThey may be used in cases where wine /is useful, but something\\nstronger is required. They are indicated in all chronic, wasting\\ndiseases, and are prompt antidotes to the poisoning of aconite,\\ndigitalis, conium, and the bites of poisonous serpents, but, to be\\nof value in any of these cases, must not be given to intoxication.\\nAs soon as that point is reached, they should be discontinued, to\\nbe renewed as soon as the intoxication has disappeared, and the\\nprocess is thus to be continued until the poison has been over-\\ncome.\\nIt cannot be denied that the employment of alcoholics of any\\nkind is accompanied by danger of the patient s becoming addicted\\nto their use. This objection, therefore, should always be con-\\nsidered, and, except to elderly people, or in cases of great need,\\nthey should be administered very sparingly, if at all, and for a\\nbrief time only.\\nTHE DIET IN HEALTH.\\nA quart of milk, three-fourths of a pound of good beef, and\\nfive ounces of wheat flour, severally contain about the same", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0094.jp2"}, "93": {"fulltext": "SANITATION. 85\\namount of nutritive material. Milk contains every element\\nneeded by the human body, and comes nearest to being a perfect\\nfood. The quantity needed as a complete diet for an adult is\\nabout one and a half gallons per day. Y\\\\ neat bread also con-\\ntains all the necessary ingredients, and though not in the proper\\nproportions, when taken alone will sustain life. Although it\\nwould be an imperfect diet, a man could live on beef alone, but\\nbeef and wheat bread together make the essentials of a perfect\\ndiet form its foundation and body, all other parts being but\\nadditions and adornments to give variety, stimulate the appetite,\\netc. A study of the composition of these two great staples of\\ndiet logically leads to this conclusion, and all experience con-\\nfirms it.\\nThe amount of food daily required in health, and the proper\\nproportion of its nitrogenous and non-nitrogenous parts, have\\nbeen made the subject of much investigation. The tables of\\nProfessor Voight of Munich are generally accepted by scientific\\nmen. They show the following as the proper average amount\\nper day:\\nStarches\\nProteids. Fats. and Sugars. Total.\\nMan with light exercise 22 lbs. .22 lbs. .88 lbs. 1.32 lbs.\\nMan with moderate labor 28 .28 .98 1.54\\nMan with hard labor. 33 .33 1.10 1.76\\nCOMPOSITION OF FOOD MATERIALS.\\nShowing proportions of waste, water and nutritive parts.\\nNutritive\\nFood, Waste. Water. Material.\\nBeef Neck 20. 49.6 30.4\\nShoulder 12.6 55.8 31.6\\nChuck-rib 14.6 49.5 35.9\\nRib 21. 38.2 40.8\\nSirloin 19.5 48.3 32.2\\nRound 7.8 60.9 31.3\\nSide 19.2 44.3 36.5\\nRump (corned) 5. 70.8 24.2\\nFlank (corned) 12. 1 43-7 44.2\\nVeal\u00e2\u0080\u0094 Shoulder 17.9 56.7 25.4\\nMutton Shoulder 16.3 49. 34.7\\nLe g 18.1 50.6 31.3\\nLoin 15-8 4i-5 42.7\\nSlde 173 44-2 3%-5\\nPork\u00e2\u0080\u0094 Fresh I4 .6 43. 42.4\\nSalt Ham 11.4 36.8 51.8\\nChi cken 3 8. 2 44.6 17.2", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0095.jp2"}, "94": {"fulltext": "86\\nSANITATION.\\nFood. Waste.\\nTurkey 3~-4\\nEggs 137\\nBluefish (dressed) 45-9\\nMackerel (whole) 44.8\\nHalibut (dressed) 177\\nSalt cod 42.1\\nSalt mackerel 40.4\\nCanned salmon 4.9\\nLobsters 62. 1\\nOysters 82.3\\nNutritive\\nWater.\\nMaterial.\\n447\\n22.9\\n63.1\\n23.2\\n43-\\nII. I\\n40.2\\n15.\\n61.9\\n20.4\\n40.5\\n17.4\\n28.1\\n3i-5\\n59-3\\n35-8\\n31.\\n6-9\\n15-4\\n2.3\\nCOMPOSITION OF FOOD MATERIALS.\\nShowing percentage of water, nutrients and\\nfreed from bones, skin, shell and other refuse:\\nFood. Water. Proteids. Fat.\\nBeef Neck 62. 19.5 17.5\\nRib 48.1 15-4 35-6\\nSirloin 60. 18.5 20.5\\nRound 68.2 205 10. 1\\nVeal shoulder 68.8 20.2 9.8\\nMutton leg 61.8 18.3 19.\\nPork Shoulder 50.3 16. 32.8\\nSmoked ham 41.5 16.7 39.1\\nSalted 12.1 .9 82.8\\nFresh sausage 41.5 13.8 42.5\\nChicken 72.2 24.4 2.\\nEggs 73.8 14.9 10.5\\nMilk 87. 3.6 4.\\nButter 10.5 1. 85.\\nOleomargarine 11. .6 85.\\nCheese, full cream 30.2 28.3 35.5\\nCheese, skimmed milk 41.3 384 6.8\\nSalt mackerel 53.7 17.3 26.4\\nOysters 87.1 6. 1.2\\nWheat flour 12.5 11. 1.1\\nGraham flour 13. 1 11.7 1.7\\nOatmeal 7.6 15. 1 7.1\\nCornmeal 15. 9.2 3.8\\nRice 12.4 7.4 .4\\nPeas 12.3 26.7 7\\nBeans 12.6 23.1 2.\\nPotatoes 78.9 2.1 .1\\nSweet potatoes 71. 1 1.5 .4\\nTurnips 89.4 1.2 .2\\nOnions 87.6 1.4 .3\\nApples 832 .2 .4\\nCabbage 91.0 2.1 .3\\nSugar, granulated. 2.\\nWhite bread 32.3 8.8 1.7\\nBoston crackers 8.3 10.7 9.9\\nminerals when\\nStarch Mineral\\nnd Sugar. Matter,\\n1.\\n9\\n1.\\n1.2\\n1.2\\n9\\n\u00e2\u0080\u00a29\\n2.7\\n4.2\\n2.2\\n1-4\\n.8\\n4-;\\n-7\\nc\\nS 3-\\niX\\n8.9\\n1 3-\\nI 4.2\\n4.6\\n2.6\\n3-;\\n7 2.\\n74\\n71-:\\n68..\\n-5\\n7 1.8\\n2 2.\\n7o.(\\n5 1.4\\n79-\\n1- -4\\n57-\\n2.9\\n59-\\n3-1\\nI7.(\\n26.\\nI.\\nI.\\n8.;\\nI.\\n10.\\n.6\\n15\\n-3\\n5-\\n5 11\\n97. i\\n56.\\n68.;\\n5 .2\\n5 -9\\n7 2.4", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0096.jp2"}, "95": {"fulltext": "SANITATION.\\n87\\nTHE HEAT-PRODUCERS.\\nThe comparative heat-producing values of various foods is\\nshown by the table below. The unit of heat is the caloric. A\\ncaloric may be defined as the amount of heat necessary to raise\\nthe temperature of a pound of water four degrees Fahrenheit.\\nOne pound of proteids will produce 1,860 calori.\\nOne pound of fats will produce 4,220 calori.\\nOne pound of carbo-hydrates will produce 1,860 calori.\\nThe amount of heat and energy required per day is\\nFor a man with light exercise, 2.980 calori.\\nFor a man with moderate muscular work, 3.520 calori\\nFor a man with severe muscular work, 4,060 calori.\\nTABLE SHOWING FUEL VALUES PER POUND.\\nCalori\\nBeef, sirloin 970\\nBeef, round 855\\nBeef, rib 1,405\\nBeef, shoulder 895\\nVeal, shoulder 640\\nMutton, leg 935\\nFresh pork 1-435\\nSmoked ham 1735\\nChicken 330\\nTurkey 550\\nEggs 655\\nSalt codfish 315\\nSalt mackerel 910\\nCanned salmon 1,005\\nOysters 40\\nCheese, whole milk 2.150\\nButter 3.615\\nMilk 670\\nMolasses 1.320\\nCalori\\nWheat flour 1,645\\nGraham flour 1,625\\nRye flour 1,625\\nBuckwheat flour 1,605\\nOatmeal 1,850\\nCornmeal\\nRice\\nPeas\\nBeans\\nPotatoes\\nSweet Potatoes\\nTurnips\\n1.645\\n1,630\\n1,565\\n1,616\\n370\\n530\\n185\\nOnions 225\\nTomatoes 80\\nCabbage 155\\nApples 315\\nSugar, granulated 1,820\\nWheat bread 1,280\\nCrackers 1,895\\nAMOUNT OF NUTRIENTS WHICH ONE DOLLAR WILL BUY.\\nFood. Price.\\nBeef, sirloin, per lb. 15c.\\nBeef, round, per lb 10c.\\nBeef, neck, per lb 8c.\\nMutton, leg, per lb 14c.\\nSmoked ham. per lb 16c.\\nSalt pork, per lb 10c.\\n8c.\\nIOC.\\nSalt codfish, per lb\\nSalt mackerel, per lb\\nOysters, per qt 35c\\nTotal\\nWeight.\\n6.67\\n10.\\n12.50\\n7.14\\n6.25\\n10.\\n12.50\\n10.\\n5-72\\nNutrients\\n2.14\\n3-13\\n3 So\\n2.23\\n3-23\\n8-37\\n2.17\\n3-15\\n.62", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0097.jp2"}, "96": {"fulltext": "SANITATION.\\nFood. Price\\nEggs, per doz 15c\\nMilk, per qt 5c\\nCheese, whole milk, per lb 15c\\nButter, per lb 15c\\nButter, per It) 25c\\nSugar, granulated, per lb 5c\\nWheat flour, per lb 3c\\nWheat bread, per lb 5c\\nCornmeal, per ib 2c\\nOatmeal, per lb 5c\\nRice, per lb 8c\\nBeans, per lb 5c\\nPotatoes, per bu 50c\\nApples, per bu 50c\\nCrackers, per lb 10c\\nChickens, undressed, per lb 8c\\nTurkeys, undressed, per lb 8c\\nTotal\\nWeight.\\nNutrients\\n11.30\\n2.63\\n40.00\\n4-99\\n6.67\\n4-37\\n6.67\\n579\\n4.00\\n346\\n20.00\\nI9-56\\n33-33\\n29.\\n20.00\\nI3-36\\n50.00\\n41.80\\n20\\n18.08\\n12.50\\n10.90\\n20\\n16.86\\n120\\n24.12\\n112\\n18.48\\n10\\n8.93\\n12.50\\n2.16\\n12.50\\n2.86\\nBILLS OF FARE.\\nThe quantities of various articles which will furnish the proper\\nmedium amount of proteids, fats and starches for the daily diet\\nof the average man at moderate labor, is shown in the following\\nschedules, together with their approximate cost, as given in the\\nforegoing table. Each will furnish about three pounds of gross\\nfood, and about one and a half pounds of pure nutrient material\\nI.\\nRound steak 13 oz.\\nButter 3 oz.\\nPotatoes 6 oz.\\nBread 22 oz.\\nCost, 24 cents.\\nII.\\nSalt pork 4 oz.\\nButter 2 oz.\\nBread 18 oz.\\nBeans.. 16 oz.\\nCost, 14 cents.\\nIII.\\nSirloin steak 12 oz.\\nButter 3 oz.\\nPotatoes 12 oz.\\nFlour 12 oz.\\nMilk 1V2 pints.\\nCost, 29 cents.\\nIV.\\nHam 12 oz.\\nSalt pork V2 oz.\\nButter 1 oz.\\nPotatoes 8 oz.\\nBeans 5 oz.\\nFlour 12 oz.\\nCost, 18 cents.\\nV.\\nChuck steak 10 oz.\\nHam 6 oz.\\nEggs 2 oz.\\nFlour 8 oz.\\nButter 2 oz.\\nPotatoes 12 oz.\\nSugar 1 oz.\\nMilk 1 pint\\nCost, 26 cents.\\nVI.\\nRound steak 6 Oz.\\nMackerel 12 oz.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0098.jp2"}, "97": {"fulltext": "SANITATION. 89\\nButter 2 oz. Egg i oz.\\nCheese I oz. Butter 3 oz.\\nPotatoes 8 oz. Potatoes 12 oz.\\nOatmeal 1 oz. Turnips 4 oz.\\nWheat fxour 8 oz. Canned corn 4 oz.\\nGraham flour 4 oz. Oatmeal 1 oz.\\nSugar 2 oz. Rice 1 oz.\\nMilk 1 pint Wheat flour 4 oz.\\nCost, 27 cents. Graham flour 2 oz.\\nVII.\\nSugar 3 oz.\\nPork chop 8 oz. Milk P in t\\nLiver 8 oz. Cost, 30 cents.\\nDIGESTIBILITY OF FOODS.\\nThe amount of nutrition which any article of food contains\\nis quite independent of the time required for its digestion, thus,\\nrice, which is digested in an hour, has more than seven times the\\nnutritional value of boiled cabbage, the digestion of which re-\\nquires four and a half hours and fried salt pork, which takes four\\nand one-fourth hours, contains more than five times as much\\nnutrition as an equal weight of fresh apples, digested in one and\\na half hoars.\\nIn 1822, Alexis St. Martin, a Canadian voyageur, 18 years\\nold, received a charge of duckshot in such a manner as to blow\\naway a portion of the covering of his abdomen, and make a hole\\nabout an inch in diameter in his stomach, and, although under\\nthe care of Dr. Beaumont, a surgeon of the United States army,\\nhis wound entirely healed and he fully regained his health, mar-\\nried, reared a family, chopped and did other hard labor, and lived\\nto the age of 84 years, the hole in his stomach never closed. It\\nwas partly closed, however, by a curtain or fold of mucous\\nmembrane which grew down inside, that was easily pushed back\\nby his physician as often as he wished during a long and exceed-\\ningly interesting series of experiments, which shed more light\\nupon the exact functions and mechanism of the stomach, and\\nits mode of working, its secretions and their functions in\\nthe digestive process, than had been learned in all the centuries\\nbefore.\\nThe time required for the digestion of various articles of\\nfood, as thus ascertained by Dr. Beaumont, is given in the follow-\\ning table", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0099.jp2"}, "98": {"fulltext": "90\\nSANITATION.\\nTHE TIME REQUIRED TO DIGEST VARIOUS FOODS.\\nPigs feet\\nTripe\\nRice, boiled\\nEggs, whipped\\nSalmon-trout\\nBarley soup\\nVenison, broiled\\nApples, sweet, mellow, raw.\\nApples, sour, mellow, raw.\\nCodfish, cured, dry, boiled.\\nLiver, broiled\\nH. Min.\\n30\\n30\\n30\\n30\\n30\\n2\\n2\\n2\\nMilk, boiled 2\\nBeans, boiled 2\\nTapioca 2\\nMilk, raw 2 15\\nTurkey, boiled 2 25\\nTurkey, roasted 2 30\\nGoose, roasted 2 30\\nLamb, fresh, boiled 2 30\\nBeans, green, boiled 2 30\\nCabbage, raw 2 30\\nPotatoes, Irish, baked. 2 30\\nParsnips, boiled 2 30\\nHashed meat and vegetables. 2 30\\nCustard, baked 2 45\\nBeef, salted, boiled 2 45\\nApples, sour and hard, raw. 2 50\\nOysters, fresh, raw 2 55\\nEggs, soft boiled 3\\nBass, fresh, broiled 3\\nBeef, fresh, lean, rare, roast... 3\\nBeefsteak, broiled 3\\nMutton, fresh, boiled 3\\nMutton, fresh, broiled 3\\nH. Min.\\nSoup, bean, boiled 3\\nDumpling, apple 3\\nCorn cake 3\\nCarrot, orange, boiled 3\\nCorn bread 3\\nMutton, fresh, roasted 3\\nPork chop, broiled 3\\nOysters, fresh, roasted 3\\nEggs, hard boiled 3\\nEggs, fried 3\\nOysters, fresh, stewed 3\\nBeef, fresh, dry roasted 3\\nBeef with mustard, etc., boiled. 3\\nOyster soup, boiled 3\\nChicken soup, boiled 3\\nButter, melted 3\\nCheese, old, strong, raw 3\\nMutton soup, boiled 3\\nTurnips, boiled 3\\nPotatoes, Irish, boiled 3\\nBeets, boiled 3\\nCorn and beans, green, boiled. 3\\nBeef, fresh, lean, fried 4\\nSalmon, salted, boiled 4\\nVeal, fresh, broiled 4\\nFowls, domestic, boiled 4\\nFowls, domestic, roasted 4\\nPork, recently salted, fried 4\\nBeef, old, hard, salted, boiled.. 4\\nVeal, fresh, fried 4\\nCabbage, boiled 4\\nDuck, wild, roasted 4\\nPork, boiled 4\\nPork, roasted 5\\n15\\n15\\n15\\n15\\n15\\n30\\n30\\n30\\n30\\n30\\n30\\n30\\n30\\n30\\n30\\n30\\n30\\n45\\n45\\n15\\n15\\n30\\n30\\n30\\n30\\n15\\nIt has also been learned that food digests most quickly when\\nvery finely divided, as by thorough chewing; when eating is fol-\\nlowed by a period of rest and when little liquid is taken at the\\ntime of eating; also that digestion is retarded when food is taken\\nwhen there is great bodily fatigue, or during strong emotion\\nor excitement. Articles fried in fat are generally hard to digest.\\nFood should not be eaten either very hot or very cold, it should be\\neaten at regular hours, and there should never be any piecing\\nbetween meals.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0100.jp2"}, "99": {"fulltext": "CHAPTER VII.\\nTHE TEETH.\\nBy Alfred C. Sloan, D.D.S.\\nStanding at the outer portal of the human body, the teeth\\ngive beauty, symmetry and expression to the face, but their princi-\\npal office is the performance of the main portion of the mechani-\\ncal part of digestion. By grinding the food into small particles\\nand mixing it with the saliva, they reduce it to the condition most\\nsusceptible to the action of the stomach and intestines. When\\nsome of the teeth become diseased, or are imperfect, or missing,\\nthe remainder are unable to properly perform the duty of all, and\\nthe food goes to the stomach in much the same condition as that\\neaten by birds, and the pangs of indigestion with its train of ills\\nresult.\\nIt is fully established that diseases of the teeth, as well as\\nmost other diseases, are due to germs. The mouth is an ideal\\nbreeding place for micro-organisms, since its warmth, moisture\\nand abundant food, all favor their unlimited multiplication and\\ndevelopment. Food passed into the stomach through a filthy\\nmouth is in no condition to produce pure healthy blood, for from\\ndiseased, carious and abscessed teeth the food is mixed with\\nthe debris of decay, and ferments or poisonous, disease-produc-\\ning bacteria. When long continued these causes alone are suffi-\\ncient to produce serious derangements of the alimentary canal;\\nand many cases of blood poisoning, by pus from diseased teeth,\\nare recorded in medical and dental literature.\\nFrom these facts it may be seen what dire results may follow\\nneglect, and how important it is that the teeth should receive intel-\\nligent care. This should date from the time when the first ones be-\\ngin to appear, which, usually, is when the child is from six to eight\\nmonths old. The first to arrive are the central incisors; then\\nthe lateral incisors, first molars, cuspids and second molars come\\nin the order named, the last ones appearing at from the eighteenth\\nto the twenty-fourth month, and completing the temporary set\\ntwenty in all, ten above and ten below.\\n9*", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0101.jp2"}, "100": {"fulltext": "92 sanitation:\\nThe mother should give her careful personal attention to the\\nteeth of the baby, always remembering that a tooth is not complete\\nwhen it emerges from the gum, and that it will be a good year\\nand a half later before its roots are fully formed. Wrap a piece\\nof soft linen around the finger and gently cleanse the baby s\\nteeth. When the eight front teeth are all in place, a badger s hair\\nbaby tooth brush may be substituted, for these brushes are so\\nsoft as to do no harm. Brush from the gum towards the cutting\\nedge, thus removing the particles of food from between the\\nteeth, and when the back teeth come, brush their grinding surfaces\\nas well as their sides. It has been positively proven not only\\nthat caries in teeth is due to micro-organisms, but that a colony\\nof these germs forms lactic acid abundantly in twenty-four hours,\\nand that this acid by acting directly upon the tooth produces its\\ndecay. The germs find lodgment in the seams and pits on the\\ngrinding surfaces of the back teeth and between the teeth, hence\\nthe necessity of cleansing them thoroughly in all their parts.\\nHave decayed teeth filled, thus stopping further decay, and have\\nthose crowned that have gone too far to be filled.\\nTHE TEMPORARY TEETH.\\nThe preservation of the temporary teeth of the child is a\\nmatter of much importance. Remember that he has but twenty\\nteeth, while you have thirty-two, sixteen in each jaw, and that\\nthorough mastication of food is as essential to him as to you, for\\nwhich reason alone the loss of one tooth would be a serious mat-\\nter; but there is another very important reason for preserving as\\nlong as possible the first teeth, and that is the injury which their\\nearly loss exerts upon the dental arch. The teeth are partly\\nheld in place by the lateral pressure exerted one upon another.\\nWhen one is removed this mutual support is gone, and gradually\\nthe teeth nearest the opening are crowded into it, until, as often\\nhappens, the vacant space is entirely obliterated, hence when the\\npermanent tooth for this place is formed it is forced out of the\\narch, and a crooked deformity results.\\nAs the permanent teeth develop, the roots of the temporary\\nteeth are absorbed to make room for them, but the roots of a\\ntemporary tooth whose nerve has died are not absorbed and, there-\\nfore, become an obstruction to the eruption of the new tooth,\\nforcing it aside and causing a serious malformation. Do not think", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0102.jp2"}, "101": {"fulltext": "SANITATION. 93\\nit money ill spent to have the first teeth filled and thus preserved as\\nlong as possible. As soon as a cavity shows itself have it filled,\\ninstead of waiting until the tooth aches, and your child will not\\nbe hurt, then when the time arrives for the permanent teeth to\\ncome, the roots of the temporary ones will be entirely absorbed\\nso that their crowns can be picked off without pain, and a set of\\nnew teeth, symmetrical and beautiful, will develop in their place.\\nThe common practice of pulling the child s teeth with a cord or\\nother device, as fast as they begin to loosen, is a most pernicious\\none, and results in irreparable distortion of the second teeth, if not\\nof the jaw itself.\\nTooth Powders are numerous, but none excels precipitated\\nchalk, a preparation to be had for a few cents at any drug store.\\nIt is a soft, tasteless antacid, absolutely non-injurious and when\\nsystematically used is one of the best, if not the very best, of all\\nthe preservatives of dental structures. It removes any light dis-\\ncoloration, but will not remove dark heavy stains or tartar, and\\nany preparation that will, or that is advertised to do it, should be\\nshunned, for its use cannot be other than injurious to the teeth.\\nHave nothing to do with it.\\nIf in place of the chalk you wish a nicely flavored dentifrice,\\nuse Oraline Tooth Paste, prepared by the S. S. White Mf g Co.,\\nor Enthymol Tooth Paste, put up by Parke, Davis Co., for\\nneither of these will in anyway injure your teeth.\\nMouth-washes. When you have decayed teeth, or inflamed\\nspongy gums, with an unpleasant taste, and odor to the breath, a\\nmouth-wash is needed in addition to the dentrifice. An excellent\\none can be made by adding to either Listerine, Enthymol, Boro-\\nlyptol or Pastrine three times its volume of water. After cleansing\\nthe teeth, thorough!) rinse the mouth with this wash, and if there\\nis irritation of the throat, as is frequently the case with an impure\\nbreath, gargle the throat with the wash. It will remove all odors,\\nand, besides being curative, will impart a pleasant sense of cleanli-\\nness and purity. A thorough and systematic use of such a wash\\ntwo or three times a day is an imperative necessity in the mouth of\\na person wearing bridge work, and should be used also by those\\nwearing artificial teeth, to rinse both mouth and plate after cleans-\\ning them. It will insure a cleanliness that can be attained in no\\nother way, and keep at the minimum the many little irritations\\nof the delicate mucous membrane on which the artificial dentines\\nrest.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0103.jp2"}, "102": {"fulltext": "94 SANITATION.\\nSalivary Calculus, or, as commonly termed, tartar, is com-\\nposed of lime salts held in solution in the saliva and deposited upon\\nthe sides of the teeth, forcing back the gums, and causing their\\nabsorption, also the absorption of the bony walls of the sockets of\\nthe teeth. If allowed to remain it slowly increases, then causes\\ninflammation of the gums and loosening of the teeth a condition\\noften erroneously called scurvy. Its cure is effected by a thorough\\nand careful removal of all deposits, even though they reach below\\nthe gums, by a competent dentist, who will advise as to what local\\ntreatment, if any, should be applied to the gums. When you\\nfind any tartar collecting upon your teeth have it removed.\\nIn employing a dentist, be sure to retain a good one; do not\\nlet the main consideration be cheapness. Cheap dental work, like\\ncheap work in everything else, is likely to be dear at any price,\\nand you have but one set of permanent teeth.\\nAlthough the teeth should be cleansed every morning, it is\\nstill more important to give them attention just before retiring\\nat night. At both times first rub them and the gums on both\\nsides of the teeth, with precipitated chalk, then follow with a\\ngood brush and rinse well. In case the sides of the teeth become\\ntender discontinue the chalk a few days. He that cares for his\\nteeth by simply brushing them on the front or outside does not\\nlive up to his privileges.\\nDuring sickness the teeth are usually neglected. They should\\nbe kept clean, and if the patient is too ill to attend to them it\\nmust be done by the nurse, who should, with a piece of soft linen,\\nclipped in the wash described above, clean them as well as she\\ncan, then have the patient rinse the mouth with the same kind of\\nwash. It will be exceedingly grateful to the sick one. The\\ndecay of teeth during sickness is not as much due to strong medi-\\ncines used, as to the altered condition of the fluids of the mouth at\\nthis time. A person under homeopathic treatment suffers as great\\ninjury to his teeth as the allopathic patient does.\\nDuring the nine months of pregnancy the teeth decay more\\nrapidly, and may become abnormally sensitive, causing great suf-\\nfering. Much of this can be alleviated, in many cases entirely\\novercome, and the decay retarded in a marked degree, by the use\\nof Phillips Milk of Magnesia. The teeth should be cleansed\\nnight and morning with the mouth-wash described, after which a\\nteaspoonful of the Magnesia is to be taken into the mouth and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0104.jp2"}, "103": {"fulltext": "SANITATION. 95\\nallowed to float around over the teeth. It will thus coat them with a\\nfilm of magnesium hydrate, which is sufficiently adherent to\\nprotect them from acid action for a number of hours. The fluids\\nof the mouth during pregnancy are nearly always acid, and it is\\nprobably due to this that the teeth are then so sensitive. After\\nusing the milk of magnesia do not rinse the mouth, but spit out\\nany excess. This remedy will be found serviceable also in the\\nvomiting of pregnancy, especially when acidity of the stomach\\nexists. Dose One teaspoonful as may be required.\\nIn jumping toothache from an exposed nerve, nothing will\\nbring comfort sooner than strong carbolic acid placed directly on\\nthe nerve. This is best accomplished by placing loosely in the\\ncavity a bit of cotton saturated with the acid, and covering it with\\na little dry cotton, beeswax, or other substance to keep the tongue\\nfrom the acid. (The relief afforded is only temporary, but the\\napplication may be repeated as often as necessary until treatment\\ncan be obtained from the dentist.) Care must be taken not to get\\nany of the acid on the gum, or other tissues, but in case of such an\\naccident the burning may be stopped by touching the spot with\\nglycerin or oil. Oil of cloves, laudanum, creosote, etc., are also\\noften used for toothache. The following compound is excellent\\nBest alcohol one-half ounce.\\nChloroform one ounce.\\nSulph. ether three drams.\\nGum camphor two drams.\\nLaudanum one-half dram.\\nOil of cloves one-fourth dram.\\nPlug the tooth with cotton saturated with this cordial. The\\npain following extraction of a tooth can be relieved by pressing\\na pledget of cotton, thus saturated, well up into the socket and\\nleaving it there an hour or two, and a little powdered tannin on the\\nside of the pledget first entering the socket will prevent hemor-\\nrhage. The most stubborn toothache of pregnancy may be re-\\nlieved by bathing the tooth and gums with this preparation, then\\ndrawing in the breath a few times to pass the air over it. This\\nis also an excellent application for swellings and bruises where\\nthe skin is not broken.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0105.jp2"}, "104": {"fulltext": "CHAPTER VIII.\\nSTIMULANTS AND NARCOTICS.\\nBy Louis C. Duncan, M.D.\\nALCOHOL.\\nThe deleterious effects of alcohol have been so often and\\nfully set forth, it would seem a superfluous work to write of them\\nagain. Every volume on medicine and every school book on\\nphysiology and hygiene tells of destruction, suffering and death\\nwrought by alcohol. Societies make war upon it, lecturers de-\\nnounce it and tracts emphasize its evils; but the disease and\\nmisery in evidence m every community prove that the lesson has\\nnot yet been learned, that its teaching must be continued, and\\nthe physiological effects of alcoholism, if possible, made still more\\nclear and convincing.\\nIt is not our purpose to detail many of its most serious ef-\\nfects. The moral degradation of the drinker, the deterioration of\\nintellect, the crimes and accidents resulting from drink, the\\nwretched poverty, the breaking up of families, the misery of wo-\\nmen, the suffering of children, and all the crime and debauchery\\nfollowing in the wake of alcohol we must leave to others. We\\nhave only to speak of its physiological effects, the diseased con-\\nditions produced by its action in the human body, though most\\nwill agree that harmful as these are, they are not more serious\\nthan its influence upon the intellect and morals of its victim. Al-\\ncohol is indeed an enemy that steals away the brain, the keenness\\nof perception, the accuracy of judgment, the power of continued\\nthought and, above all, the fine distinctions between right and\\nwrong that characterize the upright man.\\nGeneral Effects. In sufficient quantity, alcohol at first pro-\\nduces quickened action of the heart and lungs, a slight rise in tem-\\nperature, an increased supply of blood to the brain and internal or-\\ngans, increased muscular activity, and a general sense of well\\nbeing; the senses are more acute, the imagination is stimulated,\\nideas come more readily; the face is flushed, the eyes bright and\\n96", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0106.jp2"}, "105": {"fulltext": "SANITATION. 97\\nthe tongue loose. The speaker is more eloquent, but his judg-\\nment and reason are less sure. Following these effects the tem-\\nperature falls to below normal, the muscles become unsteady,\\nthe tongue thick, the gait staggering and speech incoherent.\\nAt this stage the drunkard may be very good natured and happy,\\nor ill natured, morose and quarrelsome. Finally he can walk no\\nlonger, speech fails, and he passes into a stupor. The face is red\\nand congested, the breathing slow and stertorous, the breath\\nsmells of alcohol and he can be only partially aroused. Such are\\nthe immediate effects of alcohol. After the debauch is over, the\\npatient returns to his normal condition, not seriously damaged\\nphysically; but if one debauch follow another, or if he contract\\nthe habit of drinking a small amount each day, permanent and\\nserious injury will certainly follow. It may be long delayed but it\\nis sure to come.\\nAll experience in severe athletics, military campaigns, and\\nNorth Pole and other expeditions involving fatigue, exposure and\\nlong tests of endurance, show that the total abstainer withstands\\nthese adverse conditions better than the toper, or even the mod-\\nerate drinker. Lieut. Peary, in his inventory of supplies for his\\nlast trip toward the Pole, stated that no liquors were to be taken\\nexcept those required by the surgeon, for not only are the highest\\nachievements possible without the aid of liquors of any kind, but\\ntheir continued use lowers the power of resistance, the vitality of\\nthe body, rendering it less able to endure fatigue, extremes of tem-\\nperature and injury. It is well known by all surgeons that habitual\\ndrinkers do not bear anesthetics or stand surgical operations well,\\nand that they are more seriously affected by injuries and all severe\\nacute diseases.\\nLet it not be supposed that the claims as to the evils caused\\nby alcohol are figments of the mind, due to the excited imagina-\\ntions of over anxious mothers, or too zealous temperance fanatics.\\nSuch eminent authorities as Drs. Revilliod and Sinet, Professors\\nin the University of Geneva, Switzerland, as translated by Dr. Law,\\nset forth their physiological effects as follows\\nThe morbid conditions brought about by alcoholism involve\\nevery organ and tissue of the body, and consequently distuib\\nevery one of its physiological functions, sometimes giving rise to\\nspecial diseases characteristic of alcoholic poisoning, at others\\nproducing complications arising in the course of various maladies.\\n7", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0107.jp2"}, "106": {"fulltext": "98 SANITATION.\\nThe organs specially affected by alcohol, taken as a beverage,\\nare, first of all, the stomach. After passing through the liver these\\nalcoholic drinks, more or less modified, enter the general blood\\nstream and circulate throughout every part of the body; but we\\nwish here to specially refer to the kidneys, the heart, and the\\nbrain. The morbid alterations induced in these parts by the con-\\nstant presence of alcohol in the tissues of which they are composed,\\nthough at first comparatively trifling and temporary, become per-\\nmanent and incurable sooner or later, according to the quantity of\\nalcohol usually consumed and the duration of the drinking\\nhabit.\\nThe accompanying plates show the various changes and\\ndiseased conditions of the organs referred to. They are repro-\\nductions from nature by experts in such subjects, viz. (i). Dr.\\nLancereaux, Physician to the Hotel-Dieu in Paris, well known by\\nhis works on Alcoholism; (2). Professor Charcot, who illustrated\\nhis lectures on diseases of the liver and kidneys by a representation\\nof the affections of the kidneys, in which excessive alcoholic in-\\ndulgence played the chief part. These are the large white kid-\\nney so named by Richard Bright, M. D., of Guy s Hospital; and\\nthe contracted kidney, from a drawing by Dr. Gombault, Physi-\\ncian to the Beaujon Hospital in Paris. These designs, executed\\nby the experienced hand of M. Balicki, and here faithfully re-\\nproduced, show each organ as it would appear if actually before\\nthe eyes. Each plate exhibits for comparison the parts in their\\nhealthy, as well as in their diseased state.\\nPLATE I. THE STOMACH.\\nFig. I. Normal Stomach. Laid open to show its internal\\nsurface lined by healthy mucous membrane. The organ, here\\nrepresented moderately distended, varies much in size according to\\nthe amount of food contained, and the habits, as to eating and\\ndrinking, of the individual. The inner surface of the stomach,\\nlike that of the rest of the alimentary canal, consists of mucous\\nmembrane. This mucous lining is smooth, velvety, and moist,\\nand varies in tint from pale rose to a reddish violet as anyone\\nmay see for himself by looking at the mucous membrane of his\\nmouth in a mirror. When not distended it lies in folds. The\\nmucous membranes constitute the inner coating of most of the\\ncavities of the body, they serve as a basis of support to the blood", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0108.jp2"}, "107": {"fulltext": "*w\\nFIG. 1.\\nk i\\nFig. 1. A Health) Stomach.\\nFigs. 2 and 3. Alcoholic Stomachs.", "height": "4252", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0109.jp2"}, "108": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0110.jp2"}, "109": {"fulltext": "SANITATION. 99\\nvessels and nerves, and to the glands which secrete the gastric\\njuice and the mucus which lubricates the lining membrane.\\nFigs. 2 and 3 represent Alcoholic Stomachs seen from their\\ninternal aspects.\\nTig. 2. Stomach. Laid open longitudinally to display\\nits mucous lining on which are clearly shown the following le-\\nsions (a). Patches dotted with bright red, showing intense in-\\nflammatory congestion, or slate colored, due to small extravasa-\\ntions of blood of long standing. Here and there are noticed\\nsmall rounded, or linear, ulcers which appear to follow the\\ncourse of the blood vessels. Below, on the left, we may observe\\na large star-shaped scar showing the former existence of a vast\\nulcer, which has destroyed the mucous membrane and its sub-\\njacent layers at this place. This ulcer must have given rise, dur-\\ning life, to severe vomiting of blood. If its cause be not invariably\\nfound in alcoholic excess, its cure demands, none the less, com-\\nplete abstinence from spirituous liquors.\\nFig. 3. Stomach turned inside out like a glove to show its\\nmucous lining. The latter, instead of being soft and velvety, as\\nin the normal state, presents a papillated condition due to thick-\\nening of the mucous membrane and submucous glands. Towards\\nthe center is seen a large opaline white patch. The general tint,\\nwhich, in the normal state, is uniformly roseate, is here, in some\\nplaces slate colored, in others, light purple with black dots due\\nto old extravasations of blood in the various layers of the coat.\\nOne of the first deleterious effects produced by alcoholic\\nabuse, and one experienced by all drinkers, is Mucous Catarrh.\\nUpon waking in the morning the mouth is dry and clammy and\\nthere is oppressive thirst. Very soon, either upon first rising and\\nmoving about, or after gulping down liquid, the stomach contracts\\nand expels a glain ropy fluid sometimes mixed with bile. At a\\nmore advanced stage, when to simple catarrhal irritation, there\\nhas supervened inflammation of the organ with the serious lesions\\ndepicted in Plate I, Figs. 2 and 3, the digestive functions become\\nderanged and are accompanied by eructations, vomiting, pain, and\\na sensation of burning at the pit of the stomach; the appetite is\\nlost, diarrhea, sometimes alternating with constipation, occurs\\nand the patient loses flesh. Y\\\\ hen ulcerations have been pro-\\nduced the taking of food is often followed by very severe pains;\\nvomiting sometimes attains excessive frequency, the vomited mat-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0111.jp2"}, "110": {"fulltext": "100 SANITATION.\\nter taking on a black tint from the presence of altered blood, or\\nthere may be actual hemorrhage. In such cases death may be\\nspeedy.\\nPLATE II. THE LIVER.\\nFig. I. Normal Liver.\\nFig. 2. Enlarged Liver.\\nOne can readily understand why this organ, which directly\\nreceives the liquids absorbed from the stomach, should be the first\\nto be injured when these liquids, by their quality, are of such a\\nnature as to alter the substance of the organs they pass through.\\nAlcohol, which is of that number, produces eventually an increase\\nof each of the, anatomical elements of which the liver is com-\\nposed, and consequently of its entire bulk. By and by, this pro-\\ncess specially affects the bile ducts, causing increase in their num-\\nber and size, and ending by obstructing them. A work of disor-\\nganization results, which invades the substance of the organ, and,\\nof course, perverts its functions. This variety seems to us to\\nspecially pertain to excessive drinkers of beer and white wine.\\nFig. 3. This is the small contracted liver atrophic cirrho-\\nsis a variety which may be called characteristic of that organ in\\nalcohol drinkers. In England, it is known as gin drinker s\\nliver. In this variety, the liver, which must at first have under-\\ngone a stage of enlargement, is now, so to speak, reversing the\\nprocess. It shrinks progressively, becoming more and more con-\\ntracted within an enveloping membrane, which sends fibrous\\nprolongations into the substance of the liver, choking vith a\\nscar-like tissue the proper secreting elements of the gland. Al-\\ncoholic cirrhosis, or hardening of the liver, is one of the most\\nfrequent diseases of drunkards. After a longer or shorter period\\nof digestive troubles, the disease is characterized by effusion of\\nfluid into the cavity of the abdomen, caused by the difficulty of\\ncarrying on the circulation through the hard shrunken liver. The\\nbelly becomes enormous, and by its size contrasts with the general\\nemaciation of the individual; while upon its surface the subcu-\\ntaneous veins, engorged with blood, testify to the obstacles placed\\nin the way of circulation. If, to relieve the patient, we draw off\\nby an operation, the fluid from the belly, it may amount to\\ntwenty-five, or even thirty-five, pints. The relief thus obtained\\nis only temporary; the fluid is usually re-formed very shortly.\\nHemorrhages are frequent. There is often bleeding of the nose;", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0112.jp2"}, "111": {"fulltext": "FIG 1\\n2\\nPLATE II.\\nFig. 1. Healthy Liver. FiCx. 2. An Enlarged Liver.\\nFig. A Contracted or Gin Drinkers Liver.\\nFIG. 2", "height": "4244", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0113.jp2"}, "112": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0114.jp2"}, "113": {"fulltext": "SANITATION. 101\\nat other times, spitting or vomiting of blood. There is seldom\\ntrue jaundice, but the skin assumes an earthen tint, the patient\\nemaciates more and more, and death seldom fails to supervene\\nwithin one or two years, and often indeed much sooner. Cure is\\naltogether exceptional.\\nPLATE III. THE HEART AND KIDNEYS.\\nFig. I. The Normal Heart.\\nFig. 2. The Heart completely enveloped by fat. This adi-\\npose layer is able to penetrate also into the substance of the heart,\\nseparating the bundles of muscular fibers which often themselves\\nbecome the seat of fatty degeneration. Alcoholism is a frequent\\ncause of this lesion, which leads to death by the disturbance pro-\\nduced in a function so important as that of the central organ of\\nthe circulation.\\nFig. 3. The Normal Kidney. The kidneys act in cleansing\\nthe organism. The circulation here is very active, and carries to\\nthem all the substances in the blood which, because they are either\\nwastes, superfluous, useless, or noxious, have to be eliminated.\\nBut the texture of these organs is very delicate, and is easily altered\\nif the blood conveys to them an irritant substance, such as alcohol.\\nAlthough the alcohol has undergone a partial chemical trans-\\nformation in the organism before reaching the kidneys, it never-\\ntheless retains, where taken in large quantity, its noxious effect\\nupon the blood vessels of the kidneys, and the uriniferous tubules.\\nWe recognize here, as in the liver Fig. 4 an enlarged kidney,\\nthe large white kidney, and Fig. 5 a small, contracted or\\natrophied kidney. These are different forms from an anatomical\\npoint of view but they may be combined in the same individual.\\nBesides the lesion of the heart mentioned above, alcohol pro-\\nduces circulatory troubles, and alterations in the vessels which re-\\nact in an injurious manner on all the organs. The diseases of\\nthe kidneys represented in Plate III, Figs. 4 and 5, are, unfor-\\ntunately, very often observed under the influence of numerous\\ncauses independently of any alcoholic excess; but they are also\\nfrequently the consequence of abuse of alcoholic beverages. We\\nmay well ask whether the great frequency of these diseases at the\\npresent day, is not accounted for in a certain measure, quite apart\\nfrom actual drunkenness, by the long continued and somewhat\\ntoo free indulgence in habits of drinking. The kidneys thus", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0115.jp2"}, "114": {"fulltext": "102 SANITATION.\\naffected, on the one hand, permit the albumen of the blood to pass\\naway in the urine albuminuria which constitutes a loss to the\\norganism on the other hand, they do not fulfill their cleansing of-\\nfice, and the dangerous substances, which they are charged with\\nthe duty of eliminating, gradually accumulate in the blood. This\\ngives rise to a series of symptoms of poisoning, often fatal, known\\nby the term uremia. These sometimes take the form of con-\\nvulsive seizures, at others of loss of consciousness often, also they\\nare shown by an extremely distressing feeling of suffocation, by\\nviolent headaches, or by repeated vomiting. The circulation is\\nfrequently deranged during the course of kidney disease. It may\\nthen give rise to effusion of fluid into the serous cavities, and the\\nsubcutaneous cellular tissue a state well known under the name\\nof dropsy.\\nPLATE IV. THE BRAIN.\\nFig. i. Normal Brain with its coverings (Membranes).\\nFig. 2. Alcoholic Meningitis.\\nWe are too well acquainted with some of the disorders of\\nthe nervous system which may result from excessive drinking. It\\nis not necessary that functional derangement should always be ac-\\ncompanied by permanent lesions that can be recognized in the\\nbrain after death. It may even happen that a fatal termination\\nmay occur without the disease having left behind any material\\ntrace during its course. On the other hand, the complex con-\\nditions which interfere with the daily existence of the drunkard,\\nthe bruises, -brain joltings, etc., form a large proportion of the\\nlesions we are able to find after death. Nevertheless, as has been\\nstated by Dr. Lancereaux, there exists an alteration peculiar to\\nalcohol which specially affects the membranes of the convexity of\\nthe brain. These, which in the healthy state are thin, delicate,\\nand transparent, become thickened, opalescent or opaque, and\\nscattered throughout with minute patches and small whitish eleva-\\ntions (Fig. 2). In the acute stage, in case of death, during an at-\\ntack of delirium tremens, we may find, moreover, an intense vascu-\\nlar injection, which imparts to the convex surface of the brain a\\nbright rosy tint. Blood may even be extravasated upon the sur-\\nface. These lesions affect those membranes most closely applied\\nto the brain. The dura mater, the outermost covering, a thick\\nwhite membrane which lines the internal surface of the skull, may\\nalso, under the influence of chronic alcoholism, become vasculai-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0116.jp2"}, "115": {"fulltext": "FIG. 1.\\nFIG 2\\nFIG. 5\\nr\\nFIG. 3.\\nFIG. 4.\\nPLATE III.\\nFig. 1. A Healthy Heart. Fig. 3. A Healthy Kidney.\\nFig. 2. An Alcoholic Heart. Fig. 4. An Enlarged Kidney.\\nFig. 5. A Contracted Kidney.", "height": "4280", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0117.jp2"}, "116": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0118.jp2"}, "117": {"fulltext": "SANITATION. 103\\nized, and give rise to repeated hemorrhages forming layers of\\nblood clot, which by their thickness exercise a gradually increas-\\ning compression of the surface of the brain. The latter, in its\\nturn, may participate in the inflammatory trouble, when various\\ndisturbances of the nervous system may result, such as weakness\\nand perversion of motion and sensation, enfeeblement of the\\nintellectual faculties, madness, and all the symptoms of an ad-\\nvanced form of general paralysis.\\nThe nervous disturbances produced by alcohol are very\\nnumerous. First, there are the acute phenomena characterized\\nby excitement of the nervous system, constituting inebriety or\\ndrunkenness. In an extreme case, this ends in coma; that is to\\nsay, complete loss of consciousness and muscular power. This\\ncondition, the result of heavy drinking, sometimes terminates in\\ndeath. Among the more chronic manifestations are to be noted\\ntrembling, which often impedes delicate manual operations, dis-\\nturbances of sensation, perversions of the organs of the senses,\\nenfeeblement of intelligence and memory, bad dreams, etc. At-\\ntacks of delirium may supervene with fever and terrifying halluci-\\nnations, general trembling, and brutish impulses. These attacks\\nare known under the name of delirium tremens. Abuse of alco-\\nholic liquors sometimes produces also weakness of sight, the result\\nof an inflammation of the nerves which place the eyes in communi-\\ncation with the brain (optic nerves). The dimness of vision is\\nspecially pronounced in looking at small objects or doing close\\nwork, such as reading, writing, or line mechanical work. Occa-\\nsionally the patient is unable to distinguish colors. This affection\\nof the optic nerves is quite comparable with the paralysis of the\\nnerves of the limbs, which is sometimes observed in alcoholic sub-\\njects. It rarely proceeds to blindness, but it may cause more or\\nless complete incapacity for work.\\nThe lesions, which are shown in Plate IV, at first affect the\\nmembranes and lead either to mental alienation or to convulsive or\\napoplectiform seizures, which often prove fatal.\\nLastly, it is important to draw attention to the injurious\\ninfluence which alcoholism in parents exercises over the nervous\\nsystems of their offspring, who are born to the sorrowful heritage\\nof a predisposition to insanity and mental degradation.\\nAlcoholism is recognized as one of the direct causes also of\\nepilepsy, a disease which is not only practically incurable, but fre-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0119.jp2"}, "118": {"fulltext": "104 SANITATION.\\nquently leads to insanity, and is likely to be stamped upon the\\nchildren of the drunkard in the form of consumption, epilepsy,\\nfeeble-mindedness, insanity or idiocy.\\nTOBACCO.\\nSo much had been said for as well as against tobacco, many\\nhad come to believe that any treatment of the subject would result\\nonly in an assertion of the preconceived opinion of the investigator,\\nand that while the tobacco habit was injurious to some, to a much\\nlarger class it did no harm; but in later years, as more scientific\\nmethods of inquiry have been employed, and its effects upon in-\\ndividuals have been grouped together in classes sufficiently large\\nto secure reliable averages, indisputable and startling facts have\\nbeen discovered.\\nThe composition of the dried tobacco leaf has long been\\nknown. Besides starch and various acids and salts, its two essential\\nelements are nicotine and nicotianine. The former, a colorless\\nliquid alkaloid with an odor of tobacco and a sharp burning, taste,\\nturns to a dark brown and dries to a resinous gum on exposure to\\nthe air, and is one of the most virulent poisons known a single\\ndrop of it being sufficient to kill a dog. The latter is an oil, and\\nscarcely less poisonous than the nicotine, which it resembles in\\nodor and taste. In mode of action both are much like Prussic\\nacid, and almost as deadly, and both have narcotic properties, the\\nprincipal qualities which give tobacco fascination for its dev-\\notees, but the alkaloid has properties distinct from those of the\\noil, and each is said to act differently from the other upon the\\nvarious vital organs, of the body. Thus, the smoker, who gets less\\nof the alkaloid but more of the oil than the chewer, is affected in\\nways quite different from those experienced by the latter, yet it\\nmay be impossible to say that the one is injured less than the other.\\nThe proportion of nicotine in Havana dried leaf is usually\\nfrom one to two per cent, but in many varieties grown in Northern\\nStates it is seven or eight per cent. Burning tobacco does not\\ndestroy its nicotine as high as 84 per cent of it has been recovered\\nfrom the smoke. Hence, from each ounce of strong tobacco used,\\nmaking liberal deductions for all possible waste, the smoker draws\\ninto his mouth several grains of the deadliest poisons known.\\nThat they do not kill him instantly is largely due to his blowing\\nthem nearly all out again, but a good deal of the portions which", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0120.jp2"}, "119": {"fulltext": "P,\\nbd\\n3", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0121.jp2"}, "120": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0122.jp2"}, "121": {"fulltext": "SANITATION. 105\\ncome in contact with the moist membranes is quickly absorbed,\\nas shown by the headache, dizziness, deathly pallor, distorted fea-\\ntures, feeble pulse, labored breathing, faintness, salivation, and\\noften by the vomiting and violent abdominal pain, of those just\\nlearning the art. After repeated protests the system comes to\\ntolerate it because the nerves involved become so dulled or dead-\\nened as no longer to be able to resist.\\nHaving reached the tolerant stage many appear to be able\\nto use tobacco without any ill effects, but the proportion of those\\nwho can really do so is much smaller than is generally supposed.\\nOf this a proof was furnished on a large scale at the breaking out of\\nwar with Spain, in the great number of would-be-volunteers re-\\njected because of heart disorders, due in most cases to smoking.\\nIt is claimed that oo per cent of the cigarette smokers offering\\nthemselves were unfit for military service for this reason. Indeed,\\nso frequently have heart troubles been traced to this cause, it has\\nbecome a common statement that what alcohol is to the brain\\ntobacco is to the heart, an assertion partly true, but misleading if\\nunderstood to mean that the brain is not also injured. The pecu-\\nliar action of nicotine upon the heart is explained by physiologists\\nas due to its special influence upon the vagus, the great nerve of\\nthat organ, paralyzing its activity, thus leaving the uncontrolled\\nheart muscle to wear itself out.\\nThe lungs also suffer from tobacco. The constantly in-\\ncreasing mortality in the French army is charged to pulmonary\\ndiseases favored by cigarette smoking, for while other presumable\\ncauses are no more active now than formerly, this one during the\\nlast few years has been steadily growing. The specially serious\\neffects of the cigarette are no longer charged to adulterations of\\nthe tobacco, or of its wrapper, but to the facility cigarette smoking\\naffords for excessive indulgence; to the common practice of in-\\nhaling its smoke, when of mild tobacco, thus adding the entire\\ninner surface of the lungs to the poison-absorbing area; and\\nto the completeness with which the end held in the lips is burned,\\na result being thus obtained similar to that experienced by a\\ncigar smoker, who partly smokes, partly chews his cigar, thus get-\\nting all the poison which the stub had filtered from the smoke\\nor by the excessive smoker of a dirty cutty. Like opium it quiets\\nthe nerves for a time, but becomes an irritant later.\\nTo afford an opportunity for the study of tobacco effects upon", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0123.jp2"}, "122": {"fulltext": "106 SANITATION.\\nthe brain, the students in a polytechnic school in Paris were some\\nyears ago divided into two classes, smokers and non-smokers. In\\nthe averages of work done, and in the competitive examinations,\\nduring the four years course, those who did not smoke far out-\\nstripped the others.\\nMore recently, a somewhat similar comparison between users\\nand non-users was made at Yale, and some of the results of four\\nyears of careful observation were as follows\\nIncrease in height 20 per cent greater in non-users.\\nweight 25\\nlung capacity ...66\\nInflated chest measurements 19\\nAlthough 30 pei cent of the class used tobacco, all its promi-\\nnent athletes, with but one exception, were non-users, and none\\nof the candidates for the crew used it.\\nAt Amherst a similar study disclosed even greater differences.\\nThey were as follows:\\nIncrease in height 37 per cent greater in non-users\\nweight 24\\nchest girth 43\\nlung capacity 75\\nUpon these facts the director of the physical laboratory of\\nYale remarks: The widely differing growths in lung capacity\\npoint to the influence of tobacco on respiration. Inspiration is\\nessentially a muscular act, and as such is seriously impeded by\\nnicotine. But even further than this must act the irritating sub-\\nstances of a smoke which readily causes inflammation and soreness\\nof any mucous membrane. Now, to fully expand the lungs under\\nsuch conditions is uncomfortable, if not impossible, and respiration\\ndegenerates into an incomplete act.\\nVery strong testimony, too, as to the injurious effects of to-\\nbacco poisons on the brain, and consequent depression of mental\\nactivity, is found in the records of Yale which show that of all the\\nstudents who entered that college during a period of nine years\\nthe average age of non-users was fifteen months less than that of\\nthe users of tobacco.\\nAmaurosis, a form of partial or total blindness resulting from\\ndisease of the optic nerve, may primarily be due to so many differ-\\nent things that it is often hard to point to the cause, but Hutchin-\\nson found that in $7 cases of amaurosis from white atrophy of the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0124.jp2"}, "123": {"fulltext": "SANITATION. 107\\noptic nerve, 31 of them occured in immoderate smokers. Tobacco\\nis positively known to be the cause in many cases, and as its irri-\\ntating effects upon the nervous tissues are no longer questioned\\nthe smoker whose sight is failing rapidly may well suspect his\\nhabit. Indeed, by an examination of the eye, the results of the\\nprolonged use of tobacco can often be cleariy seen in the optic\\ndisc the end of the optic nerve, the only large nerve accessible\\nto ocular observation.\\nAlthough the processes employed in the manufacture of snuff\\nrender it less poisonous than the tobacco of which it is made, its use\\nseems to cause a profound depression not only of all the bodily\\nsenses, but, to an even greater degree, of the higher mental quali-\\nties, as often seen in loss of pride in character and appearance,\\ndiminished ambition, disregard of surroundings and indifference\\nto the opinions of others; with continuance of the habit delusions\\nmay appear, a low form of dementia or melancholia follow, and\\ndeath come from some acute disease to which the condition pre-\\ndisposes.\\nIt is not well enough understood, even by intelligent people,\\nthat tobacco is rich in insidious poisons, often cumulative in action,\\nand deadly in result, Although formerly used as a medicine, it\\nis now almost entirely discarded because too dangerous, either to\\nbe given internally, or applied to the skin. Among the disorders\\nof which it may be an exciting cause are indigestion, dyspepsia,\\ncancerous affections of the tongue and throat, congestion of the\\nbrain, loss of memory, nervousness, deafness, paralysis, insanity,\\nemasculation, loss of courage, and lessened power of resistance\\nto disease.\\nTreatment. By far the best, if not the only treatment\\nfor the tobacco habit is to abruptly and entirely quit, then through\\nthe aid of Turkish baths, vapor baths, wet packs, or any other de-\\nvice for causing profuse perspiration, get the accumulated poisons\\nout of the system as quickly as possible. Place no dependence\\nupon substitutes, or any of the so-called cures, but assert your\\nwill-force and mastery over self. Let tobacco entirely alone and\\nkeep away from those who use it, and in ten days or less the\\nappetite for it will be nearly or entirely gone.\\nIn the government schools of this country and those of some\\nEuropean countries, where the directors, unhampered by con-\\nsiderations of income from tuition, are free to manage pupils in", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0125.jp2"}, "124": {"fulltext": "108 SANITATION.\\nthe most scientific manner for their highest good, the use of to-\\nbacco is forbidden, and the same advanced step is being taken\\nin many private schools. As the habit has grown to such pro-\\nportions that the people of the United States are spending about\\nas much for tobacco as for flour, the time has certainly arrived\\nwhen its use should be prohibited in all our schools.\\nMORPHIOMANIA.\\nOpium, is obtained from the juice of green poppy-buds, is a\\nvery complex substance possessing many properties, and, for\\nnumerous diseases, is an excellent medicine, both for allaying\\npain and promoting a cure, but no other drug is more sadly per-\\nverted. Opium smokers and opium eaters are found throughout\\nthe world, though the practice is by far the most prevalent in the\\norient, especially in China, where it has become so general as to be\\na national calamity. To obtain the temporary ease and delight\\nwhich give the vice its charm the victim must continuously in-\\ncrease the dose until, in a few years, it becomes many times larger\\nthan that required to cause certain death in one unaccustomed\\nto its use. But, finally, a time arrives when in any amount it fails\\nto bring the desired relief, and the patient is reduced to a condition\\nof physical and moral degradation wretched in the extreme.\\nWhen thoroughly formed the habit is seldom cured, for so great is\\nthe irritation, unrest, pain and suffering, from physical derange-\\nment and mental depression, whenever the drug is even partially\\nwithdrawn, that very few have the stamina to quit.\\nThe same is true of slaves to morphine, opium s most power-\\nful alkaloid. It is a valuable remedy for many diseases, but so\\ngreat is the danger of its creating a morbid desire that cannot be\\nshaken off, it should be employed with the utmost caution and,\\nexcept in very urgent cases, administered hypodermically only by\\na physician. Six months is often long enough to establish the\\nhabit so firmly as never to be broken, except by the most deter-\\nmined. The duration of a morphine fiend s career is one of\\nconstitutional peculiarity only; his ultimate physical, mental and\\nmoral ruin is sure.\\nMorphinism and alcoholism are in many respects alike, but in\\ndevelopment they are different. Alcohol first attacks the diges-\\ntive organs, then destroys the nervous system morphine reverses\\nthis order.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0126.jp2"}, "125": {"fulltext": "SANITATION. 109\\nSince the victim can hardly fail to be aware of the cause of\\nhis ills, and the habit can be treated successfully only in a sanita-\\nrium, or other institution specially equipped, space will not here be\\ngiven to listing the disorders to which it gives birth, nor to detail-\\ning the steps essential to the cure. It will require the services of a\\nphysician and nurses most vigilant and faithful, and such long and\\nthorough treatment as to fully destroy the appetite, for, otherwise,\\nthe patient will return to his indulgence when freed from re-\\nstraint.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0127.jp2"}, "126": {"fulltext": "CHAPTER IX.\\nDISINFECTION AND DISINFECTANTS.\\nBy Joseph T. Lovewell, Ph.D.\\nThe object of disinfection is to remove or destroy that which\\nwill cause disease.\\nIt is now well established that most forms of disease are\\ncaused by germs, or at least are associated with germs which live\\nand multiply in the body, poisoning its blood and interfering gen-\\nerally with the functions of its organs. These microscopic forms\\nof life occupy a borderland between animals and plants, and it was\\nlong difficult or impossible to determine to which they belonged.\\nWe call them microbes, small forms of life, a term applying equally\\nto both kingdoms animalcula and bacteria are names also often\\napplied to them.\\nIt must not be understood that all microbes are harmful to\\nhuman life. They have their place in the economy of nature, and\\nstand at the gateway where inorganic matter becomes organic,\\nor where the process is reversed and the organized structure\\nbreaks down into simple elements or combinations, into which\\nwhat we call animal life does not enter.\\nThe great French chemist and physicist, Pasteur, has shown\\nthat all forms of fermentation are caused by bacteria, or little\\nplants of which yeast is a most familiar example. Keep these\\ngerms out and fermentation does not ensue, and so we seal up our\\nmeats, fruits and vegetables, and preserve them from decay. Sim-\\nilar germs are associated with mold and fungus growths, and with\\neverything known as putrefaction the general breaking up of or-\\nganic structures. The final products of this decay are principally\\ncarbonic acid and water, for all the protean forms of the organic\\nworld are built up from a very few elements of which carbon, hy-\\ndrogen and oxygen are chief. As the processes of decay run their^\\ncourse the elements which enter in smaller proportions, such as\\nsulphur and nitrogen, often form a great variety of intermediate\\nproducts, some of which have very offensive odors and warn us\\nagainst touch and taste.\\nno", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0128.jp2"}, "127": {"fulltext": "SANITATION. Ill\\nOn the other hand when elements are to be combined into\\norganic matter, the work of the microbe is also utilized and is\\nessential. For example, take nitrogen, which is needed as a\\nconstituent of many forms of animal and plant life this element\\nforms four-fifths of the atmosphere but will not enter into organic\\ncombinations until it has undergone nitrification a combination\\nwith oxygen and hydrogen and it is believed that this combina-\\ntion is always effected through the agency of microbes. It is not\\nnecessary to give here a full account of microscopic beings, nor is\\nit possible, for bacteriology is comparatively a new science and its\\nresearches have extended but a little way. It is sufficient to be\\nreminded of the mighty hosts which surround us, ready either to\\nsuccor or to destroy. They will, sooner or later, bring our bodies\\nback to the dust from which they came, but we prefer to run the full\\ncourse of life and not to suffer a premature decay. Of the various\\ndiseases, such as small-pox, cholera, the yellow, typhoid, scarlet\\nand malarial fevers, consumption, measles and diphtheria, which\\nkill a large part of the human race, each one is caused by a microbe\\nof special kind suited to its work. It is positively known that by\\nproper agencies these microbes can be destroyed or danger from\\nthem in a large degree averted.\\nWHEN TO APPLY DISINFECTANTS.\\nThe presence in any locality of a germ disease proves at once\\nthe need of disinfection, both to prevent the spread of the disease\\nand to mitigate its effects. The first case of yellow fever, for\\nexample, is usually light and, as in this country the disease is not\\nendemic, it is comparatively easy by isolation and disinfection to\\nprevent it from spreading. The same is usually true of other in-\\nfectious as well as contagious diseases. Hence the importance of\\nprompt disinfectant measures. It is also proper to disinfect be-\\nfore any disease appears, provided the season, or the condition of\\nthe locality in respect to drainage, cleanliness, or proximity to in-\\nfected places makes the precaution a prudent one.\\nPRINCIPLES OF DISINFECTION.\\nIn the destruction of all forms of disease germs certain general\\nprinciples apply: The first is the principle of dilution, nature s\\ngreat remedy whereby the world is kept habitable for man. This\\nis effected by movements of air and water, through which all", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0129.jp2"}, "128": {"fulltext": "112 SANITATION.\\npoisons lose their virulence and the death dealing microbe perishes\\nfrom lack of that on which to feed.\\nSecond. There is disinfection by changes in temperature.\\nSome germs, as those of yellow fever, are killed by frost others,\\nand perhaps all, are rendered inert by freezing, but many of them\\nbecome active again when the temperature is raised. It is obvious\\nthat on a large scale, low temperature is a matter of climate and\\nthat man sooner than microbes will succumb when deprived of heat.\\nIn cold storage we make a limited use of this principle in arresting\\ndecay. On the other hand when the temperature is raised we\\nsoon reach a point destructive to all forms of life with which we are\\nacquainted: It is safe to say that no germ or living organism\\ncan long withstand the temperature of boiling water. There is\\nlarge use made of this principle in disinfection. Garments and\\nutensils which can be soaked in boiling water for half an hour\\nwill thereby be thoroughly disinfected, and hot steam is a most\\nexcellent agency for disinfecting rooms and cars.\\nDry heat will disinfect, but it is generally less conveniently\\napplied than hot water or steam and is so untrustworthy that it\\nis now very little used. The extreme heat of combustion is re-\\nsorted to when we are willing to sacrifice the infected articles in\\norder to destroy the disease germs they contain. This is the\\ncommon disposition of rubbish, and pest houses, with their in-\\nfected furniture and clothing, are frequently best committed to the\\nflames. The burning of old buildings in cities is often of enough\\nsanitary advantage to pay for the simultaneous destruction of\\nstructures new and without fault. Cremation of the dead, for the\\nsake of good sanitation, is supported by arguments that ought to\\nfind general acceptance.\\nDirect sunlight is a powerful disinfecting agency. The\\nactinic rays are potent in effecting chemical action, and exposure\\nto sun and air is often all that is needed to disinfect bedding, cloth-\\ning and furniture but mattresses, comforts and thick clothing are\\nliable to become infected to a depth to which sunlight cannot pene-\\ntrate, hence too much confidence must not be placed in this\\nmethod.\\nCHEMICAL DISINFECTANTS.\\nWe next consider the disinfectants of more special application.\\nMany substances have been proposed as germicides and it should\\nbe remembered that they are all poisons, generally as destructive", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0130.jp2"}, "129": {"fulltext": "SANITATION. 113\\nto human as to germ life. A disinfectant may be in the solid, liquid\\nor gaseous form, and that form should be chosen which is best\\nadapted to the end in view. Then, too, there are deodorizers\\nwhich may or may not be disinfectants they act by forming with\\nthe odoriferous principle a substance which is odorless, or they de-\\nstroy the odor by another which is more pungent. The latter\\nclass may be positive obstacles to the ends in view, for the sense of\\nsmell tells us what to avoid, and if this sense be cheated or over-\\npowered we will lose a most important guard of health and safety.\\nCarbolic Acid is slow in its action but when it can have plenty\\nof time is one of the most useful disinfectants. It is used in solu-\\ntions, and their activity can be increased both by adding common\\nsalt and by using them hot. It is a deadly poison if swallowed,\\nand it should not be applied extensively to the human body. If\\ndissolved in alcohol, oil or glycerin, it loses most of its disinfecting\\npower.\\nCrude Carbolic Acid is only slightly soluble in water, but\\nhot water containing three per cent of soap dissolves five per cent\\nof crude carbolic acid, and in this form is a valuable disinfectant.\\nCrcsol. The cresols are obtained from crude carbolic acid by\\ndistillation, and are only slightly soluble in pure water but, by\\nadding neutral potash soap, water can be made to dissolve one-\\nhalf its volume of cresol, thus forming lysol, which by the addition\\nof water can be reduced to any strength desired, and for disin-\\nfecting purposes is preferable to carbolic acid solutions for the\\nfollowing reasons It is cheaper, it is not quite as poisonous, and\\nis better for disinfecting excreta and tuberculous sputa. It is\\nexcellent for washing floors and woodwork, and for disinfecting\\nlinen and cotton clothing soaked in it, but it is likely to injure the\\ncolors and the fabrics themselves.\\nSolutol is obtained by dissoh ing sixty per cent oi cresol in\\nwater to which an alkali has been added. It is cheap, effective and\\nwell adapted to disinfecting large quantities of organic matter.\\nFor general use a half pint of the solution may be mixed with\\ntwo or three gallons of water.\\nTricresol and Creolin are other solutions of the cresols and,\\nalthough less valuable than lysol and solutol, form the bulk of\\nseveral patented compounds sold under high sounding names.\\nCorrosive Sublimate (bichloride of mercury) under favorable\\nconditions is a quick and powerful disinfectant, but as it coagulates", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0131.jp2"}, "130": {"fulltext": "114 SANITATION.\\nalbumen, and is decomposed by hydrogen sulphide and several\\nother things, it is not adapted to disinfecting sputa or excreta. Its\\nsolutions must be prepared and kept in glass or earthenware, they\\nwill destroy metallic waste pipes, and they are very poisonous. It\\nis excellent when used as a wash upon walls, floors, woodwork,\\nfurniture, upholstery and clothing it is also a good disinfectant for\\nthe hands, face, hair and beard, but it should not be applied to a\\nvery large portion of the body at one time. It does not often\\ninjure the colors of fabrics and does the fabrics themselves no\\nharm.\\nLime. When freshly slacked and diluted with water until\\nit reaches the consistency of thin cream, lime is a good disinfectant\\nfor excreta, but it is slow and must be used in large quantities-\\nApplied as whitewash it is good to disinfect walls. Air slacked\\nlime has no value as a disinfectant.\\nChloride of Lime. This is one of the best disinfectants and\\nmay be used for the same purposes as lime, but to be trustworthy\\nit should come from a reliable manufacturer, be kept in air-tight\\ncans, the solutions be freshly prepared when used, and used in\\nlarger quantity than the bulk of the material to be disinfected.\\nSoap and Soda. Hot soapsuds, and solutions of washing soda\\nhave some value as disinfectants. Hot lye, made from one part of\\nfresh hardwood ashes and two parts of water, will effectually\\ndisinfect tuberculous sputa and discharges from the bowels.\\nPermanganate of potash, sulphate of copper (blue vitriol),\\nsulphate of iron (copperas), sulphate of zinc, and chloride of zinc\\nwere formerly much used as disinfectants, but they are now known\\nto have little disinfecting value and some of them are almost\\nworthless.\\nChlorine and bromine gases are efficient disinfectants for\\nsome purposes, but are very injurious to articles subjected to them\\nand too disagreeable and dangerous to be recommended.\\nSulphur. Sulphur dioxide, made by burning sulphur at the\\nrate of four pounds for every 1,000 cubic feet, with allowance for\\nwaste, is one of the agents longest in use for the fumigation of\\nrooms. All doors, windows, flues and crevices must be tightly\\nclosed and the fumes allowed to act for at least twenty-four hours\\nand abundant moisture, best as steam, must be present at the same\\ntime. Sulphur fumes are very poisonous, are injurious to many\\narticles of furniture, are not very reliable as a disinfectant for", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0132.jp2"}, "131": {"fulltext": "SANITATION. 115\\ndiphtheria and some other diseases, and the results are not as\\ntrustworthy as they ought to be.\\nFormaldehyde. A new substitute, safer and more efficient\\nthan chlorine, bromine or sulphur, chemically known as formalde-\\nhyde (CH 2 O), has lately come into general use. It is usually\\nprepared by burning wood alcohol (methyl alcohol) in a lamp de-\\nsigned for the purpose and so arranged that the flame comes in\\ncontact with red hot platinum, by which treatment the alcohol\\nloses the elements of water and formaldehyde is the result a gas\\noT very peculiar and penetrating odor, but not as offensive or\\npoisonous to man as sulphur fumes, and much more conveniently\\nmanaged. When formaldehyde lamps are used, one and a half\\npints of wood alcohol to each 1,000 cubic feet should be changed\\ninto formaldehyde in one and a half hours. The room must be\\nkept very tightly closed while the gas is being applied, all cracks,\\nflues and openings having been thoroughly calked. Eight hours,\\none-third of the time required for sulphur dioxide, is sufficient to\\ndisinfect with formaldehyde and the result is more certain.\\nFormaldehyde may be dissolved in water, and a forty per cent\\nsolution of it is called formalin. By boiling formalin the formalde-\\nhyde is again set free, and this is generally the most convenient way\\nof getting the gas, as well as the most reliable, since the lamps\\noften fail to do their work. It can be passed into a room by a\\ntube through a small aperture, as a keyhole, and thus very safely\\nand quickly four per cent of the atmosphere within is changed to\\nformaldehyde. One gallon of a forty per cent solution of formal-\\ndehyde will yield fifty cubic feet of the gas, an amount sufficient\\nfor a room of 1,250 cubic feet. If there is a probability of infec-\\ntious sputum being dried upon the walls, floor or furniture, as\\noften happens in cases of diphtheria, consumption, scarlet fever,\\nand the like, the surfaces should be washed or sprayed with for-\\nmalin diluted (Solution 7) before the gas is turned in.\\nDISINFECTING SOLUTIONS.\\nFor these formulae and details as to their application, together with\\nother material used in the preparation of this department, we are indebted\\nto investigations by the State Board of Health of Maine.\\nSolution 1. For clothing, woodwork, floors, leather, excreta\\nin the sick-room, sputa, the hands, the person.\\nSolution 2. For the same general uses as Solution 1. It is", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0133.jp2"}, "132": {"fulltext": "116 SANITATION.\\na little more efficient than Solution i but more likely to injure\\ncolors.\\nSolution j. For tuberculous sputum, and discharges in the\\nsick-room.\\nSolution 4. For excreta, privy vaults, cesspools, etc.\\nSolution 5. For the same purposes as Solution 4.\\nSolution 6. For clothing, the hands, and the surfaces of\\nwalls, floors, furniture, etc.\\nSolution 7. For clothing, the hands, etc.\\nSOLUTION 1.\\nCarbolic acid (pure liquefied), seven ounces;\\nWater, one gallon.\\nMix. This is approximately a five per cent solution. Its\\npower is somewhat increased by the addition of from twelve to\\nfourteen ounces of common salt to each gallon when used for the\\ndisinfection of excreta, or for other uses where the salt is not objec-\\ntionable. (See Carbolic Acid.\\nSOLUTION 2.\\nFor the disinfection of clothing this solution mixed half and\\nhalf with water will do.\\nLysol, five ounces\\nWater, one gallon.\\nMix. This may be used as a substitute for Solution 1, one-\\nhalf the strength sufficing for uncolored clothing. Many colors\\nare changed by it.\\nSOLUTION 3.\\nSolutol (crude or pure), one-half pint;\\nWater, two or three gallons.\\nMix. This is a very efficient disinfectant for excreta, tuber-\\nculous sputum, and gross disinfection generally. If to be used\\nin dwelling houses or wherever the odor of the crude product\\nwould be offensive, pure solutol should be applied.\\nSOLUTION 4.\\nChloride of lime, six ounces\\nWater, one gallon.\\nMix. This is about a three per cent solution. It decolor-\\nizes and destroys fabrics.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0134.jp2"}, "133": {"fulltext": "SANITATION. 117\\nSOLUTION 5. Milk of Lime.\\nSlake a quart of freshly burned lime in small pieces with\\nthree-fourths of a quart of water or, to be exact, 60 parts of\\nwater by weight, with 100 of lime. A dry powder of slaked lime\\n(hydrate of lime) results. Make milk of lime not long before it\\nis to be used, by mixing one quart of this dry hydrate of lime\\nwith four quarts of water.\\nAir-slaked lime is worthless. The dry hydrate may be pre-\\nserved for some time if it is inclosed in an air-tight container.\\nMilk of lime should be freshly prepared, but may be kept a few\\ndays if closely stoppered.\\nSOLUTION 6.\\nCorrosive sublimate, one dram\\nWater, one gallon.\\nMix and dissolve. Label, Poison! This is approximately\\na 1 to 1,000 solution. One ounce of this solution contains very\\nnearly half a grain of corrosive sublimate.\\nSOLUTION 7.\\nSolution of formaldehyde (formalin), six ounces:\\nWater, one gallon.\\nMix. This mixture contains a little less than two per cent\\nof formaldehyde.\\nWHAT DISINFECTANTS TO USE AND HOW TO USE THEM.\\nThe disinfection of infected rooms and their contents cannot\\nusually be well done with a single disinfecting agent or disinfecting\\nprocess. Special disinfectants and special processes must be em-\\nployed for special purposes. Thorough work, however, may be\\ndone even when the means at one s disposal are but few and\\nsimple, but the expense involved in washing paper from the\\nwalls of an infected room will often be more than the cost of\\nan apparatus for using formaldehyde. In disinfection it should\\nbe remembered that success is influenced by\\nTemperature. Disinfecting solutions generally act more effi-\\nciently when used warm or hot. A somewhat elevated tempera-\\nture in the room increases also the activity of formaldehyde when\\nused for its disinfection.\\n2. Time. This is an important element in disinfection. In", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0135.jp2"}, "134": {"fulltext": "118 SANITATION.\\ntreating discharges in the sick-room, or tuberculous sputum, for\\ninstance, disinfectants should act several hours.\\nj. Quantity. The volume of the disinfectant used, as com-\\npared with that of the infectious material, is often much too small.\\nCare should be taken to use enough.\\nTo Protect Houses. At the beginning and during the whole\\ncourse of a case of an infectious disease, the family and the\\nattendants on the sick should be under instructions, that as\\nsmall a part of the house as possible shall become infected.\\nEverything not absolutely needed in the sick-room should be\\nremoved from it before the patient is carried into it, or before\\nthey become infected. This applies particularly to carpets, drap-\\neries, upholstered furniture, and other things disinfected with\\ndifficulty. All the patient s bed and personal clothing should be\\ndisinfected as soon as it is removed. Every other article carried\\nfrom the infected room should be disinfected then and there.\\nRooms. In the disinfection of rooms it should be kept in\\nmind that the chief task is the destruction of infectious dust. At\\nevery movement be on guard against the danger of whisking it\\ninto the air or diffusing it into other rooms. Before the disin-\\nfection of the rooms themselves is begun, there should be a pri-\\nmary sorting out. Some things, as the clothing and some or all\\nof the bedding, should be removed for separate or special treat-\\nment. (See Clothing, Bedding, etc.)\\nIn the disinfection of rooms formaldehyde is by far the most\\nconvenient agent. Properly used it can be trusted to disinfect\\nthe exposed surfaces of walls, floors, furniture, etc., and the infec-\\ntious dust of the rooms. (See Formaldehyde.\\nIf formaldehyde is not available the next best process is that\\nof washing all surfaces with a disinfecting solution (Solutions I,\\n2, 6 or 7). Floors, particularly, should receive careful treatment\\nand the solution should wet all the dirt in the cracks. The ceiling\\nmust be brushed with a damp cloth to remove infectious dust and\\ncobwebs. The walls should be wiped carefully with a sponge or\\ncloth squeezed out frequently from the disinfecting solution.\\nWhen the walls are papered, it will be a case of injured paper or\\nincomplete disinfection. With a cloth dampened in the disinfect-\\ning solution wipe the dust carefully from all surfaces that can\\nharbor it. as furniture, moldings, doors, windows, etc. (See Fur-\\nniture.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0136.jp2"}, "135": {"fulltext": "SANITATION. 119\\nCotton and Linen Clothing. The most trustworthy agency\\nfor the disinfection of clothing generally is moist heat either\\nsteam or boiling. Steam disinfection wets the goods less than\\nboiling, does not shrink woolens as much, and is less likely to\\nchange the colors of fabrics. This can be well done on a small\\nscale in a common tin wash boiler by supporting a bottom of\\nlath or a thin board above the water by two bricks, placing the\\ninfected articles in the chamber thus formed, covering them tightly\\nand keeping the water boiling for an hour. Many kinds of cloth-\\ning that would be injured by boiling can be disinfected in this\\nway without injury. After the steaming, the boiler should be\\ncarried immediately to the open air and the clothing thrown over\\na line. It will not usually be very wet, and will soon dry if\\nspread out in the open air, while hot. If the clothing be put\\ninto the water and boiled thirty minutes its thorough disinfection\\nis equally sure.\\nWhen infected bed or body linen is removed, it may be\\ntreated differently according to circumstances. If stained, it\\nshould be soaked some hours in a disinfecting solution at a tem-\\nperature not exceeding 120 degrees F. For this purpose Solu-\\ntion 2, half strength, is especially appropriate, having the proper-\\nties of soap as well as of a disinfectant or Solution 1 mixed with\\nan equal quantity of soap and water may be used. Subsequent\\nboiling, as in ordinary laundry processes, will complete the disin-\\nfection. Unstained clothing may be immersed in Solutions 1, 2,\\nor 7, one-half strength, or in Solution 6, then treated as already\\nadvised or it may be boiled immediately. If Solution 6 is used,\\nthe clothing should be well rinsed before it is transferred to the\\nwash boiler, to avoid corroding the latter.\\nClothing which has been wet is not readily penetrated by\\nheat in steam disinfection. In transferring infected clothing from\\nthe sick-room, it should be wrapped in a sheet wet in a disinfecting\\nsolution, or simply in water if the disinfecting solution is not at\\nhand. Infected clothing should never be sent to a public\\nlaundry.\\nWoolen Clothing. Disinfect with steam when available;\\nwhen not, in solutions as under Cotton and Linen Clothing/ or\\nwith large doses of formaldehyde. In a cask or box made air\\ntight by pasting paper over it, calking, or some other device,\\nclothing and other articles may be disinfected by pouring in", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0137.jp2"}, "136": {"fulltext": "120 SANITATION.\\nwith them upon a cloth to absorb it, formalin, or a mixture of\\none part formalin, one part wood alcohol, and two parts water,\\nand leaving the box sealed up in a warm place for twelve hours.\\nBedding. When steam disinfection is available, quilts, com-\\nforters, blankets, pillows, etc., should be treated by it, and mat-\\ntresses also if the apparatus is large enough. In the absence\\nof a steam disinfector, even if the room is to be disinfected by\\nformaldehyde, remove all bedding, excepting the mattresses, for\\nsteam disinfection in the wash boiler or in Solutions i, 2, 6 or 7.\\nIf these articles are left in the room their disinfection with formal-\\ndehyde will be uncertain, so will the surfaces of furniture and\\nfloors covered by them. Disinfect pillows and feather beds with\\nsteam in the wash boiler, or with large doses of formaldehyde in\\nsmall inclosures that are practically air tight, as the tight box\\nor a small closet carefully calked.\\nMattresses. Leave mattresses upon the bedstead wholly\\nexposed to formaldehyde when the room is being disinfected.\\nIf the mattresses have been soiled by the penetration of dis-\\ncharges, as sometimes happens in typhoid fever, burn them. The\\nonly safe alternative is the injection of large quantities of formal-\\ndehyde or formalin into their interiors while they are inclosed\\nin a gas-tight covering. Mattresses of but little value should\\nbe burned. The contents of straw beds should be burned; the\\nticks may then be disinfected as for clothing.\\nIf the room is not to be disinfected with formaldehyde the\\nsurfaces of valuable mattresses should be washed with a sponge\\nor cloth squeezed out of Solutions 1, 2 or 6. The removal of\\nlarge pieces of bedding should be through a window into the\\nopen air instead of through other rooms.\\nFurniture. Simply leave all furniture in the room, with\\ntheir parts well exposed to formaldehyde. If formaldehyde is not\\navailable, wash or wipe carefully every part of the surfaces with\\na soft sponge or cloth squeezed out of Solutions j, 2 or 6. Solu-\\ntion 6 must not be used upon gilt or metallic articles.\\nUpholstery, the unfinished backs of furniture, cracks and\\nplaces where dust has lodged, must be washed with special care.\\nAfter this treatment upholstered furniture should be carried out-\\ndoors and exposed to direct sunshine several days. Pictures\\ncovered with glass may be rubbed with a clamp cloth; those not\\nthus covered should be wiped with a soft, dry cloth. The common", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0138.jp2"}, "137": {"fulltext": "SANITATION. 121\\npractice of purchasing furniture, especially upholstered furniture,\\nat second-hand stores cannot be too strongly condemned. Surely\\nno prudent person who understands the nature of infection and\\ncontagion, or the methods of their dissemination, can consent to\\ntake such articles into his home, without any knowledge of the\\nplace from which they came, and assume that they are not reeking\\nwith scarlet fever, diphtheria or other germs.\\nRugs and Carpets. Disinfect rugs with steam or formalde-\\nhyde the same as Bedding. Fur rugs must not be steamed.\\n(See Furs. If, unfortunately, a carpet was left upon the\\nfloor of a sick-room, it should be removed before the room is dis-\\ninfected, and treated as follows Disinfect with steam if the\\nappliances are available, but if these are not obtainable, use formal-\\ndehyde as for Bedding. If neither steam nor formaldehyde\\ncan be used, spray or sprinkle the carpet on both sides until\\nthoroughly wet with Solutions I, 6 or 7. The only other way\\nis burning, and this is the best course for carpets and rugs of\\nlittle value.\\nFurs, Skins, Etc. These can be efficiently disinfected only\\nby formaldehyde as for Bedding, or by spraying or sprinkling\\nvery thoroughly with a disinfectant. Solution 6, or the tight\\nbox with formaldehyde, is best.\\nBoots, Shoes and OtJier Leathern Articles. Wash in Solu-\\ntions 1, 2, 3, or 6, or expose to formaldehyde.\\nExcreta. In the sick-room the discharges from the boweis\\nmay be treated with any of the solutions herein given except Solu-\\ntions 6 and 7.\\nDisinfecting solutions should act three or four hours, at\\nleast. A still longer time is better. The quantity used of I,\\n2, or 3 should be at least twice the volume of the discharge; if\\n4 or 5 is used, the quantity should be much larger. The intimate\\nmixture of the solution and the matter to be disinfected is impor-\\ntant. A sure way to disinfect fresh excreta is to pour upon it\\nin the vessel at least three or four times its volume of boiling\\nwater, then cover the vessel and let it stand until cool.\\nPrivy Vaults. Disinfect with Solution 4 or 5, used in\\nlarge quantity, sufficient to thoroughly saturate the contents\\nafter the vault is emptied pour in pailful after paiiful of the milk\\nof lime until the ground beneath the privy is completely saturated\\nwith it. Cesspools should be disinfected in the same way.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0139.jp2"}, "138": {"fulltext": "122 SANITATION.\\nWater Closets. If they have received infectious excreta, the\\nhowls of water closets should be scrubbed out with Solutions i,\\n2, or 3.\\nSputa. Fresh tuberculous sputum is hard to disinfect. It\\nmay be received on pieces of cloth or paper and burned. In spit-\\ntoons it may be disinfected with Solutions 2, 3, or 1. The effi-\\nciency of these solutions is increased by using them hot, and\\nSolution 1 is made still more effective by adding to each gallon two\\nounces of hydrochloric acid, or twelve to fourteen ounces of\\ncommon salt. These solutions should act twenty-four hours\\nnecessitating several spittoons for the patient.\\nTuberculous sputum may also be disinfected by filling the\\nspittoon with boiling water, covering it and letting it stand until\\ncold. The cleansing of the spittoon will be facilitated by\\nadding washing soda before the hot water is poured in. Other\\ninfectious sputa should be treated the same as tuberculous sputum.\\nCorpses. Wrap in a sheet wet in Solutions 6, 7, or 2, and\\nbury as soon as possible.\\nMouth and T/iroat of the Atte?idant. As a preventive, rinse\\nthem in a solution of five drops of formalin to one ounce of water.\\nClothing of Nurses and Physicians. Steam is preferable, or\\nthe suit may be put into a tin wash boiler, or gas-tight box, and\\na rag, wet with two or three ounces of formalin, placed beside\\nit, then the box closed tightly and left during the night. The\\nclothing must not be worn again until thoroughly aired.\\nHOW TO MAKE THE HOME HEALTHY.\\nMake large provision for the free circulation of air and the\\nadmission of sunlight, insure good drainage, and see to it that\\nthere are no stagnant pools and sewage accumulations. Burn all\\ncombustible debris, clean out ditches and allow no vegetation to\\ngrow in them. Vaults and cesspools must be frequently emptied,\\nand the contents removed far from buildings and covered with\\nearth, and during the cleansing such places should be liberally\\ntreated with Solution 4 or 5, and with dry earth. As ordinarily\\narranged, the cesspool is an abomination that should not be tol-\\nerated, for it places corruptible matter in the best condition for\\nthe long-continued generation of microbes, from which to infect\\nthe air and water of the neighborhood. Where sewer connections\\nare impossible, let drainage from the kitchen sink be conducted to", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0140.jp2"}, "139": {"fulltext": "SANITATION. 123\\nsome distance from the house, through a movable pipe, and dis-\\ncharged upon the surface of ground exposed to the sun, and\\nwhere no vegetation is allowed to grow move the pipe so that\\nit shall discharge in a fresh place each week, and as the ground\\nthat has been soaked becomes partially dried treat it liberally\\nwith Solutions 3, 4, or 5. The disposition for any considerable\\ntime, of such matter, by seepage from underground pipes, is\\nlikely to prove a delusion and a snare. Do not attempt it.\\nIn cleaning buildings, secure if possible a free circulation\\nof air under them especially see to it that there are no damp,\\nmoldv rooms bring- out and burn all decavine; rubbish found\\nin attic or cellar, and with freshly slaked lime whitewash the cellar\\nand attic walls.\\nPATENT DISINFECTANTS.\\nMany inventors have tried their hands at mixing disinfecting\\ncompounds, and to their nostrums have given fanciful names to\\ncatch the popular ear and secure their sale. It is doubtful if\\nany of them possess any real advantages many of them are abso-\\nlutely worthless. Because a substance emits a powerful odor is\\nno proof that it is a disinfectant on the other hand, those com-\\npounds that have a pleasing smell seldom have any disinfecting\\nproperties, and, by creating a mistaken idea of security, may do\\nmore harm than good. To secure reliable results we must first\\nknow what we want to do, then how to do it and we can never\\nbe sure of accomplishing what we wish with patent compounds\\nwhose compositions are kept secret.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0141.jp2"}, "140": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0142.jp2"}, "141": {"fulltext": "MATERIA MEDICA.\\nBy Louis C. Duncan, M.D.\\nINTRODUCTION.\\nMateria medica is the science of the materials used in treating\\nthe sick. It includes not only drugs, but also foods, air, water,\\nelectricity, and serums, besides agents not describable in a brief\\nchapter. With the exception of water, only those remedies known\\nas drugs will be considered here. They are vegetable, mineral and\\nanimal in origin, and are prepared in the forms of pills, tablets,\\nsolutions, tinctures, extracts, etc.\\nA solution is either a solid or gas transformed to the liquid\\nstate through the agency of a liquid which is called the solvent.\\nWhen the solvent will dissolve no more of a substance, the solution\\nis called a saturated solution of that substance.\\nA mixture is a fluid containing some drug not dissolved, but\\nheld suspended in it.\\nAn emulsion is a milk-like mixture, usually prepared by\\nmixing an oil and an alkaline or mucilaginous fluid.\\nA decoction is a solution made by boiling.\\nAn infusion is a solution made by steeping in water.\\nAn extract is prepared by evaporation of the juice of a plant\\nalmost to dryness.\\nA tincture is prepared by dissolving an extract in alcohol.\\nAn extract is stronger than a tincture.\\nA trochee or lozenge is a button-shaped mass of drug, in-\\ntended to be dissolved in the mouth.\\nA tablet is like a trochee, but smaller, and is to be swallowed.\\nTablets are generally to be preferred to the hard-coated pills,\\nsince they dissolve more readily in the stomach, but, on the other\\nhand, they lose strength more rapidly with age.\\nIt may be startling to the uninitiated, but it is nevertheless\\ntrue, that from among the fiercest poisons come some of the most\\nvaluable medicines. A knife of very keen edge, when used with\\na light and dexterous hand, will make a cleaner and better wound\\n125", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0143.jp2"}, "142": {"fulltext": "126 MATERIA MEDIC A.\\nthan the blunter instrument which has to be pressed heavily on\\nthe part and so a remedy of greatest power, when skillfully\\ntimed and apportioned to the varying progress of the case, is often\\nsafer and more valuable, under urgent and dangerous circum-\\nstances, than the simples of the timid practitioner. A few small\\ndoses of the one may turn the current of disease, and save a\\nprecious life, where the large and sustained doses of the other\\nwould prove unavailing. Prussic acid, aconite, strychnia, arsenic,\\nopium and belladonna are at once intense poisons and admirable\\nmedicines in the hands of the skillful, but, it can hardly be neces-\\nsary to add, as domestic remedies they have little place. They\\nare mentioned here, not to encourage their use in home treat-\\nment, but to inform the layman as to some of the weapons em-\\nployed by masters in the healing art, and, that, apprised of their\\ntrue character and the effects they may be expected to produce,\\nhe may more fully realize the importance of using them exactly\\nas prescribed.\\nGENERAL TONICS.\\nA Tonic is a remedy that increases the strength, and gives\\nvigor of action to the system.\\nCod Liver Oil. Cod liver oil is one of the best tonics to\\nrestore and build up the system in all wasting diseases. Not\\nonly is it indicated in consumption, but in a large number of other\\ndiseases, such as marasmus of infants, rickets, nervous exhaustion,\\nchronic bronchitis, scrofula, rheumatoid arthritis, and anemia.\\nIt is best given pure, and, owing to its nauseous taste, should be\\ngiven in a single, large dose once a day. Many cannot take it\\npure, and for such an emulsion must be made. One of the most\\npalatable is an egg emulsion put up by Parke, Davis Co. Not\\nmany can digest more than three teaspoonfuls of the pure oil per\\nday. It should be taken for weeks at a time.\\nIron. While iron is a general tonic, its special action is upon\\nthe blood. It increases the number of red blood corpuscles, as\\nwell as the amount of hemaglobin. It is indicated in all affec-\\ntions that weaken the blood; as anemia, chlorosis, leucemia,\\ntuberculosis, diabetes, rheumatoid arthritis, cancer, and Bright s\\ndisease, also in neuralgia and erysipelas.\\nThe old preparation, tincture of chloride of iron, still holds its\\nplace as one of the best. It should be given in doses of five\\nto fifteen drops, well diluted, and kept from the teeth as much as", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0144.jp2"}, "143": {"fulltext": "MA TERIA MEDIC A 127\\npossible. There are modern preparations which are more palat-\\nable. Pepto-mangan is as good as any of them. They all have\\na constipating effect, and for that reason should not be given long\\nwithout interruption. They are best taken after meals. Taken in\\nlarge doses iron is likely to disorder the stomach.\\nArsenic. Arsenic, in small doses, strengthens the action of\\nthe stomach and is a general tonic. It also has a special effect\\nupon the skin, and is said to clear the complexion. It improves\\nthe breathing or wind. When too long continued it irritates\\nthe stomach and produces a puffiness under the eyes which is a\\ndanger signal. Arsenic is useful in all debilitating diseases. It\\nwill give good results in the beginning of tuberculosis, anemia,\\nmalaria, diabetes, nervous exhaustion, chlorosis and other diseases\\nof the same weakening nature. It is also useful in all chronic\\nskin diseases. It is the principal ingredient of the various cancer\\npastes of the quack cancer doctors, and enters also into a compo-\\nsition used very generally by dentists to destroy the nerves of\\nteeth.\\nFowler s solution of arsenic is the safest as well as the most\\nconvenient form. The dose should begin at five drops once in\\nsix hours, and gradually increase to twenty or thirty. The eyelids\\nmust be very closely watched, and if they begin to puff, the arsenic\\nmust be stopped for a while.\\nQuinine. In small doses, quinine is a very valuable general\\ntonic. For this purpose from six to ten grains per day should\\nbe given. The compound tincture of cinchona may be used in-\\nstead, in doses of from one to four drams, three times a day. The\\ntaste may be disguised by taking it in quinimal, or verba santa\\nsyrup, or it may be taken in lozenges or in capsules.\\nBitters. Of the various bitter tonics used to stimulate the\\nstomach, promote the appetite and better the general health, the\\nchief ones are columbo, dogwood, quassia and gentian. The\\ndose of each is from one-half to two drams. Nux vomica tincture,\\nin five drop doses, and strychnia, one-sixtieth of a grain, may be\\nincluded in this list. Iron, quinine and strychnia are now com-\\nbined in an elixir which is regarded as quite generally useful.\\nLet it be remembered, however, that loss of appetite and nausea\\nare often nature s agents for calling a halt that the stomach, liver\\nand other over-worked organs may have needed rest, and that\\nat such times far more harm than good may result by overcoming\\nthese protests by bitters, or tonics of any kind.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0145.jp2"}, "144": {"fulltext": "128 MA TERIA MEDIC A\\nMercury, in small doses, is said to be a tonic. For this pur-\\npose, calomel, in one-fourth grain doses, three times a day, is the\\nsafest form.\\nPhosphorus and the hypophosphites are useful in all cases of\\nnervous exhaustion. The dose of phosphorus is one-hundredth\\nof a grain in a pill but of the syrup of hypophosphite from one\\ndram to one ounce may be taken.\\nHEART STIMULANTS.\\nStrychnia. Strychnia sulphate is a white crystalline powder\\nhaving an intensely bitter taste. The dose is from one-sixtieth\\nto one-thirtieth of a grain. Strychnia stimulates both the heart\\nand lungs, raises the body temperature, increases the muscular\\npowers and renders the special senses more acute. Strychnia is\\nuseful in cases of paralysis, constipation, chronic bronchitis, be-\\nginning consumption, anemia, etc. It is an active poison, and an\\nantidote to poisoning by chloral or chloroform.\\nNitro Glycerin is a colorless, oily liquid, soluble m alcohol or\\nether. It explodes if heated in a closed vessel, or subjected to\\npercussion. It is also known as glonoin and trinitrin. Its action\\non different persons differs so widely, it is difficult to say what the\\ndose is. It varies from one to fifty drops of a one per cent solu-\\ntion. It causes the heart to beat both more rapidly and more\\nforcibly, and, at the same time, lessens arterial tension, thus lessen-\\ning the work of the heart. It is a remedy which can be used\\nsafely only by a physician.\\nDigitalis. The tincture of digitalis is prepared from the leaves\\nof the wild fox-glove. It causes the heart to beat more slowly and\\nmore forcibly, but also narrows the caliber of the arteries, thus\\ngiving it more work to perform. The dose is from one to ten\\ndrops. Patients who have been taking digitalis should not rise\\nfrom the recumbent posture suddenly. It is one of the best\\ndiuretics known. Its principal use is in diseases of the heart, for\\nwhich it is used extensively. It must be remembered that it is a\\ndangerous poison, and be employed very cautiously.\\nCaffeine. The citrate of caffeine is a white crystalline powder\\nobtained from the ordinary coffee berry. The usual dose is five\\ngrains. Its most important action is to stimulate the heart and\\ncirculation. Its action on the heart resembles that of digitalis,\\ncausing the heart to beat more slowly and forcibly. At first it", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0146.jp2"}, "145": {"fulltext": "MATERIA MEDIC A. 129\\nproduces a drowsy feeling, and later stimulates the brain. It is\\nan effective remedy for that particular form of headache which is\\nassociated with disturbance of the stomach and known as nervous\\nor sick-headache. It is also useful in dropsy.\\nAlcoholics. While alcohol in quantity is a narcotic, in small\\ndoses (and it is never given medicinally except in small doses),\\nit is a stimulant. It increases the action of the heart and the cir-\\nculation, causes a slight rise in temperature, produces a feeling of\\nexhilaration, and aids digestion. An overdose produces almost\\nthe exact opposite of these conditions, and the evil effects of\\nprolonged indulgence, in quantities above the medicinal dose, are\\nwell known. The dose may be placed at from one to two ounces\\nof whisky or brandy, which contains nearly fifty per cent of pure\\nalcohol. Of the wines and lighter preparations more may be\\ntaken.\\nAlcoholics are useful, in fact almost indispensable, in many\\nconditions, such as the very low stages of any disease, con-\\nvalescence, prolonged wasting diseases, severe hemorrhage or in-\\njury, the bite of a poisonous serpent, and poisoning by agents\\nwhich depress the heart. Alcohol is also an antiseptic, useful ex-\\nternally in washes and liniments.\\nALCOHOLIC STRENGTH OF LIQUORS.\\nAlcohol 50 to 99$\\nRectified Spirit 85^\\nProof Spirit 50$\\nWhisky 44 to 50$\\nBrandy 39 to 47$\\nRum and Gin 42^\\nPort Wine 30 to 40$\\nSherry Wine 25 to 30^\\nLight red wines Claret, Red Rhine, Concord, etc. 5 to 7$\\nDry acid Wines Rhine, Moselle, Ohio, etc 5 to 7$\\nSparkling wines Champagne, Hock, Catawba, etc.... 8 to 12$\\nSweet wines Burgundy, Tokay, Madeira, Angelica 6 to 7^\\nBeer, Ale and Porter 2 to Gfc\\nKoumis 1 to 3 per cent.\\nANTIPYRETICS.\\nAntipyretics are remedies which reduce the temperature of\\nthe bod}-; in other words, lessen fever. As a rule, they have no\\neffect on a normal temperature. Some act by abstracting the\\n9", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0147.jp2"}, "146": {"fulltext": "180 MATERIA MEDIC A.\\nheat irom the body; others by lessening the production of heat by\\nslowing- the heart and diminishing the processes of the body and\\nothers by removing the elements which produce the excessive\\nheat, as quinine given in malarial fever. Those of the last class\\nare usually the best, but the others are sometimes necessary.\\nWater. Water is one of the safest and best of antipyretics.\\nFor reducing fever it may be used as a bath, or for sponging the\\nbody. As a rule it may be drunk freely. The bath may either\\nbe cold (40 to 60 degrees F.), temperate (60 to 85 degrees F.), or\\ntepid (85 to 95 degrees F.). When a physician is not at hand the\\ntepid or temperate bath is safest. If the patient cannot be placed\\nin a tub, the wet pack may be used. A linen sheet is wrung from\\ncold water, the patient placed in the middle of it, and both sides\\nfolded over him, and he is then covered with blankets. The\\nlength of time that he should remain in the pack is from fifteen\\nminutes to one hour, and when removed, he must be well rubbed\\nwith dry towels. If there is objection to the pack, sponging may\\nbe substituted. The face and neck are first sponged, then the\\narms, and so on until the whole body has been treated. Though\\nnot as efficient as the tub bath or pack, sponging also makes the\\npatient feel more comfortable and cool, and reduces the tem-\\nperature quite appreciably, and by many physicians is preferred\\nto either of the other methods, as being more convenient, shocking\\nthe patient less, and involving less risk, and by repetition giving\\nquite as good results (through opening the pores of the skin and by\\nthe cold produced by evaporation). It is a rule, followed by many,\\nin continued fevers to give the bath or spongings whenever the\\ntemperature goes above 103 degrees, and as often as may be\\nnecessary to keep it below that point. There is no doubt that such\\nmeasures are more certain and safe than all the fever drops,\\nantipynms and antifebrins that have ever been devised. The old\\nnotion that fever patients should not be allowed to drink cold\\nwater freely has given way to more humane and sensible ideas.\\nQuinine. Omnia bisulphate is, after water, the most success-\\nful antipyretic. Though it has the most marked effect in the\\nfevers called malarial, it is useful in nearly all fevers. It acts as an\\nantiseptic in the fluids of the body, and has a specially fatal effect\\nupon the germ of malarial fever, and for this fever is an absolute\\ncure. That there are rare exceptions does not disprove the rule.\\nFor this, as well as for other fevers, large doses are required.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0148.jp2"}, "147": {"fulltext": "MATERIA MEDIC A. 131\\nThirty grains a clay usually suffice for an adult, but in cases of\\npernicious malaria, and the so-called congestive chill, larger doses\\nmay be given up to sixty grains in twenty-four hours. It should\\nbe divided into six equal parts and one taken every four hours.\\nThe deafness that sometimes follows heroic doses is seldom per-\\nmanent.\\nQuinine is also destructive of other disease germs. In blood\\npoisoning, erysipelas and childbed fever quinine is extremely use-\\nful. It has an important place in the treatment of cerebro-\\nspinal meningitis, measles, scarlet fever and pneumonia. A large\\ndose at the beginning will often break up a cold, or even a case\\nof pneumonia or pleurisy. In typhoid and typhus it has little\\neffect.\\nQuinine should be given in the natural state or in capsules\\nwhen possible. If the taste is to be disguised, it may be given in\\nsome of the preparations now in vogue such as verba santa,\\nyerbazine. quinimel, etc., or the chocolate lozenges may be given.\\nThe hard coated pills and tablets cannot be recommended. Qui-\\nnine bisulphate does not differ materially from the sulphate com-\\nmonly used.\\nAnt i pyrin, Phenacetin and Acetanilide. These three modern\\ndrugs are much alike in their derivation, properties and effects.\\nThe} are white powders, and are made from coal tar. The dose\\noi each is from three to ten grains. Antipyrin is the most efficient\\nas an antipyretic. By a full dose the temperature in fever may be\\nreduced one or two degrees, or even to sub-normal, the decline\\nbeginning in ten to fifteen minutes, and lasting from two to ten\\nhours. Besides reducing fever, they have a quieting effect upon\\nthe nervous system, and lessen pain in any part of the body, but\\ncare must be exercised in their use because of their depressing in-\\nfluence upon the heart. Phenacetin is the safest of the group,\\nand antipyrin stands next. The preparation in tablet form known\\nas acetanilide compound is generally useful in slight fevers, neural-\\ngia, headache, rheumatism, etc., and is comparatively safe, for the\\nacetanilide is here combined with caffeine, which, being a heart\\nstimulant, counteracts its possible depressing effects. One tablet\\ncontains three grains and is a dose. Antipyrin is the best known\\ndrug for the reduction of fever, but, unfortunately, it has no effect\\non the cause of the fever; therein lies its inferiority to quinine.\\nAcetanilide is sometimes called antifebrin. Antipyrin with salicy-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0149.jp2"}, "148": {"fulltext": "13 k MATERIA MEDIC A.\\nlate of soda is effective in relieving rheumatic pains. Most head-\\nache tablets contain one of these drugs.\\nAconite. The tincture of aconite is prepared from the root\\nof aconitum napellus or monkshood. The dose is from one-half\\nto five drops. Although it has other powerful effects, its prin-\\ncipal use is as a heat reducer. It is much employed by homeop-\\nathic practitioners (although its action is in direct opposition to\\ntheir great principle of similia, etc. because a very small quan-\\ntity will produce a very marked effect. It slows both the heart\\nand the respiration, reduces arterial tension, lowers the tem-\\nperature, induces muscular weakness and lessens the nervous\\nsensibilities, i\\nIn large doses, or rather, in what of other drugs might be\\ncalled a small dose, it is an active poison and for this reason is a\\ndrug not suitable to be used as a home remedy. It is useful in\\nslight fevers, bronchitis, pneumonia, pleuritis, scarletina, erysipe-\\nlas, acute rheumatism and neuralgia. It should not be given in\\ncontinued fevers, as typhoid, and is of no real advantage in\\nmalarial fevers. It should never be given to a very weak patient.\\nANTISEPTICS.\\nAntiseptics may be defined as agents which arrest the action\\nof germs. They are useful in many internal diseases resulting\\nfrom germ action, as stomach disturbances, diarrhea, dysentery,\\nand typhoid. Many of the modern antiseptics are derived from\\ncoal tar by distillation.\\nCarbolic Acid is a coal tar product, and one of the most pow-\\nerful antiseptics. It occurs in white crystals, but that sold in the\\ndrug stores is a watery solution which, if nearly pure, crystallizes\\nagain in moderate cold. The dose is from one-fourth to one\\ngrain, or from one-half to two drops, well diluted. It is useful\\nin vomiting, fermentation in the stomach or intestines, cholera\\ninfantum and cholera morbus. For internal use, creosote and\\ngnaiacol are preferable. Weak solutions of carbolic acid are\\nmuch used as external antiseptics.\\nCreosote resembles carbolic acid, but is derived from wood\\ntar. The best creosote is made from beech wood. It may be\\nused in place of carbolic acid in the diseases mentioned. The\\ndose is from two to five drops.\\nGuaiacol is similar to creosote, and the same dose may be", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0150.jp2"}, "149": {"fulltext": "MATERIA MEDIC A. 133\\ngiven, and either may be given in cod liver oil, brandy or whisky.\\nBoth have a peculiarly destructive action on the germs of tuber-\\nculosis and for that reason are much given in cases of consumption,\\nand with good results.\\nSalicylic A cid occurs in small white crystals. The dose is\\nfrom ten grains to one dram. Large doses disturb the stomach.\\nSalicylic acid arrests fermentation, lowers the body temperature,\\nand is useful in diarrhea and typhoid. Its special use is in acute\\narticular rheumatism, commonly known as inflammatory rheuma-\\ntism. Powdered salicylic acid makes an excellent dusting powder\\nfor ulcers, eczemas, etc.\\nSalicylate of Sodium is much like salicylic acid but is even\\nmore effective. For acute rheumatism it comes very near to\\nbeing a certain cure. It is also useful in chronic rheumatism,\\nmuscular rheumatism, neuralgia, lumbago and gout. In all these\\naffections it may be given conjointly with antipyrin. The dose is\\nfrom ten to thirty grains.\\nSalol. Salol is made by combining sixty parts of salicylic acid\\nwith forty parts of carbolic acid, and is, perhaps, the best anti-\\nseptic for internal use. It is a white powder, tasteless and in-\\nsoluble in water. The dose is from five to thirty grains. When\\nlarge doses are given continuously there is danger of carbolic\\nacid poisoning. It is useful in all fermentations in the stomach\\nand intestines, in all suppurative processes, in acute tonsilitis,\\nrheumatism, neuralgia, la grippe, and typhoid. It is one of the\\nbest agents known for rendering the urine antiseptic in diseases\\nof the bladder, prostate and urethra.\\nBoric Acid, or boracic acid, as it is sometimes called, is a\\nmild antiseptic. Its principal use is external, for mild eye washes,\\nand as a dusting powder. A four per cent solution, which is a\\nsaturated solution of this acid if the water is cold, is an excellent\\nmild antiseptic wash for general use. Powdered boric acid may be\\nused on all kinds of ulcers, burns, scalds, and external wounds.\\nBorax, or the borate of sodium, has much the same properties\\nas boric acid.\\nBismuth Subnitrate is a grayish white powder of mild anti-\\nseptic power. It may be given with much benefit in simple in-\\nflammations of any part of the gastro-intestinal tract it gives relief\\nin each, whether it be the stomach, small intestines or colon. It\\nhas usually been given in too small doses. To obtain the desired", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0151.jp2"}, "150": {"fulltext": "134 MATERIA MEDIC A.\\nresult, from one-half to one dram should be given every three or\\nfour hours. As bismuth is not a poison, very large doses may be\\ngiven. It is also useful externally in cases of sore mouth, ulcers,\\nburns, etc.\\nThe list of diseases benefited by bismuth is a long one, in-\\ncluding acute indigestion, inflammation of the stomach, ulcer and\\ncancer of the stomach, summer diarrhea and cholera infantum,\\nvomiting, diarrhea of typhoid, chronic diarrhea, diarrhea of con-\\nsumption, and some cases of stomach neuralgia. It is best given\\nin milk, and on an empty stomach. It colors the stools dark, and\\nsometimes produces constipation. Bismuth subgallate, or der-\\nrnatol, has much the same action, and is, perhaps, superior for\\nexternal use.\\nMenthol occurs as colorless crystals derived from the oil of\\npeppermint. It is frequently put up in the form of a cone, stick or\\npencil for external use. It is also used in washes, sprays and\\ngargles, and seems especially beneficial in the affections of the\\nthroat. It is useful in neuralgia of the face, certain headaches\\nand toothache. In cases of neuralgia the solid stick is rubbed\\nover the surface until the skin reddens.\\nHydrogen Peroxide is a clear fluid, and an excellent external\\nantiseptic and deodorant. Its especial use is in suppurating\\ncavities, or on surfaces, which it cleans more effectively than any\\nother agent. It seems to have an affinity for pus, and, when\\nthey come in contact, unites with it to form a sort of foam which\\nis easily washed away. It ma be diluted or used full strength.\\nIt should be kept in an amber bottle in a dark place, and well\\ncorked, as it loses strength on exposure.\\nBichloride of Mercury. This is the most powerful of all anti-\\nseptics. It should never be taken internally, except on prescrip-\\ntion by a physician. For external antiseptic purposes, solutions\\nare made varying in strength from one to fifteen grains to the pint\\nof water. For application to the body a stronger than a two grain\\nsolution should not be used. For general disinfecting purposes,\\ndestroying vermin on beds, etc., a fifteen grain solution may be\\nused. It should always be borne in mind that the bichloride is a\\ndeadly poison.\\nChlorinated Lime is a grayish white substance, occifrring in\\npowder or lumps. It is useful for disinfecting excreta, vaults,\\netc., for which it is vastly superior to the quick lime often used.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0152.jp2"}, "151": {"fulltext": ".1 1 A TERIA MEDIC A 1 35\\nCharcoal. Ordinary charcoal is a useful antiseptic and de-\\nodorant. It acts by absorbing poisonous substances. When\\nused in filters it must be renewed occasionally. Powdered char-\\ncoal may be given internally in doses up to a dram.\\nPermanganate of Potash occurs in deep purple crystals. Its\\nsolution may range in color from a light rose to a deep purple, de-\\npending on the strength. One to two grains may be given in-\\nternally. It may be administered whenever an internal anti-\\nseptic is needed, but its principal use is in solutions for washing\\nout cavities, cleansing foul ulcers, etc. It has recently been learned\\nthat the permanganate of potash is an antidote for morphine poi-\\nsoning; a grain of the potash neutralizing a grain of the morphine.\\nWhen injected into the part bitten by a poisonous serpent the\\naction of the poison is arrested.\\nIodoform is a yellow powder having a very pronounced and\\ndisagreeable odor. It has long been the favorite powder for\\ndusting burns, abrasions, closed wounds, etc., but it is giving way\\nto other preparations more efficient and elegant. For this pur-\\npose boric acid, bismuth, quinine, acetanilide, salicylic acid, soda,\\nor one of several other powders may usually be substituted.\\nTincture of Iodine. The tincture of iodine is a brown-colored\\nliquid, having a more important place in the list of home remedies\\nthan in the practice of the physician. It stains the skin a dull\\nyellow and acts as an irritant. Painted over swollen glands and\\nlocal inflammations, before the formation of pus, it will sometimes\\nprevent that condition. It also hastens the absorption of fluids,\\nand for this reason is painted on the chest in cases of pleurisy with\\neffusion, and on inflamed joints containing fluid. It is also in-\\njected into goiter, enlarged tonsils, and glandular growths about\\nthe neck.\\nIchthyol is another of the new remedies, derived from coal tar.\\nIt is a dark, semifluid substance having the odor of bitumen. It\\nmay be used in most cases where iodine has heretofore been used,\\nand is decidedly superior to that drug. It dissolves in water,\\nether or alcohol, and mixes readily with vaseline, lard and oils to\\nmake ointments. For reducing the inflammation and relieving\\nthe pain of sties, boils, felons, carbuncles, and similar affections,\\nit has no equal. For this purpose it should be dissolved in three\\ntimes its bulk of alcohol and ether, and this preparation painted on\\nthe inflamed part every hour, or as often as may be necessary\\nto relieve pain.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0153.jp2"}, "152": {"fulltext": "136 MATERIA MEDIC A.\\nZinc Sulphate is a white crystalline substance, used in solution\\nand mostly externally. Solutions varying from one to six grains\\nto the ounce are used. Given internally, in doses of from one-half\\nto one dram, it is an active emetic.\\nEMETICS.\\nEmetics are medicines which cause vomiting. The prompt\\nuse of an emetic is often necessary to free the stomach of poison, or\\nother objectionable materials, and sometimes greatly relieves\\nheadache, hysteria, convulsions in children, and other troubles,\\nwhen the cause is a disordered stomach. They may also be valu-\\nable agents in the removal of obstructions from the throat or wind-\\npipe.\\nWarm Water, when taken in large quantities, is usually an\\nefficient emetic, especially if vomiting has already begun and\\ncopious draughts of it materially aid the action of other emetics.\\nMustard is a safe emetic, and one which is at hand in almost\\nevery home. Besides being an emetic it is also a stimulant. One\\nor two teaspoonfuls of powdered mustard, stirred into a cup of\\nwarm water and taken warm, is usually sufficient.\\nAlum. Powdered alum is another common drug which may\\nbe used as an emetic. It is slow but safe and reliable. Vomiting\\ndoes not occur for a half-hour after it has been taken. It is\\nespecially recommended for croup and diphtheria, as an. aid in the\\nremoval of the false membrane, and to prevent the formation of a\\nsecond one. The close is a teaspoonful. It may be taken in\\nsyrup, and should be repeated every forty minutes until there is\\nfree vomiting.\\nSquill or Scilla. The compound syrup of squill, or hive\\nsyrup/ is another active emetic, but its action is partly due to the\\ntartar emetic which it contains. The dose is from five drops to a\\nteaspoonful. It is not as safe as some other emetics.\\nIpecac is an efficient and safe emetic for all ordinary purposes.\\nThe time required for its action is from twenty to thirty minutes.\\nIt produces no depression or bad after effects, and, in weak con-\\nditions, is safer than the mineral emetics. The dose is from five to\\nsixty grains of the powdered root.\\nSulphate of Copper, or blue vitriol, is a prompt emetic, acting\\nin a few minutes. It is useful in many cases of poisoning, es-\\npecially in phosphoric poisoning. From five to ten grains may\\nbe given, dissolved in a few ounces of water.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0154.jp2"}, "153": {"fulltext": "MATERIA MEDIC A. 137\\nSulphate of Zinc, or white vitriol, is also an emetic, similar in\\nits action to the sulphate of copper, but is said to be less irritating\\nto the stomach, and not as powerful. A half-teaspoonful of the\\nsulphate should be given, dissolved in water. The action of this,\\nas of most emetics, is aided by drinking freely of lukewarm\\nwater.\\nTartar Emetic is a tartrate of antimony and potassium. It is\\na powerful emetic, but depressing, and its use as a home remedy\\nis attended with danger. A good way to give it is to dissolve five\\ngrains in a half-teacup of water, and give a tablespoonful of the\\nsolution every fifteen minutes until vomiting is produced.\\nApomorphine is one of the quickest and most effect-\\nive of all the emetics. Usually not more than ten minutes elapse\\nafter taking until vomiting begins. The dose, when taken into\\nthe stomach, is one-eighth of a grain. It is most commonly given\\nby means of the hypodermic syringe, the dose then required being\\none-sixteenth of a grain. It produces free and easy vomiting with\\nbut little nausea.\\nDIURETICS.\\nDiuretics are remedies which increase the flow of urine, either\\nby stimulating the kidneys, or otherwise. The principal diuretics\\nin use are water, sweet spirits of niter, digitalis, the acetate and\\nthe citrate of potash, oil of turpentine, copaiba, cubebs, buchu and\\nsquills.\\nWater. Water is, perhaps, the safest and best of all the\\ndiuretics for general use. To act as a diuretic it must be drunk\\nin quite large quantities. It works in a purely mechanical way,\\nwashing out and cleansing the kidneys. There are cases, how-\\never, where instead of relieving it adds to the difficulty. Milk, too,\\nis diuretic in its action and at times is preferable to water, not\\nonh acting on the kidneys but also nourishing the patient.\\nSweet Spirits of Niter or the nitrous spirits of ether, is a well\\nknown home remedy, but none the less effective on that account.\\nIt is a clear, sweet liquid, pleasant to take, and usually productive\\nof the desired effect. The dose is from a half-dram to a half-ounce.\\nIt should not be kept long, as it rapidly deteriorates.\\nDigitalis has been described under the head of Heart Stimu-\\nlants. It is especially useful in dropsies, but must be used with\\ngreat care.\\nPotash Salts. The acetate, citrate and bitartrate of potash", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0155.jp2"}, "154": {"fulltext": "138 MATERIA MEDIC A.\\nare all excellent diuretics. From five to twenty grains may be\\ngiven, well diluted, three times a day. Large doses often disturb\\nthe stomach. They are useful for keeping the urine alkaline, and\\nin many cases of Bright s disease, and in valvular disease of the\\nheart.\\nOil of Turpentine is a popular household remedy, and justly\\nso. The dose should not be over thirty drops. Taken internally,\\nin proper dose, it acts as a diuretic, but in large doses it produces\\nscanty, bloody urine, with a frequent desire to urinate, pain and\\nstraining. In medicinal doses, it also stimulates the heart and\\ncirculation, and acts as an antiseptic in the stomach and intestines.\\nIt dries up discharges from the lungs, and from the bladder and\\nurethra also. Y\\\\ nen applied externally over the kidneys, it has a\\nslight diuretic effect, and often will relieve pain in the kidneys.\\nIt is a good counter irritant, and enters into the composition of\\nmany liniments. The steam from heated turpentine and water\\nmay be used in cases of croup, etc.\\nBalsam of Copaiba is a diuretic, principally used for its heal-\\ning effect upon inflamed mucous membranes of the urethra and\\nbladder. The close is from ten drops to a teaspoonful, but large\\ndoses may produce indigestion. It is nauseous and very difficult\\nto take. It has been much used in venereal diseases.\\nBitchu and Cubed s are two vegetable preparations much used\\nin patent nostrums. Neither is of much value. Cubebs have\\nthe same uses as copaiba but are not as effective.\\nSquills is one of the old time remedies, now becoming obso-\\nlete. The dose is from one-half to one dram. It is used as an\\nexpectorant in many cough mixtures, and as a diuretic. It is irri-\\ntant to the stomach, and when an overdose is given produces\\nvomiting. It should never be given when there is any disturbance\\nof the stomach, nor to young babies in any case. It is effective\\nas a diuretic, but an overdose produces inflammation, straining\\nand bloody urine or suppression of the urine.\\nCATHARTICS.\\nCathartics are medicines that promote intestinal discharges,\\nand thus cleanse the stomach and bowels. They may be divided\\ninto several classes on the basis of their efficiency and rapidity of\\naction: Thus we have laxatives or aperients, purgatives and\\ncholagogues.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0156.jp2"}, "155": {"fulltext": "MATERIA MEDIC A. 139\\nLaxatives or Aperients are those remedies which excite only\\nslight peristalsis, cause no irritation or pain, and produce softened\\nstools in ten to twelve hours.\\nSulphur dose, one to three drams.\\nOx gall dose, two to four grains.\\nCascara, fluid extract dose, fifteen to forty drops.\\nPurge comes from two Latin words meaning to make pure,\\nand purgatives are medicines having the power to cleanse the\\nbowels. They are more severe and thorough than laxatives, and\\nare of three principal classes Simple, saline and drastic.\\nThe Simple Purgatives increase peristaltic action, and stimu-\\nlate the secretions of the intestinal glands, cause more copious\\ndischarges than the laxatives, and some irritation and griping.\\nThey operate in eight to ten hours, and produce one or more\\nwatery stools. The following are of this class\\nCastor oil dose, one to eight drams.\\nSenna, fluid extract dose, one-half ounce.\\nRhubarb dose, one-half to two drams.\\nAloes dose, one to five grains.\\nCastor Oil is a very reliable laxative, causes little irritation,\\npain or straining, and produces copious stools. It is an especially\\nvaluable laxative for children and pregnant women. In chil-\\ndren s diarrhea caused by undigested food or irritating secretions,\\nthere is no better remedy. It has very little effect upon the liver.\\nIt may be easily taken in a half-cup of hot coffee or hot milk, and\\nits offensive taste may be disguised by a few drops of wintergreen\\noil.\\nSaline Purgatives are such salts as have the power to in-\\ncrease peristalsis, and to cause large secretions of fluid from the\\nmucous membrane of the bowels, thus causing free watery stools\\nin from six to eight hours. They include such medicines as\\nMagnesia suiph. or Epsom salts. dose, one to eight drams.\\nMagnesium citrate dose, one to four drams.\\nRochelle salts dose, one to eight drams.\\nSeidlitz powders.\\nThe Drastic Purgatives are medicines which act still more\\nintensely than the salines. They operate powerfully and quickly,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0157.jp2"}, "156": {"fulltext": "340 MATERIA MEDIC A.\\nproducing violent peristalsis, griping and straining, and copious\\nwatery stools, in from two to six hours. In large doses they are\\ndangerous, causing inflammation and symptoms of irritant poi-\\nsoning. The following are of this class\\nJalap, comp. powder dose, ten to sixty grains.\\nScarnmony, comp. powder dose, five to ten grains.\\nCoiocynth, comp. powder dose, five to ten grains.\\nCompound cathartic pills dose, one to three.\\nCJwlagogucs are medicines which are supposed to act upon\\nthe liver and cause flow of bile into the intestines. In about eight\\nhours they produce free purging of watery stools of greenish color.\\nThe leading cholagogues are\\nCalomel dose, one-tenth to ten grains.\\nPodophyllum resin dose, one-fourth to one grain.\\nAloes dose, one to five grains.\\nMercurial Purgatives increase glandular action, and empty\\nthe ducts of the liver. Their action is slow, producing several\\nstools in from ten to twenty hours. In large doses they produce\\ngriping.\\nCalomel dose, one-tenth to ten grains.\\nBlue Mass dose, five to fifteen grains.\\nHydragogues are medicines supposed to be able to expel\\nserum that has been effused into any part of the body. The\\ncathartics of this class produce violent purging with watery stools.\\nGamboge not prescribed alone.\\nElaterium dose, one-sixteenth to one-fourth grain.\\nCroton oil dose, one to two drops.\\nIn large doses these are dangerous. The salines are also\\nhydragogue cathartics.\\nWHAT CATHARTICS TO TAKE AND HOW TO TAKE THEM.\\nSmall doses of calomel, as one-tenth of a grain repeated every\\nthirty to sixty minutes until a grain or more has been taken, give\\nbetter results than large doses at longer intervals. In case\\nthorough action is not obtained, follow in eight or ten hours with\\ncastor oil, or one of the salines.\\nThe best and safest cathartics, as general domestic remedies,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0158.jp2"}, "157": {"fulltext": "MATERIA MEDIC A. 141\\nare castor oil, magnesia sulphate, Rochelle salts, calomel and\\npodophyllum. For chronic constipation cascara is a good remedy.\\nIt may be combined with aloes, strychnia and nux vomica, for,\\nalthough the last two drugs are not cathartics, they stimulate\\nperistalsis of the bowels and thus counteract constipation. It\\nmust be remembered that the last two are poisons, and are to be\\nused only in very small quantities. (See Poisons\\nThe too common habit of taking cathartics immediately upon\\nthe appearance of each and every disorder is most pernicious.\\nThese medicines are excellent in their places, but in cases of\\nindigestion and constipation resort to drugs should be made only\\nwhen a thorough trial of laxative diet, regular habits, pure air, both\\nday and night, and outdoor exercise, have failed to overcome the\\ndisorder. A rectal injection also sometimes brings great relief in\\nthese cases, and must be counted among the valuable remedies,\\nbut, like drugs, it must be employed only when actually needed,\\nfor not only are too frequent injections likely to create a condition\\nwhich makes their continuance more and more necessary, but they\\nsometimes do great and irreparable injury by causing permanent\\ndilatation of the rectum and its sphincters.\\nHYPNOTICS.\\nHypnotics are remedies that produce or tend to produce sleep.\\nThe leading hypnotics are chloral hydrate, sulphonal and trional.\\nChloral Hydrate is a white crystalline substance, having a\\npungent odor and a burning, bitter taste. It is soluble in water,\\nand is a useful remedy in tetanus and other nervous disturbances,\\ndelirium tremens, chorea, hysteria, strychnia poisoning, con-\\nvulsions, etc. It does not cause headache or nausea, and does not\\nconstipate, as opium does. Combined with an equal part of bromide\\nof potassium, it is excellent to quiet the nerves. The dose is\\nfrom five to sixty grains. An overdose is dangerous.\\nSulphonal and Trional are coal tar preparations and occur in\\nwhite tasteless crystals, soluble in hot liquids. They are better\\nthan chloral to relieve sleeplessness, and are also safer. There\\nis a difference of opinion as to which is the better remedy, but\\ntrional seems to have the preference. Both are safe and reliable,\\nand do not leave the after effects of opiates. The dose is from ten\\nto twenty grains. Ten grains may be taken on retiring and not\\nrepeated. If that amount is not effectual, a larger dose should be", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0159.jp2"}, "158": {"fulltext": "142 MA TERIA MEDIC A\\ntried the next evening. They are patented preparations and are\\nsold at exorbitant prices.\\nANTHELMINTICS.\\nAnthelmintics are drugs which cause the expulsion of worms.\\nSantonin is a colorless, crystalline substance having a bitter\\ntaste. It is very conveniently put up with calomel in a chocolate\\ncoated trochee. Of those containing one-half grain, from one to\\nthree are sufficient for a child. Santonin is especially effective\\nagainst the round worm ascarides lumbricoides.\\nMale Fern. The oil of male fern is an almost certain agent,\\nif properly taken, for the expulsion of the tape worm. The dose\\nis from one-half to two drams. This should be given in divided\\ndoses, preceded by a fluid diet and followed by an active purge.\\nPomegranate. A decoction of the bark of the fresh root of\\nthe pomegranate is an effective tape worm remedy. A decoction\\nprepared by boiling two ounces of the bark in a quart of water\\ndown to a pint is the average quantity required. This may be\\ngiven in two ounce doses every hour until all is taken.\\nPumpkin Seed is one of the best remedies for tape worm.\\nTwo ounces of the fresh seed are pounded in a mortar with a half\\npint of water until the husks are loosened, and an emulsion made.\\nThe husks are strained out and the emulsion taken in one dose.\\nIf one close is not successful, try again the following morning.\\nAll tape worm remedies should be taken after a fast of twenty-\\nfour hours, and followed by an active cathartic.\\nQuassia. The infusion of quassia is a safe and effective\\nremedy for pin or seat worms ascarides vermiculares. It is in-\\njected into the rectum and held there several minutes. The ex-\\nternal parts must be washed with a very weak solution of carbolic\\nacid at the same time (a half-teaspoonful of acid to the pint of\\nwater).\\nMISCELLANEOUS.\\nArnica. The tincture of arnica is prepared from the root of\\narnica montana, a mountain plant. It has obtained a wide reputa-\\ntion for the relief of external bruises, strains and inflammations\\na reputation which it does not deserve. Its effects are largely due\\neither to the rubbing which usually accompanies its application,\\nor to the imagination, or to the alcohol of the tincture, which\\nof itself is an excellent liniment.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0160.jp2"}, "159": {"fulltext": "MA TERIA MEDIC A 143\\nAsafetida is an odorous gum which exudes from the root of\\nan eastern tree. In Persia and other countries where it grows,\\nthe gum is used as a condiment with meats and other eatables.\\nIt is soluble in spirits, and ma} be given that way, or in pill form.\\nThe dose is from two to five grains. Taken in moderate doses it\\naids digestion, and gently stimulates all the bodily functions.\\nIt is one of the best known remedies for flatulence or colic of in-\\nfants, and is useful in cases of flatulence in adults. It also gives\\ngood results in infantile convulsions, and in hysteria, and other\\nnervous affections. The old idea that it would ward off con-\\ntagious diseases has no foundation. The germs of disease do not\\nseem to be affected in the least by its horrible odor.\\nAmy I Nitrite is an exceedingly volatile liquid, having in some\\ndegree the properties of nitro-glycerin. It is used by inhalation,\\nand for this purpose is put up in fragile glass pearls, which may\\nbe crushed in the handkerchief and the drug thus inhaled. It\\noften affords speed}- relief in spasmodic asthma and angina pec-\\ntoris. If taken at the first premonitory symptom, an epileptic con-\\nvulsion may be averted.\\nAlum is a crystalline substance with a bitter, astringent taste.\\nIn a dose of a teaspoonful, powdered, it is an emetic, safe and\\neffective. It is useful as a gargle for sore mouth and throat, and,\\npowdered, as an application to cuts and ulcers. Burned alum\\nis a favorite home remedy for proud flesh in wounds and ulcers.\\nA teaspoonful of the powdered alum in water will give relief in case\\nof spasmodic croup, by exciting vomiting. Any other emetic will\\ndo the same thing, but alum is safe, and in most families is usually\\nat hand.\\nBromide of Potassium. The bromide of potash occurs in\\ncolorless cubical crystals, soluble in water. The dose is from\\nfifteen grains to two drams. The principal use of the bromide is\\nas a nerve sedative. It greatly lessens reflex irritability, slightly\\nreduces sensibility to pain, and, in large doses, produces a feeling\\nof drowsiness. Bromides are used for the relief of convulsions of\\nall kinds, but especially for those of epilepsy. Some cases of\\nepilepsy are cured by them. The bromides are also useful in in-\\nsomnia, delirium tremens, acute mania, congestive headache,\\ntetanus, and strychnia poisoning. When their use is long con-\\ntinued, there may be produced a condition of bromine poisoning,\\ncalled brominism. The bromides of soda, ammonium, calcium,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0161.jp2"}, "160": {"fulltext": "144 MA TERIA MEDIC A\\nlithium and strontium are all used with or in place of potash.\\nThey have similar effects.\\nBelladonna. The extract and tincture of belladonna and the\\nsulphate of atropine are obtained from the plant commonly known\\nas the deadly nightshade. Everyone knows its power of dilating*\\nthe pupil of the eye. Belladonna is an active poison. The medicinal\\ndose of the tincture is from five to twenty drops of atropine from\\none-one hundred and twentieth to one- sixtieth of a grain. Bella-\\ndonna lessens the secretions of the glands. This is seen in the\\ndryness of the mouth and throat following a dose. It may be\\ngiven in cases of salivation, acute nasal catarrh with copious\\nwatery secretions, incontinence of urine, and night sweats. There\\nis a long list of diseases which it is said to benefit, but, in most of\\nthem, it is unreliable. Externally, it is used in liniments and\\nplasters. Stramonium (jimson) and hyoscyamus (henbane) re-\\nsemble belladonna in their actions and uses.\\nCerium Oxalate is an insoluble white powder; a salt of the\\nmetal cerium. It may take the place of bismuth, and is prin-\\ncipally used as a remedy for vomiting. It restrains vomiting from\\nvarious causes, but especially the vomiting of pregnancy. The\\ndose is from two to five grains, usually given in pill form.\\nCocaine is an alkaloid derived from a South American plant\\nthe erythroxylon coca. It is used almost entirely as a local\\nanesthetic. On mucous membranes, as of the eye, mouth and\\nnose, it readily produces anesthesia by simple contact, but\\nnot so on the skin. There it must be introduced beneath the skin\\nby a hypodermic syringe. Different solutions are used, varying in\\nstrength from one to four per cent. It should be remembered\\nin using it that there is danger of forming the cocaine habit,\\nwhich is as serious as the morphine habit.\\nCamphor is the gum of an eastern tree. Spirits of camphor\\nis camphor gum dissolved in alcohol. Externally, it is a counter\\nirritant, producing redness and heat. The powdered gum is an\\ningredient of most tooth powders. It is a mild nerve sedative,\\nuseful in nervousness, hysteria, mania, etc. Inhaled, it is a heart\\nstimulant, useful in syncope or fainting, palpitation and threat-\\nened heart failure.\\nCollodion is a syrupy liquid composed of ether, alcohol and\\ngun cotton. When applied to the skin it produces a firm, protect-\\ning film. It is useful for covering abrasions, small cuts, wounds,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0162.jp2"}, "161": {"fulltext": "MATERIA MEDIC A. 145\\netc. When first applied to a raw surface it smarts severely.\\nA clean wound may be sealed with collodion and kept clean.\\nCJiloroform is a colorless liquid of a pleasant ethereal odor\\nand a sweet, burning taste. It dissolves many other drugs, oils,\\nresins and fats. Used externally it is a counter irritant. It may\\nbe mixed with turpentine and sweet oil, or with camphor. Its\\nprincipal use is as an anesthetic. It is more powerful than ether,\\nbut not quite as safe. The principal danger from chloroform is\\nto the heart that from ether to the lungs.\\nSulphuric Ether is a thin, colorless liquid with a characteris-\\ntic odor and sweetish taste. The nitrous spirits of ether has al-\\nready been mentioned as a diuretic. Ether is mainly used as an\\nanesthetic. It is dangerous to handle at night, for the reason\\nthat its vapor takes fire and burns readily. Both these drugs\\nshould be used only when administered by a physician.\\nDandelion. The root of the dandelion has long had a pop-\\nular reputation as an agent of great medicinal virtues. It has\\nbeen used as a home remedy and in many patent nostrums.\\nBeyond being a mild tonic, it is worthless.\\nGlycerin is a thick, syrupy liquid, having no odor and a\\nsweetish taste. It is derived from animal fats by heat and pres-\\nsure, and is soluble in water and alcohol. It is a weak antiseptic,\\nand, as a rule, is not irritating to the skin, though it is with some\\npersons. Applied to the tissues it abstracts Avater from them.\\nInternally it has little effect, but is an excellent vehicle for a\\nnumber of other remedies. It is useful as an application for\\nchapped skin, inflamed membranes of the nose and throat, and\\nas an injection in cases of constipation and dysentery.\\nIodide of Potassiujji. The iodide of potash occurs in white\\ncrystals, soluble in water, and having a salty taste. The iodide\\nof sodium and the iodide of ammonium are very similar to it.\\nThe dose of either is from two to ten grains, but more of the\\niodide of potash may be given, up to a dram. The principal\\naction of the iodides is to increase the elimination of the waste\\nproducts of the body. They are given in cirrhosis of the liver,\\nasthma, chronic bronchitis, chronic pneumonia and pleurisy, en-\\nlargement of the liver and spleen, scrofula, syphilis and chronic\\nrheumatism.\\nLithium is one of the rare metals. Its salts, but chiefly the\\ncarbonate and citrate, are used in medicine. The dose is from\\n10", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0163.jp2"}, "162": {"fulltext": "146 MATERIA MEDIC A.\\ntwo to ten grains. The carbonate is most used, is strongly\\nalkaline, and renders the urine alkaline. It is beneficial in cases\\nof rheumatism, especially in the chronic form, gout, the condition\\nknown as the uric acid diathesis and kidney stone. It may be\\nadvantageously combined with salicylate of sodium.\\nLead. Salts of the metal lead are used as medicines, mostly\\nas external applications. The solution of the subacetate of lead\\nis most useful. It may be applied in cases of burns, eczema,\\nerysipelas, ivy poisoning, nettle rash, herpes, or as an injection for\\ninflammation of the urethra. Combined with a small amount of\\ntincture of opium it is generally useful for relieving pain in external\\nparts.\\nLobelia, or Indian Tobacco, is quite popular as a household\\nremedy, and among certain herb doctors and quacks. Its prin-\\ncipal action is as an emetic, for which purpose it is excelled by\\nmany other remedies. It is also a mild tonic, diuretic and cathartic.\\nIts most important use is in the treatment of asthma. On the\\nwhole it is a drug which could easily be dispensed with.\\nOpium is the dried juice of the unripe poppy. Powdered\\nopium is a brown powder, having a bitter, nauseous taste. It\\ndepends for its strength on the morphine it contains. The\\ntincture of opium is often called laudanum, and a tincture con-\\ntaining camphor and other drugs is much used under the name\\nparegoric. Morphine is prepared from opium, and is about twelve\\ntimes as strong as the powder. Codeine is another prep-\\naration, about one-fourth as powerful as morphine. The dose\\nof laudanum is from ten to thirty drops of paregoric, from ten\\nto sixty drops; of powdered opium, from one to four grains; of\\ncodeine, from one-fourth to one grain; and of morphine, from\\none-eighth to one-third of a grain. After taking opium for a\\nlength of time, a larger dose is required. Opium is a narcotic\\npoison. The best antidotes are coffee, strychnia, atropine and\\nphysical exercise. The patient must be kept awake and in motion\\nif possible.\\nIn small doses, opium stimulates the imagination, but not the\\nreason or judgment. Its continued use renders the moral sense\\nless acute. It depresses the heart and muscular powers, and less-\\nens the action of the glands and internal organs. Large doses\\nproduce a heavy sleep, followed by a stage of depression with\\nheadache, vertigo, nausea and mental confusion. The dreams of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0164.jp2"}, "163": {"fulltext": "MATERIA MEDIC A. 147\\nopium narcosis are vivid and pleasing. Opium lessens sensibility\\nto pain of all kinds, and is the greatest of all anodynes. It is\\nmore effective for the relief of pain when injected beneath the\\nskin. It is given in inflammations, neuralgia, sciatica, rheumatism,\\nheadache, melancholia, diarrhea, and a long list of other dis-\\neases.\\nA\\\\ hile opium is chiefly given to relieve pain, it is not true that\\nit only blunts the perception of pain and is of no permanent\\naid. In many cases it is of real and lasting benefit. All opiates\\ncheck the action of the bowels, codeine less than morphine.\\nOpium is the best of all cough remedies, and codeine is, per-\\nhaps, the best of the opiates. In using opiates it is well to remem-\\nber the danger of forming the habit.\\nOx Bile, as its name implies, is the bile of the ox. It is\\npurified and dried to about the consistency of tar. It may be\\ngiven with benefit in cases of jaundice when the gall duct is\\nobstructed. It is usually given in pill form, in doses of from two\\nto three grains. It acts as an antiseptic and stimulates the action\\nof the bowels.\\nPepsin is a natural ferment found in the human stomach.\\nThat used in medicine is prepared from the stomach of the hog\\nand given when, owing to disease, the natural pepsin is not pro-\\nduced in sufficient quantity. It is a yellowish gray powder, hav-\\ning a disagreeable odor and taste. The dose is from two to five\\ngrains. As to its efficiency there is some doubt. The dose of\\nsaccharated pepsin is from twenty grains to one dram. The liquid\\npreparations are not as reliable.\\nPancreatin is a powder similar to pepsin in preparation and\\ntheory of use. It is prepared from the pancreases (sweetbreads)\\noi animals, and given to supply the want of the natural pancreatic\\njuices, when, for any reason, they fail. It resembles pepsin in ap-\\npearance, but is odorless and has rather a pleasant taste.\\nSilver Nitrate. The nitrate of silver is used in medicine,\\nboth externally and internally. The dose is from one-eighth to\\none-half a grain. It is given for ulcer of the stomach, jaundice,\\ncholera infantum, acute and chronic dysentery, ulcer of the rectum,\\nand various diarrheas.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0165.jp2"}, "164": {"fulltext": "148 MATERIA MEDIC A.\\nWEIGHTS AND MEASURES.\\nFLUID MEASURE.\\n60 minims, 1 fluid dram, written 1 fl3 or :j.\\n8 drams, 1 fluid ounce, written 1 fli or l].\\n16 fluid ounces, 1 pint, written 1 O, or Oj.\\n8 pints, 1 gallon, written 1 C. or C-j.\\nOne minim of thin liquids is about equal to one drop.\\nOne dram equals an ordinary teaspoonful.\\nTwo drams equal an ordinary dessertspoonful.\\nFour drams equal an ordinary tablespoonful.\\nOne ounce equals two ordinary tablespoonfuls.\\nTwo ounces equal an ordinary wineglassful.\\nFour ounces equal an ordinary teacupful.\\nThick liquids cannot be measured by the drop or spoonful.\\nAPOTHECARY S WEIGHTS.\\n60 grains, 1 dram, written 13.\\n8 drams, 1 ounce, written 1 3.\\n12 ounces, 1 pound, written 1 lb.\\nGrains, drams and ounces by weight cannot be measured by\\nbulk. Most solid preparations are now put up in tablets, each\\ncontaining an exact amount of a certain drug, thus affording\\nan easy way to give preparations which cannot be measured\\nwithout special instruments. Quinine may be measured by cap-\\nsules; thus a No. 2 capsule will hold three grains; but as drugs\\nvary greatly in weight, other powders cannot be measured with\\nthe quinine capsule. Although the No. 2 capsule holds three\\ngrains of quinine it will hold four of aloes, eight of bismuth, and\\nstill more of calomel.\\nWhen possible, liquids should be measured in a small glass\\ngraduate, which may be procured of any druggist and solids\\nshould be given either in tablet form, or by weight. Otherwise\\nthere is no certainty as to the amount given.\\nTHE ADMINISTRATION OF MEDICINES.\\nThe dose of any medicine is the quantity of it which has been\\nfound through experience to be necessary to produce its cura-\\ntive effects. It varies greatly in different individuals, and in the\\nsame individual under different circumstances. The principal\\nconditions which modify the action of medicines and affect their", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0166.jp2"}, "165": {"fulltext": "MA TERIA MEDIC A 149\\ndosage are the age, weight, sex, habits and health of the individual,\\nand the intervals between the doses.\\nIn general it may be stated that a smaller dose should be\\ngiven\\nTo a child than to an adult\\nTo an aged person than to an adult between twenty-one and\\nsixty\\nTo a light person than to a heavy one\\nTo a weak person than to a strong one\\nTo a female than to a male\\nTo one living within doors than to one living in the open air.\\nMost medicines give better results in small doses frequently\\nrepeated, than in large doses at long intervals, if in doubt as to\\nthe quantity required, give the smaller dose. Most drugs when\\nused unnecessarily are liable to be injurious.\\nExcept in the department of Diseases of Children, the\\ndoses indicated in this work, unless otherwise stated, are for ad-\\nults. Perhaps the best way to arrive at the proper close for a\\nchild is by a comparison of weights. Thus, if the child weigh\\none-third as much as the average adult, the average being about\\n150 pounds, he will require one-third as large a dose if he be one-\\nfifth as heavy he will require one-fifth the dose, and so on. A\\nyouth from 11 to 16 years of age usually requires from x to J\\nthe adult dose; and one from 17 to 20 years of age from to f\\nthe adult dose.\\nAnother way of determining the size of the close for a child\\nunder thirteen ears of age is found by the following rule To the\\nage of the child add 12, and by the sum thus obtained divide his\\nage, the resulting fraction will show the part of the adult dose re-\\nquired. Thus, for a child six years old we have i i2=T 6 8 i and\\nthe close is one-third that for the adult. In this way the following\\ntable has been prepared\\nTo a child i year old give r V of the adult dose.\\n2 years 4-\\n3 i\\n4\\n6 Vx", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0167.jp2"}, "166": {"fulltext": "1 50 MA TERIA MEDIC A\\n80 90 y 2\\nIn general, but little medicine should be given to children,\\nand, when given, should be in small doses frequently repeated\\nnever in large doses at long intervals. Don t be too free in the\\nuse of drugs. Both the patient and the physician are too prone\\nto forget that the real cure must be wrought by the reparative en-\\nergies of the system, and that medicines should be given only at\\nsuch times and in such quantities as will best assist nature in its\\ncombats with disease.\\nMEDICINAL DOSE LIST.\\nProper Name. Common Name. Preparation. Dose.\\nAcetanilidum Acetanilide Crystals 2 to 15 grains.\\nAcetic Acid Vinegar is impure ac. acid, Liquid 1 to 2 drams\\nArsenicum White Arsenic Powder to grain.\\nArsenicum Fowler s Solution Liquid 1 to 10 drops.\\nAconitia Aconite, Monkshood Tincture 2 to 10 drops.\\nAlcohol Alcohol Liquid to 2 ounces.\\nAloes Aloes Extract to 6 grains.\\nAlum Alum Crystals 10 to 15 grains.\\nAmmonia Carbonate Am. Carb. Smelling Salts. Crystals 3 to 10 grains,\\nAmmonia Chloride Sal Ammoniac Crystals 5 to 20 grains.\\nAmyl Nitrite Amyl Nitrite Liquid Inhalation.\\nAntimony Antimony Powder 2 to 6 grains.\\nAntimony Tartrate Tartar Emetic Crystals to 2 grains.\\nAnise Oil Anise Oil Oil 1 to 4 drops.\\nApomorphia Apomorphine Powder 2V to g ram\\nAristol Aristol External Application.\\nArnica Leopard s Bane Tincture 1 to 2 drops.\\nAssafoetida Assafoetida Gum 5 to 20 grains.\\nAtropia Sulphate Atropine Crystals t -|q to grain.\\nAntipyrin Antipyrin Powder 3 to 20 grains.\\nBalsam Peru Balsam of Peru Liquid 10 to 15 drops.\\nBelladonna Deadly Nightshade Tincture 10 to 20 drops.\\nBenzoic Acid Benzoic Acid Crystals 5 to 15 grains.\\nBismuth Subnitrate Bismuth Powder 5 to 20 grains.\\nBryonya Byrony Tincture .20 to 60 drops.\\nBuchu Buchu Tincture 1 to 2 drams.\\nCaffeina Caffeine Crystals. 2 to 10 grains.\\nCalamus Sweet Flag Tincture 1 to 2 drams.\\nCalcium Chloride .Chloride of Lime .Crystals 3 to 10 grains.\\nCalomel Calomel Powder to 10 grains.\\nCamboge Gamboge Powder i to 3 grains.\\nCamphor Camphor Spirits 10 to 30 drops.\\nCamphor Monobromate Camphor Crystals 2 to 10 grains.\\nCannabis Indica Indian Hemp, Hasheesh.. Tincture 5 to 20 drops.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0168.jp2"}, "167": {"fulltext": "MATERIA MEDICA. 151\\nCantharis Cantharides, Spanish Fly. Tincture 5 to 20 drops.\\nCapsicum Pepper Tincture 5 to 20 drops.\\nCarboligni Charcoal Powder 1 o to 60 grains\\nCarbolic Acid Carbolic Acid Liquid 1 to 3 drops.\\nCardamon Cardamon Tincture to 2 drams.\\nCaryophylum Cloves Tincture to 1 dram.\\nCaulophyllum Blue Cohosh Tincture 30 to 60 drops.\\nCascara Sagrada Cascara Fl. Extract 5 to 30 drops.\\nCascarilla Cascarilla Tincture I to 2 drams.\\nCerium Oxalate Cerium Oxalate Powder 1 to 10 grains.\\nCetraria Iceland Moss Decoction 2 to 3 grains.\\nChloranodyne Chloranodyne Liquid 5 to 15 drops.\\nChenopodium Worm Wood Powder 20 to 40 grains.\\nChionanthus Fringe Tree .Fl. Extract 5 to 60 drops.\\nChloral Hydrate Chloral Crystals 5 to 60 grains.\\nChloroform Chloroform Liquid 3 to 10 drops.\\nCimicifuga Racemosa Black Cohosh Tincture 15 to 60 drops.\\nCinchona Bark Cinchona Bark Tincture 4- to 1 dram.\\nCinnamomum Cinnamon Bark Powder 3 to 10 grains.\\nCinnamomum Cinnamon Bark Tincture 1 to 2 drams.\\nCitric Acid Citric Acid Crystals 10 to 30 grains.\\nCoca Ery throxylon Coca Fl. Extract 1 to 2 drams.\\nCocaine Hydrochlorate. .Cocaine Liquid i to 1 grain.\\nCodeina Codeine i to 1 grain.\\nColchicum Meadow Saffron Tincture 15 to 30 drops.\\nCod Liver Oil Cod Liver Oil Oil -J- to 2 ounces.\\nColocynth. Bitter Cucumber.. Extract 1 to 2 grains.\\nColumba. Columbo Tincture i to 2 drams.\\nConium Poison Hemlock Extract 4 to S grains.\\nConvallaria Lily of the Valley Tincture 10 to 20 drops.\\nCopaiba Copaiba Balsam 20 to 30 drops.\\nCopper Sulphate Blue Vitriol Crystals to 2 grains.\\nCorn Silk .Corn Silk Fl. Extract 1 to 2 drams.\\nCornus Floridia. Dogwood Fl. Extract i to 1 dram.\\nCreasote Creasote Solution to 2 drops.\\nCreolin Creolin External Only.\\nCreta Praeparata Prepared Chalk Powder 20 to 60 grains.\\nCroton Oil Croton Oil Oil 1 to 3 drops.\\nCubebs Cubebs Powder 1 to 2 drams.\\nDamiana Damiana Extract 1 to 5 grains.\\nDigitalis Foxglove Tincture 2 to 10 drops.\\nDisoscorea Wild Yam Fl. Extract 5 to 20 drops.\\nDover s Powder Dover s Powder Powder 5 to 10 grains.\\nDulcamara Bittersweet Extract 5 to 10 grains.\\nElaterium Elaterium Powder to i grains\\nErgota Ergot Fl. Extract 5 to 30 drops.\\nErgotinum Extract of Ergot Extract 2 to 5 grains.\\nEucalyptol Eucalyptus Oil 1 to 5 drops.\\nEuonymus Wahoo Tincture 10 to 40 drops.\\nFel Bovis Ox Bile Liquid 5 to 10 grains.\\nFerri Chloridum Chloride of Iron Tincture 5 to 20 drops.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0169.jp2"}, "168": {"fulltext": "152 MATERIA MEDIC A.\\nFerri Phosphas Phosphate of Iron Crystals 5 to 10 grains.\\nFerri Sulphas Sulphate of Iron Crystals 3 to 5 grains.\\nGalla Nut Galls Powder 8 to 20 grains.\\nGaultheria Wintergreen Oil 1 to 2 drops.\\nGelsemium Yellow Jasmine Tincture 5 to 20 drops.\\nGentiana Gentian Comp. Tincture. to 2 drams.\\nGlycerinum Glycerine Liquid -J to 1 dram.\\nGlycyrrhiza Liquorice Root Extract to 1 dram.\\nGranati Pomegranate Root Bark. .Powder 20 to 30 grains.\\nGrindelia Robusta Grindelia, Nuttal Extract 2 to 4 grains.\\nGuaiacol Guaiacol Fluid to 2 drops.\\nGuaiacum Guaiac Resin 10 to 30 grains.\\nHaematoxylon Logwood Decoction 1 to 2 ounces.\\nHamamelis Witch Hazel. Fl. Extract 2 to 5 drops.\\nHelleborus Niger Black Hellebore Powder 5 to 10 grains.\\nHelonias Helonias Compound Fl. Extract to 1 dram.\\nHydrastis Golden Seal Tincture 20 to 60 drops.\\nHydrocyanic Acid Hydrocyanic Acid Dilute 2 to 8 drops.\\nHydrochloric Acid Muriatic Acid Dilute 10 to 30 drops.\\nHydriodic Acid Hydriodic Acid Syrup 1 to 2 drams.\\nHydrangea Hydrangea Fl. Extract 10 to 30 drops.\\nHydrogen Peroxide Hydrogen Peroxide Liquid for external use.\\nHyoscyamus Henbane Tincture 10 to 30 drops.\\nIchthyol Ichthyol Semifluid 10 to 30 grains.\\nIgnatia St. Ignatius Bean Extract to 1 grain.\\nIodoform Iodoform Powder for external use.\\nIodum Iodine Tincture 5 to 20 drops.\\nIpecacuanha Ipecac Syrup 1 to 2 drams.\\nIpecacuanha Ipecac Powder 1 to 30 grains.\\nJaborandi Pilocarpine or Jaborandi. .Tincture 30 to 60 drops.\\nJalap Jalap Powder 2 to 30 grains.\\nJuglans Walnut Leaves Decoction 1 to 2 ounces.\\nJuniperus Juniper Oil 1 to 3 drops.\\nKola Kola Fluid Extract 10 to 30 drops.\\nLeptandrin Leptandrin Resin 1 to 2 grains.\\nLithium Carbonate Carbonate of Lithium Powder 3 to 10 grains.\\nLobelia Indian Tobacco Tincture 10 to 30 drops.\\nMagnesium Light Magnesia Powder 10 to 20 grains.\\nMagnesium Sulphate Epsom Salts Crystals 1 to 4 drams.\\nMale Fern Male Fern Oleo-Resin 10 to 20 drops.\\nMarubium Horehound Infusion 1 to 2 ounces.\\nMentha Piperita Peppermint Oil 1 to 4 drops.\\nWater 1 to 2 ounces.\\nMenthol Menthol Crystals External use.\\nMorphia Sulphate Morphine Powder i to grain\\nMorrhuse Oleum Cod Liver Oil Oil 1 to 8 drams.\\nMyrrha Myrrh .Tincture 30 to 60 drops.\\nMass of Mercury Blue Mass Mass 1 to 5 grains.\\nNaphthol Beta Naphthol Powder 2 to 15 grains.\\nNitro Glycerine Nitro Glycerine Oil to T grain.\\nNitrate of Silver Nitrate of Silver Crystals r V to I grains.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0170.jp2"}, "169": {"fulltext": "MATERIA MEDIC A. 153\\nNux Vomica Nux Vomica Tincture 10 to 20 drops.\\nOpium, Camphorated .Tincture Paregoric Tincture 15 to 60 drops.\\nOpium, tincture Laudanum Tincture 5 to 30 drops.\\nOpium, Powdered Opium Powder J to 1 grain.\\nPancreatin Pancreatin Powder 2 to 5 grains.\\nPanax Ginseng Liquid to 1 dram.\\nPepsin Pepsin Powder 2 to 5 grains.\\nPennyroyal Pennyroyal Fluid Extract i to 2 drams.\\nPetroleum Coal Oil Oil i to 1 dram.\\nPhenacetine Phanacetine Powder 5 to ig grains.\\nPhosphorus Phosphorus Solid \u00c2\u00b11^ to T grain\\nPhysostigma Calabar Bean Powder 1 to 4 grains.\\nPlumbum Subacetate Subacetate of Lead Solution External.\\nPine Compound Pine Compound Syrup 15 to 60 grains.\\nPhytolacca Poke Root Powder 1 to 5 grains.\\nPodophyllum .-May Apple, Mandrake.. .Powder 10 to 20 grains.\\nPotassium Acetate Acetate of Potash Crystals 10 to 20 grains.\\nPotassium Bicarbonate Saleratus Powder 10 to 40 grains.\\nPotassium Bromide Bromide of Potash Crystals 5 to 60 grains.\\nPotassium Chlorate Chlorate of Potash Crystals 5 to 20 grains.\\nPotassium Citrate Citrate of Potash Powder 10 to 60 grains.\\nPotassium Iodide Iodide of Potash Crystals 5 to 60 grains.\\nPotassium Nitrate Saltpetre Crystals 5 to 30 grains.\\nPotassium Permanganate.. Permanganate of Potash. .Crystals 1 to 2 grains.\\nPotassium Tartrate, Acid. Cream of Tartar Powder i to 2 drams.\\nPrunus Virginia, Cortex. .Wild Cherry Bark Syrup to 2 drams.\\nQuinine Bisulphate Quinine Bisulphate Powder 5 to 40 grains.\\nQuinine Sulphate Quinine Powder 2 to 30 grains.\\nJResorcin Resorcin Crystals 5 to 10 grains.\\nRhei Radix Rheubarb Powder 2 to 20 grains.\\nRicini Oleum Castor Oil Oil to 2 ounces.\\nRutae Oleum Oil of Rue Oil 1 to 4 drops.\\nSabinae Sabine Oil 1 to 4 drops.\\nSabal Saw-Palmetto Fluid Extract 10 to 20 drops.\\nSaccharum Lactis Sugar of Milk Powder 1 to 2 drams\\nSalacinum Salacin Crystals 5 to 20 grains.\\nSalicylic Acid Salicylic Acid Crystals 5 to 30 grains.\\nScammonium Scammony Resin 2 to 10 grains.\\nScilla Squills Syrup 30 to 60 drops.\\nScutellaria Scull Cap Fluid Extract 5 to 20 drops.\\nSalol Salol Crystals 5 to 20 grains.\\nSanguinaria Bloodroot Powder 1 to 20 grains.\\nSantoninum Santonin Crystalline 2 to 5 grains.\\nSenega Snakeroot Powder 1 to 20 grains.\\nSenna Senna Infusion 1 to 2 ounces.\\nSerpentaria Snakeweed Fluid Extract 10 to 20 drops.\\nSoda Tartarata Rochelle Salts Powder to 4 drams.\\nSodium Benzoate Benzoate of Sodium Powder 10 to 30 grains.\\nSodium Bicarbonate Baking Soda Powder 5 to 20 grains.\\nSodium Bromide. Bromide of Soda Powder 10 to 30 grains.\\nSodium Hypophosphite. .Hypophosphite of Soda. .Powder 5 to 10 grains.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0171.jp2"}, "170": {"fulltext": "154 MATERIA MEDIC A.\\nSodium Salicylate Salicylate of Soda Crystals 10 to 30 grains.\\nSodium Sulphate Glauber s Salts Powder to 1 ounce.\\nSpiritus AetherisNitrosus. Sweet Spirits of Nitre. .Solution -J to 2 drams.\\nStaphisagriae Stavesacre Seeds Oil to 2 drops.\\nStramonium Thornapple, Jimson Weed. Tincture 10 to 30 drops.\\nStropanthus Stropanthus Tincture 2 to 10 drops.\\nStrychnia Strychnine Powder eV to iV g ram\\nSulphonal Sulphonal Crystals 10 to 30 grains.\\nSulphur Sulphur Powder 20 to 60 grains.\\nStillingia Queen s Root Fluid Extract to 1 dram.\\nSan tali Oleum Oil of Sandalwood Oil 10 to 20 drops.\\nSarsaparilla Sarsaparilla Liquid Extract 2 to 4 drams.\\nTanacetum Tansy Oil 1 to 5 drops.\\nTanic Acid Tannin Powder 5 to 1 5 grains.\\nTaraxicum Radix Dandelion Root Extract 5 to 15 grains.\\nTurpentine Turpentine Oil or Spirits. 5 to 30 drops.\\nThymol Thymol Crystals External use.\\nToxicodendron Poison Oak Powder 1 to 3 grains.\\nTrifolium Clover Syrup 1 to 2 drams.\\nTriticum Repens Tritica, Couchgrass Liquid Extract 1 to 2 drams.\\nTolu, Syrup Syrup of Tolu Syrup i to 2 drams.\\nThyroid Extract Thyroid Extract Powder 2 to 5 grains.\\nUva Ursi Bear Berry Leaves Infusion 1 to 2 ounces.\\nYerba Santa Syrup of Yerba Santa .Syrup 1 to 2 drams.\\nValerian Valerian Tincture i to 1 dram.\\nVeratrum Veride Green Hellebore. Tincture 5 to 20 drops.\\nVirburnum Opulum Cramp Bark Fluid Extract 10 to 30 drops.\\nViburnum Prunifolium. .Black Haw Liquid Extract 10 to 30 drops.\\nVinum Wine Liquid i to 2 ounces\\nWarburg s Tincture Warburg s Tincture Tincture to 1 dram.\\nXanthoxylum Prickly Ash Berries Fluid Extract 5 to 10 drops.\\nZincum Oxidum Oxide of Zinc Powder i to 5 grains.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0172.jp2"}, "171": {"fulltext": "NURSING.\\nmentioning\\nBy Robert S. Magee, M.D.\\nAs recovery of the patient often depends more upon the\\ncare he receives than upon the medicine he takes, the importance\\nof good nursing can hardly be overestimated. Everyone should\\nknow of what it consists, for, although the care of the sick is a\\nhigher duty, a more responsible work, than can best be performed\\nwithout special knowledge and experience, in the large majority\\nof all cases the members of the family care for each other, so that\\nto almost everyone, sooner or later, the call comes to act as nurse,\\nand to women it is likely to come as an imperative demand.\\nThe Nurse. Before\\nher duties,\\na few words, applicable\\nto all women while act-\\ning in this capacity,\\nshould be said of the\\nnurse herself. The trained\\nnurse of the hospitals\\nwears a uniform consist-\\ning of a blue gingham\\ndress, a large white apron,\\nwhite linen collar and\\ncuffs, or detachable white\\nlinen half-sleeves instead\\nof cuffs, soft, heelless\\nslippers, and a white In-\\ndia linen cap, which is\\nthe badge of her profes-\\nsion. At some hospitals\\npink gingham is worn,\\nand at others white ging-\\nham, instead of the blue.\\nWhile it is not ex-\\npected that others will don this costume, it is very desirable\\nthat every woman who performs the duties of nurse should so\\ni55\\nThe Costume.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0173.jp2"}, "172": {"fulltext": "156 NURSING.\\nfar imitate it as to wear aprons and dresses of soft, easily washed\\ncotton or linen, and easy, quiet shoes. Rubber soled slippers\\nare best for the sick-room, but if these cannot be obtained, the\\nshoemaker will attach rubber heels to your every-day shoes, or\\nyou can yourself nail on small pieces of the sole of an old over-\\nshoe, thus making them almost noiseless. The nurse should\\nalso pay such attention to her toilet as to be cleanly in person\\nand dress, to have well brushed teeth and a sweet breath, and to\\nbe neat and tidy in her general appearance. Her nails should al-\\nways be closely cut and well brushed, and her hands be kept warm,\\nsoft and smooth. Cold cream, or glycerin, or a mixture of one\\npart of glycerin and two of bay rum, well rubbed into the hands\\nat night, will greatly aid in softening and keeping them in\\ngood order.\\nA good nurse will have self-control, be calm in all em-\\nergencies, quiet and discreet, and maintain a cheerful, hopeful\\nbearing. A peaceful but cheery atmosphere will prevail wherever\\nshe goes. She will engage in no discussions with the patient, or\\nin his presence, and will allow no whispering in his room, or any\\nthing else likely to excite or agitate him, but will try to secure to\\nhim repose of mind, as well as of body. As prolonged usefulness\\nwithout health is impossible, she will care for herself as well as\\nfor her patient, and to this end will have a regular and proper\\ndiet, take an outing in the open air for an hour or two each day,\\nand as far as possible have her regular hours of sleep.\\nGood nursing includes the faithful execution of the phy-\\nsician s orders, the personal care of the patient, attention to the\\ncleanliness, temperature and ventilation of the sick-room, the\\ncontrol as far as may be of contagion and infection, an accurate\\nreporting of the symptoms as they develop from day to day, and\\nthe proper preparation and administration of food.\\nThe Physician s Orders. The nurse should make a time-\\ntable showing the hours for giving the medicines prescribed, also\\nthose for giving food, then as each is given check the hour with\\na small mark, drawing a line through those hours at which, for\\nany reason, food or medicine was omitted, thus forming an ac-\\ncurate and useful record for the inspection of the physician. It\\nis a singular weakness of human nature that leads very many\\nignorant people to feel called upon to give advice to the afflicted,\\nno matter how serious the case, or how competent and skillful", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0174.jp2"}, "173": {"fulltext": "NURSING. 157\\nthe physician in charge. Many a patient has lost his life because\\nof well-meant interference of friends. It is as clearly the duty\\nof the nurse to guard the patient against all such dangers as to\\nadminister medicines and food, and it often requires much tact and\\ngentle firmness to ward them off.\\nFaithfully follow the directions of the physician, and, until\\nhis sanction has been obtained, permit the use of no additional\\nremedies or foods, and substitute none, no matter by whom pro-\\nposed. In many cases short calls may do the patient good in\\nothers even personal friends may have to be excluded. The\\nnurse must see at all times that visiting is not carried to the point\\nof fatigue, and never permit the rehearsal of harrowing or excit-\\ning tales or the announcement of deaths, or any other startling\\nnews in the sick-room.\\nPersonal Care. Except in a few diseases, as spinal meningi-\\ntis, in which the extreme nervousness of the patient requires the\\nutmost quiet, it is of the first importance that the patient be kept\\nclean. He must have a clean skin, clean clothes, clean air and\\nclean surroundings. Y\\\\ nether he wishes it or not, he should, as\\na rule, be thoroughly washed or sponged every morning with\\nsoap and water of the temperature most agreeable to him, and\\nin the following order Face, ears, neck, hands, arms, chest,\\nlimbs, feet, back and abdomen. Take good care as soon as a part\\nis washed to immediately and thoroughly dry it with a soft towel.\\nExpose only the part that is being washed, or, if the air is chilly\\nto the patient, do the sponging under cover of the blankets. The\\nface and hands should also be washed every evening, and there\\nshould be such washing done at other times as occasion shall re-\\nquire. The teeth should be cleaned each day with a brush or\\nlint, and the hair should be carefully combed and brushed. No\\niron-clad rule can be given as to the frequency of changing the\\nbody and bed linen, but be generous in this regard. Nothing\\nadds more to the comfort of the bed-ridden than fresh night-\\nshirts, sheets and pillows, but always air and warm the clean\\nchanges, in another room, before placing them up\u00c2\u00a9n the patient or\\nhis bed.\\nTo change the under sheet, remove all covers, except one\\nblanket and the upper sheet, then draw out this sheet, leaving the\\nblanket next the patient. Remove the pillow, turn the patient on\\nhis side near the middle of the bed, and fold the soiled sheet close", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0175.jp2"}, "174": {"fulltext": "158 NURSING.\\nto his back; against this soiled sheet place a clean one half rolled,\\nspread the unrolled part of it smoothly over the exposed part of\\nthe mattress, and firmly tuck it in then having turned the patient\\nover on the clean sheet and removed the soiled one, unroll the\\nclean sheet over the rest of the bed, draw it smoothly and tuck it\\nfirmly under the mattress. If the patient cannot be turned on his\\nside, the sheet can be changed in a somewhat similar manner by\\nworking from the head to the foot of the bed.\\nTo change the tipper sheet, spread the clean sheet over the\\ncovering blanket, then, while holding the sheet with one hand,\\ndraw out the blanket, after which spread on the remaining bed\\nclothes.\\nThe Draw-sheet A draw-sheet is formed by folding an or-\\ndinary sheet crosswise into three or four thicknesses, placing it\\nsmoothly across the bed over the lower sheet so that it shall reach\\nfrom the middle of the patient s back to his knees, and firmly\\ntucking its ends under the mattress at both sides of the bed.\\nWhen soiled it can easily be withdrawn and a new one substituted,\\nan assistant lifting the patient a little if he is unable to raise him-\\nself.\\nBed Sores. Failure to keep the patient perfectly clean and\\ndry, and to keep his bed dry and fresh, is the chief cause of bed\\nsores. Besides taking great care to guard against these errors,\\nthe nates, back and hips should be examined daily in all cases of\\nprolonged illness, and if any red spots are found, or there is com-\\nplaint of any tenderness, after carefully washing and drying these\\nparts, apply water and alcohol, water and vinegar, brandy, spirits\\nof wine, or strong alum water, and, when the parts have dried,\\nanoint them with olive oil, or vaseline, and having thoroughly\\nrubbed it in, dust the parts with powdered boric acid, powdered\\noxide of zinc, or subnitrate of bismuth, or with powdered starch\\nif none of the others be at hand, and repeat this treatment every\\nthree hours until all signs of sores disappear. These serious afflic-\\ntions can nearly always be avoided by this treatment if begun early\\nand properly continued. In all cases of paralysis it should be\\nbegun very early, and before the appearance of any redness. Care\\nmust always be taken to keep the bed free from crumbs and every-\\nthing that would irritate the skin. Let there be no wrinkles.\\nSmoothness of the bed is more desirable than softness. Keep the\\nsheet drawn snugly and its edges well tucked under the mattress.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0176.jp2"}, "175": {"fulltext": "NURSING. 159\\nThe nurse will sometimes find a bed sore when she first takes\\ncharge of a patient, in which case it is very important to heal\\nit immediately. The following treatment, faithfully administered,\\nwill almost always cure Wash the part with ether, apply to the\\nsore a pad, about its size, of absorbent cotton saturated in gly-\\ncerin, lay over it oil silk, and fasten it securely and smoothly with\\nstrips of adhesive plaster. Repeat this washing and dressing, at\\nleast twice daily.\\nThe Sick-room. In every well arranged home there should\\nbe a room specially designed for the use of the sick. It should\\nhave a southern aspect, several windows arranged to open at both\\ntop and bottom, abundant sunlight, and an open grate, and be so\\narranged that it can easily be isolated from the rest of the house\\nduring a case of infectious disease. It will be a great advantage to\\nhave another well ventilated room opening into it, and near at\\nhand on the same floor a lavatory and water closet with an out-\\nside window. A water closet must never open directly into a sick-\\nroom, nor should such a room ever contain a stationary wash\\nbasin, sink or other sewer connection. The larger and more airy\\nthe room the better. It should be as far removed from the\\nkitchen and living rooms as possible without fronting on a noisy\\nstreet, and, for greater safety in cases of infection or contagion,\\nshould be in the highest story of the house. Its floor should be\\none for use without carpets, its walls should be painted, or of a\\nfinish which can be washed; its woodwork plain and smooth, and\\nwithout heavy moldings or cornices that would afford lodging\\nplaces for dust.\\n\\\\^ciitilation. To no other class is ventilation so important\\nas to the sick, for, although weak and less able to overcome toxic\\ninfluences, they must for days, weeks, or even for months, breathe\\nonly such air as they can get in their apartments, yet, how often\\nAve find the atmosphere of the sick-room extremely foul and every\\ncrevice tightly closed. Instead of such an atmosphere, reeking\\nwith poisons from his exhalations, excretions and bodily dis-\\ncharges, the patient should have air as pure as it is possible for\\npainstaking intelligence to furnish.\\nPure air and cold air must not be confounded. Cold\\nair from a hall or adjoining room is not what is needed, for such\\nair may be very impure, but air from outdoors, as fresh and\\npure as can be obtained, and a gentle current of it should be kept", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0177.jp2"}, "176": {"fulltext": "160 NURSING.\\nconstantly flowing through the room. To this end, an outlet as\\nwell as inlet must be provided, for it is as important that impure\\nair be carried out as that pure air be brought in. If care be taken\\nto keep the patient from cold draughts, resort being made to\\nscreens or other devices, if necessary, to deflect the currents, there\\nwill be very little danger of his taking cold from the admission of\\noutdoor air, even in midwinter. In connection with a window\\nlowered a little from the top, a fire in an open grate makes a\\nmost excellent ventilator, and at the same time affords a safe\\nmeans for the ready disposal of soiled dressings, cloths and other\\nwaste. When no fire is needed, a lighted lamp in the fireplace will\\nheat the air sufficiently to create an upward current and serve a\\nuseful purpose.\\nWith all the advantages just outlined the nurse should have\\nlittle difficulty in keeping the sick-room cheerful and healthy. In\\nsmall, inconvenient houses, with close dark rooms, her skill and\\ninventive ability will often be taxed to the utmost, but a clear\\nand positive knowledge as to the importance of pure air and clean-\\nliness will prove a large part of the battle. In most cases where\\nthere is a will there will be a way.\\nTemperature. It is not desirable that a patient who is cov-\\nered in bed should be kept in as warm an atmosphere as is often\\nfound in an ordinary sitting room, and many recommend 60 de-\\ngrees Fahrenheit as ideal for the sick-room, but as few nurses will\\nfeel safe in constantly remaining where it is so cold, we advise\\nwarmer air and lighter coverings for the patient. A thermometer\\nshould hang near the bed, and the temperature be kept as uniform\\nas possible, care being taken that it shall not rise above 70 degrees.\\nIt should be remembered, too, that infants and old people require\\nwarmer air than others, that the room should be made warmer for\\nbathing, and at the times when the patient leaves his bed, also\\nthat the temperature of the body is always lowest about three\\no clock in the morning, and that there should be an extra blanket\\nready for use at that time.\\nThe careful nurse will always have hot water within easy\\nreach for use in case of an emergency. It is best applied to cold feet,\\nor other parts, when carefully sealed in fruit jars and wrapped suffi-\\nciently to guard against burning the patient, for, in many cases of\\nparalysis or numbness, a patient may be seriously blistered with-\\nout his knowing it. Jugs and well stoppered bottles are also used\\nfor this purpose.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0178.jp2"}, "177": {"fulltext": "NURSING. 161\\nFurniture. Iron bedsteads, good coil springs, and smooth,\\nfirm mattresses of excelsior or cotton are the best for the sick,\\nand probably no bed is worse for them than a feather bed. When\\npracticable, it is best to have two beds, one for use through the\\nday, the other for the night, thus admitting of thorough airing,\\nbut, in cold weather, care must be taken to warm the fresh bed\\neach time before putting the patient into it. There should be a\\nlounge and table, an easy chair and one or two cane bottom chairs,\\nbut no upholstery and no portieres, woolen hangings, or curtains\\nexcept plain roller shades, of a green tint, and no carpets, unless\\na single strip or rug that can often be taken outdoors and well\\nshaken and aired, be spread in front of the bed for the comfort of\\nthe nurse and to aid in securing perfect quiet. All woolens and\\nupholstery retain dust and infections, thus becoming sources of\\ndanger. A portable screen is often useful, and may be improvised\\nby spreading a sheet over a clothes-horse, or an easily made frame.\\nThe room should be made as cheerful as possible, and, except\\nin cases of infectious diseases, pictures, with smooth frames that\\ncan be cleaned with a damp cloth, are almost a necessity; the\\nsame is true of potted plants, and cut flowers if kept in fresh\\nwater and removed as soon as they begin to dry and fade. Let\\neverything be neat and tidy. No food, dishes, medicines, or medi-\\ncal appurtenances, bed-pans, or similar vessels, should be left in\\nsight of the patient. In cases of infectious diseases they can be\\nplaced behind a screen. In all other cases they should be brought\\ninto the sick-room only when wanted for immediate use, and be re-\\nmoved as soon as they have been used. The room can be well swept\\nonly when the patient has been removed from it, but with a damp\\ncloth wrapped on a broom most of the dust can be wiped from\\nthe floor, and twice a week all the window sills, sashes and other\\nprojections should be wiped with damp cloths.\\nInfectious Diseases are those caused by bacteria, or micro-\\nscopic germs, disseminated without personal contact, direct or\\nindirect. For the public safety, as well as for the protection of\\nherself and the friends of the patient, it is very important that the\\nnurse be so fully informed as to the nature of the disease in hand\\nas to enable her the most effectually to checkmate its methods of\\nspreading to others.\\nAs shown in the Department of Sanitation, the infectious dis-\\neases are of two great classes, the air-borne and the water-borne.\\n11", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0179.jp2"}, "178": {"fulltext": "162 NURSING.\\nThe former class consists of those caused by genns which are car-\\nried in the air and, usually, first enter the system by being in-\\nhaled with the breath. Consumption, pneumonia, diphtheria,\\nscarlet fever, yellow fever, small-pox, whooping cough, mumps,\\nmeasles and influenza are of this class, and, although their germs\\ndiffer widely as to virulence, and in their effects upon the body\\nwhen they have found access to its tissues, we would in nearly\\nall cases be safe from their ravages could the air we breathe be\\nkept entirely free from them.\\nTo this end, a patient with any of these diseases should be\\npromptly isolated and, to reduce to a minimum the danger from\\ninfection after his recovery, the sick-room before the patient en-\\nters it should be cleared of all unnecessary furnishings, especially\\nof all upholstery and woolens, since they afford good refuges for\\nbacteria, some of which are so tenacious of life as to be a menace\\nfor years, lying dormant until they chance to find their way into\\na human being, then multiplying with as great rapidity and viru-\\nlence as had the opportunity occurred when they first left the\\npatient in which they were formed.\\nVentilation must now be as perfect as possible, for the greater\\nthe dilution of the poison thrown off by the patient the better for\\nhim, and the less the danger to the nurse and to others, but special\\ncare must be taken that air from the sick-room shall not be blown\\ninto other parts of the house. As children have less power than\\nadults to resist disease, they should be sent away. If the malady\\nbe one of the most serious, as scarlet fever or small-pox, there\\nshould be two nurses that, by relieving each other, each may\\nhave a few hours daily in the open air, and neither be obliged\\nto sleep in the same room as the patient. Only the physician\\nand nurses should have access to the room, and, as far as pos-\\nsible, all communication between it and the rest of the house\\nshould be cut off.\\nThe nurse should wear only such clothing as can be boiled\\nand washed, unless it is to be burned as soon as she is through\\nwith the case, for the danger from carrying such diseases in\\nclothing is very great. As the hair of the nurse is also a source\\nof much peril, she should wear over it a closely fitting cap, and\\nwash the hair thoroughly in a strong disinfectant, such as one\\npart of formalin in twenty parts of water, each time before min-\\ngling with other people. After carefully washing, and changing to", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0180.jp2"}, "179": {"fulltext": "NURSING. 163\\nclean clothing kept in another room, she should take a brisk\\nwalk in the open air each day, nor should fatigue, or the dread of\\nmaking the preparations, deter her from a faithful observance\\nof these precautions for preserving her own health and efficiency.\\nThe broom, brushes, cloths, etc.. used, must not be taken\\nfrom the room until the quarantine is over, and must then be\\nburned. The dishes used should be kept in the room; in fact,\\nnothing should be removed after the patient enters, unless it be\\nimmediately disinfected. The soiled clothing of the patient and\\nnurse, and all bedding that requires washing, should be carried\\nfrom the room in a tight bag and thrown, bag and all, into boil-\\ning water and boiled half an hour before it is sent to the wash.\\nFor the management of the sputa and nasal discharges of such\\npatients, see Department of Disinfection and Disinfectants.\\nThe bedsteads and all other furniture, floor, walls and wood-\\nwork should be wiped carefully twice a week with cloths wet in\\nsome disinfectant. A i: 1,000 bichloride of mercury solution (fif-\\nteen grains of the bichloride to a quart of water) is probably the\\nbest for this purpose but a 1 :20 solution of carbolic acid, or a\\ntwo per cent solution of formaldehyde, will do. It must not be for-\\ngotten that these substances are poisonous and require careful\\nhandling, and that if bichloride or carbolic acid solutions are used\\nupon the skin they must be applied only to small surfaces at one\\ntime, because of the danger from absorption. Sheets, or other\\nlarge cloths, should be hung in various parts of the room, espe-\\ncially over the door, and be kept wet in the disinfecting solution.\\nThis precaution is important, partly because of the real good that\\nit does, and partly because of its influence in reassuring the family\\nand neighbors that the disease will thus be prevented from spread-\\ning.\\nThe wonderful power of the mind over the body is often\\nvery clearly seen during epidemics, and no one can overestimate\\nthe services of the calm, cheerful nurse who, discerning be-\\ntween real and imaginary dangers, dispels false alarms and en-\\ncourages hope. An intelligent comprehension of the situation is\\nnow valuable beyond measure. Depression, anxiety and fright\\ninvite disease by deranging the system and rendering it less able\\nto resist, and many have died at such times simply from the stress\\nof ignorant fear. Having taken every proper precaution, an in-\\ndividual is safer for keeping the mind occupied with healthful", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0181.jp2"}, "180": {"fulltext": "164 NURSING.\\nthemes and, as far as may be, pursuing his ordinary business rou-\\ntine.\\nWater-borne diseases are those caused by bacteria which\\nare usually carried into the stomach of the patient in his drink,\\nbut sometimes are introduced with the food and, rarely, in other\\nways. Typhoid fever, malarial fever, cholera, and some of the\\ndiarrheas, are the principal examples of this class. In these\\ndiseases isolation of the patient is not necessary, for instead of\\nbeing thrown off in the breath, or in eruptions or excretions\\nof the skin, their bacteria are carried out in the excreta. The\\ndissemination of these diseases is, therefore, prevented by thor-\\noughly disinfecting all the discharges from the bowels, also all\\ncloths and clothing used about the patient, and by keeping him\\nclean.\\nA pint of strong disinfecting fluid, such as the bichloride\\nor carbolic solution, should be kept standing in the vessel which\\nreceives the stools of the patient.\\nNever throw such stools into the common water closet, lest\\ntheir disinfection may have been imperfect. A safe and con-\\nvenient disposition of them is afforded by a trench or pit three\\nor four feet deep, if each time dejections are thrown in they are\\nimmediately and thoroughly covered with fine dirt, and, when\\nthe pit. is thus filled to within eighteen inches of the top, it is\\nshoveled full of fresh earth, a new one being dug for further use\\nbut let it be remembered that such an arrangement must never\\nbe less than 100 feet from any well or cistern, or other source\\nof water supply, or where the drainage is toward such supply, and\\nin case the soil or underlying stratum is of sandy formation, the\\npit must be much more than ioo feet away.\\nAs flies often contaminate food with disease germs brought\\non their feet from excreta over which they have walked, it is\\nvery important that they never be allowed access to such sources\\nof danger. For the disinfection of clothing nothing is better\\nthan steady boiling for thirty minutes. All soiled cloths and\\ndressings should be burned. For the treatment of nasal dis-\\ncharges, sputa, and excreta, see the Department of Disinfection\\nand Disinfectants.\\nContagions Diseases. Like the air and water-borne diseases,\\ncontagious diseases are due to germs, but to germs which are\\ncommunicated from one person to another only through contact,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0182.jp2"}, "181": {"fulltext": "NURSING. 165\\neither direct or indirect. Itch, syphilis and gonorrhea are dis-\\neases of this class. Safety lies in destroying their germs as\\nfar as possible by such agents as the bichloride of mercury, and\\nin touching the affected parts of the patient, or anything with\\nwhich they have been in contact, only when absolutely necessary,\\nand then immediately washing the hands in strong disinfectants\\nto destroy or get rid of the bacteria that may have adhered to\\nthem. If soap is used for this purpose, the variety known as\\ngreen soap, saponis viridis, specially prepared by druggists, is\\nbest, and the next best is the old-fashioned soft soap, made from\\ngrease and the lye of wood ashes, either being safer, because\\nfar more efficient as a cleanser and germicide, than any toilet\\nor laundry soap. The same precautions as required in infec-\\ntious diseases should be taken Avith the soiled bedding, cloths\\nand clothing. The danger from handling gonorrheal clothing,\\nthen rubbing the eyes with the hands, is very great. Innocent\\nlaundresses have thus been made incurably blind in one week.\\nProper disinfection of the clothing before sending it to the wash\\nwould have prevented this possibility.\\nAs to the management of the room and its contents at the\\nconclusion of an infectious or contagious case, see Department\\nof Disinfection and Disinfectants.\\nCorpses. In case of death in the city, the undertaker will\\ntake immediate charge of the body, the sooner the better, but\\nin remote country districts, it is necessary to prepare the body\\nfor burial before such aid can arrive, and in infectious cases\\nthis duty will devolve upon the nurse. In all cases the body\\nshould be washed in one of the disinfecting solutions and imme-\\ndiately placed upon its back on a wide board seven or eight feet\\nlong, the head end being raised about two feet higher than the\\nfeet, as by placing the one end in a chair and the other on the\\nfloor, that the blood, before coagulating, shall settle into the\\nlower parts, thus preserving the natural color of the face, ears\\nand neck (instead of permitting the purple or almost black dis-\\ncoloration often mistaken for immediate putrefaction), and add-\\ning from six to twelve hours to the time the body can be kept\\nin gt)od condition. Wet in the disinfectant a handful of cotton\\nand place it under the buttocks, straighten the limbs, bind the\\nfeet together, fold the hands across the breast, hold the lower\\njaw in place by a snug bandage about the chin and head (the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0183.jp2"}, "182": {"fulltext": "166 NURSING.\\njaws are likely to become fixed within forty-five minutes after\\ndeath), and close the lips and eyes, gently placing small pieces\\nof cotton, wet in the solution, over the eyelids with very little\\npressure. The quite common practice of using coins for this\\npurpose should never be permitted, for they almost always dis-\\ntort the features by flattening the eyeballs. Cover the face with\\nseveral thicknesses of cloth wet in the solution, spread a sheet,\\nwet in the same, over the body and secure thorough ventilation,\\nthen thoroughly cleanse your own person and don a clean change\\nof clothes.\\nAlthough it is the duty of the physician, when a patient has\\ndied of an infectious disease, to prohibit a public funeral, the\\nnurse should also understand the great importance of this pre-\\ncaution, and never hesitate to use her influence on the side of\\nsafety.\\nThe Observation of Symptoms. The temperature of a\\nhealthy body changes very little, remaining at about 98.4 Fahren-\\nheit whether in summer or winter, but in disease it may vary quite\\na number of degrees, and as these variations form important\\ndiagnostic symptoms they should be carefully reported by the\\nnurse. A clinical thermometer, designed for this purpose, can\\nbe purchased at the drug store, and is a necessary part of the\\nnurse s equipment. To ascertain the temperature, this instru-\\nment should be placed under the tongue of the patient and held\\nthere, the lips being kept closed, for three to five minutes, the\\nnurse then carefully noting the point registered, after which the\\nthermometer should be thoroughly cleansed. If the patient is\\nunable to take the instrument in his mouth, it may be placed\\nin his armpit, and the arm drawn down snugly by his side, or\\nit may be anointed with vaseline or oil and inserted about an\\ninch and a half into the rectum, and left there the required time.\\nThe rectal temperature is usually a little higher than that of the\\nmouth and is more reliable.\\nThe Pulse is ascertained by counting the beats of the radial\\nartery, in the wrist just above the thumb, for one minute by\\nthe watch. The nurse should cultivate the ability to correctly\\nobserve all the symptoms of the patient, for if this be done fully\\nand accurately from day to clay, it will greatly aid the physician\\nin prescribing the proper treatment. It is better to make this\\nreport in writing, and it should cover the following points\\nTemperature and state of pulse at certain hours.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0184.jp2"}, "183": {"fulltext": "NURSING. 167\\nBowels, number of movements, at what time and of what\\ncharacter.\\nSleep, number of hours and of what quality.\\nSpecial symptoms, as vomiting, nausea, headache, etc., and\\nthe time of the occurrence of each.\\nThe Preparation of Foods. Cooking, in the broadest sense,\\nis the palatable preparation of all articles of diet but in its usual\\nsense means the subjection of food to the action of heat as by\\nsteaming, boiling, baking, roasting, broiling, either to render it\\npalatable or digestible, or both. Cooking also destroys or ren-\\nders harmless many of the poisons with which foods are some-\\ntimes contaminated.\\nVery different temperatures are required for the proper\\npreparation of different kinds of food. The greatest heat to\\nwhich eggs should ever be subjected is 160 degrees F., since\\nat that point their albumen coagulates, is tender, and becomes\\npalatable and the most easily digestible, but, if heated beyond\\nthis point, in proportion to the degree applied, becomes tough\\nand indigestible. Thus, in the so-called soft boiled egg, i. e..\\none that has been kept a short time in water at 212 degrees,\\nthere is a tough layer next the shell, and a soft digestible center;\\nbut the hard boiled egg, one that has remained in the water\\nuntil every part of it has undergone the action of the boiling\\ntemperature, is all tough, and hard to digest; and an egg cooked\\nin a temperature of 400 degrees becomes so tough and hard\\nas to be good marble cement, but wholly unfit for food.\\nSoft Boiled Eggs. To prepare soft eggs for the sick, since\\nit is difficult to maintain an even temperature of 160 degrees,\\nplace them in a basin on a part of the stove that has but little\\nwarmth, pour over them boiling water, a pint for each egg,\\nand leave them uncovered eight minutes.\\nTo Poach Eggs. Let a basin of water come to a simmer-\\ning heat, never to the boiling point, add a teaspoonful of salt,\\ncarefully break in the eggs, dip the water over them until the\\nwhites are firm and films form over the yolks, remove with a\\nskimmer, add a little butter to each, salt and pepper to the taste,\\nand serve while hot.\\nFried Eggs. Like every other kind of fried food, fried eggs\\nare unfit for the sick.\\nTo Cook Starchy Foods. To properly cook starch requires", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0185.jp2"}, "184": {"fulltext": "168 NURSING.\\na great deal of heat, for the object now to be attained is the\\nbursting of the woody envelope covering each individual gran-\\nule, thus setting free its elements, that, when eaten, they can be\\nreadily acted upon by the saliva the fluid which digests starch\\nby changing it into sugar. Starch itself will not pass through\\nthe membrane lining the alimentary canal, into the blood, and\\nhas to undergo this chemical change into sugar before its ingre-\\ndients can be absorbed. Hence, the importance of well-baked\\nbread, well-cooked potatoes, in fact, of all starchy foods being\\ncooked so long and well as to thoroughly break up all their gran-\\nules. Indeed, unless well cooked, a large portion of such food\\npasses through the body unchanged, doing a healthy person no\\ngood, a sick one positive harm. Because of the greater heat\\nobtained in the roasting process, a roasted potato is more easily\\ndigested than a boiled one. The more easily digestible a food\\ncan be made the better, and this end should always be especially\\nsought in cooking for the sick.\\nDiet in Disease. In disease the diet should, of course, be\\nrestricted. In this the appetite of the patient is usually, but\\nnot always, a safe guide. In apathetic states, as of typhoid, the\\nattendant should not wait until the patient calls for food or drink,\\nand in such diseases as consumption, more than the appetite de-\\nmands may be eaten with benefit. On the other hand, in con-\\nvalescence from fevers and other wasting diseases, the nurse must\\nsee that the patient does not eat too much, and be slow in increas-\\ning the food. She must also be slow in changing from a liquid\\nto a solid diet, and in so doing be extremely careful, for the first\\nday or two, giving, besides the liquid, only a piece of buttered\\ntoast as large as the two fingers, with a little tea or cocoa, every\\nthree hours; and she must carefully guard the patient from get-\\nting food at any other time, since the craving for nourishment\\nis likely to be so great as to quite overcome his judgment, and\\nthe condition of the system such that even a little of seemingly\\nharmless food might cost him his life.\\nFevers and Inflammations. The best food in these cases,\\nas well as in many others, is milk. If it irritates the stomach,\\nit should be scalded, or diluted with one-third its bulk of lime-\\nwater, or, what is often much better, should be peptonized (by\\nwhich we mean the addition of artificial pepsin to the milk, thus\\nproducing a change before it is taken that naturally occurs after", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0186.jp2"}, "185": {"fulltext": "NURSING. 169\\nit reaches the stomach). Pepsin tubes with full directions can\\nbe bought at any drug store. Milk alone will sustain life indefi-\\nnitely. It is especially suitable food in typhoid and scarlet fevers,\\nand may be given there alone. It should not be gulped down\\nin large quantities, but sipped or eaten slowly with a spoon,\\nsince, if taken too rapidly to mix with the digestive juices, a curd\\nis likely to form upon the outside of the mass, in which condition\\nit may lie in the stomach for hours as a plastic, indigestible ball.\\nIf properly administered, neither beef teas nor extracts are so\\nuseful, or as easily digested, but beef tea must sometimes be given\\nas the next best resort.\\nBeef Tea. As often prepared, beef tea is worthless as an\\narticle of diet. Bartholow gives the following recipe for its\\nproper preparation A pound of lean beef should be freed from\\nall bone, cartilage, fat, tendon, vessels and refuse of every kind;\\nchopped fine, and digested for two hours in a pint of cold water.\\nIt should then simmer, but not boil, on the stove for three hours,\\ncold water being added if necessary to keep the amount up to\\na pint. It should then be strained, and the beef pressed. Two\\nounces of this liquid every three hours is a suitable quantity for\\nan adult.\\nBeef Juice. The various beef extracts put up by the large\\npacking companies and other firms are nutritious and useful,\\nbut inferior to fresh beef juice. Other meat juices are also in-\\nferior. Chicken broth ranks next to beef, and then comes that of\\nveal. A good method of preparing beef juice is as follows\\nSelect a good piece of round steak, free it from all fat, refuse,\\netc., season to the taste and broil slightly on both sides in a\\nhot skillet, then press out the juice with a meat press or lemon\\nsqueezer. Give from two teaspoonfuls to two tablespoonfuls,\\naccording to the condition of the patient, once in three hours. It\\nshould be remembered, however, that beef juice is more of a\\nstimulant than it is a food, because so difficult of digestion as to\\nreally be of little value in many cases. If it nauseates the patient,\\nit should be frozen like ice cream, in which form it is very palat-\\nable.\\nBarley Water and egg-nog are other foods. To prepare bar-\\nley water: Wash two ounces of pearl barley, add fresh water,\\nboil five minutes, and pour off the water; then pour on two quarts\\nof boiling water, and boil down to one quart. Flavor to the taste,\\nbut do not strain.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0187.jp2"}, "186": {"fulltext": "170 NURSING.\\nEgg-nog. Scald some milk and let it cool; beat up a fresh\\negg with granulated sugar in a tumbler and having beaten it to\\na froth, add a dessertspoonful of brandy, and fill up with milk.\\nEgg-nog. Separate the egg, and whip up the yolk with a\\nteaspoonful of sugar and about a third of a glass of milk or cream\\nthe latter is better because more digestible; then beat in from\\na teaspoonful to two ounces of whisky, or leave out the whisky\\nand flavor with lemon or vanilla if preferred whip the white\\nseparately and place it on the other, grate a little nutmeg on top\\nand serve immediately. An egg-nog should not be allowed to\\nstand after it is made, since the egg and milk both lose some\\nof their freshness by exposure to the air.\\nMilk PitncJi. Into a cup of milk, sweetened with a teaspoon-\\nful of sugar, stir two tablespoonfuls of brandy and pour from\\nglass to glass, or shake in a lemonade shaker, to thoroughly mix,\\nthen grate a little nutmeg on top and serve.\\nSome prefer to cool a cup of milk with cracked or shaved ice\\nand add enough sugar to make it quite sweet shake to a good\\nfoam in a lemonade shaker, add two tablespoonfuls of brandy and\\none or two teaspoonfuls of Jamaica rum, and serve while cold.\\nMilk Lemonade. Into one-fourth cup each of lemon juice\\nand sherry and one tablespoonful of sugar, pour a cup of boiling\\nwater, stir thoroughly, then add one and a fourth cups of milk,\\n\u00e2\u0080\u00a2stir until curdled, strain through linen, and cool by placing on ice.\\nIn Wasting Diseases. In wasting diseases, as cancer or con-\\nsumption, both classes of foods are required, the proteids to re-\\nplace the rapidly disappearing tissues, and fats and starches to\\nmaintain waning strength. The fats are more valuable here than\\nthe starches and sugars, because more readily assimilated. Those\\nmost useful are fat meats (except pork), butter, cream and olive\\noil. Cod liver oil is also very useful, for although a medicine it is\\nalso a food. In these conditions the malt liquors may also be\\ngiven to advantage, but they are of more benefit in aiding diges-\\ntion and assimilation than they are as foods. They have a peculiar\\npower of converting starches and sugars into fats. In these dis-\\neases the quantity of food should be large, more than the appetite\\ndemands.\\nIn Diseases of the Stomach and Bowels. In these diseases\\nthe least amount of food consistent with strength should be taken.\\nIn severe acute cases it is often well to withhold all food for forty-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0188.jp2"}, "187": {"fulltext": "NURSING. 171\\neight hours, and in some cases it is necessary to resort to rectal\\nfeeding an excellent way of supplying nourishment and keeping\\nup the strength of the patient when, because of stomach irritabil-\\nity, he is unable to retain food taken by the mouth. It should\\nbegin early in acute diseases, but only when advised by a phy-\\nsician. It is done by injecting into the rectum predigested food,\\nas peptonized milk, an egg beaten up in peptonized milk, or some\\nother easily digested liquid food, by means of a syringe. It may\\nbe repeated once in four hours. The hips should be raised a little\\nto assist the patient in retaining it, and once or twice each day,\\nshortly before a feeding, the bowel should be cleansed by an in-\\njection of soap and water. Of course, rectal feeding is never to\\nbe administered in rectal diseases. In diseases of the stomach,\\nstarches may be given since they are digested in the intestines\\nbut in diseases of the intestines give proteids for they are mostly\\ndigested in the stomach. Scalded milk, milk and lime water, or\\nbetter milk and pepsin, lemonade, barley water and albumen water\\nmay be given.\\nAlbumen Water or Egg Water is prepared as follows To the\\nwhite of one fresh egg add half a pint of cold water previously\\nboiled, a little sugar and one teaspoonful of brandy shake thor-\\noughly and feed cold. It is a very useful food in the digestive\\ntroubles of infants. In these cases milk is not as good a food and\\nit should be peptonized. Of milks, the human milk is best, and\\ncows milk is next. Condensed milk and the many varieties of\\nInfant s Food on the market are all inferior. Although in-\\nfants reared on them often look fat and hearty, they are not really\\nstrong, and readily succumb to diarrheas and other diseases.\\nMiscellaneous. In diabetes all sugars and starches should\\nbe avoided as the plague. The diet must consist of the proteids.\\nDiseases of the liver and kidneys, as a rule, are benefited by a\\nliquid diet. Milk is superior here to all other articles, and skimmed\\nmilk is often better than new milk.\\nPatients suffering from scurvy, as is well known, rapidly im-\\nprove on a diet which includes fresh vegetables.\\nIn rickets the food should contain lime and other minerals.\\nUnbolted wheat flour and oatmeal contain these elements in\\ncomparatively large proportions.\\nIn rheumatism, gout, and similar diseases, vegetables and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0189.jp2"}, "188": {"fulltext": "172 NURSING.\\nacid fruits are beneficial. Animal foods and sweet substances\\nshould be avoided.\\nConstipation can usually be overcome by proper food. Oils,\\nfats, bulky foods, fruits and vegetables are the diet for such cases.\\nPatients suffering from scrofula, continued suppuration and\\njoint disease should have a plentiful diet, including unbolted\\nflours and meals, both lean and fat meats, cod liver oil, cocoa, milk\\nand eggs.\\nNursing mothers who do not furnish sufficient milk should\\ndrink milk, cocoa and beer, and eat fatty and oily foods.\\nThe Administration of Food. Let there be nothing luke-\\nwarm. Serve hot foods hot, and cold foods cold. They should\\nbe clean, daintily prepared, and brought promptly at the time\\nprescribed. Give the patient all the time he wants that he may\\neat slowly, but as soon as he has finished, remove all dishes and\\nremnants to avoid unpleasant sights and odors. Never ask a\\nsick person what he wants to eat. If he calls for a certain kind of\\nfood, and the physician consents, give it the preference in prepar-\\ning his meal, otherwise, try to make each bill of fare a surprise\\nto him, and so change it from day to day as to give variety and\\nrelish.\\nBILLS OF FARE FOR TFIE CONVALESCENT.\\nSince personal tastes differ greatly, especially in the sick, it\\nis often extremely difficult to prescribe a diet that shall be palatable\\nand at the same time best for the patient, but the bill of fare must\\ncontain only such articles as are nutritious and easily digestible,\\neven though abnormal cravings have to be restrained. The fol-\\nlowing outline may serve as a guide for a week during con-\\nvalescence and, with such variations as will be likely to suggest\\nthemselves to the nurse, may be a help thereafter. Due care must,\\nof course, always be taken not to give any article of food contra-\\nindicated by the patient s disease.\\nFIRST DAY.\\nBreakfast. Beef broth with bread crumbs.\\nLunch. Egg-nog.\\nDinner. Raw oysters crackers and butter a glass of sherry.\\nLunch. Hot beef tea.\\nSupper. Cream toast; jelly; cocoa.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0190.jp2"}, "189": {"fulltext": "NURSING. 173\\nSECOND DAY.\\nBreakfast. Granose with sugar and cream cup of chocolate.\\nLunch. Glass of milk.\\nDinner. Small piece of broiled bass or crappie a baked\\nIrish potato bread and butter.\\nLunch. Cup of custard with cream.\\nSupper. Milk toast; jelly; tea.\\nTHIRD DAY.\\nBreakfast. Poached egg; bread and butter; coffee.\\nLunch. Egg-nog.\\nDinner. Mutton soup tender sweet breads whipped cream\\nlight wine.\\nLunch. Beef tea.\\nSupper. Raw oysters bread and butter chocolate.\\nFOURTH DAY.\\nBreakfast. Oatmeal with sugar and cream; lamb chop;\\ncream potatoes; bread and butter; coffee.\\nLunch. Glass of milk.\\nDinner. Chicken soup baked potato bread tapioca cream.\\nLunch. Custard with cream.\\nSupper. Buttered toast; currant jelly; wafers; cocoa.\\nFIFTH DAY.\\nBreakfast. An orange; soft boiled egg; wheat germ, with\\nsugar and cream; soft buttered toast; coffee.\\nLunch. Hot beef tea.\\nDinner. Mutton soup; small rare piece of tender steak;\\nbaked potato rice pudding bread.\\nLunch. Milk punch.\\nSupper. Calf s foot jelly; raw oysters; bread and butter; tea.\\nSIXTH DAY.\\nBreakfast. Granose with sugar and cream poached eggs on\\ntoast; coffee.\\nLunch. Chicken broth with crackers.\\nDinner. Beef soup; small piece of breast of roast chicken;\\nbaked potato whipped cream bread.\\nLunch. Glass of milk.\\nSupper. Baked apples raw oysters bread and butter grape\\njelly; cocoa.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0191.jp2"}, "190": {"fulltext": "174 NURSING.\\nSEVENTH DAY.\\nBreakfast. An orange; oatmeal and cream; scrambled egg:\\nbuttered toast coffee.\\nLunch. Hot beef tea.\\nDinner. Chicken soup; a little tender roast beef; creamed\\npotatoes; tapioca pudding; bread.\\nLunch. Cup of custard.\\nSupper. Sponge cake with cream; buttered toast; apple\\njelly; tea.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0192.jp2"}, "191": {"fulltext": "EMERGENCIES.\\nBy Louis C. Duncan, M.D.\\nCHAPTER I.\\nPOISONING.\\nKnowledge of poisons is older than history. The first peo-\\nple known to have used them were the Egyptians, who probably\\nobtained the basis of their knowledge from the Chaldeans. The\\nChinese and Hindus were acquainted with them as early as 900\\nB. C. and among the Greeks, and other contemporaneous peo-\\nples, they were so often used that it was customary for cup-bear-\\ners to taste beverages in his presence before presenting them to\\nthe king. The death of Socrates by hemlock in 339 B. C is known\\nby every school boy, and in Rome also poisons were much used\\nas a means of getting rid of obnoxious persons.\\nDuring the middle ages the study of poisons was ignored\\npartly because it was not an age of study, and partly because the\\ndagger and ax were weapons better suited to the boid spirits\\nof the time for, be it remembered, poisons in those days were not\\nemployed for the healing of disease, but were used as poisons only,\\neither to rid one of his enemies or to rid himself of the incubus of\\nlife when it had become no longer endurable.\\nIn ancient times life was thought to be a mysterious some-\\nthing which inhabited the body, and took flight on the entrance of\\nanother mysterious something called a poison, but if still another\\nmysterious something, called an antidote, could be introduced in\\ntime, the poison might be thwarted and life remain. The same\\nidea prevailed in regard to all diseases; they were entities in some\\nway to be driven out. If these views are held by any now, let us say\\nthat there is no more mystery about disease and poisons than\\nabout paint wearing off a house, shingles blowing from a roof, or\\nrats gnawing holes through partitions and there is no more mys-\\ntery about antidotes and other curatives than there is about re-\\npairing the house with paint, shingles and plaster.\\nWith the advent of reason and logic in the study of physi-\\n175", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0193.jp2"}, "192": {"fulltext": "176 EMERGENCIES.\\nology and medicine, came a gradual change in our views of life,\\ndisease and death. From patient investigation, by thousands of\\nscientific men, it has been learned that poisons do not act in a\\nmysterious way, but in a very certain and definite manner, which\\nmay be known and as certainly counteracted. When the physical\\nlife ceases it does so from a cause some part fails. For example\\nA person takes a poisonous dose of aconite perhaps a teaspoonful\\nof the tincture. If he receives no aid his life will soon be ex-\\ntinguished, not in a mysterious way, but because aconite weakens\\nand slows the heart until it is stopped. Now what could be more\\nsimple or logical than to give this patient something, as strychnia,\\nthat will stimulate the heart and keep it going until the body elimi-\\nnates the aconite? And so, although there is a legion of them,\\nby careful study and experiment, an antidote has been found for\\nevery poison.\\nTaking the word in its broadest sense, there are three classes\\nof antidotes First The remedies or means of getting the\\npoison out of the body such as the stomach tube, emetics, phys-\\nics, etc.\\nSecond The chemical antidotes drugs which unite with\\nthe poison, while yet in the stomach and render it harmless. Thus,\\nin case an alkali has been swallowed, an acid may be given as a\\nchemical antidote.\\nThird The physiological antidotes the drugs or measures\\nwhich have the opposite effect on the functions of the body from\\nthat of the poison, an example of which is given above.\\nMODERN USES OF POISONS.\\nFormerly poisons were used as poisons only, but to-day the\\nmost deadly of them are used in the arts and sciences, as medicines,\\nand in the affairs of every-day life. Consequently we have a large\\nnumber of accidental poisonings; in fact, they exceed all others.\\nIt should be remembered that many of the well known drugs are\\npoisonous, if taken in quantities larger than the medicinal dose.\\nSome physicians, using vegetable remedies exclusively, strive\\nto inculcate the idea that minerals are poisonous and that vege-\\ntables are not, merely to advance their own merits at the expense\\nof those employing all remedies of known virtue, no matter from\\nwhat kingdom they have come. To refute the fallacy it is only\\nnecessary to mention such vegetable remedies as aconite, strych-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0194.jp2"}, "193": {"fulltext": "EMERGEXCIES. 17\\nnia, belladonna, opium and conium, each a poison of well known\\npower, and that most deadly of all common poisons, hydrocyanic\\nacid, found in the kernels and leaves of the ordinary peach tree.\\nA person may be poisoned in a variety of ways.\\nFirst. By swallowing some poisonous substance. This is\\nthe most frequent.\\nSecond. By inhaling a poison, such as illuminating gas\\nwhich annually numbers its victims by hundreds.\\nThird. By the absorption of poisons, as in the case of lead\\npoisoning of painters. The other methods are so rare as to be of\\nlittle importance.\\nIt is impossible to say just what is the smallest quantity of\\nany poison that will produce death. That depends upon the age,\\nweight and condition of the system, contents of the stomach\\nand the peculiar constitution of the person. The administration\\nof two grains of arsenic has proven fatal, while persons have\\ntaken as much as an ounce and recovered. In treating the\\nvarious poisons the medicinal dose of each will be named. Any\\nquantity larger than that is dangerous.\\nSPECIAL POISONS.\\nMineral Acids. Sulphuric acid, hydrochloric (or muriatic)\\nacid, and nitric acid.\\nThese acids may be described as one, since they all pro-\\nduce the same symptoms and require the same treatment. They\\nare not g iven as medicines until diluted so as to contain only\\nabout ten per cent of the pure acids, in which state they are\\nknown as dilute acids.\\nThe dose of dilute sulphuric acid is from five to ten drops.\\nThe dose of dilute nitric acid is from five to fifteen drops.\\nThe dose of dilute hydrochloric acid is from five to twenty\\ndrops.\\nSymptoms of Mineral Acid Poisoning. Severe burning pain\\nin the mouth, throat and stomach immediately after swallowing\\nthe acid. The pain afterward extends over the abdomen and\\nchest, and becomes excruciating agony. Stains will very soon be\\nobserved about the mouth and throat sulphuric acid pro-\\nducing a gray stain that gradually becomes brown nitric acid a\\nbright yellow; and hydrochloric acid either a whitish stain or\\nnone at all. Vomiting occurs without relieving the pam.\\n12", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0195.jp2"}, "194": {"fulltext": "178 EMERGENCIES.\\nBreathing is difficult swallowing is difficult and painful collapse.\\nDeath may result in a few hours or in several days. Hydrochloric\\nacid is liable to produce suffocation. About 78 per cent of the\\npatients recover, but in these strictures of the stomach and\\nesophagus often remain.\\nTreatment. For the purposes of treatment it is not necessary\\nto distinguish between the three acids. The treatment should be-\\ngin at once. Milk in large quantities is one of the best antidotes.\\nMagnesia, chalk, soda, soapsuds, or lime-water from fresh lime\\nmay be given. If none of the remedies are at hand lime-water\\nmay be prepared from lime scraped from a plastered wall. Be-\\ning alkalies these substances neutralize the acids. Do not give\\nan emetic. Small pieces of ice relieve thirst and pain. Opiates\\nmay be necessary when ice will not suffice. In collapse give\\nstimulants, such as whisky or brandy, and apply heat by hot water\\nbottles, hot sandbags, etc.\\nALKALIES.\\nThe most important alkalies are caustic soda and caustic\\npotash. The latter is the principal constituent of the lye used for\\nsoap-making and scouring. Every community has its case of a\\nchild that has swallowed lye. Adults are rarely poisoned by it.\\nSymptoms. A soapy taste in the mouth, followed by violent\\nburning pain; the parts are swollen and stained; at first white,\\nthen red or brown. Vomiting occurs at first thick and slimy, later\\ndark or tinged with blood. The matter vomited contains shreds\\nof tissue from the throat and stomach and is alkaline. Perforation\\nof the stomach, with peritonitis, collapse, or suffocation may cause\\ndeath within twenty-four hours, but most cases do not result in\\ndeath at once. About twenty-five per cent of all cases recover.\\nThe majority die in from one month to two years, from lack of nu-\\ntrition, caused by stricture of the esophagus or stomach. Of late\\nyears these strictures are relieved by a skillful surgical operation.\\nTreatment. One of the best antidotes for the alkalies is\\nvinegar. It should be diluted with water until it can be taken as\\ndrink. Citric acid, or lemon juice, diluted, will also neutralize\\nthem. After these, olive oil, milk or eggs are useful. They unite\\nwith the alkali to form a harmless soapy mixture. Do not give\\nemetics. Treat pain and collapse as in acid poisoning. If the\\npatient survives, there will probably be strictures of the esophagus\\nthat will require surgical treatment.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0196.jp2"}, "195": {"fulltext": "EMERGENCIES. 179\\nAMMONIA.\\nSymptoms. Same as those for the alkalies.\\nFor treatment give dilute vinegar or lemon juice. These are\\nbetter if mixed with oil. The later results must be treated by a\\nphysician.\\nARSENIC.\\nAcute Arsenical Poisoning. Arsenic occurs in the following\\ncompounds Arsenic trioxide, the ordinary white arsenic, and the\\nso-called arsenious acid sold in the shops. The medicinal dose is\\nfrom gV to tV of a grain.\\nFowler s solution of arsenic dose from two to eight drops.\\nRough on rats contains ninety-six per cent of pure arsenic.\\nNearly all fly papers and fly poisons.\\nParis green and London purple.\\nWall papers colored with arsenical colors.\\nCandies colored with arsenical colors.\\nImpure subnitrate of bismuth.\\nThe fact that arsenic is practically tasteless accounts for its\\nfrequent use in homicidal poisonings.\\nSymptoms. The first symptoms of arsenical poisoning do\\nnot usually appear until from thirty minutes to an hour after\\nthe poison has been swallowed, though they may come on in a\\nfew minutes, or after several hours. Rapid appearance of symp-\\ntoms indicates a large dose and a dangerous case. The average\\nduration of a fatal case is twenty-nine hours. The symptoms of\\narsenical poisoning vary more in different cases than those of any\\nother poison. Only the most common can be given here.\\nThere is first a feeling of faintness and nausea. Vomiting\\nsoon begins and increases in frequency and retching continues,\\neven after the stomach has been entirely emptied. The first mat-\\nter vomited is food, then watery and mucous substances, tinted\\noften with blood, and nearly always colored green with bile.\\nVomiting is followed by pain, beginning in the stomach, then\\nspreading over the abdomen and going through the back. This\\npain is sometimes said to feel like a red hot coal in the stomach.\\nThroat dry and parched and constricted with great thirst. Drink-\\ning increases pain and nausea. Later purging comes on with\\ngriping and straining. The stools are at first dark colored and\\nfetid, but later resemble the rice water discharges of cholera.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0197.jp2"}, "196": {"fulltext": "180 EMERGENCIES.\\nGreat prostration and collapse follow. The skin becomes cold\\nand clammy. There are fainting spells and convulsions. Death,\\nwhich occurs in about twenty-four hours, is quiet, the mind being-\\nclear to the last.\\nIn some cases after twenty-four to forty-eight hours the pa-\\ntient appears to be relieved and a recovery is looked for, but\\ninstead he gradually sinks and dies in from three to ten days.\\nIn other cases the patient soon becomes unconscious and remains\\nso until death, which, in these cases, usually takes place in from\\nfour to eight hours.\\nhi this connection it is necessary to say that one may become\\naccustomed to taking arsenic, by gradually increasing the dose,\\nuntil a large amount may be taken with safety. There are people\\nwho habitually eat arsenic, either to improve the complexion and\\npersonal appearance, or in mountainous regions to improve the\\nwind for climbing the mountains. Such a person has been\\nknown to eat three or four grains a day, for nearly a lifetime,\\nwithout bad results.\\nTreatment. First Empty the stomach either by a stomach\\ntube or such emetics as zinc sulphate or ipecac, but never give tar-\\ntar emetic. Second Convert what is left into a harmless com-\\npound. This is best done by ferric hydroxide, which is found at the\\ndrug stores. A physician should be summoned at once. Mean-\\ntime the giving of milk, melted butter, or lard, and stimulants\\nwill be of service. Arsenical poisoning cannot be well treated by\\nother than a skillful physician.\\nChronic Arsenical Poisoning. These cases occur from tak-\\ning arsenic too long in medicinal form, sometimes from a single\\nlarge dose, in those working with arsenical compounds, and those\\nliving in rooms papered with arsenical paper. There are also\\ncases where repeated small doses are given for a homicidal pur-\\npose.\\nSymptoms. \u00e2\u0080\u0094Indigestion with vomiting, but little pain;\\nheadache fever resembling typhoid red patches on the skin\\nredness and puffy appearance of the eyelids; cold in the head; sore\\nthroat scaling of the skin and falling out of the hair numbness\\nin the hands and feet. Later there is weakness of the feet and\\nlegs, and finally complete paralysis. Death occurs from heart\\nfailure.\\nTreatment. Stop the arsenic and give iodide of potash in", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0198.jp2"}, "197": {"fulltext": "EMERGENCIES. 181\\ncloses of ten to twenty grains, three times a clay. There may be\\nvarious injuries which will make necessary the presence of a phy-\\nsician.\\nLEAD POISONING.\\nAcute. Most cases of lead poisoning are accidental, and are\\nchronic rather than acute. Lead is found in\\nLead acetate, or sugar of lead, used medicinally, lead sub-\\nacetate, or lead water, and in lead carbonate, or white lead, used in\\npainting.\\nSymptoms. Sweet metallic taste other symptoms follow in a\\nfew minutes, but may be delayed an hour or more if the stomach\\nbe full. Vomiting begins early, is continuous and is increased\\nby drinking, which is resorted to for the exceeding thirst. There\\nis a colicky, abdominal pain that is characteristic of lead poison-\\ning. The tongue becomes coated and the breath has a sweetish,\\nfetid odor. Headache, sleeplessness and cramps follow and the\\nstrength gradually diminishes.\\nTreatment. I. Empty the stomach either by a stomach tube\\nor an emetic.\\n2. Give Epsom salts in large quantities, and opiates for pain.\\nIodide of potash will aid in eliminating the poison from the sys-\\ntem it may be given in doses of from ten to twenty grains three\\ntimes a day.\\nThe patient should be kept upon a fluid diet.\\nChronic. Chronic lead poisoning occurs in persons hand-\\nling lead, as painters, smelters and workers in chemical establish-\\nments.\\nSymptoms. Abdominal pains of a colicky nature commonly\\nknown as painter s colic; a bluish line on the gums at the mar-\\ngin of the teeth constipation headaches, paralysis especially of\\nthe extensor muscles of the wrist and fingers (wrist drop), so that\\nthe patient is unable to lift the hand or straighten the fingers. In\\nsome cases the arm cannot be raised.\\nTreatment. Remove the source of poisoning and give iodide\\nof potash in doses of ten to twenty grains three times a day, to\\neliminate the poison. Morphine may be necessary to relieve\\nthe colic, in which case it may be given in doses of one-tenth to\\none-half grain once an hour.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0199.jp2"}, "198": {"fulltext": "182 EMERGENCIES.\\nMERCURY.\\nForms. Metallic mercury, not poisonous.\\nMercuric chloride calomel, rarely poisonous if pure. Dose,\\nup to ten grains.\\nMercurous chloride bichloride of mercury or corrosive sub-\\nlimate, frequently used as a disinfectant and bug exterminator,\\nvery poisonous. Medicinal dose, up to one-tenth of a grain.\\nRed oxide of mercury red precipitate used in ointments.\\nSulphide of mercury vermilion used as a color.\\nSymptoms. On swallowing a mercurial poison there is an\\nacrid metallic taste in the mouth that cannot be concealed, and\\nin a very few minutes a sensation of hefat in the throat and\\nstomach. In from three to ten minutes violent vomiting begins,\\nand continues for several hours. The vomited material has a\\ngray, mucus-like appearance, with shreds of tissue. Soon there\\nis purging of copious, liquid, bloody, fetid passages, with pain\\nand straining. The usual duration of a fatal case is from five to\\ntwelve days.\\nOn the second or third day there is salivation, with sore\\nmouth, loose teeth and ulceration of the gums. The pulse be-\\ncomes small and fast, and the temperature is below normal, some-\\ntimes going as low as 93 degrees Fahrenheit. Later there are\\nparalyses, convulsions, and collapse preceding death. In cases that\\nrecover there is inflammation of the stomach and bowels that may\\nlast for several weeks.\\nTreatment. 1. Give albumen, such as white of tgg, and\\nmilk in large quantities, to unite with the mercury and for a time\\nrender it harmless.\\n2. Then give emetics. 3. Next give stimulants, as whisky\\nor brandy. 4. Iodide of potash will help get the mercury out\\nof the system, and ten drop doses of tincture of belladonna, three\\ntimes a day, will help the salivation.\\nPHOSPHORUS.\\nCases of phosphoric poisoning are quite rare because of the\\ndecided odor and taste of the drug, and its luminous appearance\\nin the dark. Phosphorus is found in some rat and vermin\\npoisons, and on the tips of matches, and from these sources there\\nare occasional cases of poisoning. Cases are on record in which\\nfatal poisoning resulted from anointing the hands and face with", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0200.jp2"}, "199": {"fulltext": "EMERGEXCIES. 183\\nphosphoric paste, for the purposes of dark seances. Medicinal\\npoisoning with phosphorus is extremely rare. The dose is one-\\nthirtieth of a grain, or less.\\nSymptoms. First Stage. After an interval of from two to\\nsix hours pain in the stomach, of a burning character, comes on,\\nand there is headache, great thirst and low temperature. Belching\\noccurs, and the odor of phosphorus is easily detected in the\\nbreath. Xausea and vomiting follow with plain evidence of phos-\\nphorus. Later there is purging. After two or three days there\\nis an apparent recovery, and the patient seems better for per-\\nhaps a week, then comes the second stage in which the former\\nsymptoms reappear, with pain in the region of the liver, with\\nmarked jaundice headache, fever and unconsciousness follow, and\\ndeath results from exhaustion.\\nTreatment. Owing to the late appearance of symptoms\\nthere is more time for treatment. Wash out the stomach by means\\nof a tube, or give of sulphate of copper fifteen grains. Physics\\nshould be given later. No oils or fats should be given until re-\\ncovery is complete.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0201.jp2"}, "200": {"fulltext": "CHAPTER II.\\nACONITE.\\n(Monkshead, Wolfsbane, Blue Rocket).\\nAconite is a vegetable preparation used in medicine, especially\\nby eclectics and homeopathists. Dose of the tincture, rive to fif-\\nteen drops.\\nSymptoms. Aconite acts rapidy if taken in a poisonous dose,\\nthe average duration of fatal cases being less than five hours.\\nIn a very few minutes there is a prickling sensation and feeling\\nof numbness about the mouth that soon spreads over the entire\\nsurface of the body, and is especially noticeable in the hands and\\nfeet. The throat is dry and seems swollen, and there is a horrible\\nchoking sensation, which is spasmodic like hydrophobia, when the\\npatient tries to swallow salivation vomiting, violent and contin-\\nuous and of an explosive character the pulse becomes slow, irreg-\\nular and flickering; breathing is shallow and difficult. The pa-\\ntient is pale, prostrated and fearful with blue lips, clammy skin\\nand a low temperature. The eyes stare and the pupils are dilated.\\nThe patient may or may not be conscious. Death occurs in a\\nfainting spell.\\nTreatment. An emetic of zinc sulphate should be given or\\npreferably the stomach should be washed out with a solution of\\niodine in iodide of potash by a stomach tube.\\nThe breathing should be kept up by applying to the nostrils\\ncamphor or ammonia, or by artificial respiration. Heart stimu-\\nlants, as strychnia, digitalis or atropia, are necessary. Nitrite of\\namyl is also useful. The extremities should be kept warm by hot\\nbottles, rubbing, etc.\\nTHE BELLADONNA GROUP.\\nThere are several vegetable poisons that are very closely\\nallied, and may be spoken of together. They are\\nBelladonna, or deadly nightshade, dose of the tincture, five\\nto thirty drops.\\nAtropine a preparation from belladonna.\\n184-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0202.jp2"}, "201": {"fulltext": "EMERGENCIES. 185\\nStramonium thorn apple, or jimson weed, a common weed\\nin the central and western states.\\nHyoscyamus, or henbane.\\nPoisoning occurs from taking the drugs by mistake, or in chil-\\ndren from eating the berries of the weeds of this group. The\\ndeadly nightshade bears berries resembling those of a similar plant,\\nknown to country children as ground cherries, and eaten by them.\\nSymptoms. Dizziness; dryness of mouth and throat; no\\nsaliva; thirst; redness of skin, with heat, itching and dryness; eyes\\nstaring with pupils widely dilated; noisy delirium. The patient\\nhas hallucinations of all kinds and has to be restrained. He talks\\nconstantly in a nonsensical way.\\nThe delirium gradually subsides and the patient, if he does\\nnot recover, passes into a stupor, with slow snoring breathing and\\nvery weak pulse, from which he never awakes.\\nTreatment. Wash out the stomach or give an emetic. Mor-\\nphine given hypodermically is a physiological antidote.\\nTendency to sleep should be combated, as in opium poisoning,\\nby walking and slapping, also by brandy, nitrite of amyl and arti-\\nficial respiration.\\nHYDROCYANIC ACID.\\n(Prussic Acid).\\nThis substance is found in bitter almonds, the kernels of the\\npeach, cherry, plum and other fruit tree seeds, in the bark and\\nleaves of many plants, in the cyanide of potash used in photog-\\nraphy, and in Prussian blue and other chemicals. The medicinal\\npreparation contains but two per cent of the pure acid and the\\ndose is from two to eight drops. Cases of poisoning in children,\\nfrom eating quantities of peach or other kernels, are not rare.\\nHydrocyanic acid is the most deadly of all ordinary poisons.\\nOf 455 reported cases, eighty-four per cent resulted fatally, and\\nthe average time from taking the poison until death was only\\nhalf an hour. In a large number of the cases death occurred in less\\nthan five minutes. Whatever is done for hydrocyanic poisoning\\nmust, indeed, be done quickly. In most cases the physician ar-\\nrives too late to be of any service.\\nSymptoms. If a large close be taken, consciousness is lost\\nalmost at once and the patient falls to the ground. There are\\nslight convulsive movements, then he lies still in a state of col-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0203.jp2"}, "202": {"fulltext": "186 EMERGENCIES.\\nlapse, breathing only at intervals, and in a few minutes the breath\\nstops entirely. For such cases treatment is generally useless.\\nIf the dose was smaller there are a hot, bitter taste and a\\nchoking sensation. Then come severe headache, dizziness, mental\\nconfusion, insensibility and loss of all muscular power. The face\\nis pale, though full the eyes staring, glassy and rolled upward.\\nThere is frothing at the mouth and convulsions, resembling those\\nof lockjaw. The patient does not vomit.\\nTreatment. If peach or other kernels have been swallowed,\\ngive an emetic, as zinc sulphate.\\nArtificial respiration should always be practiced, as in cases\\nof drowning, and the breathing may be stimulated by holding to\\nthe nostrils camphor or ammonia. Such stimulants as whisky, or\\nother spirits, and strychnia are very useful. If the acid has been\\ntaken by the mouth the stomach should be washed out with a\\nsolution, either of permanganate of potash or peroxide of hydro-\\ngen.\\nThe electric current is a good stimulant for the heart. If\\nthe patient can be tided over the first half hour he is probably safe.\\nCONIUM.\\n(Poison or Spotted Hemlock).\\nAlthough this plant grows abundantly in some parts of\\nAmerica, poisoning from it in this country comes principally from\\nthe medicinal preparations, and is somewhat rare.\\nSymptoms. Loss of muscular power, beginning in the legs\\nstaggering gait; drooping eyelids; dilated pupils; some nausea\\nbut no vomiting; speech becomes difficult and is finally lost; swal-\\nlowing is difficult the mind remains clear to the last. Death re-\\nsults from paralysis of the muscles of respiration.\\nTreatment. Remove the poison from the stomach by zinc\\nsulphate, mustard, or any other emetic, and stimulate by hot ap-\\nplications to the spine, and by the use of spirits, and perform\\nartificial respiration, as in cases of drowning.\\nOPIUM AND OPIATES.\\nOpium is obtained from the juice of the poppy. It is found\\nin the following preparations\\nExtract of opium. Dose From one-half to two grains.\\nDover s powder contains ten per cent of opium. Dose Five\\nto fifteen grains.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0204.jp2"}, "203": {"fulltext": "EMERGENCIES. 187\\nTincture of opium, or laudanum. Dose. Five to thirty\\ndrops.\\nCamphorated tincture of opium, or paregoric. Dose Five\\nto sixty drops.\\nMorphine. Dose One-tenth to one-half grain.\\nCodeine. Dose One-sixth to one grain.\\nA large number of proprietary nostrums, such as soothing\\nsyrups, pectoral syrups, cough syrups, bronchial troches, etc.,\\ncontain morphine as their principal ingredient. From thirty-five to\\nforty per cent of all cases of poisoning are by opiates. Infants\\nand young children are especially susceptible to their poisonous\\nqualities. The action of morphine is more diminished by habit\\nthan that of any other poison. De Quincey relates that at one time\\nhe took nine ounces of laudanum daily. Another fiend took\\n1 20 grains of morphine at a single dose without ill effects.\\nSymptoms of Opium Poisoning. After an interval of from\\nthirty minutes to an hour the patient becomes excited and restless,\\ntalks fluently and pleasantly, and moves about much. This is\\nknown as the stage of excitement and lasts but a few minutes.\\nIt is absent in habitues. Then comes a period of drowsiness and\\ndiminished sensibilities. There is a sensation of weight in the ex-\\ntremities, and the desire to sleep is irresistible. At first the sleep\\nis normal and the patient may be aroused. The skin is pale and\\nthe pupils contracted. The patient passes into a deep, heavy sleep\\n(coma) from which he cannot be awakened. He lies perfectly\\nmotionless with eyes closed, their pupils the size of a pinhead; the\\nskin pale and moist lower jaw drooping, and the muscles com-\\npletely relaxed. The respiration is slow, shallow and snoring. The\\ntongue falls back in the throat and mucus accumulates there,\\ncausing the rales popularly known as the death rattle. The\\nbody cools rapidly and, if treatment is not successful, death takes\\nplace in from twelve to twenty-four hours. If, after the deep sleep,\\nthe treatment is so far successful that the patient can be aroused\\nrecovery will probably be made, although he may remain asleep\\nfrom twenty-four to thirty-six hours longer.\\nTreatment. First remove the poison from the stomach by\\nthe use of emetics. If possible arouse the patient by slapping\\nwith wet towels, or by an electric current, then keep him awake\\nby walking him between two persons. Strong coffee, or caffeine\\nin one grain doses, is useful. Strychnia (one-fortieth of a grain) is", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0205.jp2"}, "204": {"fulltext": "188 EMERGENCIES.\\na good heart tonic, and if breathing fails artificial respiration\\nshould be kept up, for hours if necessary. As the patient does\\nnot pass urine, the bladder should be watched and the urine drawn\\nwith a catheter.\\nCOPPER.\\nFound in\\nCupric sulphate or blue vitriol or blue stone medicinal dose,\\nas an emetic, ten to fifteen grains.\\nVerdigris, a mixture of copper acetates; sometimes found on\\ncopper or brass vessels, containing acid substances.\\nCases of poisoning from copper are rare. While it is possible\\nthat poisoning may occur from eating food that has stood in\\ncopper vessels, most such cases are really poisoning from bacteria,\\nptomains, or trichinae.\\nSymptoms. Pain in the stomach, extending over the abdo-\\nmen, accompanied by vomiting of greenish matter. There is\\nalso purging, with frequent scanty urination. The urine is al-\\nmost black. There are cramps in the legs, weakness and head-\\nache. There may be a decided improvement followed by relapse.\\nThe average duration of fatal cases is fifty hours.\\nLittle can be done except by a physician. If the stomach has\\nnot already been emptied, emetics should be given; then give milk\\nor eggs. Soap and soda are chemical antidotes. Stimulants, such\\nas whisky or brandy, may be necessary.\\nCOCAINE.\\nSymptoms. Restlessness and excitement, dizziness, head-\\nache, delirium, difficult breathing, rapid feeble pulse and dilated\\npupils. Most cases end in recovery.\\nTreatment. Strong coffee, or caffeine in one grain doses\\nevery hour, nitrite of amyl by inhalation, and stimulation by\\nwhisky, brandy, etc.\\nNICOTINE.\\nNicotine is an alkaloid of tobacco. Its action may be as rapid\\nas that of hydrocyanic acid. Death has occurred from it in less\\nthan five minutes.\\nSymptoms. Faintness, nausea and vomiting, headache, dim-\\nness of vision, deafness, drowsiness and fainting spells. The pulse\\nis rapid and weak, the breathing quick and the skin cold.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0206.jp2"}, "205": {"fulltext": "EMERGENCIES. 189\\nTreatment. Place the patient in bed and empty the stomach\\nby a tube or emetic; then give tannin in twenty grain doses every\\ntwo hours; or strychnia in one-fortieth of a grain doses once in\\ntwo hours; or stimulants, as whisky or brandy, and apply heat to\\nthe hands and feet.\\nSTRYCHNIA AND NUX VOMICA.\\nStrychnia is the active principle of mix vomica. Dose.\\nFrom one one-hundredth to one-fortieth of a grain.\\nTincture of nux vomica. Dose. From five to twenty drops.\\nCases of strychnia poisoning are common, both accidental\\nand intentional. Strychnia has been mistaken for quinine, cal-\\nomel, etc., and children have been poisoned by eating animal\\npoisons containing strychnia. The least amount of strychnia that\\nwill cause death is one-half grain, in a healthy adult. In fatal\\ncases death usually occurs within one hour, is rarely delayed be-\\nyond two hours, and may occur within a few minutes. If the pa-\\ntient survives two hours, recovery is probable.\\nSymptoms. A bitter, hot taste is noticed on sw T allowing the\\npoison. In a short time, usually ten to twenty minutes, spasms\\nbegin. At first there are twitchings of the muscles, followed by\\nviolent convulsions, resembling those of lockjaw. During the\\nspasm every muscle is contracted and the head is drawn back-\\nward, the jaws are locked, and the eyes protrude with dilated pupils.\\nThere is frothing at the mouth, swelling of the neck and a hideous\\ndistortion of the features. This spasm passes off, but is followed\\nby others at shortening intervals. The spasm lasts from thirty\\nseconds to ten minutes, and there may be from one to ten of\\nthem. In fatal cases death usually occurs in the fourth or fifth\\nspasm. The whole course closely resembles that of lockjaw.\\nTreatment. Owing to the short time available for aid, a phy-\\nsician should be summoned at once, if within call. Meantime\\nthe stomach should be emptied by emetics or other means then\\nchloral in fifteen grain doses every fifteen minutes, or chloroform\\nby inhalation, are the best remedies.\\nTannin in twenty grain doses every hour will do some good,\\nor whisky may be given to the point of intoxication. Opium or\\nmorphine should be given only when no other antidotes can be\\nobtained. The patient should be kept perfectly quiet, in a dark\\nroom, undisturbed by noise or sudden movements of attendants.\\nArtificial respiration may be necessary. (See page 196.)", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0207.jp2"}, "206": {"fulltext": "190 EMERGENCIES.\\nDIGITALIS.\\n(Foxglove.)\\nDose of the tincture, from one to five drops.\\nSymptoms. Vomiting and purging of green material, fol-\\nlowed by headache, delirium and convulsions. The skin is cold\\nand clammy and the pupils of the eyes are dilated. Death occurs\\nsuddenly from heart failure.\\nTreatment. Keep the patient lying down, empty the stom-\\nach by emetics and give tannic acid every hour in twenty grain\\ndoses. Stimulate by heat applied to the hands, feet and limbs and\\nover the heart, and by strong, hot coffee or whisky,\\nCHLORAL, OR CHLORAL HYDRATE.\\nDose, from five to thirty grains.\\nSymptoms. Immediate burning pain in the mouth, throat\\nand stomach. After a short period of excitement the patient\\nsinks into a deep sleep, which in fatal cases may last seventy-two\\nhours. In fatal cases the sleep deepens into coma, with snoring\\nbreathing, muscular relaxation, cold skin and failing pulse and\\nrespiration.\\nTreatment. Empty the stomach by tube or emetics and ap-\\nply heat to the body. Try to rouse the patient and stimulate with\\nammonia by inhalation, electricity, or strychnia in one-fortieth\\ngrain doses every two hours.\\nCARBOLIC ACID, OR PHENOL.\\nSymptoms. The symptoms appear quickly. There is burn-\\ning of the mouth and throat, producing a white stain that after-\\nward turns red. Vomiting, with the odor of carbolic acid, may\\noccur. The odor of the acid can always be detected in the breath.\\nThe patient soon becomes unconscious and sinks into a state of\\ncollapse, with snoring breathing, purple face, contracted pupils\\nand cold skin. In fatal cases death usually occurs in from two to\\neight hours.\\nTreatment. Emetics should first be given, then Epsom salts\\nin large quantities (from one-half ounce to one ounce hourly). Oil\\nwill counteract the corrosive effect. If there is none at hand,\\nmelted butter or lard may be used. Treat the collapsed condition\\nby stimulants and the application of heat to the spine. Atropine\\nin one one-hundredth of a grain doses is an antidote.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0208.jp2"}, "207": {"fulltext": "EMERGENCIES. 191\\nZINC.\\nThe chloride of zinc is the most common form.\\nSymptoms. Burning in the throat and stomach, with vomit-\\ning and purging, followed by compulsions and coma.\\nAs treatment give soda, milk, eggs, or tannic acid in twenty\\ngrain doses every two hours.\\nIODINE.\\nMost cases of iodine poisoning come from taking the tincture\\nthrough mistake.\\nSymptoms. Burning pain in the throat and stomach, with\\nvomiting and purging.\\nTreatment. Give an emetic, then follow it with starch in any\\nform. It may be necessary to give opiates to relieve pain.\\nPOISON IVY.\\n(Poison Oak.)\\nThis is an exceedingly poisonous vine, climbing by rootlets\\nover rocks, fences, trees, etc., having compound palmate leaves,\\neach consisting of three leaflets, and bearing clusters of small, dark\\nberries. Some persons can handle it without being injured, while\\nothers are poisoned by coming into its vicinity without even\\ntouching it.\\nSymptoms. Swelling and redness of the skin, accompanied\\nby intense itching and burning, and in many cases by the forma-\\ntion of small watery blisters.\\nTreatment. If the parts affected by the plant be immediately\\nwashed with ordinary alcohol there will be no further symptoms.\\nIf this has not been done in time, and swelling and eruption or\\nblisters have appeared, the parts should be washed in a solution\\nof subacetate of lead, as often as may be necessary to give relief.\\nIf the pain is great use the following\\nSolution of subacetate of lead, two parts.\\nTincture of opium, one part.\\nWater, one part.\\nOne teaspoonful of the fluid extract of grindelia robusta in\\nfour tablespoonfuls of water applied to the parts is an excellent\\nremedy.\\nThe poison is an acid and the object of the treatment is to\\nneutralize it bv alkaline washes.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0209.jp2"}, "208": {"fulltext": "192 EMERGENCIES.\\nIf the above remedies are not accessible, apply strong solu-\\ntion of common baking soda, ammonia water, lime water, weak\\nlye, or soft soap.\\nPOISON SUMAC.\\nThis is a shrub from six to eighteen feet high, grows in\\nswamps and, in the Northern States, flowers in June. Its bark\\nis smooth and its leaves compound, with from seven to thirteen\\nleaflets. It is often called, incorrectly, Poison Elder and Poison\\nDogwood.\\nThe symptoms and treatment are the same as in poisoning\\nfrom ivy.\\nMUSHROOMS.\\nThe poisonous varieties of the mushrooms are usually colored\\nred and yellow, but no certain rules for detecting them can be\\ngiven. Varieties harmless to some may be poisonous to others,\\nthough not fatally so. Tyson says Avoid highly colored fungi\\nwith astringent taste and pungent odor.\\nSymptoms of Mushroom Poisoning. Excitement with vio-\\nlent colicky pains, vomiting and diarrhea. The skin is cold and\\nthe pulse slow, showing a failing heart.\\nTreatment. Give emetics and after their action give physics.\\nStimulate by applying heat externally and by giving spirits in-\\nternally, as whisky or brandy.\\nAtropine is the physiological antidote, but it should only be\\ngiven by a physician.\\nPTOMAINS.\\nPtom ains are poisons resulting from the decay of animal or\\nvegetable matter. Recent studies show that they are formed by\\nmicrobes, otherwise known as bacteria, bacilli, etc. The prin-\\ncipal ptomain poisons are those of meat, milk and fish.\\ni. Meat poisoning follows the eating of meat that has under-\\ngone decomposition, and may result from ham, beef, mutton, sau-\\nsage, poultry or canned meats.\\n2. Milk and its products. There is a ptomain peculiar to\\nmilk, cream, cheese, and various other eatables, composed prin-\\ncipally of milk. It is called tyrotoxicon.\\n3. Fish that have decomposed contain ptomains.\\n4. Mussels frequently contain ptomains. Whether they\\nare peculiar to a certain variety of mussels, or are common to all", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0210.jp2"}, "209": {"fulltext": "EMERGENCIES. 193\\nvarieties, is uncertain, but it is known that mussels found in stag-\\nnant water are most frequently poisonous. Mussels may be poi-\\nsonous to some persons and not to others.\\nThe symptoms in all kinds of ptomain poisoning do not\\ngreatly vary being the symptoms of violent inflammation of the\\nstomach and intestines.\\nIn fatal cases death does not generally take place in less than\\nforty-eight hours.\\nSymptoms. Nausea, vomiting, cramps and diarrhea or con-\\nstipation.\\nThere is dryness of the throat, disturbance of vision and great\\nprostration.\\nTreatment. Ptomain poisoning is more like a disease than\\nmost other forms of poisonings, and cannot be well treated except\\nby a physician. Uusually there is. sufficient vomiting and purging\\nto expel from the body the poison not absorbed. If not, emetics\\nshould be given and followed later with physics. Stimulants are\\nnecessary, such as heat and spirits, or strychnia in one-fortieth\\ngrain doses once in two hours. Opiates may be given to allay\\nthe pain.\\nTURPENTINE.\\nAlthough not a real poison, turpentine may cause serious\\nharm, and even death, if taken in sufficient quantities. It has been\\nused for producing abortions, for which it is an insufficient and\\nvery dangerous agent, and it is frequently taken for coughs and\\ncolds. The medicinal dose is from five to thirty drops, and more\\nthan that should never be taken.\\nOBJECTS SWALLOWED.\\nStones, coins, buttons and various other small objects are\\nfrequently swallowed by children, to the great alarm of their\\nparents. These accidents seldom do any harm. A full meal of\\nmashed potatoes is an excellent antidote. The object will be en-\\nclosed in a ball of the soft potato and do no harm until expelled\\nfrom the body.\\nSometimes by quickly grasping the child by the heels, hold-\\ning him head downward and rapping him briskly on the back with\\nthe palm of the hand, the object will fly out of his mouth.\\nrs", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0211.jp2"}, "210": {"fulltext": "CHAPTER III.\\nDROWNING.\\nRespiration is absolutely necessary to life. When God\\nbreathed into man the breath of life, man became a living soul,\\nand when the breathing stops his body soon becomes a clod.\\nDeath from lack of air, or oxygen, which is the essential element,\\nis scientifically known as asphyxia. In drowning, asphyxia is\\ncaused by water entering the lungs, or otherwise cutting off the\\nentrance of air.\\nThe time that persons may remain under water without losing\\ntheir lives varies greatly. The latest and best authorities state\\nthat, in the great majority of cases, death takes place within two\\nminutes, and that after five minutes recovery is very doubtful,\\nbut there appear to be well authenticated cases in which persons\\nwere restored after having been under water for half an hour. A\\nperson in a fainting or cataleptic state will survive much longer\\nthan one who continues to fight until suffocation takes piace, since\\nthe latter, in his struggles for breath, draws water into the lungs,\\nwhile the former stops breathing immediately, and, by closure of\\nthe glottis, water is prevented from entering the lungs.\\nEfforts should always be made to revive a person, even though\\nhe has been under water an hour or two, unless it is plain that the\\nheart has stopped. As long as there is the slightest flutter in the\\nregion of the heart, all efforts should be made persistently and\\ncontinued for hours, if need be but when it is certain that the heart\\nhas stopped, further attempts are useless. Other functions of the\\nbody may cease and begin again, but when the heart stops it stops\\nforever.\\nThree things should be considered in treating a case of\\ndrowning\\ni. Get the water out of the lungs, that the breathing may be\\nrestored. To do this, piace the patient on his face with his head\\nand shoulders lower than his hips. A roll of clothing or blankets,\\na log, barrel, or any similar device, may be placed under the abdo-\\nmen, and the mouth should be kept open by tying a handkerchief\\n194", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0212.jp2"}, "211": {"fulltext": "EMERGENCIES.\\n195", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0213.jp2"}, "212": {"fulltext": "196 EMERGENCIES.\\nthrough it like a gag, then press firmly upon the spine below and\\nbetween the shoulders. The water will run out and very soon\\nempty the lungs. Should none of these things be at hand, lose no\\ntime in looking for them, but immediately step astride the body\\nas it lies face downward, and, clasping your hands below the abdo-\\nmen, lift the middle of the body as high as possible and hold it\\nthere, the face still resting on the ground, until the water has\\nrun out of the lungs. Many prefer this to the first method.\\n2. Restore the breathing by artificial respiration. There\\nare many ways of doing this, of which the following, known as\\nthe Satterthwaite Method, is perhaps the best As soon as\\nthe water has been gotten out the lungs, turn the patient on his\\nback, keep his mouth open (by a gag, if necessary), and draw out\\nthe tongue, press gently, but firmly and slowly upon the abdomen,\\nthen suddenly remove the pressure. The direction of the pressure\\nshould be backward (toward the spine) and upward (toward the\\nlungs). Repeat these movements five or six times a minute, and,\\nlater, ten or fifteen times a minute, but do not become excited\\nand make them more rapid than that, and do not pound or slap\\nthe patient.\\nThe Sylvester Method is probably more widely known than\\nany other, and is as follows With the patient lying on his back\\nplace a roll of clothing under his shoulders to raise them three to\\nfive inches, the back of the head still resting on the ground, and,\\nkneeling back of his head and grasping his forearms just below\\nthe elbows, press them very firmly, but gently upon his abdomen,\\nas shown in Fig. i, then slowly raise them to the position shown\\nin Fig. 2, keeping the elbows well apart and higher than the shoul-\\nders, and continue the movement until the arms are brought above\\nthe head as shown in Fig. 3. Hold them there five seconds, then\\nreturn to the first position and press again upon the abdomen so\\nfirmly as to drive the air out of the lungs. Repeat this series of\\nmovements five or six times per minute, later increase them to fif-\\nteen times per minute and thus continue until the natural breath-\\ning is restored, or all possible chance of recovery has passed.\\nWhen there are assistants, the two methods may be carried on\\nsimultaneously, one person pressing the abdomen at the same time\\nthat the other operator presses down upon it with -.he arms, and\\nremoving the pressure when the arms are raised.\\nOther assistants should meantime remove the wet cloth-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0214.jp2"}, "213": {"fulltext": "EMERGENCIES. 197\\ning, ripping or cutting it off, if necessary, to get it away quickly,\\nespecially remove all constriction from the waist and chest, and\\nwrap the patient in warm, dry clothing, overcoats, blankets, or\\nany such thing obtainable then rub the body under the cloth-\\ning, particularly upon the extremities, making the frictional move-\\nments toward the heart to restore the circulation. Apply am-\\nmonia to the nostrils, and heat, as hot stones, bricks, cloths, or\\nhot water bottles, if it is possible to get them, to the extremities.\\nArtificial respiration should be continued for hours, if there is the\\nslightest hope of success. In drowning, and in many cases of\\npoisoning, it is of more value than electricity, or any other known\\nrestorative measure.\\n3. Stimulants. When the pulse returns to the wrist, warm\\ndrinks, beef tea, or alcoholics, if very carefully administered, may\\nbe given.\\nSUFFOCATION.\\nSuffocation from smoke, poisonous gases, loads of earth,\\nhanging, or any other cause, should be treated by artificial respira-\\ntion, and in every other way, as outlined for drowning, except\\nthat in these cases dashing cold water in the face often aids in\\nrestoring to consciousness.\\nFROST BITES.\\nThe principal object in treating frost bites is to bring about\\na gradual restoration of sensation, circulation and heat to the in-\\njured part. If the temperature be raised suddenly great pain will,\\nand permanent injur} ma} follow; while if the temperature be\\nraised very slowly, complete recovery will often take place, al-\\nthough the extremity or part of a limb is completely frozen. When\\nrestoration does not occur gangrene follows, which, in case of a\\nlimb, necessitates amputation. Freezing is accompanied by a\\nsense of numbness, and is shown by the white, blanched appear-\\nance of the part.\\nTreatment. First rub with snow, or put the part in ice water,\\nand use gentle friction, the patient always being kept in a cold\\nroom, and never placed in a warm bed. Gradually raise the room\\ntemperature, also that of the water bath. After the natural tem-\\nperature of the body returns, warm drinks and stimulants may be\\ngiven. Cases of gangrene must be treated by the surgeon. In", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0215.jp2"}, "214": {"fulltext": "198 EMERGENCIES.\\ncase of apparent death from cold, the treatment should be used, to-\\ngether with artificial respiration and heart stimulants, such as\\nstrong coffee, whisky or brandy, or strychnia one-fortieth of a\\ngrain every two hours. There are cases on record in which re-\\ncovery occurred after unconsciousness and burial in the snow for\\nseveral days.\\nSUNSTROKE, OR HEATSTROKE.\\nSunstroke is a very high fever, resulting from exposure to the\\nheat of the sun. The same condition may result from exposure to\\na high temperature artificially produced, as in laundries, the fire-\\nrooms of steamships, etc. Sunstroke is rare in a dry atmosphere,\\nbut frequent in a moist one, even at twenty degrees lower tempera-\\nture. Persons who drink alcoholic liquors to excess are more\\nliable to this danger than the temperate. After recovery from a\\nsunstroke mental injury may remain, and very frequently those\\nwho have once suffered from it cannot afterward endure even a\\nmoderate degree of heat without headache and nervous excite-\\nment. Sunstroke may be followed by meningitis or, more rarely,\\nby epilepsy.\\nSymptoms. There is first a sense of burning, heat and op-\\npression, which may be accompanied by dizziness, headache,\\nvomiting and sometimes diarrhea. Unconsciousness then comes,\\nwith restlessness and delirium.\\nThe face is flushed, the eyes bloodshot, the skin hot and dry,\\nthe breathing labored and the temperature very high (107 degrees\\nto 112 degrees Fahrenheit). There may be slight convulsive\\nmovements; the unconsciousness becomes a stupor- and the stupor\\na coma. The pulse grows rapid and the breathing irregular.\\nIf consciousness returns and the -temperature begins to fall,\\nrecovery may be expected. A temperature above 110 degrees\\nindicates that recovery is improbable. Death occurs after several\\nhours.\\nTreatment. There is but one immediate object in the treat-\\nment to lower the temperature and that as speedily as possible.\\nThis is best done by stripping the patient and placing him in a cold\\nbath the colder the better. If ice can be had it should be added\\nto the water, and the skin rubbed with pieces of ice. Ice water\\ninjections into the rectum are also useful. If bathing facilities are\\nnot at hand the patient should be stripped and placed on a piece", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0216.jp2"}, "215": {"fulltext": "EMERGENCIES. 199\\nof oil cloth and cold water be poured over him. A horse trough\\nand pump will answer the same purpose. Do not fear his taking-\\ncold, but use every means at hand. Of course, the temperature\\nshould be watched and when it begins to go down the heroic treat-\\nment should be gradually lessened until the body reaches some-\\nthing like its natural temperature (98.6 degrees).\\nBURNS AND SCALDS.\\nBurns and scalds do not differ in their effects. In fact, a scald\\nis only a burn made by a fluid substance. A burn may be pro-\\nduced by a variety of substances; such as heated metals, hot water\\nor steam, lightning or electricity, acids, alkalies, molten metal,\\netc. Practically, the symptoms and treatment are the same, but\\nthere is a difference in the degree of severity of burns that is\\nhighly important. Physicians very logically divide burns into\\nthree classes, according to the degree of injury.\\nBums of the First Degree. A burn of the first degree pro-\\nduces only a redness of the skin, with slight inflammation and\\nsome pain. It leaves no after effects, and should be treated by\\nthe application of common dry baking soda and a wet cloth, or\\nby smearing over with carbolized vaseline.\\nBums of the Second Degree. A burn of the second degree\\nis more severe and produces a blister. The blister should be punc-\\ntured, then treated as above. Other applications are lard, olive oil\\nand flour, any of which should be covered with a damp cloth. An\\nold remedy is carron oil, composed of equal parts of olive oil and\\nlime-water, but it is one of the poorest of all remedies. An ex-\\ncellent application, and one that is always at hand, is ordinary bak-\\ning soda. It should be dusted on plentifully until the wound is\\nwell covered, then bind a wet cloth over all. The soda relieves\\npain, keeps the wound clean, and promotes healing. Opiates or\\nchloral should be given if necessary. Bits of ice will relieve thirst.\\nA saturated solution of picric acid is a comparatively new\\nremedy for burns, and is probably the very best. Spread a thin\\nlayer of cotton, wet in the solution, over the burn. It gives in-\\nstant relief, and should be renewed from time to time to keep the\\nskin constantly wet. A burn upon a patient in good health will\\nheal very rapidly under this treatment. The acid is poisonous, but\\nis soluble in water to the extent of only one-half of one per cent,\\nhence, unless spread upon very large surfaces, there is no danger\\nfrom absorption.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0217.jp2"}, "216": {"fulltext": "200 EMERGENCIES.\\nIt was formerly thought that a burn of the second degree, or\\neven of the first, affecting one-third of the surface of the body,\\nmust prove fatal, but patients now are often saved, after having\\nbeen burned very much worse, by simply keeping their wounds\\naway from the air by constant immersion in water until the new\\nskin forms. For this purpose a bath tub should be quickly pre-\\npared by making a triangular support of clean boards for the legs,\\nalso supports for the head and back, as shown in the illustration.\\nImmersion for Severe Burn\\nA soft blanket, folded in several thicknesses, is then spread over all,\\nthe patient placed thereon, and water, at 94 degrees Fahrenheit,\\nturned in until it rises to his neck, after which a small stream, warm\\nenough to maintain the temperature as nearly as possible at 94 de-\\ngrees, must be kept running into the tub, and an overflow of the\\nsame size provided for. that by continual, gradual change the\\nwater shall be kept pure. A watchful attendant must remain con-\\nstantly with the patient until the recovery is made. Patients have\\nbeen kept thus under water for weeks, even months, and finally\\nsaved, although at first their cases seemed hopeless. Unless thus\\ntreated, if one third of the body surface is burned, death follows\\nwithin forty-eight hours. It is fortunate that in very severe burns\\nthe patient is spared great suffering by dying during the uncon-\\nscious period of shock.\\nBurns of the Third Degree are still more severe, and are those\\nby which some part of the body is burned to a black char and\\ndestroyed. They are often fatal, but if not, they always leave a\\ndisfiguring scar, and should be treated by a surgeon, if possible.\\nThey may be fatal in a variety of ways, as from immediate nervous", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0218.jp2"}, "217": {"fulltext": "201\\nshock, congestion of the brain, erysipelas, or inflammation of any\\nof the internal organs.\\nThe objects of the treatment should be twofold:\\ni. To Relieve Pain. The directions for doing this we have\\nalready given. An important factor in most applications for re-\\nlieving pain is the exclusion of air from the burned surface, which\\nshould be covered with a silk or rubber protector, then with cot-\\nton and loose bandages. The dressings should be changed every\\nthree or four days.\\n2. To Relieve Shock. Treat the shock by rest and warmth\\nand, after consciousness returns, give stimulants, such as hot cof-\\nfee, milk punch or beef tea.\\nA large burned surface that does not heal readily should not\\nbe allowed to heal by granulation, but should be covered by skin\\ngrafts to avoid the contraction of the scar which, without this pre-\\ncaution, will always .cause great deformity, and is liable to be so\\nserious as to destroy the use of the limb. Poultices are not used\\nby the modern surgeon. They are apt to cause suppuration, just\\nwhat should be avoided. Everything in the dressing of wounds\\nshould be done with reference to preventing suppuration.\\nInhalation of hot air is one of the deadliest of all the dangers\\nincident to fires, but one which by a little intelligence, calmness\\nand seif-control can usually be overcome. If caught, so that the\\nonly escape lies through the fire, quickly tie a handkerchief, stock-\\ning or other article of clothing over the mouth and nose, or if\\nthere be no chance for this, having filled the lungs with air, clasp\\nthe nose and mouth in the hand, and, remembering, no matter\\nhow great the pain, that life depends upon holding the breath,\\ndash through the flames to safety. As cotton ignites far more\\nreadily than wool, draw on woolen clothing if possible before ex-\\nposure to the flames.\\nLIGHTNING OR ELECTRIC SHOCK.\\nThe injuries produced by electricity are nervous shock, burn-\\ning and paralysis. These shocks should be treated the same as\\nany other shock by applications of heat to the spine, strong cof-\\nfee and other stimulants.\\nThe burn should be treated just as any other burn. The\\nparalysis should be treated by an intelligent physician; and when\\nso treated usually disappears.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0219.jp2"}, "218": {"fulltext": "202 EMERGENCIES.\\nBITES AND STINGS OF INSECTS.\\nLeptus (Harvest Mite). This pest is a minute red mite,\\nwhich buries itself in the skin. It attacks all parts, but more\\noften the ankles, causing pimples which are very itchy or burn-\\ning.\\nTreatment. Bathe the part with a dilute wash of carbolic\\nacid.\\nBees, Wasps and Hornets. The bites and stings of many in-\\nsects, as the mosquito, bee, wasp and hornet, may not only be\\nsevere and very painful, but death has sometimes occurred, either\\nfrom the shock to the nervous system or from absorption of the\\nvirus. Children suffer more from them than do adults, because\\nof the more impressible nervous system in youth.\\nTreatment. Soda and ammonia are common household rem-\\nedies, but they afford little relief. Water containing all the sugar\\nof lead it will dissolve is an excellent remedy and is best applied\\nwith absorbent cotton. Wet salt or mud may be used. Ichthyol\\nis a newly discovered drug, which relieves the pain and swelling of\\na sting almost instantly. It should be spread on pure with a brush,\\nin which case it will act surely and promptly.\\nSpiders are also able to inflict severe injury by the injection\\nof poison. In warm countries the tarantula is well known from\\nthe severity of its bite. Some species of ants and caterpillars also\\nattack the human skin and produce burning, stinging pain, with\\nmore or less swelling. Treat all these bites with sugar of lead\\nor ichthyol, as recommended for bee stings. It is a wise precau-\\ntion to lance a tarantula bite and cause free bleeding as soon as\\npossible. If no other remedies can be quickly obtained cover the\\npart with mud, first sucking the wound vigorously and spitting-\\nout the poison. One with sore lips, sore mouth or decayed teeth\\nshould never attempt this for another person, lest he absorb the\\npoison into his own system.\\nBITES OF SERPENTS.\\nMany people firmly believe that the bite of any and every\\nsnake is poisonous and dangerous. This idea is erroneous. Ac-\\ncording to the best authorities, there are only three poisonous\\nsnakes in North America and in a great many cases a bite by one\\nof these does not prove fatal. The venomous snakes of this coun-\\ntry are: The Rattlesnake [crotalus Jwrridus), the Copperhead (tri-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0220.jp2"}, "219": {"fulltext": "EMERGENCIES. 203\\ngonocephalus), and the Moccasin. In Europe the only dangerous\\nsnake is the viper. In India and South America there are many\\nothers.\\nThe poison apparatus is similar in all. It consists of a sac\\ncontaining the venom, situated below the eye and near the root\\nof the fang; the fangs, two in number, in the upper jaw, and a tube\\nleading from the sac through each fang to its point. Pressure on\\nthe fang produces pressure on its sac, forcing the venom out\\nthrough the tube. This venom, or poison, seems to be almost\\nindestructible. Nothing affects it; neither heat nor cold; acids\\nnor alkalies time, nor decomposition. Yet it is perfectly harm-\\nless when taken into the healthy stomach. It acts upon children\\nmore seriously than upon adults.\\nSymptoms. The part bitten immediately swells and becomes\\npainful dark, red spots appear and the swelling spreads giddi-\\nness comes on with dizziness and dimness of vision clammy sweat\\nand great terror. Later there may be nausea and vomiting; the\\npulse grows fast and feeble and the breathing labored. Death may\\noccur quickly, but usually not until from five to forty-eight hours.\\nIf the case does not yield to antidotes, blood poisoning, which\\nis always a serious affair, comes on. The part is then greatly\\nswollen, and the skin becomes puffy and mottled; often giving\\nrise to the idea that the person is turning to the color of the\\nsnake. This condition demands the services of a competent phy-\\nsician at once.\\nTreatment. The wound should be sucked or cupped, but\\nalways bear in mind that the person who sucks any poisonous\\nwound must have a perfectly healthy mouth and sound teeth. If it\\nbe an extremity that is bitten, a moderately tight bandage above\\nthe bite will to some extent prevent the spread of the poison but\\nthis bandage must not be left on too long. The principal anti-\\ndote is a stimulant of some kind. Ammonia is very good, but as\\nwhisky is efficient, and usually at hand, it will probably continue to\\nbe used more than all other remedies. In its use, but one caution\\nis necessary; do not give it to the point of intoxication. When\\nso given it adds to the effects of the poison, instead of combating\\nit. Give the whisky slowly until it produces a slight exhilaration,\\nthen stop. When this effect begins to pass off give a little more\\nand thus continue and it will prove safe and effective.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0221.jp2"}, "220": {"fulltext": "204 EMERGENCIES.\\nHYDROPHOBIA.\\nHydrophobia, or rabies, is an infectious disease of animals,\\nwhich is sometimes communicated to man. The dog is the most\\nfrequent subject of the disease, but it is sometimes also seen in\\nthe horse, mule, cow, wolf, skunk, rat, cat, pig and rabbit. Its\\ncause is a virus, most probably a germ, contained in the saliva of\\nthe afflicted animal and from it communicated to others and to\\nman. The time from the infection until the appearance of the dis-\\nease is usually about six weeks, but may be as short as one w T eek,\\nor as long as several months. If the disease does not appear in\\nless than eight months it will, in all probability, never appear.\\nNot all of those bitten by rabid animals become infected.\\nOne eminent authority says only fifteen per cent, but the greater\\nnumber say that about two-thirds of those bitten take the disease.\\nOf course, there are many who think they have been bitten by\\nmad dogs, when, in fact, the dogs were not rabid. Children are\\nmore susceptible than grown people, and bites in the face are much\\nmore dangerous than those upon other parts of the body. The\\nnext most serious location is the hand. When the disease has ap-\\npeared, all treatment and all hope are vain. Dr. Nicholas Senn\\nsays In man this terrible disease is invariably fatal. There is\\nnot an authentic instance of recovery from genuine hydrophobia/\\nSymptoms of Hydrophobia in Dogs. Hydrophobia means\\nfear of water, and in man a dread of water is the most prominent\\nfeature of the disease but dogs drink with eagerness and manifest\\nno such fear. This is contrary to the general opinion, but, never-\\ntheless, true. At first the dog becomes dull and morose, mopes\\nand avoids his master and companions; then restless, and runs\\nabout barking and snapping at imaginary objects. During this\\ntime there is rarely a tendency to bite, or to fits of uncontrollable\\nfury. In this stage the danger is from licking rather than from\\nbiting.\\nAfter a time comes a fit of maniacal fury, generally provoked\\nby the sight of another dog. When this subsides he becomes\\ncontrollable again, but is disposed to wander from place to place.\\nWith a slinking appearance, head and tail down, eyes bloodshot,\\nand with foam at his mouth, he trots along snapping and biting at\\nimaginary objects. He is aggressive only when attacked, but his\\nfury is then unbounded. He drinks water eagerly and will try\\nto drink when swallowing becomes difficult or impossible. He", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0222.jp2"}, "221": {"fulltext": "EMERGENCIES. 205\\nseems entirely insensible to pain, dashes himself against his ken-\\nnel, and has been known to seize and hold a red hot poker in his\\nmouth. When tired out from hunger and wandering he drops ex-\\nhausted in some out of the way corner, to start again after a short\\nrest, and finally dies from exhaustion. The average duration of the\\ndisease in the dog is five days; it never exceeds ten, after the\\nfirst symptoms appear.\\nSymptoms of Hydropliobia in Man. The first symptoms ap-\\npear in the wound itself. It becomes red and tender, with sensa-\\ntions of uneasiness, itching, or even of pain. The patient becomes\\nirritable and melancholic, and his sleep is disturbed. The first defi-\\nnite symptom is a sense of tightness and choking in the throat,\\nwith slowness in swallowing, especially in swallowing liquids.\\nThere is inflammation and great dryness of the throat. On at-\\ntempting to swallow, the patient becomes agitated, hesitates, then\\ndrinks a very small quantity, or none at all. The difficulty in\\nswallowing rapidly increases and the act soon becomes impossible.\\nNext, the breathing becomes difficult and painful, with a sense\\nof want of air, or of impending suffocation. Indeed, the most\\nmarked symptoms are spasms of the muscles of the throat and\\nneck, by which swallowing is prevented and breathing interfered\\nwith. The voice becomes dry, hoarse and spasmodic often giv-\\ning rise to reports that the patient growls like a dog. Shuddering\\ntremors run through the whole body, and a fearful expression of\\nanxiety, terror and despair is depicted in the countenance. Froth-\\ning at the mouth is rare, but mucus collects in the throat, occa-\\nsioning hawking and spitting.\\nThe pulse becomes feeble and rapid, and the temperature\\ngoes up to 102 degrees or 103 degrees. The mental faculties are\\nbut little impaired. To a bystander, the most distressing feature\\nof the case is the fear of impending death, which is usually mani-\\nfest after the first attack, and remains throughout the whole course\\nof the disease. 1 The distinction between hydrophobia and lock-\\njaw is one that is not always easy to make. Death occurs from\\ncomplete exhaustion, its immediate cause being lack of air from\\nspasm in the throat.\\nTreatment. There are various methods of treating hydro-\\nphobia, most of which are wrong. Before detailing the proper\\ntreatment, it seems necessary to mention one very improper treat-\\nment; namely, the application of the so-called mad-stone. The", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0223.jp2"}, "222": {"fulltext": "206 EMERGENCIES.\\nsubject of mad-stones is never mentioned in works written for\\nphysicians, for such a mention would be an insult to their intel-\\nligence. But it may be that there are yet in America persons so\\nbenighted as to believe in the efficacy of the mad-stone, although\\nit is only a relic of barbarism of the time when our ancestors\\nlived in caves, wore the skins of wild animals and worshiped idols.\\nIt is on a par with the fetich of the cannibal, the voodoo of the\\nAfrican, and the rabbit s foot of the American negro and belongs\\nto the same category as wearing a rattlesnake s skin next the body\\nfor rheumatism, blowing a silk handkerchief through chest wounds,\\nand putting camphor in the baby s coffin. to dry up the mother s\\nmilk.\\nThe so-called mad-stone is either a porous stone of volcanic\\norigin, or an accretion stone; such as is sometimes found in the\\nstomach of ruminating animals. In either case it is porous like a\\nsponge, and is usually prepared for use by boiling in milk, though\\nboiling in water or heating in an oven would serve the purpose\\nquite as well which is to drive the air out of the pores of the\\nstone by the action of heat. It is then clapped on the wound and\\nthe vacuum, produced in the pores of the stone by cooling, causes\\nit to cling to the raw surface and absorb blood and the juices of the\\nflesh until the vacuum is overcome and the stone drops off. It\\nis thus seen that the mad-stone does possess some slight absorp-\\ntive power, and, if immediately applied to the wound, might pos-\\nsibly absorb some of the virus, though cupping or a moist sponge,\\ntightly squeezed just before its application, would be better, and\\nsuction by the mouth would be very much better but when several\\nhours have passed before the stone is used, it can be of no possible\\nvalue. The poison has then entered the blood and been carried\\nto all parts of the body, and to attempt to draw it from the wound\\nis as useless as to try with a sponge to sop up milk that was spilled\\non soft ground yesterday.\\nSomeone says that if it does no good it can do no harm.\\nBut it does do harm; and in this way: It gives the patient a\\nfalse sense of security and prevents him from employing intel-\\nligent and efficient methods of treatment, until forever too late.\\nTo use it is to forsake common intelligence, and lose precious hours\\nin foolish voodooism, thus giving the poison time to spread\\nthrough the system, and get such a hold that even scientific\\ntreatment will be powerless to overcome it. It is certainly time", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0224.jp2"}, "223": {"fulltext": "EMERGENCIES. 207\\nthat such ignorant and childish beliefs should be abandoned, and\\nhydrophobia treated with the same degree of intelligence that we\\nemploy in treating small-pox, malaria, diphtheria and other dis-\\neases.\\nIn case of a rabid dog bite there is but one course to pursue.\\nThe wound should be sucked as soon as possible, by one without\\nany badly decayed teeth, or any sores in his mouth or on his lips,\\nthen immediately cauterized. The cauterizing may be done by\\na poker, nail or any other small iron heated to redness. It may\\nalso be done with caustic soda, caustic potash, nitrate of silver, or\\nnitric acid, but actual cautery with the hot iron is better and less\\npainful, and can be placed in the exact spot better. The iron\\nshould be thoroughly applied and carried well down to the bottom\\nof every part of the wound, but care must be taken not to need-\\nlessly burn a larger surface than was injured by the bite, and to\\nthen quickly cover the wound with absorbent cotton or some\\nother antiseptic dressing to keep out pus producers, and other\\ngerms, lest by making a sore that shall become covered with\\nscabs, the spread of any remaining virus be promoted instead of\\nprevented.\\nThe very best remedy that can next be used is fresh lemon\\njuice, two or three times a day. Wipe a lemon clean and cut\\na hole in it with a clean knife then, without touching the wound,\\nsqueeze the lemon over it, dropping the juice into it until the\\nwound is saturated. Then replace the antiseptic dressing. Mean-\\nwhile, the patient must lose no time, but as soon as possible reach\\nan institution where he can receive the Pasteur treatment. There\\nis nothing more certain in the whole range of medicine than that\\nthis treatment will, if taken soon enough, prevent hydrophobia.\\nAs already stated, there is no record of a singJe case of hydro-\\nphobia that ever recovered under any treatment, and as two-\\nthirds of all those bitten take the disease, we may say that the\\ndeath rate with all treatments besides the Pasteur is about 67 per\\ncent. The records of the original Pasteur Institute in Paris show\\nthat by its method the death rate was reduced to a small fraction\\nof 1 per cent. The treatment is so complex and requires such\\ngreat skill and care that it can be administered only in an institu-\\ntion specially prepared for it. There are Pasteur institutes in\\nall the great cities of Europe, and one in Xew York, one in Balti-\\nmore and one in Chicago. Although care is used to receive\\nno patients except those bitten by animals known to be rabid,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0225.jp2"}, "224": {"fulltext": "208 EMERGENCIES.\\nor strongly suspected of being so, the treatment has failed to\\nprevent hydrophobia in only about one-third of I per cent of\\nthe many hundreds treated at the Pasteur Institute in Chicago\\nand, doubtless, these would also have been saved had they arrived\\nin time.\\nUnless the animal inflicting the bite is positively known to\\nbe rabid, it should not be killed, but carefully confined where it\\ncan do no harm. If it does not die within fifteen days it is cer-\\ntain that it was not rabid at the time of the biting. The popular\\nidea that if a dog goes mad at any time longer than fifteen days\\nafter biting someone, he was probably mad at the time of the\\nbiting, is wholly wrong. No dog lives longer than ten days\\nafter showing the first signs of rabies. Pasteur proved that a\\ndog carries the poison in his mouth seven days before showing\\nany signs of the disease, a fact that has since been verified by\\nother investigators. Never allow a dog to lick the hand if there\\nbe upon it any sore, scratch or abrasion of the skin.\\nHydrophobia chiefly affects the nervous system, notably the\\nspinal cord and brain. A healthy animal inoculated with virus\\ntaken from the spinal cord of one suffering with hydrophobia\\nsoon develops the disease, but if the affected spinal cord be re-\\nmoved from the body and slowly dried in an incubator kept\\nat a uniform temperature of yo degrees, its virus gradually loses\\nits strength until in fifteen days it becomes so weak as to be able\\nno longer to produce the disease. The Pasteur treatment con-\\nsists of a series of inoculations, beginning with virus that has\\nthus been dried fifteen days, and each time using virus that has\\nbeen dried one day less and is therefore a little stronger than that\\nused the preceding time, thus gradually bringing the system to\\na toleration of the poison, until it is rendered immune, i. e., inca-\\npable of being injured by direct injections of the strongest virus\\nof hydrophobia. The time required in which to give the treat-\\nment is fifteen, eighteen or twenty-one days, according to the\\nseverity of the case, and the sooner after the bite it is given the\\nbetter the chances for the patient. To this phenomenon, of the\\nsystem gradually accommodating itself to a poison, and the won-\\nderful fact that the virus works more slowly when communicated\\nthrough the saliva of the animal inflicting the bite than when\\ntaken from its nervous tissues and injected into the subdermic\\ntissues of the patient, any person may sometime owe his deliv-\\nerance from a dreadful death.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0226.jp2"}, "225": {"fulltext": "BACTERIA.\\nBy L. C. Duncan, M.D.\\nIn 1675 Leeuwenhoek, a Hollander, by the aid of single\\nlenses, first saw the minute forms of life which we call bacteria.\\nHe found them in saliva. A little later, the compound microscope\\nhaving been perfected, putrid liquids were shown to swarm with\\norganisms so minute that millions were held in a single drop,\\nbut it is not known if he associated these germs with the causa-\\ntion of disease. It is thought, however, that the man who first\\nconceived the cause of disease to be a living contagion was the\\nRoman Varro, who lived in the time of Caesar. In one of his\\nbooks he says: If there be any marshy places, certain minute\\nanimals breed there which are invisible to the naked eye, and\\nyet, getting into the system, cause diseases difficult to treat.\\nHe evidently had in mind malaria, which we now know is caused\\nby just such minute animals. It was almost 2,000 years before\\nthe idea was again taken up, and Henle, in 1821, proposed the\\ngerm theory of disease. Of course it aroused opposition, but\\nevery objection was met and overcome.\\nLatour and Schwann proved, in 1837, the active principle\\nof yeast to be a minute vegetable form of life, since known as\\nthe yeast plant. In 1849 Pollander discovered the germ of\\nanthrax (the splenic fever of animals), and in 1863 Davaine\\nproved by inoculative experiments that this bacillus produces\\nthe disease. In 1862 Pasteur showed that many forms of life\\nfloat about in the air, and in 1872 Klebs taught that blood poison-\\ning is caused by bacteria. The next year Obermeier discovered\\nthe germ of relapsing fever, and by 1875 the germ theory had\\nsecured general recognition. It was in that year that Lister\\nproposed the use of substances that would either prevent the\\ngrowth of the bacteria of disease or destroy them. The former\\nsubstances are now known as antiseptics, the latter as disinfect-\\nants. He began with the use of solutions of carbolic acid in his\\nsurgical operations and immediately revolutionized surgery.\\nThis was the first, and it still remains the greatest practical\\napplication of the germ theory of disease.\\n14 209", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0227.jp2"}, "226": {"fulltext": "210 BACTERIA.\\nIn 1879 Hanson discovered the bacillus of leprosy and Neiser\\nthe micrococcus of gonorrhea. In 1880 Eberth and Koch dis-\\ncovered the bacillus of typhoid fever, Pasteur the bacillus of\\nchicken cholera and Sternberg the bacillus of pneumonia. In\\n1882 Koch made the greatest discovery of them all, by finding\\nthe germ which causes consumption, scrofula, joint disease, Potts\\ndisease, lupus and all the other forms of tuberculosis a disease\\nwhich destroys one-seventh of the human race.\\nIn 1884 Koch discovered the spirillum of cholera. Loftier\\nthe bacillus of -diphtheria, and Nicolaier the bacillus of tetanus.\\nIn 1892 PfeifTer found the bacillus of influenza or la grippe. In\\n1894 Yersin discovered the germ of the Eastern bubonic plague,\\nand in 1897 Sanarelli reported the discovery of the bacillus\\nof yellow fever, but it has never been made to comply with all\\nthe tests required in such investigations. Cancer and syphilis\\nare two other diseases evidently of bacterial origin, but though\\nsought long and carefully, their germs have not yet been found.\\nGERM CAUSATION OF DISEASE.\\nThat there should be no doubt that a certain germ causes\\na certain disease, Henle and Koch laid down four laws\\n1. The germ must always be found associated with the\\ndisease.\\n2. It must be found in the living body.\\n3. It must be obtained from the body and grown on culture\\nmedia, uncontaminated with other germs.\\n4. These separated germs, when injected into another per-\\nson in sufficient quantities, must produce the disease.\\nUnless the germ fulfills all of these four conditions it cannot\\nbe said to be the cause of the disease.\\nThe germ causation of infectious diseases is now universally\\nbelieved by scientific men, and, since the germs of most dis-\\neases have been found, efforts at present are not so much in\\nthe line of discovering new germs as in new applications of our\\npresent knowledge. If the germs which cause disease are living\\nbodies, we have only to destroy them to prevent or stop disease.\\nThe question is, how to destroy them, or at least how to stop\\ntheir action. It has been found that a number of chemicals,\\nsuch as bichloride of mercury, carbolic acid and alcohol, will do\\nthis. In surgery these antiseptics applied to a wound destroy", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0228.jp2"}, "227": {"fulltext": "BACTERIA. 211\\nthe germs there, and in this way suppuration, blood poisoning,\\nhospital gangrene, erysipelas, tetanus and other complications\\nmay be prevented. With these dangers removed the surgeon\\ndares to enter the abdomen, stomach, lungs, brain and other\\nparts of the body, heretofore sacred ground in fact there is\\nscarcely any part of the human anatomy that the surgeon of\\nto-day fears to touch with his knife.\\nIn medicine, progress has not been as gratifying, for although\\nseveral diseases have been conquered many yet remain. Obvi-\\nously, in the case of a general disease, strong chemicals cannot\\nbe introduced into the body in sufficient quantities to destroy\\nthe germs without also destroying the life of the patient. Hence\\ninvestigators have sought a cure in the bacillus itself, or in its\\nproducts. Since a person who has once had a certain disease,\\nas yellow fever, does not usually have it again, it is thought that\\nthe disease must leave some substance in the blood which renders\\nit an unsuitable habitation for that particular germ. The diffi-\\nculty is to find and secure that substance, toxine or antitoxine,\\nwhatever it may be.\\nBehring and Roux were the first to succeed in this field.\\nBy inoculating a horse with diphtheria they prepared an anti-\\ntoxine from its blood which, on being injected into the arm of a\\nhealthy child, will prevent diphtheria from one to two months,\\nand, if injected early enough, will cure most cases of the disease.\\n(See Diphtheria.) In the same way an antitoxine for tetanus\\nhas been prepared, though not yet an unqualified success, and the\\nPasteur treatment for hydrophobia is somewhat on the same\\ngeneral plan. (See Hydrophobia.)\\nA most valuable addition to our knowledge of diseases is\\npromised in the treatment of cancers and other tumors by the\\ntoxine of erysipelas. Since it has been found that some germs\\nprey upon others, or, more properly, the toxine produced by\\none variety is fatal to those of some other varieties, the happy\\nidea has taken shape that the germs of a mild disease may be\\nset upon those of a fatal disease and made to destroy them.\\nDr. Coley of New York has cured a number of cases of cancer by\\ninoculating the patient with the toxines of diphtheria but others\\nhave tried the plan with little success, and it is still in the experi-\\nmental stage.\\nThe only diseases that have thus far been successfully prevented", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0229.jp2"}, "228": {"fulltext": "212 BACTERIA.\\nor treated are small-pox, diphtheria and hydrophobia but, know-\\ning the cause, we know how to stamp out all infectious diseases\\nall we lack is the power. Had we authority to handle every case\\nof typhoid in accordance with our best knowledge, we could pre-\\nvent in each case the escape of any typhoid germs to produce\\nother cases, and in a comparatively short time typhoid fever\\nwould be banished from the earth. So with scarlet fever, yellow\\nfever, tuberculosis, and all other infectious diseases. Since we\\nhave not the power of banishing them we must seek means of\\ncuring them. The child does not fear until it is hurt; the adult\\nfears first and avoids the hurt. Society, apparently, is still in the\\nchild-like stage, but the time is coming when disease and crime\\nwill be prevented, instead of being permitted to develop and\\nharass and destroy their victims.\\nEven doctors are often heard to speak of germs of disease\\nas bugs, thus conveying the impression that they are animals.\\nThis idea is false, for with few exceptions they are minute vegeta-\\nble forms of life, the only exception of importance being the\\ngerm of malarial fever, which belongs to the group of protozoa\\nthe lowest form of animal life.\\nDefinitions. In common use the terms germs, bacteria and\\nmicrobes are used interchangeably, but there are many other\\nnames given them, descriptive of some particular characteristic,\\nfor germs are classified according to their form, etc., thus:\\n(i) Micrococci, usually called cocci, are those germs which are\\novoid like an egg or round like a marble; (2) Bacilli, those rod-\\nshaped, like a pencil (3) Spirilla, the varieties shaped like a spiral\\nor corkscrew.\\nAgain there are modifications of these classes, according to\\nthe mode of grouping, thus Diploco.cci always occur in pairs,\\ntetrads in fours, staphylococci in clusters like grapes, streptococci\\nin chains, sarcina in cubes. A bacillus may be straight or curved\\nsquare or rounded at the ends, or enlarged at one or both ends.\\nMost disease germs are bacilli.\\nSize. Bacteria are so minute that they can be seen only with\\nthe highest power of the microscope. Figures convey little\\nidea of their size. The tubercle bacillus, larger than many, is\\nT\u00c2\u00a5 000 of an i ncn long and 50 roo of an inch thick. Of the\\naverage bacilli it is estimated that 6,000 billions would be re-\\nquired to weigh a grain. Bacteria are also of such trans-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0230.jp2"}, "229": {"fulltext": "BACTERIA. 213\\nparency that it is exceedingly difficult to study them until\\nstained. The discovery by Weigert in 1877 that these little\\nbodies have such an affinity for the coloring matter of aniline\\ndyes as to take a deeper stain than the substances or media in\\nwhich they are found was a great step in their investigation, and\\nit will be noticed that it is since that date that most of the varie-\\nties have been isolated, that is, studied separately and the\\npeculiarities distinguishing each variety pointed out.\\nHOW BACTERIA GROW AND MULTIPLY.\\nMany varieties of bacteria reproduce their kind in two\\nways By fission (division) and by spores. In reproduction by\\nfission, around the parent germ a little pale line may be seen\\nwhich grows deeper until the two portions are entirely separated,\\neach thereby becoming a complete organism, which in turn by\\ndivision, like the parent from which it came, also multiplies\\nitself by two. As, by thus dividing once an hour, a single germ\\nand its progeny may increase to over sixteen and a half millions in\\ntwenty-four hours, the rate of increase under favorable conditions\\nis seen to be wonderful the more so when it is remembered\\nthat they have been known to divide as often as once in twenty\\nminutes. It does not often happen that all of the conditions\\nare favorable to their most rapid development. Temperature\\nis a most important factor. It must not be less than about\\n61 degrees or greater than 104 degrees Fahrenheit. Cold prevents\\nthe multiplication of bacteria but does not destroy them, and,\\nwhile they may be rendered dormant by a 1ow t temperature for a\\nlong period of time, they awake to renewed activity and virulence\\nas soon as the proper degree of heat is supplied. On the other\\nhand, a sufficiently high temperature destroys all kinds of germs,\\nthe degree required for this purpose varying, according to Stern-\\nberg, from 129.2 degrees to 158 degrees Fahrenheit, in streaming\\nsteam but boiling is the surest method.\\nMoisture is quite as important as favorable temperature\\nto germ development, for its presence is absolutely necessary.\\nWhen deprived of moisture, most vegetable germs, in drying,\\nchange their form, thicken their covering or skin, and become\\nwhat are called spores, in which condition they may lie dormant\\nindefinitely, unless moisture and warmth be supplied in the right\\nproportions, when they again become germs, and, like their", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0231.jp2"}, "230": {"fulltext": "214 BACTERIA.\\nancestors, multiply rapidly. Specification may also take place at\\nother times, especially when the food supply becomes exhausted,\\nor when, by means of the poisonous products formed by the\\ngerms themselves, it is changed into an unsuitable medium for\\ntheir sustenance.\\nSpores are able to offer much greater resistance than bac-\\nteria to destructive influences they withstand higher tempera-\\ntures and the action of most poisons, and, as long as deprived\\nof a combination of moisture and proper temperature, cannot\\ngerminate and are practically immortal. It requires boiling, often\\nfor twenty minutes, and sometimes longer, to destroy them.\\nCareful experiments with spores taken from cavities in petrified\\nwood, where they had lain no one knows how long, probably\\nhundreds of years, resulted in their growing as perfectly as had\\nthey been but a few days old. Again most germs thrive best in\\nthe dark, and to many species bright sunlight is fatal.\\nTHE UNIVERSAL PREVALENCE OF BACTERIAL GERMS.\\nGerms are everywhere, in the air we breathe, the soil we\\ntread, the water we drink, the food we eat, the clothes we wear,\\nand in the skins covering our bodies. Fortunately only a com-\\nparatively few species are injurious to man some varieties are\\neven thought to aid digestion by supplementing the action of\\nthe digestive juices; and many forms seem to live to prey upon\\nother forms, the conflicts in the microscopic realm being quite\\nas real as those waged in the visible world.\\nHOW BACTERIA PRODUCE DISEASE.\\nMost of the disease-producing bacteria do their deadly work\\nnot by directly attacking living tissues, but by producing fer-\\nments called toxines or ptomains, which by absorption are\\ntaken into the blood and thus enabled to spread their poisonous\\neffects. One variety shows an affinity for certain parts, others for\\nothers, and their presence in each case is manifested by the\\nsymptoms of the disease thus produced. So often and so posi-\\ntively have certain well-known varieties been proven the causes\\nof certain diseases, that the physician now depends largely upon\\nthem for his diagnosis, and, by so doing, is able to determine\\nthe exact nature of the ailment at an earlier stage of its devel-\\nopment than would otherwise be possible. By placing a minute", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0232.jp2"}, "231": {"fulltext": "BACTERIA. 215\\nportion of the diseased tissue, or of the secretions or excretions\\nof the patient, in a preparation of gelatin, broth., seaweed, or\\nother substance in which the suspected microbe is known to\\nthrive, and supplying the conditions favorable to germ devel-\\nopment, care having been taken to exclude germ life from all\\nother sources, a culture is soon obtained, in many cases unmis-\\ntakably revealing the character of the disease.\\nTHE PUTREFACTIVE PROCESSES.\\nIt is certain that the putrefactive processes are due to a few\\nkinds of these bacteria which are widely disseminated and abound\\nupon the objects all about us, and. as putrefaction hinders if it\\ndoes not entirely prevent the healing process, it is most important\\nin the dressing of all wounds that we understand the tiny foes\\nwith which Ave have to deal and the measures necessary to outwit\\nor overcome them. Indeed, in healthy persons, when the proper\\nprecautions have been taken to exclude all kinds of germs, the\\nmost extensive cuts made by the surgeon very quickly heal\\nwithout any sloughing or pus.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0233.jp2"}, "232": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0234.jp2"}, "233": {"fulltext": "MINOR SURGERY.\\nOR FIRST AID TO THE INJURED.\\nBy J. C. McClintock, A.M., M.D.\\nIn the war with Spain the American soldiers were supplied\\nwith emergency or first aid packets before going to the front.\\nThey were put up by several firms and differed somewhat in\\ntheir contents. Those furnished to the Illinois volunteers were\\ndevised by Senn, and consisted of about a teaspoonful of powder\\ncomposed of one part of salicylic acid and four parts of boracic\\nacid; one dram of absorbent cotton containing the powder in\\nits center; a piece of sterilized gauze about forty inches square,\\nand several safety pins; the whole wrapped in gutta percha.\\nThose put up by Johnson Johnson, New Brunswick, N. J.,\\ncontained two small gauze compresses, a roll of bandage, two\\nsafety pins and a triangular bandage on which were illustrations\\nshowing how to bandage every part of the body, all inclosed in\\noiled linen, and so prepared as to be absolutely free from germs\\nof every kind. Each man was instructed to open his packet\\nonly in an emergency, but on receiving a wound to place one\\nof the compresses upon it as soon as possible, to apply the anti-\\nseptic bandage over the compress, and to then use the triangular\\nbandage as shown by the illustrations on the same. By follow-\\ning these directions, nearly every wounded man recovered, not,\\nas many have supposed, because of the less serious wound made\\nby the modern high power gun, but because the pus germs were\\nthus shut out and the wound kept pure by the occlusional dress-\\ning until it could receive a permanent dressing at the hands of\\nthe surgeon.\\nSurgeon Newgarden, in speaking of the hospital work at\\nBloody Ford, Santiago, says: Before the battle opened many\\nof these packets had been thrown away by the thoughtless as\\nbeing so much unnecessary encumbrance; but later, so high did\\nthey rise in the estimation of the men, I several times heard\\nthem trying to buy of one another, but without success. They\\nevidently realized the value of the packet then. Small and almost\\n217", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0235.jp2"}, "234": {"fulltext": "218 MINOR SURGERY.\\ninsignificant as it appeared before the fight, it really was one of\\nthe most important parts of the equipment, next to the actual\\nmunitions of war and commissary supplies. We owe directly to\\nits prompt use the low mortality from wounds and the small\\nnumber of amputations necessary. Many injuries which were\\nnot disturbed for some days after this first dressing was applied\\nwere found completely healed, and required no more care, when\\nthe dressing was removed, for the purpose of putting on a fresh\\none.\\nThere could hardly be a clearer demonstration of the\\nvalue of the discovery of the germ causation of suppuration and\\nsloughing than is found by contrasting this scientific treatment\\nwith the murderous neglect inflicted upon brave heroes in all\\nour former wars, when, left in many cases for two or three days\\nupon the battlefield, their uncared-for wounds became terribly\\nswollen and inflamed, if not horrid masses of suppuration and\\ngangrene, before reaching the surgeon.\\nPackets, similar to those used in the army, are now put\\nup by several manufacturers of antiseptic dressings and sold for\\nabout twenty-five cents each. They should be kept in every\\nhome. No family can afford to be without one. A box of\\nantiseptic cotton, never to be opened until needed, and a bar\\nof carbolic soap should also be on hand against emergencies.\\nAny clean soap will do, but carbolic soap is the best of any\\nthat can be readily obtained and easily preserved.\\nPUS GERMS.\\nOf the few varieties of germs which are pus producers, each,\\non entering the blood or tissues, forms a product peculiar to\\nitself. The most common is that called staphylococcus aureus.\\nIt produces a yellow or whitish yellow pus and is the chief factor\\nin four-fifths of all cases of suppuration. Its germs are very\\nwidely distributed, being found almost everywhere, in the soil,\\non objects all about us, upon our clothing, our hands, and\\nespecially in. the accretions under the nails, but not often in\\nair that is free from dust.\\nThe staphylococcus albus is the next most important variety,\\nand produces a white pus. Although its germs occur everywhere,\\nthey most abound in the deep follicles of the skin, and are nearly\\nalways troublesome in surgical cases in which proper precau-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0236.jp2"}, "235": {"fulltext": "MINOR SURGERY. 219\\ntions were not used prior to the operation. A thorough scrubbing\\nof the skin at and around the places where cutting and stitching\\nare to be done are the measures for. avoiding them. The varie-\\nties which severally produce green, red and blue pus are less\\ncommon and need only be mentioned here.\\nSURGICAL CLEANLINESS.\\nTo the surgeon the words clean and cleanliness mean\\nthat which is surgically clean free from foreign matter and\\nall pus germs a condition so important that first of all, unless\\nthere be such severe hemorrhage as to demand immediate atten-\\ntion, the hands of any person_about to do up a wound should be\\nmade clean by thoroughly washing with clean soap and water.\\nAs the ordinary washbowl and soapdish, even when apparently\\nclean, are generally very unclean, teeming with the very germs\\nto be avoided, it is safer for this purpose to use almost any other\\nbasin or pan, it having first been carefully washed and scalded.\\nHaving thus prepared the hands, do not try to wash or\\ncleanse the wound, except to remove from it all bits of clothing\\nand other foreign matter, using great care not to soil the wound.\\nNext take the gauze compress from the packet, and without\\nallowing anything but the clean hands to touch it, place it over\\nthe wound, cover with a layer of antiseptic cotton thick enough\\nto absorb all the blood and serum likely to be discharged, and\\nover all wrap the bandage, drawing it firmly if there is much\\nbleeding, but not so tightly as to obstruct the circulation in the\\nparts beyond. The surgeon seldom uses less than a half pound\\nof cotton to cover a wound and absorb its discharges. Only\\ncotton that has been antiseptically prepared is fit for this purpose.\\nShould the bandage be found too snug it may be loosened\\na little, but the gauze and cotton should not be disturbed until\\npreparations are complete for the permanent dressing.\\nIf the patient is suffering from shock, or is faint, very weak\\nor pale, he should be put to bed and surrounded by bottles of\\nhot water, securely corked and wrapped in cloths to prevent blis-\\ntering the patient. Mason fruit jars, carefully sealed, are excel-\\nlent for this; jugs serve the purpose well. The clothing about\\nthe neck, chest and waist should be loosened, if not removed. If\\nammonia be applied to the nostrils it must be quite dilute and used\\nfor only a short time. Do not use large pillows; the horizontal\\nposition is best.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0237.jp2"}, "236": {"fulltext": "220\\nMINOR SURGERY.\\nTHE TEMPORARY DRESSING OF WOUNDS.\\nMany lives have been lost because of fright at the sight of\\nblood. Paralyzed with fear, the doctor s coming has been help-\\nlessly awaited until too late, when the patient, or anyone else,\\nby pressing the right spot, could have stayed the crimson current\\nuntil the arrival of more skillful aid. No one need bleed to death\\nunless wounded in more places than he can reach with his fingers\\nand thumbs.\\nHEMORRHAGE.\\nThe temporary con-\\ntrol of hemorrhage is ef-\\nfected by direct pressure\\nin the wound, or by pres-\\nsure upon the blood ves-\\nsels above or below the\\nwound. To control hem-\\norrhage directly in the\\nwound, wipe out the clots\\nwith a piece of clean ab-\\nsorbent cotton and im-\\nmediately fill the wound\\nwith another piece of dry\\ncotton, pack it in, and\\npile it up over the wound,\\nthen firmly bandage over\\nall. Should the hemor-\\nrage persist, take out the\\ncotton, repack the wound\\nwith fresh cotton, and ap-\\nply the bandage much\\nmore tightly than before,\\nif necessary using addi-\\ntional pressure over the wound with the hand.\\nIf the bleeding be from an artery, it will come from the side\\nof the wound next the heart, and will be controlled by pressure\\nbetween the wound and heart upon* that artery. This pressure\\nwill be most efficiently applied at the points shown in Plate V.\\nIf the bleeding be from a vein, it will come from the side of the\\nwound furthest from the heart, will be darker in color than bright\\nTo Prevent Bleeding from the Femoral Artery at\\nany Place in the Limb Below the Point of Pressure.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0238.jp2"}, "237": {"fulltext": "FOR HAND\\nOR\\nHAND S\\nFOR FACE\\nFOR ARM\\nFOR FOREHEAD\\nFOR SCALP\\nFOR NECK AND HEAD\\n(heart j\\nv\\nFOR THIGH\\nFOR TOP OF FOOT\\nFOR SOLE\\nOF FOOT\\nPLATE V.\\nPoints at which pressure controls Arterial Bleeding.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0239.jp2"}, "238": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0240.jp2"}, "239": {"fulltext": "\u00e2\u0096\u00a0MINOR SURGERY.\\n221\\nred arterial blood, and will be controlled by pressure on the vein\\non the side of the wound furthest from the heart. The pressure\\ncan often be exerted upon the selected point by applying the\\nhand thereon and throwing the weight of the body upon the\\nhand, the weight to be sufficient to control the hemorrhage.\\nA better way is to cut or tear a half yard or more of gauze\\nor muslin into strips three or four inches wide, wind them into a\\nfirm roll, apply it to the selected point, and over it wrap a\\nbandage very tightly:\\nIf it be found impos-\\nsible to thus bind the ar-\\ntery tightly enough to\\narrest the hemorrhage,\\ntry a tourniquet or\\nSpanish windlass, i. e.,\\ntie a strong bandage\\nloosely about the limb,\\nplace the compress over\\nthe selected spot and un-\\nder the bandage, then\\nwith a cane or similar\\nlever thrust through the\\nbandage, twist it round\\nand round until the\\nbleeding stops. Where a\\ncompress roll cannot be\\nquickly obtained, a ball\\nof any kind, a smooth\\nstone, a block with\\nrounded corners, or even\\nan apple or potato may be used under the tourniquet bandage\\nto press upon the artery or vein.\\nShould all these devices prove insufficient, a piece of strong\\none-fourth to one-half inch elastic rubber tubing can be wound\\nseveral times around the limb, without any compress, tightly\\nenough to control hemorrhage under any circumstances. If\\nresort to either of the last two methods is required, a surgeon\\nmust be summoned immediately, and the limb be left bound but\\na few hours, for cutting off the circulation too long may result\\nThe Tourniquet Applied to the Arm.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0241.jp2"}, "240": {"fulltext": "222\\nMINOR SURGERY.\\nThe Tourniquet Applied by an Assistant to Prevent Arterial Bleeding in the Leg.\\ni-n gangrene, possibly in death. These measures, therefore, are\\nto be employed only as a last resort, when the other means have\\nfailed, but must be used rather than let the patient bleed to death.\\nThe Tourniquet Applied by the Patient Himself.\\nAs soon as the hemorrhage has been controlled, the wound\\nshould be given a temporary dressing as already described.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0242.jp2"}, "241": {"fulltext": "MINOR SURGERY. 223\\nTHE PERMANENT DRESSING OF WOUNDS.\\nThe permanent dressing should be applied as soon as proper\\npreparations can be made, and, for obvious reasons, this should\\nbe done by a surgeon. To enable him to secure perfect cleanli-\\nness, from two to four gallons of pure water should be provided.\\nIt is best prepared by boiling twenty minutes, (then cooling in\\nthe same vessel, until comfortably warm for the patient. If the\\ntime be limited, it is better to boil it in several small kettles, that it\\nmay thus cool more quickly than it would in one large one. If, how-\\never, the water is pure enough to be good drinking water, boiling\\nis not very important, for it will contain so few disease germs\\nas to be practically clean. One or two dozen freshly laundered\\nclean towels, a bar of carbolic soap, or better still, some of\\nthe green soap known as saponis viridis, a small hand-scrubbing\\nTo Suppress Arterial Bleeding Below the Knee.\\nbrush of vegetable fiber, and a clean basin should also be provided.\\nA table is a much better place than a bed for the patient to\\nlie while his wound is being dressed. It should be covered by\\ntwo or three thicknesses of comforts, or by several blankets, and\\na clean sheet spread smoothly over them, the patient laid thereon,\\na clean sheet spread over him, and blankets also if the room\\nbe cool, exposing only the wounded limb during the dressing.\\nThe table and everything about it, and the patient and every-\\nthing about him, must be clean, and the site of the wound and\\nits surrroundings must be especially clean.\\nBoth operator and assistant should first prepare by cutting\\ntheir nails as closely as they can be trimmed, and scrubbing their\\nhands and fingers thoroughly, especially about the nails, then", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0243.jp2"}, "242": {"fulltext": "224 MINOR SURGERY.\\nrinsing in clean water until rid of every trace of soap. All prep-\\narations having been properly made, the assistant will remove the\\nold dressings and render such other aid as will enable the operator\\nto work with surgically clean hands.\\nFRACTURES.\\nA fractured bone is a broken bone, and is caused by violence\\napplied either directly at the place of fracture, or to the ends\\nof the bone so that a break is made at some point between them.\\nSymptoms. Pain, following violence, at and about the site\\nof the injury; the patient may have felt or heard the crack when\\nthe injury occurred frequently a crackling or grating sound is\\nproduced by the rubbing together of the broken ends. There\\nis deformity, usually a shortening of the injured limb, and a\\nbending from its natural line. Swelling adds to the deformity,\\nand there is likely to be the red or blue discoloration, often termed\\nblack and blue, caused by bleeding into the tissues beneath\\nthe skin. Often, but not always, when the limb is moved there\\nseems to be an extra joint a point of motion where there should\\nbe continuous bone. Loss of all strength or force does not often\\noccur, the patient usually being able to move his fingers and toes.\\nThe first thing to do is to keep cool, then bare the limb with-\\nout bending it, either by carefully slipping the clothing from it\\nor by neatly ripping up the seams and turning it back; sacrifice\\nthe clothing only when necessary to avoid bending the limb.\\nNext, the limb should be drawn into a straight natural position,\\nand as many splints applied and carefully but firmly bound to\\nthe limb as may be required to hold the fractured ends rigid and\\nimmovable, for there is great danger lest even slight movements\\nof the sharp broken ends lacerate the surrounding tissues, sever\\nan artery, injure a large nerve, or by pushing through the skin\\nopen the way for septic poisoning. Almost any stiff object of\\nsuitable size may be used as a splint; a board, cane, umbrella, or\\neven a stiff cornstalk will serve the purpose in an emergency.\\nUse the stripped off clothing as padding to prevent the ends\\nof the splints from injuring the limb.\\nIn case of a fractured leg, unless an ambulance be at hand\\nfor conveying the patient to his home, or other refuge, a stretcher\\nshould be improvised from a board, door, shutter, or something\\nsimilar. If held by enough hands to keep it from sagging too", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0244.jp2"}, "243": {"fulltext": "MINOR SURGERY. 225\\nmuch, a strong blanket makes a good stretcher. If there be\\nonly two bearers and a blanket is at hand, it may be made into a\\nsling by placing the patient on the blanket and tying its corners\\ntogether over him, then, by means of a pole, rail or strong board\\nthrust under the part of the blanket covering the patient, he\\nmay be safely borne upon the shoulders of his friends. In any\\ncase, the bearers should keep step at an easy, swinging pace,\\nto cause as little jarring as possible, or, if the distance be long,\\nthey may stand in a wagon and hold the stretcher in such a w T ay\\nas to prevent all sudden jolts. Let every precaution be taken\\nagainst disturbing the injured limb, or grating the fractured ends\\nupon each other.\\nFrom the stretcher the patient should be transferred to a\\nnarrow bed, that the surgeon may have access from either side\\nit should be rather hard and without springs, a board having\\nbeen placed beneath the mattress to prevent sinking down in the\\nmiddle.\\nDo not get excited. An ordinary fracture is not a dangerous\\naccident. It should be reduced as soon as possible, but time is\\nnot the element of greatest importance, and it is better to await\\nthe coming of the surgeon of your choice than to send in every\\ndirection and get several, then have no one to take the individual\\nresponsibility of making a perfect limb.\\nReducing the fracture, or setting the bone, is bringing\\nthe broken parts together in their natural position and retaining\\nthem there by proper splints and bandages. Make no attempt\\nto set the bone, but keep the injured place covered with cloths\\nwrung frequently from clean cold water, and await the surgeon s\\ncoming.\\nRepair occurs when the fractured ends are brought together\\nin the proper position and condition, and held there perfectly\\nstill by the aid of splints, usually two in number, bandaged to\\nthe limb. The length of time required is considerably influenced\\nby the health and age, but usually is from six to eight weeks.\\nSPRAINS.\\nA sprain is an excessive strain of the muscles or ligaments\\nof a joint, without dislocation.\\nA sprain may be of any degree of severity, from one of little\\nconsequence that recovers in a few days without any treatment, to\\n15", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0245.jp2"}, "244": {"fulltext": "226\\nMINOR SURGERY\\nan injury of very great importance. The joint itself may have been\\ntorn open, or the ligaments about it so strained or torn as to\\nproduce serious permanent lameness. Hence, a sprain should\\nnot be regarded lightly, and, if the injury is apparently severe,\\na surgeon should be called and his directions followed.\\nTreatment. As soon\\nas possible after the ac-\\ncident immerse the in-\\njured joint in very warm\\nwater and hold it there\\nfrom thirty minutes to\\nan hour, keeping the\\nwater all the time, by\\nfrequent additions of\\nvery hot water, as hot\\nas can be borne by the\\npatient. Then, having\\ncarefully dried the limb\\nin soft towels, cover the\\njoint and limb for some\\ninches above and below\\nthe injury with strips of\\nadhesive plaster running\\nlengthwise of the limb,\\nafter which cover that\\nby winding a long strip,\\nabout three inches wide,\\nof the same plaster,\\nround and round the\\nlimb, drawing it snugly\\nbut not so tightly as to\\nstop the circulation, and\\nusing care to make each\\nturn slightly overlap the\\npreceding one. This\\nhaving been properly done, the patient may immediately resume\\nthe natural use of the joint. The modern surgeon does not advise\\nresting a sprained joint, but that it be given moderate use from\\nthe first. Do not apply washes or liniments of any kind.\\nAdhesive Bandage for Sprain.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0246.jp2"}, "245": {"fulltext": "MINOR SURGERY. 227\\nDISLOCATIONS.\\nThe displacement of a bone from its natural joint with another\\nbone is a dislocation.\\nSymptoms. The general symptoms are a change in the\\nshape of the joint; lengthening or shortening of the limb; pain\\nin the joint and great difficulty or absolute impossibility of\\nmoving it.\\nTreatment. To reduce a dislocation is to restore the bones\\nto their natural place, and usually this can be done by the surgeon\\nonly. This is especially true of a hip dislocation, the treatment of\\nwhich would be almost impossible by anyone not possessed of\\nspecial knowledge and training. In general, as soon as a dislo-\\ncation occurs, a surgeon should be called, but frequently a dis-\\nlocation may be reduced by an intelligent bystander through\\nsimply pulling the joint apart having an assistant hold and\\nsteady the bone above the dislocated joint, while he pulls on\\nthe limb below the dislocation, and in the natural line of the limb.\\nOften this will be followed by the reduction sought, the bones\\nreturning to their places and the pain being thereby immediately\\nrelieved.\\nThe shoulder dislocation can often be reduced by the operator\\npulling in line of the arm as it hangs by the patient s side, the\\nassistant at the same time placing his hands in the arm-pit and\\nlifting the shoulder upward and outward from the body. If the\\nbone goes back into its socket with a snap it can safely be con-\\nsidered as all right.\\nIf an attempt to reduce a dislocation is not successful, do\\nnot resort to violent measures, but await the arrival of the sur-\\ngeon, meantime constantly applying cold water to the injured\\njoint, unless it has received an external wound also, in which\\ncase only a dry dressing of absorbent cotton should be applied.\\nY\\\\ nen the dislocation has been reduced, the member should\\nbe put at rest for three or four weeks by bandaging or splinting\\nthe part, thus holding it immovable until the torn and injured\\nparts about the joint have recovered. The larger joints, as the\\nelbow, shoulder and hip, require from five to six weeks for repair.\\nBRUISES.\\nA bruise is an injury to the soft parts beneath the skin.\\nWhen accompanied by an injury to the skin it is called a bruised", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0247.jp2"}, "246": {"fulltext": "2 48 MINOR SURGERY.\\nwound. The most common causes are blows and falls. Bruises\\nmay be of any grade of severity, from a simple bruise of the\\nmuscles of an extremity, to the severe purification of internal\\norgans.\\nSymptoms. Pain, discoloration and swelling followed by\\nheat. In severe or extensive bruises great and even fatal prostration\\nmay follow. The blood vessels of the bruised part are likely to be\\ntorn so that there is bleeding into the tissues, thus giving rise\\nto pain, usually of a dull, heavy, aching character, and accompanied,\\nfrequently, by a certain numbness. Swelling also occurs as a result\\nof the bleeding. Later when this blood comes nearer the surface,\\nit shows through the skin in what are ordinarily known as black\\nand blue spots. At first the color is usually purple, changing\\nafter a few days to violet, brown, olive and green, and, lastly, to\\na yellowish hue which usually disappears within two weeks.\\nTreatment. If the bruised part be a limb, it should be ele-\\nvated as much as possible, consistent with the comfort of the\\npatient, to prevent bleeding from the torn vessels, for this bleeding\\ninto the tissues will be much freer, and the consequent swelling\\nmuch greater, if the limb be allowed to hang low.\\nOrdinary temperatures favor free bleeding either very cold or\\nvery hot applications should, therefore, be made to the bruised\\npart. Cold should be given the preference, if agreeable to the pa-\\ntient, and nothing is better than a bag of pounded ice, kept con-\\nstantly applied should hot applications be more agreeable, they\\nshould be used instead of the cold, but whichever is chosen should\\nbe continued without interruption for several hours, during which\\ntime the very low or very high temperature should be steadily\\nmaintained by rapid and frequent changes of the applications.\\nIf the swelling unduly increases, or if the limb becomes cold\\nbeyond the bruised part, or if the bruise be in the body and ac-\\ncompanied by prostration, a physician should be called without\\ndelay. To overcome such prostration, the patient should be placed\\nas soon as possible in a warm bed, given a hot drink, and sur-\\nrounded with bottles or sealed fruit jars of hot water, but not of\\nwater so hot as to burn, for a patient in this condition may be\\nso numb as not to feel even severe burning. Quiet must be\\nmaintained for several clays, and twice daily the bruised part should\\nbe gently rubbed towards the body.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0248.jp2"}, "247": {"fulltext": "MINOR SURGERY. 229\\nHERXIA.\\n(Rupture).\\nA hernia or rupture is a tumor formed by the protrusion of\\ncontents of a cavity through its wall, the external skin usually\\nremaining unbroken. Its most common sites are the navel and\\ngroin. If at the navel, it is called an umbilical hernia. This form\\nis very rarely found except in new-born children and fleshy women\\nwho have borne children, and whose abdominal walls have thereby\\nbeen thinned out and weakened.\\nA hernia in the groin occurs either just above or just below\\nits fold (Poupart s ligament). If above, it is an inguinal hernia\\nthe form most common in boys and men, and if the protrusion\\ncontinues until it pushes down into the scrotum it is a scrotal\\nhernia. If it occurs below the fold in the groin, it is a femoral\\nhernia, almost the only groin hernia that occurs in females. In the\\nvery rare cases in which the protrusion pushes down into one of the\\nlabia, it is called a labial hernia. A boy or man at any age\\nmay have a hernia in the groin, but in the female this rarely occurs\\nuntil puberty, and usually not until middle or advanced life. Al-\\nthough brought on by severe strain, a hernia is generally due to a\\nnatural weakness in the walls. When such constriction occurs as\\nto prevent the passage of blood and feces in the part protruded,\\nthe condition is known as strangulated hernia.\\nThe new-born child that has a hernia at the navel should be\\npromptly treated by pressing the protrusion back into the abdo-\\nmen, then applying to the navel a compress composed of several\\nthicknesses of soft cloth, and binding it firmly to its place by a\\nbandage, and this should be worn day and night until a cure is\\neffected by nature s own methods. In like manner a child having\\nhernia in the groin should have the protrusion reduced, a compress\\napplied to the hernial site and firmly bound in place by several\\nturns of a figure 8 bandage, one turn passing around the body,\\nthe next around the thigh on the defective side and. coming\\nback, be crossed over the hernia, then around the body, and again\\naround the thigh, repeating these turns until the protrusion can\\nhave no chance of escape. This bandage must likewise be worn\\nday and night that the hernial opening may be kept constantly\\nclosed and the parts thereby have a chance to grow together. The\\nbest material for such a bandage is soft white flannel, cut bias in\\nstrips about three inches wide and sewed together end to end until", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0249.jp2"}, "248": {"fulltext": "230\\nMINOR SURGERY.\\nBandaging for Groin Hernia in a Child.\\nthe required length is secured. Several such bandages should be\\nprovided, as there will need to be changes when they become\\nsoiled. In doing this the nurse must lay her finger over the\\nhernial opening and prevent the protrusion of the gut, until the\\ncompress and bandage have been reapplied. In babies and chil-\\ndren, if care be taken to keep the hernia properly and constantly\\nreduced for a year or two, a cure will almost always follow; but\\nnot so with adults, for in them a cure is the exception, rather than\\nthe rule.\\nIn an adult the protrusion should be reduced and held in place\\nby a well fitting truss, for when a hernia is out there is always\\ndanger of its becoming strangulated, and a surgeon meets nothing\\nin his practice more serious than a strangulated hernia. To secure\\na perfectly fitting truss the patient should have the aid of his\\nphysician, and during the fitting should assume all kinds of pos-\\ntures, as those of lifting, stretching the limbs, and bending the body\\nthis way and that, and he should strain in each of these unusual\\npositions, through all of which the truss should hold the hernia\\nin place. If it does not it should be rejected and another applied,\\nand so on until a perfect fit is secured. A truss is not usually\\nworn by an adult at night, but is removed after the patient lies\\ndown, then reapplied before rising. That hernia is much more\\ncommon than most people realize may be seen by a glance at the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0250.jp2"}, "249": {"fulltext": "MINOR SURGERY,\\n231\\nmagnitude of the truss business; a single city in the United States\\nturns out a half-million hernial trusses annually.\\nStrangulated Hernia. Should one be so unfortunate as to\\nhave strangulation of a hernia, a physician should be summoned\\nimmediately and at the same time be informed as to what has\\nhappened that he may not delay in answering the call. The symp-\\ntoms are pain and tenderness in the hernia the swelling becomes\\nharder than usual there are colicky pains through the abdomen,\\nsometimes extremely severe occasionally the patient sweats pro-\\nfusely because of the pain, even becoming cold and almost lifeless,\\nthus showing that he has entered a very dangerous stage of col-\\nlapse.\\nPosition for a Patient Suffering with Strangulated Hernia.\\nTreatment. A patient with strangulated hernia should be\\nmade to lie upon his back, with his hips much elevated.- A very\\ngood way to get this position is to place a chair so that its top and\\nthe front edge of the seat shall rest upon the bed, the back of the\\nchair being pushed under the back of the patient until his hips rest\\non the rear edge of the seat, his legs from the knees falling over\\nbetween the chair legs, its back and rounds having been covered\\nwith a folded blanket.\\nA bag of pounded ice, or some other very cold application,\\nshould be placed upon the hernial swelling to arrest inflammation,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0251.jp2"}, "250": {"fulltext": "232 MINOR SURGERY.\\nand in ten or fifteen minutes efforts at reduction of the protrusion\\nshould be made by the patient, who is likely to be much more skill-\\nful than anyone else in reducing his own hernia. Failing to reduce\\nit, he should be kept in the above position that the blood may\\ngravitate from the swelling, and the cold applications continued\\nuntil the doctor arrives. Do not apply heat in any form.\\nThe surgeon usually treats such a case by administering chlo-\\nroform, thereby relaxing the tissues surrounding the hernia, then,\\nhaving bent the thigh upward and turned it somewhat inward, by\\ngently pressing and kneading with the broad surface of his hands,\\nhe attempts to reduce the hernia. If this is not successful, it is\\nhis duty to cut down from the hernia to slightly enlarge the open-\\ning, thus allowing the gut to fall back into its natural position, then\\nsew the edges of the wound together. To do this properly is\\nusually a complicated procedure.\\nTo effect a cure by means of a truss it must be so applied as\\nto produce great pressure and pain, in fact all the pain that the\\npatient is willing to bear, and the process continued for several\\ndays and nights, or even weeks, thereby exciting an adhesive in-\\nflammation which shall result in a growing together of the surfaces\\nof the hernial opening. This treatment is much more likely to\\nsucceed if applied soon after the hernia first appears. In an old\\nhernia it is not often of much value.\\nRECTAL PROLAPSUS AND PROCIDENTIA.\\nProlapsus of the rectum is a descent of the lower part of the\\nrectum, either partial or complete, the mucous membrane and\\nsub-mucous tissue being turned out of the anus.\\nProcidentia is the descent of the upper part of the rectum,\\nall its coats, through the anus, the upper part of the rectum de-\\nscending through the lower part.\\nBoth these conditions, although most common in children,\\nquite often occur in won] en who have borne many children, and\\nin men of advanced years. In children it is thought to be caused\\nby diarrhea, dysentery, severe coughing, long continued crying,\\nand much straining to move the bowels.\\nA frequent cause is the bad practice of placing a child upon a\\nchamber and leaving it there a long time.\\nIn adults it may be caused by chronic diarrhea, dysentery,\\nsevere cathartics, long continued use of injections, strictures of the\\nurethra, severe straining, internal piles, polypi, tumors, etc.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0252.jp2"}, "251": {"fulltext": "MINOR SURGERY. 233\\nTreatment. In children a speedy cure can generally be ob-\\ntained by removing the cause, but when no source of irritation can\\nbe found the general health must be improved. The child must\\nnot be allowed to sit and strain at stool, but all movements of its\\nbowels should be made while lying upon its side near the edge of\\nthe bed, or while in a standing position, and one buttock should\\nbe drawn aside to tighten the anal orifice while the feces are pass-\\ning. After the movement the protruding parts should be well\\nbathed by dashing cold water upon them with the hand, then\\nthoroughly treated with a solution of alum or oak bark, or weak\\ncarbolic acid, applied with a soft cloth or sponge. The bowel\\nmust then be gently pressed back through the anus to its natural\\nposition, and the child should for some time continue lying upon\\nits stomach. As a rule cathartics should not be given, but where\\nthere is intestinal irritation from three to five grains of cascara\\nsagrada may be administered morning and evening.\\nHard feces should be softened by mild injections before they\\nare passed, and a repetition of the condition avoided by a diet of\\ngruels, graham mush, and other laxative foods. Only nutritious,\\neasily digestible articles should be eaten by one suffering from this\\ntrouble.\\nThe more serious cases usually require surgical treatment,\\nwhich may include the use of acids, hot instruments and the knife.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0253.jp2"}, "252": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0254.jp2"}, "253": {"fulltext": "GENERAL DISEASES.\\nCHAPTER I.\\nBy R. E. McVey, M.D.\\nDIGESTION.\\nThe alimentary canal is the great duct by which the foods are\\nconveyed through the body and their useless parts evacuated, and\\nconsists of the esophagus or gullet, the stomach, and the small and\\nlarge intestines. The stomach is the most dilated of these four\\nparts, and besides serving as a reservoir for food, is the principal\\norgan of digestion the mill which completes the w r ork begun by\\nthe teeth. The esophagus opens into it near its larger or\\ncardiac end, and the duodenum the upper portion of the\\nsmall intestine begins\\nat its smaller or pyloric\\nend. It is composed of\\nfour coats or mem-\\nbranes the external or\\nperitoneal, the muscu-\\nlar, the sub-mucous and\\nthe mucous, and be-\\ntween them are distrib-\\nuted the blood vessels,\\nlymphatics and nerves.\\nIt is now known to have\\nno villi like those of the\\nintestine for absorbing\\nnutrients.\\nThe size of the\\nstomach varies in differ-\\nent persons, and in the\\nsame person at different\\ntimes according to the\\ndegree of its distention,\\nlative size of the stomach. but when moderately\\n235", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0255.jp2"}, "254": {"fulltext": "236 GENERAL DISEASES.\\nfilled its average length is about twelve inches and its vertical\\ndiameter about four inches. It has two movements A kind of\\nrotary or churning movement whereby the food is mixed with\\nthe gastric juice and triturated or broken up into very fine parts,\\nand a peristaltic movement which, as fast as the food is dissolved\\nor reduced to a semi-fluid state called chyme, presses it along\\nand out through the pylorus.\\nDigestion is the process of dissolving food until, in fluid form,\\nit can pass through the membranes of the digestive canal into the\\nblood. This is accomplished by means of mechanical and chemi-\\ncal processes. The mechanical parts are mastication and the\\nmuscular action of the stomach whereby it grinds or disintegrates\\nthe food. The chemical part is performed by the aid of ferments.\\nA ferment is a substance which works changes in other sub-\\nstances and to some extent alters their chemical composition;\\nthus yeast is a ferment used in bread-making. Saliva is a diges-\\ntive ferment, gastric juice is another, and pancreatic secretion a\\nthird. As derangement of any of these may cause digestive dis-\\nturbances, it is desirable to know something of the function of\\neach.\\nMastication consists not only of carefully chewing the food,\\nbut also of thoroughly mixing it with saliva and atmospheric air.\\nThe saliva is an alkaline ferment and its action upon the starchy\\nparts of the food is the beginning of digestion. It continues until\\nthe food has entered the stomach and, by its presence there, excited\\nglands that pour upon it a thin fluid known as gastric juice. This\\nis an acid ferment, and as starch can be digested only in an alkaline\\nsolution, the gastric juice stops the digestion of the starchy\\nmaterials, but through its affinity for albumen, immediately com-\\nmences to act upon the albuminoids those parts of the food\\ncontaining albumen.\\nThe muscular action of the stomach now begins and, rolling\\nthe food over and over, works and rubs it until the two forces,\\nchemical and mechanical, have reduced the entire mass to a half\\nfluid condition called chyme a task generally requiring from\\ntwo to four hours. The duodenum, into which the food next\\npasses, is the seat of the most active digestive processes occurring\\nin the whole system. Here the liquefied albuminoids are ab-\\nsorbed by a network of microscopic veins lying within the walls of\\nthe intestine; and here the chyme is mixed with the bile and the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0256.jp2"}, "255": {"fulltext": "GEXERAL DISEASES. 237\\npancreatic secretion. The latter is the most powerful of all\\ndigestive ferments, and the most complex in composition. It\\ncontains diastase to digest the remaining starchy food, trypsine\\nto dissolve the remaining albuminoids, a ferment to act upon milk,\\nand one to act upon the fats and, with the help of the bile, change\\nthem into an emulsion, that is break them up into exceedingly\\nminute particles, that they too can be absorbed.\\nThe nutrients derived from the starchy and albuminoid ma-\\nterials are absorbed by myriads of microscopic veins and borne\\nalong with the blood to the great portal vein, to be carried to the\\nliver for purification while the fats are absorbed by another sys-\\ntem of vessels called lacteals, borne to the thoracic duct and thence\\nthrown into the blood.\\nINDIGESTION.\\nThe brief outline just given may serve to show that so many\\nparts compose the digestive process as to make the term indiges-\\ntion, as commonly used, a very indefinite one, far too indefinite\\nto be of much value in the diagnosis of disease that the very part\\nof the work that is being improperly, or not at all, performed must\\nbe pointed out before a remedy can be chosen and therefore that\\nthe use of any nostrum or cure-all, though patented, sold ready\\nmade and cheap, is much more liable to do harm than good, and\\nthat because pepsin has relieved one man s stomach ache it is not\\nsure, or even likely, to help yours.\\nDiagnosis. To locate any digestive trouble begin at the\\nbeginning and examine the teeth to learn whether they are in con-\\ndition to properly chew the food. If not, secure the services of a\\ngood dentist. This matter should have much more attention than\\nit usually receives. Through lack of care in early life, people are\\noften left without teeth just when they need them most. Al-\\nthough no substitute can make good the loss, artificial teeth, as\\nperfect as possible, should be promptly obtained.\\nSalivation should next receive attention. How do you eat?\\nIf it is your habit to eat hurriedly and bolt the food, not taking time\\nto chew it well, and properly mix it with air and saliva, or if you\\nwash it down with large amounts of drink, especially iced drink,\\na halt should be called. That it may perform its part of digestion\\nby changing cane sugar and starch into glucose, or grape sugar,\\nthe form in which their nutrients are taken into the blood, the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0257.jp2"}, "256": {"fulltext": "238 GENERAL DISEASES.\\nsaliva must be undiluted and thoroughly mixed with the food.\\nRefrain from drinking much at meals, since it not only interferes\\nwith digestion and impairs the health but, what seems of even\\nmore importance to many, is the chief cause, by stomach and\\nbowel distention, of the big, unsightly abdomens so common\\nin middle and later life. Would you long enjoy perfect health,\\ntake your food slowly and chew it well. Even a glass of milk\\nis better for being taken slowly, for, as curdling is the first step in\\nits digestion, if it be taken a little at a time, the formation of many\\nsmall curds instead of one large one makes the remaining parts of\\nthe process natural and easy.\\nThe muscular action of the stomach may be so impaired\\nas to render it unable to disintegrate the food, and indigestion fol-\\nlow. This may result from a diseased condition of the muscular\\ncoat, or from ulcer or cancer. Disease of the muscular coat is\\nusually some form of gastric catarrh, often, but not always, accom-\\npanied by catarrh of the nose and throat. Gastric catarrh in its\\nchronic form is known by many as chronic dyspepsia. In this\\nstage pain amounting to a burning soreness is felt back of the\\nbreast bone and is sometimes increased by taking food. There is\\noften tenderness, nausea, some retching, furred tongue with con-\\nstipation, sometimes diarrhea, belching, dilatation, regurgitation,\\nacidity of the stomach, foul taste in the mouth, heartburn, sore\\nmouth, headache, dizziness, drowsiness but sometimes sleepless-\\nness, nervousness, mental confusion and sometimes insanity.\\nIn all of these cases the chief remedy is a modified diet. The\\nfood must be so prepared and of such kinds as not to require dis-\\nintegration. In the milder forms of the disease it may be suffi-\\ncient to avoid such food as has been found to disagree with the\\npatient, and all foods not easily disintegrated, such as pork, veal,\\npastries, etc., but in severe cases a very strict diet must be enforced,\\nand all the food be in fluid or semi-fluid form, as milk, milk-gruel,\\nbeef juice, beef tea, mutton broth, or some similar preparation, to\\nmost of which some baked flour can often be added with advan-\\ntage. In this disease the effectiveness of the muscular action of\\nthe stomach is often greatly diminished by the presence of an\\nexcessive amount of mucus that binds the food together in a\\ntenacious mass about which, as the mass rolls over and over, it\\nforms an insoluble coat so that the action of the gastric juice is also\\nvery much impeded, and little digestion of any kind can be effected\\nuntil the materials finally pass from the stomach into the intestine.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0258.jp2"}, "257": {"fulltext": "GENERAL DISEASES. 239\\nTreatment. The stomach should first be thoroughly washed\\nout. This may be done by taking five to ten grains of ipecac in a\\nhalf tumbler of warm water. If free vomiting does not follow,\\nassist by tickling the throat. The work is done in a much more\\nthorough and better way by means of a stomach tube and salt and\\nwater, a teaspoonful to the quart. The best time for doing this\\nis at bed time or four to six hours after eating, and the temperature\\nof the water should be as nearly that of the body as possible. The\\nstomach tube is made of very soft flexible rubber, is about a half\\ninch in diameter and expands at the upper end to form a funnel.\\nWhen the lower end has been placed well back in the patient s\\nthroat he swallows it when some fourteen inches of the tube have\\nthus been taken, the assistant pours about a pint of water into the\\nstomach, then, as he lowers his end, the tube becomes a syphon,\\nor the patient by straining or coughing a little expels the water\\nthrough the tube and with it the mucus and whatever else is\\nthere. Repeat the process until the water drawn out is clear. It\\nis not difficult to swallow the tube after the first time and its use\\nnot only immediately relieves the patient of a very injurious and\\nloathsome mass, and cleanses the stomach thoroughly, but it\\nreveals, better than any other method, the exact condition of the\\nstomach itself. The use of the tube should be continued every\\nother day as long as such relief is required, and an hour later give\\nten grains of papoid to check the formation of more mucus.\\nPowdered charcoal is also an excellent remedy.\\nTo restore activity to the muscular walls, after the washing\\nout use the following: Nux vomica ten grains; phosphide of\\nzinc three grains; mix. make into thirty pills and take one im-\\nmediately after each meal. This remedy should be taken only\\nupon a full stomach. In this, as in all cases of inefficient stomach\\ndisintegration, diet is the main remedy; but remember that too\\noften a course of dieting is made a course of starving. Diet in\\nthis connection does not mean a rigid cutting down of the food\\nsupply, but a very careful selection of the kinds of food.\\nThe body needs to be thoroughly nourished at this time and\\ncare must be used not only to take the right food in the right form\\nat the right time, but to take enough of it to keep the nutrition\\nfully up to, or above, what it has been, always guarding, however,\\nagainst overeating. It is of great importance to take the meals\\nat regular hours and to eat nothing at all between meals.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0259.jp2"}, "258": {"fulltext": "240 GENERAL DISEASES.\\nUlcer and Cancer are both indicated by pain in the stomach,\\naggravated upon taking food, and it is not always easy to diagnose\\nbetween them. Cancer is most common in the male sex above\\nthe age of forty and is usually found in the pyloric or lower end\\nof the stomach. If there be an increase of pain immediately after\\ntaking food it is probably due to an ulcer in the upper end, but if\\nthe increase comes later a lesion in the lower end is indicated and,\\nif it be a cancer, it can usually be felt with the hand as a hard lump\\nor tumor in the stomach just below the ends of the right ribs. The\\nappetite is often abnormal with cancer and the patient craves\\nthings that in health he would loathe, but with ulcer this is not\\nthe case. With ulcer the pain is generally relieved by vomiting,\\nbut with cancer it is not. As long as the stomach is at rest there is\\nlikely to be no pain with ulcer, but with cancer there may be pain\\nat any time, and, as the disease progresses, the pain becomes con-\\ntinuous. In either case, or for any irritation of the mucous coat,\\ntwenty grains of subnitrate of bismuth in a tablespoonful of water\\nshould be taken just before each meal to form a coating over the\\naffected parts and prevent irritation and pain. The same diet\\nmust be used as in cases of gastric catarrh.\\nCONSTIPATION.\\nConstipation is an unnatural retention of fecal matter in the\\nbowels, and is a most common disorder. It is almost always\\npresent in dyspepsia, precedes and accompanies most other dis-\\neases, and often follows them. Its causes are many, but chief\\namong them are too much sitting and too little outdoor air and ex-\\nercise, too rich food, the use of opiates, and of tea, coffee, tobacco\\nand other stimulants, inactivity of the muscular coat of the intes-\\ntines, intestinal catarrh, intestinal strictures, taking medicines for\\nevery slight ailment, too frequent use of injections and neglect to\\nheed the calls of nature the last named being a very frequent\\ncause. The health very largely depends upon regularity of the\\nbowels.\\nThe seat of the trouble is the large intestine. This organ\\nis so called because of its size. It is about five feet in length its\\nupper, middle and lower portions being the cecum, colon and\\nrectum. The contents of the bowels are gradually carried down\\ninto the rectum, where their presence excites a desire to discharge\\nthem but if not gratified this desire soon ceases, for the peristaltic", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0260.jp2"}, "259": {"fulltext": "GENERAL DISEASES. Ul\\naction of the intestine presses the feces up into the colon again\\nin which case their liquids are absorbed and their poisonous im-\\npurities taken into the blood, often causing great derangement\\nand very serious disorders.\\nThe liver in its efforts to throw out the poison becomes over-\\nworked and disabled, and is often wrongly blamed as the cause\\nof the trouble, although at the same time the blood may be so\\ncharged with fecal matter as to badly contaminate the breath of\\nthe patient. The kidneys may become clogged with the excess of\\nimpurities, the circulation of the blood be impaired, resulting in\\ncold feet and limbs, and the stomach, pancreas, spleen, heart and\\nbrain all partake of the general disorder.\\nThere is great difference in the frequency with which healthy\\npeople have action of the bowels. Some move them more than\\nonce a day others only once in two or more days but when the\\nusual number is not maintained, and at the same time there is dis-\\ncomfort, a condition is indicated which calls for treatment. Xo\\none who is irregular in this respect can long enjoy good health.\\nSymptoms. Infrequent movement of the bowels; hard,\\nlumpy feces, voided with difficulty inactive liver foul breath\\nbad taste in the mouth in the morning; variable appetite; trans-\\nparent urine sallow complexion headache mental depression\\npalpitation of the heart piles cold feet and a tendency to take\\ncold upon the slightest exposure.\\nTreatment As much as possible remove all the causes. If\\nthe patient has been much confined within doors he should take\\nabundant outdoor exercise, of which, for most people, horseback\\nriding is the best. A change to an outdoor occupation is an ex-\\ncellent way of restoring this function. The bowels should be\\nmoved every day, and the best time for this is just after breakfast.\\nAlways obey nature s call immediately. If there has been no move-\\nment, take a little gentle exercise and half an hour after breakfast\\nsit down in the privy and wait fifteen minutes, making frequent\\nefforts.\\nVigorously kneeding and striking the bowels with the hands\\nfor five minutes or more several times each day is often a great\\nhelp. The diet must be such as to assist in this work. If the\\nstomach will tolerate it the food should consist of coarsely-cracked\\nboiled wheat, preparations from graham, Ralston flour and un-\\nbolted meal, and fruit, either fresh or dried. Fresh fruit is best,\\n16", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0261.jp2"}, "260": {"fulltext": "242 GENERAL DISEASES.\\nThe meals should always be taken at regular hours and all piecing\\nor eating between meals prohibited. It is unwise to drink much\\nduring meals, but water should be taken freely an hour and a halt\\nor two hours later. Drinking a glass of water before breakfast has\\nbeen known to do the work if found to be ineffectual it should be\\ndiscontinued.\\nInjections are often a help, and their efficiency may be in-\\ncreased by adding a little salt or soap, but the more injections are\\nused the more the need for them increases, until the bowels will not\\nmove at all without them. They should, however, be used before\\na movement when the feces have formed into large lumps and be-\\ncome dry and hard. Applications of electricity, also of heat, to\\nthe abdomen are recommended. By patience and a thorough per-\\nsistence in the use of the above simple means the most obstinate\\ncases may be overcome. It is better not to use many drugs, for, as\\nalready seen, drugs frequently cause the disease, but where there\\nare insufficient fluids and diminished peristaltic action, from five\\nto ten drops of the tincture of mix vomica in a glass of water three\\ntimes a day is a most valuable remedy, correcting the constipation\\nwithout the debilitating and other bad effects produced by most\\ncathartics. By acquiring habits of regularity in early life, then\\npersisting in them, most cases of constipation can be avoided.\\nDIARRHEA.\\nDiarrhea is a morbidly frequent evacuation of the bowels, the\\nstools being more or less fluid in character. It is called acute or\\nchronic accordingly as it is of short or long duration. As a rule\\naffections of the large intestine give rise to dysentery and those of\\nthe small one to diarrhea. At least three conditions may occur in\\nthe small intestine, any one of which may cause diarrhea. They\\nare an increase in its peristaltic movements, an increase in its secre-\\ntions, and a diseased condition of its mucous membrane. Two\\nor all of these conditions are often present at the same time.\\nIn diarrhea there is very little if any blood and, next to watery\\nserum, mucus is the most common and constant admixture\\nwith the feces, and when present of course indicates a morbid\\ncondition of the mucous membrane. Although the discharges are\\nalways more or less fluid their character changes with the progress\\nof the disease; and they may range in color from a light yellow\\nto a dark brown in infants they are often green, and in adults are\\nsometimes so fluid and pale as to look almost like rice water.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0262.jp2"}, "261": {"fulltext": "GEXERAL DISEASES. 243\\nACUTE DIARRHEA.\\nThe exciting cause is often very definite. Mental excitement,\\nexposure to cold, irritating foods or medicines, food but partially\\ncooked, food that has commenced to decompose, chunks of meat,\\ngreen or over-ripe fruit, some kinds of plums, raw vegetables, as\\ncabbage, celery, radishes and cucumbers, raw dried fruit and im-\\npure drinking water, especially that containing animal or excre-\\nmentitious matter, may any of them cause diarrhea. It may also\\nbe caused by water impregnated with sewer gas, such as usually\\nfound in cisterns with overflows opening into the sewer.\\nIt is a very fatal disease in infancy and is most frequent among\\nthose living amid bad surroundings, the poorly nourished, and those\\nsuffering front or predisposed to other diseases. It is most com-\\nmon in infants from six to eighteen months of age and its ravages,\\nin the north temperate zone, are greatest in July. Among its\\ncauses in infants the following are prominent\\ni. Improper food. In the very young, food containing\\nstarch will provoke it, because infants until about six months old\\ncannot digest starch. They should not be fed anything but milk.\\nIf the mother s milk be not sufficient, cows milk should be the\\nonly substitute, and, as bacteria cause a large proportion of the\\ndiarrheal disorders in artiiically fed children, care should be taken\\nto get milk that is as fresh and pure as possible and, in every case,\\nto properly sterilize and modify it before feeding.\\n2. Irregularity in feeding.\\n3. Exposure to cold. Very young children must be pro-\\ntected against sudden changes of temperature, and, if predisposed\\nto diarrhea, must, while in health as well as while suffering from\\nan attack of the disease, wear soft flannel next the skin.\\n4. Weaning in hot weather. Except in cases of emergency,\\na child should never be weaned during hot weather.\\n5. Increase in atmospheric heat. The prevalence of the\\ndisease increases as summer advances until mid-summer is reached,\\nafter which it usually gradually subsides. Although very com-\\nmon in warm weather among children cutting teeth, it is by no\\nmeans a necessary accompaniment of dentition, and then, as at all\\nother times, thorough means should be used to effect a cure.\\nDiarrhea of mild form may be attended by very little disturb-\\nance of the general health in adults, though to the aged and those in\\nmiddle life who have been weakened by other diseases it may some-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0263.jp2"}, "262": {"fulltext": "244 GENERAL DISEASES.\\ntimes prove fatal, but to infants it is a very dangerous disease, a\\nslight diarrhea often causing great loss of vital power, as indicated\\nby coldness of the extremities, dark color and sinking in of the\\nspaces around the eyes, and depression of the fontanels (spaces be-\\ntween the skull bones) the last being a most valuable sign, since\\nit may give warning of clanger at an early stage of the disease,\\nwhen otherwise there may seem to be little if any cause for\\nalarm.\\nEpidemics of diarrhea are thought to be due usually to a com-\\nmon cause rather than to contagion or infection, but, as some\\nforms of the disease are caused by germs, it is a wise precaution\\nto carefully disinfect the discharges and all clothes soiled by the\\npatient and, as much as possible, to avoid exposure to the disease.\\nUnless prolonged by continued use of bad water or bad food, or\\nby bad surroundings, acute diarrhea runs its course in a period\\nvarying from a few hours to a week or ten days.\\nSymptoms. The following are symptoms, though they may\\nnot ah be present in one case Looseness of the bowels or purging;\\npain in the abdomen nausea vomiting foul breath headache\\ngas faintuess dizziness and a sense of great weakness. Children\\nmore often than adults have fever with diarrhea, but more fre-\\nquently the surface, especially of the hands, feet and limbs, is cold.\\nTreatment for Adults. In an adult it is not best to im-\\nmediately check a diarrhea of mild form lest the patient be\\nthrown into some more serious disorder but if the attack be of any\\nSeverity he should seek absolute rest in bed and heat should be\\napplied to the abdomen, or a mustard poultice used instead, or a\\nlayer of batting be spread over the abdomen and covered by oil-\\nlinen to retain the animal heat, and care must be taken to keep\\nthe feet and limbs warm. First give from one to two tablespoon-\\nfuls of castor oil to clear the stomach and intestines of all irritating\\nsubstances. If preferred, the patient may take rhubarb instead,\\nbut it is not as good a remedy. Ten hours later he should take\\nfrom fifteen to forty-five grains of subnitrate of bismuth, and repeat\\nthe dose after each movement.\\nGreat benefit is often derived from an injection. It should\\nconsist of a quart of water that has been well boiled, then cooled\\nto the point of endurance, thrown into the rectum with a syringe\\nand retained as long as possible. The hotter it can be taken with-\\nout burning the more it will relieve pain. Cloths wrung from ice\\nwater and applied to the rectum are an aid.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0264.jp2"}, "263": {"fulltext": "GENERAL DISEASES. 245\\nAlthough prescriptions containing a large number of in-\\ngredients are not as highly favored now as formerly, the follow-\\ning has given such excellent results, and can be so easily kept on\\nhand for a household remedy, we recommend it\\nLaudanum two drams\\nSpirits of camphor two drams\\nTincture of rhubarb two drams\\nTincture of myrrh two drams\\nTincture of Cayenne pepper one dram\\nGive from five to thirty drops after each movement until the\\nbowels are controlled. This sometimes succeeds where bismuth\\nfails.\\nThe patient will often be greatly helped by an abdominal\\nbandage. It should be a strong soft cloth about a foot wide\\npinned snugly around the body. Soft flannel underclothing\\nshould be worn during the attack and until full recovery by those\\npredisposed to the disease it should be worn all the time.\\nThe diet should consist of beaten eggs cooked in water, boiled\\nmilk, either pure or diluted with lime water, boiled rice and milk,\\nbroths, beef tea and other bland articles. Until full recovery the\\npatient must refrain from meat and all rich and irritating food.\\nTreatment of Infants. Although in adults it is not best to\\ncheck a diarrhea immediately, in children it should be arrested at\\nthe very beginning, or as soon thereafter as possible, for with them\\nit often does its work quickly. First give castor oil, a teaspoon-\\nful to a child of from three to six months, and proportionally more\\nto those that are older, and in five or six hours give from five to\\nten drops of paregoric, or from five to ten grains of subnitrate of\\nbismuth, after each movement. It should take very little food\\nfor twenty-four hours, after which its diet should be breast milk,\\nthin broth, or fresh milk that has been properly sterilized and\\nmodified, and to which a little lime water has been added.\\nTo guard against another attack the careful feeding should\\ncontinue five or ten days after recovery. Until quite well the\\nchild must be kept very quiet in bed, for running about at this\\ntime is very injurious.\\nCHRONIC DIARRHEA\\ngenerally given to a\\nthan fifteen days it is. however, a very different form from acute\\nThis is the name generally given to a diarrhea lasting more", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0265.jp2"}, "264": {"fulltext": "246 GENERAL DISEASES.\\ndiarrhea, and may last months or even many years. The intes-\\ntines may then present appearances thought to be due to chronic\\ncatarrhal inflammation, but in many cases examinations made\\nafter death have failed to disclose any change at all in the intes-\\ntines, although the patient had suffered a very long time from\\nthis disease. Bad surroundings, old age, an enfeebled constitu-\\ntion, chronic disorders of digestion, all are predisposing causes.\\nIt is so uniformly present in tuberculosis, typhoid fever and\\nsyphilis as to constitute prominent symptoms of those diseases.\\nIn addition to what has been said, an extended description\\nis not needed to enable anyone to recognize a case of chronic\\ndiarrhea, but it may arise from so many different causes, or com-\\nplications, as to baffle the most skillful physician in his efforts\\nto prescribe a cure. In general it may be said that the same\\nremedies and diet should be used in this as in the acute form,\\nbut they must be used a long time steadily and with great per-\\nsistence. Astringents are often valuable here, although they\\nshould not be used for the acute form.\\nAs long-continued diarrhea steadily saps the strength, means\\nmust be used to keep up the vitality. For this purpose beef juice\\nis excellent, for by its use the patient obtains the nutrients of\\nthe beef without incurring the risk of injury from its coarse and\\nirritating fibers. It is prepared by cooking good steak just enough\\nto heat it through, then, while hot, extracting its juice with a\\npress or lemon squeezer, and salting to the taste. The white\\nof an egg, whipped into foam and eaten with boiled miik, is also\\nrecommended. To increase its richness a teaspoonful of sugar of\\nmilk (not cane sugar) should be added to each tumblerful of the\\nmilk.\\nSlices of white bread, kept in a moderately hot oven until\\nbrown and crisp clear through, eaten with boiled milk, is a very\\nvaluable food at this time. In both of these dishes a little lime\\nwater should be added to the milk to aid in its digestion. Both\\nare better eaten hot.\\nDYSENTERY.\\nDysentery is an inflammation of the rectum or colon, attended\\nwith griping pains, constant desire to evacuate the bowels, and\\ndischarges of mucus and blood. There is likely to be chilliness\\nfollowed by high temperature, ulceration of the intestine and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0266.jp2"}, "265": {"fulltext": "GEXERAL DISEASES. 247\\nburning pain in the rectum. In the epidemic form the disease\\nis infectious, being due to germs, and to prevent its spread great\\ncare should be taken to disinfect the discharges, and all articles\\nused about the patient as soon as removed from him, and only the\\nnurse should be admitted to his room.\\nTreatment To cleanse out the intestine the patient should\\ntake a tablespoonful of Epsom salts in a glass of hot water, and\\neach evening at bedtime be given an injection made up as follows:\\nLaudanum fifteen drops\\nQuinine twenty grains\\nSubnitrate of bismuth forty grains\\nWater four to six ounces\\nwhich should be held in the rectum as long as possible.\\nAlthough he may feel able to be up, the patient should re-\\nmain quiet in bed, and should be kept warm, especially his feet\\nand limbs. Sponge the body with water and vinegar or alcohol\\nto cool the burning skin, and wash the anal region often with a\\ndisinfectant, such as a solution of boric acid, after which anoint\\nthe rectum with vaseline. Cold applications, such as recom-\\nmended for diarrhea, may also be made to the rectum. To relieve\\npain in the bowels apply heat to the abdomen. The diet should\\nbe restricted to a small amount and should consist of such articles\\nas named in the treatment for diarrhea. There should be no\\ncold food taken, and tea, coffee and tobacco should be let alone.\\nIf properly treated the patient will soon be well, but to prevent\\na recurrence he should guard against exposure, improper food\\nand overexertion for some weeks.\\nObstinate cases of chronic dysentery are thoroughly cured\\nonly by a sea voyage, a sojourn at the seashore or in the moun-\\ntains, or some other change of climate and surroundings.\\nCHOLERA MORBUS.\\nCholera morbus is thought by some to be a form of acute\\ngastric catarrh which extends to the mucous membrane lining\\nthe intestines, but it is quite as likely that it is often a result of\\nnervous exhaustion. It most often occurs in hot countries but is\\ncommon throughout the temperate zones, and is most frequent\\nthere during the middle and latter parts of summer when the\\ndays are hot and the nights are cool. It is found also among\\nadults, but is most frequent in youths and children.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0267.jp2"}, "266": {"fulltext": "248 GENERAL DISEASES.\\nIn hot weather persons of very nervous tendencies, those\\nundergoing severe nervous strain, and those much reduced by\\ngreat bodily fatigue are the most liable to the disease, a fact that\\nhas led to the belief that because of exhaustion of the motor nerves\\nof the stomach the digestive processes are impaired and food,\\nremaining longer than it ought in the stomach, gives rise to\\npoisonous fermentative products, irritating to the sensory nerves\\nand exciting more and more disturbance.\\nIt is so called from the close resemblance of many of its symp-\\ntoms to those of Asiatic cholera, but the two are very different\\ndiseases. Cholera morbus is characterized by very severe ab-\\ndominal pain centering near the navel, nausea, violent and frequent\\nvomiting, purging of watery stools, very painful contraction of the\\nmuscles, especially of those of the calf of the leg and the ex-\\ntremities. The countenance has a pinched, sunken appearance and\\nis of a pale or bluish cast the pulse becomes weak and very rapid;\\nbreathing is difficult the mouth and tongue are dry and there is\\ngreat thirst. The surface of the body has a shriveled look and is\\ncold, but the internal temperature may range from 99 degrees to\\n102 degrees. Because of the transudation of serum into the\\nstomach and intestines the blood constantly becomes thicker and\\nthe secretions, especially the urine, are greatly diminished, if not\\nentirely stopped.\\nThe attack often comes in the night and usually is very sud-\\nden. The food last eaten is first vomited and appears but little\\nchanged, but as vomiting is repeated there are large quantities of\\npale yellow or greenish fluid thrown out with great force; there\\nis rumbling or gurgling of air in the intestines the stools be-\\ncome thin and fluid, and the greater their quantity the less their\\ncolor until they assume a rice-water appearance the voice be-\\ncomes faint, the patient weakens rapidly and there are signs of\\na general collapse. But no matter how bad the symptoms or how\\ngreat the depression of the patient, a previously healthy adult al-\\nmost always recovers in a few hours, though an attack may last\\nthree days. Usually the vomiting and purging gradually grow\\nless frequent and the exhausted patient falls asleep to awake\\nin a few hours greatly restored.\\nTreatment. The treatment must be adapted to each case.\\nIf begun before sufficient vomiting has occurred to clear the\\nstomach of all undigested food, emetics of hot water and mustard", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0268.jp2"}, "267": {"fulltext": "GENERAL DISEASES. 249\\nflour or common salt should be given and repeated until the\\nstomach is thoroughly emptied but if there be frequent vomiting\\nof green watery material containing no undigested food, and there\\nbe much purging, pain, cramps and great weakness, a hypodermic\\ninjection, consisting of one-eighth of a grain of morphia and one-\\ntwo hundredth of a grain of atropia, is the best remedy, and if\\nthe patient is not greatly relieved another should be given in two\\nhours, care being taken in every case to first thoroughly disinfect\\nthe syringe by placing it in alcohol or boiling water. It is better\\nnot to give brandy or any other stimulants, in connection with the\\nmorphia. To patients who object to hypodermics a tenth of a\\ngrain of calomel should be given every half-hour until ten doses\\nhave been taken, and with every other dose one-twentieth of a\\ngrain of morphia should be given by the mouth. The extremities\\nshould be warmed by free friction and applications of heat, as hot\\nwater bottles and the like. In case the vomited material be\\nstrongly acid, bicarbonate of soda and subnitrate of bismuth, five\\ngrains of each, may be given. Unless the vomiting is excessive\\nit is better not to try to check it. In mild cases children may\\nrequire no other medicine than a dose of castor oil, but calomel,\\nin one-tenth-grain doses every hour until eight or ten have been\\ntaken is a better remedy. Bits of ice are good to quench thirst,\\nbut ice-cold ginger ale, a half glass at once, is excellent, and,\\nif the ale cannot be obtained, hot ginger tea is good to restore tone\\nto the stomach. As this organ needs absolute rest no food should\\nbe given for a long time, and then the diet should be very light\\nand consist of easily digested and nutritious food.\\nCholera morbus very rarely proves fatal except in weak or\\naged people, or in children to the latter, especially, it is a danger-\\nous disease. To guard against a second attack indulge but spar-\\ningly in iced drinks, avoid exposure to night air, dampness and\\nsudden changes of temperature, protect the body with plenty of\\nblankets at night, discard all green or over-ripe fruits and foods\\nliable to fermentation, and attend promptly to attacks of indiges-\\ntion and all irregularities of the bowels.\\nCOLIC.\\nColic, from a Greek word which signifies pertaining to the\\ncolon, is a term that, properly used, applies only to such affections\\nas are attended with severe pain in the abdomen and with spas-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0269.jp2"}, "268": {"fulltext": "250 GENERAL DISEASES.\\nmodic contractions of the muscular walls of the intestines, but\\nmany of the symptoms are so similar to those of neuralgia of the\\nintestines (enteralgia) that the name is also often applied to the\\nlatter disease; hence, to be explicit, some writers designate the\\nformer as intestinal colic. Its causes are numerous, but the prin-\\ncipal ones are direct irritation of the bowels by green fruit, stale\\nor decaying vegetables, or other improper or undigested food, acrid\\nor poisonous substances, ices, cold drinks, excessive secretion of\\nbile, retained feces, as when associated with constipation, gas, for-\\neign bodies, as fruit-stones or worms, various forms of intestinal\\nobstruction, the morbid conditions of the blood sometimes at-\\ntending gout and rheumatism, taking cold, lead poisoning, dis-\\norders of the nervous system, strong emotion, etc. Similar symp-\\ntoms may be caused by reflex irritation, as in ovarian and uterine\\naffections, and by the passage of kidney stones or gall stones.\\nSymptoms. Attacks of severe pain in the abdomen, often\\nvery sudden and intermittent, usually most severe about the navel\\nbut sometimes spreading over the whole abdomen and liable to\\nchange from one place to another; sometimes so intense as to be-\\ncome excruciating agony, known as twisting, tearing or griping\\npain. Pressure almost always gives relief, the patient bending over\\nsomething, as the back of a chair, or pressing the abdomen with\\nhis hands, or lying upon his stomach. The bowels are usually con-\\nstipated and distended with gas, but sometimes there is diar-\\nrhea. The spasmodic movements of the bowels and their motions\\nfrom the rolling about of the gas can sometimes be seen, felt and\\nheard. The abdominal muscles are often knotted or rigidly con-\\ntracted. There is no fever. Vomiting may occur, but in that\\ncase the difficulty is likely to be in the stomach. The attack may\\nfinally end as abruptly as it came, and be followed by great relief\\nand comfort, but on the other hand it may last so long and be so\\nsevere as to threaten collapse.\\nTreatment. The first thing to do is to stop pain and spasm,\\nthen find and remove the cause if possible. An injection of\\nwater as hot as can be borne, to which has been added twenty\\ndrops of turpentine or two teaspoonfuls of tincture of assafetida,\\nis generally useful if there is much gas, or a brisk purgative may be\\ngiven by the mouth. In children, especially, the large intestine\\nmay often be relieved of gas by gently inserting through the anus\\na long flexible tube, the patient lying face downward with his", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0270.jp2"}, "269": {"fulltext": "GEXERAL DISEASES. 251\\nshoulders lower than his hips. In less urgent cases a full dose of\\ncastor oil is recommended, and this is often best preceded by one-\\ntenth of a grain of calomel every hour until one grain has been\\ntaken. Hot drinks, as peppermint, anise, or wintergreen tea, may\\nafford relief in the milder cases. The patient should be covered\\nwarmly in bed and applications of heat, as hot water bottles, hot\\nsand bags, or hot fomentations, be applied to the abdomen and\\nrenewed as often as they cool. Gentle friction is also an aid.\\nA little whisky and hot water is often a good remedy. If\\nan opiate is given, paregoric is the best; dose from ten to forty\\ndrops. For severe cases a hypodermic injection of morphia\\nis the best remedy to give quick relief, but a few cannot take\\nthis drug and there are very serious objections to using it at all.\\nOne-third of a grain of morphine paralyzes the peristaltic action\\nof the intestines for ten or twelve hours, and, without removing\\nthe cause, so quiets or deadens the pain and tenderness in the\\nbowels as to make it impossible in many cases to distinguish\\nthe comparatively harmless forms of colic from those caused by\\nintestinal obstruction, the early relief of which by surgical means\\nis often necessary to save life. For this reason many of the\\nbest physicians no longer use morphine in treating this disease.\\nChloroform or ether by inhalation, or by the mouth, is excel-\\nlent, but these remedies should be used sparingly, with great\\ncare, and under the direction of a physician. Use stimulants to\\ncombat threatened collapse. The patient may be greatly pros-\\ntrated at the end of the attack, but gets well. Careful attention\\nto diet and general hygiene should then be exercised to guard\\nagainst other attacks.\\nFor enteralgia a gentle galvanic current is often the best\\nremedy. See Neuralgia. For the lead poisoning cases see the\\nchapter on Poisons.\\nINTESTINAL OBSTRUCTION.\\nIntestinal obstruction may be caused by intussusception,\\nwhich is a drawing or telescoping of the intestine into itself, as\\na part of the finger of a glove may be drawn into another part\\nby contraction of the diameter of the intestine; by a twisting\\nof the intestine upon itself; by an entanglement of the intestine\\nknown as strangulation by compression, as from tumors or other\\nmorbid growths, or from uterine displacement and by impac-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0271.jp2"}, "270": {"fulltext": "252 GENERAL DISEASES.\\ntion of hardened feces in the lower end of the large bowel. The\\nlatter condition may be relieved by carefully removing the feces\\nwith the handle of a spoon or similar instrument, or better,\\nby inserting the finger into the rectum and with it breaking up\\nthe feces, introducing water during the process as may seem\\nadvantageous then, as soon as a way is opened for it, adminis-\\ntering a large injection of soap and water and repeating as often\\nas necessary to thoroughly empty the bowel. As the other\\nforms of intestinal obstruction are usually serious and demand\\nearly attention, and are likely to need very skillful treatment,\\nthey should be promptly placed under the care of the best\\nphysician. Irreparable injury might be done by giving a severe\\npurgative, or by waiting too long before applying the right rem-\\nedy. They are too serious for domestic treatment.\\nSymptoms. The symptoms of obstruction are extreme pain\\nin the intestines, persistent vomiting, vomiting fecal matter, im-\\npeded respiration, anxious expression, cold sweat upon the fore-\\nhead, bowels enlarged with gas, constipation, great prostration,\\nand, in bad cases, persistent hiccough.\\nSEA-SICKNESS.\\nSea-sickness is generally defined as a nervous affection,\\nattended with nausea and vomiting, produced by the motions\\nof a ship at sea, ibut it is identically the same condition as that some\\ntimes caused on land by such unusual motions as riding backward,\\ngoing swiftly up and down in an elevator, swinging, turning rap-\\nidly, etc. The experiences at sea are more serious since their\\ncause is more prolonged.\\nThe real nature of sea-sickness has never been explained.\\nSome persons have it every time they take a voyage, others have\\nit but once, a few never have it at all, and it comes in calm weather\\non a smooth sea to a few who are not affected in the strongest\\ngales. It may last but a few hours, or may cling to one as long\\nas the voyage lasts, but it almost always ceases as soon as the\\npatient lands. In many cases it leaves its victims in much better\\nhealth than they had before it attacked them, especially such\\nof them as were affected with disorders of the liver or digestive\\norgans, melancholia, or intermittent fevers. To those suffering\\nwith organic stomach, heart, lung or brain disease, and to pregnant", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0272.jp2"}, "271": {"fulltext": "GENERAL DISEASES. 253\\nwomen, it is dangerous; and such persons should not take sea-\\nvoyages.\\nAs preventives, exercise in swings, and taking medicines, are\\nof little avail, but eating only light, easily digested food for three\\nor four days before going on board is a wise precaution. Many\\nsailors recommend wearing a tight girdle. If the voyage is to\\nbe a short one, sea-sickness may be diminished or escaped entirely\\nby taking one s bed as soon as any nausea is experienced, retaining\\nthe horizontal position for twenty-four hours, keeping a bag of ice\\nupon the back of the neck, keeping the eyes closed, and eating very\\nlittle, and that only of the lightest food. Indeed, after a day or two\\nof this, many persons find themselves able to go about ship without\\nfurther difficulty. As the smell of bilge, and other foul odors, in\\nunventilated parts of the ship, are liable to aggravate the diffi-\\nculty, the patient, after this preliminary, is likely to be better off\\nwhen dressed warmly and in the open air.\\nTreatment. To control the nausea and vomiting, wash out\\nthe stomach with a tube keep the bowels regular, by using a\\nhot enema if needed apply heat to the stomach and ice to the\\nspine opposite the stomach lie quietly in bed, and quench thirst\\neither by holding in the mouth bits of ice or drinking sparingly\\nof hot liquids. Things that work well in some cases fail in others.\\nEffervescing citrate of magnesia, soda water and lemon juice are all\\ngood remedies. Sucking an orange will sometimes restore the\\nnormal tone to a debilitated stomach. When the appetite re-\\nturns, eat very moderately and only of light, easily digestible foods.\\nAvoid all sweets, alcoholic drinks, fried foods, pastries, and the\\nlike.\\nAPPENDICITIS AND TYPHLITIS.\\nThe vermiform appendix is a small tube or gut attached to\\nthe back part of the cecum (upper portion of the large in-\\ntestine). It is about as large as a goose quill, from three to six\\ninches long, may be either curved or straight, and at its free end\\ncomes to a sudden or blunt termination.\\nIts purpose was long a puzzle to anatomists, but the best\\nauthorities now regard it merely as a remnant of the subsidiary\\nstomach of the lower form of life from which man has come,\\nand that it is of no use whatever to the human organism. In\\nmany persons it is entirely wanting and from many more it has\\nbeen removed without, in the least, impairing any function of the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0273.jp2"}, "272": {"fulltext": "254 GENERAL DISEASES.\\nbody. In health it is filled with a tough mucus, and for several\\nyears in childhood is partially closed by a valvular fold of mucous\\nmembrane at or near its opening into the cecum.\\nInflammation of this appendix is called appendicitis.\\nInflammation of the cecum is called typhlitis.\\nMany writers hold that the latter is always an outgrowth\\nfrom the former disease the inflammation beginning in every\\ncase in the appendix and spreading from it to the large intestine.\\nBe that as it may, the two disorders are so closely related, and\\nour space so limited, we will follow the usual custom of con-\\nsidering them both under the general head of typhlitis.\\nAbout half the cases of appendicitis are caused by hard sub-\\nstances in the appendix, for when they have made an entrance\\nit has no means of expelling them. These substances sometimes\\nremain in this structure indefinitely without doing any harm, but\\nin other cases, sooner or later, lead to inflammation and most\\nserious consequences. Such foreign bodies as intestinal worms,\\nseeds, pills, bristles, pieces of bone, shot, etc., may be exciting\\ncauses, but by far the greater number of cases are occasioned\\nby small stones, called concretions, formed from fecal matter and\\noften closely resembling a cherry stone in appearance. Tuber-\\nculosis (consumption) is sometimes the cause, and other germs\\nor disease virus may start the inflammation, but in many cases\\nit has been impossible to discover any cause. It may occur at any\\ntime of life, but is most frequent between the ages of twenty\\nand thirty years, and more common in the male sex, due, it is\\nbelieved to the female appendix having an additional artery and a\\nbetter blood circulation than has the corresponding structure in\\nthe male.\\nAs already explained, the inflammation soon extends to and\\ninvolves the cecum, thus becoming typhlitis. It is sometimes\\nimpossible to distinguish this disease from a case of mechanical\\nobstruction of the bowels; many of its symptoms are like those\\nof local peritonitis, and some of them resemble those of typhoid\\nfever, so, as a rule, it is only the milder cases that can be satis-\\nfactorily diagnosed those in which inflammation has not ex-\\ntended beyond the serous covering of the cecum and the adjacent\\nparts.\\nSymptoms. Pain, likely to be spasmodic and of great\\nseverity; tenderness, often so great that the patient cannot bear", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0274.jp2"}, "273": {"fulltext": "GENERAL DISEASES. 255\\nthe slightest touch nausea, vomiting and constipation, all usually\\nvery persistent loathing of food heavily furred tongue and foul\\nbreath a stooping posture and disinclination to either stand\\nor walk; a sensation in the right leg as of ants crawling over the\\nskin hard, quickened pulse scant, high colored urine often the\\nfirst symptom is a chill, closely followed by acute pain, which soon\\nbecomes constant and terribly severe, and the anxious look and\\nappearance of suffering seen in peritonitis is observed. An ill-\\ndefined, rounded swelling extends upward from the iliac region\\n(the point of greatest tenderness) toward the right loin, princi-\\npally due to the accumulation of fecal matter in the cecum.\\nIts form and size may change from day to day, and if the disease\\nsubsides the swelling gradually disappears.\\nTreatment. The patient must be kept perfectly quiet and the\\ndiet be only liquid food, and but little of that. Not a bit of physic\\nshould be given, but opium should be freely used, just as in treat-\\ning peritonitis, and the same precautions must be observed be-\\nfore beginning its use. When the disease subsides the greatest\\ncare must be used to prevent a relapse, for the disease is very\\nprone to recur even after a considerable time. Give only liquid\\nfood for quite a number of days after all need for the precaution\\nseems to have passed, and move the bowels only by use of in-\\njections. Very slight straining or exertion may result in per-\\nforation, which is usually recognized at once by the signs of\\ncollapse, death quickly following. The disease usually runs its\\ncourse in from fourteen to twenty-one days.\\nIn no other direction, perhaps, has modern surgery been more\\nsuccessful than in the treatment of appendicitis and typhlitis, for in\\nthe latter disease perforation of the appendix is one of the dangers\\nto be greatly feared, a contingency easily avoided by a prompt and\\nskillful use of the knife.\\nPERITONITIS.\\n(Inflammation of the Bowels.)\\nPeritonitis is inflammation of the peritoneum (the thin,\\nsmooth, serous membrane lining the abdominal cavity and cover-\\ning the stomach, intestines, etc.). It is either acute or chronic,\\nand is called local or general, accordingly as it affects a small\\nportion of the membrane or spreads over the greater part or all\\nof it. It is common to all ages of life, and sometimes seems to", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0275.jp2"}, "274": {"fulltext": "256 GENERAL DISEASES.\\noccur spontaneously, but can usually be traced to some one of a\\nlarge variety of causes, such as blood poisoning, or other morbid\\ncondition of the blood an injury, as a wound, blow, or surgical op-\\neration tuberculosis, abscess, appendicitis, typhoid fever, Bright s\\ndisease, cancer, disease of the heart, lungs or pleura, and perfora-\\ntions of the stomach or intestines; ruoture is also a frequent\\ncause.\\nSymptoms. The attack is likely to be sudden, and the first\\nsymptom to be pain in a small part of the intestines, but soon\\nspreading over every part of the bowels, and as the pain ad-\\nvances tenderness comes and increases more and more until the\\nslightest touch and the movements of breathing are painful. The\\nbowels become greatly puffed out with gas, and the patient,\\nto relieve the abdomen from tension as well as to protect it from\\nthe weight of the bed clothes, lies upon his back with his knees\\ndrawn up.\\nThere is vomiting, often of a deep green color, and a fever,\\nwith pulse sometimes reaching from ioo to 120 per minute in two\\nor three hours after the beginning of the attack. The face is\\npale, haggard and anxious, the eyes sunken, the teeth set and lips\\ntightly drawn, the expression of the whole face being one of ex-\\ntreme suffering. The disease usually runs its course in a few\\ndays, rarely in forty-eight hours, and sometimes lasts over a\\nweek. A case is recorded in which the patient recovered after\\nforty-five days. Peritonitis is always very dangerous, but its\\ntermination depends largely upon the promptness with which\\ncorrect treatment is begun, and the vigor and persistence with\\nwhich it is conducted. When it follows perforations, tuber-\\nculosis or cancer, the case is almost hopeless.\\nTreatment. The treatment must depend upon the cause, and,\\nof course, be such as to allay inflammation as much as possible.\\nComplete rest and abstinence from food are necessary through-\\nout the entire disease. The patient should be put to bed and\\ngiven neither food nor drink, his thirst being allayed by bits of ice,\\nwhich are also valuable to suppress vomiting. All nourishment\\nmust be given by the rectum, either as suppositories or injec-\\ntions.\\nCathartics of any kind should not be given. Dr. Alonzo\\nClark, who is an authority, says the bowels should be left entirely\\nat rest until they recover their muscular tone, when they will expel", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0276.jp2"}, "275": {"fulltext": "GENERAL DISEASES. 257\\nfirst the e as, then the feces, or if, after the inflammation has sub-\\nsided, they do not move of their own accord, injections may be\\ngiven and adds that he has often left the bowels absolutely inac-\\ntive in this disease for fourteen days without recognizable con-\\nsequences. Generally, however, it is considered best by many to\\nfreely move the bowels at the beginning of the attack by means\\nof an injection of water and soap, and then to give them ab-\\nsolute rest.\\nDuring the acute period of the disease a cold water or ice\\npack should be spread over the whole abdomen to arrest the in-\\nflammation, care being taken not to make it so large and heavy\\nas to increase the discomfort of the patient. If cold water is used\\nthe cloths should be wrung from ice water and changed every\\nten or twelve minutes. Later, flannels wrung from hot water,\\nor heated between folds of paper upon the stove, and liberally\\nsprinkled with laudanum, should be applied instead of the cold\\nones. There is likely to be some doubt as to when the change\\nfrom cold to hot applications should be made. Probably the feel-\\nings of the patient is the best guide, for in the acute stage the cold\\nis usually well borne. Opium is the sovereign remedy in this\\ndisease. From five to ten drops of the tincture should be given\\nevery four hours as long as there is pain, but the use of opium\\nshould not be begun until a diagnosis has been made by the best\\nphysician within reach, for opium, by allaying the pain and tender-\\nness, destroys the most characteristic symptoms of the disease so\\nthat it may then be impossible for even the most skillful to make\\nout the true nature of the trouble until the effects of the opiate\\nhave worn away.\\nWhile recovery is taking place, the inflamed serous mem-\\nbranes sometimes become attached to each other, resulting in\\nthe folds of the bowels growing together, or growing to the walis\\nof the abdomen, in such a way as to form strictures, or stoppages\\nof the intestines, menacing health and even life. In some cases\\nthese adhesions can be broken up by hot and cold applications,\\nusing first one, then the other, changing every five minutes, and\\nsometimes a surgical operation is the only resort.\\nAs this is usually a result of some other disease, and a very\\nimportant part of all treatment is removal of the cause, no minute\\nrules can be laid down for the management of all cases of peritoni-\\ntis. Often the cause is so hidden as to baffle the most skillful.\\n17", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0277.jp2"}, "276": {"fulltext": "258 GENERAL DISEASES.\\nThe best physician within reach should be called immediately,\\nand the giving of opium postponed until after his examination,\\nlest by its reduction of pain important symptoms be concealed.\\nThere are cases in which very large doses of calomel are advised\\nby the best masters of the healing art.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0278.jp2"}, "277": {"fulltext": "CHAPTER II.\\nBy R. E. McVev, M.D.\\nTYPHOID FEVER.\\nTyphoid fever is a germinal disease, and occurs most fre-\\nquently during the autumn months. The germ is supposed to\\nenter the system through the alimentary canal. Cess pools,\\ndirty stables, barnyards, or any place that has become\\nsaturated with fecal matter, piles of rotting manure, and\\nmost other accumulations of filth, are its favorite breeding places.\\nIt is probable that in by far the greatest number of cases it is\\ntaken into the system in drinking water that has become con-\\ntaminated from some such source, but it may also be carried\\nin milk that has been infected by dilution or from cans or other\\nvessels that have been washed in impure water. In the same way\\nfruits and other foods may become a medium of contagion. Oys-\\nters in beds near the mouths of sewers, or where sewage is de-\\nposited by polluted currents, sometimes become infected with\\ntyphoid, and have been known to transmit the disease to persons\\neating them raw. Thorough cooking would have destroyed the\\ngerms.\\nThe alarming spread of this fever in our military camps during\\nthe late war was found by the board of investigation to have been\\ndue to an ignorant, if not criminal, disregard of simple sanitary\\nrules. From feeding upon excrementitious matter in open latrines,\\nswarms of house flies passed to the hard tack and other food of\\nthe troops, infecting it with millions of germs carried upon their\\nrough, hairy little feet. Had all fecal matter been promptly and\\nproperly covered with fresh earth, and all water been kept pure,\\nor thoroughly boiled before it was used in food or as drink,\\npractically all of the dreadful scourge would have been avoided.\\nIn perfect health the acidity of the stomach is usually sufficient\\nto destroy these germs, in which case they do no harm, but, enter-\\ning when this organ is in a deranged condition, they pass through\\nto their favorite fields, the Peyerian glands in the last section of the\\nsmall intestine.\\n259", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0279.jp2"}, "278": {"fulltext": "260 GENERAL DISEASES.\\nThe first change wrought is in the blood; the second, in the\\nspleen, which, by percussion, is found to be tender after the first\\nchill, and later undergoes very marked changes, becoming en-\\nlarged and of diminished consistency. It continues to grow larger\\nuntil the end of the third week, when it becomes soft like jelly, and\\nis easily broken down, even by moderate pressure, and when re-\\nmoved from the body its cavities collapse.\\nThe capillaries of the lungs are filled with blood, a condition\\nliable to result in static pneumonia. Changes in the brain and\\nnervous system are only inferential. The salivary glands may be-\\ncome hard like cartilage, which explains the lack of secretion or\\nmoisture in the mouth. Changes in the glandular structures of\\nthe stomach give rise to digestive disturbances.\\nThe essential lesions of typhoid fever are found in the lymph\\nstructures of the intestine, the infiltrated cells being the lymphoidal\\ncells. Four or five glands, near the valve joining the smaller to\\nthe larger intestine, are involved. There is soon an abnormal\\naccumulation of blood and catarrh of the mucous membrane, and\\nthere is also enlargement from increase of cells in the glandular\\ntissue. These abnormal changes may terminate by absorption\\nor by resolution. The most frequent way is through separation of\\nthe dead tissues by a slough, or by the formation of typhoid ulcers.\\nIn the fourth week cicatrization commences, gradually the swollen\\nedges of the ulcers heal, and, springing up from their bottoms,\\nconnective tissue membrane is formed the fever gradually sub-\\nsides, and the patient slowly returns to health.\\nSymptoms. The length of time from the entrance of the\\ngerm into the system until the first symptom is probably unknown.\\nThe first manifestations of the disease are so mild and gradual that\\nit is often hard for the patient to tell exactly when the attack\\nbegan. The symptoms most commonly noticed at the onset are\\nfrontal headache with giddiness and noises in the ears, general\\npains in the limbs and back, with feelings of lassitude and illness,\\nrestlessness and disturbed sleep, slight and irregular chills, diar-\\nrhea, loss of appetite, tongue furred with a thin whitish or yellowish\\ncoat, not extending to the tip and edges, which may be quite red,\\nnausea and vomiting; but no disease presents more diversity at the\\nbeginning, and any of its symptoms may be either greatly exag-\\ngerated or wanting altogether.\\nRarely at first, there is a moderate fullness from gas in the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0280.jp2"}, "279": {"fulltext": "GENERAL DISEASES. 261\\nbowels, with tenderness and a slight gurgling upon pressure in\\nthe right iliac fossa (the region in the right side of the abdomen\\nin front of and near the upper part of the hip bone), but generally,\\nand in the severer cases almost invariably, there will be some pain\\nand tenderness in this spot by the sixth day, generally increasing\\nas the disease advances, and in some cases becoming so great as\\nto be unbearable, even if pressed slightly a condition due to the\\nulceration of the Peyerian glands because of the poison generated\\nwithin them by the typhoid germs. Sometimes there is much ab-\\ndominal pain very early in the attack. In some cases diarrhea is\\nthe only prominent symptom for some days; in some, instead of\\ndiarrhea, there is constipation throughout the full course, of the\\ndisease and there are very rare cases in which there are no ab-\\ndominal symptoms from first to last.\\nThe tongue may be quite clean for several days, even when\\nthere is high fever, and, when coated with the thin whitish fur, it is\\nusually small and moist, but it may be laree and thickly coated, or\\nred, smooth and glazed. There may be repeated bleedings at the\\nnose. In a few days the fever begins to increase toward evening,\\nand the temperature is soon found to be rising steadily from day to\\nday, and from morning until evening and to decrease from evening\\nuntil morning. This, in connection with several of the above\\nsymptoms, is a very strong indication of typhoid, especially if in\\nfour or five days the temperature is 103 or 104 degrees, but the\\nother symptoms by themselves are not very positive signs, for\\nthey may be present in the early stages of other fevers, hence it\\nmay be impossible during the first few days to positively diagnose a\\nease of typhoid fever.\\nIt often happens that the patient does not feel sufficiently\\nill for some days to give up his occupation, thinking that there is\\nnot much the matter with himself, and sometimes a patient will\\nwalk during his entire illness. Although there may be some de-\\npression, the general appearance during the first week or ten days\\ndoes not indicate any particular prostration there is nothing pe-\\nculiar in the expression, and the face is normal in color, or it may\\nbe pale, or a pinkish circumscribed flush may be seen on one or\\nboth cheeks, varying in depth of tint, but not constant. The skin\\nis usually hot and dry, but is sometimes moist. The pulse is\\nquickened to 100 or 120 per minute, is rather weak and soft, and\\nvaries in frequency in the same patient, is sometimes readily in-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0281.jp2"}, "280": {"fulltext": "262 GENERAL DISEASES.\\ncreased, and generally is more rapid at night. The lips are\\nparched and dry; the mouth feels slimy; there is thirst, loss of\\nappetite, and, frequently, nausea and vomiting; there is enlarge-\\nment of the spleen. The severity of the diarrhea varies greatly,\\nthe stools averaging from three to six per twenty-four hours, but\\nsometimes as few as two, or as many as twenty, or even more. In\\na few days these discharges assume special characteristics, becom-\\ning thin, yellow (but sometimes brown, like coffee grounds), nearly\\nfluid, and in appearance somewhat resembling pea-soup; very of-\\nfensive, often ammoniacal and alkaline in their chemical reaction.\\nWhen first passed they are uniform throughout, but, by standing,\\nseparate into an upper watery layer of brownish or yellowish color,\\nand a lower layer or deposit, consisting principally of the remains\\nof food, epithelium and mucus, corpuscles, blood and shreds of\\nmembrane. The urine is diminished and of high color. The\\nsleep is restless and disturbed, but the mind at this stage is\\nclear.\\nThere is usually a specific eruption in typhoid fever that is very\\ndiagnostic, but in quite young patients and in those over thirty\\nthis is often wanting. In rare instances it appears as early as the\\nfourth day, but is not usually seen until from the seventh to the\\ntwelfth day, sometimes not until the twentieth. It may .appear\\nupon the limbs, especially upon the thighs, and very rarely upon\\nthe face, but its usual locations are the abdomen, chest and back.\\nThe eruption consists of small papules of pin-head size or smaller,\\nround, long, or oval in shape, slightly elevated, with rounded sur-\\nface, of soft feel, and of a pink or rose color. They disappear upon\\npressure to reappear when the pressure is removed they come\\nin successive crops, each spot lasting from two to five days, then\\nfading away, the number present at one time ranging from two\\nor three to twenty or thirty; they may continue to come until the\\nthirtieth clay or longer, but the average time during which they\\nappear is about fifteen clays they never become livid like flea-bites,\\nand they are never present after death.\\nSome cases of typhoid are mild throughout their entire course,\\nsome are severe at first and mild later, some are mild first and\\nsevere later, and some are severe from first to last. If the tongue\\nremains moist throughout the attack, and there is no marked pros-\\ntration, nor severe nervous manifestations, the symptoms thus far\\ndescribed may continue without any particular change until the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0282.jp2"}, "281": {"fulltext": "GENERAL DISEASES. 203\\npatient begins to recover. But if the disease is more severe, as it\\npasses into the second or third week, the tongue is likely to become\\nmore heavily furred, the coating becoming brown and dry, and\\nfoul matter will probably gather upon the teeth and lips, often\\nforming crusts, which increase as the disease advances but at any\\ntime during the attack the tongue may suddenly become clean and\\npresent a shiny, red appearance the odor of the breath becomes\\nvery bad the lips may become dry and crack, and a spreading\\neruption (herpes labialis) appear upon them. Sometimes the\\nwhole inside of the mouth becomes covered with dark colored in-\\ncrustations, indicating blood changes and a very serious condition.\\nWhile the tongue is thus heavily coated, the taste may be so\\nimpaired that the patient cannot distinguish between bitter and\\nsweet. There is likely to be great thirst all through the attack.\\nAs the disease progresses the patient emaciates and weak-\\nens sometimes at the last being very much reduced; the face\\nis more flushed; the whites of the eyes may become injected, the\\npupils dilated, and there may be inability to tolerate light. The\\nheadache is likely to be a dull, heavy pain, and to increase\\nfor the first week or ten days, or longer. There is pain in\\nthe back and limbs and throughout the whole body. From\\nabout the tenth to the fourteenth day the headache and gen-\\neral pains cease, and there is more giddiness and deafness.\\nThe hearing is nearly always impaired at this time and usu-\\nally so much that it is difficult for the patient to hear ordinary\\nconversation. About the second or third week the mind becomes\\naffected, as shown by drowsiness, mental confusion, or delirium.\\nFor a time the delirium occurs only at night, but it may become\\ncontinuous, though remaining worse at night. When it is of a\\nlow type the patient usually answers questions correctly, but he\\nmay sink into a condition in which he will lie with half closed eyes,\\nappearing to understand what is said but unable to make in-\\ntelligent replies. He may become noisy and violent, and may\\ndevelop suicidal tendencies.\\nThe abdominal symptoms continue and are likely to grow\\nworse, and there is danger as long as the abdomen is distended with\\ngas, no matter what the other indications may be. The formation\\nof the gas is thought to be due to changes in the mucous mem-\\nbrane lining the intestine, and, although the process is not well\\nunderstood, it is evident that as long as the gas continues to form", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0283.jp2"}, "282": {"fulltext": "264 GENERAL DISEASES.\\nintestinal changes are still in progress. In all cases of typhoid\\nfever with abdominal distention, perforation of the intestine is a\\ndisaster greatly to be feared, and this danger continues until the\\npatient is nearly well.\\nThe outlook is unfavorable in proportion to the height of\\ntemperature, and duration of the fever, especially if the morning\\nremissions are but slight. Either a sudden rise or a rapid and\\nextreme fall in temperature is a bad sign.\\nHemorrhage of the bowels occurs in about five per cent of\\nthe cases, and may take place at any time after the tenth day, but\\nis most frequent between the fourteenth and twenty-fourth days,\\nand may be independent of any known cause, it may be very\\nslight, in which case, as in bleeding from the nose, the blood comes\\nfrom the capillaries of the mucous membrane and serves to show\\nthat the patient has a hemorrhagic tendency or it may be very\\nabundant, the patient sometimes discharging as much as eighteen\\nounces. In these cases the blood comes from an artery opened\\nby an intestinal ulcer, and it may not immediately make its ap-\\npearance externally indeed a patient may die -from intestinal\\nhemorrhage before any blood is voided from the rectum. Such a\\nhemorrhage is indicated by a sudden fall of two or three degrees\\nin temperature, accompanied by extreme prostration. Unless\\ndeath soon follows severe intestinal hemorrhage, peritonitis is very\\nlikely to set in. Even in the latent or walking form of typhoid\\nfever, sudden death may occur either from perforation or intestinal\\nhemorrhage.\\nIn some cases there may be constipation throughout the\\nentire illness, and in some diarrhea may not come until the third\\nweek, although the second week is the most usual time for its\\nappearance. A mild diarrhea during the entire course of the dis-\\nease is a favorable symptom. Many cases terminate about the\\ntwenty-first or twenty-eighth day the average duration of fatal\\ncases is said to be about twenty-two days, but death may occur\\nwithin the first few days, and sometimes cases run seventy days or\\nlonger and terminate in recovery. The disease is especially severe\\nupon those who have not become acclimated to the place in which\\nthey are while ill. The great majority of patients fully recover, but\\nothers are doomed to permanent ill-health thereafter, in some cases\\ndue to constrictions of the intestines, in some to the destruction\\nof many of the villi of the digestive tract by the intestinal ulcers\\ncharacteristic of the disease.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0284.jp2"}, "283": {"fulltext": "GEXERAL DISEASES. 265\\nOne of the first indications of recovery is a moistening of the\\ntongue along its edges, which gradually extends over its entire sur-\\nface. The temperature which in the evening may have been from\\n103 to 106 degrees, or even 107 or 108 degrees, declines very\\ngradually, the first indication of which is seen in more distinct\\nmorning remissions. In three or four days the evening tem-\\nperature falls, and the morning remissions considerably increase,\\nso that a difference of two or three degrees, or more, occurs be-\\ntween the morning and the evening. The length of time until the\\nevening temperature becomes normal differs greatly. Complica-\\ntions may ]ead to irregularities, and a relapse may cause the fever\\nto rise in the same irregular manner as at first.\\nNo part of the illness is attended by greater danger than that\\nof convalescence. Of this the patient should be fully advised,\\nand the nurse or attendant must constantly be very alert and\\nfirm. As the fever subsides the appetite increases until it be-\\ncomes a controlling passion, so great is the craving of the tissues\\nfor food. Many a patient has lost his life at this stage by eating\\na banana, a little scraped apple, or some other longed-for and\\nseemingly harmless article of food. As great care must also be\\ntaken in regard to exercise and exposure, until the patient is quite\\nwell. Visitors should not be admitted, and excitement of every\\nkind should be avoided. Even so slight a strain as sitting up in\\nbed too soon may prove serious. Through pumping poisoned\\nblood so long, and having to draw its nourishment from it, the\\nheart has become very weak and tender, and the patient must not\\nadd to its work, either by exercise or posture, until it can in some\\nmeasure recover its old-time strength and tone, and he should then\\nonly Aery gradually resume such gentle activities as short walks\\nand rides.\\nTyphoid is prone to relapses, and they may recur several\\ntimes. There may be only a rise of temperature, but usually a\\nrelapse is attended by all the prominent symptoms of the first\\nattack, except that everything is likely to be more condensed\\nand last a shorter time. It may or may not be due to mistakes\\nin diet or overexercise. It is probably caused by the involvement\\nof one or more glands, which, until this time, had escaped. The\\nclaim that it is a result of reinfection has not been proved. It\\ngenerally comes from seven to ten days after the temperature\\nhas become normal, but the interval may be longer than that,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0285.jp2"}, "284": {"fulltext": "266 GENERAL DISEASES.\\nand it may be much shorter, in some cases beginning before the\\nevening fever has all gone. The fever rises more rapidly than it\\ndid at first, but in the same way, being lower in the morning\\nand higher in the evening, and its duration is shorter in the re-\\nlapse, seldom reaching fifteen days; its decline, too, is more\\nabrupt, but it may run higher than it did in the first attack. The\\neruption returns, often on the third day, the spleen enlarges again,\\nthe discharges from the bowels may or may not resume the liquid\\nform, and all kinds of complications are liable to arise, but the\\nconsequences of a relapse are not usually as dangerous as sup-\\nposed, and, with proper care and nursing, the patient generally\\nrecovers.\\nMalaria may appear at any time, hence is one of the complica-\\ntions to be guarded against. Many cases of so-called remittent,\\nbilious or malarial fever are modified typhoid. It should be\\nremembered, too, that malarial fever and typhoid fever are no\\nprotection against each other on the contrary, either may pre-\\ndispose to the other by reducing the system until it is less capable\\nof resisting disease.\\nTreatment. The first factor in treatment is the proper\\nnourishment of the patient the second is the control of his tem-\\nperature without debilitating* him. For the latter purpose, one\\ndrop of the tincture of aconite with one-sixteenth of a grain of\\nmorphia may be given every two hours, or at such longer in-\\ntervals as may be required to keep the temperature below 103 de-\\ngrees. Also give the patient- quiet rest. As already stated, a\\npositive diagnosis of typhoid fever cannot always be made until\\nabout the fifth day.\\nThe abortive treatment consists of calomel, iodine and the\\nmineral acids. Three grains of calomel, twelve grains of the bicar-\\nbonate of soda and twelve grains of the sugar of milk should be\\nmixed, divided into twelve powders, and one given every hour.\\nCalomel is a germicide, but its chief value probably lies in its\\nstimulation of the biliary functions of the liver, for bile is the great-\\nest antiseptic known for the prevention of decomposition in the\\nalimentary canal. The calomel should be given only in small\\ndoses and continued only five days, after which give sulpho-car-\\nbolate of zinc every three hours. The calomel treatment in much\\nlarger doses was thoroughly tried in the army during the war of\\nthe Great Rebellion, but the mortality was over sixty per cent.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0286.jp2"}, "285": {"fulltext": "GENERAL DISEASES. 267\\nIn Germany the treatment, as given by Leibermeister, is one\\ndram of the tincture of iodine, and three drams of the iodide of\\npotassium, with one ounce of water dose, three drops in a wine-\\nglass of water every two hours.\\nIn this country the carbolic acid treatment has been used\\ninstead. It consists of one dram of carbolic acid, one dram of the\\ntincture of iodine, and two drams of glycerin, mixed together, and\\ndoses of four drops each given every four hours; but, although\\nit has many advocates, its success has not by any means been an\\nunqualified one, and the same is true of every combination of\\nantiseptics yet devised. No agent has been found by which\\ntyphoid germs in a human intestine can be dislodged or overcome\\nwithout killing the patient, but the work of these parasites is self-\\nlimited, and when their race is run, and only then, the reparative\\nenergies of the system can be relied upon to effect the cure.\\nThe process cannot be hastened. Upon the vitality of the patient\\nmust depend the success of the final effort hence, if the calomel\\ntreatment of the first five days proves unavailing, and the fever\\nbecomes well established, instead of trying to abort it with power-\\nful medicines, give only such remedies as are needed to ward off\\ncomplications, control the bowels, temperature, pulse and nerves,\\nand, by careful feeding and nursing, keep up the strength until\\nthe diseased glands shall heal.\\nTo lubricate or coat over the intestines and soothe the ulcer-\\nated glands, as well as to check excessive bowel movement, noth-\\ning is better or safer than bismuth and to stimulate the liver, and\\nquiet the nerves, Dover s powder is excellent. The two are best\\ngiven together five grains of the subnitrate of bismuth with two\\nor three grains of the Dover s, once in three or four hours. Should\\nconstipation set in, the quantity of bismuth may be diminished. It\\nis so important in this disease to keep the bowels quiet, it is better\\nnot to give laxatives as long as there is a passage once in two\\ndays, but should a longer time intervene (and a good movement\\ncannot be obtained by means of a rectal injection), a mild cathartic\\nmust be given. A small close of castor oil is best, repeated every\\nfour hours until action is obtained. All severe cathartics must be\\ncarefully avoided, since, by causing violent peristalsis, they might\\ndo great harm by irritating the intestinal ulcers and increasing in-\\nflammation. It is well for the patient to spend two-thirds of his\\ntime in sleep, but if there is too much stupor, less Dover s should", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0287.jp2"}, "286": {"fulltext": "268 GENERAL DISEASES.\\nbe given, the quantity to be diminished as the case requires. In\\nsuch cases it will usually be best left off in the morning and given at\\nnight.\\nWhen the temperature rises above 103 degrees, it should be\\nreduced by sponging with water as warm as can be borne. Dr.\\nCurry advocated the use of cold water, as the greatest of anti-\\npyretics, for the reduction of temperature, and many have fol-\\nlowed his theory; but I get better results from the use of warm\\nw r ater. The temperature should be lowered by evaporation, not\\nby the application of cold, which may drive the blood from the sur-\\nface, to the great central vessels, engorge them, and throw ex-\\ncessive work upon the heart, already overtasked and in a feeble\\ncondition. There is danger of heart failure. Everything that\\nexcites, shocks or weakens should be studiously avoided. Warm\\nwater, with its consequent evaporation, controls temperature\\nquite as well as cold water, without the risks from depression. It\\nis safer, too, to apply it with a sponge than to put the patient\\ninto it. Keep him as quiet as possible, and out of cold draughts.\\nSponge first the face, then the hands and arms, next the trunk\\nand lower limbs, repeating the process every fifteen to thirty\\nminutes until the temperature yields, but do not expect to reduce\\nit more than two, or, in some cases, possibly three degrees.\\nThe patient should drink freely of coir 1 water; give him all he\\nwants, for it will lower temperature as well as quench his thirst,\\nand by stimulating the kidneys, help in the elimination of poisons.\\nWhen the pulse rises above 105 beats per minute give from\\none-sixtieth to one-thirtieth of a grain of the sulphate of strychnia\\nevery four to six hours, until the rate is reduced. It is kept ready\\nprepared in tablet form at the drug stores, and is one of the best\\nheart tonics known.\\nQuinine during the early part of the attack is of very little\\nservice in typhoid, but, in the later stages, it has antipyretic\\nvalue, wards off malaria, and serves as an excellent tonic. It may\\nbe given in from two to four grain doses, every two to six hours\\nor it may alternate with the strychnia, or may be given in the fore-\\nnoon only, the Dover s powder being given instead in the after-\\nnoon and at night.\\nIn case there is any distention of the abdomen with gas, or\\nmuch abdominal pain, liberally sprinkle a soft woolen cloth with\\nturpentine, spread it over the abdomen and leave it there until", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0288.jp2"}, "287": {"fulltext": "GENERAL DISEASES. 269\\nthe skin is well reddened, but not long enough to cause a blister,\\nthen remove it and in its place apply a similar cloth without the\\nturpentine. This may be repeated at intervals of eight or ten\\nhours as the case may require. Do not apply warm or hot cloths\\nor poultices to the abdomen in treating this disease.\\nShould the limbs and feet become lame with a soreness akin to\\nrheumatism, they can usually be much relieved by gentle massage.\\nIf the back and hips become inflamed, bathe them each day with\\nalcohol to prevent bed sores.\\nWhile the fever lasts the diet must consist of fluids, and, dur-\\ning the return to health, the restoration of solid foods must be\\nvery gradual. Milk is the proper food, and, in cases where it\\nagrees, should be the only food. It is of the greatest importance\\nthat the strength be sustained as well as possible, and to do\\nthis the milk must be given with careful regularity, not oftener\\nthan once in three hours, and in as large quantity as the patient can\\ndigest. If curds appear in the stools, the quantity must be dimin-\\nished until the right measure is found, after which this amount\\nmust be given steadily. If its casein disagrees with the patient,\\nthe milk should be modified by adding barley water, lime water, or\\nsome other diluent. Sometimes milk from a different cow is what\\nis needed. Should the milk continue to disagree, nothing is bet-\\nter as a substitute than beef tea, or will do more to keep up the\\nstrength give from two to hive teaspoonfuls every two hours. For\\nits preparation see Nursing.\\nWhen the fever has gone, and solid, easily digestible foods are\\ngradually restored, maltine with pepsin and pancreatin should be\\ngiven, a teaspoonful after each meal or five drops of nitro-hydro-\\nchloric acid may be given instead. Let it not be forgotten that\\nthere is now great danger from overfeeding and overexercise,\\nand that until the patient is quite well his condition is always\\ncritical. In some cases the hydrochloric acid increases the hunger\\nso much that it should not be given.\\nThe sick-room should be removed as far as practicable from\\nthe family living rooms, should have an abundance of sunlight,\\nand its air must be kept pure by good ventilation. All milk and\\nwater used by the family, unless the supply be hydrant water,\\nknown to be pure, should be boiled. As the spreading of the dis-\\nease is wholly from the excreta, all discharges from the patient\\nshould be thoroughly disinfected (see Disinfection and Disin-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0289.jp2"}, "288": {"fulltext": "270 GENERAL DISEASES.\\nfectants and buried at a safe distance from cisterns and wells.\\nAs an additional precaution, it is wise to drop a five-grain bi-\\nchloride of mercury tablet into the chamber after each cleansing,\\nand add a pint of water.\\nMALARIAL FEVER.\\nMalarial fever is a disease caused by the development and\\nmultiplication in the blood of a germ called plasmodium malaria.\\nThere are three types or forms of the parasite, and they do their\\nmischief by destroying the red-blood corpuscles. As they are\\nexceedingly minute, and can be detected only by a skillful micros-\\ncopist with the aid of a good instrument, we will not describe the\\nvarious forms nor enumerate the differences which distinguish each\\nfrom the others; we will, however, observe that the form called\\nthe tertian lives forty-eight hours that another, the quartan, has\\na life-cycle of seventy-two hours and that the aestivo-autumnal\\nis thought to live but about twenty-four hours, but, as with all\\nother living creatures, their lives may be shortened or lengthened\\nby external conditions. Their natural life-cycle terminates in\\nsegmentation the process by which each germ breaks up or\\nseparates into from six to twenty segments, whereupon, by burst-\\ning the membrane of the containing corpuscle and escaping into\\nthe blood, each of these parts attacks a fresh red-blood cell, in\\nwhich to live and develop into a mature organism like the parent\\nfrom which it came.\\nThe paroxysm (the chill and the fever), which in this dis-\\nease is always intermittent, appears to follow the act of segmenta-\\ntion so closely that, in the tertian and quartan forms, they occur\\nat nearly the same hour every day, or every second or third day,\\naccordingly as the patient has been infected with one or more than\\none crop of the same or different forms of the parasite. The\\naestivo-autumnal type differs from the others also in being less\\nregular in its development in crops, in being smaller, and in its\\nmore rapid destruction of blood cells. It is often the cause of the\\nirregular malarial fever seen in the fall of the year, and is destroyed\\nby quinine less readily than the other forms. Koch has proven\\nthis form to be identically the same as tropical malaria.\\nIt is thought that all three forms get their food entirely from\\nthe blood, and probably from the red-blood corpuscles. As each\\nvoting p-erm makes its abode in a red-blood cell, feeding, maturing", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0290.jp2"}, "289": {"fulltext": "GEXERAL DISEASES. 271\\nand segmenting there, each crop or brood destroys a very great\\nnumber of cells, and it has often been found that after a paroxysm\\nfrom ten to fifty per cent of the normal proportion of these red\\ncells are wanting, and that their coloring matter has been left as\\nrefuse in the blood.\\nHow the first germs get into the blood is not certainly known,\\nbut it is probable that, in by far the greatest number of cases,\\nthey enter the body with the drinking water. Strong proof of this\\nis found in the following facts, which have been widely quoted\\nAt Brownsville, Texas, is a military post, which takes its water\\nfrom the Rio Grande. It is surrounded by what have long been\\nconsidered most typical malarial conditions, such as swamps and\\nstagnant lagoons. Until 1890 the hospital record of this post was\\nby far the worst of any in this country in the proportion of its\\nmalarial diseases. The medical report for that year shows that\\nits hospital admissions of malarial cases were 1,876 for each 1,000\\nmen stationed there, and this was the usual proportion. The next\\nyear an ice plant and condensing apparatus for supplying distilled\\nwater were put in at this post, and so great were the advantages\\nderived from the pure water that it was immediately furnished, for\\nall drinking and culinary purposes, to the entire command. In\\nthe following year the number of admissions for malarial diseases\\nwere but sixteen for each 1,000 men, or less than one per cent of\\nwhat the regular number had been from the first establishment of\\nthe post. There had been no change in anything except the\\ndrinking water. The swamps and lagoons were still there, and\\nthe unhealthy city of Brownsville, in which impure water was\\nstill used, remained on their borders, and the few cases of malaria\\nthat still entered the hospital may have been caused by soldiers\\ndrinking water when away from the post. This would seem,\\ntherefore, to prove that the malarial troubles were wholly due to\\nimpure drinking water, and not at all to the air that was breathed,\\nand that malarial diseases are produced by water-borne germs.\\nIt is believed by Professor Koch of Berlin and many other\\ncareful investigators, that the infection is also disseminated by\\nmosquitoes these agents playing much the same part in malaria\\nthat is played by ticks in the cattle disease, known as Texas\\nfever. Human blood, known to be pure before being absorbed\\nby them, has been found, a little later, abundantly impregnated\\n*Address of Prof. J. B. Johnson before the Kansas State Board of Health.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0291.jp2"}, "290": {"fulltext": "272 GENERAL DISEASES.\\nwith malaria germs, thus proving that the mosquito sometimes\\ncarries them within its body, and it is probable that it may also\\noccasionally carry them upon its bill from the contaminated pools\\nat which it drinks.\\nA strong, vigorous person, through the natural resistance of\\nhis system perhaps by the acidity of a healthy stomach, perhaps\\nby an antitoxine formed in the blood for that purpose is able to\\novercome the few germs which ordinarily effect an entrance, but,\\ncoming when the blood is reduced or the stomach is disordered,\\nas from disease, fasting, fatigue, dissipation, or the effects of heat\\nor cold, or coming in large numbers for a long time, as from re-\\npeatedly drinking infected water, the natural resistance is finally\\noverpowered and malarial fever results.\\nSymptoms. The first symptom is depression of the brain and\\nnervous system. Soon there is a yellow, jaundiced appearance in\\nthe eyes and skin, caused by the coloring matter of the destroyed\\nblood cells, which is also carried to the liver, spleen and other\\norgans. The temperature begins to rise before the chill begins,\\nand usually reaches its highest point while the chill is on. There\\nis an increased amount of urine and changes in its composition\\nwhich give it a clear, watery appearance. This occurs about two\\nhours before the chill. There is more or less nervous disturbance,\\nand as the disease progresses there is constriction of the surface\\nvessels, which drives the blood to the central organs and engorges\\nthem. This is the period of chill, and it lasts from thirty minutes\\nto half an hour, when reaction comes. The surface vessels now\\ndilate and become over-filled with blood. This is the fever stage.\\nFinally these distended vessels are relieved through sweating.\\nThere are three stages to each attack the chill, fever and sweat.\\nAn interval follows during which the patient feels that he is well,\\nits length depending, as we have seen, upon the form of the germs\\nand the number of crops with which he is infected.\\nTreatment. To relieve the liver, spleen and other organs, use\\nthe following Calomel, three grains bicarbonate of soda, twelve\\ngrains, and sugar of milk, twelve grains mix and divide into twelve\\npowders, then give one every hour until the bowels move freely.\\nBoth as a germicide and as a support to the nervous system,\\nquinine is the remedy. It should be taken in three-grain doses in\\ncoffee, capsules, or lozenges, the hard coated pills not being as\\ngood. Children take it best in yerba santa. This treatment should", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0292.jp2"}, "291": {"fulltext": "GENERAL DISEASES. 273\\nbe continued until all the symptoms have subsided. To do its\\nbest work the quinine should be given six hours before the chill,\\nor during the sweating. If there be great pain, or an accompany-\\ning diarrhea, mix with the quinine from one-sixteenth to one-\\neighth of a grain of morphia. If, when the urine first begins to\\nincrease, we give one-fourth of a grain of pilocarpine, we will an-\\nticipate and prevent the recurrence of the chill and fever, and tide\\nthe patient over to the sweating stage.\\nAs already shown, malaria can be very largely prevented\\nby properly observing the laws of its development and dissemina-\\ntion. Except distillation, boiling is the best method of freeing\\nwater from all bacterial germs, and in a malarious country, espe-\\ncially in its most malarious seasons, all the water used for drink-\\ning and culinary purposes should first be boiled. Malaria is most\\nprevalent where there is most decaying vegetable matter, and this\\noccurs not at times of greatest rainfall, but when the wet earth\\nand low lands are drying out and the danger reaches its height\\nduring drouths after very wet seasons. Draining millponds and\\nlakes is attended with danger while their bottoms are drying up,\\nbut having been thoroughly dried and cultivated with crops they\\nbecome healthful. On the other hand malarious swamps have been\\nrobbed of their terrors by flooding to a depth sufficient to keep\\nthem covered with water.\\nAgain the amount of malaria in a region appears to be in-\\ndirectly proportional to the amount of plant growth going on\\nthere at the same time, a condition to be expected if we remember\\nthat the poison consists of germs- whose development is retarded\\nby the excessive moisture, prevailing during the periods of most\\nrapid growth.\\nWhile water is indisputably the principal medium for dis-\\nseminating the infection, it has not been ascertained that the germs\\nmay not be borne in the air to the lips and thence carried to the\\nstomach in saliva, or that they may not enter the blood through\\nthe lungs, hence, the old safeguards against miasmatic air should\\nnot be discarded, even though of less importance than formerly\\nsupposed. In brief, they were as follows Winds blowing from\\noff swamps, marshes and low lands impregnated with decomposing\\nmatter are laden with malarial germs, so in choosing a home let\\nit not be in these currents, but where the prevailing winds will\\nblow toward the pestilential centers, rather than from them. It\\n18", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0293.jp2"}, "292": {"fulltext": "274 GENERAL DISEASES.\\nis not usually thought that the poison is thus carried far, but in\\nhigh winds it may be borne a considerable distance. Forests\\ninterpose a barrier and orchards and groves afford valuable pro-\\ntection. Plant them about the home, especially on the sides from\\nwhich malaria is most likely to come, using care not to shade the\\nhouse itself much and cultivate and crop the surrounding land,\\nespecially all neighboring low land. Grass is far less dangerous\\nthan growths of weeds.\\nAs the germs are more numerous near the ground than a\\nlittle above it, sleep upstairs. Because of the destructive influence\\nof sunlight upon germs, malaria is not as intense during the day\\nas at night, hence in malarial regions avoid exposure to night air.\\nJf you must be out at night, or in the dews and fogs of early morn-\\ning, wear flannel next the skin, and dress warmly, for taking cold\\npredisposes to this disease. Chilling is one of the most dangerous\\nof all the predisposing influences so reducing systemic resistance\\nthat it may be unable to longer overcome malarial germs. See to\\nit that children are properly covered during the cool part of the\\nnight and early morning. The same is true of the condition pro-\\nduced by long fasting, so guard against exposure before breakfast\\nfortify the system by taking a drink of hot coffee before beginning\\noutdoor work in the early morning. Its preventive power against\\nmalaria is considered great. On damp mornings in summer a lit-\\ntle fire in the living rooms is a wise precaution.\\nLime is thought to destroy malaria, if applied fresh and in\\nconsiderable quantities. It should be freely spread upon freshly\\nupturned earth in cities, as when grades are being changed, or\\ntrenches dug for pipes, sewers, etc., for such ground is usually\\nfull of malaria. Smoke and fumes from burning sulphur,\\npetroleum refineries, lime-kilns and gas works are also said to be\\npreventives.\\nIf much exposed to malaria, quinine is the surest and best anti-\\ndote. Many recommend it in two-grain doses morning and even-\\ning, when forced to remain in very malarious regions, such as\\nabound in low, tropical countries but in the temperate zones it is\\nbetter to use it only in case of attack, since the changes in the sys-\\ntem, resulting from constant absorption of the drug, may prove\\nmore serious than the disease itself.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0294.jp2"}, "293": {"fulltext": "GENERAL DISEASES. 275\\nINFLUENZA.\\n(La Grippe. Grip.)\\nInfluenza is a specific, highly infectious fever, characterized\\nby nervous symptoms and great debility, and often accompanied\\nby catarrhal inflammation of the respiratory and digestive organs.\\nIt was mentioned by Homer, who wrote about 800 B. C, and is\\nknown to have been epidemic in Ireland in the fourteenth century.\\nStarting from Malta in 15 10, it quickly swept over all Europe,\\nscarcely missing an individual, and it has been widely epidemic\\nthere nearly a hundred times since.\\nIt has been common to all ages and altitudes, climates and\\ncountries, hot and cold, wet and dry, regardless of surroundings,\\nand nothing can better prove the definite character of the disease\\nthan the similarity of the symptoms it has shown through all these\\ncenturies amid the most widely differing circumstances and en-\\nvironments, and although the improved hygienic conditions of\\nthe present may have reduced the amount of mortality, they\\ndo not appear to have influenced the diffusion of the epidemic.\\nIt has many names as lightning catarrh, epidemic bronchitis,\\nand epidemic catarrhal fever. The French term, la grippe, is\\nwidely used and means to seize, so suddenly does it lay hold of its\\nvictims. The English word grip is quite as proper. It is due\\nto a short-lived germ, which secretes a poison of very great vir-\\nulence, for in this, as in most other infectious diseases, it is not\\nthe number of parasites that circulate in the blood, but the viru-\\nlence of the poison they produce that measures their capacity for\\ninjury. No other malady is attended by a. greater variety of\\nsevere symptoms, or followed by more sequels of a serious nature,\\nleading a little later to loss of health, if not to death; and it should\\nbe understood that while grip often lasts only two or three days,\\nand in some cases the patient hardly knows that he is ill, to the\\ninfirm, the aged and the predisposed it is a very dangerous\\ndisease.\\nIn uncomplicated cases death rarely results, but there are\\nfew disorders of the nervous system that are not liable to occur,\\neither as its accompaniments or consequents. It was long con-\\nsidered a catarrhal affection, and there is much about it that is not\\nyet understood, but the most careful investigators now regard it\\nas a nervous fever, caused by a poisoning of definite nerve centers\\nby the toxine produced by the micro-organisms, the parts affected", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0295.jp2"}, "294": {"fulltext": "276 GENERAL DISEASES.\\nin each case depending upon the center that is attacked, the seri-\\nousness of the disease, upon the power of resistance possessed by\\nthe patient. Catarrhal inflammations may or may not be present.\\nThey are often very important features, but in nearly twice as\\nmany cases the nervous symptoms predominate, and there have\\nbeen frequent cases of grip in which the patients neither coughed\\nnor sneezed.\\nThe period of incubation varies greatly as in some cases the\\nsymptoms come on immediately after exposure, while in others\\nthey do not appear until several days after. One attack does\\nnot confer immunity, and a patient may suffer two attacks during\\none epidemic.\\nSymptoms. A sharp, short attack of fever; great physical\\nand mental prostration severe pain in the head, body and limbs\\noften pain in the eyeballs, much increased upon motion a sense\\nof fullness across the forehead sleeplessness, sometimes delirium,\\nconvulsions, coma, paralysis, deafness and loss of smell and taste.\\nTonsilitis, bronchitis, croup, heart complications, catarrh of the\\nmucous membranes or pneumonia may follow. The fever attack\\nis usually very sudden, the temperature soon reaching ioo degrees\\nto 103 degrees. Althaus reports a case in which the temperature\\nwas 109 degrees for three days, then soon subsided and the patient\\nrecovered; and adds: There is no correspondence between the\\ndegree of heat and the severity of the illness, as in the eruptive\\nfevers, and in other acute diseases.\\nIn uncomplicated cases, in otherwise healthy people, the\\nfever rarely lasts longer than one, two or three days, and the\\nsymptoms often leave as suddenly as they came. Those cases do\\nbest in which high fever is followed by perspiration and loss of\\nheat. When the fever lasts more than two or three days it is due\\nto unfavorable complications, or to the age, weakness or pre-\\nexisting diseases of the patient.\\nGrip is likely to engraft itself upon the remnants of any\\nold disorder still lurking in the system, and rouse it to greater\\nvirulence than it ever before displayed thus heart disease may be\\nsuddenly increased to such dangerous proportions that even a\\nlittle change of position, or slight effort of any kind, may prove\\nfatal syphilitic poisoning of long standing and sluggish form may\\nbe roused to uncontrollable activity and alcoholism be speedily\\nadvanced to delirium tremens of more persistent type than is ever\\nshown when caused by alcohol alone.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0296.jp2"}, "295": {"fulltext": "GENERAL DISEASES. 277\\nGrip is not as common in children as in adults, but they are\\nby no means exempt. It often begins its attacks upon them with\\nintense headache, vomiting, constipation, grinding of the teeth,\\nstiff neck, delirium, convulsions and coma. Sometimes uncon-\\nsciousness comes so suddenly as to resemble apoplexy, and the\\nalarming features then subside in a day or two.\\nIn the nervous form, headache, next to fever, is the most\\ncharacteristic feature. It is often associated with backache of very\\nsevere type, especially in the loins. There is also liable to be sore-\\nness and stiffness of the whole body and great pain in the limbs,\\ncausing tremors, twitches and cramps.\\nTreatment. Many cases are so mild as to need no treatment,\\nother than light diet and precautions against taking cold. In the\\nseverer attacks first give the following:\\nHyoscyamus extract fifteen grains\\nQuinine one-half dram\\nCamphor one-half dram\\nSocratine aloes five grains\\nMix and put in thirty capsules, then give one every four hours\\nuntil relief is obtained. The patient should take a hot foot-bath,\\nlasting ten or fifteen minutes, kept as warm as can be borne by\\nadding more hot water from time to time then drink copiously of\\nhot lemonade and be covered up warmly in bed.\\nAs great depression attends this disease it is very important\\nto keep up the strength of the patient as much as possible hence\\ndebilitating remedies of every kind should be avoided. Bronchial\\ncongestion and sore throat may be greatly relieved by the inhala-\\ntion of steam. (See acute sore throat.) Should pneumonia de-\\nvelop, give five-grain doses of carbonate of ammonia in a tea-\\nspoonful of yerba santa every four hours. It must be remembered\\nin all such cases that poison in the blood is the primary trouble\\nand that it will admit of no depressing remedies. As much as\\npossible avoid weakening the patient. The bronchitis and\\npneumonia are secondary affections, and their suppression will\\nsoon follow the use of supporting measures. In such cases, besides\\nthe other treatment, give four ounces of yerba santa maltine,\\nsuch as is kept at the drugstores, in one teaspoonful doses three\\ntimes a day or an ounce of good wine three times a day with\\nmeals.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0297.jp2"}, "296": {"fulltext": "278 GENERAL DISEASES.\\nIf taken in the beginning, from three to rive grain doses of\\nquinine three times a day may terminate the attack. In cases\\nof slow recovery the elixir of iron, quinine and strychnia, found\\nready prepared at drugstores, in teaspoonful doses three times a\\nday after meals, will restore strength and vitality.\\nThe patient should guard carefully against taking cold, and\\nnot resume work too soon, for very often when in a fair way to\\nrecovery a little imprudence leads to relapse, or challenges a\\ntrain of ills, when, because of its depressed condition, the system\\nis not able to cope with any one of them. The aged and infirm\\nshould remain housed in well warmed rooms during an epidemic\\nof grip, and take a nourishing diet for the healthy and well fed\\nare best prepared to resist the disease.\\nDIPHTHERIA. MEMBRANOUS CROUP.\\nDiphtheria means membrane. It is a fungous disease, wholly\\ndue to a specific germ, the Klebs-Loffler bacillus, a microscopic\\nplant so minute that the shell of a mustard seed would hold ten\\nmillions of them. Just as the growth of wheat, corn, or any other\\nform of larger plant-life, is subject to certain laws, so the dissemi-\\nnation, growth and multiplication of these little plants, these deadly\\ndisease germs, are controlled by certain conditions if these con-\\nditions be unfavorable the germs will cease to multiply; if very\\nunfavorable, they will die. It is now thought that, except in\\nwarm milk and when artificially cultivated, they never grow and\\nmultiply outside an animal body, and it is known that although\\nthey may live in the human throat at any time from infancy to old\\nage, they grow fastest and flourish best in the throats of children\\nfrom two to ten years old. Why this is so no one can tell,\\nbut it is known that it is so.\\nDr. Charles T. McClintock, of Detroit, says: As larger\\nplants, under unfavorable conditions, may barely keep alive, with-\\nout increasing or spreading to adjoining soil, so it has been shown\\nthat diphtheria germs may at times live in the throat of an adult,\\nbut merely live and not multiply, because of the unfavorable\\nconditions, and the individual, therefore, not have the disease,\\ndiphtheria.\\nThe- germs grow best at about the temperature of the human\\nbody 94.4 degrees Fahrenheit. They cease to multiply when the\\ntemperature falls to 68 degrees, and this is one of the reasons they", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0298.jp2"}, "297": {"fulltext": "GEXERAL DISEASES. 279\\ndo not multiply in sewage. They also cease to grow when the\\ntemperature is raised a few degrees higher than that of the body\\nand are killed at a heat of 136 degrees to 140 degrees. The germs\\ngrow only where there is moisture. They may remain alive but\\ndo not multiply in dried sputum, in dus.t, on dry clothing, etc.\\nDried on cloth they may live for one or two months, and there\\nare instances of apparent infection from rooms, clothing and bed-\\nding which seem to show that the germ in a dry state may live for\\nmonths, possibly years. Like other particles of dust, the germs\\ncling to a moist surface. Neither they, nor any other disease\\ngerms, are to be found in the breath of the patient, so, though\\nthey be emptied by million. s into the sewers, they do not. cannot\\nrise with the sewer gas. In coughing and gagging, the patient\\nwill throw out particles of saliva and of the diphtheritic membrane.\\nThese may contain thousands of the germs. Many a physician has\\npaid with his life for his care in examining and treating the throat\\nof a diphtheria patient, the coughed-out particle striking his eye,\\nnostril or mouth, piving him the disease. Contrary to the condi-\\ntions obtained in higher plants, sunlight is fatal to these, as to all\\ndisease germs even the most resistant of them being killed by a\\nfew hours exposure to the direct rays of the sun. The lesson to\\nbe learned from this is obvious, yet, through fear of faded carpets,\\nwe shut out the best of all disinfecting agents.\\nIt is probable that an unsound throat, or a debilitated condi-\\ntion, even in an adult, facilitates the development of diphtheritic\\ngerms, but that vigorous health prevents them from increasing to\\nnumbers capable of working any injury, unless it be by finding\\ntheir way. as through a public drinking-cup, kissing, or some other\\nmedium of transmission, to the throat of a more susceptible per-\\nson. The custom in our schools of using books and pencils fur-\\nnished at public expense and indiscriminately passed from one\\nchild to another, cannot be too strongly condemned, for even\\nthough the pupils may be instructed never to touch them to their\\nlips, they must ever be a source of constant danger.\\nThe quantity of these germs present in any case bears a close\\nrelation to the intensity of the disease. As they multiply it ad-\\nvances, and as they diminish it subsides. They are divided into\\ntwo classes the aerobic and the anaerobic. The first class live\\nwhere they can get air. and cover the membranes of the throat\\nas grass covers a lawn. The second class burrow in the tissues and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0299.jp2"}, "298": {"fulltext": "280 GENERAL DISEASES.\\nlive without air. These two kinds of fungous growths, and the\\nexudation they produce, make up the membrane of diphtheria.\\nIn simple inflammations of the throat there are always pres-\\nent certain forms of germs which, in case diphtheria sets in, are\\ndisplaced by the diphtheritic germs, which are the stronger and\\nmore virulent. In this way we account for a simple sore throat\\nsometimes suddenly changing into a diphtheritic one, and, for this\\nreason, when diphtheria is prevalent, a sore throat should be care-\\nfully watched from day to day. If an exudation appears it is evi-\\ndence of the presence of diphtheria.\\nSymptoms. The symptoms of typical diphtheria are quick\\npulse, fever, white streaks on the tonsils, scant high-colored urine,\\nthin white coating of the tongue, and loss of appetite, accompanied\\nby more or less nervous prostration. In grave cases the pulse is\\n1 20, the temperature from 100 degrees to 103 degrees, the breath\\nis fetid and there is likely to be vomiting. Albumin appears in\\nthe urine about the third or fourth day, and about the same time\\nthe exudation appears in the throat and extends from the pharynx\\nup into the nasal cavities, forming into a thick, leathery membrane.\\nThe glands at the angles of the jaws and under the chin become\\nswollen, their connective tissues having become infiltrated with\\nthe diphtheritic virus, which has also been carried throughout the\\nwhole system. This poison, produced by the growth of diphthe-\\nritic germs, has been demonstrated to be analogous to that of cer-\\ntain venomous serpents.\\nFor four or five days after the formation of the membrane\\nit does not seem to change much, then it loosens at its edges and\\nrolls up toward the center, where it finally also loosens and becomes\\nfree, the parts beneath being left bare and covered with red points.\\nIf the patient is to recover no new membrane forms, but if his\\nvitality is greatly reduced this cast-off membrane is replaced by\\nanother which may be more extensive than the first, project into\\nthe larynx, and even into the trachea, diminishing the supply of air\\nand endangering the patient s life.\\nTreatment. The treatment should begin with two grains of\\ncalomel in a tablespoonful of water, mixed with nothing else, and\\nswallowed slowly, that it may lodge in the throat and act as a\\ngermicide. This should be repeated every two hours until the\\nbowels move freely. Instead of this, some prefer to use the\\nbichloride of mercury, one-fourth of a grain to four ounces of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0300.jp2"}, "299": {"fulltext": "GENERAL DISEASES. 281\\nwater, giving- a teaspoon ful of the mixture every four hours.\\nWhile giving this, all discharges from the bowels should be care-\\nfully examined, and if any green color appears in the dejections\\nthe medicine must be stopped immediately, or changed, lest\\nmercurial poisoning follow.\\nPilocarpine in very small doses, one one-hundredth of a grain,\\nmay be given to prevent the attachment of the membrane upon\\nthe surface of the throat, by the intervention of mucus, the flow\\nof which is greatly stimulated by this drug. If the patient becomes\\nweak he may be given two grains of quinine every two hours until\\nthe strength is restored. In case of marked depression alcoholic\\nstimulants may be used.\\nDo not try to remove the membrane by tearing it off, for the\\nraw place thus caused w T ill surely be covered by another membrane.\\nA most valuable agent for hastening its removal is peroxide of\\nhydrogen. It should be sprayed into the throat with an atomizer\\nevery twenty minutes for three times. The following mixture\\nshould then be used: Oil of sweet almonds one ounce, oil of\\neucalyptus five drops, and menthol from five to fifteen grains\\nspray it into the throat once an hour, or as often as the throat\\nbecomes dry and painful. Inhaling steam from water, or from\\nwater and cider vinegar, as hot as can be taken, by means of a\\nrubber tube attached to the spout of a teakettle, is good to afford\\ntemporary relief, but, aside from this, is of little value, and, if long\\nused, or often repeated, is liable to do harm. Never use poultices\\nin treating this disease.\\nIn some cases where the diphtheritic membrane is large the\\npatient can be saved from smothering by intubation, which con-\\nsists of inserting a silver tube, designed for the purpose, into the\\nthroat and leaving it there until the membrane loosens and can\\nbe removed. Sometimes this fails because of the formation of\\nanother membrane in the trachea below the end of the tube, but\\nthe device has saved many lives.\\nThe Antitoxin Treatment There has been a wide differ-\\nence of opinion among physicians as to the value of antitoxin, but\\nthe treatment seems to have promptly reduced the death rate of\\nthis disease in Parisian hospitals to one-half that prevailing before\\nits introduction there, and about the same reduction through its\\nuse is reported in Germany, but, if statistics can be relied upon, far\\nmore beneficent results have been obtained in this country.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0301.jp2"}, "300": {"fulltext": "282 GENERAL DISEASES.\\nPrior to the introduction of antitoxin, the mortality rate in\\nChicago was about 35 per cent, and in the first twenty-six months\\nof its use by the health department of that city the rate was reduced\\nto 6.77 per cent, but the results recorded for November last are\\nnothing short of marvelous. During that month 163 cases were\\nreported and investigated, 98 of which were found to be true\\ndiphtheria, and were treated with antitoxin. In addition there\\nwere four cases remaining from the previous month, so that in all\\n102 cases were treated, from which there were 97 recoveries, 3\\ndeaths, and 2 remaining under treatment at the end of the month,\\nmaking the extremely low death rate of 3 per cent. These facts\\nshould remove any remaining scruples which may exist against this\\ntreatment. -Med. Record.\\nDiphtheria antitoxin is the serum of an animal s blood, usu-\\nally that of a horse or goat, rendered immune by a large number\\nof inoculations with diphtheritic virus. The following is substan-\\ntially the process, as given by E. Roux of Paris A healthy horse\\nis given at first a hypodermic injection of 15^ drops of strong\\ndiphtheritic virus prepared by culture. As soon as the resulting\\nfever subsides he is again inoculated, but with a larger amount.\\nThis is repeated again and again, the amount injected being\\neach time increased. At the end of the first month from twenty to\\nthirty times as much virus is used as at first, without increasing\\nthe symptoms. The inoculations are thus continued a great many\\ntimes until very large amounts of the most virulent diphtheritic\\npoison can be injected directly into his veins without causing more\\nthan a fleeting rise of temperature. This requires from three\\nmonths to two years, and the horse is then said to be immune\\nand the serum of his blood is ready for the treatment of patients.\\nIt is usually injected under the skin of the thigh, and the aver-\\nage amount used at first is about one one-thousandth the weight\\nof the patient.\\nIt is expected that within twenty-four hours after the injec-\\ntion the diphtheritic membrane will cease to form and that it will\\nbecome detached from the throat in from thirty-six to seventy-two\\nhours. Intubation is the complement of the treatment, enabling\\nthe patient to breathe until the membrane can be removed.\\nDiphtheritic germs are often found in the throat of a patient\\nmany days after all signs of the disease have disappeared, hence\\nhe should remain in quarantine until from^examination he has been", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0302.jp2"}, "301": {"fulltext": "GEXERAL DISEASES. 283\\nfound free from the contagion. Each day his sputa and the soiled\\ncloths used about him should be burned and all his dejections dis-\\ninfected.\\nAs a preventive measure in suspected cases of diphtheria, the\\nthroat should be dusted twice a day for three clays with equal parts\\nof quinine and flour sulphur. In a small glass tube, six inches or\\nmore in length, place the mixed powder, then blow it into the\\nthroat, using the precaution of placing the tube in boiling water\\nimmediately afterward.\\nHaving had diphtheria is no protection against having it\\nagain, on the contrary it seems to predispose the patient and\\nrender him more liable to the disease. Recurrences sometimes\\nare separated only by short intervals, and there is considerable\\ndanger in placing patients that are convalescent from it in close\\ncontact with new cases of the same disease.\\nMEMBRANOUS CROUP.\\nExcept in degree of severity there is no difference between\\nmembranous croup and diphtheria. Both are caused by the same\\ngerm, but croupous inflammation involves only the superficial or\\nepithelial layer of the mucous membrane of the throat and is com-\\nparatively mild, while diphtheria extends to the deeper layers of\\nthe membrane and is the severe form of the disease. The treat-\\nment is identically the same for both.\\nVARIOLA.\\n(Small-pox.)\\nSmall-pox is such an old disease that its original habitat is\\nuncertain, but it is known to have been epidemic in China many\\ncenturies before Christ, and that it was introduced into America\\nby the Spaniards shortly after the discovery of the New World.\\nThe germ to which it is due has not been found, but the\\nvirus, or poison, produced by it is of such virulence as to make\\nsmall-pox the most infectious, malignant and fatal of all diseases.\\nIt is supposed that it usually makes its entrance into the system\\nby way of the lungs, being inhaled with the breath. It is also con-\\ntagious, but in this case the virus must reach the blood through a\\nwound, for contact alone is not enough. The eruptive matter,\\nthough taken fresh from a small-pox pustule and reeking with\\nthe septic poison, will not convey the disease by being merely\\nsmeared upon the unbroken skin.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0303.jp2"}, "302": {"fulltext": "284 GENERAL DISEASES.\\nThe disease, when introduced through a wound or abrasion,\\nhas the singular property of running its entire course with less than\\na hundredth part of the malignancy and danger that accompanies\\nit when, as infection, it is taken into the system through the\\nbreath a phenomenon which has never been explained, but of\\nwhich practical advantage has been taken in India and China for\\nmany centuries, and from which countries the system now known\\nas inoculation spread to other lands and became almost universally\\nemployed by all civilized nations.\\nAs people of both sexes and all ages of every race and climate\\nare subject to this disease, rarely failing to take it at the first\\nexposure, and as it was usually fatal in one-third of all the cases\\ncontracted through infection, and of the other two-thirds a very\\nlarge proportion were disfigured, maimed or disabled for life\\nand as it is variously estimated that only one case in every\\nthree hundred to ten hundred cases from inoculation is fatal, and\\nthe disease from this source is as sure to cause immunity from\\nfurther attacks, as an attack brought on by infection, it is at once\\nseen that the value of this discovery was beyond comprehension.\\nAuthorities differ as to the time at which a small-pox patient\\nwill first give the disease, some affirming that this danger is not\\nreached until the eruption begins, while others maintain that the\\npoison constituting the infection exists in the breath and exhala-\\ntions of the body, as well as in the eruptive matter of the pustules,\\nthat the clanger commences even before the first symptoms appear,\\nreaches its height during the period of desiccation (drying of\\nscabs), and continues until sometime after the eruption disappears.\\nThere is also a wide difference of views as to the distance to\\nwhich the infection may extend, some claiming that it may be dis-\\nseminated over a whole city, others denying that there is any dan-\\nger further than from three to six feet from the patient, if he be\\nin the open air. Both of these theories may contain some grains\\nof truth, for the distance must vary greatly in different stages of\\nthe attack. As drying does not destroy the germs, the dried scales,\\nas a dust-like powder, are the most-to-be-dreaded medium of\\nspreading the disease, for the germs upon them, retaining their\\nvirulence indefinitely, may settle upon everything in the room or\\nbe borne considerable distances by favoring breezes. Of course,\\nthey may also be carried in clothing hundreds of miles, and there\\nis always very great danger from clothing and bedding used by", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0304.jp2"}, "303": {"fulltext": "GENERAL DISEASES. 285\\npatients with this disease. If laid away it may continue to be a\\nmenace for many years. Open air and bright sunshine, especially\\nthe latter, are good disinfectants and exposure to them greatly\\ndiminishes the danger, but the only safe way is to immediately burn\\nall clothing and furnishings used about the patient as soon as he\\nrecovers.\\nThe mildest case of small-pox may impart the disease in the\\nmost malignant form, for the degree of severity depends upon the\\nconstitutional condition of the patient. Although one attack usu-\\nally confers immunity there have been a few people who have had\\na second attack, and a very few who have had small-pox for even\\nthe fifth or sixth time, and, strangely enough, the last attack, in\\nsome cases, was severer than the first. On the other hand, there\\nis said to be, once in a great while, a person who is insusceptible\\nto the disease and does not take it, no matter how often exposed.\\nThe dark-skinned races, especially the negro and Indian,\\nsuffer most from small-pox, whole tribes of the latter having been\\nswept out of existence by it in a few months, but the Mexicans\\nseem to be an exception to this rule, for, although the disease is\\nvery common anion sr them, and, anionic their lower classes, is\\nspread chiefly by infection, the advantages of inoculation not\\nbeing understood by them, there is not an unusually large per-\\ncentage of mortality, and often the attack is so light that the patient\\nhardly lies by for repairs.\\nSymptoms. By many writers the course of this disease, from\\nexposure to recovery, is divided into stages, each of which merges\\nalmost imperceptibly into the next.\\n(i) The Stage of Incubation, or the time from exposure or\\ninoculation until the first symptoms appear. This interval in\\ncases from inoculation consists of about seven days, but cases\\nfrom infection proceed so much more slowly that the first symp-\\ntoms do not usually appear until the twelfth day, rarely a day or\\ntwo earlier or later, but never later than the fifteenth day.\\n(2) The Stage of Invasion. In children the attack usually\\nbegins with convulsions, in adults with a sudden severe chill, fol-\\nlowed by fever that increases so in intensity that a temperature of\\n105 degrees to 106 degrees may be reached by the time the erup-\\ntion appears, which is usually on the third day. Many\\nconstitutional disturbances accompany the fever and, like\\nit, increase in severity until the eruption appears. They", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0305.jp2"}, "304": {"fulltext": "286 GENERAL DISEASES.\\nconsist of fullness, or pain in the abdomen, nausea,\\nvomiting (often severe and obstinate), pain throughout the\\nentire body, but especially in the middle and lower parts of the\\nback, trembling, such weakness that the patient can hardly stand,\\nand a sense of severe illness. There is generally intense headache,\\nthe face is flushed and the great arteries of the neck throb violently,\\nwith the pulse from 120 to 160 per minute; but sometimes the\\nface is sunken and pale, and the extremities cold. There is great\\nthirst, the tongue and lips are dry and parched and the tongue is\\nlikely to be thickly furred there is no appetite and constipation is\\nusually prominent throughout the entire course of the disease, but\\nthere may be diarrhea instead.\\nIn two, days there are likely to be inflamed and swollen tonsils,\\nsore throat, hoarseness, and sometimes a condition resembling:\\ncatarrh. Occasionally there are nervous symptoms at the begin-\\nning, such as restlessness, delirium, drowsiness, stupor and coma.\\nConvulsions are frequent in children, and sometimes occur in\\nadults. The intensity of the symptoms during this stage does not\\nalways indicate the severity of the succeeding stages, and the diag-\\nnosis cannot always be positive until this stage has passed.\\n(3) The Stage of Eruption. The eruption begins upon the\\nface, especially the forehead, and upon the scalp and neck, and, as\\nalready stated, usually first appears the third day, but may come\\non the second, or may not arrive until the fourth. It may be so\\ncopious that the minute red spots almost cover the skin, in which\\ncase, at this time, it is liable to be mistaken for measles, but in one\\nor two days the papules of the eruption spread over the entire\\nbody, though not as thickly as upon the face. They may be\\nseparate or may run together. The eruption may appear at the\\nsame time upon the mucous membranes, and the saliva be greatly\\nincreased.\\n(4) The Stage of Suppuration begins in from six to eight\\ndays after the appearance of the eruption, is characterized by the\\nmaturing of the pustules and the discharge of their contents, and\\nis the most dangerous period of the disease. More deaths occur\\non the eleventh day than any other, but from the eighth until the\\nthirteenth day there is very great peril, especially if the eruption is\\nvery copious, in which case one pustule is likely to run into another\\nuntil the entire face is covered with a mass of corruption. The\\nevelids may be swollen shut and the features so disfigured as to", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0306.jp2"}, "305": {"fulltext": "GEXERAL DISEASES. 287\\nbe unrecognizable. The feet, hands and genital organs may be\\naffected in the same way and fearfully distorted.\\nThe primary fever probably subsided as the eruption pro-\\ngressed, but now the secondary or suppurative fever begins, and\\nfrequently reaches a greater height than the first. It is usually\\nushered m by a chill, and, although intermittent in type and at its\\nworst in the evening, increases in intensity until the suppuration\\nreaches its height, then gradually declines as desiccation advances.\\n(5) The Stage of Desiccation (drying period) begins about\\nthe twelfth day and lasts from one to two weeks. The pus and\\nfluids from the pustules dry and harden into scabs or crusts which.\\nin severe cases, may cover the whole face like a mask. Gradually\\nthe scabs loosen and come off, the process being attended by the\\nmost uncomfortable itching.\\nRoberts thus describes a typical pock It starts as a bright\\nred spot a little raised; enlarging and becoming more elevated, it\\nforms a distinct papule on the second or third day, circular, well\\ndefined, flattened on top and having a peculiar solid, hard, dense\\nfeel, compared to that of shot or mustard seed under the skin.\\nThis soon changes into a vesicle, a little clear, thin fluid collecting\\nin the center under the epidermis.\\nAbout the fifth clay a depression forms on the top of the pock.\\nAt the same time the contents gradually assume a purulent char-\\nacter. This change begins at the circumference, the central part\\nstill for some time remaining vesicular, and separated from the\\nsurrounding pus by a transverse partition, so that either part can\\nbe emptied of its contents without disturbing the contents of the\\nother part. At this time a distinct ring of inflammatory redness\\nappears around each pock, the pus increases and after a while the\\ndepression disappears, the pock becoming either globular or\\npointed at the top, while the color changes to yellow.\\nAbout the eighth clay the pustule is at its height, having\\narrived at the end of the stage of maturation. It then undergoes\\nretrograde changes and within the next two or three days either\\nbursts, its contents discharging and drying up, thus forming\\na yellowish-brown scab, or it shrivels and dries up without ruptur-\\ning. In from eleven to fourteen days the scab usually separates,\\nleaving a reddish-brown stain, which remains for a variable period.\\nSometimes the scabs remain adherent a long time, especially about\\nthe nose and on the scalp. When they fall off the body generally", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0307.jp2"}, "306": {"fulltext": "288 GENERAL DISEASES.\\nthere is a fine, dusty scaling of the skin and where its deeper layers\\nare all destroyed a pit is left which finally becomes of a dead white\\ncolor. The course of the eruption is greatly modified by the vari-\\nous circumstances peculiar to each case. The skin between the\\npocks is usually of a deep red color and feels sore and tender, and\\nthere is nearly always such intense itching that the patient can\\nhardly refrain from scratching, although this aggravates the sore-\\nness and adds greatly to the final disfigurement.\\nTreatment. The patient should be confined in a single room\\nand be kept quiet in bed. His room should be large, light and\\nwell ventilated, without exposing him to drafts, and its tem-\\nperature should be kept as nearly as possible at from 60 degrees to\\n65 degrees. Carpets, curtains, surplus bedding and all other furni-\\nture that can be spared should be removed at the very beginning.\\nAll surroundings and conditions must be made as healthful as\\npossible. Cleanliness is of very great importance. The room,\\npatient, clothing and bedding must all be kept clean. The linen\\nshould be changed often, and that removed should be plunged\\nimmediately into hot water and kept boiling for thirty minutes to\\nsecure thorough disinfection..\\nBegin with a scant diet of easily digestible food, giving fruits,\\nespecially baked apples, a prominent place. A little later the diet\\nshould be gradually increased, as by the addition of soups, beef tea,\\nbeef juice, jellies, etc., and care taken to furnish sufficient nourish-\\nment to keep up the strength of the patient, especially when a\\ncopious eruption or other severe symptoms give warning that the\\nstruggle is to be long and hard. The suppurative stage is the most\\ntrying one, and the early management must be such that the\\npatient shall reach it in the best possible condition. The best drink\\nis cold water and the patient should have all that he wants of it,\\nbut lemonade, milk and mucilaginous drinks are permissible.\\nStimulants of all kinds are to be prohibited at this time.\\nThe fever is best controlled by giving from three to five grains\\nof quinine once in four hours, and by sponging the face, hands\\nand body in water as hot as can be borne, since opening the pores\\nfacilitates the escape of heat and poisonous exhalations. Sponging\\nat this time is better than immersion baths.\\nFor the headache apply ice compresses or ice bags to the head.\\nFor sore throat hold bits of ice in the mouth, apply ice com-\\npresses to the throat, and use a gargle of one part of listerine to\\nseven parts of water every hour.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0308.jp2"}, "307": {"fulltext": "GENERAL DISEASES. 289\\nFor vomiting hold ice in the mouth in some cases sipping\\nhot water and applying a hot fomentation to the stomach will be\\nfound to serve the purpose better, and sometimes a Seidlitz powder\\nwill give relief.\\nFor constipation saline laxatives should be used to secure\\na free movement every day, for which purpose a teaspoonful of\\ngranular effervescing phosphate of soda is a good remedy.\\nFor diarrhea give from twenty to twenty-five grains of sub-\\nnitrate of bismuth every three hours should this not prove effect-\\nual add to the dose two grains of tannic acid or, if the case be\\nvery urgent, give with the bismuth from five to fifteen drops of\\nthe tincture of opium.\\nFor hemorrhage give three grains either of tannic acid or\\ngallic acid every four hours, or fifteen drops of the fluid extract\\nof ergot every three hours until the bleeding is stopped.\\nIf nervous disturbances appear, three-grain doses of Dover s\\npowder may be given every three hours until they are controlled.\\nA warm bath often soothes the patient and induces sleep. If these\\nmeasures are not successful, trional in doses of from fifteen to\\ntwenty-five grains should be given every four hours until sleep is\\nobtained.\\nThe urine should be drawn with a catheter, if retained beyond\\na reasonable time.\\nWhen the eruption appears especial attention should be given\\nthe eyes.\\nThey should be protected from bright light by a green shade\\nand bathed very often in a warm solution, composed of one grain\\nof corrosive sublimate and four ounces of water, but it must be\\nremembered that this remedy is a poison.\\nTo prevent pitting and disfigurement, use has often been\\nmade, during the suppurative stage, of such devices as nitrate of\\nsilver, carbolic acid, opening each pustule as soon as it contains\\nany pus, keeping the patient in a dark room, etc., but none of them\\nhas proved successful. Nothing can prevent scars if there is much\\ndestruction of the lower layers of the skin.\\nThe better course is to apply ice compresses to the face, for\\nalthough they may not so control the eruption as to make it less\\ncopious, they reduce the swelling and inflammation and, to some\\nextent, prevent destruction of the skin tissues, besides greatly re-\\nlieving the patient. Anointing the rest of the body with olive oil,\\n19", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0309.jp2"}, "308": {"fulltext": "290 GENERAL DISEASES.\\ncontaining one-tenth its volume of carbolic acid, serves a good\\npurpose and during the drying-up stage is especially valuable.\\nDuring suppuration much care must be exercised to keep up\\nthe strength by plenty of good, easily digestible food, and stimu-\\nlants should be administered if there is great weakness or signs of\\ncollapse. Cod liver oil is often used with excellent results at this\\ntime.\\nThe secondary fever should be treated in the same way as al-\\nready outlined for the primary fever.\\nWhen the stage of desiccation arrives, a warm bath each day\\nwill not only be very grateful to the patient, but will assist in re-\\nmoving the scabs the body should then be thoroughly dried with\\nsoft towels and anointed with the carbolized oil to prevent itching\\nand assist the-healing process. It will also do much to suppress the\\noffensive odor often present in this disease. As disfigurement\\nis greatly increased by scratching, the patient must refrain from it\\nas far as possible. The scabs should be left until they dry and are\\nrubbed off. The face may then be painted with the tincture of\\niodine to prevent warty nodules, but nothing will prevent scars if\\nthe lower layers of the skin have been destroyed.\\nNot until the patient has taken five or six baths at intervals of\\ntwo days each, after all the scabs have disappeared, and has spent\\nconsiderable time in the open air, should he be allowed to resume\\nhis place in the family or mingle with other people.\\nAll bedding and furniture contained in the sick-room should\\nbe very carefully disinfected or, better still, burned and until\\nthe room has passed through a most thorough course of disinfec-\\ntion no one, not immune to the disease, should be allowed to en-\\nter it. The nurse and physician, while attending a case of small-\\npox, should never meet other people without having first care-\\nfully bathed and cleansed themselves, dressed in clean clothing,\\nand taken a thorough airing.\\nThere is no way of aborting small-pox after it has begun.\\nNo intelligent person any longer thinks of attempting to modify\\nit by sweating, vomiting, purging or bleeding.\\nVACCINIA.\\n(Cow-pox.)\\nAs already shown, the discovery that small-pox can be robbed\\nof its chief terrors by inoculation was of priceless value to the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0310.jp2"}, "309": {"fulltext": "GEXERAL DISEASES. 291\\nhuman race, but it had this very grave defect The contagion of\\nthe disease thus induced is as virulent and dangerous to other\\npeople as any other case of small-pox. It remained for Jenner, an\\nEnglish physician in 1798, to bring to the attention of the scientific\\nworld the curious fact, which for some time had been known and\\npracticed by his townsmen, that cow-pox introduced into the hu-\\nman system by inoculation, now called vaccination, renders it\\nfor a time, at least, almost immune, and, in a large majority of\\ncases, after thorough and satisfactory revaccination, constitutes\\nan absolute protection against small-pox, and when it does not en-\\ntirely prevent the disease, almost always so modifies it that it is\\nattended by little if any danger.\\nCow-pox, or vaccinia, is an acute disease caused by a specific\\nvirus and occurs naturally in the cow, but is seen in people only\\nas a result of inoculation with lymph (virus), taken from the cow\\nor from individuals previously inoculated. The contagion is by\\nsome believed to consist of germs belonging to the class known\\nas micrococci, because they are always present in the lymph and\\nsince filtration of lymph destroys its virulence. Certain investiga-\\ntors also claim to have propagated these germs in substances pre-\\npared for the purpose, and from these artificial cultures to have\\nsuccessfully practiced vaccination: still it is not certain that the\\ndisease is due to these cocci rather than to another germ that has\\nthus far eluded detection.\\nAs skin diseases, scrofula, syphilis and the like, may be trans-\\nmitted by vaccination from one person to another, too great care\\ncannot be taken to secure healthy lymph, and although lymph\\ntaken on the eighth day from the vesicles of a patient is quite as\\nefficient as animal lymph, the latter is much to be preferred be-\\ncause of the greater certainty of its being free from such contami-\\nnations. There is no danger in using the lymph obtained at prop-\\nerly managed vaccine farms from inoculating healthy heifers. It\\nis usually preserved on bone or ivory points, and kept on sale at the\\ndrugstores.\\nUnless at a time of great danger from small-pox infection, a\\nchild should not be vaccinated unless in good health and until it is\\nfrom six to twelve weeks old. The outside of the arm, midway\\nbetween the shoulder and elbow, is the place generally selected for\\nthe insertion of the lymph, but for girl babies many careful moth-\\ners prefer to have it placed in one of the lower limbs, because of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0311.jp2"}, "310": {"fulltext": "292 GENERAL DISEASES.\\nthe ugly scar it causes. The skin should be cleansed and drawn\\ntightly and a place a half-inch square scarified by cutting many\\nparallel and cross lines with a lancet or sharp pointed knife just\\ndeep enough to scarcely start the blood, then dip the vaccine\\npoint in water and thoroughly rub its charged sides upon the\\nscarified surface, and when it has dried protect it with a little cot-\\nton-batting, or soft cloth. If there is any erysipelas or suppura-\\ntion in the house keep the place of inoculation protected by cover-\\ning it with a pad of antiseptic cotton.\\nSoreness begins in two or three days and about the eighth\\nday the vesicles reach their most perfect stage, but the swelling\\nmay continue two or three days longer. There is more or less\\nhardness and sense of tightness of the skin, itching, heat, pain\\nand stiffness, and during maturation there may be fever, sometimes\\nreaching 104 degrees. In about three weeks the scab which has\\nformed falls off, leaving a permanent scar. If the first vaccination\\nfails or is only partially successful there should be revaccination in\\na few days, and it is necessary to revaccinate after puberty, no\\nmatter how perfect the vaccination may have been in early child-\\nhood. If this revaccination is thoroughly successful it is thought\\nby many to be sufficient for the remainder of life, but vaccination\\nis not an invariably permanent preventive, and a person exposed\\nto small-pox should be immediately vaccinated, whether he has\\never been vaccinated before or not, for the stage of incubation in\\ncow-pox is shorter than that of small-pox and the severer disease\\nmay thus be averted. When small-pox has begun vaccination will\\nin no way modify its course. There is a much smaller proportion\\nof deaths from this disease in persons in whom the effects of a\\nsingle vaccination have so far worn out as to render them no\\nlonger immune, than there is in people who have never had any\\nprotection. Vaccination may lead to blood poisoning and ery-\\nsipelas, but these cases are extremely rare.\\nTreatment. It usually is necessary only to protect the arm\\nfrom irritation. The vesicles must not be scratched and the scab\\nshould be left until it falls off. In case of much inflammation the\\npart should be covered with wet lint, cream or powdered starch.\\nDuring the fever the child should be kept in the house and given\\na mild laxative, as a teaspoonful of castor oil or Epsom salts, as\\noccasion may require. If unusual complications arise they must\\nbe specially treated.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0312.jp2"}, "311": {"fulltext": "GEXERAL DISEASES. 29b\\nYELLOW FEVER.\\nYellow fever is an acute, specific, highly infectioas disease, oc-\\ncurring chiefly in epidemics within certain geographical limits in\\ntropical or subtropical countries. Although skillful scientists have\\nlong looked for the micro-organism which produces it, and sev-\\neral have at different times announced its discovery, no one has\\nyet succeeded in isolating a germ that has been found in over fifty-\\nsix per cent of the cases investigated, including even post-mortem\\nexaminations, nor in finding one that by inoculation produces\\nsymptoms in animals sufficiently like those of yellow fever to\\nwarrant the conclusion that they are those of the disease itself, or\\nof a modified form of it. So good an authority as Guiteras says\\nAs far as our present methods go, it is impossible to distinguish\\nbetween a drop of yellow fever blood, and blood from a healthy\\nman. Yet no intelligent person any longer doubts that yellow\\nfever is a germ disease, for its phenomena can be explained upon\\nno other theory.\\nBad sanitary conditions will not produce the disease, de novo,\\nbut they furnish excellent soil for its propagation, for when once\\nintroduced the infection increases with great rapidity in decaying\\nmatter and all kinds of filth. The germs are transmitted through\\nthe air and may enter the lungs through the breath, and thence\\nfind their way into the blood, or they may enter the system upon\\ncontaminated food, but it is probable that the usual mode of in-\\nfection is by their settling upon the lips or being drawn into the\\nmouth, and finding their way in the saliva to the stomach, thence\\nto the upper portion of the small intestine, which is their favorite\\nhabitat, and, rapidly multiplying, produce the poison that by ab-\\nsorption gives rise to the disease. One attack, however light, ren-\\nders the patient immune ever afterward. Natives of yellow fever\\ncountries are less susceptible than immigrants, and negroes are\\nless liable than whites, and, when they do take the disease, have\\nit in milder form. The time from exposure to the appearance of\\nthe first symptoms varies greatly, ranging from one to ten days.\\nThe following treatment for yellow fever is given by Surgeon\\nR. D. Murray in the report prepared for 1898 under the direction\\nof the Supervising Surgeon-General Marine Hospital Service of\\nthe United States\\nI have seen yellow fever in twenty-one summers and in every\\nmonth, except February. The elimination of yellow fever from", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0313.jp2"}, "312": {"fulltext": "294 GENERAL DISEASES.\\nour nomenclature will follow when there is a proper conception of\\nthe influence of clothing, bedding and unclean bedrooms as trans-\\nmitters. The disease is borne for some distance; the infection is\\nstronger at sometimes and places than at others; whether it is in-\\ntensity or quantity I do not know it may be diluted, and is trans-\\nmitted by clothing bedding and related articles. Hair from the\\ndead has transmitted it; corn sacks, blankets and old newspapers\\nhave carried it mountains of filth will not produce it but they\\nmay give it a new nidus or garden from which it goes out seeking\\nwhom it may devour. The cleanest town in the South may have\\na severe prevalence if the people insist on disobeying the advice of\\nthe health officials.\\nIn 1875, as a result of several post-mortems and an attack\\nof the disease, I came to the conclusion that yellow fever is\\nprimarily an inflammation of the duodenum. Many post-mortem\\nexaminations have since convinced me that the primary lesion is\\nin the duodenum, and I insist that the mildest cases have a lesion\\nin that organ which can be demonstrated, if due care be taken.\\nThe same after-death examinations, as well as bedside experience,\\nhave shown that the death-dealing process is not the inflam-\\nmation that I was taught thirty years ago to understand as in-\\nflammation, i. e., there is no proliferation of cells or tissue, and no\\nnew growth.\\nThere is a primary involvement of the duodenum and the\\nsymptoms of the disease generally follow in regular order. The\\nmildest cases have a tender duodenum if you know how to press\\nand a little backache (note how close to the spinal column the\\nduodendum lies.) If the stools could all be examined, sometime a\\nmass of white mucus with a black or brownish middle would be\\nfound. Perhaps there would be a stool of black mucus only once;\\nbut it is fair to say there is always a clay or bismuth stool with the\\nmucous clot stained with black. In bad cases the upper intestine\\nand stomach are also involved.\\nSometimes the symptoms come in such quick succession\\nthat we think the attack is necessarily fatal. Many times in such\\ncases Ave have no chance to ask the patient how matters fared\\nwith him twenty-four or thirty-six hours before, when he was sick,\\nbut would not admit it. Walking cases are as common in this as in\\nother bed diseases. I have known a man, suffering with head-\\nache, to remain on duty three days, then vomit black on the stairs", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0314.jp2"}, "313": {"fulltext": "GEXERAL DISEASES. 295\\non the way to his death bed. I have given immune certificates to\\npersons who did not go to bed at all.\\nIn ordinary, the patient should like the medical attendant. If\\nthe physician is distrusted, he should be called out, that a favored\\none may step in. Consultations over a patient are injurious. I\\nwould have the doctor do his share in keeping up courage, hope\\nand life-purpose in his patient to minimize the aches, distress and\\nfears, and to carry the patient s mind away from the now with\\nits dreads to to-morrow, with its rewards or revenges. Several\\npeople are living now 7 because, in their desire to take vengeance\\non me for what they thought was my indifference, they forgot\\nthemselves and their condition.\\nNot every case needs treatment.\\nOf one hundred cases, seventy-five need only to be let alone,\\nboth by physician and nurse. They will get well under any plan\\nof treatment and under miserable local conditions notably so of\\ninfants, who, if they die, are generally sacrificed by curds or some\\nacrid medication. These seventy-five are cases and should be\\nrecorded, but only for the sake of good records and to establish\\ntheir immunity. They should receive only what occasion de-\\nmands and be watched for untoward incidents. Of the other twen-\\nty-five, some will need formal attention and careful procedure;\\nothers will die in spite of all reasonable aid. Some vicious habit or\\nchronic disease will add to the trouble, and in some cases uncon-\\ntrollable fear will insure a fatal result.\\nMy oldest patient to get well was 109 years of age the young-\\nest was 52 hours old when she threw up black vomit. One of my\\nchildren had black vomiting five days after she was born. I know\\nof the recovery of a chronic B right s disease sufferer; of a mor-\\nphiomaniac s recovery, and I last summer gave a diabetic doctor\\nsuch cheerful counsel that he had a severe attack without fatal\\nresult, and has been in better health since than before. These\\ncases show r the triviality of the disease if taken in time. Yellow\\nfever is the most honest, most trivial and cheapest to treat of all\\ndiseases that kill. It is honest because it comes with definite\\nsigns and leaves no trace, always assuring the afflicted one that\\never after he will be immune it kills, if at all, in a few days, and\\nis merciful in the killing, as the doomed one is conscious to the\\nlast and does not linger, as a consumptive or victim of cancer\\ntrivial, because fifty per cent of the cases are scarcely aware of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0315.jp2"}, "314": {"fulltext": "296 GENERAL DISEASES.\\nserious illness, and have no sequels to make them miserable the\\nrest of their lives also because it rarely takes off children, and by\\nreason of the attack they gain the privilege of living in its habitat\\ncheapest to treat, because it is so, the medicine needed costing very\\nlittle.\\nTreatment. When called to a man who has had a chill some-\\ntime during the previous night, has a pulse of ioo to 112, with\\ntemperature of 101.5 degrees to 103 degrees, headache (cutting\\nacross the forehead), backache running down into the thighs, sore\\nmuscles, skin hot if you hold your hand on it a while (hands and\\nwrists not hot to gentle touch), loss of appetite, white tongue\\n(may be a yellow center far back the red edges and red diamond\\non tip will not show at once), suffused eyes and notably or faintly\\npurpled cheek bones with half-puffed upper lip, the hundred\\nchances are you have a case of yellow fever. Yellow fever usually\\nbegins at night when the person is in bed and in a relaxed condi-\\ntion malarial fever usually attacks when the patient is at work.\\nNight watchmen have sickened in daytime. A restless early morn-\\ning in bed, with little desire for breakfast, is a frequent history;\\neverything eaten at breakfast does harm in such cases. Dengue\\npains are w T orst in joints yellow fever soreness is between the\\njoints. As to malarial coincidents, there is no rule for differentia-\\ntion excepting, perhaps, the attack in bed or at work.\\nGive three or four compound cathartic pills at once, and as\\nsoon as possible give a hot foot bath with or without mustard\\nand salt. An all-over bath is better, but is not always possible.\\nMustard at this time is really non-essential, but sometimes the\\npatient thinks it is the proper thing so with table salt. As to the\\ncathartic, calomel at first is too slow and usually must be sent\\nfor; the pills contain enough of it and are in your vest pocket.\\nEverv yellow fever doctor should carry First, doses of compound\\ncathartic next, compound acetanilide tablets then, such other\\npocket remedies as may be needed on emergency. The parade of\\na small medicine chest is not advised. Do not begin to make a\\nreputation for wonderful medical skill now. Dwell on the dengue\\nsymptoms and the signs of malaria, and without great formality\\nconvince your patient that it is not yellow, but do not say so.\\nKeep back information as to the actual temperature all the way\\nthrough. No patient should ever hear that his temperature went\\nabove 102 degrees until after he gets well. (I saved a doctor once", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0316.jp2"}, "315": {"fulltext": "GENERAL DISEASES. 297\\nby hiding his thermometer and using my French scale, which he\\ncould not translate.)\\nGive as soon as convenient, or, if fever is above 102 degrees, at\\nonce, any coal tar derivative in seven and a half grain doses, with\\nsome bicarbonate of soda and caffeine. The antikamnia compound\\nis a good one. If powders or tablets are objectionable to the\\npatient, give antipyrine. I nearly always use acetanilide with soda\\nand caffeine. Have no objection to any, except that I like cheap-\\nness and simplicity. After the bath and a good sweating, under\\nblankets, for from four to six hours, rub dry and cover with two\\nblankets. (The clothing should have been hung outside the house\\nor dumped into a tub of water; dispose of the wet sheets and\\nblankets in like manner. When washed and boiled they are ready\\nfor use again this hint in regard to prevention of infection.) If\\na person likes blankets next the skin they are better for prevention\\nof skin shock. Quilts and counterpanes are objectionable because\\nof the nasty odors they retain.\\nRepeat the coal tar derivative every three to six hours if fever\\nkeeps above 102 degrees; give for effect and not pro forma. Have\\nthe face and hands wiped frequently, give orange-leaf tea, Apol-\\nlinaris water, lemon-grass tea, hot lemonade, ginger ale, small sips\\nof ice water, and other drinks ad libitum, but not ad nauseam.\\nAlways start with the quantity you are willing the patient should\\nhave, and let him drain the cup this particularly in the case of\\nwater. Try to supply fluid for the three or four days sweating\\nthat will be kept up. Apollinaris is good on account of the com-\\nmon salt it contains for some reason common salt is a good thing\\nto give and has been grossly neglected. Passed Assistant Sur-\\ngeon Smith, on duty at Ship Island last year, used it, methodically,\\nabout a dram a day, with excellent results. I have always given\\nmuch salt in the food, but never gave it dry. No spirits of any\\ncombination should be even thought of for the patient.\\nThe first bowel actions should be while sitting up for the first\\nthirty-six hours or so for physical reasons, and for mental reasons,\\ntoo. If the bowels are not freely and completely relieved within\\nsix hours, give a small saline and let the patient choose the kind.\\nCastor oil is the best thing to give, but many so bitterly object\\nto it that it is not advisable in all cases. Sulphate of soda is the\\nnext best. As a rule, the magnesias cause griping and flatulence.\\nSeidlitz powders are good, but cause some gas and uneasiness", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0317.jp2"}, "316": {"fulltext": "298 GENERAL DISEASES.\\nhowever, the patient should have his choice, as he feels bad at this\\ntime and an insistence on one thing magnifies his dangers, in his\\nown mind. Sometimes an extra pill w 7 ill do the hoped-for duty.\\nI do not object to syrup of figs, castoria, or other cathartics only\\nwant results. If nausea is present an enema is in order.\\nDiet, or Lack of It, a Matter of First Importance.\\nDo not deny food, but give the milk-like water of long boiled\\nhominy or corn meal, salted and strained through cheese cloth.\\nKeep the pot boiling all the time. Rice water is good sago is\\nbetter, as it is slightly aromatic, but my experience has been with\\nthe poor. Mexican atole is excellent, made from crushed lye-\\nhominy. Sometimes it is well to flavor with a bit of meat juice.\\nChicken soup, with rice, so thin as to be equal to starch water, is\\nnot to be tabooed. The point is to give no food for four or five\\ndays, but to appear to give food regularly. Often, you must\\npromise food and abuse the nurse in the presence of the patient for\\nthe non-fulfillment of your orders, then apologize to the nurse out-\\nside.\\nIf the first fever remedy tires the patient, or seems to do him\\nno good, change the form here lactophenin or amonol or anti-\\npyrine will serve as substitutes maybe capsules of the same as\\nyou were giving will accomplish the object sought. Do not for-\\nget the bicarbonate of soda and caffeine. Remember always that\\nthe patient is sick not the doctor.\\nHere I must advise you to carefully consider the question of\\nmalaria, for the Laveran organisms can do their work while the\\nyellow fever germ is also active. In a malarial region it is advisable\\nto give from forty to sixty grains of a cinchona salt in the first\\ntwelve to twenty-tour hours, in order to ward oft or forefend a\\nmalarial chill, which might occur during the period that should\\nbe yellow fever convalescence. I lost two patients from malaria,\\ntwenty years ago, when they were convalescing from yellow fever.\\nIn non-malarious regions, or on shipboard, no such caution is nec-\\nessary, but in Mobile, New Orleans, Scranton, or the back country,\\ncare must be exercised. The preliminary cinchonidia or quinine\\nmay be given with the compound cathartic pills, and it is believed\\nthat early cinchona aids in producing calm in or to the patient.\\nDo not give all at once, and do not expect the cinchona salt to\\nact instead of the coal tar products. Give them together, or\\nnearly so.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0318.jp2"}, "317": {"fulltext": "GENERAL DISEASES. 299\\nAfter thirty-six hours or so give an enema every day and\\ntry to have a bed-pan used. It is impossible for some to use a bed-\\npan; in which cases have the patient helped up on a vessel or\\ncommode. Instruct the attendant that the patient must be helped,\\nand not allowed to use his own strength his muscular force must\\nbe saved. If the expected does not occur, give another enema with\\na long tube. A short catheter of thirty or thirty-two caliber should\\nbe in every yellow fever doctor s pocket, which, attached to an\\nordinary self-injecting syringe, makes a long tube. The large\\ncatheter has saved many lives it may be washed and used again\\ndo not fear infection.\\nEnemas may be made most quickly with soapsuds and mo-\\nlasses ordinarily soapsuds will suffice, later on not too strong.\\nConsider the stools and if they are not sufficient in quantity, and\\nyou have reason to believe there is a fecal matter high up, give a\\ndose of castor oil, two drams, and olive (not lard) oil, six\\ndrams, more or less as occasion seems to demand. Lemon juice\\nis the best vehicle for the oil. Perhaps it will be best to tell the at-\\ntendant to give the potion as if you knew nothing about it. Pa-\\ntients like to circumvent the doctor! I believe that small doses of\\ncastor oil and large doses of sweet oil will not produce the fre-\\nquent contractions of the colon and the common intussusceptions\\nof the small intestines that are found post mortem. Constant\\nperistalsis downward is necessary harsh purgation is to be avoided.\\nThis remark does not refer to the primary emptying of the bowel.\\nbut to repeated emptying efforts by calomel or pills or salts to in-\\nsure a daily bowel movement. Olive oil does not cause the bowel\\nstrictures that I dread I think small doses of castor oil will not.\\nI prefer to mix them and have saved many lives by this plan.\\nFor nausea use ice about the head, face and neck. A piece of\\nice in a cloth, rubbed rapidly about the lips, temples and neck, will\\nkeep down almost any offensive close. If the nurse cannot do it\\neffectively, or does it rudely, do it yourself. Give cocaine in one-\\nfourth grain tablets floated down the throat, repeating as required\\nsolutions do not accomplish the object as well and as patients are\\nhuman beings they might be poisoned. Dr. Thorington of Colon\\nintroduced cocaine as a remedy in yellow fever nausea, in doses of\\ntwo to three grains in solution. I think that I was the first to\\ninsist on small doses in tablet form floated into the stomach, where\\nit is needed. Bathing the face frequently with vinegar is excellent", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0319.jp2"}, "318": {"fulltext": "300 GENERAL DISEASES.\\nto subdue nausea. Eau sedatif is praiseworthy for the vinegar\\nit contains. Elegant toilet waters are pleasing to all and possible\\nto some. Mustard to the upper part of the abdomen is always to\\nbe resorted to, but avoid sickening the patient by putting the\\npungent mass too near to his nose. Look to the covering, the pil-\\nlow, the mattress, the commode, the nurse s breath, or other con-\\ndition, as a cause of nausea. A fresh sheet, or pillow case, or pil-\\nlow sometimes makes a lot of difference in the matter of com-\\nfort. Do not forget the bowel peristalsis; the duodenal bloody\\nsweat may be trying to get up into the stomach, and maybe an\\nenema from a long tube is now essential to produce quiet. To\\nrelieve restlessness and the aches and tired feeling it is well to\\nbriskly rub the legs and back with a coarse towel under the cover\\nevery three to six hours. Massage through the cover is some-\\ntimes grateful.\\nAfter sixty hours, in ordinary, examine the urine. If albu-\\nmin appears as a trace give more fluids. If the quantity increases\\nfrom five to twenty per cent, give turpentine in seven to ten drop\\ndoses every four hours. For five per cent albumen nothing but\\nmore fluid is necessary if it increases to seventy-five per cent give\\nmore turpentine. Rub the chest and back with turpentine, not so\\nmuch for absorption as to put your charge in a turpentine atmos-\\nphere, to prevent him from smelling and tasting the medicine. Do\\nnot let the patient know that you have examined, or want to ex-\\namine, the urine have portions saved without his knowledge.\\nIt is amazing what quantities of turpentine can be taken without\\nharm. There is no danger from strangury. I have given half,\\nsometimes a teaspoonful, to children where there was suppression,\\nand generally with good effect. But it is not advisable to give\\nall that may be considered necessary in a case at one dose. Tur-\\npentine is a diffusible stimulant and a good styptic; it is laxative\\nalso. I have never seen a particle of benefit follow the adminis-\\ntration of digitalis. Large enemas of water, about the temperature\\nof the air, or cooler, placed high up, do much good if retained.\\nPlease note that the kidneys are not inflamed, but rather para-\\nlyzed.\\nFor sleeplessness after the second night give sulfonal in fifteen\\nto thirty grain doses, and repeat if necessary in three or four\\nhours. Bromide and chloral are good, but are often borne badly.\\nI used trional once with good result. Sleeplessness is often due", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0320.jp2"}, "319": {"fulltext": "GEXERAL DISEASES. 301\\nto the odor from a dirty quilt or pillow sometimes to a lumpy\\nmattress. These may seem trivial, but it is a doctor s business\\nto look out for his patient. In some cases a woolen shirt a\\nsweater is necessary, as in restless children and persons who will\\nnot keep the arms under cover.\\nAs the fever subsides diminish the remedies and increase the\\nfood, but it is generally unsafe to give anything like milk or eggs\\nbefore the fifth or sixth day. The patient will not starve to death,\\nbut if he is fretted by a great lot of rules, or unpleasant attendants\\nand surroundings he may not get well.\\nCollapse.\\nCollapse is a horror. Generally an enema with a little whisky\\nand turpentine, given with a long tube, will do good. Hypoder-\\nmic strychnia, brisk rubbing of arms and legs and back with mus-\\ntard is to be adopted. It is always necessary to procure an action\\nfrom the pylorus downward. If this is not done there will soon\\nbe black vomit. A deft administration of olive oil, one to three\\nounces, is a life-saver. Collapse is usually caused by an influence\\nequivalent to surgical shock, and the organs through which the\\nshock comes are in order of frequency the stomach, from excess\\nof, or because of faulty food the skin, from chilling by getting up\\nor getting uncovered the brain, from hearing bad or unwelcome\\nnews. To avoid collapse it is needful to prevent any shock to the\\norgans mentioned. Whatever the origin of the collapse, the treat-\\nment is the same, but in case of mental disturbance some abusive\\nor consoling talk, as the case requires, must be indulged in also.\\nMore people have died in consequence of too early or imprudent\\nfeeding than is generally supposed. I have saved a life by insist-\\ning on having a window shut down to prevent the entrance of the\\nlovely breeze. Free ventilation has caused the death of many;\\nso has the sleepy nurse who let the rolling patient get naked in\\nthe chilly hours of the early morning so has the gossipy neighbor,\\nwho consoled the convalescent by telling him of the death of a\\nfriend, or the outbreak of fever in the town to which the patient s\\nfamily had fled. There is another source of collapse. During\\nearly convalescence there is an excessive venereal desire, and un-\\nder such circumstances conscience is much dulled or dead. It is\\nnecessary to warn the partner, who is not sick, or arrange that\\nman and wife shall not be left alone until convalescence is complete.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0321.jp2"}, "320": {"fulltext": "302 GENERAL DISEASES.\\nThus nurses of the opposite sex are to be doubted and tabooed, if\\npossible.\\nI am confident that collapse, whatever its apparent cause, is\\ngenerally accompanied with an obstruction of the small intestine\\nand oftener in the upper part. I would like to say that the shock\\ncaused the obstruction. Sometimes it is food then high up\\nsometimes it is intussusception then lower down sometimes it\\nis clue to a contracted colon, but if the patient could have been per-\\nmitted to lie in quiet there might have been continued peristalsis.\\nThere are some who dispute my mechanical theories and the\\neffects of mental conditions.\\nSecondary Fever.\\nThe secondary fever (that of after five clays) is a ptomain\\npoisoning and needs some modifications of the routine. Give anti-\\npyretics and high clysters for effect and increase the food. Ice to\\nthe head and rubbed down the spine, every half hour rolling the\\npatient from side to side, will do good. Alcohol will do much\\ngood at this stage the patient s choice is the form to use brandy\\nis the worst form as it produces hiccough. Dry catawba has\\nserved me well. Gin is the best form, as it may assist the kidneys.\\nI have never seen any benefit follow champagne ginger ale is bet-\\nter.\\nContinue the turpentine if the albumin compels it. I think\\nguaiacol rubbed into the skin of the abdomen would be beneficial,\\nbut I never had a chance to try it if put into the stomach, it is\\nliable to cause nausea and eructations. Chronic vomiting after\\nfour or five days may be relieved by cocaine, or one- tenth grain\\ndoses of calomel with one grain soda bicarbonate frequently re-\\npeated. One-twelfth grain closes of morphia hypodermically do a\\nlot of good; watch the urine, for opium increases the albumin or\\nthe chance for it. Small blisters over the stomach do good service.\\nSometimes bismuth serves a good purpose peppermint and soda\\nhave served well, but it is necessary to compel a through and\\nthrough action of the bowels.\\nFor five days give no food but thin starches. Milk kills, as\\ndoes every sort of food that requires stomach digestion. Lime-\\nwater alone sometimes gives comfort to the stomach, but mixed\\nwith milk it often causes the milk to stay in the stomach to be-\\ncome curds in the half rotten duodenum. Patent and predigested", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0322.jp2"}, "321": {"fulltext": "GENERAL DISEASES. 303\\nfoods are all right in the ptomain fever and recuperating stages,\\nbut hurtful for the first four or five days; so with opium and\\nalcohol.\\nThe physician should remember always that the senses of the\\nyellow fever patient are as acute as those of a puerperal fever pa-\\ntient and that all necessary subterfuges must appear to be absolute\\ntruth. I know of many deaths due to actual truth, brain shock and\\ncollapse following. There is no other febrile disease in which\\nphysic and the mind play such prominent roles. A constipated\\npatient, or one who has a dreadful fear of the fever, will, as a rule,\\nnot recover.\\nPrimarily, it is the physician s duty to be, or to appear to be,\\nfrank, nonchalant, observant, cheerful, confident, hopeful and posi-\\ntive he must convince the patient by word or manner that he\\nfor one among the sick is not suffering with the prevailing fever\\nand is not very sick. Except in disputed cases, a half dozen ques-\\ntions will elicit all the information needed for detailed action for\\nthe next twenty-four hours. As patients later in the disease are\\nall embracing in acuteness of senses, it is necessary to be frank\\n(not truthful) and to remember and adhere to whatever has been\\nsaid before. Many a life has been lost by ill-advised sympathy,\\ntoo much nursing and attention, too frequent dosing, and sense-\\nless gossip.\\nIf obedient, the more ignorant the nurses in this disease the\\nbetter. All the professional nurses I have seen are at odds with\\nthe doctor and continuallv try to convince the patient that when\\nall fails he will bring order out of chaos, and, presto the patient\\nwill be cured. The nurse should have only sense enough to obey\\norders. Dumb nurses would be ideal in all critical or extra\\ncritical cases. The doctor should know how to direct the nurse\\nas to his duties and to emergencies and crises, and should be care-\\nful that no disputes arise. The sick person must depend upon\\nnurse as well as doctor. I know of too many preventable, but not\\nprevented, deaths due to strife between physician and nurse un-\\nfortunately, in some instances the doctor was to blame in being\\ncareless in giving directions. I know of some cases sacrificed to\\nthe zeal of the nurse who knew more than all the doctors.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0323.jp2"}, "322": {"fulltext": "304 GENERAL DISEASES.\\nFirst Aid To Suspicious Cases.\\nIn the Brownsville epidemic I was compelled to include within\\nthe cordon a small region inhabited by non-immunes. If I had\\nacted in accordance with the laws of Texas then in force, I would\\nhave exposed many more people and had an area to care for nearly\\nas large as Rhode Island. To protect the people outside the\\ninfected town and inside the guard line I supplied my guards and\\npatrols with the medicines then in use, i. e., compound cathartic\\npills, mustard, and quinine pills, and gave directions for their use.\\nNearly a hundred cases were treated by the guards, in the coun-\\ntry, without a death. Since then I have advised interested persons\\nto provide the pills, mustard, and acetanilide in advance. Were I\\nto outfit a guard line now, I would furnish compound cathartic\\npills, compound acetanilide tablets, and mustard, to be used while\\nthe doctor was being summoned, I have suggested to Major\\nO Reilley, of the Army Medical Corps, that the pills and tablets\\nbe added to the first-aid package of the troops who go into yellow\\nfever regions, with instructions for a man to take a pill at bedtime\\nif his bowels were not freed during the past day; to take more\\nif he has a chill in the night, and to^take a tablet if he suffers with\\nheadache. It takes time to get a physician, and I feel confident\\nthat if men are given a little instruction and the few necessary\\nremedies there will be less suffering and perhaps less mortality.\\nIt is well known to Southern physicians that a dose of compound\\ncathartic pills will stop a malarial attack, particularly in negroes,\\nand it is believed that the use of the coal tar derivatives has less-\\nened the necessity for cinchona in the treatment of malarial dis-\\neases.\\nI have tried to tell how to treat the yellow fever with a limited\\nnumber of remedies. Any person who will carefully follow direc-\\ntions will succeed in keeping the death rate at about four per\\ncent, and, counting accidents, age, habits and conditions, that is as\\nlow as can be expected.\\nFor ridding the premises of infection after recovery, see chap-\\nter on Disinfection.\\nPrevention.\\nAs one in perfect health is less susceptible to this disease, per-\\nsonal hygiene is very important. In addition to avoiding every\\nknown means of infection, the bowels, kidneys and skin should be", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0324.jp2"}, "323": {"fulltext": "GEXERAL DISEASES. 305\\nkept in first-class condition. Constipation is especially to be\\nguarded against the bowels should be moved every day, by a mild\\ncathartic if necessary, but excessive purging should be avoided.\\nPartake freely of ripe, juicy fruits and fresh vegetables, all of which\\nare safer for being cooked safest for being boiled. It is not\\nthought that yellow fever is a water-borne disease, but it is a wise\\nprecaution, especially at this time, since malaria is often a danger-\\nous complication, to boil all the drinking water and thus free it\\nfrom germs of every kind. Indulge but sparingly in meats do\\nnot use alcoholic drinks avoid great bodily fatigue, and undue ex-\\nposure to the sun for this purpose the pith helmet is the best hat\\nThe house should be on high, well-drained ground, where\\nthere is free circulation of air and plenty of sunshine, and so\\nplanned that the sun can shine into every room sometime during\\nthe day. There should be no closet under the stairs, and no dark\\nor damp cellar. Damp ground, dark rooms, deep shade, imperfect\\nsewers, decaying matter and all kinds of filth, favor the develop-\\nment of this infection and are a constant menace.\\nAs chilling is one of the most dangerous of all the causative\\ninfluences, great care must be taken not to cool quickly when\\nheated, not to get wet, and not to expose the body to night air.\\nSoft woolen clothing should be worn next the skin, plenty of\\nblankets used at night, and care taken at all times to avoid draughts\\nof cool air. There is far more danger from infection at night and\\non damp or cloudy days, hence leave your home as little as possible\\nexcept when the sun is shining brightly from ten o clock till four\\nis considered the safest for being abroad. If obliged to be out in\\nthe early morning, first drink a cup of hot coffee and wear warm\\nclothing. During the day throw open all parts of the house to the\\nfree ingress of pure air and bright sunshine, but close them as night\\napproaches. As the infection is denser or more virulent near the\\nground, as far as possible sleep up stairs.\\nKeep the mind occupied with work or pleasing themes, and\\ndo not worry about anything. The authorities are not agreed that\\nfear of the fever increases the danger of contracting it, but they\\nare united in declaring that when once the disease has seized a\\npatient, great fear as to the result is one of the most damaging ele-\\nments in the case. Many, who would probably have recovered had\\nthey been kept in ignorance, have been frightened to death on\\nlearning that their disease was yellow fever.\\n20", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0325.jp2"}, "324": {"fulltext": "CHAPTER III.\\nBy R. E. McVey, M.D.\\nTHE LIVER.\\nThe liver is the largest gland in the human body, and in many\\nrespects the most wonderful, since it varies more in size, shape and\\nfunctions than any other. Not only does its weight in adults range\\nfrom less than two to more than five pounds, but it varies greatly\\nat different times in the same individual while in health, and much\\nmore when under the influence of disease. Its average size in\\ninfancy is one-twenty-fifth that of the person in adult life one-\\nthirty-fifth, and in old age one-forty-fifth; but in disease it may\\nbe reduced to one-eightieth, or enlarged to one-seventh of the\\nweight of the entire body. In the average man of good develop-\\nment it is about a foot\\nacross the longest way,\\nwhich is from side to side\\nof the trunk, six or seven\\ninches wide, some three\\nand a half inches thick at\\nits largest place and con-\\ntains about one hundred\\ncubic inches.\\nIn shape it also var-\\nies much, conforming to\\nthat of its owner. Any\\nconstriction of the waist,\\nas tight lacing, not only\\npresses this organ up or\\ndown so that it is often\\npermanently displaced,\\nbut frequently causes\\ndeep fissures or creases\\nin the substance of the\\nliver itself. While these\\nPosition and Relative Size of the Liver. abllOmial COllditioilS are\\n306", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0326.jp2"}, "325": {"fulltext": "GENERAL DISEASES. 307\\nmost usual among women, they are not uncommon in men accus-\\ntomed to wearing tight belts.\\nIt is situated under the right lower ribs, its lower border cor-\\nresponding to the lower border of the ribs and its upper part is\\non a level with the fifth rib. It extends from the right side to a\\nlittle past the middle line of the body. When enlarged it may\\nextend much beyond these boundaries.\\nAlthough many of the most skillful scientists have given a\\ngreat deal of study to the liver, some of the changes wrought\\nwithin its tissues are still very little understood. It is not likely\\nthat aliitssecretscverwill be found out until new methods of inves-\\ntigation shall be devised, but it has been learned with a good deal\\nof certaintv that its functions are at least fourfold. They are:\\nFirst. The preparation of glycogen or animal starch.\\nSecond. The purification of the blood.\\nThird. The formation of new blood from the nutritive and\\nlife-giving elements, as derived from the digested food and poured\\ninto it through the great portal vein.\\nFourth. The secretion of bile a yellowish-green, bitter,\\nsticky, nauseous fluid, most of which is stored in the gall-bladder\\nuntil needed to aid in the processes of digestion, when it is dis-\\ncharged into the intestine. A powerful antiseptic, it is supposed\\nto also serve a useful purpose in preventing putrefactive changes\\nwithin the intestines and, as it consists in part of what is thought\\nto be waste and impurities from the blood, it acts as a scavenger\\nby carrying this refuse into the channel leading to the sewer of\\nthe body.\\nThe liver works all the time but is very much more active dur-\\ning the periods of digestion immediately following meals, and it is\\nprobable that the chemical changes then taking place in the forma-\\ntion of glycogen, blood and bile, also make sufficient heat for\\nimmediate wants, and that as this supply subsides the deficiency\\nis met by chemical reactions upon the starch and fats in other\\nwords, by burning fuel stored up for this purpose, and into the\\nfurnace with them are thrown the worn-out blood corpuscles and\\ntissue debris.\\nXot only are itS duties many and laborious, but its mechanism\\nis so delicate that its finest ducts and tubules are only one two-\\nthousandth of an inch in diameter, and as it must begin work\\nupon the products of digestion as often and almost as soon as any", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0327.jp2"}, "326": {"fulltext": "308 GENERAL DISEASES.\\nfood or drink is taken, and must continue to receive and transform\\nthem until digestion is finished, no matter how poor the quality or\\nexcessive the amount, it is not strange that of all the organs of\\nthe body the liver is the one most likely to become disordered.\\nThen, too, its derangements act more quickly than those of any of\\nits comrades, upon the other organs, especially the stomach and\\nintestines, and scarcely later upon the nervous system, particu-\\nlarly the brain.\\nThis extreme sensitiveness, though often disagreeable to its\\nowner, is a great advantage to his organism, for by its protests it\\nwarns him when he takes too much, too little, or the wrong kind\\nof food or drink, when he takes them at the wrong time or swal-\\nlows them too quickly, when he gets too much or too little exer-\\ncise, or too little sleep, or has been exposed to cold, or is too\\nanxious, or worries, or overworks his mind. The sage was doubly\\nwise when to the question, Is life worth living? he replied:\\nThat depends upon the liver, for so dependent are all the other\\norgans upon this great gland that, more than the determination\\nand will, it decides in advance what its owner shall enjoy or suffer\\nand what he may and may not accomplish in life.\\nCONGESTION OF THE LIVER.\\nCongestion means the act of gathering into a mass, but in\\nmedical language the term is used to designate an unnatural\\naccumulation of blood in any part of the body. It is the most com-\\nmon of all liver disorders. As already stated, this organ is very\\nsensitive to kind and quantity of food and drink, temperature, rest,\\nexercise and emotional excitement. When from any cause its cells\\nare rendered unable to properly transform and remove from the\\nblood certain materials as fast as absorbed and sent up from the\\nintestines, the minute branches of the portal vein, by which they\\nare distributed throughout the liver, are obstructed, and, becom-\\ning engorged and enlarged, so press upon other parts of the\\nmechanism as to interfere with their free and perfect operation\\nuntil, as the work continues to accumulate and the pressure in-\\ncreases, the whole gland becomes more and more helpless.\\nSymptoms. The symptoms of this disease are numerous and\\nvaried, but of course do not all appear in any one case. The fol-\\nlowing are some of them Either diarrhea or constipation, head-\\nache, mental confusion, nausea, flatulence, low spirits, loss of appe-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0328.jp2"}, "327": {"fulltext": "GENERAL DISEASES. 309\\ntite, sense of fullness, tenderness just below the ribs, pain in the\\nback or right shoulder, loss of strength and flesh, alterations of\\nvision, sleeplessness, sometimes jaundice, dizziness and difficult\\nbreathing, weariness and aching of the limbs.\\nTreatment. In many cases all that is needed to restore an\\nenlarged liver to perfect health is rest, but as that is permitted to\\nthis organ only when the current of digested nutrients absorbed\\nand borne to it from the intestinal surfaces is greatly diminished,\\nthe amount of food should be cut down to a very low limit. The\\ndiet must be rigid both in quantity and kind, and the food most\\nacceptable to the stomach may be just the thing you should not\\ntake. The popular idea that lean meat, dry bread and tea and\\ncoffee without milk are good in this disease, because easy to\\ndigest, is wrong, for they impose too much work upon the liver\\nafter leaving the alimentary canal.\\nAlthough farinaceous foods do not digest as readily, they are\\nbetter, for when they finally enter the portal vein they are so far\\non their way to grape sugar as to cause the liver no trouble.\\nHence eat foods composed largely of starch, such as corn and oat\\nmeal, hominy, rice, sago, potatoes and fruits, either fresh, canned\\nor dried. Nearly all vegetables are admissible, but peas and beans\\nshould be eaten sparingly. Take no eggs, unless it be a yolk now\\nand then, and discard most meats, especially pork and veal.\\nBoiled chicken, codfish and oysters may be taken, but pastries,\\nstimulants, alcoholic drinks and tobacco should be let alone.\\nChoose from this list such articles as best agree with you. Take\\nmild exercise in the open air every day that the weather permits,\\nand as far as possible avoid warm, damp, malarious regions.\\nCHRONIC CONGESTION OF THE LIVER.\\nIn cases of long standing the derangements may have gone\\nso far that rest alone cannot restore a healthy activity, and often\\nthe congestion is not limited to the liver, but has extended to all\\nthe internal organs. Of all remedies for chronic simple enlarge-\\nment of the liver there is no other nearly as good as calomel if it\\nbe properly used, which means that it should be taken in very\\nsmall doses, and its value is much enhanced by combination with\\npepsin. One-fifth grain of the former with two grains of the\\nlatter, after dinner two or three times a week, may be sufficient.\\nFor quiet, useful and sure action upon the liver sulphate of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0329.jp2"}, "328": {"fulltext": "310 GENERAL DISEASES.\\nsoda is also excellent. It should be taken before breakfast in tea-\\nspoonful doses in a half-glass of water. For cases of obstinate con-\\nstipation, or of congestion caused by severe colds, one-fifth of a\\ngrain of calomel every two hours until five doses have been taken,\\nand followed the next morning by a tablespoonful of castor oil, is\\na very reliable remedy.\\nThe following is an old prescription and preferred by some\\nSulphate of soda four ounces\\nSulphate of magnesia one ounce\\nChloride of ammonium two drams\\nNitrate of potash two drams\\nCommon salt one ounce\\nPowder finely, mix and keep well stoppered, in a large-necked\\nbottle, and take a teaspoonful in a half-glass of water every morn-\\ning before breakfast. For quickly removing the bad taste and set-\\nting the system in order, this has few equals.\\nEffervescing phosphate of soda, in tablespoonful doses, is also\\ngood in these cases.\\nSometimes all that the liver needs besides rest is a thorough\\nwashing out, to accomplish which drink a quart or more of water\\nevery day, in half-pints at equal intervals between meals. It should\\nbe boiled for fifteen minutes, then thoroughly cooled, and may be\\nflavored with lemon to suit the taste.\\nLinseed meal poultices and hot fomentations applied to the\\nregion of the liver are often useful. The wet girdle is an excellent\\ndevice for this trouble. It is best made from a piece of toweling\\nnine or ten feet long wet about half of it, wring enough to prevent\\ndripping, fold the wet end into several thicknesses large enough to\\ncover the front half of the body, and, having placed it in position,\\nwrap the dry part over it and around the body and secure the end\\nwith pins. It should be worn for weeks, sometimes for months,\\nand it is better to have several and wash and boil them often.\\nIf they injure the skin they should be discontinued for a few\\ndays, then worn again.\\nIn cases where there is much pain, counter irritants, such as\\nmustard poultices, may be applied, but they should not be worn\\nlong enough to blister. Massage, rubbing and pressing should\\nnot be employed, for such treatment of an inflamed and tender\\norgan needing rest might do much harm.\\nThe custom of prescribing tonics for the liver, such as iron,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0330.jp2"}, "329": {"fulltext": "GENERAL DISEASES. 311\\ngentian and quinine compounds, is often pernicious. Neither\\nshould the appetite be whipped up with condiments and bitters.\\nNausea is nature s method of calling a halt when the body has\\nbeen too richly fed. You must obey its orders or suffer its pen-\\nalties. Absolute abstinence from food is not advised. Meals\\nshould be taken at the regular hours, but must be made of the\\narticles indicated and be as small as consistent with bodily health,\\nuntil the liver resumes its normal activity, after which practice such\\nself-denial as will not lead to a recurrence of the malady.\\nBILIARY CONCRETIONS.\\n(Hepatic Colic. Gall Stones.)\\nGall stones are granular, friable masses formed in the liver,\\nin the ducts leading from the liver to the gall-bladder, in this blad-\\nder itself, or in its outlet. They are from millet seed to lien s tgg\\nsize and are rounded, angular, faceted, or of very irregular shape,\\nas where one stone is made up from several smaller ones, adhering\\ntogether. They rarely occur in infancy and childhood, are com-\\nmon to both sexes during and after mature life, and are most\\noften found in women beyond the age of forty.\\nThey are yellow, brown, black, or brownish-green.\\nJust how they are formed is not known, but certain condi-\\ntions of the genial health are thought to be factors, and stag-\\nnation of the bile is probably favorable to their formation. Usu-\\nally there is but one or two present at one time, but occasionally\\nthey exist in great numbers, and may completely fill the gall-blad-\\nder. Not until the stone begins its passage through the duct, or by\\nstopping up the duct obstructs the passage of its fluids, is the pa-\\ntient likely to feel that anything is wrong, but at this stage, if the\\nstone is of any considerable size, there is sure to be very severe\\npain, which is relieved only when the stone passes through into\\nthe intestine or, as sometimes happens, returns from the duct into\\nthe bladder.\\nThese stones vary greatly in composition, but in by far the\\ngreater number of cases they are composed of coloring matter and\\nthe fatty substances of the bile, in which liquid this variety is solu-\\nble whenever it contains less than a saturating amount of these in-\\ngredients, hence, by changing slightly the composition of the bile,\\nstones in the gall-bladder may sometimes be dissolved, and the\\nformation of new ones prevented. nere the stone has entered", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0331.jp2"}, "330": {"fulltext": "312 GENERAL DISEASES.\\nthe duct, relief can be expected only when it has passed through.\\nSoon after the attack has subsided the stone may usually\\nbe found in the dejections by diluting with water then passing\\nthem through a coarse muslin or sieve, but in some cases the pa-\\ntient retains them for several days.\\nSymptoms. The disease is a difficult one to diagnose with\\ncertainty, unless there has been a previous attack followed by\\njaundice, accompanied with constipation and light-colored stools;\\nor unless the stones have been found. Heredity often throws some\\nlight upon the problem, as it is an affection likely to run in families.\\nIt is often associated with gout or neuralgia. It is likely to come\\non a feAv hours after a hearty meal, if not severe at first, soon be-\\ncoming so, and continuing to increase until the patient is in ter-\\nrible agony. The seat of the pain is in the upper part of the abdo-\\nmen and under the free ends of the false ribs on the right side,\\nfrom which it may radiate backward and upward, but never down-\\nward. The attack may be brought on by menstruation, indiges-\\ntion, strong emotion, or by a sudden jolt or strain. There is likely\\nto be vomiting and violent retching, and the patient is soon re-\\nduced to extreme weakness. The attack may last but a few hours,\\nbut in severe cases has been known to continue several days.\\nTreatment. As relief will come as soon as the stone passes\\nthrough the duct into the intestine and little can be done to has-\\nten the process, the first effort should be to ease the pain, and\\nthis should be done if possible without resorting to narcotics.\\nHeat is an anesthetic, not as powerful as morphia, but one in whose\\ntrain no dangers follow. Place a large, moist, linseed-meal poul-\\ntice between several thicknesses of paper and lay it upon a hot\\nstove, turning often to keep it from burning, and when w T ell heated\\napply the poultice as hot as can be borne to the affected parts, then\\nheat another to clap on as soon as the first shall cool a little, and\\ncontinue the process until the pain is relieved. In some cases ice\\nbags bring more relief than hot applications. Striimpell recom-\\nmends equal parts of chloroform and olive oil to be rubbed into\\nthe skin over the seat of pain by very gentle movements, but it is\\nprobable that this gentle massage does more than the drugs to\\nbring the relief.\\nThese stones are soluble in chloroform. An old remedy, and\\none that still has its advocates, was to locate the stone with the\\nhand by feeling for it at the center of pain, then to throw into it", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0332.jp2"}, "331": {"fulltext": "GENERAL DISEASES. 313\\na teaspoonful of chloroform with a hypodermic syringe. The stone\\nis thus dissolved, or so much of it as to facilitate its passage\\nthrough the duct. The serious effect of the drug upon some peo-\\nple is the main objection to this treatment.\\nDrinking pure olive oil in very large doses has permanently\\ncured many severe and obstinate cases of this disease. A half-\\npint should be taken once every four hours until relief has been\\nobtained or a quart has been consumed. Be very careful to get\\npure olive oil for this purpose. The concoctions made from cot-\\nton seed, and other cheap substitutes, that are sold as olive oil,\\nmight be very injurious.\\nIf the patient shows signs of collapse because of excessive\\npain the strength should be kept up with stimulants. Quinine,\\ngood wine, or strong coffee may be used for this purpose. A\\nstone of irregular shape or very great size may become so im-\\npacted in the duct as to be removable only through surgical aid.\\nThe operation, if properly performed, is not a dangerous one and\\nshould not be postponed too long. Whatever the treatment it\\nshould be followed by a mild laxative to move the bowels gently,\\nand measures to build up the general health. The patient usually\\nrecovers and the disease is often permanently cured.\\nICTERUS.\\n(Jaundice.)\\nJaundice is not a primary disease, but a result, a symptom\\npointing to some other disease to which it is due. The name is\\nfrom a French word, signifying yellowness, and is used to desig-\\nnate a morbid state of the system, characterized by the presence\\nin the blood of coloring matter from the bile, which stains yellow\\nthe skin and the white of the eyes. Whether in health the blood\\ncontains any bile is uncertain. It was long supposed that it did,\\nand that it was mechanically filtered therefrom by the liver, but\\nthe weight of opinion now is that it is a secretion formed in the\\nliver, the ingredients being drawn from the blood and portal vein,\\nbut differing much from the product itself; and that jaundice is\\ncaused, not by a failure of the liver to act upon and purify the\\nblood, but by absorption into the blood of bile already formed and\\nexcreted by that organ.\\nAs fast as bile is formed it is conveyed through the biliary\\nducts to the gall-bladder and there stored until needed to aid", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0333.jp2"}, "332": {"fulltext": "3 14 GENERAL DISEASES.\\nin the processes of digestion, when it is poured through the com-\\nmon duct into the intestine, for that purpose. This natural order\\nmay be interrupted by any obstruction in this duct, as by a stone\\n(see Gall Stones), by the formation of a plug of mucus within the\\nduct, by the closing up of the duct by a catarrhal thickening of\\nits tissues, or by outside pressure as from a tumor.\\nStopped thus in its course, the flow of bile is turned back\\ninto the liver, and absorbed and carried away by the blood. A\\ncomplete closing of the duct is not needed to accomplish this, but\\nmerely that its caliber be narrowed enough to cause the bile to pass\\nthrough it with some difficulty.\\nAll cases of jaundice thus caused are known as jaundice from\\nobstruction.\\nExperiments upon animals have shown that the pressure un-\\nder which bile is excreted is extremely small, and that it enters al-\\nmost as readily into the circulation of the blood as into its normal\\noutlet. Even in perfect health very little force will thus divert it;\\nthe amount required being only the slight pressure needed to\\novercome that of the blood in the liver tissues. These forces are\\nso nearly balanced that any considerable decrease of the natural\\nblood-pressure leads to a turning back of the bile into the general\\ncirculation. This is what happens when jaundice follows great\\ngeneral bleeding, strong mental emotions, venomous snake bites,\\nor any other depressment that renders the heart unable to do\\nnearly its full amount of work. This variety of cases is called\\njaundice by absorption.\\nMalaria is a very prolific cause of jaundice, principally be-\\ncause the coloring matter, set free in the destruction of red cor-\\npuscles by the germs of the disease, is left floating in the blood\\nand stains the tissues when a little later it is absorbed by them.\\nThere are other varieties, but as these two classes embrace\\nnearly all cases of the disorder, we will not discuss the others.\\nSymptoms. The diagnosis of jaundice is usually very easy,\\nfor it is clearly seen in the yellow color in the face and eyes.\\nThe tint of the skin much resembles that caused by the action of\\nthe sun, but tan never affects the color of the eyes and jaundice\\ndoes. The yellowness appears first in the eyes, then in the face,\\nand gradually extends over the entire body. The mucous mem-\\nbranes are not usually affected and the lips retain the redness of\\nhealth. The urine becomes high colored, sometimes very $ark,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0334.jp2"}, "333": {"fulltext": "GENERAL DISEASES. 3] 5\\nand stains yellow. The sweat, except under the armpits, seldom\\nstains.\\nThere is little if any pain if present it is due, not to the\\njaundice, but to some accompaniment, or to its cause. The\\npatient is likely to be fretful, peevish and much inclined to sleep,\\nand his mind becomes sluggish and heavy. There is likely to\\nbe diarrhea, with stools of light clay color. In most cases of\\njaundice from obstruction there is severe itching, liable to extend\\nover the whole body and to be worse at night. Loss of flesh\\nand weakness usually follow, and there is slow, feeble pulse, and\\nchanges in the senses of taste and sight. Hemorrhages of the\\nmucous membranes often occur, of which bleeding from the nose\\nis the most common. In chronic jaundice hemorrhages are very\\ngrave indications and nervous symptoms, such as delirium, coma\\nand convulsions, are usually soon followed by death.\\nTreatment. The treatment should be mainly directed to the\\ndisorders causing the jaundice, but as the latter may itself work\\nserious injuries to the liver and the general health, it should not\\nbe neglected. Diet must be the chief reliance, for it is often very\\ndifficult to affect the malady with medicines. The patient should\\nlive upon such food as lean beef, mutton, skimmed milk and\\nstrained broths and must avoid fat in every form, also sweet fruits,\\ntea, coffee and all alcoholic drinks and, if there be much trouble\\nfrom gas in the stomach, food containing sugar and starch must\\nalso be discarded.\\nRelieve constipation by alkaline remedies, as a tablespoonful\\nof Epsom salts every four hours until the bowels act freely. It\\nis no longer thought wise to purge the patient, or to give emetics\\nfor, although they may do good in some cases, they are liable\\nto do harm. Digestion and secretion of urine are both aided by\\ntaking from one and a half to three ounces of lemon juice daily\\nand there may be free use of lemonade. Injections of from one to\\ntwo pints of water, at 60 degrees Fahrenheit, retained as long as\\npossible, are recommended.\\nWarm rooms and warm clothing should be provided for the\\njaundiced, and their chilliness is best treated in this way. Warm,\\nvapor and Turkish baths are good to stimulate excretions by the\\nskin, and their efficiency may often be increased by gentle massage.\\nItching may be relieved by using a five per cent ointment of calo-\\nmel and lard, or by washing in warm soft water containing three\\nper cent of carbolic acid.-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0335.jp2"}, "334": {"fulltext": "316 GENERAL DISEASES.\\nLittle can be done for hemorrhages, except when they are\\nfrom the nose. An ordinary nose bleed can usually be controlled\\nby bathing the face and head in cold water and applying cloths\\nwet in cold water to the forehead, the patient using care to stand\\nerect with the head thrown well back and his arms raised above\\nhis head, the blood being absorbed by a sponge, cotton wool or\\nsimilar material held by an attendant. The frequent posture of\\nbending over a basin is wrong, as it is likely to stimulate the\\nbleeding. The nose bleed accompanying jaundice is often so\\npersistent as to require plugging of the nostrils with cotton.\\nExamination should then be made, and if blood is passing down\\nthe throat the back of the nares. should also be plugged. To\\ndo this thread a small strong cord through one end of a short\\npiece of leather shoestring, trim the other end smoothly and run\\nit through the nose into the throat, and with forceps draw it\\nthrough the mouth until about twelve inches, of the small cord\\nextends beyond the lips; tie this firmly around a piece of cotton\\nas large as required to stop a nostril, leaving the free end of the\\ncord about eight inches long, and draw the cotton back through\\nthe mouth snugly into the nares, then tie together the ends of\\nthe cord hanging from the mouth and nose. Serve the other\\nside of the nose in the same way, then plug the nostrils with\\nballs of cotton as before. The blood thus confined will soon\\nform a clot, press upon the membranes and stop the flow. After\\ntwenty-four hours remove the lower plugs, cut the cords, draw\\nthe wads to which they are fastened out through the mouth, and\\ngently cleanse the nostrils with cool water. Should the bleeding\\nbegin again, repeat the plugging.\\nThe gravity of a case of jaundice depends upon its causes,\\nfor when they are overcome the jaundice usually fades away.\\nThe first sign of recovery is the return of color to the dejections,\\nthe last is the disappearance of color from the urine. The dis-\\norder is likely to run about six weeks and the patient usually\\ngets well.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0336.jp2"}, "335": {"fulltext": "CHAPTER IV.\\nBy R. E. McVey, M.D.\\nRHEUMATIC FEVER.\\n(Acute Rheumatism.)\\nAlthough the germ has not yet been discovered, the phe-\\nnomena of rheumatic fever are best explained by regarding it as\\na germinal disease, the poison of which is carried in the blood\\nto all parts of the body, but affects most seriously those tissues\\nwhich are composed wholly or largely of white or yellow fibers,\\nsuch as the ligaments of the joints, the tendons of the muscles,\\nand the membranes or sheaths covering the bones, cartilages,\\nglands and muscles. Rheumatism is a specific inflammation of\\nthese fibrous tissues. Other parts are usually affected too, but\\ntheir involvement is thought to be only sympathetic, due to\\ntheir close proximity to these tissues although it is probable\\nthat the serous membranes, which are the linings of the closed\\ncavities of the body, may be directly infected and become diseased\\nin the same maimer as the fibrous ones.\\nThe disease is most common between the ages of fifteen\\nand forty, but is sometimes found in children from five to ten\\nyears old. It is more frequent in the temperate zones than in\\neither very warm or very cold countries. Much exposure to\\ncold was long considered the cause of the disease, but is now\\nthought to be only a condition favorable to its development.\\nSevere labor and strain are also conducive influences, and\\nabout one-third of all cases of the disease are hereditary that is,\\nthe sufferers have inherited such peculiarities of structure as to\\npredispose them to the disease but neither this nor any other\\nof the influences named ever caused rheumatism. The system\\nmust first be infected but when the poisonous germs have been\\nadmitted, these favoring conditions aid in their rapid multiplica-\\ntion, and thus become very important factors in developing the\\ndisease.\\nSymptoms. The first symptoms are likely to be chilliness,\\nthen rise of temperature, weakness and general malaise, but not\\n3i7", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0337.jp2"}, "336": {"fulltext": "318 GENERAL DISEASES.\\noften as much headache and thirst as in other fevers tongue cov-\\nered with a dirty white fur and red at the tip and sides; urine\\nscant, acid and turbid, depositing reddish sediment upon standing.\\nPain in the limbs and perhaps in other parts also soon follows, in-\\ncreases rapidly and settles in a few or many joints, which soon be-\\ncome swollen and very painful. The suffering is likely to be severer\\nat night than during the day, and is increased by the slightest\\nmovement, such as that caused by a person walking over the\\nfloor or the jar of a car or heavy wagon passing rapidly in the\\nstreet. There is profuse perspiration with sour odor. The patient\\nfeels helpless and will not try to move lest he add to his torture\\nand pain. The large joints are the ones most likely to be affected,\\nsuch as the knee, ankle, wrist, elbow, shoulder and hip. The\\nmost characteristic feature of rheumatism is the tendency of the\\npain to shift from one part of the body to another and to attack\\nnew parts, meanwhile remaining in the joints first visited, or\\nreturning to them, or leaving them entirely for new locations.\\nThe temperature is usually from ioo degrees to 104 degrees,\\nbut in severe cases with heart complication it may go as high as\\nno degrees, when it is very likely to be fatal. Its liability\\nto attack the membranes of the heart is its only really dangerous\\nfeature, for however painful, if this organ be not affected, it\\nalmost always runs its course and the patient recovers in from\\none to three weeks, though it sometimes lasts seven or eight,\\nif not influenced by treatment. The fever is remittent in char-\\nacter and goes and comes quite suddenly and from no apparent\\ncause. The same is true of the swelling in the joints. In a large\\nproportion of cases the structures of the heart are affected. This\\nfeature is usually accompanied by dull pain beneath the breast-\\nbone and a sense of heaviness in the chest. This is a grave form\\nof the disease and should be treated with care, but the patient\\noften recovers. Many suppose that rheumatism of the heart is\\ncaused by driving the disease from some other part to that\\norgan by the use of external remedies, but this is a mistake.\\nThe trouble is a diseased condition of the heart itself, usually\\nconsisting of an inflammation of its outer covering, called the peri-\\ncardium, which is a membrane composed largely of fibrous tissues,\\nnot exactly like those composing the ligaments of the joints,\\nbut very much resembling them. Modern investigators think\\nthat rheumatic infection upon entering the system is attracted", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0338.jp2"}, "337": {"fulltext": "GEXERAL DISEASES. 319\\nto this membrane in the same way as to the fibrous structures\\nof the joints, but so much more slowly that it does not become\\naffected until from five to eleven days later than the joints.\\nPericarditis is not the only danger, for endocarditis, or inflam-\\nmation of the heart s inner lining, may follow, in which case, if\\ndeath does not occur, the valves are likely to suffer permanent\\ninjury. As proper treatment at the beginning of the attack\\nusually cures acute rheumatism in from one to four days, the dis-\\nease may in almost every case be arrested before reaching the\\nheart, and it is difficult to see how the importance of prompt\\nand intelligent treatment can be made more emphatic than by a\\nplain statement of the nature of the disease.\\nTreatment. Since acute rheumatism is due to a septic poison\\nthat affects the whole system, it must be mainly treated by internal\\nremedies in a general way, rather than by local applications.\\nSalicylic acid is the great specific for rheumatism. It is best used\\nin the form of Parke, Davis Co. s, or Warners Salicylic Acid\\nCompound, and should be taken in doses of a teaspoonful every\\nfour hours. It is not as likely to unsettle the stomach as most\\nforms of the drug, but if not within the reach of the patient, the\\nnext best form is salicylate of soda. Take from ten to twenty\\ngrains every two hours, but if it causes vomiting reduce the\\ndose or take the same amount of bicarbonate of soda a few times\\ninstead, then return to the salicylate. As soon as the pain and\\nswelling begin to subside, reduce the dose. As the salicylate dete-\\nriorates rapidly, that found in stock in the drugstores is very apt\\nto be worthless, for which reason it is better to have the druggist\\nprepare it specially when needed. Many prefer wintergreen oil,\\none of whose principal ingredients is salicylic acid. It should\\nbe taken upon sugar or in capsules, from ten to fifteen drops\\nevery four hours. The bowels should be kept open by giving\\na tablespoonful of Epsom salts as often as may be required.\\nThe alkaline treatment also has its advocates, and in some\\ncases is a valuable remedy. It consists of the following\\nAcetate of potash two drams\\nBromide of potash two drams\\nIodide of potash two drams\\nEssence of wintergreen four drams\\nGlycerin three ounces\\nater three ounces\\nMix and give a teaspoonful every four hours.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0339.jp2"}, "338": {"fulltext": "320 GENERAL DISEASES.\\nIn cases that refuse to yield to the salicylic treatment it is\\nwell to combine the alkaline treatment with it, giving first one,\\nthen the other, every four hours. The following is valuable\\nwith either treatment\\nOlive oil two ounces\\nChloroform four drams\\nLaudanum two drams\\nTincture of iodine four drams\\nTincture of aconite two drams\\nMix and use as a liniment upon the affected joints, or use\\nSalicylic acid three drams\\nLanolin three drams\\nOil turpentine three drams\\nLard three ounces\\nAfter either of these wrap the joints in cotton batting or soft\\nflannel.\\nMilk is the proper diet, but soups, soft eggs and other light\\nfoods are permitted. An abundance of acid drinks may be taken\\nas often as desired. All alcoholic stimulants, meats and hearty\\nfood should be let alone.\\nThe patient should remain in bed several days after he thinks\\nhe is well and use care to avoid exposure which might invite a\\nrecurrence. One attack seems to predispose to other assaults,\\nhence the patient must be more careful than ever before not to\\nexpose himself to dampness, cold or other influences likely to\\nassist in developing the disease.\\nCHRONIC RHEUMATISM.\\nChronic articular rheumatism is a mild but persistent inflam-\\nmation of the ligaments, membranes and cartilages of the joints,\\noften resulting in their enlargement from thickening of the parts.\\nWriters usually consider it under two heads The first consisting\\nof those cases that result from acute rheumatism the other, of\\nthose that are chronic from the start and develop slowly until\\nthe joints become permanently altered. Some regard the two\\nclasses as of very different causation others maintain that both\\nmay result from the same cause. There is much about the disease\\nthat is not yet understood, but it is certain that the same influ-\\nences that favor the development of acute rheumatism are also", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0340.jp2"}, "339": {"fulltext": "GENERAL DISEASES. 321\\nactive agents in bringing forward both forms of this. It is most\\ncommon in cold, damp, changeable climates, and finds its victims\\nchiefly among those whose occupations require severe muscular\\nexertion and much exposure to wet and cold. The larger joints,\\ntoo, and those most used are the ones most often attacked, but\\nthe heart is not as likely to be affected in this as in the acute\\nform, although the cases in which it is diseased are by no means\\nrare. On the other hand, chronic rheumatism is not often hered-\\nitary, is more common among women than men, and is mostly\\na disease of advanced age, being rarely seen in children and youth.\\nIn cases of long standing the inflamed and thickened liga-\\nments sometimes adhere to and unite with the softer tissues lying\\nnext to them and the joints become fixed and immovable, often\\nvery badly deformed.\\nSymptoms. There is great variety in the symptoms, as they\\nare modified by the severity of the disease, the degree of its devel-\\nopment and the habits of the patient. From slight pain, stiffness\\nand swelling in one or many joints, there may be considerable\\npain and every degree of swelling, distortion, rigidity, to immov-\\nable stiffness and loss of several joints.\\nThe pain in the joints is of a dull, heavy character and is\\ngreatest at nig ht. The stiffness is usually greatest in the morn-\\ning, and is somewhat relieved by exercise. Often when at rest\\nthrough the day there is little if any pain, but resting permits\\nthe stiffness to return and it is soon as great as before. The\\nsymptoms are sure to be aggravated by changes in the weather,\\nespecially by increased dampness. Although the trouble is in\\nhis tissues, the rheumatic has been said to carry a barometer in\\nhis bones, so accurately do his stiffness and pains enable him to\\nforetell coming storms. The tissues around the joints are likely\\nto become thickened and show the greatest changes. There is\\noften constipation and scant, high colored urine. Again the\\ngeneral health may be good. In case of bad nutrition, a tea-\\nspoonful of the following mixture may be taken three times a day\\nBitter wine of iron four ounces.\\nLiquor potas. arsenitis one dram.\\nIn case of acute attacks give either of the treatments for\\nacute rheumatism until the pain is relieved, but not after that,\\nfor they are of little value for reducing thickened membranes and\\nstiffened joints.\\n21", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0341.jp2"}, "340": {"fulltext": "322 GENERAL DISEASES.\\nWarm alkaline baths (common baking soda, a tablespoonful\\nto each two gallons of water, makes an excellent one) should be\\ntaken once or twice every week, and be followed by free friction.\\nTurkish baths are also very valuable in the treatment of this\\ndisease.\\nAdhesions in the sheaths of tendons and other fibrous tissues\\ncan best be remedied by massage, passive motions, etc., con-\\ntinued month after month if necessary. In all friction and mas-\\nsage, care must be taken not to irritate the tender parts, or more\\nharm than good may be done.\\nWintergreen or peppermint oil, well rubbed in over the\\naffected joints and followed by applications of hot sand, salt\\nor cornmeal, will often afford great relief in acute attacks. It is\\nbest to have several bags, about a foot square and half filled with\\ndry sand, that wjiile some are in use the others may be heating\\nin an oven, that by frequent changes the parts may be kept as\\nhot as can be borne. A convenient and excellent way of apply-\\ning heat is to fill a large jug with boiling water, cork securely\\nand wrap in cloths sufficiently to prevent burning the patient,\\nthen place it against the affected part as he lies in bed.\\nAvoid exposure and wear only woolen clothing next the\\nskin. If able move to a mild, dry climate. Discard all alcoholic\\ndrinks and very strong tea and coffee. Eat only nutritious, easily\\ndigested foods, as chicken, tender beef, game of all kinds, bread\\nand butter, milk, cream, eggs, soups and acid fruits, and take\\nmoderate outdoor exercise in good weather, at stated times, but\\ncarefully guard against occasional overexertion. Keep the bow-\\nels regular and build up the general health as much as possible.\\nThe disease is very stubborn and its cure depends more upon\\nclimate and carefully regulated hygiene than upon medicines,\\nbut as some cases yield to treatment, internal remedies should\\nnot be neglected. The road is long and recovery can be reached\\nonly through persistence. Taking treatment for a time, then\\nneglecting it until a new attack drives the sufferer to his reme-\\ndies, will never cure chronic rheumatism.\\nMYALGIA.\\n(Muscular Rheumatism.)\\nMuscular rheumatism is a painful affection of the muscles,\\nattended by most of the phenomena that characterize articular", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0342.jp2"}, "341": {"fulltext": "GEXERAL DISEASES. 323\\nrheumatism. It is commonly attributed to the same cause, but\\nas it occurs chiefly in the muscles most subjected to stretching\\nand strain, such as those of the shoulders, neck and loins, it is\\nprobably often due to a tearing or rending of their fibers. It is\\nnever general in its distribution throughout the system, like the\\narticular form, but is confined to a single muscle, or to a single\\nset of muscles. It may precede, accompany or follow the artic-\\nular form, and it may be entirely independent of it. Many dis-\\neases, such as some of the infectious fevers and cases of chronic\\npoisoning, are accompanied by symptoms commonly called rheu-\\nmatism, and until the true nature of trichinae was discovered\\nits painful manifestations were classed under the same head.\\nWhen the true nature of rheumatism is better known, it is prob-\\nable that the term will be used in a more restricted sense and\\nbe made to include less than it does now.\\nIts favorite seat seems to be the loins. When located there\\nit is called lumbago; when in the neck, torticollis; in the shoulder,\\nomalgia and so on, these names designating not different dis-\\neases but different locations of the same disease.\\nSymptoms. Pain, more or less intense, in the affected\\nmuscle. This may be of a dull, heavy character until the muscle\\nis brought into action or placed under strain, when it is greatly\\nintensified if in the back, it is almost impossible to stoop down.\\nThe muscles are very sore and tender when touched or pressed\\nlightly, but often not as painful when grasped firmly. The pain\\nis seldom permanent in one place, but wanders here and there.\\nIt is of both kinds, acute and chronic, and may last from a few\\nhours to several months, and be of every degree of severity.\\nTreatment. The treatment should be the same as in similar\\nforms of articular rheumatism. Careful massage, preceded and\\nfollowed by applications of dry heat, usually brings great relief.\\nElectricity, if properly used, is also an excellent remedy. Four\\ngrains of quinine every four hours for three or four days usually\\nrelieves the trouble. When the disease is obstinate, one-tenth of\\na grain of calomel every four hours until the bowels move freely\\nis beneficial. In chronic cases a four-grain dose of quinine at\\nbedtime, in connection with the calomel treatment, is often useful.\\nSometimes hot vapor baths, by producing profuse perspiratidn,\\nafford relief, but this remedy should be used sparingly if the\\nheart is diseased. The internal remedies should be continued for", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0343.jp2"}, "342": {"fulltext": "324 GENERAL DISEASES.\\nsome time after the pain subsides and exposure and overexertion\\ncarefully avoided, since the disease is prone to return.\\nRHEUMATOID ARTHRITIS.\\n(Deforming Rheumatism.)\\nRheumatoid arthritis is a chronic affection of the membranes\\nand cartilages of the joints, the adjoining muscles and the artic-\\nular ends of the bones. It is most common in women, is some-\\ntimes hereditary and most often attacks its victims when from\\nforty to fifty years of age. Severe mental shocks, anxiety and\\ncare are thought to be causes, especially if coupled with com-\\nbined dampness and cold when the body is insufficiently nour-\\nished from lack of good food. Poor health is a very prominent\\ncause.\\nIt may follow the change in life and is often associated\\nwith uterine disturbances, due, it is thought, to the reduced con-\\ndition of the system at such times. The injurious and debili-\\ntating tendencies resulting from the privations of poverty and\\nthe lowered vitality caused by depressing influences of any kind\\npredispose to the disease. It is aggravated by sudden changes\\nin the weather.\\nSymptoms. The first symptom may be enlargement of one\\nor more joints, but more often this is preceded by a tingling,\\nprickling sensation like needles in the hands and arms, or by\\n.neuralgic twitches in the ball of the thumb and inner side of the\\nwrist. The disease comes on very slowly and is likely to first\\nattack the overworked joints, as those of the fingers of seams-\\ntresses, laundresses, etc. It differs from acute rheumatism in\\nattacking the small joints first, and in not being accompanied\\nby acrid sweat and little if any fever.\\nExcept in the quite rare cases in which it attacks the young,\\nit is very chronic and spreads slowly from joint to joint with\\ncomparatively little pain; but the pain varies greatly in different\\ncases, and in the same case from time to time. It is often most\\nsevere at night, being aggravated by the warmth of the bed;\\nand as rest increases the stiffness, this feature is worst in the\\nmorning. Gradually the cartilages are worn away or absorbed\\nsa that the bones come together in the joints and wear upon\\n55 h other until their shape and normal bearings may be greatly\\nchanged. Their sockets often become much distorted from the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0344.jp2"}, "343": {"fulltext": "GEXERAL DISEASES. 325\\ngradual extension of the flanges, giving these joints a prominence\\nthat is increased by the shrinking and wasting away of their\\nsofter parts and the adjoining muscles, though the enlargement\\nis mostly due to the increased size of the articular ends of the\\nbones. As the joints grow more and more stiffened, until they\\nbecome fixed and immovable, their pain and tenderness grow\\nless, and new joints are attacked, to be also destroyed. Spreading\\nthus from the smaller joints to the larger ones, the disease may\\ngo on for thirty years, and more, for it does not interfere with\\nthe general health and is limited only by the patient s life.\\nTreatment. First remove the patient from the depressing\\ninfluences, prevent all anxiety and worry, and cheer and brighten\\nher trains of thought. In the acute attacks, accompanied with\\nfever, absolute rest in bed is best, but as these give place to\\nthe chronic forms, moderate exercise is an advantage, but should\\nnever be carried far enough to cause much fatigue.\\nExcept in the acute attacks the diet should be very nourishing\\nand as plentiful as the patient can digest. Meat should be eaten\\nfreely and mustard taken with it. Malt liquors and good wines are\\nan advantage if taken with the food. In an ounce of wine take\\nfrom ten to fifteen drops of the syrup of iodide of iron with the\\nmeals three times a day, for a week, then skip three days, after\\nwhich repeat as before. Good doses of cod liver oil should also be\\ntaken, especially during the winter months.\\nAfter two months of the iodide and oil, leave them off for two\\nweeks and take a warm bath each day, following it with good\\nmassage, but be careful not to continue them to the point of de-\\nbilitating the patient, for she needs all her strength to combat the\\ndisease. If heart affection be associated with the arthritis, the\\nbaths must be very brief and taken with great care and if any bad\\nresults appear they should be discontinued. Keep the bowels\\nregular and build up the general health.\\nSome physicians prefer the bitter wine of iron prescription as\\nused in the treatment of chronic rheumatism, given in this work.\\nFive grains lithium carbonate two hours after meals is excellent.\\nLocal vapor baths and imbedding the affected parts in hot\\nsand may afford relief. Some cases are so stubborn that all treat-\\nment fails. It is very important that the disease be fought most\\nthoroughly at its first appearance, for as it progresses it becomes\\nharder to subdue. Cases that are not cured are sometimes checked\\nand held in abevance for vears.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0345.jp2"}, "344": {"fulltext": "326 GENERAL DISEASES.\\nGOUT.\\nGout is a joint disease caused by an excess of uric acid in the\\nblood, in the form of urate of soda. It is most common in men,\\nrarely occurs before the age of forty, and in two-thirds of the cases\\nis hereditary. It may be a result of great fatigue, overexertion,\\nor mental strain but usually it is brought on by excessive in-\\ndulgence in wines and malt liquors.\\nIt was long called the disease of the rich, but is quite as\\nfrequent now among the poor. It is often associated with chronic\\nlead-poisoning hence, is especially liable to attack house-painters,\\ntype founders and setters, lead miners and smelters, etc. It is\\nfound with many other disorders, such as bronchitis, pneumonia,\\nneuralgia, catarrh of the urinary and intestinal organs, and\\naffections of the heart and kidneys. When it attacks the in-\\nternal parts it is called irregular or retrocedent gout and is more\\ndangerous. It may become chronic and is very obstinate.\\nIn severe cases the excess of uric acid in the blood may\\ncrystallize as urate of soda in the cartilages of the joints, perhaps\\nalso in the muscles and tendons, and form nodules that can be\\nfelt beneath the skin. In the vast majority of cases it locates in\\nthe joint that unites the foot and great toe, but it may appear in\\nany joint, especially if it has been previously injured, as by a\\nwound, rheumatism, etc. Except in cases of long standing, each\\nattack is nearly always confined to a single joint. Around this\\nabscesses sometimes form and concretions of the urate may escape\\nfrom them.\\nSymptoms. Some or all of the following symptoms are\\nusually present:\\nDigestive disturbances loss of appetite weight and fullness\\nin the stomach irregular bowels heartburn pain in the calves\\nof the legs slight fever with chilliness mental depression head-\\nache and irritable temper. Sometimes the attack is without warn-\\ning of any kind, but acute gout always comes unexpectedly in\\nspite of the premonitions, and surprises the patient like a thief\\nin the night. Having retired and gone quietly to sleep, he is\\nawakened about midnight by a severe pain which may be in the\\njoint of the great toe, or in any other joint of the body. The pain\\nrapidly becomes unbearable. The patient feels as if the affected\\njoint were in a vise he sighs, moans and throws himself about in\\nbed; the leg, or even the entire body trembles with pain. Soon", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0346.jp2"}, "345": {"fulltext": "GENERAL DISEASES. 327\\nafter the commencement of the attack, the skin covering the\\njoint begins to swell and redden, and there is fever with a full\\nbounding pulse, dry skin, intense thirst, concentrated, red urine\\nand great mental excitement.\\nToward morning there is a remission, but the affected joint\\nremains swollen, shining and very red, and the whole leg is slightly\\nswollen. The next night the scene is repeated with equal severity.\\nThe following day brings another remission, and so on for a week\\nor ten days, when the swelling, redness and pain gradually disap-\\npear, the skin peels away and the part returns to its normal state.\\nThis form of the disease is more common in Europe than in this\\ncountry, but is here, too, and is increasing.\\nGout sometimes takes an eczematous form and a rash appears\\nupon the surface of the body, in patches here and there. The skin\\ntries to eliminate the excess of uric acid in the blood, and is in part\\nsuccessful. With the microscope crystals of the urate can be seen\\nin the rash and often when there is no rash, they may be seen\\nupon the skin covering the affected joints.\\nTreatment. First: Oxidation which means taking pure\\ncold water and plenty of exercise in the open air. Secondly:\\nDiet taking certain kinds of food and letting some kinds entirely\\nalone. The total amount of food should be reduced, and the\\npatient should live upon such food as lean meat, fish, broths, green\\nvegetables, and small amounts of milk, eggs, oatmeal and bread,\\nand a very little fruit. He must discard all fat meats, potatoes, acid\\nfood and very hearty things of every kind also wine and all malt\\nliquors. If whisky is used at all at first, it must be in small\\nquantity, the amount gradually reduced and soon entirely dis-\\ncontinued.\\nThe leg should be placed in as comfortable a position as\\npossible and the affected parts wrapped in soft Manuel or cotton-\\nwool. Hot compresses are useful, so are applications of dry heat.\\nRegulate the bowels by enemas.\\nFrom three to five grains of carbonate of lithia in a glass\\nof water may be given three times a day. Fifteen or twenty\\ndrops of the wine of colchicum three times a day soon brings\\nrelief, but as such internal remedies arrest the elimination of\\nthe poison, the next attack will come sooner because of their use,\\nhence the better practice is to discard them in acute gout and rely\\nupon exercise and persistently rigid diet. When one has had", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0347.jp2"}, "346": {"fulltext": "328 GENERAL DISEASES.\\ngout he is sure to have it again, sooner or later, and prudence lies\\nin making the intervals between the recurrences as long as pos-\\nsible\\nDIABETES.\\nDiabetes is a disease characterized by an excessive amount of\\nurine, and is of two kinds That called Diabetes insipidus (Poly-\\nuria), in which the urine contains very little if any sugar, being al-\\nmost entirely water; and that known as Diabetes mellitus, or\\nsugary diabetes, in which the urine contains sugar, sometimes in\\nvery large amounts.\\nThe former is not nearly as serious as the latter and is usually\\ncurable. Although the average patient discharges from three\\nto twelve quarts of urine in twenty-four hours it may not cause\\nmuch depression of the system, and cases sometimes run for many\\nyears without any serious results, yet it is liable to reduce the vi-\\ntality and pave the way for some other disease that will prove\\nfatal. There are cases on record in which there was for a long\\ntime the enormous average discharge of from eight to ten gallons\\nof urine daily.\\nDiabetes mellitus is a most persistent, serious, and, in its se-\\nverer forms, incurable disease. Beginning gradually and running\\na quiet, insidious course, it usually has a firm hold before the symp-\\ntoms have been noticed by its victim. The disease is not well\\nunderstood, but many regard it as a nervous disturbance result-\\ning in a failure of the muscular tissues of the bodv to absorb\\nor utilize sugar. During health there are from one to three parts\\nof sugar in every one thousand parts of blood. When the pro-\\nportion becomes greater than three the kidneys, to purify the\\nblood, try to excrete the excess with the urine, the amount they\\nthrow out depending upon the condition of the excreting organs,\\nthe diet, and the extent or degree of the failure of absorption by\\nthe tissues. This failure results in enfeebled, wasted muscles, a\\nworn, tired and anxious look and a ravenous appetite. The pa-\\ntient is slowly starving for want of the nourishment he is unable\\nto use, though furnished in abundance by the blood.\\nAnother class of investigators, among whom Purdy is prom-\\ninent, maintain that it is a result of a deranged liver, whereby\\nthose nutrients called carbohydrates, which in health make fat,\\nare broken up and their elements combined in such proportions\\nas to form sugar and waste and that even albumin may be trans-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0348.jp2"}, "347": {"fulltext": "GEXERAL DISEASES. 329\\nformed by chemical changes into sugar and urea, that its constit-\\nuents are nearly the same as the united ingredients of these two\\nsubstances which are not only found in diabetic urine but increase\\nand decrease in the same proportions during the progress of the\\nmalady.\\nA slow, chronic disease, it usually requires from one to three\\nyears to run its course, but sometimes takes less time, and oc-\\ncasionally lasts ten. twelve, or even more years. It is more com-\\nmon among men than women, and chiefly occurs between the\\nages of 25 and 65 years. It is sometimes hereditary. Among the\\ncauses to which it is attributed are exposure to wet and cold,\\nemotional disturbances, mental exhaustion, anxietv and grief,\\nsedentary habits, physical violence, concussions of the whole body,\\ndiseases affecting the nerve centers, acute fevers, gout, rheumatism\\nand syphilis. By some it is thought that high altitudes and cold\\nclimates are unfavorable.\\nSymptoms. The most characteristic symptom is a largely\\nincreased amount of urine, often averaging from one to three\\ngallons per day, paler than the natural color, and discharged with\\nincreasing frequency. Its irritating quality is likely to be so\\ngreat as to cause a burning sensation in the urethra and inflam-\\nmation at its opening, and sometimes irritation of the skin wher-\\never it may happen to reach. It is heavier than healthy urine,\\nhas a sweet taste, often attracting flies and bees when discharged\\nupon the ground, and has a sweetish odor resembling that of\\nsweet apples or hay, and when discharged intd a vessel or shaken\\nin a bottle forms abundant white froth that is slow to disappear.\\nThe average amount of sugar daily passed in this way ranges\\nfrom twelve to twenty-four ounces, but there may be much\\nless or a good deal more. Urine analysis is the most certain way\\nof diagnosing diabetes, and in many cases, until the disease\\nis far advanced, it is the only way. but the presence of sugar,\\nwhich is the positive proof, can often be detected by simple\\nevaporation. Put all the urine passed in twenty-four hours in\\na kettle and boil it until it has evaporated if the residuum is a\\nsweetish mass diabetes mellitus is indicated.\\nThe patient for a time may be well nourished, but sooner\\nor later his muscles, especially those of the legs, become weak,\\nand there is great fatigue upon slight exertion. The mouth is\\ndry and parched, there is unquenchable thirst, and, as already", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0349.jp2"}, "348": {"fulltext": "330 GENERAL DISEASES.\\nstated, a ravenous appetite, but later, because of overtaxing the\\ndigestive organs, this condition may give place to loss of appe-\\ntite and even to loathing of food; and the red, glazed tongue\\nof the earlier stages may become thickly covered with white fur.\\nThere is great emaciation and loss of flesh, sometimes amounting\\nto fifty pounds or more in a few weeks. The patient becomes\\nirritable, fretful and sleepless, and may be the victim of neuralgia\\nand other nervous disorders. He has a low temperature and\\nsensations of chilliness and takes cold very easily. Boils are a\\nfrequent accompaniment, sometimes great numbers of them.\\nGangrene may appear. There are often changes of vision. Con-\\nsumption is a frequent accompaniment.\\nTreatment. Most cases of diabetes insipidus and the milder\\nforms of diabetes mellitus can be cured, but their treatment\\nshould begin early, and be followed with great persistency. The\\nobjects aimed at are a lessening of the manufacture of sugar in\\nthe body and stimulation of the muscular tissues to a greater\\nuse of that which is made. The former must be mainly accom-\\nplished by diet. All sweets must be avoided, and as far as the\\npatient can refrain from foods containing starch he should do so,\\nfor it is from starchy food that the sugar in the body is principally\\nderived. He will probably take less of these in the long run\\nif permitted to have them in limited quantity than if wholly\\ndenied them until his craving for them becomes so great as to\\nlead him to break away from all restraint. Formerly the prin-\\ncipal diet was fats and such other articles as assist the stomach\\nto tolerate fats, but a strictly meat diet is no longer advised.\\nFresh meats, such as mutton, beef, poultry and wild game may\\nbe taken in moderate amounts, but as livers and oysters contain\\na good deal of sugar they should be excluded. Green vegeta-\\nbles, such as lettuce, water cress, radishes and cucumbers, and\\nacid fruits and berries may be taken raw. Cabbage, cauliflower,\\nstring-beans, spinach, asparagus and celery may be eaten if cooked.\\nGreen peas and all beans except string-beans are better omitted.\\nCream, buttermilk and cheese may be freely used. Wheat bread\\nand potatoes are so largely composed of starch they must be\\ntaken very sparingly, if at all.\\nThe following substitute for bread may be more safely used\\nOne cup Graham flour, one cup of the best bran previously\\nscalded, one cup boiling water, two eggs, German yeast or baking", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0350.jp2"}, "349": {"fulltext": "GEXERAL DISEASES. 331\\npowder, salt to the taste, one cup of milk or water; mix with\\na spoon and bake in loaves.\\nAlmond flour beaten up with eggs, raised with a little baking\\npowder and baked in small tins, is recommended by some as very\\npalatable and safe. A milk diet is now thought to be good only\\nin very mild cases.\\nThe tincture of opium, in ten-drop doses three times a day\\nbefore meals, was long the standard remedy, but it is not as\\nmuch used now. In many cases the following gives better results\\nArseniate of soda one grain\\nCarbonate of lithia one dram.\\nMix, divide into twenty powders and give one three times a\\nday in water after meals.\\nThe following will often relieve the itching which sometimes\\naccompanies this disease\\nCalomel twenty grains.\\nAcetate of lead thirty grains.\\nExtract of belladonna fifteen grains.\\nSubnitrate of bismuth one dram.\\nCarbonate of zinc thirty grains.\\nBenzoated lard two ounces.\\nApply once a day and paint the parts twice a day with phenol\\nsodique.\\nThe patient should take all the exercise in the open air that\\nhe can without very much fatigue. Horseback riding is the\\nbest. He must avoid all nervous, mental and physical excite-\\nment must wear warm flannels next the skin and use great care\\nagainst taking cold. A warm bath every other day, followed\\nby brisk rubbing with dry towels, is a great advantage. He\\nmay drink all the cold water he wishes, but must let alcoholic\\nstimulants of all kinds alone. The urine should be tested for\\nsugar every ten days and the treatment regulated accordingly.\\nThe disease runs its course most quickly in the young. Strong,\\nhealthy men in the prime of life stand the best chance for\\nrecovery.\\nOBESITY.\\n(Corpulency. Fatness.)\\nObesity or corpulence is such an excessive development of\\nfattv tissue in the bodv as to become burdensome. It occurs", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0351.jp2"}, "350": {"fulltext": "332 GENERAL DISEASES.\\ntwice as often among women as among men, and is most frequent\\nafter forty years of age. Its most common cause is the habitual\\ntaking of too much food. Most people past middle life are in\\nthe habit of eating too much, though the excess at any one time\\nmay not be large. Too little exercise in the open air is another\\nfruitful cause, and is often associated with the first, yet a few\\ncases of obesity are found among persons who take a great deal\\nof exercise and in those who eat less than a normal quantity\\nof food. The condition can be regarded as a disease only when\\nthe habits of eating, drinking and exercise fail to account for it.\\nAlcoholic beverages very often cause obesity, and it is some-\\ntimes a result of disease, as of paralysis or other nervous dis-\\norders, anemia, etc., and it may be the first warning of the\\napproach of some malady more serious than itself, in which case\\nthe danger signal is of great importance if the condition be\\ncomplicated with heart or kidney disease. A very large propor-\\ntion of those suffering from obesity inherited the tendency from\\ntheir ancestors. Diabetes, gout and rheumatism are its frequent\\nassociates.\\nTreatment. The main thing in the treatment is a carefully\\nregulated diet, and while the authorities differ as to some of the\\narticles that should be placed upon the prohibited list, all agree\\nthat the first step should be a diminished quantity of food, that\\na gradual reduction is better than a sudden, severe one and that\\nthe scanty fare must be enforced for months to be successful.\\nThe diet should be varied enough to keep up the health and\\nstrength, and a proper proportion should be maintained between\\nits carboniferous and nitrogenous elements, that is, fats and\\nstarches are not to be discontinued, but limited. Most agree,\\nhowever, that if butter and sugar are allowed at all, they must\\nbe taken in very small quantities.\\nVery little liquid should be taken with the meals, and no\\ndrink allowed until two hours or more thereafter. All alcoholic\\nbeverages, especiallybeer, must be discontinued.\\nVarious courses of diet have been recommended. Lyman,\\nin his Practice of Medicine, says: Milk and eggs furnish the\\nbest diet for this purpose. The patient should take, for twenty\\ndays in succession, not more than one-half pint of milk and one\\nQgg every three hours during the waking portion of the day.\\nNo other food or drink should be allowed. Under this treatment", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0352.jp2"}, "351": {"fulltext": "GENERAL DISEASES. 333\\nthe bowels become constipated and require gentle laxatives or\\nenemata. As first this restriction of the diet causes faintness,\\nweakness and sometimes dizziness, but in a short time these\\nunpleasant symptoms disappear and the disagreeable consequences\\nof obesity rapidly diminish. At the end of three weeks the\\ndiet may be varied and gradually increased.\\nYeo, in A System of Therapeutics, Vol. I, edited by H. A.\\nHare, Philadelphia, 1891, gives the following excellent summary:\\nThe albuminates in the form of animal food should be strictly\\nlimited. Farinaceous and all starchy foods should be reduced\\nto a minimum. Sugar should be entirely prohibited. A mod-\\nerate amount of fats should be allowed.\\nOnly a small amount of fluids should be permitted at meals,\\nbut enough should be allowed to aid in the solution and digestion\\nof the food. Hot water or warm aromatic beverages may be\\ntaken freely between meals, or at the end of the digestive process,\\nespecially in gouty cases, on account of their eliminative action.\\nNo beer, porter or sweet wines of any kind should be\\ntaken and no spirit of any kind except in very small quantity.\\nIt should be generally recognized that the use of alcohol is one\\nof the most common provocatives of obesity. A little Hock,\\nstill Moselle, or light claret, with some alkaline table water,\\nis all that should be allowed. The beneficial effects of such diet\\nwill be aided by abundant exercise on foot, and by such a use of\\nsaline purgatives as to secure a complete daily unloading of the\\nintestinal canal.\\nOf animal foods, all kinds of lean meats may be taken,\\npoultry, game, fish (eels, salmon and mackerel are best avoided),\\neggs.\\nMeat should not be taken more than once a day, and not\\nmore than six ounces of cooked meat at a time. Two lightly\\nboiled or poached eggs, or a little broiled fish, may be taken at\\none other meal.\\nBread should be toasted in thin slices and completely,\\nnot browned on the surface merely. Hard captain s biscuits may\\nalso be taken.\\nSoups should be avoided, except a few tablespoonfuls of\\nclear soup.\\nMilk should be avoided, unless skimmed and taken as the\\nchief article of diet. All milk and farinaceous puddings and\\npastries of all kinds are forbidden.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0353.jp2"}, "352": {"fulltext": "334 GENERAL DISEASES.\\nFresh vegetables and fruits are permitted.\\nIt is important to bear in mind that the actual quantity of\\nfood permitted must have a due relation to the physical devel-\\nopment of the individual, and that what would be adequate in\\none case might be altogether inadequate in the case of another\\nperson of larger physique.\\nA very important part of every mode of treatment is mus-\\ncular exercise, and it should be taken in the open air if possible,\\nthus the better increasing heart action, inducing deeper and\\nmore rapid breathing, and assisting in a fuller oxidation of the\\nadipose tissue. Mountain climbing is one of the best forms,\\nrowing is good, horseback riding can be recommended, and a\\nbrisk, swinging walk until considerably fatigued is excellent.\\nBaths stimulate the excretory functions of the skin, and to\\nthis end a warm bath, containing a tablespoonful of common\\nbaking soda to the gallon of water, lasting from fifteen to thirty\\nminutes, and followed by a cold spray and brisk rubbing, is\\nvaluable.\\nThe advertised anti-fat nostrums are often positively inju-\\nrious. Taking vinegar, or large amounts of other acids, using\\nopium or tobacco, and starving the body to reduce flesh, must\\nall be condemned as likely to lead to more serious consequences.\\nSome cases of obesity are incurable, and in these it is better to\\nattempt only a mitigation of the suffering by measures prescribed\\nby reliable physicians and known to be safe, than to surrender\\none s self to the advertising charlatan, who in consideration of\\na fat fee may promise the impossible.\\nACUTE NEPHRITIS.\\n(Bright s Disease.)\\nThe kidneys are very often diseased. The chief reason for it\\nis that the body must eliminate all injurious matter that enters the\\nblood and must do it very largely through these organs, which\\noften become infected with the poison they are required to throw\\nout. B right s disease was named after Richard Bright, an Eng-\\nlish physician, who discovered some of the pathological features\\nof this form of kidney disease which might more properly be\\nknown as nephritis. It is classified in two forms Acute and\\nchronic. The acute form runs its course in a few days or weeks,\\nand in rare cases lasts for some months. It is very liable to follow", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0354.jp2"}, "353": {"fulltext": "GEXERAL DISEASES. 335\\nscarlet fever, is often induced by other infectious diseases, as\\nmeasles, small-pox, typhus fever and diphtheria, also by cholera,\\nsyphilis, etc., and sometimes is clue to other causes. Pregnancy\\nis sometimes thought to favor its development.\\nAs the kidneys are so located as to make direct examination\\nof them impossible we must, to determine their condition, rely\\nupon urine analyses and such phenomena in other parts of the\\nsystem as have been found to accompany their derangement but,\\nas these phenomena are often associated with other disorders, a\\npositive diagnosis of this disease can be made only by analysis of\\nthe urine, which in this trouble contains albumin, casts and some-\\ntimes minute, and sometimes considerable, quantities of blood.\\nSuch an analysis requires experience, use of the microscope and\\nsome knowledge of chemistry, hence the patient should early\\nconsult a competent physician and secure an examination that will\\nleave no doubt as to the nature of his malady.\\nThe symptoms vary in different cases but some of the fol-\\nlowing indications are always present: Pain in the back and\\nlimbs headache chilliness followed by fever diminished urine\\nbut frequent urination accompanied by burning sensations; con-\\nstipation, but sometimes diarrhea; nausea; vomiting; bron-\\nchitis; swollen ankles and legs swollen eyelids and face, the dropsy\\nsometimes increasing until the patient- is greatly distressed.\\nTreatment. The patient should be kept very quiet, should\\nremain in bed and be covered sufficiently to induce constant slight\\nperspiration, thus somewhat diminishing the work of the kidneys.\\nHot fomentations upon the small of the back. If there be no\\nheart trouble, hot baths lasting from thirty minutes to an hour,\\ntheir temperature kept up by additions of hot water, followed by\\nthorough rubbing, precautions against taking cold, and cover-\\ning with warm blankets to produce profuse sweating. To aid\\nin securing this result drink freely of warm water. The wet pack\\nis in many cases useful. A dose of senna every other day to\\nthoroughly move the bowels and eliminate injurious products\\nthat are normally excreted by the kidneys is especially useful\\nin dropsical cases. But little medicine should be used. The diet\\nshould be milk exclusively. Many have been cured by the milk\\ntreatment, which consists of taking no other food or medicine.\\nHe may drink freely of water and lemonade. Meats and stimu-\\nlants are positive!} forbidden. When there is great distress chloro-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0355.jp2"}, "354": {"fulltext": "336 GENERAL DISEASES.\\nform, rather than narcotics, should be used. Opiates of all kinds\\nare very bad for this disease, and mineral waters and medicines\\nto act upon the kidneys would better be let alone.\\nUntil far advanced the symptoms in the chronic are much\\nthe same as those in the acute form, except as revealed by the\\nmicroscope, and the treatment is almost identically the same in\\nboth forms, hence, we will not here discuss chronic nephritis, but\\nwill add that if the patient wears warm flannels and carefully\\nguards against taking cold he will be benefited by mild exercise\\neach day in the open air, though this must not be continued until\\nthere is fatigue, and he must never go out when the air is either\\ncold or damp. Sun baths are useful and his room should have\\nan abundance of sunlight. Two or three quarts of milk should\\nbe taken daily, and the chances for recovery will be much im-\\nproved by abstaining from all other food.\\nNEPHROLITHIASIS.\\n(Gravel. Kidney Stone.)\\nThis disease is most common before the age of fifteen and\\nafter that of fifty years. It is usually due to a depressed or\\nnervous condition, such as results from gout, rheumatism, dys-\\npepsia and self-abuse. It rarely occurs from local causes, such\\nas a catarrhal and ulcerative condition of the mucous lining of\\nthe pelvis of the kidney or of its prolongations, detached par-\\nticles of which serve as nuclei about which the urine salts gather\\nand adhere until a stone is formed. The presence in any of the\\nvesicles of the kidney of a solid body, though very minute, as a\\nclot of blood, or shred of membrane, may become the center of\\na stone. How the salts thus gather and form a calculus without\\nsuch a nucleus at the start, instead of being washed out with\\nthe urine, is unknown, but it is probable that in by far the great-\\nest number of cases the stones are thus formed and are due to\\nconstitutional causes alone.\\nThe disease is not always painful. Sometimes the gravel,\\nwhile small, are carried by the urine through the ureter into the\\nbladder with little or no pain; sometimes they become large\\nenough to obstruct the passage of the urine, inflammation sets\\nin and the patient undergoes great pain, which usually, though\\nnot always, subsides with the passage of the stone; and there\\nhave been cases in which one or both kidneys contained large", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0356.jp2"}, "355": {"fulltext": "GENERAL DISEASES. 337\\nstones without at all inconveniencing the patient. The disease\\nis much more common in men than in women.\\nSymptoms. Small concretions or reddish or whitish sedi-\\nment in the urine when allowed to stand, and high colored urine\\nthat on standing deposits many acid crystals dull, aching pain\\ndeeply situated in the small of the back, running down the side\\ninto the thigh, calf of the leg and foot, or running into the groin\\nand testicle; sometimes pain very sharp and severe in these re-\\ngions after hard jolting; these pains may run through all stages\\nof severity and end suddenly after lasting from a few minutes\\nto several hours, rarely a day; nausea and vomiting; frequent\\nand urgent urination.\\nTreatment. In the early stages of the disease the patient\\nshould carefully regulate his habits and diet and occasionally\\ndrink alkaline water. He should not eat heartily and should\\nwholly abstain from such acid food as tomatoes, rhubarb, aspara-\\ngus, and from wild game, shell-fish and highly spiced viands,\\nshould use little sugar, no beer and few stimulants but may have\\nbread, butter, milk, potatoes, eggs, beef, chicken, fish, rice, oat-\\nmeal, coffee and tea if taken while fresh and hot.\\nThe medicines recommended by Morrow are citrate of potash,\\nfrom ten to thirty grains, from three to four times per day or the\\ncitrate or carbonate of lithia, two to five grains three times a day.\\nHot baths and hot fomentations over the kidney are valuable.\\nLarge draughts of cold water should be taken often if the stom-\\nach is unable to retain it, frequent enemas should be given, the\\nobject being to increase the urine and thus help the passage\\nof the stone through the ureter. The patient should be kept\\nquiet and half unconscious during the severe pain. If hypodermics\\nof morphia over the kidneys are not sufficient to do this, ether\\nor chloroform should be used. It is very important that the\\npatient be made as comfortable as possible. Relief from pain\\noften results in relaxation of the parts and passage of the stone.\\nIn very severe cases a surgical operation may be the only re-\\ncourse.\\nCONTRACTED KIDNEY.\\nThis disease is most often found among old people. Both\\nkidneys are usually diminished in the same degree, which in rare\\ncases may be to one-third their normal size. In some cases it is\\nregarded as a form of chronic Bright s disease in some it follows\\n22", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0357.jp2"}, "356": {"fulltext": "338 GENERAL DISEASES.\\nclosely upon acute Bright s disease, as where the latter is a sequel\\nof scarlet fever; and it sometimes appears as a primary disease.\\nIts chief causes are alcohol, lead poisoning and uric acid. It may\\nalso result from malaria and syphilis.\\nMany other disorders are associated with it, as valvular heart\\ndisease, gout, uremia, bronchitis, certain forms of asthma, dropsy,\\ndisturbances of vision, severe headache, sometimes confined to\\none side of the head and sometimes darting down the neck,\\nvertigo, poor appetite, irregular bowels, enlarged liver, profuse\\nnose-bleed, hard pulse, clear and abundant urine.\\nAlthough none of these symptoms are conclusive, the pres-\\nence of any considerable number of them are strong indica-\\ntions, and should prompt the patient to secure several analyses of\\nthe urine, made at different times, that its persistent average com-\\nposition may be accurately determined, for this is the only way of\\ndiagnosing the disease with certainty. If the disease is present\\nthe urine should be found to be lighter than normal because con-\\ntaining less salts and other solids, should contain a few hyaline\\ncasts, some albumin, often some white and, more rarely, a few\\nred blood corpuscles.\\nIt is probable that contracted kidney is causative of most or\\nall the disorders found in company with it. In the spirit of mu-\\ntual helpfulness that seems to possess all parts of the body, as\\nthe kidneys become contracted, their filtering tubes diminished\\nand their capacity for purifying the blood impaired, the heart\\ntries to aid these organs in their all important work of purifica-\\ntion by increasing the pressure and forcing the liquid through\\nthe remaining tubules more rapidly. Thus for a time the work\\nis done by a part that should have been shared by all of the tubules,\\nbut as the degenerative changes go on and the filtering areas\\ncontinue to contract, more and more heart pressure is required\\nuntil that organ, able no longer to bear its ever increasing bur-\\nden, becomes itself diseased. The increased blood pressure may\\nhave resulted in hemorrhages of the nose, stomach, intestines,\\nlungs or other organs, but when the heart becomes unable to do\\nthe extra work complications rapidly multiply. The blood being\\nno longer purified by an elimination of its salts and other urinary\\ningredients, uremia is especially liable to appear with its train\\nof ills, such as headache, vomiting, diarrhea, pruritus, coma and\\nconvulsions, sometimes ending in death. The sight may be de-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0358.jp2"}, "357": {"fulltext": "GEXERAL DISEASES. 339\\nstroyed through retinitis; dropsy is one of the complications to\\nbe feared and sometimes apoplexy suddenly terminates the dis-\\nease. Still the attack may pass off and the patient rally.\\nNot until the disease is far advanced is the patient likely to\\nnotice any symptoms to excite his suspicions, hence, it is usually\\nimpossible to determine how long he has been affected. It is\\nprobable that the disease often lasts ten years, or even longer.\\nIt is generally regarded as incurable, but the patient may be made\\nvery comfortable, and his life preserved for years.\\nTreatment. The treatment consists principally of hygienic\\nmeasures.\\nThe patient must avoid everything that would lead to greater\\nheart action, as fatigue, violent exercise or excitement, and\\nshould carefully refrain from eating or drinking that which might\\nirritate the kidneys. According to his condition his diet should\\nbe meager or abundant, but milk is the principal food. Beer must\\nbe let alone, and all alcoholic beverages either prohibited or\\ntaken very sparingly. Corpulent patients should exercise moder-\\nately and regularly, but always stop short of fatigue. Warm\\nbaths are useful, with precautions against taking cold. The use\\nof drugs could be of little value and might do much injury in\\nthis disease.\\nTHE DROPSIES.\\nBy T. H. Peers, M.D.\\nWe head this article with the plural because we desire to em-\\nphasize the fact that dropsy may result from several diseases, but\\nin itself is not a disease. Dropsy may be defined as a certain\\ncondition of the tissues of the body whereby they contain too\\nlarge an amount of liquid. This liquid comes from the blood,\\noozing from the blood vessels, particularly the veins, into the\\nsurrounding tissues. Instead of spreading through the tissues, it\\nsometimes collects in one of the serous cavities of the body, making\\na sac of fluid. hen it thus collects in the abdominal cavity, it\\nis called ascites. It sometimes collects around the heart, and\\nsometimes about or within the brain.\\nWhat, we may ask, are the conditions which tend to produce\\ndropsy? A moment s thought will suggest the answer, which is:\\nAnything that affects the walls of the veins so that the fluid part\\nof the blood may leak through into the tissues, while the blood\\ncorpuscles are retained, and the things that favor this are pressure", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0359.jp2"}, "358": {"fulltext": "340 GENERAL DISEASES.\\ninside the veins, and weakness of the walls of the veins. Those\\ndiseases, therefore, which allow the blood to accumulate in the\\nveins, or prevent its return to the heart, or relax or weaken the\\nwalls of the veins, may produce a dropsy. From statistics it has\\nbeen found that (i) Diseases of the kidneys, (2) Diseases of the\\nheart, and (3) Wasting diseases like consumption are its most\\nfrequent causes.\\nIn acute inflammation of the kidneys, the swelling usually\\nbegins in the face, particularly around the eyes, where the cellular\\ntissue is loose and flabby. It next shows itself in the feet, legs and\\nscrotum, and may continue till there is a general diffusion of\\nserous fluid into the connective tissues of the entire body, The\\nserous cavities are next involved, and we may get dropsy of the\\npleura, of the peritoneum, and even of the pericardium. The\\nswelling is not continuously progressive, but comes and goes, as\\nthe parent disease increases or decreases in severity. The fluid\\nin the tissues bleaches them, giving to the skin a very white ap-\\npearance. If the skin is stretched very much it takes on a shiny\\nappearance, and looks as though it had been greased. At times\\nthe distention is so great as to burst the skin, in which case the\\nfluid leaks out rather rapidly, and the swelling decidedly dimin-\\nishes. The amount of swelling does not accurately determine the\\nseverity of the disease producing it, and the patient sometimes\\nrecovers after very severe swelling over a large portion of the\\nbody.\\nIn dropsy from heart disease, the swelling usually begins in\\nthe feet and gradually extends up the legs to the body. It then\\nbegins to affect the serous cavities, especially that of the abdo-\\nmen, where the fluid accumulates, and, unless the heart disease\\nis arrested, or the fluid drawn from the abdominal cavity, the\\nabdomen becomes very large. The operation of drawing off the\\nwater is called tapping, 1 and, if properly done, is not at all danger-\\nous. Sometimes large quantities of fluid are removed, and the op-\\neration has been performed as many as fifty times on one person.\\nIt is not a curative process, but gives the patient great relief, en-\\nabling him to breathe much easier, to get around much better, and\\nto lie down and sleep. Cathartics and medicines that cause sweat-,\\ning are often used, and help to carry off the fluid, but the treat-\\nment should be directed mainly to the heart, which is the real\\ncause.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0360.jp2"}, "359": {"fulltext": "GENERAL DISEASES. 341\\nIn wasting diseases dropsical accumulations often occur to-\\nward the end, and usually indicate a fatal termination. An ex-\\nhaustive discussion of this subject is not intended here, our pur-\\npose being, rather, to correct the popular belief that dropsy is a\\ndisease, and a very fatal one. Dropsy is only a symptom of an-\\nother disease, and is not a serious symptom, unless the disease\\ncausing it is one dangerous to life.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0361.jp2"}, "360": {"fulltext": "CHAPTER V.\\nDISEASES OF THE HEART.\\nBy Louis C. Duncan, M.D.\\nANATOMY AND PHYSIOLOGY.\\nThe heart is a hol-\\nlow muscular organ, sit-\\nuated near the middle of\\nthe chest, extending\\nfrom the second to the\\nfifth intercostal space,\\nand from one inch to the\\nright of the sternum\\n(breast bone) nearly to\\nthe left nipple. It is\\nabout five inches long\\nand four inches wide, and\\nweighs from eleven to\\ntwelve ounces in men,\\nand about two ounces\\nless in women. It is large\\nabove (the base), and\\nsmall below (the apex).\\nA good idea of it may be\\nobtained by examining\\nthe heart of a beef, which\\nit resembles in shape.\\nThe heart is contained in a sac, called the pericardium, and\\nis divided by a partition into two parts the right and left sides\\nof the heart.\\nEach side is again divided into two parts or cavities. The\\nsmaller upper portion is the auricle, the larger lower portion\\nthe ventricle. The auricles have thin walls and merely receive\\nthe blood. The ventricles have thick muscular walls, which by\\ntheir contractions force the blood out into the arteries, which\\ndivide and subdivide until they form a network of very minute\\n34 2\\nPosition and Relative Size of the Heart.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0362.jp2"}, "361": {"fulltext": "GEXERAL DISEASES. 343\\nor microscopic vessels conveying this blood to all parts of the\\nbody, and thus supplying to them the nutrient elements of repair\\nand growth. The final subdivisions of the arteries are called\\ncapillaries and are only one-three thousandth of an inch in diame-\\nter; some of them even less.\\nThe capillaries open also into minute veins, which unite with\\neach other and form larger veins, and these again to form still\\nlarger ones, and so on to one large vein called the vena cava,\\ntheir function being to gather up the blood, with its impurities,\\nfrom all parts and convey it to the heart, whence it is sent to\\nthe lungs for purification, preparatory to being again sent through\\nthe arteries.\\nThe blood is carried by the vena cava to the right auricle\\nthence passes through the tricuspid valve into the right ventricle,\\nthen through the pulmonary valve into the pulmonary artery,\\nwhich carries it to the lungs, where it is oxygenated. It is then\\ncarried through the pulmonary veins to the left auricle, next passes\\nthrough the mitral valve into the left ventricle, then through the\\naortic valve into the great artery the aorta and the aorta and its\\nbranches again carry it to all parts of the body. Thus the heart\\nis really a pump, its function being to force the blood through\\nthe arteries to all parts of the system, thence to be returned\\nagain through the veins to the heart.\\nIn health, the heart beats about seventy times a minute, or\\nabout four times to each respiration, but this average is greatly\\nmodified during health by various influences, as exercise, age,\\nexcitement, etc. Thus, at birth the rate is 136; from two to\\nseven, 97 fourteen to twenty-two, 76 twenty-eight to thirty-\\nfive, 70 rifty-rive to sixty-three, 68 seventy-five to eighty-five,\\n71 and the average is from seven to ten beats faster in females\\nthan in males. These figures are general averages, and do not\\napply to all cases. Some people always have a more rapid rate,\\nand some a slower one. The pulse is slower while the body is in\\na recumbent position by about six beats per minute.\\nEach beat sends a wave of blood through the arteries, just\\nas each stroke of a pump sends a wave of water through a hose.\\nThis wave may be felt in any of the arteries which lie near the\\nsurface of the body, and is known as the pulse. So, by feeling\\nthe pulse we may determine how rapidly the heart is working,\\nalso how forcibly. The beating of the heart is an alternate contrac-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0363.jp2"}, "362": {"fulltext": "344 GENERAL DISEASES.\\ntion (systole), and expansion (diastole), the two making one beat.\\nBy listening to the heart two sounds can be heard. The first, long\\nand dull, is caused by closure of the mitral and tricuspid valves,\\nmuscular contraction and the striking of the apex against the\\nchest wall the second, short and sharp, is produced by the closing\\nof the aortic and pulmonary valves. These sounds are altered in\\ndiseased conditions of the heart.\\nMany constitutional diseases, as well as poisons, are spread\\nthrough the body by means of the blood. Examples of these are\\nhydrophobia, blood poisoning, diphtheria, syphilis, the poison\\nfrom snake bites, and nearly all vegetable poisons.\\nThe blood is composed of a fluid known as blood serum, and\\nof red and white corpuscles, or cells. One of the principal con-\\nstituents of the red cell is an albuminoid substance called hemo-\\nglobin. It owes its red color to the iron it contains. When much\\noxygen is united with it a bright scarlet red is shown, as in\\narterial blood, and when the hemoglobin has exchanged a part\\nof its oxygen for carbon dioxide, it becomes a dark bluish red, as\\nin venous blood. The red blood cells have an average diameter\\nof about one-thirty-two hundredth of an inch, and are round\\ndiscs with concave sides. The white cells are about one-fourth\\nlarger, and, like masses of jelly, change their shape to meet emer-\\ngencies, thus passing through openings, much smaller than\\ntheir own average diameter, in the walls of the capillaries, and\\nfinding their way between the cells composing the various tissues,\\nTo nourish them and assist in the formation of new ones to take\\nthe place of those worn out, and to repair wounds and injuries.\\nThey are also capable of absorbing or taking up and carrying\\naway injurious debris, so their function is at least two-fold\\nThat of repairing the waste that is constantly going on in the\\nbody, whether in sickness or in health and that of carrying\\nwaste and injurious matter to the eliminating organs, the skin,\\nlungs, liver and kidneys, to be thrown out of the system. It is also\\nthought that they envelop any disease germs that chance to effect\\nan entrance into the tissues, and that, when strong and healthy,\\nthey are able to destroy them by absorption, much as a jelly fish\\nconsumes its prey.\\nAs the digested food products are absorbed by the villi (the\\nmicroscopic ducts of the intestines), they are carried into the\\nblood, and become a part of it, and these nutrients, together", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0364.jp2"}, "363": {"fulltext": "GENERAL DISEASES. 345\\nwith the oxygen obtained in the lungs, are thus, with the help\\nof the heart, borne to every part of the body and there build\\nnew cells, or are consumed to furnish animal heat and energy.\\nThe heart is one of the vital organs, its action being ab-\\nsolutely necessary to life. In the past it was regarded as the seat\\nof life, including the mental and moral faculties now located in\\nthe brain. A survival of this idea, together with the present\\ngeneral knowledge of the heart, is responsible for the common\\nbelief that any affection of the heart is necessarily dangerous to\\nlife. YVe hear that a certain person has neuralgia of the heart,\\nor that some disease has gone to the heart, and are gravely in-\\nformed that the patient will now live but a few days; or, if by\\nchance his life shall be spared, it can be for only a few uncertain\\nyears, with the fear of impending death haunting his every wak-\\ning hour. Like many other popular ideas, this is erroneous.\\nTrue, many persons do die suddenly from heart failure, but many\\nof these cases are results of some acute disease, like diphtheria\\nor pneumonia, and are not due to a disease of the heart.\\nThe heart is subject to a number of diseases, some of which\\nare not at all dangerous others render the individual physically\\nunsound for life and a few so affect the heart that it may fail at\\nany moment, thus constantly menacing the patient with sudden\\ndeath. Even wounds of the heart are not always fatal.\\nIt is not possible for the average person to treat diseases of\\nthe heart, or even to recognize many of them, but there are many\\npeople who desire to know what these diseases are, their manifes-\\ntations and especially what their outcome will be. For the in-\\nformation of such individuals, rather than for the treatment of\\nheart diseases, this chapter has been written. Then, too, there\\nare some points in the treatment, especially in the diet, care\\nand surroundings, that are practical and may be applied by anyone.\\nCONGENITAL DEFECTS.\\nSome infants are born with defects of the heart. The most\\nfrequent of these is a malformation, allowing the arterial and\\nvenous blood to mix, producing the so-called blue child. The\\nsymptoms usually, though not always, appear soon after birth,\\nthe most striking of which is the blue color of the skin, due to an\\nimperfect oxygenation of the blood in the lungs. The ends of\\nthe fingers are club-shaped; the breathing is always embarrassed;\\nany exertion is impossible and development is prevented.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0365.jp2"}, "364": {"fulltext": "346 GENERAL DISEASES.\\nHalf of these patients die before the end of the first two\\nmonths of life, the great majority before sixteen months, and very\\nfew have been known to live thirty months.\\nPERICARDITIS.\\nPericarditis is an inflammation of the pericardium or outer\\ncovering of the heart, and is almost always secondary to some\\nother disease. Jts most frequent cause is acute articular rheu-\\nmatism (inflammatory rheumatism).\\nOther causes are scarlet fever, diphtheria, typhoid fever and\\nBright s disease. A few cases cannot be traced to any cause.\\nSymptoms. Usually the first symptom is a sharp pain in the\\nheart, but sometimes it is a chill. There is a feeling of discomfort\\nin the region of the heart, and breathing becomes difficult; the\\ntemperature ranges from 101 degrees to 103 degrees; the pulse\\nis rapid, and the patient restless. After a short time there is an\\neffusion of serum into the pericardial sac, forming the so-called\\nwater around the heart. This so interferes with the heart s ac-\\ntion as to cause it to beat irregularly. There are other symptoms\\nthat can be detected only by a physician. The symptoms are not\\nvery marked sometimes they are almost entirely absent. The\\ndiagnosis is seldom made, except by an experienced physician.\\nIn every case of acute articular rheumatism the heart should be\\nclosely watched.\\nPericarditis runs a course of one to three weeks, occasionally\\nlonger, and relapse may occur, but the final outcome is recovery.\\nIf the pericardium becomes infected, from a wound or otherwise,\\nand suppuration takes place a fatal result may be expected.\\nTreatment. Put the patient to bed at once and apply a\\nblister over the heart. Opiates are often necessary to relieve\\npain, and digitalis to steady the heart; but these drugs cannot\\nbe given in these cases, except by a physician. Digitalis, al-\\nthough one of the most generally useful drugs in all affections\\nof the heart, is absolutely dangerous in unskilled hands.\\nIf there is a large effusion into the sac, tapping by the sur-\\ngeon will be necessary. The patient should be restricted to a\\nliquid diet, such as milk and broths and soft boiled eggs, and\\nkept perfectly quiet. He should not be allowed to rise suddenly\\nfrom bed until out of all danger.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0366.jp2"}, "365": {"fulltext": "GENERAL DISEASES. 347\\nENDOCARDITIS.\\nEndocarditis is an inflammation of the lining membrane of\\nthe heart.\\nThe disease is usually confined to the valves; and is generally\\ndue to an invasion of the germs of some infectious disease, such\\nas acute articular rheumatism, diphtheria, erysipelas, scarlet fever,\\nmeasles, pneumonia, typhoid fever or small-pox. The old idea\\nthat the disease went to the heart was not very far from cor-\\nrect, though how it went was not understood. The majority of\\ncases occur between the ages of five and fifteen years.\\nSymptoms. Endocarditis usually occurs in the course of\\none of the above mentioned diseases. There are no distinctive\\nsymptoms noticeable by the ordinary observer, but the patient\\nbecomes worse, the breathing is more difficult and rapid, there is\\nan increase of restlessness, and the temperature goes up a de-\\ngree or two. A valve murmur may be heard by the practiced ear,\\nand it is upon this that the diagnosis rests. Injury to one or\\nmore valves occurs, which may or may not be permanent.\\nThe outlook as to life is good. Some cases recover com-\\npletely, but many a patient gets up with a heart permanently\\ndamaged. The injury is to the valves, and constitutes a val-\\nvular disease, which will be mentioned later in this chapter.\\nOne attack is liable to be followed by another.\\nTreatment. The principal treatment is absolute rest. When-\\never any part of the body is diseased it should be allowed to rest.\\nAlthough we cannot put the heart to rest, by placing the patient\\nin bed and keeping him perfectly quiet, we can reduce the num-\\nber of its beats by one-fourth.\\nOften nothing else is required. Indeed, drugs have very\\nlittle effect.\\nThe diet should consist of liquids and be easily digestible.\\nMALIGNANT ENDOCARDITIS.\\nThis is a suppurative inflammation of the lining membrane\\nof the heart and is a rare affection. It is characterized by chills\\nand fever, as is the case in extensive suppuration in any part of\\nthe body. It occurs in connection with several of the infectious\\ndiseases, but most often with pneumonia, pleurisy, blood poison-\\ning, puerperal fever, rheumatism and gonorrhea.\\nSymptoms. Following, or occurring with one of the above", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0367.jp2"}, "366": {"fulltext": "348 GENERAL DISEASES.\\nmentioned diseases, there are chills, fever and sweats, much re-\\nsembling malaria; quinine, however, has no effect upon the tem-\\nperature. Other symptoms are varied and not distinctive. Some-\\ntimes the disease resembles typhoid fever, and again blood poison-\\ning.\\nDeath always results, usually in five or six weeks, but life may\\nbe prolonged for months.\\nTreatment. Treatment, of course, is useless, except to nour-\\nish the patient and prolong life as long as possible. Rest, stimu-\\nlants and nourishing foods are indicated. Alcoholics may be\\ngiven, also quinine in small doses. The evidently grave nature of\\nthe disease will preclude home treatment.\\nVALVULAR DISEASES OF THE HEART.\\nA valvular disease of the heart is a chronic affection of a\\nvalve following acute endocarditis. Valvular affections are of two\\nkinds, known as obstructive and regurgitant.\\nIn obstructive lesions the opening of the valve is narrowed,\\nobstructing the flow of blood. Such an affection is called a\\nstenosis.\\nIn regurgitant lesions the valve is so weakened that it- fails\\nto close entirely and allows part of the blood to flow back, or\\nregurgitate. Such an affection is called a regurgitation or ah\\ninsufficiency.\\nEither or both of these conditions may be found in any of\\nthe four valves of the heart, and more than one valve may be\\naffected at the same time. The valves in the left side of the heart\\nare the ones most likely to be attacked, since the left side has the\\nhardest work to perform. Lesions of the mitral valve are more\\nfrequent than those of the aortic, but not as serious. Any valvu-\\nlar disease places more work on the heart.\\nSymptoms. These affections give few marked symptoms for\\nsome time, it may be for years. The increased work required of\\nthe heart causes it to enlarge, just as severe exercise enlarges\\nthe muscles of the blacksmith s arm. As long as the heart s\\npower continues to increase in proportion with the growth of the\\ndisease it is said to compensate, and there are few symptoms.\\nSooner or later there comes a time when compensation fails and\\nthe heart dilates, its walls becoming thinner. The symptoms are\\nthen plain and danger is at hand. These symptoms of enlarge-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0368.jp2"}, "367": {"fulltext": "GENERAL DISEASES. 349\\nmerit and dilatation will be described. There are some general\\nsymptoms, such as palpitation, getting out of breath easily, dizzi-\\nness and dropsy, which should lead anyone experiencing them to\\nhave a careful examination by a competent physician. In these\\ncases the sounds of the heart are so changed that the disease may\\nbe recognized by a trained ear.\\nThe prospects of recovery cannot often be determined.\\nMuch depends upon the mode of life of the patient, whether it\\nbe quiet or subject to frequent changes, either physical or mental.\\nDisease of the mitral valve often continues for an average life-\\ntime. Recurring attacks (of endocarditis) make the outlook\\nmore grave. Death is usually preceded by dilatation with warn-\\ning symptoms.\\nAortic disease is a serious one. It is a condition in which\\nsudden death is to be feared, yet the patient may live many years.\\nDisease of the tricuspid valve is still more fatal, but it is ex-\\ntremely rare. The valve diseases in children are much more\\nserious than in adults. The impression given out by some phy-\\nsicians that children outgrow valvular diseases is false.\\nAny serious acute disease, especially of the lungs, is more\\nserious if the patient already has a valve lesion. But these are only\\ngeneral rules. The prognosis of each case rests upon the condi-\\ntions in that case, and upon the subsequent mode of life.\\nTreatment. Each case must be treated by itself and by a\\nphysician. A person with valvular disease should avoid over-\\nexercise and excitement. He should not run, or walk rapidly, or\\nclimb stairs hurriedly. He should avoid extremes and passions\\nof all kinds, especially fits of anger, and must lead an easy, quiet\\nlife, as free from sudden changes as possible, eating and sleeping\\nregularly and avoiding exposure. When compensation fails medi-\\ncinal treatment will be necessary.\\nHYPERTROPHY OR ENLARGEMENT OF THE HEART.\\nThis is a condition in which there is an increase of the muscu-\\nlar tissue of the heart, bringing about an increase in size, thick-\\nness of the walls, weight, force and efficiency. The walls are the\\nseat of enlargement, the cavities having their normal proportional\\nsize. The weight increases from the normal weight of 1 1.8 ounces\\nto from twenty-five to fifty ounces. The cause of hypertrophy is\\nusually valvular disease, but it may be Bright s disease, aneurism,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0369.jp2"}, "368": {"fulltext": "350 GENERAL DISEASES.\\ndisease of the capillaries or liver. It may or may not be accom-\\npanied by dilatation.\\nSymptoms. As long as enlargement keeps pace with the\\nforce required to pump the blood through the body the symptoms\\nare few. After a time the increased force of the heart produces\\nan increased blood pressure in the vessels. We then have hard,\\nthrobbing arteries, palpitation, dizziness, headache, ringing in the\\nears, flushing of the face and a tendency to nose-bleed. The pulse\\nis bounding and may be seen throbbing in the neck, the heart beat\\nbeing very forcible and plainly visible. The prospects for re-\\ncovery in enlargement of the heart are those of the condition\\ncausing it. Of itself it is not a thing that threatens life.\\nTreatment. There is no drug that will have any effect what-\\never. The cause only can be treated.\\nDILATATION.\\nDilatation of the heart is a condition in which the cavities\\nare enlarged, while the walls remain of normal thickness or, more\\noften, are thinned. Usually there is also a fatty degeneration of\\nthe muscular fibers. The force of the heart is lessened. Dilata-\\ntion is often the last stage of valvular disease, following hyper-\\ntrophy. It ma) occur from any wasting disease, or from overex-\\nertion. In these cases it comes suddenly and death results quickly.\\nDeath from dilatation is the so-called heart failure, that ends\\nvalvular disease. It is also seen in acute infectious diseases.\\nSometimes a child with broncho-pneumonia or diphtheria or\\ntyphoid fever is past the danger point and well on the road to\\nrecovery, when he is unwisely allowed to get out of bed and walk\\nabout the room, resulting in sudden collapse and death from\\ndilatation.\\nHeart failure is also a name that is used to cover many\\ndeaths, the cause of which is unknown. The heart gradually\\ndilates and weakens, until sometimes it dilates past the point of\\ncontracting again, and life goes out. The process is usually\\nslow, but may take place in a moment and from a very slight ex-\\nertion.\\nSymptoms. In acute cases there is sudden pain in the heart,\\nshortness of breath, rapid, feeble pulse, collapse and death. In\\nprolonged cases these symptoms appear, then disappear, to come\\nagain with renewed exertion.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0370.jp2"}, "369": {"fulltext": "GENERAL DISEASES. 351\\nThere are general symptoms, such as dropsy, enlargement of\\nthe liver, short breath, congestion of the veins all over the body\\nand fainting spells.\\nThe result will be fatal. The only question is as to time.\\nDilatation means that the end is approaching.\\nTreatment.\u00e2\u0080\u0094 In acute cases there is no time for treatment,\\nand if there were it would be useless. In prolonged cases the\\ntreatment must be by a physician. The patient should avoid all\\nexertion and excitement.\\nRUPTURE OF THE HEART.\\nRupture of the heart is rare, but it sometimes occurs. It\\ntakes place only when the heart has been weakened by dilatation\\nor degeneration, and is then subjected to strain. There is sud-\\nden pain in the heart, loss of breath, collapse and death.\\nObviously there is no treatment. This is another of the affections\\nknown as heart failure.\\nDEGENERATIONS.\\nThese are conditions in which the muscular libers of the\\nheart degenerate into lower structures. Fatty degeneration is\\nmost common others are fibroid, albuminoid, amyloid and cal-\\ncareous degenerations. As these conditions are so difficult of\\ndiagnosis as to often be overlooked, even by competent phy-\\nsicians, it is useless to speak here of symptoms or treatment.\\nPALPITATION.\\nPalpitation of the heart is an unnatural, irregular or rapid\\nbeating of the heart, usually of nervous origin. The patient is\\npainfully conscious of the palpitation, and often greatly alarmed.\\nThe disease is much more common in women than in men. It\\nmay be caused by anemia, indigestion, mental emotion, protracted\\nillness, sexual excess, overwork, excitement or worry. Alcohol,\\ntobacco, coffee or tea, in excess, may cause palpitation, especially\\nin those of a nervous temperament. Cigarette smoking is a fruit-\\nful source of the disorder.\\nSymptoms. The unnatural beating of the heart is the chief\\nsymptom.\\nThis beating may be so rapid as to become a mere flutter,\\nreaching a rate of two hundred per minute. The attack comes", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0371.jp2"}, "370": {"fulltext": "352 GENERAL DISEASES.\\nwithout any apparent cause, lasts a few minutes, or, more rarely, a\\nfew hours, then passes away, leaving the heart normal until an-\\nother attack. These paroxysms, at irregular intervals, may occur\\nfor years without serious harm. Accompanying them there is a\\nfeeling of goneness weakness in the region of the stomach,\\nand sometimes nausea. There are cases in which the only symp-\\ntom is the occasional missing of a heart beat. The omitted beat\\nmay range from one in thirty to one in three. The patient notices\\nit and is likely to be annoyed or alarmed by it.\\nAn abnormally slow heart may be found in epilepsy, cata-\\nlepsy, hysteria, and several other affections.\\nTreatment. Rest and nourishing food are important ele-\\nments in the treatment. Sedatives, such as potassium bromide in\\nfifteen-grain doses three times a day, are useful in nervous cases.\\nWhen the patient is weak and anemic the following is good\\nFowler s solution two drams.\\nGlycerole of iron four ounces.\\nDose. A teaspoonful after each meal.\\nThe elixir of iron, quinine and strychnia, in doses of a dessert-\\nspoonful three times a day, will help to build up weak patients.\\nOutdoor exercise and everything that will improve the general\\nhealth will tend to prevent the attacks. During the attack the\\npatient should be kept quiet, lying down. Small doses of bromides\\n(ten grains), digitalis (one drop), or aconite (one drop), are then\\nuseful, but not necessary. These cases furnish subjects for the\\nhypnotist and Christian Scientist.\\nANGINA PECTORIS.\\nAngina Pectoris is an affection, characterized by severe pain\\nin the heart, and a sensation of impending death. Its cause is\\nvalvular disease, hypertrophy or disease of the arteries of the\\nheart (coronary arteries). It is seen only in persons past middle\\nage, and most frequently in women. The attack is brought on by\\nphysical exertion or mental emotion.\\nSymptoms. The principal symptom is pain, beginning in\\nthe heart and extending up into the neck and down the arms,\\nespecially the left arm.\\nWith the pain there is a sensation of oppression in the heart,\\nshortness of breath, and an uncontrollable feeling that death is", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0372.jp2"}, "371": {"fulltext": "GENERAL DISEASES. 353\\nat hand. The skin is pale and beaded with perspiration, and\\nthere is an expression of anguish in the face, which once seen is\\nnot forgotten. The attack lasts from a few minutes to half an\\nhour, when the patient either recovers or dies. Another attack\\nmay come in a few months, or not for years. Hysterical patients\\nsometimes have attacks of hysteria closely resembling angina.\\nOne-fourth of all cases die in the first attack. Others live\\na longer or shorter time, but some attack finally proves fatal.\\nAny attack may be the last, but occasionally a patient lives to a\\nmoderately old age.\\nTreatment. The attack should be treated with morphine\\n(one-fourth grain hypodermically), or nitrite of amyl by inhala-\\ntion. Chloroform is useful, and hot applications should be used\\nover the heart. Between attacks the patient must avoid all ex-\\nposure, hurry, exertion and excitement, being careful to lead a\\nperfectly quiet life and to eat no indigestible food. He should,\\nhowever, take moderate exercise. Medicinal treatment, with a\\nview to keeping off the attacks, may be given by a physician.\\nIt is well for the patient to carry the small pearls of nitrite of\\namyl kept by druggists. The pearl should be crushed in the\\nhandkerchief, and the nitrite immediately inhaled at the begin-\\nning of an attack.\\nDISEASES OF THE BLOOD AND VESSELS.\u00e2\u0080\u0094 ANEURISM.\\nSometimes when the walls of an artery are diseased and sub-\\njected to a strain they give way without entirely rupturing, form-\\ning a bulb or sac in the course of the artery. This is called an\\naneurism. The same condition in a vein is called a varix, and the\\nvein is said to be varicosed.\\nThe most common cause is the one just mentioned, a strain\\nin a vessel already weakened by disease, but a violent strain may\\nproduce aneurism in a vessel previously sound. Any of the large\\narteries may be thus affected.\\nSymptoms. The symptoms vary with the location of the\\naneurism, and are not plain to the ordinary observer.\\nPrognosis. Aneurism of the aorta is fatal sooner or later,\\nfrom perforation of the walls and hemorrhage. Aneurism of the\\narteries of the brain often gives way, causing cerebral hemorrhage\\n(apoplexy). Aneurism of the other arteries may not shorten life.\\nTreatment. The treatment must be by the surgeon. The\\n23", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0373.jp2"}, "372": {"fulltext": "354 GENERAL DISEASES.\\nonly drug reputed to have any effect whatever is iodide of potas-\\nsium.\\nVARICOSE VEINS.\\nVaricose veins are veins that have enlargements or dilated\\nportions.\\nThey are usually the superficial veins of the lower extremities,\\nor the spermatic veins. They indicate a weak heart action, slug-\\ngish circulation, or lack of tone in the vessel walls.\\nTreatment. There are two ways of treating varicose veins.\\nOne is the palliative method. As its name implies, it is temporiz-\\ning and palliative, not curative, and consists of the application\\nof bandages, silk or elastic stockings, etc. It may slightly re-\\nlieve the condition, but does not cure it. The other method is\\nsurgical, and consists of simply cutting down to the dilated vein\\nand tieing it at seyeral points, or removing it entirely. This opera-\\ntion is very easily performed, is not dangerous, and puts an end\\nto the varicose vein. By the aid of cocaine, it may be done with-\\nout even giving an anesthetic.\\nARTERIO SCLEROSIS.\\nThis is a disease of the arteries in which there is first an in-\\nflammation, then the formation of alternate soft and hard spots in\\nthe vessel wall. The hard parts destroy elasticity, thus interfer-\\ning with circulation the soft parts give rise to aneurism, or rup-\\nture and hemorrhage. The caliber may be much diminished by\\nthickening of the walls, and the vessel may be closed entirely by\\nclots. In some cases the artery becomes a solid rod, shutting off\\nall circulation and leading to gangrene. Arterio sclerosis is a\\ndisease of those past middle life, and is found more frequently\\nin men. It is often hereditary. Some of the exciting causes are\\ngout, rheumatism, lead poisoning, alcohol, syphilis and the over-\\nexertion of athletes and acrobats.\\nSymptoms. In superficial arteries the disease may be de-\\ntected by the dilated, hard, often bony feel of the vessel. It is\\ndifficult to compress, and rolls under the finger like a cord.\\nOften the alternate hard and soft rings may be felt, giving the\\nsame sensation as the windpipe felt in the neck of a small animal.\\nIt is frequently accompanied by hypertrophy of the left side of the\\nheart. Cerebral apoplexy, pulmonary congestion, angina, vari-\\ncose ulcers and gangrene of the lower extremities are some of the\\nserious complications directly resulting from this disease.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0374.jp2"}, "373": {"fulltext": "GENERAL DISEASES. 355\\nThe prognosis is grave. If the disease is of syphilitic or gouty\\norigin, treatment often produces good results; otherwise a fatal\\ntermination may be expected, though it be postponed for years.\\nTreatment. The only drug having any effect upon this dis-\\nease is iodide of potash, which should be given three times a\\nday. It is well to begin with ten grains at a dose and gradually in-\\ncrease. Fifty, or even one hundred grains, three times a day can\\nthus be given after a little with safety. The patient should live\\na quiet life, free from excitement and excesses of every kind. Any\\nsudden exertion may lead to a fatal central hemorrhage. The\\nfirst thing should be to find the cause gout, syphilis, or what-\\never it may be then to treat that cause appropriately. Many\\ncases reach a very serious condition before being recognized. In-\\ndeed, many are never recognized.\\nANEMIA.\\nAnemia is a condition in which either the quantity or quality\\nof the blood is materially below the normal. Of course, anemia\\nfollows a large hemorrhage. It also occurs in the later stages of\\nwasting diseases, such as consumption, cancer and diabetes.\\nThese are only symptoms or results of other conditions and will\\nnot be described here, being treated elsewhere in this work.\\nAnemia, as here referred to, is a certain disease known by phy-\\nsicians as pernicious anemia. Chlorosis is also an anemia, but\\nwill be treated separately.\\nThe cause can seldom be found. The disease is most fre-\\nquent in the old, although no age is exempt from it. Men are\\nmore often affected than women, but pregnant women seem quite\\nsusceptible. Fortunately it is a rare disease.\\nSymptoms. The disease begins as a weakness, weariness or\\nlanguor, which gradually increases to such extreme debility that\\nany exertion causes faintness. Finally the patient takes to his\\nbed and is unable to rise.\\nBoth body and mind are torpid. The lips, gums and con-\\njunctiva are pale, while the skin is a faintly yellowish or greenish\\nwhite. Contrary to what might be supposed there is no emacia-\\ntion, and very little weight is lost.\\nDigestion is interrupted, and often there is nausea, vomiting\\nand diarrhea. The principal change in the blood is not in the\\namount of blood, but in the decrease of red-blood cells. The", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0375.jp2"}, "374": {"fulltext": "356 GENERAL DISEASES.\\nnumber may be reduced to one-fourth, one-tenth, or even one-\\ntwentieth of the healthy number. The amount of hemoglobin in\\neach cell is not diminished.\\nThe prognosis is serious. Some cases improve under proper\\ntreatment, and recoveries do take place, but they are the excep-\\ntions.\\nTreatment. Put the patient to bed and in place of exercise\\ngive massage. Good nourishing food and hygienic surroundings\\nfavor recovery. Beef juice, liquid peptonoids and peptonized milk\\nare excellent foods. Of medicines, arsenic is the most useful.\\nIt is best given in the form of Fowler s solution, three times a\\nday, beginning with five drops at a dose and increasing to twenty\\nor thirty. This should be kept up for months. Iron should also\\nbe given, but its use is not as important as that of arsenic.\\nWyeth s glycerole of iron, Parke, Davis Co. s syrup of\\nthe chloride of iron, and Gude s Pepto-mangam are excellent\\npreparations.\\nCHLOROSIS. GREEN SICKNESS.\\nChlorosis is an anemia met with in young women between\\npuberty and twenty-four years of age, and it seldom occurs in\\nanyone else. It is more common in blondes than in brunettes,\\nand in the delicate than in the vigorous. Girls who menstruate\\nearly are most subject to it. Confinement, lack of exercise and\\ncontinued emotional excitement are factors of its cause.\\nSymptoms. -The patient, who is nearly always a girl between\\nthe ages of sixteen and twenty, is weak and easily gets out of\\nbreath. The lips are pale and the skin has a yellowish or greenish\\npallor. Vertigo and palpitation of the heart are common. Men-\\nstruation is apt to be irregular, the patient missing periods. Some\\ncases resemble the decline of consumption, but there is no cough.\\nThe blood is materially altered. The number of red-blood cells is\\nreduced, but not as much as in pernicious anemia. The hemo-\\nglobin is usually reduced by one-half or more. The shape of the\\nred cells is also changed.\\nThe prognosis, under proper treatment, is favorable. Res-\\ntoration to normal health may always be expected, but time\\nweeks or months may be required. The disease should not be\\nallowed to go on very long. In such cases development is inter-\\nrupted and permanent depraved conditions of health established.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0376.jp2"}, "375": {"fulltext": "GENERAL DISEASES. 357\\nTreatment. The patient should be put to bed and given\\nplenty of nourishing food. Massage is a useful measure. A\\nchange of scene is beneficial, especially if it be to the seaside.\\nIron has an almost miraculous effect upon chlorosis. It should\\nbe given in small doses as directed for anemia.\\nArsenic is less useful, but should also be given, in the form\\nof Fowler s solution, five drops three times a day, and gradually\\nincrease the dose to fifteen or twenty drops.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0377.jp2"}, "376": {"fulltext": "CHAPTER VI.\\nDISEASES OF THE LUNGS.\\nBy Louis C. Duncan, M.D.\\nThe two lungs, one on each side of the chest, are covered\\nby a smooth, serous membrane, the pleura, which also lines the\\ninner walls of the\\nchest, providing smooth\\nsurfaces to avoid friction\\nin the movements of the\\nlungs in breathing.\\nThese two surfaces, the\\nouter surface of the\\nlungs and the inner sur-\\nface of the chest wall, are\\nusually in contact, leav-\\ning no vacant space; but\\nthey may be separated to\\nform a vacancy known as\\nthe pleural cavity. Be-\\ntween the lungs is the\\nheart, and below them\\nthe diaphragm or midriff.\\nThe structure of the\\nlungs is very delicate and\\ncomplicated. To study\\nit we begin at the trachea\\n(windpipe).\\nThe trachea is com-\\nposed of rings of cartilage, which keep it open. It extends down\\nthe middle of the neck and about four inches into the chest,\\nwhere it divides into two branches known as the bronchi, which\\nare similar to the trachea and divide and subdivide until their\\nbranches are too small to be seen with the naked eye. These\\nsmall tubes are known as small bronchi, bronchioles, or capillary\\nbronchi; each of the smallest terminating in a sac whose thin\\n358\\nPosition and Relative Size of the Lungs.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0378.jp2"}, "377": {"fulltext": "GENERAL DISEASES. 359\\nelastic walls are pouched outward into little pockets called air\\nvesicles, or air cells, having a diameter of but T j\u00e2\u0080\u009e of an inch,\\nand walls grVo \u00c2\u00b0f an inch in thickness, between and around\\nwhich is a capillary network of blood vessels. Here the venous\\nis changed into arterial blood by discharging carbonic dioxide\\nand absorbing oxygen in its stead. This exchange is probably\\nfacilitated rather than hindered by the extremely delicate mem-\\nbrane separating the air from the blood. The caliber of the\\ncapillaries is only a little greater than the diameter of a blood\\ncorpuscle, but they are so numerous as to constantly contain\\nabout four pints of blood.\\nThe lungs are estimated to contain about 725 millions of\\nthe air cells above described, with a total respiratory surface more\\nthan 100 times greater than the external surface of the body. Res-\\npiration or breathing consists of the alternate expansion and con-\\ntraction of the chest by means of which air is drawn into and\\nforced out of the lungs. Drawing air into the lungs is called\\ninspiration, and expelling it from them expiration. The chief\\nagent in breathing is the diaphragm, which is aided by the muscles\\nof the chest. The movements of normal respiration take place\\nfrom fifteen to eighteen times per minute, but disease, especially\\nlung disease, greatly quickens them. The volume of air taken\\ninto the lungs and given out at each quiet normal respiration, by\\nthe average adult, is about 30 cubic inches, and is called tidal air.\\nAfter each normal inspiration, from 100 to 130 cubic inches can\\nbe forcibly inspired, and after each normal expiration about 100\\ncubic inches can be forcibly expelled, but after the most forcible\\nexpiration there always remain in the lungs from 100 to 130 cubic\\ninches, called residual air. From this it will be seen that only a\\nsmall part of the air in the lungs is subject to renewal at each\\ninspiration, and that by forced inspiration the lungs may contain\\nabout 330 cubic inches.\\nIt is important to remember that the lungs, even after the\\ndeepest expiration, always contain a large amount of air. In\\nthis way the diffusion of gases, between the air in the lungs and\\nthe blood gases, can go on continuously, with increase of the\\nprocess at every inspiration. The vital capacity, the amount of\\nair that can be forcibly expelled from the lungs by the average\\nman of ordinary height, is 230 cubic inches, this capacity being\\ngreatest at about 35 years of age. (Landois and Sterling.)", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0379.jp2"}, "378": {"fulltext": "360 GENERAL DISEASES.\\nSighing consists of a prolonged and almost noiseless inspira-\\ntion, followed by a sudden, noisy expiration.\\nIn hiccough there is a spasmodic contraction of the dia-\\nphragm, causing a sudden inspiration, with a peculiar sound as\\nthe air rushes through the larynx.\\nCoughing is a complex process First there is a contrac-\\ntion of the diaphragm as if for expiration, but the larynx is closed\\nthen, as the other muscles aid the diaphragm and the pressure\\nbecomes great, the larynx opens suddenly and the air is forced\\nout with an explosive sound.\\nSneezing is like coughing, except that the air is forced out\\nthrough the nose instead of the mouth.\\nFunction. As already implied, the function of breathing is\\nto supply the blood with oxygen, and carry from it carbon dioxide.\\nThe 30 cubic inches of pure air inspired at each breath contain\\nabout 21 parts, in every 100, of oxygen and a mere trace of car-\\nbon dioxide, but that which is expired has only 16 parts of oxy-\\ngen, and contains parts of carbon dioxide. The oxygen is\\nnecessary to life the carbon dioxide is poisonous. A large quan-\\ntity of water and some animal matter is also thrown out with the\\nexpired air.\\nBRONCHITIS.\\n(Cold in the Chest. Cold on the Lungs.)\\nBronchitis is an inflammation of the membrane lining the\\nbronchial tubes. It is limited to the larger tubes and affects both\\nlungs. Its principal cause is chilling of the body (taking cold).\\nIt may follow a cold in the head or throat. It is rare in the sum-\\nmer and autumn most frequent in the late winter and early\\nspring. It may accompany measles or la grippe.\\nSymptoms. There is a feeling of weight, soreness or tight-\\nness in the chest, with continued coughing. The cough is hard\\nand dry in the beginning, gradually becoming looser. With the\\ndry cough there is little expectoration, but when it loosens the pa-\\ntient spits a yellow mucus. There is only slight fever (too degrees\\nto 1 01 degrees). The disease usually lasts but six or eight days,\\nbut in the weak, debilitated and aged it may last several weeks.\\nSome cases become chronic. There is seldom interference with\\nthe breathing, except in children, and there are no sharp local\\npains.\\nIn infants bronchitis may lead to pneumonia with fatal", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0380.jp2"}, "379": {"fulltext": "GENERAL DISEASES. 361\\nresults. In adults the prospects as to life are absolutely good.\\nThe worst that can happen is the disease may become chronic.\\nBronchitis does not tend, as some people think, to consumption.\\nTreatment. If possible, the patient should be put to bed.\\nIf this can be done, no other treatment is necessary, but many\\nwish to keep up, or even to attend to their business, and for these\\nmedical treatment is needed. An application of mustard or tur-\\npentine to the chest will, in many cases, effect a cure. Care\\nshould be used not to blister. One of the best medicinal reme-\\ndies is the citrate of potash. A tablespoonful of the solution\\nshould be given every two hours. Sweet spirits of niter, thirty\\ndrops every three hours, will promote perspiration and loosen\\nthe cough.\\nIf the cough is very harassing, give the following: Syrup\\nof white pine compound, four ounces codeine, eight grains shake\\nthoroughly and give a teaspoonful every hour until the cough is\\nrelieved.\\nIf the cough does not loosen readily and an expectorant is\\nwanted, give a teaspoonful every three hours of the following:\\nChloride of ammonia, two drams; syrup of wild cherry, three\\nounces.\\nDo not put a poultice upon the chest. Hot drinks and a hot\\nfootbath just before retiring are old and meritorious measures.\\nCHRONIC BRONCHITIS.\\nWhen bronchitis continues for several weeks it is said to\\nbe chronic.\\nChronic bronchitis may be caused by a succession of colds, or,\\nit may be, by an extension of acute bronchitis. It also follow T s\\nmeasles, la grippe and pneumonia. Other causes are valvular\\ndisease of the heart and chronic Bright s disease.\\nSymptoms. The most prominent symptom is the cough.\\nThere is more or less coughing at all times, but there are spells\\nof continuous coughing, caused by an accumulation in the bron-\\nchial tubes. These spells usually come on in the morning, but\\nmay come in the night or at any time. There is considerable\\nexpectoration of a thick, stringy, yellowish substance said to be\\nmuco-pnrulent a mixture of mucus and pus. It often contains\\ngreenish masses. In some cases there is hardly any expectoration.\\nUsually there is no fever, and there is but slight interference with", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0381.jp2"}, "380": {"fulltext": "362 GENERAL DISEASES.\\nthe breathing. The appetite remains good, and there is but little\\nloss of weight. In old persons the symptoms almost disappear\\nin summer, but come on again each winter.\\nThe prognosis is favorable as to life, but unfavorable as to\\nrecovery.\\nLong-continued cases are frequently complicated with\\nasthma. In the aged the disease may prove fatal.\\nTreatment. The patient should be warmly clothed, with\\nwool next the skin, and should take particular care to keep the\\nfeet warm and dry. Every cold makes the condition worse.\\nIf, in the early stages, the patient can go to a warm climate, he\\nwill recover without any other treatment. Of medicinal remedies,\\nperhaps the best is creosote. At first one drop of it should be given\\nthree times a day, then the dose should be slowly increased to\\nfive drops. It may be given in pill form, or in red wine well\\ndiluted. Inhalations of the vapor are often useful. Place a few\\ndrops of creosote in a cup of water, heat over an alcohol lamp and\\ninhale the vapor. Atomizers do no good. If an expectorant is\\nneeded give a teaspoonful every four hours of the following:\\nCarbonate of ammonia, three drams; syrup of tolu, four ounces.\\nStrychnia is useful in all cases. Begin with one-sixtieth of a\\ngrain and very gradually increase to a twentieth of a grain three\\ntimes a day.\\nQuinine, in small doses, and cod liver oil are excellent reme-\\ndies. The climates suitable to one with chronic bronchitis are\\nthose of Georgia, Florida, New Mexico and the coasts of the\\nMediterranean.\\nASTHMA.\\n(Bronchial Asthma.)\\nBronchial asthma is a disease of the bronchial tubes charac-\\nterized by attacks of labored and difficult breathing. There is a\\ntemporary, spasmodic contraction of the tubes that causes gasping\\nfor breath. The cause of this contraction is not known. The\\ndisease is frequent in children, more frequent in men than in\\nwomen, and those of a nervous temperament are more prone to it,\\nAn attack may be brought on by exposure, taking cold, overexer-\\ntion, indigestion and similar causes, and although it may come at\\nany time it is most frequent in the evening.\\nSymptoms. The patient can get his breath only with diffi-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0382.jp2"}, "381": {"fulltext": "GENERAL DISEASES. 363\\nculty, the amount of this difficulty depending upon the severity of\\nthe attack. His face is pale and anxious, or it may be bloodshot.\\nThe inspiration is long drawn and the patient seems unable to get\\nenough air into the lungs, but often he has even greater difficulty\\nin expelling it; and there is a whistling, wheezing sound as it\\npasses in and out. The patient makes idolent muscular exertions\\nto breathe the muscles of the neck and chest are contracted and\\nthe abdominal muscles are hard; his chest moves but slightly;\\nhe sits upright, or leans a little forward, and seems to be suffocat-\\ning, but in spite of all his efforts the breathing is not accelerated.\\nAll the phenomena are very distressing to behold. The attack\\nlasts from one to three or four hours, and may terminate with a\\nfit of coughing, but coughing is not a prominent symptom and\\noften does not occur. The patient soon learns to recognize the\\ncoming of an attack. Between the attacks the health is likely to\\nbe good. Asthma is very distressing, but not fatal. Some cases\\ngrow worse with age others improve, then entirely recover. A\\ncure is possible in many cases.\\nTreatment During the Attacks. The patient should carry\\npearls of nitrite of amyl, and when the attack comes crush one in a\\nhandkerchief and inhale the drug.\\nA quarter of a grain of morphine, hypodermically admin-\\nistered, is the best remedy, but it involves the danger of causing\\nthe morphine habit if often repeated. Chloroform or ether may\\nbe used by inhalation.\\nMost of the patent asthma cures contain niter and stramo-\\nnium leaves.\\nAnyone can prepare them. Add all the saltpeter to a pint of\\nwater that it will dissolve. In this solution soak strips of common\\nblotting paper, then dry them thoroughly. Burn these on a dish\\ncovered by a large paper cone, and inhale the vapor. It very often\\ngives great relief. It may be improved by adding the dried leaves\\nof the stramonium datura (common jimson weed or thorn apple).\\nTreatment Between the Attacks. Y\\\\ nen the cause is undis-\\ncoverable, as it frequently is, one of the following may be given\\nTincture grindelia robusta three ounces.\\nTincture convalaria one ounce.\\nWater nine ounces.\\nMix and give a teaspoonful three times a day.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0383.jp2"}, "382": {"fulltext": "364 GENERAL DISEASES.\\nTincture grindelia robusta three drams.\\nTincture belladonna two drams.\\nIodide of potash five drams.\\nWater enough to make four ounces.\\nMix and give a teaspoonful three times a day.\\nThe patient should wear warm clothing, keep his feet dry\\nand avoid exposure and taking cold. Cold and moist climates\\nand high altitudes are generally harmful. Low altitudes and\\nwarm, dry climates are best suited to asthmatics. Lower Califor-\\nnia and Egypt are ideal places for those thus afflicted.\\nPNEUMONIA.\\nThere are tw r o varieties of pneumonia, broncho-pneumonia, a\\ndisease of infants, and the ordinary pneumonia, seen both in chil-\\ndren and adults. The latter is variously known as pneumonia,\\npneumonic fever, lung fever, lobar pneumonia, fibrinous pneumo-\\nnia and croupous pneumonia. We will here speak of it simply as\\npneumonia or croupous pneumonia.\\nIt is an acute, infectious inflammation of the lungs, affecting\\nthe lung tissue proper as well as the air vesicles and bronchial\\ntubes. It is usually confined to one lung. There is no longer\\nany doubt that its cause is a specific germ, the bacillus lanceola-\\ntus, discovered by Surgeon-General Sternberg of the United\\nStates army in 1880. It enters the lungs with the breath, is fre-\\nquently found in the mouths of healthy people and may be intro-\\nduced into the lungs of such persons without injury, for if one\\nbe in good health and in no way weakened or lacking in vitality\\nthe germ, on entering the lungs, is destroyed. But when the body\\nis exhausted by fatigue or chilled by cold, or its vitality is in any\\nw r ay materially lessened, even for a short time, the lungs seem to\\nhave no power to resist or throw out the germs, hence, finding\\nlodgment there, they multiply at a marvelous rate and produce\\npneumonia.\\nThat cold is an important factor in bringing on the disease is\\nshown by the fact that most cases occur in the winter or early\\nspring. It is usually seen in but single cases, but pneumonia epi-\\ndemics sometimes occur. One attack does not prevent another,\\nbut renders its victim more susceptible to future attacks. The\\nrobust and vigorous seem to be more subject to it than the weakly\\nand delicate, but probably this is because they are less careful about", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0384.jp2"}, "383": {"fulltext": "GENERAL DISEASES. 365\\nexposure and fatigue. Children of from three to ten years seem\\nto be favorite subjects of attack, for it occurs oftener in them than\\nthose of any other age, although it is quite common in the old\\nand feeble. The lower lobes of the lungs are most often affected\\nand the right one more frequently than the left. It may be inter-\\nesting in this connection to notice that consumption usually be-\\ngins in the apex of the left lung, and that bronchitis affects both\\nlungs.\\nSymptoms. An attack of pneumonia is divided into three\\nstages, depending upon the condition in the lungs and the ex-\\nternal symptoms.\\nThe Stage of Congestion is the first, and lasts about twenty-\\nfour hours. The very minute blood vessels surrounding the air\\nvesicles are overfilled with blood and there is some exudation of\\nblood into the vesicles themselves. This stage almost invariably\\nbegins with a severe chill, though in children it may begin with\\nvomiting or convulsions. There may or may not be headache\\nand a feeling of discomfort a day or two before the chill.\\nFollowing the chill there is high fever 103 degrees to 105\\ndegrees and the pulse is full and strong, with from 100 to 120\\nbeats per minute. The respiration is from 40 to 60 per minute\\na rate more rapid than in most other diseases. The face is flushed,\\nthe cheeks red and the eyes bright. Very soon in the side of the\\nchest there is severe pain, aggravated by deep breathing, and\\nthere is a cough, dry and hard at first, but becoming looser, with\\nexpectoration in the later stages.\\nThe Stage of Consolidation comes next and is sometimes\\ncalled the stage of red hepatization. The air vesicles and finer\\nbronchial tubes are so filled with cells, serum and a tenacious\\nsubstance, known as fibrin, that the part becomes a solid mass.\\nThe lobe affected is said to be solidified, and has the appearance of\\na piece of liver hence the name, hepatization. The lung tissue\\nis swollen and inflamed, but in this stage the cough is looser and\\nthere is the typical expectoration of pneumonia a sticky, reddish\\nor brownish-red mucus known as brick-dust or rusty expec-\\ntoration.\\nIn some grave cases the sputum is watery and dark purple\\nin color, resembling prune juice, and known as prune juice ex-\\npectoration. The rusty sputum generally appears in from one\\nto three days after the attack, but may not come until the tenth", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0385.jp2"}, "384": {"fulltext": "366 GENERAL DISEASES.\\nday, or even later, and then be only small in amount. In rare\\ncases it does not occur at all. (In old persons the temperature\\nmay be but little above normal and the respirations but from\\n24 to 30 per minute.)\\nThe other symptoms continue, the rapid breathing becomes\\nlabored and the temperature remains high. This stage lasts from\\nfour to nine days and ends in a crisis; that is, the temperature\\nsuddenly falls to normal and the patient seems much better.\\nStage of Resolution, or Gray Hepatization. This is the stage\\nof recovery, or death. The substance in the air vesicles is softened\\nand in the cases that recover is absorbed, but in those that are\\nfatal it becomes purulent. The temperature should fall to normal,\\nor below, and there should be free perspiration, the breathing\\nbecoming easier and the patient seeming better in every way.\\nFrom this time recovery is rapid, and in from four to six days\\nshould be complete.\\nBut the cases do not all run such a typical course. The stages\\noften merge into each other, and two stages may be present at the\\nsame time. The temperature and rate of breathing are highest in\\nchildren. In aged people many prominent symptoms are absent.\\nFever sores (herpes labialis) on the lips are common. In some\\ncases there are typhoid symptoms with delirium.\\nWhen a case goes on to death, the breathing grows faster\\nand more difficult, until the patient literally gasps for air; expec-\\ntoration is scanty or entirely lacking; the face is first blue, then\\npale the skin grows cold and clammy, and the strength fails\\nrapidly; there is loss of consciousness, and often there is low de-\\nlirium. Death takes place from heart failure, or by suffocation\\nfrom filling up of the lungs. The fatal case usually runs its course\\nin less than ten days.\\nComplications. The complications are empyema, abscess of\\nthe lung, gangrene, consumption, pleurisy, endocarditis and peri-\\ncarditis.\\nOne case in every five dies, even with the best treatment,\\nand in the aged and intemperate the percentage of deaths is yet\\ngreater. Children usually recover, even when desperately ill, the\\nmortality rate in those under five years of age being less than one\\nin twenty. The young and vigorous adult, with seemingly mild\\nsymptoms, sometimes dies suddenly. The prospect depends\\nsomewhat upon the amount of lung tissue involved the order of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0386.jp2"}, "385": {"fulltext": "GENERAL DISEASES. 367\\ngravity being one lobe, two lobes, both lungs and the whole of\\nboth lungs. In the latter case death is the invariable result. Most\\ncases end definitely, either in complete recovery or in death.\\nTreatment. As yet there is no specific cure for pneumonia.\\nThe disease usually runs its course and cannot be broken up\\nor shortened by drugs. The object of treatment, then, is to lessen\\nthe intensity of the disease, stimulate the patient until the crisis is\\npast, stimulate the lungs and heart when necessary, nourish and\\nnurse the patient, and treat other symptoms or complications as\\nthey arise.\\nFifty years ago bleeding was always the practice in pneumo-\\nnia, but it has been entirely abandoned and the death rate, as\\nshown by reliable statistics, is no greater. Instead of blood-letting,\\nwhich is weakening, the foundation of the present treatment of\\npneumonia is nourishment and stimulants. The patient should\\nhave plenty of good, easily digestible food.\\nA suitable diet is one and a half to two pints of milk, two or\\nthree eggs, and meat broths each day. Alcoholic, stimulants are\\nneeded almost from the first. There is hardly any other disease\\nin which they are so useful. A half-ounce of whisky or brandy\\nmay be given every three to six hours, and, for a short time, it\\nmay be given oftener than that. About the time of the crisis\\nstrychnia is needed. In weak patients it may be needed through-\\nout the whole course of the disease. One-fortieth of a grain may\\nbe given every four hours.\\nTo relieve the pain, codeine, in one-half grain doses every\\nfour hours, is good. Poultices should not be used upon the\\nchest, for they do harm instead of good. An application of well-\\ndiluted turpentine is often useful.\\nExpectorants are not needed until the stage of resolution\\narrives. During that period five grains each of ammonia carbo-\\nnate and iodide of potassium may be given every three hours.\\nThe fever in pneumonia is not dangerous in itself, but when a\\ntemperature of 104 is reached it should be reduced by sponging\\nwith tepid water. The room in which the patient is kept should\\nbe well ventilated both day and night. Lack of sufficient oxygen\\nin the blood is a feature of the disease, and it should be supplied\\nas freely as possible. In the large cities oxygen is used as part of\\nthe treatment, and with excellent results.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0387.jp2"}, "386": {"fulltext": "368 GENERAL DISEASES.\\nBRONCHO-PNEUMONIA.\\nBroncho-pneumonia is an inflammation of several small\\nareas, or parts, of the lungs, and is practically the same disease as\\ncapillary bronchitis.\\nAlthough almost entirely a disease of children, and, in the\\ngreat majority of cases, occurs in those of less than three years, it\\nis also found in old age. It is not caused by any one class of\\ngerms or microbes. It may occur as a separate disease, but it very\\noften follows one of the infectious diseases, especially measles,\\ndiphtheria or whooping cough.\\nIt also, though rarely, follows scarlet fever, typhoid fever and\\nbronchitis. In the aged it may follow la grippe, typhoid fever or\\nBright s disease. Like croupous pneumonia, it is a disease of\\nwinter and spring. It can hardly be called contagious, though we\\noccasionally see two cases in one family.\\nSymptoms. The symptoms are not well marked and plain\\nlike those of croupous pneumonia. In the course of, or during\\nconvalescence from measles, diphtheria or whooping cough, there\\narises a cough, with fever from 101 degrees to 103 degrees, and\\nthe breathing becomes very rapid. This rapidity of breathing is a\\ndiagnostic symptom. It may range from 60 to 100 per minute,\\nand the lack of sufficient air in the lungs is very apparent and dis-\\ntressing.\\nThe cough is continuous and painful, but there is no expec-\\ntoration.\\nThere is great weakness, which increases to profound pros-\\ntration, and the face becomes purple (cyanosis) from lack of suffi-\\ncient oxygen in the blood. Death may occur in less than twenty-\\nfour hours, but usually the symptoms continue from one to three\\nweeks, then disappear gradually, not suddenly, as in croupous\\npneumonia. The temperature varies considerably, frequently\\nreaching 104 degrees or 105 degrees. Since the temperature of\\nall diseases goes higher in children than in adults, a high fever in\\na child in such cases is not of as grave import as it would be in an\\nadult. The diagnostic symptoms are Acute onset, continued\\nhigh fever, very rapid breathing, prostration and cyanosis. Death\\ncomes from heart failure.\\nBroncho-pneumonia is a serious and treacherous disease. In\\nhospital practice the mortality is from 30 to 50 per cent. In\\nprivate practice better results are obtained, but even here from", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0388.jp2"}, "387": {"fulltext": "GENERAL DISEASES. 369\\ni o to 25 per cent of those who take the disease die. The younger\\nthe child the greater the danger, but a case, in which the fever is\\nhigh and the child seems desperately sick, frequently recovers.\\nOn the other hand, those with a low but fluctuating temperature\\nand seemingly mild symptoms may die suddenly. There is no\\nother disease in which the outlook is so uncertain and the fate\\nof the patient seemingly so subject to caprice as this form of\\npneumonia. One attack does not prevent another.\\nTreatment. As in croupous pneumonia, the foundation of\\nthe treatment is nourishment and stimulants. The disease runs a\\ncertain course and we must maintain the bodily strength until the\\ndangerous period is past and reaction comes.\\nThe entire trunk, back and all, from neck to navel, should\\nbe wrapped in cotton batting and covered by a closely fitting\\njacket of oiled silk or oiled linen, and it should be worn until\\nrecovery. This is much better than heavy poultices, which impede\\nthe already difficult breathing. If a counter-irritant is wanted,\\nand it often is, apply to the chest a paste of one part of mustard\\nto six parts of flour or meal, or a cloth wrung from hot water\\ncontaining a little turpentine. Although the modus operandi of\\nthese things is not exactly known, all agree that they do good.\\nIn children all expectorants, emetics, and such things as\\nsquills, ipecac and antimony are far better omitted. Their only\\neffect is to disturb the stomach. Stimulate from the beginning, for\\nwhich purpose whisky or brandy is preferable from one-half an\\nounce to two ounces of either one may be given daily to a child\\none year old. Dilute with eight parts of water. Strychnia is\\nnecessary when there is great prostration. A child one year old\\nshould have one-two hundred and fiftieth of a grain every four\\nhours. These stimulants are most needed when the temperature\\nis low or falls suddenly. More of each may be given for a short\\ntime, and, of course, a larger dose to an older child.\\nFor the fever do not give any of the antipyretics, as antipyrin,\\nacetanilid, phenacetin, or even quinine. They do no good in these\\ncases and often do harm. High fever is not as serious a thing in\\na child as in an adult. Not until the temperature reaches 105\\ndegrees is there occasion for treatment of the fever. Then take\\nequal parts of alcohol and water (temperature 80 to 85) and sponge\\nthe whole body from ten to twenty minutes. This will reduce\\nthe temperature and quiet the restless child more safely than any\\n24", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0389.jp2"}, "388": {"fulltext": "370 GENERAL DISEASES.\\nor all drugs known. If the temperature is very high it may be\\nreduced by frequent sponging with water as hot as can be borne.\\nIt may also be reduced by a cold pack, or a cold bath. While both\\nmethods have their advocates, it is thought by many that the hot\\nwater is the better and safer agent\\nThe cough is best treated by inhalations of creosote vapor.\\nThese may be taken by placing a small sponge at the end of the\\nspout of an ordinary teakettle, in which there is water hot enough\\nto produce a little steam, dropping a few drops of creosote on the\\nsponge, then allowing the child to inhale the steam as it comes\\nthrough the sponge, care being taken that the steam shall not be\\ntoo hot.\\nDo not give many drugs. They are not needed. There is\\ngreat danger, in any disease, of giving a child too much rather\\nthan too little medicine.\\nCONSUMPTION.\\nConsumption of the Lungs. Tuberculosis of the Lungs. Pulmonary Consumption.\\nPhthisis. Pulmonary Phthisis.\\nConsumption of the lungs is an infectious disease due to the\\nlodgment in the lung of a specific germ, the bacillus tuberculosis.\\nThe disease is characterized by the formation of tubercles in the\\nlungs, the destruction of lung tissue and a general wasting of the\\nbody. It is so widespread and fatal that in the temperate zone\\none-tenth of the entire population dies of it. In the torrid and\\nfrigid zones it is almost unknown.\\nIt is an established fact that the cause of consumption is the\\nbacillus tuberculosis, a minute vegetable germ discovered by\\nKoch in 1882. The disease tuberculosis, which it produces, at-\\ntacks any and all parts of the body, consumption, or tuberculosis\\nof the lungs, being but one form of the disease. The germ enters\\nthe body in one of two ways. In by far the greater number of\\ncases it is inhaled with the air. Tubercular patients spit upon\\nfloors, walks, and elsewhere, and as the sputum dries the germs are\\nblown about in the air as dust. In some cases it enters the stomach\\nin the milk of cows affected with tuberculosis.\\nIf these statements are true, the question at once arises:\\nWhy do not all people have tuberculosis? In every community\\nthere are patients spreading the germs all the time, and it would\\nseem miraculous that any of us escape. W T hile the germ is the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0390.jp2"}, "389": {"fulltext": "GENERAL DISEASES. 371\\nreal cause of the disease, there are many factors that go to make\\nfor it a suitable lodging place in the lungs. It was only the seed\\nsown on good ground that brought forth fruit, some an hundred-\\nfold, some sixtyfold, some thirtyfold. So with the germ, which\\nmay be considered the seed of tuberculosis. When it enters the\\nlung of a person who i.s strong and vigorous, and has no tendency\\nto the disease, it is destroyed but when it enters the lung of a per-\\nson susceptible, it finds a suitable soil, remains, multiplies at a\\nmarvelous rate, and produces the disease.\\nThe factors which make up the tendency to consumption will\\nnow be given in the order of their importance.\\n(i) Heredity, by which we mean a weak or peculiar cell\\nstructure, transmitted from parent to child. Its influence in this\\ndisease has long been recognized, and is more potent when both\\nparents are affected. If but one parent has the disease the chil-\\ndren most resembling that parent are more liable to it. Very\\nmany cases are not hereditary.\\n(2) Age. This has much to do with liability. Although\\nno age is exempt, nearly all cases occur between puberty and\\nthirty, and most cases occur between the ages of eighteen and\\ntwenty-live. It is likely to appear a year or two earlier in women\\nthan in men.\\n(3) A delicate constitution favors the lodgment and multipli-\\ncation of the germs.\\n(4) Cold and damp localities and climates subject to sudden\\nchange show more cases than those with the opposite conditions.\\n(5) Insufficient nourishment.\\n(6) Persons with poorly developed lungs, as shown by nar-\\nrow or flat chests, are good subjects.\\n(7) Race. No race is exempt, but the colored race and\\nthe American Indian are peculiarly susceptible.\\n(8) Chronic bronchitis.\\n(9) Sex. Women are more susceptible than men.\\n(10) Exposure to cold and wet.\\n(11) Measles and other infectious diseases of that class.\\n(12) Occupation. All confining or indoor occupations ex-\\nert a tendency to bring on the disease in those having hereditary\\nor other tendency; and work attended by irritating dust is also\\na factor, as the work of masons, miners and metal polishers.\\nExcept to those having a tendency to the disease, houses that", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0391.jp2"}, "390": {"fulltext": "372 GENERAL DISEASES.\\nhave been occupied by consumptives are not specially dangerous.\\nA person knowing himself to be liable to the disease should not\\nlive in such a house until after it has been thoroughly disinfected,\\nand it is wise to take this precaution in any case. Burning a little\\nsulphur in a room is not all that is needed. (See department on\\nDisinfection.)\\nThe disease may be directly communicated from one to an-\\nother, but this is rare. A person of a consumptive tendency should\\nnot nurse a consumptive patient.\\nSymptoms. Consumption commonly begins with a short,\\ndry, hacking cough, which is most noticeable on going to bed at\\nnight, and just after rising in the morning. At hrst the cough\\nis irritating and there is no expectoration. A peculiar sallow, or\\ngrayish, pallid complexion is early noticeable.\\nThis is often seen, in persons having the hereditary tendency,\\nbefore the disease appears, and the doctor is able to say that such\\na person will have consumption. There is a loss of strength and\\nweight, but the patient remains in good spirits yet, because of\\na tired feeling, he does not like to rise early in the morning. He\\nis easily fatigued, and feels unequal to his usual work.\\nVery early the pulse is quickened to ioo, or more, and there\\nis fever in the afternoon and evening, the temperature rising\\ngradually till evening, when it reaches 101 degrees to 103 degrees,\\nthen falling to normal during the night.\\nWhen the fever is highest the eyes are bright, and the cheeks\\nare flushed. The patient takes cold easily, and each attack is more\\nsevere. Very frequently there are attacks of pleuritic pain in the\\nside of the chest.\\nThe weight steadily decreases, and the loss of flesh becomes\\nnoticeable. The bones are prominent and the cushions of fat on\\nthe ends of the fingers disappear. The cough, which was dry, be-\\ncomes looser, and there is expectoration, which becomes more\\nand more plentiful. At first it is frothy, then muco-purulent fre-\\nquently streaked with blood. In about half the cases there is\\nspitting of blood. Hemorrhage from the lungs may occur at any\\ntime. Digestion is usually deranged, diarrhea is frequent in the\\nlater stages, and, as the disease progresses, the cough becomes\\nmore frequent and harassing. The sleep is broken and unrefresh-\\ning, the appetite fails, the patient grows weaker and weaker, and\\ndiarrhea increases the general weakness. He gets out of breath", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0392.jp2"}, "391": {"fulltext": "GEXERAL DISEASES. 373\\nvery easily and, in some cases, there are alarming attacks of\\ndyspnea, in which he literally gasps for air. Yet. through all he\\nremains cheerful and hopeful. There are periods of temporary im-\\nprovement, in which he feels so much better that even the friends\\nmay hope for recovery. In the last stages the cough is continuous,\\nthe appetite gone, the body wasted to a skeleton, the breathing\\nvery rapid and shallow, and the lower limbs swollen and painful.\\nDeath may come unexpectedly, while the patient is feeling\\nbetter than usual, or after a gradual decline of a day or two.\\nIt is usually peaceful.\\nPrognosis. If the disease be early recognized and the pa-\\ntient removes to a suitable climate, observes hygienic rules and\\npursues a vigorous course of treatment, recovery is possible other-\\nwise, the best that can be hoped for is to delay as long as may be\\nthe fatal termination. If treatment be given a person having a\\ntendency to consumption, but in whom it has not yet appeared,\\nthe disease may usually be prevented. Unfortunately, when con-\\nsumption has reached the stage at which it is easily recognized, it\\nhas reached the point at which it is incurable.\\nPrevention. The prevention of consumption is of more im-\\nportance than the cure, because, when the disease has once se-\\ncured a good foothold, it is very doubtful if a cure is possible.\\nPerhaps a majority of those who die of consumption know, before\\nit appears, that they have a predisposition to the disease. They\\nmay also know that it is only during the few years between eight-\\neen and twenty-five that they are very liable to be stricken.\\nKnowing these things and that by preventive measures and care-\\nful living the dread disease may be avoided, it is wonderful that\\nthe prospective victim does not put forth every effort, during those\\nyears, to avert it. When he is once in its clutches, he will sacrifice\\ntime, money and opportunity, and grasp at every straw that\\npromises help, but all to no avail. By putting forth proper efforts\\nduring the years of susceptibility he would be likely to escape and\\nbe enabled to consider himself safe the remainder of his life.\\nThe person subject to consumption should, if possible, first of\\nall go to a suitable climate one that is dry and uniform. The\\naltitude should be moderately high from 2,000 to 4,000 feet\\nyet, some low-lying regions are good, and sea voyages are bene-\\nficial. The best American climates, in the order of their merit, are\\nas follows: 1. Lower New Mexico and Arizona. 2. Colorado,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0393.jp2"}, "392": {"fulltext": "374 GENERAL DISEASES.\\nNorthern New Mexico and Western Kansas. 3. Southwestern\\nTexas and Lower California. 4. Montana and Wyoming. 5.\\nWestern Carolinas. 6. Florida and the Gulf States.\\nThe worst climate for a consumptive is that of the North\\nAtlantic States, being cold, moist and subject to great changes.\\nThe residence should be located on high ground and be free\\nfrom all dampness. Plenty of fresh air is essential, and the rooms\\noccupied should be accessible to sunlight throughout the day.\\nThere should be free ventilation by day, and still more by night;\\nand it must be secured without draughts. An outdoor life is to\\nbe recommended, if it be possible. At any rate he should be out-\\ndoors much of the time, and take plenty of outdoor exercise, but\\navoid overexertion and exposure. He should bathe daily in tepid,\\nnot cold, water and he should dress warmly, with wool next the\\nskin, summer and winter, day and night. The feet must be pro-\\ntected against both dampness and cold.\\nFood should be abundant and nutritious. Meats of all kinds\\nshould be eaten freely. Fats and rich broths are very useful.\\nMilk and cheese are good, and cream is still better. Alcoholic\\nstimulants are not necessary, and should be avoided, unless the\\ndisease actually appears or seems to be appearing.\\nBreathing exercises are highly beneficial, as they develop the\\nlungs and chest and so give increased vitality. They should be\\npracticed several times daily. Stand erect, with the shoulders well\\nback and the breast prominent; take a full breath, then slowly\\nraise the arms above the head and draw in as much air as possible,\\nthen expel it, allowing the hands to drop by the sides. Repeat\\nthese movements about ten times a minute, and continue them\\nfor several minutes. If these exercises be continued persistently\\nthe chest measure and expansion can be permanently increased.\\nThey are especially beneficial to young persons, to whom they\\nare recommended. Every cough should be watched and, if it\\nhangs on, or if from any cause consumption isThought to be pres-\\nent, no time should be lost before consulting a physician and\\nadopting more vigorous measures.\\nTreatment. When the disease first appears, but has not pro-\\ngressed too far, treatment is beneficial and may be curative. If\\npossible, the patient should go to one of the climates recom-\\nmended and observe all the rules of health just given, for they ap-\\nply as well to the primary stages of the disease as to the tendency.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0394.jp2"}, "393": {"fulltext": "GENERAL DISEASES. 875\\nPlentiful feeding is especially necessary. In some hospitals for\\nconsumptives, feeding is the only treatment. The patient is fed to\\nsatiety, then encouraged to eat still more, as often as five times\\na day, and good results are obtained. Alcoholic stimulants are\\nnow useful. Half an ounce of whisky, with meals, improves diges-\\ntion and increases the appetite, but two ounces a day will be just\\nas useful as a larger quantity, probably more so. It may be com-\\nbined with milk and cod liver oil. This oil has long been given\\nand is, no doubt, useful, but more as a food than as a medicine.\\nIt should be taken pure if possible, a tablespoonful morning and\\nevening. The various emulsions, wines and cordials of the oil are\\npoor substitutes, and should be taken only when the pure oil dis-\\nturbs the stomach. Many of them are frauds and contain almost\\nno cod liver oil at all.\\nTyson gives cod liver oil in the following manner: Place\\nin a wineglass a tablespoonful of whisky and overlay it with the\\nsame amount of the oil. Toss it into the back part of the throat\\nand it is swallowed with great facility, nothing being tasted but a\\npleasant residue of whisky.\\nThe whisky not only disguises the taste of the oil, but also\\nfavors its assimilation.\\nCreosote is a later remedy for consumption. It relieves cough\\nand expectoration and, in the early stages of the disease, may be\\nreally curative; at least, it comes as near that as anything now\\nknown. It is conveniently put up in one grain pills. One of\\nthese may be given after each meal, and the dose gradually in-\\ncreased to five or six three times a day. It is the large dose that\\ndoes good.\\nIron and arsenic are useful in all cases. They may be com-\\nbined as follows\\nArsenic, Fowler s solution two and a half drams.\\nGlycerole of iron four ounces.\\nGive a teaspoonful half an hour after meals.\\nStrychnia is valuable as a stimulant and tonic. Give from\\none-fortieth to one-thirtieth of a grain three or four times a day.\\nAny of these drugs must be given for weeks, or months, to obtain\\nmuch benefit. Of course, they should not all be given at the same\\ntime. In some cases one, in other cases another, is the best\\nremedy.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0395.jp2"}, "394": {"fulltext": "376 GENERAL DISEASES.\\nIn the later stages all we can do is to treat the various symp-\\ntoms, keep up the patient s strength, and delay the dread end as\\nlong as possible. All- the measures above named are still useful.\\nCough. For the cough, creosote, as given above, is the best\\nremedy. Later it can only be controlled by opiates; at first, co-\\ndeine, one-half grain, then morphine, one-fourth grain.\\nFever. The fever of consumption needs no special treatment.\\nNight Sweats. Night sweats may be controlled by either\\none-sixtieth of a grain of atropine or twenty grains of camphoric\\nacid (in capsules) at bedtime.\\nDiarrhea. The subnitrate of bismuth, in ten grain doses, is\\nthe best remedy. Later it may be combined with opium (one\\ngrain) or morphine (one-eighth grain).\\nConstipation. -Castor oil is the safest laxative. Do not give\\npurgatives.\\nHemorrhage. Hemorrhage from the lungs is very alarm-\\ning, but it usually stops of itself and, from its situation, we can\\ndo little for it. Put the patient to bed at once, with the shoulders\\nelevated, and apply ice to the chest over the seat of the bleeding, if\\nthis be known. The domestic remedy, feeding common salt to\\nthe patient, is also useful, but is not as good a remedy as ice, ap-\\nplied externally. If the hemorrhage persists a physician should\\nbe called.\\nSerum Treatment of Consumption. In 1890, Koch of Berlin\\nannounced the discovery of a substance, tuberculin, derived from\\nthe tubercle bacillus, and claimed it to be useful in the treatment\\nof tubercular disease.\\nFor a time it was thought that the long-sought consump-\\ntion cure had been found. Although this tuberculin proved to\\nbe of no value, it was a step in the right direction. A somewhat\\nsimilar substance has since been discovered for the prevention and\\ncure of diphtheria, and is an undoubted success. (See article on\\nDiphtheria.) It is believed by many that every germ disease has\\nwithin itself the means for its own cure, but this remains to be\\ndemonstrated. Vaccination against small-pox is an exemplifica-\\ntion of this idea, and the Pasteur treatment of hydrophobia is an-\\nother.\\nMany investigators are earnestly working upon the tubercu-\\nlosis problem, and it may be confidently predicted that the day is\\ncoming when a serum, or antitoxin of tuberculosis, will be found", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0396.jp2"}, "395": {"fulltext": "GEXERAL DISEASES. 377\\nthat will prevent and cure the disease, and consumption be\\nstamped out, as small-pox has been wherever vaccination has\\nbeen practiced. Various serums are now made and used with\\nmore or less success, but the subject is yet in the experimental\\nstage.\\nGeneral Preventive Measures. As has been said, in prac-\\ntically all cases of consumption of the lungs the germs of the dis-\\nease enter the lungs from the air. How do they get into the air?\\nIn this way A person affected with consumption spits, anywhere\\nand everywhere, a sputum swarming with germs. It dries and\\nthe germs float about in the air as dust. Drying does not kill them,\\nand when they are taken into the lungs they are ready to begin\\ntheir destructive work. Until the germs have become dry they\\ndo not rise in the air. The main point then in preventing the\\nspread of the disease is the disinfection of sputa. For this reason\\nthe patient should never spit, except in some vessel or receptacle\\nthat can be disinfected and the germs thus be destroyed. If he\\nuses a metallic vessel it should always contain a solution, either\\nof carbolic acid half a teaspoonful to the ounce of water or of\\ncorrosive sublimate corrosive sublimate, two drams; tartaric\\nacid, one dram; water, one gallon. The vessel should be washed\\nevery day. first with boiling water, then with some of the solution.\\nAnother good plan is to use small pasteboard boxes, or Jap-\\nanese rice paper napkins, then burn them. On no account should\\nthe patient spit on the floor, or about public places, or on the\\nfloor of a public conveyance, car or boat. When traveling he\\nmay carry a small flask with metallic screw cap. This can be\\ncleaned by boiling, or with the carbolic solution.\\nWhen a room is to be occupied by a consumptive patient, it\\nshould be stripped of all upholstered furniture, carpets and heavy\\ncurtains or hangings. Carpets may be replaced by rugs, that can\\nbe frequently shaken and aired.\\nAs the sweat of the patient may contain the germs, no one\\nshould sleep with him. It is also better that he should use sepa-\\nrate dishes, knives, forks, etc. He should be very careful not to\\nget sputa on his clothes, the bedding, furniture, or floor. A\\ntubercular mother should not nurse her baby. The room or\\nhouse occupied by a consumptive patient should always be thor-\\noughly disinfected before being taken by another tenant.\\nTo do this follow carefully the directions given in the chapter", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0397.jp2"}, "396": {"fulltext": "378 GENERAL DISEASES.\\non disinfection in this work. All the clothing and bedding should\\nbe boiled for half an hour or more. The body of a person\\nhaving died from any infectious disease should be cremated.\\nACUTE CONSUMPTION.\\n(Quick Consumption.)\\nQuick consumption is a rapid variety of consumption of the\\nlungs. It is comparatively rare. The lungs rapidly soften and\\nbreak up, small abscesses are formed and the whole of both lungs\\nis often diseased. This form occurs most frequently in children,\\nand often follows measles or whooping cough.\\nSymptoms. In the beginning the disease may resemble\\neither bronchitis or pneumonia. The cough is more continuous,\\nand soon there is fever with sweats. The child loses flesh very\\nrapidly. The cough becomes loose and there is profuse muco-pur-\\nulent expectoration. Hemorrhage from the lungs may occur\\nearly. There are often periods of temporary improvement. Dur-\\ning the first week the disease may not be differentiated from\\npneumonia, but there is no crisis, as in pneumonia, and the patient,\\ninstead of getting better, continually grows worse. The disease\\nlasts from three weeks to three months; sometimes longer. The\\nresult is death. It may occur within a few weeks, or months, al-\\nways inside of a year.\\nTreatment. The treatment is the same as for the more\\nchronic forms of consumption.\\nPLEURISY.\\nPleurisy is an inflammation of the pleura, or serous sac in\\nwhich the lung is enclosed. Most cases of the disease are really\\ncases of tuberculosis of the pleura. Many cases are caused by\\nexposure and chilling or taking cold. It is sometimes caused\\nby Bright s disease. It usually follows a penetrating wound of\\nthe chest. There is more or less pleurisy in all cases of pneu-\\nmonia and pulmonary consumption. The disease occurs in the\\nwinter or spring months, is more frequent in males and is com-\\nparatively rare in children.\\nSymptoms. In order to understand the symptoms it is nec-\\nessary to know something of what is taking place within the\\npleura. There is first a congestion and swelling of the mem-\\nbrane, then the formation of a kind of false membrane on its sur-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0398.jp2"}, "397": {"fulltext": "GEXERAL DISEASES. 379\\nface, as in diphtheritic sore throat. This false membrane may be-\\ncome permanent in places, forming bands (or adhesions) between\\ntwo adjacent surfaces. These adhesions obstruct the movements\\nof the lungs ever afterward and, at times, produce a sharp pain,\\nknown as a stitch in the side, or a pleuritic stitch. In many cases\\nthere is exudation of a thin fluid, or serum, into the pleural sac.\\nThis is called a pleural effusion. It may be absorbed again, or\\nmay not, in which case it must be removed by surgical means.\\nIn some cases pus germs enter the pleura, and the sac then\\nsoon contains a large quantity of pus. This condition is called\\nempyema. It more frequently follows pneumonia.\\nThe first symptom is usually a sharp pain in the side of the\\nchest, but there may be a few days of discomfort preceding this,\\nand there may be a chill. The pain is cutting or lancinating, and\\nit is aggravated by breathing. To avoid pain as much as he can,\\nthe patient breathes quickly and with as little movement as pos-\\nsible. There is a hacking cough.\\nThis increases the pain so, it is made very short. There is\\nlittle or no expectoration. There is always fever, but it is not as\\nhigh as in pneumonia; usually running from 102 to 103 in the\\nbeginning and falling gradually. The patient lies on the affected\\nside, in order to lessen its movements and so lessen the pain.\\nSome cases begin with no noticeable symptoms and the patient,\\n.with a large pleural effusion, may go about, apparently well. Some\\npersons may even go through the whole course of pleurisy, from\\nbeginning to recovery, and never know it. It is a difficult disease\\nto recognize, except by a careful examination of the lungs.\\nPrognosis. Cases caused by a cold always recover. Tuber-\\ncular cases often recover, too, if properly treated. The disease\\nusually lasts from one to two weeks, but may go on for months.\\nPleurisy in the course of Bright s disease and pulmonary consump-\\ntion is always fatal.\\nTreatment. Alany simple cases recover without treatment.\\nBleeding was formerly resorted to and did much good, but, owing\\nto a changed sentiment, it could hardly be used now. A blister\\nover the seat of pain is one of the very best measures. After the\\nblister, the silk or cotton-batting jacket should be worn con-\\ntinuously. Morphine (one-fourth grain) is often necessary to re-\\nlieve the pain. It is essential that the bowels be kept moving\\nfreely. A physician must be called sooner or later, as there are", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0399.jp2"}, "398": {"fulltext": "380 GENERAL DISEASES.\\nfeatures of the disease that cannot be recognized by the average\\nperson, much less treated by him. When there is a pleural effu-\\nsion, the physician gives remedies designed to aid in its absorp-\\ntion. If it is not absorbed it must be withdrawn by tapping, or\\nby incision, through the chest wall. Either is a simple operation,\\nattended by little or no danger. If the sac is infected and becomes\\nfilled with pus, we have the condition known as empyema.\\nEMPYEMA.\\nThis is a condition in which there is suppuration in the pleural\\nmembrane and pus in the pleural sac. It is most frequent in chil-\\ndren, and the majority of cases occur with or follow some form\\nof pneumonia, but it may follow pleurisy and, more rarely, measles\\nor scarlet fever. It also follows penetrating wounds of the chest.\\nSymptoms. The onset varies so greatly as to render descrip-\\ntion useless, but after there is pus in the pleural cavity the symp-\\ntoms are quite uniform. The child is pallid, bloodless, weak and\\nemaciated. The breathing is always rapid (from forty to seventy)\\nand difficult. There is cough and an extremely variable fever,\\nand sometimes there are chills, fever and sweats, as in malarial\\nfevers. When the disease goes on several weeks it may be easily\\nmistaken for consumption. There is clubbing of the fingers, loss\\nof appetite, cough, emaciation and even swelling of the feet. The\\nphysician makes sure of the presence of pus in the chest by use\\nof the hypodermic syringe.\\nPrognosis. In children, under one year of age, fifty per\\ncent die. In older children and adults, if the disease be seen rea-\\nsonably early (within one or two months), and properly treated,\\nrecovery is the rule. It is the cases that have gone untreated a\\nlong time, or refuse an operation, that end in death. There is\\nscarcely another disease that brings a child so low, yet is treated\\nwith so much satisfaction and success.\\nTreatment. There is no choice or variety of methods in\\nthe treatment of empyema, for there is but one thing to do. Call\\na surgeon who will remove the pus at once by an operation that\\nis, by an incision through the chest wall. When this is done prop-\\nerly, there is little danger, and recovery is the rule. When it is\\nnot done, death is almost certain.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0400.jp2"}, "399": {"fulltext": "CHAPTER VII.\\nDISEASES OF THE NOSE AND THROAT.\\nBy W. E. McVey, M.D.\\nCAUSES OF COLDS.\\nTo know how to prevent colds we should know something\\nof their causes. They are usually supposed to be due to sudden\\nchanges of temperature, drafts of air or exposure; but in perfectly\\nhealthy persons these things alone will not cause colds, for they\\nmake no impression upon one who has a normal digestion, a\\nnormal circulation and a properly attuned nervous system. The\\ndigestive organs, the circulatory system and the nervous system\\nare so intimately related that a disturbance of either is sure to\\naffect the others.\\nThe natural consequences of a bad digestion are impaired\\nnutrition, blood but poorly supplied with nourishment for the\\nsupport of the tissues, and a resulting loss of energy in the nervous\\nsystem, whereby it can but imperfectly bring about the changes\\nin the circulation which are necessary to the elimination of poisons\\nand to the protection of the body against the irritant effects of\\nheat, cold and dampness. The same results may arise from any\\nimpairment of the nervous system or of the circulatory system\\nitself.\\nIn a condition of perfect health the circulation readily reacts\\nupon the depressing influences of atmospheric changes, so that no\\nharm is done, but if either of these great systems is in a bad condi-\\ntion the defense is broken and the influence of the irritant is felt\\nfirst in that part which can make least resistance. The weakest\\npart of the body is the respiratory tract (organs of breathing), and\\nusually the weakest part of that is the nose hence, the most fre-\\nquent result of exposure is a cold in the head. The resistance\\nhaving once been overcome, each succeeding attack becomes\\nmore and more serious, until a condition of continuous cold is\\nestablished.\\n3 8i", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0401.jp2"}, "400": {"fulltext": "382 GENERAL DISEASES.\\nTHE PREVENTION OF COLDS.\\nThe most important thing, then, in the prevention of a cold,\\nis the maintenance of a perfectly healthy body, and this can be\\ndone only by a careful observance of the rules of exercise, diet\\nand hygiene. There are many people, although apparently\\nhealthy, in whom there is but little vigor. They lack the power\\nof resistance and consequently are among the most frequent suf-\\nferers from colds. In the preventive treatment of such cases two\\nplans have been suggested\\nFirst. Protect the body with heavy clothing and wraps from\\nall possibility of exposure.\\nSecond. Stimulate reaction and accustom the body to sudden\\nchanges of temperature by exercise and training, thus increasing\\nits vitality.\\nA large majority of the class mentioned adopt the first plan,\\nand, in consequence, suffer from every accidental exposure. The\\nman who never wraps his neck seldom has a cold or sore throat,\\nbecause his neck, like his hands and face, have become accus-\\ntomed to changes. Those in the habit of wrapping up will most\\ncertainly take cold if caught without the usual amount of protec-\\ntion, and it is to such people that the second plan of prevention\\nshould be rigorously applied. They should begin in summer to\\nprepare for winter, by taking, every morning, a cold bath, or at\\nleast a cold shoulder and chest bath, followed by vigorous rubbing\\nwith a rough towel. This should be continued persistently sum-\\nmer and winter. If begun in summer the gradual change in the\\ntemperature of the water will hardly be felt and reaction from the\\ncold bath will be immediate.\\nIn cold weather one should wear only such wraps as are\\nneeded for comfort, and should under no circumstances bundle\\nthe neck and ears. Outdoor wraps should be removed on entering\\nwarm rooms. The feet should be kept dry. Heavy overshoes, fur\\ncaps and fur overcoats should be reserved for long drives or visits\\nto very cold regions. People subject to frequent colds in the head\\nor frequent attacks of sore throat or bronchitis will find this course\\nof great benefit.\\nA cold may manifest itself within a few hours after exposure,\\nor it may not appear for a day or two. The usual symptoms at\\nfirst are malaise, aching of limbs and back, fever, some headache,\\nthirst and a dryness of the nose or throat, or both, and a sensation", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0402.jp2"}, "401": {"fulltext": "GENERAL DISEASES. 383\\nof fullness in the nose. Later the dryness disappears and there is\\na profuse watery discharge, to be followed later by a thick, yellow-\\nish- discharge, which may continue for days or weeks. The fever\\nand aching of the first stage usually subside after the free, watery\\ndischarge has well begun.\\nTreatment. A cold may be aborted if treatment be begun\\nearly enough.\\nThe patient should prepare for bed, soak his feet for about\\n1 5 minutes in water as hot as can be borne, drink a hot lemonade,\\nslip into bed and cover up warmly. In moderate cases this is all\\nthat is necessary. In more serious cases it is well with the hot\\ndrinks to give from five to ten grains of Dover s powder, and, if\\nthe attack seems very severe, a five-grain capsule of quinine.\\nIf the cold is thoroughly established, give a pill or capsule\\ncomposed of two and a half grains each of salol and phenacetin\\nevery four hours, and spray or douche the nose every two or three\\nhours with hot water containing a teaspoonful of listerine, or a\\npinch of common baking soda, to each half-glass of water. Every\\ncold should be thoroughly cured and means adopted to prevent\\nfurther attacks, for frequent colds develop chronic cold or\\ncatarrh.\\nCATARRH OF THE NOSE.\\n(Chronic Rhinitis.)\\nThere are three distinct forms of catarrh Catarrh of child-\\nhood (mnco-piiriilent rhinitis) dry catarrh (atropine rhinitis) and\\ncommon catarrh (hypertrophic rhinitis.)\\nThe Catarrh of Childhood, sometimes called snuffles, is the\\nform most frequently found in children, especially in those much\\nexposed and poorly fed, or who have inherited scrofulous tenden-\\ncies. Glandular tissue is more liable to inflammation or disease\\nin children than in adults, and it becomes diseased more readily\\nthan the other tissues. In children who have frequent colds the\\ntissues in the nose that secrete mucus become inflamed, and, if\\nthe child is badly nourished, either from exposure and bad food, or\\nfrom inherited tendencies to disease, the inflammation is likely to\\nbecome chronic. There is, then, an excessive discharge from the\\nnose which changes in character as the disease advances, being at\\nfirst watery mucus, then somewhat thicker and mixed with pus,\\nwhich makes it yellowish in color. There is usually considerable\\nswelling of the membrane of the nose, so that the child often", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0403.jp2"}, "402": {"fulltext": "384 GENERAL DISEASES.\\nbreathes with the mouth open. The accumulated discharge in the\\nnose makes a disagreeable rattling sound as the air passes\\nthrough it and the child frequently draws the discharge back into\\nthe throat and swallows it. If the nose is nearly closed by the\\nswollen membranes the discharge runs out the front of the nose,\\nand, from its irritating effect, the edges of the nose and upper lip\\noften become sore and, frequently, covered with scabs.\\nThis condition may go on for years, sometimes better and\\nsometimes worse, until the secreting tissue has been mostly de-\\nstroyed and the inflammation has extended to other tissues.\\nTreatment. The treatment should be both local and consti-\\ntutional. By means of an atomizer, or small hand syringe, the\\nnose should be thoroughly washed out with a solution of one part\\nof listerine to seven parts of warm water. This should be re-\\npeated two or three times a day, if the conditions warrant it, until\\nall signs of the trouble have disappeared. This is usually all the\\nlocal treatment that is necessary. If there are sores and scabs\\naround the nose and mouth they should be carefully washed with\\nwarm water, then well anointed with carbolized vaseline. The\\nbadly nourished or scrofulous child should be given tonics. Syrup\\nof iodide of iron, in from ten to thirty drop doses, well diluted, will\\nbe found very efficient.\\nCatarrh in Adults. The other two forms of catarrh occur in\\nadult life.\\nBefore describing them something should be said of the\\nstructure and functions of the nose. There are three oblong\\nmasses projecting from the outer wall of each nostril, known as\\nthe turbinate bodies. The lower, which is the larger one, may\\neasily be seen by spreading the nose open a little.\\nEach of these bodies consists of a shell of bone covered with\\nmucous membrane, in which is a dense network of very small\\nblood-vessels. Between these vessels and the nerves and glands\\nis a substance termed connective tissue; also some fibrous tissue\\nto give firmness to the membrane. The network of blood-vessels\\nserves to warm the air as it enters the nose; also to moisten it.\\nThe air we breathe contains some moisture, but is usually ready to\\ntake up more, as illustrated by the disappearance of water from a\\ndish on a warm day. The air passages below the nose are supplied\\nwith glands to secrete only sufficient mucus to keep the mem-\\nbranes soft and pliable. The mouth is kept moist with saliva, and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0404.jp2"}, "403": {"fulltext": "GENERAL DISEASES. 385\\nthe food is moistened by it. but it is not largely secreted except\\nduring mastication. The month soon becomes very dry at night\\nif one breathes with it open. The amount of mucus secreted in\\nthe bronchial tubes and lungs is very small, and the air, unless satu-\\nrated with moisture before reaching the lungs, would soon take up\\nall the water from this mucus and leave the membrane dry and\\nirritated. The average amount of moisture required to saturate\\nthe air breathed by a person every twenty-four hours is estimated\\nat about a pint, all of which is furnished by the blood-vessels in the\\nnose, being exuded through their walls from the blood but as it\\nis all the time being taken up by the air on its way to the lungs we\\ndo not notice it.\\nAs the amount of moisture in the air varies, so the amount\\nrequired from the nose varies, the supply being governed by the\\nnerves which control the blood-vessels. If more is required the\\nvessels, by dilating, allow more blood to flow, from which more\\ncan be drawn. Upon the disturbance of this function of the nose\\ncatarrh and its results chiefly depend.\\nThis disease is usually a later development of the condition\\nexisting in children as muco-purulent rhinitis, already described.\\nIt is in nearly every case confined to adults. The nose is dry and\\nthe air passages large. Scabs frequently accumulate in the nose\\nand often a scab is blown out, having the shape of the nasal cavity.\\nIf the scabs are retained long they begin to decompose and there\\nis a musty odor. The sense of smell is usually lost. When the\\nscabs have been forcibly removed there is a tendency to bleed.\\nThe inflammation which preceded this condition partially or\\nwholly destroyed the secreting cells (the epithelium), the deeper\\nstructures of the membrane have become involved, and, mixed\\nwith the small amount of mucus now secreted, we have a sticky,\\ntenacious material which coagulates, adheres to and contracts\\nupon the membrane, forming scabs over a part or all of the inside\\nof the nose.\\nThis condition not only prevents the air from absorbing mois-\\nture from the blood-vessels, but by contraction drives the blood\\nout of them, thus depriving the tissues of their nourishment, so\\nthat they gradually shrink away. From the loss of the moistening\\nfunction of the nose the throat becomes dry and irritable, and the\\npatient has a chronic sore throat, and, later, may develop a chronic\\nbronchitis.\\n25", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0405.jp2"}, "404": {"fulltext": "386 GENERAL DISEASES.\\nDry catarrh is usually considered incurable, but by persistent\\nattention much relief may be afforded, and, if the condition has\\nnot existed too long, a cure is possible.\\nTreatment. The main object in the treatment is to prevent\\nthe adherence and formation of scabs. The nose should be thor-\\noughly cleaned with warm water containing five grains of soda\\nand two drops of carbolic acid to each ounce, or a teaspoonful of\\nlisterine to the ounce, after which it should be well oiled with\\nmelted vaseline, or with the following ointment\\nVaseline one ounce.\\nBoric acid one-half dram.\\nAristol six grains.\\nOil eucalyptus five drops.\\nMenthol one grain.\\nThis is best used in a DeVillis atomizer. Some of the oint-\\nment should be placed in the bowl, then held over a lamp until\\nthoroughly melted, when it may be sprayed into the nostril. In\\nthe melted state it readily spreads over the membrane, and as it\\ncools adheres to it, thus preventing the attachment of scabs and\\nfacilitating the removal of secretions. There will be no odor about\\nthe nose if it be kept free from secretions, especially crusts and\\nscabs.\\nAfter this treatment has been kept up for some time an\\nattempt may be made to restore the function of the nose by the\\noccasional use of stimulating applications, such as\\nOil of cubebs five to ten drops.\\nAlboline one ounce.\\nApply as a spray once a day or every other day. This should\\nnot take the place of the other remedies, but be used in connec-\\ntion with them.\\nCOMMON CATARRH.\\nThis form is considered a disease of adult life, although it is\\nfrequently found in youth. It is a very common ailment, and much\\nmore common in some regions than in others. It often exists for\\nconsiderable time before demanding attention, when it is noticed\\nthat there is a varying but constant discharge from the nose, which\\nis much increased on going out into the^old air, and sometimes\\ngreatly aggravated by dust and irritating vapors. There is always\\nsome closure of one or both nostrils from the enlarged or swollen", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0406.jp2"}, "405": {"fulltext": "GENERAL DISEASES. 38?\\nturbinate bodies. In many cases first one side, then the other, be-\\ncomes closed, and often one nostril is completely closed so that\\nthe discharge cannot be blown out, and no air can be inhaled\\nthrough that side.\\nWhen this stoppage is very persistent there is always danger\\nof the ears becoming affected, and deafness of one or both ears\\nmay result. Soon or late the throat is sure to become dry and\\ninflamed, because the diseased condition of the nose prevents the\\nair from securing the amount of moisture required, and the watery\\npart of the mucus in the throat is absorbed; or if the nose be\\nstopped the breath is drawn through the throat and the same dry\\ncondition of the throat follows.\\nAmong the causes of this form of catarrh are repeated attacks\\nof cold in the head, and exposure to dust, especially in a dry climate\\nwith much wind, but probably the most frequent cause is deformi-\\nties of the nose. In a great many people the septum (partition)\\nbetween the two sides of the nose is bent so that one cavity is\\nsmaller than the other, and in some cases this passage on one side\\nis so small that no air can pass in, while the other side is nearly\\nas large as both should be, and all the air passes in at that side.\\nIt is nearly always found, however, that this large passage is\\npartially filled up by a large, red-looking tumor, which is the en-\\nlarged turbinate mentioned in the first part of this chapter. This\\noccurs whether one has had frequent colds or not, and does not\\ndepend upon dust or climate.\\nAs has been explained, the network of blood-vessels is called\\nupon for more moisture when the air is very dry, and the vessels\\nthen dilate and more blood enters. If this demand is permanent\\nthe vessels remain enlarged constantly engorged with blood.\\nThe water escapes from the vessels and the membrane becomes\\nswollen. From the increased supply of blood there is overnutri-\\ntion of the part and new tissue forms, so that the turbinate bodies\\nare not only swollen, but thickened (hypertrophied).\\nThe same conditions are brought about by a deformed sep-\\ntum, and in the same way, for one side of the nose, being often\\nmuch larger than the other, admits more than its share of the\\nbreath, to saturate which it must furnish more than its share of\\nwater, and the effect upon the vessels is the same as that of a dry\\natmosphere. These deformities are almost always the result of\\ninjuries, and usuallv of those received in childhood, as from falls", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0407.jp2"}, "406": {"fulltext": "388 GENERAL DISEASES.\\nor blows upon the nose. The injury itself may not have been\\nserious, but results in a slowly developing deformity.\\nTreatment. Persistent treatment will, in the majority of\\ncases, cure this form of catarrh. The first essential is cleansing the\\nnose. This may be accomplished in the same way and by the same\\nmeans as suggested for dry catarrh. After a thorough cleansing,\\neach side of the nose should be sprayed by an atomizer with some\\nof the following\\nAlboline two ounces.\\nMenthol twenty grains.\\nOil eucalyptus five drops.\\nOil cinnamon five drops.\\nRepeat this every day well and persistently for months if\\nnecessary.\\nIt is also well to use occasionally an astringent powder. The\\nfollowing may be snuffed into the nose every day or two\\nSalicylic acid ten grains.\\nTannic acid one dram.\\nSubnitrate of bismuth one dram.\\nIf the obstruction of the nose is very great, or if there is very\\nmuch thickening of the tissues, these milder measures will do little\\nmore than give temporary relief. In these conditions the extra\\ntissue must first be removed or contracted by a surgical operation,\\nwhich is simple and almost painless, after which the nose should\\nbe treated as above prescribed. No catarrh snuff or other remedy\\nshould be used which contains cocaine, as by the continued use\\nof these so-called catarrh cures many have acquired the cocaine\\nhabit. In mild cases a simple, douche of hot water, containing a\\nlittle soda, will often give great relief, and sometimes afford a com-\\nplete cure. The most careful observance of the hygienic rules sug-\\ngested early in this chapter must be insisted upon, if any perma-\\nnent benefit is to be derived.\\nADENOID GROWTHS.\\nAdenoid (gland-like) growths are masses of soft, spongy tis-\\nsue which form in what is called the naso-pharynx- that part of\\nthe throat which lies behind the nose and soft palate, reaching\\nnearly to the lower level of the latter. They form upon the wall", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0408.jp2"}, "407": {"fulltext": "GENERAL DISEASES. 389\\nof this space, hanging down in such a way as to sometimes block\\nup the openings from the nose into the throat, and are of consider-\\nable importance because of their interference with natural breath-\\ning, compelling the child to breathe through its mouth and pro-\\nducing a peculiar facial expression. There is a dull, heavy look\\nabout the eyes, with a prominence of the upper jaw, causing, in\\nmany cases, an almost idiotic expression and there is usually con-\\nsiderable discharge which is frequently removed by disagreeable\\nhawking. If the condition be not relieved permanent damage to\\nthe ears may result. They are principally found in children and\\ndisappear after adult life is reached.\\nTreatment. Removal of the growths is the only satisfactory\\ntreatment. This is not a difficult or very painful operation, and\\nis usually done by crushing the soft masses with the fingers, or by\\nan instrument devised for the purpose. After the growths have\\nbeen removed by the surgeon the nose and throat may be treated\\nafter the same plan suggested for chronic catarrh.\\nIf the child is poorly nourished and has a fickle appetite, he\\nshould be given the syrup of the iodide of iron in doses of from\\ntwenty to thirty drops after meals.\\nDISEASES OE THE PHARYNX.\\nThe Pharynx, or upper part of the throat, is that cavity the\\nlargest part of which may be seen through the arch at the back of\\nthe open mouth. The gullet and larynx open into it from below,\\nthe mouth and nostrils from above it also communicates with the\\ndrums of the ears by means of two narrow channels called the\\nEustachian tubes.\\nThe Palate is the roof of the mouth. Its front and back por-\\ntions are known respectively as the hard and soft palate the hard\\npalate being the bony portion bounded in front by the sockets of\\nthe teeth in the upper jaw the soft palate consists of the movable\\nmuscular portion or back part of the roof.\\nThe Uvula is the little pendant which hangs from the center\\nof the- back edge of the soft palate.\\nThe Fauces is the name given to the back part of the mouth\\nor the passage from the mouth cavity to the pharynx, overhung\\nby the soft palate and bounded on its sides by the pillars of the\\nsoft palate, sometimes called the pillars of the fauces.\\nThe Tonsils are the two prominent oval bodies situated one", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0409.jp2"}, "408": {"fulltext": "390 GENERAL DISEASES.\\non either side of the throat near the back part of the tongue, and\\nat the summit of the pharynx. The purpose of these glands has\\nnever been discovered; a person is quite as well off without them,\\nand in many people they seem to exist only to become diseased.\\nThe tonsils, as we usually find them, are enlarged glands, or\\nmasses of glands, situated one on either side of the throat near\\nthe back part of the tongue. When much enlarged they are very\\neasily seen, looking like large red tumors, which sometimes seem\\nto come together behind the tongue. Often several large holes\\nmay be seen in each tonsil.\\nSometimes these holes are filled with a mattery-looking fluid,\\nor may contain masses of cheesy-looking material. If much\\nenlarged, the tonsils interfere with breathing through the nose,\\nespecially on lying down, by filling up the space between the back\\npart of the nose and mouth. The same effect upon the counte-\\nnance and ears may be expected in this condition as in the adenoid\\ngrowths. In children they often hinder development and cause\\nill health, both because of their interference with normal breath-\\ning and quiet sleep, and by their absorption of poisons. They are\\nmost common to childhood, although not infrequent in adult life\\nbut in adults, because of the mouth and throat being larger, they\\ndo not so much interfere with breathing. They should be removed\\nby the surgeon. The operation is almost painless, and it is the\\nquickest, safest and in all respects the best treatment.\\nTONSILITIS. QUINSY. SORE THROAT.\\nThis is an acute inflammation of the tonsils, and usually oc-\\ncurs in persons who have enlarged tonsils, and particularly in those\\nwho have a rheumatic tendency. By many physicians, acute ton-\\nsilitis is considered one manifestation of rheumatism. It usually\\ncomes on with a feeling of malaise, aching of the limbs, chill or\\nchilly sensation, headache, fever, dryness of the throat, and pain,\\nespecially about the angle of the jaw.\\nSwallowing becomes painful and difficult, so that often noth-\\ning but liquids can be swallowed, and they are liable to come back\\nthrough the nose. The swelling of the tonsils may become so\\ngreat that the patient is threatened with suffocation, although this\\nseldom if ever occurs. Usually at the latter end of the attack,\\nwhich may last from four or five days to two weeks, if the swell-\\ning has been very great, the tonsil begins to look red and tense", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0410.jp2"}, "409": {"fulltext": "GEXERAL DISEASES. 391\\nat some point, and soon breaks, discharging considerable matter\\nand blood, after which recovery is quite rapid. It is frequently\\nadvisable to hasten this process by lancing.\\nOne or both sides may be affected at the same time, or, very\\noften, the attack is prolonged by one side becoming affected about\\nthe time the other side is getting well. The fever accompanying\\nan attack of tonsilitis may be quite high, and the patient is usually\\nweak and much exhausted during convalescence. Although a\\ngreat many things have been considered causes of this disease, it\\ncan most frequently be ascribed to enlarged tonsils, or to a rheu-\\nmatic tendency, or, more frequently, to both these conditions\\njoined to exposure.\\nTreatment. When the attack first comes give a cathartic,\\nsuch as a teaspoonful of sulphate of soda every four hours until\\nthe bowels move freely. Then, to control the fever and check the\\ndisease, a pill or capsule containing two and a half grains each of\\nphenacetin and salol should be given every four hours. When\\nthe throat first begins to feel sore a counter-irritant, such as a\\nmustard plaster, applied to the neck, care being used not to pro-\\nduce a blister, will often be of benefit. The throat should be fre-\\nquently gargled with hot water containing some antiseptic, such\\nas one part of listerine to seven parts of the water. The throat\\nusually feels hot and dry. and a spray of menthol and oil (see page\\n386 for formula; will be very grateful to the patient.\\nDry heat may be applied to the neck, but poultices should not\\nbe used. A moist poultice moistens the skin, but, since the tonsil\\nusually breaks upon the inside, this does not assist the process\\nmore than dry hot applications, and the latter are more pleasant to\\nthe patient. After the tonsil breaks the throat should be fre-\\nquently washed out with listerine and hot Avater, until the dis-\\ncharge ceases.\\nFOLLICULAR TONSILITIS.\\nThis is a much severer form of inflammation of the tonsils, and\\nis due to a specific poison. All of the symptoms are more marked\\nand more severe. The tonsils appear to be covered with white\\nor grayish spots, from the fact that it usually begins in the crypts.\\nor openings in the glands, and in the follicles which open into these\\ncrypts. These spots usually get larger until several may come\\ntogether, forming a large gray mass or slough, which finally comes\\naway, leaving a lar\u00c2\u00b0:e hole behind.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0411.jp2"}, "410": {"fulltext": "392 GENERAL DISEASES.\\nThe whole gland may be destroyed in this way. It resembles\\ndiphtheria very closely and is so difficult to distinguish from it\\nthat physicians usually place cases of this kind under the same\\nrestrictions as diphtheria.\\nSee Fig. 2, Plate VI.\\nTreatment. In uncomplicated cases the use of the cathartic,\\nthe phenacetin and salol, and the listerine gargle, as just prescribed\\nfor quinsy, will often prove very efficient. In addition to these\\nthe throat should be brushed or swabbed twice a day with gly-\\ncerole of tannin. Since, in its graver forms, this is a serious dis-\\nease, its treatment should be under the direction of a skillful phy-\\nsician.\\nPHARYNGITIS. SORE THROAT.\\nPharyngitis may be either acute or chronic, but the chronic\\nform, with frequent acute attacks, is the more common. An\\nacute simple pharyngitis usually arises from taking cold. There\\nis a sense of dryness and stiffness of the throat, with considerable\\nheat and some pain on swallowing or attempting to talk. The\\nthroat looks red and glazed, or, later, may be covered with a\\nthick white or grayish secretion, which, after a few days, disap-\\npears.\\nDebility from any cause, sedentary habits, and rheumatic or\\nscrofulous tendencies, by lessening resistance, may be predispos-\\ning causes.\\nSimple gargles of hot water with a little soda, or a spray of\\nmenthol and almond oil, are usually sufficient for local treatment.\\nA light physic and three grains of quinine every four hours will\\nusually bring about a recovery. Acute pharyngitis may be modi-\\nfied by conditions previously existing in the throat, the attack\\nbeing simply an increase of a chronic trouble.\\nChronic Pharyngitis is usually a result of nasal catarrh with\\nobstruction and loss of function in the nose, or of exposure of\\nthe throat to irritating dust or vapors for long periods, or it may\\nbe a result of over or injudicious use of the voice, as w T ith preach-\\ners or outdoor speakers. The throat looks rough and usually\\nthere are little red elevations seen in the back of it, which are very\\nsensitive when touched. The throat at times, especially in the\\nnight, becomes dry and stiff, and in the morning is likely to be\\nfound coated with a dry, stiff secretion, which it requires repeated\\nhawking to remove. The voice is generally changed in character,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0412.jp2"}, "411": {"fulltext": "w\\nS\\ni", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0413.jp2"}, "412": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0414.jp2"}, "413": {"fulltext": "GENERAL DISEASES. 393\\nand speaking is difficult and painful. The pharynx is very subject\\nto irritations and is likely to be much affected by digestive dis-\\nturbances. Slight exposures in damp or variable atmospheres\\nexaggerate the symptoms and often bring on acute attacks. A\\ncough often accompanies the disorder, and in many cases the\\nvocal organs and bronchial tubes become affected.\\nTreatment. Pharyngitis is a serious condition and requires\\nlong and systematic treatment for permanent relief. If it is de-\\npendent upon nasal catarrh that condition should be removed.\\nThe secretion that collects upon the mucous membrane of the\\nthroat should be carefully removed in such a way as to cause the\\nleast possible irritation. This may be done with dilute listerine, or\\nwarm water in which enough soda has been dissolved to give\\nit a slightly alkaline taste. The throat should then be well\\nsprayed with the oil and menthol solution recommended for\\ncommon catarrh. Two or three times a week the red points\\nshould be touched with tincture of iodine after the washing\\nprocess, and should then be immediately sprayed with the oil\\nmixture.\\nThe worst form of chronic pharyngitis is the dry or atrophic\\nform. This usually follows a catarrh of the nose, when the func-\\ntion of the nose has been almost entirely destroyed. The throat\\nlooks dry and glazed, and there are streaks of thick, tough secre-\\ntion which, when removed, leave the throat very red and in-\\nflamed. It is continuously sore and stiff, and often causes much\\npain in swallowing or speaking. Great care should be used in\\ncleaning the throat, as the removal of the tough mucus irritates\\nthe membrane. It is best in such a case. to spray thoroughly with\\nthe oil solution in the morning before attempting to remove the\\ncollected mucus. The oil saturates it and protects the mem-\\nbrane, and should be used as a spray several times each day, and\\nonce each day the throat should be sprayed with the following:\\nOil of cubebs four drains; albolene four ounces. The treat-\\nment must be regularly continued for several months if any perma-\\nnent benefit is to be gained.\\nTHE VOICE.\\nThe Larynx is the voice-box at the top of the windpipe or\\ntrachea, containing the vocal cords or lips of the glottis. It is\\nsituated in the throat, just below the angle of the throat and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0415.jp2"}, "414": {"fulltext": "394 GENERAL DISEASES.\\nlower jaw, and is composed of two principal cartilages, the thy-\\nroid and the crycoid. Roughly speaking, this voice-box is a\\nshort tube, three-cornered above and cylindrical below, and,\\nbeing larger at the top than at the bottom, may be said to\\nresemble a funnel, the upper part of which has been bent into\\na triangular shape.\\nThe Epiglottis or lid is a soft elastic substance which closes\\nthe upper opening of the larynx during the act of swallowing\\nand thus protects the larynx with its delicate organs while the\\nfood and drink pass over it into the gullet or esophagus on their\\nway to the stomach; it is sometimes called the cover cartilage.\\nThe Vocal Cords or vocal ligaments are two ledges of elastic\\ntissue, covered with very delicate membrane. Each of them\\nis connected on one side along its whole length with the shield\\ncartilage of the larynx, and their ends also are joined to other\\nparts of the larynx. The term is misleading, as it implies strings\\nlike those of the violin or other musical instruments, attached\\nonly at the ends and left free at every other point, which is not\\ntrue of the vocal cords, for they are each attached along one\\nside as well as at both ends and are free only along their inner\\nedges, and resemble membranes or bands rather than cords.\\nAll rules for the care and development of the voice must\\nbe in accord with the physiological action of the organs involved\\nin its production. The larynx is primarily the vocal organ and\\nmuch of the character of the voice depends upon the peculiari-\\nties of its construction, but there are other organs and functions\\nconcerned that are of great importance. The primary sound is\\nproduced by the vibration of the vocal cords, and these are set\\nin vibration by the column of air expelled against them by the\\nlungs, the cords being put upon a stretch and brought closely\\ntogether. The pitch of the sound will depend upon the length\\nof the vocal cords, the shorter the cords the higher the pitch\\nof the sound produced, and upon the degree of tension, the pitch\\nbeing proportional to the square root of the tension.\\nThe intensity depends upon the strength of the air blast\\nthe more vigorous the expiration the greater the intensity of\\nthe sound. The expired air is, therefore, the power which pro-\\nduces the sound, and is absolutely necessary to the production\\nof voice sounds of any kind.\\nUpon the perfection and capacity of the breathing apparatus", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0416.jp2"}, "415": {"fulltext": "GEXERAL DISEASES. 895\\ndepend the strength and duration of the voice both in speaking\\nand singing. Xo matter how complete the construction of the\\nlarynx, if there be deficient lung capacity the voice will lack\\nthe very essential features of force and duration. It will also\\nlack volume, and it is from this want that so much trouble is\\nfrequently produced in the throat by singing or outdoor speak-\\ning, for the person tries, by contracting the muscles of the throat\\nand narrowing the tube through which the sound waves pass,\\nto make up by intensity what is lacking in volume. Long or\\noft-repeated sentences of this kind result in congestion of the\\npharynx, an enlargement of the secreting follicles and a perma-\\nnently altered voice.\\nWe have spoken of lung capacity, but there is another ele-\\nment which must be considered, and that is the correct method\\nof breathing. Proper breathing is that by which the whole\\nlung expands at each inspiration. Any mode of dress which\\nprevents the expansion of the lower parts of the lungs, or any\\nhabit which restricts the movements of respiration to the upper\\nparts of the chest, is injurious to the proper development of the\\nvoice, and to such dress and habits are due much of the throat\\ntrouble which afflicts singers and speakers. In this type of\\nbreathing the abdominal wall is drawn in while the chest is\\nexpanded. The proper method of breathing is neither abdominal\\nnor costal alone, but a combination of the two. At the same\\ntime that the ribs of the chest are pushed outward and upward,\\nthe diaphragm is pushed downward and the abdominal wall\\nbecomes more prominent, so that the whole of the chest cavity\\nis increased in size, allowing the greatest freedom for the expan-\\nsion of the lungs.\\nTHE CONTROL OF THE BREATH IN SINGING AND PUBLIC\\nSPEAKING.\\nWith ample lung capacity and a correct method of breath-\\ning, there is still another consideration to be taken into account.\\nIt is necessary, the chest having been filled with air, to be able\\nto perfectly control its escape so that the various degrees of\\ntone power, from the softest possible sound to the most glorious\\noutburst, may be furnished. The escape of air must be con-\\ntrolled in such a manner that there shall be perfect freedom of the\\nmuscles about the throat. A great many control the expulsion", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0417.jp2"}, "416": {"fulltext": "396 GENERAL DISEASES.\\nof air by contraction of the muscles of the larynx, but it is evi-\\ndent that this prevents a free action of the vocal cords, and,\\nin the effort to sing, or in public speaking, results in considerable\\nstrain and often in injury to these delicate organs.\\nIn ordinary breathing the expiration of air is a passive move-\\nment, but in singing, when the lungs are filled with air, it is\\nnecessary to be able to govern its expiration by the muscles\\nof the chest and diaphragm so that the air is retained or expelled\\nat will. This is not a difficult thing to learn, as will be found\\nby a little practice. A voice which is throaty or tremulous can\\nusually be corrected by applying the principles suggested. As\\na preliminary to the study of vocal music, every student should\\nbe required to take a course in chest development and breathing\\nexercises.\\nDISEASES OF THE LARYNX.\\nDiseases of the larynx are dangerous to life because the\\nnarrow space between the vocal cords, through which air is\\nadmitted to the trachea, and through the treachea and the bron-\\nchial tubes to the lungs, may become very much narrowed or\\nentirely closed as a result of such diseases, and because the\\nepiglottis, which is frequently involved in an acute inflammation,\\nmay become so swollen as to entirely cover the opening and\\nprevent the entrance of air. They are frequently very serious,\\nalso, because of the permanent alterations which they may pro-\\nduce in the voice. For these reasons, although there are many\\ndiseases of the larynx, for all but the simpler ones a physician\\nor specialist should be consulted as early as possible.\\nIn many cases of irritable pharyngitis, where there is much\\ncough, the larynx may become sore and inflamed from constant\\ncoughing. It usually passes off on removal of the cause. A\\nsimple laryngitis is usually a result of a cold. Many people on\\ntaking cold feel the first effect in a soreness of the larynx, with\\nhoarseness and cough. The trouble may remain in the larynx,\\nbut usually it progresses into the trachea, and sometimes into\\nthe bronchial tubes, before relief is obtained. The ordinary treat-\\nment for a cold, as already outlined herein, is the proper plan to\\npursue, with the addition of steam inhalation. A paper cone\\nplaced over a cup of steaming hot water, into which a little\\ncamphor or oil of pine has been dissolved, makes a very con-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0418.jp2"}, "417": {"fulltext": "GEXERAL DISEASES. 897\\nvenient inhaler for this purpose, the apex of the cone being\\ntaken in the mouth. While inhaling the steam the breathing\\nshould be natural or but slightly increased in depth. The inhala-\\ntion may be repeated every hour or two and affords much com-\\nfort as well as hastens the cure. A spray of peppermint and oil\\nmay be thrown downward in the throat during inspiration, or\\nwith an ordinary atomizer the larynx may be thoroughly medi-\\ncated by closing the lips over the tube and breathing deeply\\nwhile the spray is made.\\nCounter-irritants applied to the outside of the neck may\\nprove of much service at the beginning of the attack. [Mustard\\nplasters, or an application of kerosene, will answer the purpose.\\nIt is not desirable to keep the neck bundled in flannel cloths, as\\nis often the custom. The bowels should be kept freely open,\\nand if there is much cough it should be controlled with small\\ndoses of Dover s powder, or some opiate mixture, for these,\\nwhile relieving the cough, also prevent spasms of the glottis,\\nwhich are painful and occasionally threaten life.\\nA very good cough mixture for such cases is made as follows\\nParegoric two parts.\\nRum one part.\\nTreacle one part.\\nDose. A teaspoonful every three or four hours, as may be\\nindicated.\\n-V very grave complication may arise in apparently very mild\\ncases. The tissues about the larynx, especially the membranes\\ncovering the epiglottis, are liable to become infiltrated with serum,\\nand they may rapidly become so puffed that suffocation is threat-\\nened. In such cases, if medical assistance be not at hand, the\\npatient should be put into a sweat bath as quickly as possible\\nand freely given hot drinks and hot steam inhalations. If the\\ncondition is not readily relieved, it may be necessary for the\\nphysician to puncture the swollen tissue and allow the fluid to\\nescape, or if there seems great danger of immediate suffocation\\nit ma} be even necessary to open the trachea through the neck,\\nthat air may be admitted to the lungs.\\nIf an attack of laryngitis be long continued and accompa-\\nnied with much cough and hoarseness, the voice may be per-\\nmanently changed, occasionally completely lost. If the trouble", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0419.jp2"}, "418": {"fulltext": "398 GENERAL DISEASES.\\ndoes not readily yield to the simple plans of treatment, a physician\\nshould be consulted, for the condition may be due to tuberculosis,\\nor some other infection, or a tumor may be developing in the\\nlarynx. There are many chronic diseases of the larynx, and as\\ntheir proper management requires skill and experience, we can\\nonly recommend the most simple measures for the patient s\\nown administration. Consumption often begins with a tuber-\\ncular laryngitis which, with prompt and proper treatment, may\\nbe cured and the patient s life prolonged, but very early recog-\\nnition and attention are required. If there be a history of tuber-\\ncular infection, much relief will be afforded the trouble in the\\nlarynx by inhalations of pure beechwood creosote, taken by means\\nof the simple paper inhaler already described, using five or ten\\ndrops of the creosote in place of camphor or in connection with\\nit. A physician should be consulted as early as possible, how-\\never, for the progress of the disease may indicate additional\\ntreatment.\\nThe importance of giving early attention to any disease\\nof the larynx cannot be too srongly urged, on account of the\\ndelicacy of its make-up, and its relation to the most important\\nfunction of life, respiration. Because of the alteration of voice\\nin protracted cases of pharyngitis, people are often led to believe\\nthat the vocal cords are affected, but it will usually be found\\nthat there is nothing the matter with the larynx excepting a\\nslight irritation, the change in the voice and difficulty in speak-\\ning being due to the thickening of the membrane covering the\\nrear wall of the pharynx, which acts as a sounding-board for the\\nvocal organs.\\nThe involvement of the larynx in catarrhal diseases of the\\nnose and throat is usually due to irritation from mouth breathing,\\nfrom coughing, or from reflex irritation, and depends for its cure\\nupon the relief of the other troubles. Paralysis of spine part of\\nthe larynx sometimes follows diphtheria, but is generally onjy\\na temporary difficulty.\\nThe following warning, given by Pattou in his excellent work\\non Voice Production, cannot be too carefully heeded: Breath-\\ning cold air through the mouth, besides drying the mucous mem-\\nbrane of the pharynx and larynx, exposes these parts to unnat-\\nural and sudden reduction of temperature, in consequence of\\nwhich temporary hoarseness is often produced. But particularly", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0420.jp2"}, "419": {"fulltext": "GENERAL DISEASES. 399\\nwhen the vocal organs have been overexercised and overheated,\\nby singing or speaking in warm rooms or halls, should the singer\\nor speaker refrain from exposing himself, without due precau-\\ntion, to the very cold or damp outdoor air; and surely he should\\nnot breathe with open mouth unless he desires to be visited with\\nserious disorders of the respiratory organs, such as congestion\\nof the larynx or lungs.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0421.jp2"}, "420": {"fulltext": "CHAPTER VIII.\\nTHE EYE AND EAR.\\nBy J. E. Minney, A.M., M.D.\\nThe eye and ear are organs of special sensation. They do\\nnot see or hear, but impressions made upon them are conveyed\\nby nerves to the brain, which takes notice of them, and the per-\\nceptions by the brain of these impressions are called seeing and\\nhearing. These organs also give expression and beauty to the\\nface. Nothing so improves the personal appearance as pretty\\neyes and ears. There are too many diseased eyes and ears; too\\nmany, because a very large proportion of their diseases are pre-\\nventable. The way to do these organs most good is to intelli-\\ngently care for them before they become permanently disabled.\\nTHE EYE.\\nMore is now required of the eye than at any other time in\\nthe world s history, and as success or failure is largely dependent\\nupon good sight and hearing during the preparation for the\\nlife-work, and as the disorders grow more serious, often becom-\\ning incurable with the lapse of years, early childhood is the proper\\ntime to carefully search for their weaknesses and defects. In\\nmost cases they may be remedied or permanently cured.\\nChildren do not often try to deceive. When, to see pictures,\\nprint or other small objects, they hold them very near the eyes,\\nthe eyes are at fault. When a child complains that he cannot\\nsee figures or writing on the blackboard at school, as the other\\nchildren can, his eyes should be examined by a competent ocu-\\nlist, not by a man who has spectacles to sell and examines all\\neyes free, for a matter of so much importance should be intrusted\\nonly to the most thoroughly competent, whose disinterested\\nadvice can be relied upon and will therefore be worth many times\\nthe small sum it will cost. If glasses will correct the trouble\\nhe will order them; if the defect be something else, he will point\\nit out and apply the proper remedy, unless it be beyond the\\nreach of remedies, in which case both parent and child, by know-\\n400", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0422.jp2"}, "421": {"fulltext": "GENERAL DISEASES. 401\\ning the truth in the beginning can plan the work for life accord-\\ningly and avoid disappointments and heart burnings in later\\nyears.\\nTwitching Eyelids. An examination should also be made if\\nthere be twitching: of the evelids, or if the eves become red and\\nwater}-, especially if the trouble be made worse by school work,\\nreading or sewing, or if much use of the eyes brings on headache.\\nThis headache is more likely to be a browache there may, how-\\never, be pain in the temples and back of the head or in the neck.\\nIn some persons an unpleasant blurring of lines occurs in looking\\nover striped or checkered goods. At other times there are burning\\nsensations, often deep-seated, in the eyes, and the eyeballs feel\\nsore when pressed. In such cases advice should be sought.\\nBright flashes of light appearing when the eyes are closed,\\nand increasing on lying down, are very grave symptoms, mean-\\ning functional or organic disease of the inner coat of the eye\\n(retina). Xo time should be lost before seeking advice. The\\nsensation of black floating specks in the eyes may be caused by\\na bad stomach, but it is a dangerous sign. hen the eyeball\\nis painful and feels full and hard on pressure it is a serious symp-\\ntom. The condition is called glaucoma, hard eveball. Treat-\\nment should be sought immediately.\\nLumps formed in the eyelids are enlarged glands (chalazii).\\nAlthough not generally painful they should be removed. They\\nare caused by eye strain and disease of the lids. Small boils\\nupon the eyelids are called sties (hordeolii) and are painful and\\nred. Owing to the loose structure of the eyelids they sometimes\\ncause the whole lid to swell and look puffy. They should be\\nopened the same as boils on any other part of the body. Some-\\ntimes they can be driven away by applying hot water to the eye-\\nlids. The water should first be boiled for fifteen minutes, then,\\nas hot as can be borne, be applied for ten or fifteen minutes from\\nthe nozzle of a fountain syringe, or from cloths wrung from the\\nwater every half minute. To secure complete asepsis (freedom\\nfrom all germs) it is necessary to also boil the syringe, cloths\\nor any other utensils used in connection with the eyes. When\\nthe eyes have thus been bathed they should be let alone until\\ntime for the next douching, unless dry and painful, in which\\ncase anoint them with a little vaseline.\\nConjunctivitis. When the eyes are red and the lids stick\\n26", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0423.jp2"}, "422": {"fulltext": "402 GENERAL DISEASES.\\ntogether in the morning, the disorder is called conjunctivitis,\\nmeaning an inflammation of the inside lining of the eyelids.\\nIt is caused by dust, smoke, particularly tobacco smoke, exposure\\nto cold or heat, bright light, bad ventilation, etc. It is common\\nin such occupations as milling, scissor grinding and threshing,\\nand is frequently caused by partaking too freely of bottled\\ngoods. Certain diseases, as measles and scarlet fever, also\\ncause conjunctivitis. When this inflammation lasts several weeks\\nit becomes chronic and sometimes gives rise to a condi-\\ntion known as granulation of the eyelids. The inner lining\\nof the eyelids, called the conjunctiva, when everted (turned out)\\nlooks rough, an appearance caused by minute, raised, red, warty\\npoints.\\nSometimes the conjunctiva presents a frog spawn appearance.\\nGranulation in any form is hard to cure. Its natural tendency\\nis to get worse, and many cases of blindness have resulted from\\ngranulated eyelids. The treatment should begin early and be\\nfollowed persistently until a cure is effected.\\nWhen the lashes turn in against the eyeball and scratch the\\ndelicate skin they cause sores and sometimes blindness. An\\noperation is required which will cause the lashes to turn outward.\\nPulling them out is a temporary expedient and must be done\\nfor immediate relief, but as the disorder grows worse all the\\ntime, an operation is the treatment demanded.\\nUlcers. Little white specks upon the cornea (crown), com-\\nmonly called the colored part of the eye, are dangerous. They\\nare little ulcers, or blisters that will break and result in ulcers.\\nUlcers are eating sores. They may either come upon or spread\\nover the sight of the eye, and, if deep, leave scars when they\\nheal. When over the sight of the eye, a white scar causes more\\nor less blindness hence wounds and ulcers of the eyeballs are\\nalways dangerous.\\nContagion. It is prudent to consider every eye affection\\ncontagious, but especially so when the eyelids stick together, or\\nthe lashes are matted together, or there is a mattery secretion\\nfrom the eyes. Granulated lids are highly contagious. As a\\nmeasure of safety any person having a sore eye should have a\\nwash basin and towel for his own exclusive use, and if the eyes\\nbe mattery should sleep alone.\\nA Pterygium (wing) is a growth upon the outside of the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0424.jp2"}, "423": {"fulltext": "GEXERAL DISEASES. 403\\neyeball, extending from the inner corner of the eye, and its\\npoint sometimes reaches over the colored part and covers the\\nsight of the eye. It is of a red or whitish color and is more\\nor less fan-shaped, with the handle of the fan pointing toward\\nthe colored part of the eye. It is not a cataract, though often\\nso called. Its treatment consists of its removal, which can safely\\nbe done.\\nA Cataract is an opacity (whiteness) of the crystalline lens,\\nand as the lens is situated within the eye directly behind the\\npupil, it gives the naturally black spot in the middle of the\\neye a gray or white appearance. Removal is the only treatment.\\nThis can be safely done only by a skillful physician, and it must\\nbe ripe before removal. This condition has arrived when the\\npatient is barely able to count his fingers when held two feet\\nor less from his eyes. The operation consists of the removal\\nof the natural lens and the substitution of a glass lens, after the\\neye has healed, the latter being worn over the eye in spectacle\\nform.\\nHOW TO FIND THE CAUSE OF AN EYE TROUBLE.\\nIn searching for the cause of an eye trouble the following\\npoints should be noted:\\ni. The length of time the eyes have worked. They should\\nbe rested at least every hour.\\n2. The character of the work, whether fine or coarse, clearly\\nor dimly outlined. The finer the work or the poorer the print\\nthe longer the eyes should rest, and the shorter should be the\\nintervals between the rests.\\n3. The distance of the work from the eyes. From twelve\\nto fourteen inches is the proper distance.\\n4. The character of the light. The best artificial light is\\nfurnished by the argand burner known as the student s lamp/\\n5. The relation of the light to the eyes. It should come\\nfrom the left side or above, and is best when falling over the left\\nshoulder, especially for right-handed people.\\n6. The position of the body. It is very important that the\\nupright position be maintained.\\nIf all the above conditions are found favorable, the uneasiness\\nof the eyes on doing their work is probably due to an error of\\nrefraction or accommodation, for the correction of which proper", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0425.jp2"}, "424": {"fulltext": "404 GENERAL DISEASES.\\nglasses are the remedy. Still, the trouble may be caused by\\na slight congestion of the mucous membrane of the eyes, or by\\nsome exposure, as to wind, dust or tobacco smoke.\\nIf error of refraction or accommodation be the cause, pain\\nin the eyes is likely to follow; also tenderness of the balls when\\npressed in the morning; or there may be some redness of the\\neyes, or branny scales on the margin of the lids, sometimes accom-\\npanied by a slight thickening of the lid margins. Slight shooting\\npains in the brow or temple, increasing to headache, and pain\\nin the back of the neck, often come on after a time. Nervous-\\nness and irritability of temper may also attend or follow these\\nerrors.\\nIt may be better, before having the eyes fitted with glasses,\\nespecially if the troubles mentioned have begun, to rest the\\neyes a few weeks and give them treatment. If the difficulty\\nbe acute conjunctivitis or slight granulation, drop into each\\naffected eye three or four dropperfuls (a small syringe such as\\nis used to fill a fountain pen is a dropper of saturated solution of\\nboric acid crystals at bedtime and follow with a little vaseline\\nor, if the acid solution be harsh or painful, with cocainized vase-\\nline (cocaine one-half grain, vaseline one ounce).\\nThe hot water treatment recommended for sties is also\\nexcellent for conjunctivitis when there are free secretions. For\\nthe congested stage, with dry, hot, shiny mucous membranes, ice\\ncompresses are probably better.\\nWhen there are branlike scales on the margins of the lids\\nand roots of the eyelashes, and crusts form and the lashes fall\\nout, either nitrate of silver or the yellow oxide of mercury\\nis needed to make a quick cure. The nitrate of silver is used\\nas a solution, from five to twenty grains of it to an ounce of dis-\\ntilled water. The mercury is used as an ointment, one grain of it\\nto one dram of vaseline. Before using either the scales and\\ncrusts must be completely removed by soaking and washing\\nwith warm alkaline water, then gently scraping them away, after\\nwhich dry the parts and apply the remedy. In using the oint-\\nment rub it in thoroughly and wipe off the excess. The treat-\\nment should be made every day or every second day, according\\nto the tolerance of the parts, and, preferably, in the evening,\\nfor appearance sake and as little exposure as possible to outdoor\\nair. From six to twelve treatments usually cure the case. If", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0426.jp2"}, "425": {"fulltext": "GENERAL DISEASES. 405\\na strong solution be used, great care must be taken not to get\\nthe silver into the eyes.\\nEpiphora, lachrymation, tearing or watering of the eyes,\\nof which people frequently complain, is clue to some irritation\\nor overstimulation of the lachrymal glands. The tears run over\\nthe eyelids onto the cheek, sometimes scalding the skin and\\ndestroying the epithelium. The eyes have a red appearance and\\noften the edges of the lids are swollen. The mucous membrane\\nof the eye usually furnishes sufficient moisture, and the lachrymal\\ngland is called upon only when an excess of fluid is required, as\\nwhen dirt gets into the eye, or the conjunctiva becomes dry and\\nrough, or the terminal nerve filaments of the conjunctiva, iris,\\nretina or ciliary body become irritated. The irritation may be\\ncaused by eyestrain, by a foreign substance, either solid, fluid\\nor gaseous, by disease, or, in old persons, by relaxation of the\\neyelids, permitting the puncta to be everted. The puncta are\\nthe openings on the eyelids situated on their inner margin\\nnear the angles of the eyes and hugging the eyeballs. They\\nreceive the excess of fluid and convey it through tubes called\\ncanaliculi to the nasal ducts which open into the nose.\\nThe tears overflow the lids when there is an excess of them,\\nor when the lids are everted, for then the fluid cannot get into\\nthe openings to be conveyed away. An examination should\\nbe made to determine whether the parts are in position, as well\\nas to look for foreign substances and diseased conditions. If\\nnothing wrong has been found the eyes should next be tested\\nfor distance and reading.\\nIf the trouble be due to eyestrain the proper glasses will\\ncorrect it; if to a foreign body, its removal will effect a cure;\\nif to tobacco smoke, bad ventilation, physical weakness or over-\\nworking of the eye, the remedy is the removal of the cause.\\nIf the vision is perfect and the examination has revealed no cause,\\neyestrain or a closing of the puncta or canaliculi with a gelatin-\\nous mass may be suspected and these ducts probed. As only\\nan experienced oculist should undertake this, the details need\\nnot be given here. Closure of the nasal duct is one of the\\nserious affections of the eye.\\nPhotophobia or intolerance of light is mainly due to the\\nsame causes as lachrymation and is cured by the same treatment.\\nCrabs. Occasionally pediculi pubes or crab lice are found", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0427.jp2"}, "426": {"fulltext": "406 GENERAL DISEASES.\\nat the roots of the lashes, causing irritation and itching. In\\nsuch cases a glass will reveal their presence and mercurial oint-\\nment will destroy them.\\nUlcers. For severe ulceration of the cornea separate the\\nlids and drop into the eye two or three dropperfuls of warm water\\ncontaining all the boric acid crystals it will dissolve, then\\ndry the eye of all water and secretions and drop into it two or\\nthree drops of a solution composed of two grains of sulphate\\nof atropia to one ounce of distilled water. Repeat the treat-\\nment every four to six hours when awake, according to pain.\\nThe acid solution should be used warm, made so by keeping\\nthe bottle in a basin of clean hot water fifteen or twenty minutes.\\nThe dropper should be cleaned by being scalded inside and out\\neach time before using it.\\nInfantile Sore Eyes. This affection attacks infants from\\nthe first to the tenth day after birth. The edges of the eyelids\\nlook a little red and swollen and may stick together, and the\\nwhite of the eye appears somewhat red. A pearly tear may be\\nin the eye although the child has not beeen crying, and there\\nmay be an itching sensation causing the little one to rub its\\nfists in the eyes. Should the lids stick together tightly and\\nsome pus appear, in addition to some or all of the above symp-\\ntoms, there is great danger of an attack that may terminate\\nmost seriously, for cases of this kind, if let alone or improperly\\n.treated, generally result in partial or total blindness of one or\\nboth eyes.\\nGreat care should be taken to clean the eyes and get out all\\nthe maternal secretions as soon as the child is born. If a\\npregnant woman has leucorrhea, commonly called whites, es-\\npecially if the secretion makes her sore, scalds the parts, all\\npossible care must be taken to keep the genitals clean. They\\nshould be syringed daily with at least two to four quarts of\\nwater with enough common baking soda, not baking powder,\\nadded to make the water taste of it distinctly. A tablespoonful\\nof carbolic acid to a half gallon of water will do as well. If the\\nscalding maternal secretions get into the child s eyes in its passage\\nthrough the canal, unless promptly and entirely removed they\\nwill set up the most virulent inflammation known and quickly\\ndestroy the eyes. The statement often made that exposure\\nto strong light causes this trouble is not true. An infant should", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0428.jp2"}, "427": {"fulltext": "GEXERAL DISEASES. 407\\nnot be exposed to strong light too soon lest it injure the eyes,\\nbut this injury is to the sight itself; it does not produce a mat-\\ntery eye.\\nA physician should be called at once. If the disease has\\nprogressed so far that the eyelids are swollen and pus is push-\\ning out between them, it will be a very hard case to manage,\\nbut with constant attention and careful cleansing, under the direc-\\ntion of a skillful physician, the eyes may yet be saved. If but\\none eye is affected the other should be bandaged immediately,\\nand kept bandaged, to prevent the secretions from getting into\\nit and the child should be kept lying upon the same side as the\\naffected eye, or upon its back, that the secretions shall not flow\\nover the bridge of the nose and contaminate the healthy eye,\\nand, for the same reason, it should always lie upon the affected\\nside while the eye is being washed or dressed. The eyes should\\nbe cleaned often, frequently as often as every half hour, after\\nwhich a little vaseline or cold cream should be rubbed upon\\nthe edges of the lids to keep them from sticking together and\\nto soothe the inflamed surfaces. Great care should be taken\\nby the nurse to prevent the poisonous secretions from getting\\ninto her own eyes and the eyes of others in the family. The\\ncloths and cotton used must be burned, and the hands care-\\nfully washed with good soap after each treatment. If the secre-\\ntions scald the eyelids, cheeks or nose, these parts must be\\nkept anointed with vaseline, cold cream, fresh lard, or some\\nother bland salve, which must be washed off once a day with\\nwarm soft water containing a little soda.\\nSLIGHT AILMENTS OF THE EYE.\\nSlight ailments of the eye, like slight affections of other\\nparts of the body, have a tendency to recover without treatment.\\nA certain percentage, however, of all cases, from lack of vitality\\nin the organism, will not recover spontaneously, and as we do\\nnot know the end from the beginning, every affection of the eye\\nshould receive prompt attention, but it is better to let it strictly\\nalone and do nothing for it than to do anything that will injure\\nthe eye.\\nTreatment. There is no more useful agent in the treatment\\nof its diseases than hot water, plentifully used. Aside from the\\nheat, which is a quickening force to nature s lagging powers, it", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0429.jp2"}, "428": {"fulltext": "408 GENERAL DISEASES.\\ndilutes and removes the poisons and filth that cause or prolong\\nthe diseased condition. Cleanliness, protection and rest are\\nthe conditions essential to recovery. To secure cleanliness use\\nplenty of water that has been boiled and use it as hot as can\\nbe borne. To the water may be added enough salt to make\\nthe water taste of it, but much better than salt is a teaspoonful\\nof boric acid crystals added to each pint of water. Although\\nthere be no secretions in the eye, the latter wash is an excellent\\none, being a cleansing and soothing disinfectant and entirely safe.\\nTwo teaspoonfuls of witch hazel, or listerine, or one tea-\\nspoonful of carbolic acid, added to one pint of boiled water, also\\nmakes a good remedy; and a teaspoonful of pulverized alum to a\\npint of boiled water is useful when the eyes are itching. Cold\\napplications should be used only when the hot ones do not give\\nrelief.\\nTo bathe the eyes with hot water, first boil it ten or fifteen\\nminutes and let it cool to the temperature of endurance in the\\nvessel in which it boiled, to make sure of cleanliness or asepsis,\\nthen, keeping the vessel on the hot stove, bathe the eyelids for\\nfive minutes, using a clean cloth that has also just been boiled.\\nLet it be remembered that cleanliness is of the greatest impor-\\ntance and that thoroughly clean water can be secured only\\nby boiling it. It is better that the basin or pan used should\\nbe a new one, kept expressly for this purpose, and thoroughly\\ncleansed by frequent scaldings. The whole body should be\\nbathed once or twice a week and the rubbing and drying done\\nby the nurse or attendant.\\nDust, some kinds of gas, and smoke, especially tobacco\\nsmoke, are very injurious to a sensitive eye. Keep out of the\\nroom while it is being swept and dusted. Washing and ironing,\\nin fact all heavy work, should be abandoned for the time, as\\nwell as all eyework, such as reading and sewing, and the eye be\\ngiven perfect rest.\\nEye shades may be worn with benefit to protect from the\\ndirect rays of light. Where the trouble is due to dirt, bright\\nlight, smoke, heat, cold or wind, plain ground glasses should\\nbe worn during the exposure, but, if the light irritates, wear plain\\nground smoked glasses, shaded according to the intensity of the\\nlight and the sensibility of the eye. Goggles are not good for\\nthe eyes, as they retain the heat and moisture of the parts,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0430.jp2"}, "429": {"fulltext": "GEXERAL DISEASES. 409\\nand the ordinary glasses found in drugstores are imperfect and\\nnot lit to be worn over the eyes.\\nDIET.\\nThe diet at such times must also receive attention and\\nshould consist of bulky, easily digested, nutritious food, and\\nsuch meats as pork, veal and beef should be prohibited, particu-\\nlarly in cataract when attended with frequent urinations, and in\\nelderly people suffering from any severe injury to the eyes.\\nFruit, vegetables and cereal foods should be the principal diet,\\nbut where milk agrees it may be taken in reasonable quantity.\\nREMOVAL OF FOREIGN BODIES.\\nPieces of steel, cinders and other foreign bodies can be\\nremoved, when seen in the eye, by gently rubbing over them\\na few times a piece of clean soft silk or cotton cloth stretched\\nover the end of the finger, or a small piece of clean wood, as a\\nlead pencil. If the mote be fastened to the eye and resists\\nremoval, it is better, after several attempts, to seek the aid of a\\nphysician than to risk doing great violence to the eye, for, as\\nalready explained, wounds upon the eyeball are dangerous.\\nIn case the object cannot be seen upon the eye, the lid\\nshould be turned inside out, when the mote will usually\\nbe found to be a little black speck sticking to the mucous mem-\\nbrane (inside skin) of the eyelid and can be removed in the\\nmanner first described, or with a little skill on the part of the\\nexaminer it may be scraped off with a dull knife-blade or the\\nend of a toothpick. For a time after the removal there may\\nbe pain, as though the object were still there, because of the deli-\\ncate skin having been cut.\\nTo turn the eyelid of the left eye inside out catch the lashes\\nbetween the thumb and index finger of the left hand, pull the\\nlid down and while it is stretched place upon it above the thumb\\nand finger a knitting needle, lead pencil or some such instrument,\\nand while pushing it downward and backward with the right\\nhand pull the lid downward, outward and upAvard with the left,\\nthus exposing the inside so that the entire surface can be\\nexamined. To turn the lid of the right eye catch the lashes\\nwith the fingers of the right hand and use the needle or pencil\\nwith the left hand. The patient should look down constantly", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0431.jp2"}, "430": {"fulltext": "410 GENERAL DISEASES.\\nwhile the lid is being turned and the first examination made, but\\nmay assist a further examination by rolling the eyeball in various\\ndirections.\\nTEN DON TS.\\ni. The eyes should not be poulticed. A poultice contains\\nheat and moisture, which aid suppuration or rotting. An eye\\nas well as a boil can be rotted by a poultice. Slippery elm, scraped\\npotato, rotten apple, several folds of wet cloth, flaxseed meal,\\ncornmeal, bran, all are used as poultices, and cloths wrung from\\nout hot water and left upon the part until they become cool act\\nas poultices. Don t use them.\\n2. The eyes should not be exposed to outdoor cold for\\nhalf an hour after bathing them with hot water.\\n3. Do not look at an intensely bright light, such as the\\nsun, an electric light, calcium light, a bright lamp flame, bright\\nhre or snow under bright sunshine. Snow blindness is not\\nuncommon.\\n4. Avoid tobacco smoke. To the sensitive eye it is very\\nirritating.\\n5. Never use the eyes long at a time when recovering\\nfrom a debilitating illness.\\n6. Never read while lying down. The body should be\\nerect when you do any close eye work.\\n7. Never face a light while reading or using the eyes\\nsteadily at any close work.\\n8. Never use the eyes more than an hour at close work\\nwithout resting them. Unless they are good and strong they\\nshould be rested oftener than that. Don t fail to do it.\\n9. Don t use a public wash dish and towel. They may\\noften be convenient, but, by increasing his work, are of far\\nmore value to the oculist than to you.\\n10. Do not use home treatment for an eye unless you\\nknow that the trouble is not serious, but seek the best medical\\nadvice you can obtain.\\nTHE LIGHT OF SCHOOLROOMS.\\nIn planning schoolrooms not enough attention is given to\\nthe requirements of vision. Correct architecture favors the\\nhealth of the eye as well as that of the body. There should be\\nthe largest possible amount of light consistent with safety of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0432.jp2"}, "431": {"fulltext": "GENERAL DISEASES. 411\\nconstruction, and it should all be admitted from one side of\\nthe room. The common method of placing windows in opposite\\nsides of the room is very bad, since by causing cross lights\\nand perverse shadows it greatly and needlessly increases the\\nstrain upon the eyes of the pupils. The arrangement of every\\nroom should be such as to admit the light from the left side\\nand rear.\\nAs the position of the body in school work is an important\\nfactor of health and perfect sight, not only during childhood but\\nthroughout the pupil s life, the seat and desk should be so adapted\\nto his form as to make the erect position the easiest and most\\nnatural and to favor the eyes the blackboards should be on\\nthe right and front sides of the room and be covered with wall\\nmaps or light colored curtains when not in use. The walls\\nshould never be of dazzling white, but of some neutral tint of\\nblue, yellow, gray or green, and the hangings, decorations and\\nfurniture should be of some light color. Of course, shades will\\nbe used to prevent direct rays of the sun from falling upon the\\npupils. All exposures should be to the east, south and west\\nand the city school should be at a distance from surrounding\\nbuildings of at least twice their height.\\nWere these suggestions observed in the construction of all\\nschool buildings the startling percentages of eye failure and dis-\\nease contracted during school life would cease to be a disgrace\\nto our educational system.\\nTESTING THE EYES FOR GLASSES.\\nThe correction of defective eyesight by means of glasses\\ndepends upon the principles of refraction of light by means of\\nlenses. When one engaged in reading, sewing or other close\\nuse of the eyes prefers to hold the work more than from twelve\\nto fourteen inches from the eyes he is affected with far sight\\n(hypermetropia), or old sight (presbyopia), and should wear con-\\nvex glasses to correct it. When he holds his work nearer than\\nfrom ten to eight inches he has near sight (myopia), and should\\nwear concave glasses.\\nTO TEST FOR OLD SIGHT.\\nThe figures above the smallest type on the next page that\\ncan be read distinctly and easily in a good light at a distance of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0433.jp2"}, "432": {"fulltext": "412\\nGENERAL DISEASES.\\nfourteen inches indicate the focus and size of the convex glasses\\nneeded. If you can easily read the smallest type here given your\\neyes do not need glasses.\\nTYPE FOR TESTING THE SIGHT.\\n0.50=80\\nDefects of eyesight requiring correction by the use of spec-\\ntacles are purely mechanical, and can be so corrected bv thi\\nproper adjustment of perfectly made lenses that their effects\\nwill be entirely obviated.\\n0.63=60\\nThe smallest size letters on this card should be\\nread easily at tifteen inches from the eye. If you\\ncannot do so you should wear spectacles. It does\\nnot pay to buy cheap spectacles.\\n0.75=52\\nThey distort the rays of light, disturb the\\nangles of vision, cause paiD and discomfort and\\ninjure the eyesight. When it is necessary to hold\\nwork or reading matter farther than fifteen\\ninches from the eyes in order to see distinctly,\\n0.88=44\\nit is a sure sign of failing vision, and much\\nannoyance, discomfort and pain will be pre-\\nvented by having a pair of glasses fitted. Pain\\n1.00=40\\nin the eyes when wearing spectacles is\\nusually caused either by improperly\\n1.12=36\\nfitted lenses, or from the centers of\\nthe lenses not corresponding with the\\n1.25=32\\ncenters of the eyes. To be per-\\nfect, a lens must be made with\\n1.50=26\\nhighly polished surfaces of accu-\\nrate curvatures. Only perfect\\nlenses should ever be used. They\\n1.75=22\\nare made from the clearest\\nand finestmaterial obtainable\\n2.00=20\\nAND SHOULD BE WARRANTED\\nTO BE OF ABSOLUTELY\\n2.25=18\\nPERFECT CONSTRUCTION\\n2.50=16\\nBUY NO OTHER KIND.\\n3.00=13\\nTHE VERY BEST\\n3.50=11\\nLENSES\\n4.00=10\\nARE THE\\n5.00=8\\nCHEAPEST\\nTO TEST FOR NEAR SIGHT.\\nFind the farthest distance from the eyes at which para-\\ngraph No. 26 can be plainly seen. The number of inches between\\nthe page and the eyes will be about the same as the number\\ndesignating the concave lenses required.\\nTO TEST FOR ASTIGMATISM.\\nAstigmatism is an eye defect whereby the rays of light de-\\nrived from one point are not brought to a single focal point,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0434.jp2"}, "433": {"fulltext": "GENERAL DISEASES. 413\\nthus causing imperfect images or indistinctness of vision. If\\nsome of the arms in the accompanying figure appear more dis-\\ntinct than the others, the presence of astigmatism is indicated.\\nThis defect can be corrected only by the use of cylindrical lenses\\ncarefully ground to the oculist s order.\\nTHE EAR.\\nThe ear is the organ of hearing and in man is composed of\\nthree portions The external, the middle and the internal ear.\\nThe external ear consists of the pinna, or exposed part,\\nand the auditory canal leading to the drumhead, the two forming\\na funnel that collects the sound vibrations, determines their\\ndirection and conducts them to the middle ear, or drum, which\\nis a bony cavity, lined by mucous membrane, separated from\\nthe external ear by a delicate membrane called the membrana\\ntympani, or drumhead, and containing the chain of small bones\\ncomposed of the malleus, incus and stapes (hammer, anvil and\\nstirrup), which transmit the vibrations of the drumhead to the\\ninner ear. This cavity also receives the Eustachian tube in front\\nconnecting with the throat, and has an opening behind that com-\\nmunicates with the mastoid process the bone that can be felt\\nby pressing upward just behind the lobe of the external ear.\\nThe inner ear or labyrinth consists of a bony cavity called the\\nvestibule, the three semicircular canals that connect with it, and\\na bony structure in the form of a small shell called the cochlea,\\nall occupied by the auditory nerve.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0435.jp2"}, "434": {"fulltext": "414 GENERAL DISEASES.\\nThe hearing may be impaired by a. plug of wax, or by a bean,\\ncherrystone or other foreign body in the external ear or by a\\nthickening of the drumhead by catarrh of the middle ear; or\\nfrom a stiffening of the joints between the ear bones, the same\\nas a knee or elbow joint may become stiff.\\nCAN DEAFNESS BE CURED?\\nThe question is often asked, Can deafness be cured? When\\nof long standing it is generally incurable, but in a large number\\nof cases deafness can be prevented, and the time to prevent it is\\nwhen the ear first becomes affected. Neglect to treat the ear\\nearly is the principal cause of most deafness. The old idea, Let\\na running ear alone, will, when put in practice, not only make\\ndeafness sure, but may cause death, for if the discharge is allowed\\nto continue, not only the soft parts but finally the bones of the\\near become involved. In some of the diseases of childhood, es-\\npecially measles and scarlet fever, ear trouble is common, and\\nmany persons can date the beginning of their deafness from\\nattacks by these maladies. Catarrh of the middle ear results\\nfrom cold, and though not as common as that of the nose, is of\\nfrequent occurrence.\\nEARACHE.\\nEarache, or pain in the ear, is a common affection, so com-\\nmon that proper attention is not given it, and impaired hearing\\nor deafness is often the result. It may be caused by exposing\\nthe ear to a cold wind, especially while sitting or riding, or by\\nbad teeth. Such affections are classed as neuralgias. Boils in\\nthe ear canal are frequent causes, but the most common cause of\\nall is an ear abscess called suppurative otitis media. With this\\nabscess the pain is deep-seated, the hearing is dull, the ear feels\\nfull and hot, chilly sensations are often felt, the temperature\\nranges from 99 to 104 degrees, there is headache, and pressure\\ndirected inward upon the front part of the ear, or pulling the\\near increases the pain, often causing the patient tp cry out in\\nagony, and the drumhead, if it can be seen, looks red and\\nbulged out.\\nA child thus afflicted, by throwing its head from side to\\nside and scratching the affected ear, often causes his parents to\\nthink he has brain fever, and there is danger of brain trouble in\\ndiseases of the middle ear.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0436.jp2"}, "435": {"fulltext": "GENERAL DISEASES. 415\\nTreatment. The correct treatment for abscess consists of\\ncutting a small slit through the drumhead, thus allowing the\\npus to escape. The wound made by the knife soon heals, leaving\\nthe membrane as good as ever, but when an abscess is permitted\\nto break or rot its way through it is likely to destroy the mem-\\nbrane, and perhaps one or more of the bones, which in either\\ncase means permanent loss of the ear. As the entire malleus\\nis scarcely a third of an inch in length, and its handle, lying\\nagainst the drumhead to receive the vibrations, is only about\\nthe size of a pin, the destruction of which means instant and\\nincurable deafness, it can be understood that lancing an abscess\\nis a very delicate operation and should be attempted only by\\none who is skillful. An artificial drumhead may be useful- where\\nthere is a large opening, or entire absence of the natural drum-\\nhead, but, as a rule, when the natural drumhead is present an\\nartificial one is of no benefit and may be injurious.\\nBOILS IN THE EAR.\\nPain, swelling, redness and tenderness on pressure are also\\npresent when there are boils (furuncles) in the ear, and some-\\ntimes there are chilly sensations, but the pain is not as deep-\\nseated and the constitutional disturbances (fever and rapid pulse)\\nare not as great as when there is an abscess in the middle ear.\\nThese boils are generall) r brought on by picking or scratching\\nthe canal of the ear, as with a pin, match, toothpick or fingernail.\\nWhen the discharge from the ear becomes offensive and con-\\ntinues for several months it is likely that the bones of the ear are\\ndiseased. The penetrating, offensive odor is from dead bone and\\nindicates a condition dangerous to life.\\nTreatment. Neuralgia (nerve pain) of the ear is relieved\\nby steaming. Make a large cone from a newspaper; place its\\nlarge end over a pot or teakettle of boiling water, and, holding\\nthe ear over its small end and as near as the heat will permit,\\nsteam the canal and drumhead of the ear until the pain is relieved.\\nThis usually requires from three to ten minutes. Repeat sev-\\neral times in as many hours if the pain returns. Dry the ear\\neach time and put a little cotton in it to keep out the cold air.\\nIf the neuralgia is probably caused by bad teeth, have an exam-\\nination made by a competent dentist, who, if he finds it, will\\nremove the cause.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0437.jp2"}, "436": {"fulltext": "416 GENERAL DISEASES.\\nIf the earache comes every other day it is of malarial origin\\nand quinine will cure it. From fifteen to twenty grains of it should\\nbe taken in five-grain doses in one day, preferably the day of\\nleast pain.\\nIf the earache be due to a severe cold; the cold must be\\ntreated. A hot footbath lasting ten minutes, and, where the\\nhead or nose is stopped up and the secretions are free, ten drops\\nof the fluid extract of belladonna in twenty teaspoonfuls of water,\\none teaspoonful taken every half hour until the discharge is\\nchecked, will generally give relief. If the nose and head are\\nstopped up and are hot, dry and feverish, aconite, in the same\\nproportions and size of dose, should be used. The bowels should\\nact freely. A heaping tablespoonful of the sulphate of magnesia\\n(salts) should be taken every two hours until there is free action\\nof the bowels.\\nHeat applied to the ear, as a bag of hot water, sand or salt,\\nor hot flannels, will usually give relief. It will shorten our story\\nand give the suffering needed information to say that in acute,\\npainful affections of the ear steam or heat may be used in any form.\\nDouching or syringing the ear with hot. water is good treat-\\nment. If a fountain syringe is used, hang it but one or two\\nfeet above the patient s head, that the force of the stream against\\nthe drumhead shall not cause pain, and use from a pint to a\\nhalf gallon of water as hot as can be borne. This may safely\\nbe repeated every hour until permanent relief is given. After\\nthe douching or gentle syringing, the canal should be dried\\ncarefully, using no violence,, and something warm and dry put\\nover the ear until the pain returns, when the douching should\\nbe repeated.\\nWhen there is much pain and heat or fever, free the bowels\\nwith salts, as before directed, and use the hot footbath, and if\\nno relief is obtained it will be best to consult a physician. The\\nchances are that there is pus (matter) in the middle ear cavity\\nand that the drumhead will have to be opened to let it out. We\\nrepeat that the time to treat the ear and to prevent deafness\\nis early in the disease. In childhood a great deal can be done\\nand a very large majority of the cases can be cured. The doctor\\nwho advises letting the ear alone to get well itself does not\\nunderstand ear diseases. Experience has proved that letting\\nthem alone is disastrous and that intelligent treatment and care", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0438.jp2"}, "437": {"fulltext": "GENERAL DISEASES. 417\\nat the proper time very often prevent deafness and save many\\nlives.\\nForeign Bodies. If an insect, bean, grain of corn, or other\\nforeign body, gets into the ear, do not push it in further, but go\\nimmediately to a competent physician. Do not try to get it out\\nwith a hairpin, knitting-needle, toothpick or similar instrument.\\nAt most only syringe with warm water, a device that is likely\\nto prove effective if the nozzle is very small and the foreign\\nbody is so located as to permit getting behind it. An insect in\\nthe ear can usually be made to crawl out by filling the ear with\\nwarm water, the patient lying with his other ear to the pillow.\\nTHINGS NOT TO BE DONE.\\nDo not pick the ear unless you want to make it sore. It\\nshould be scratched only with the elbow. If it itches intoler-\\nably an examination should be made by a competent physician.\\nThere is something wrong that can be righted by proper treat-\\nment.\\nDo not slap a person severely upon the ear with anything\\nunless you want to rupture the drumhead by a sudden com-\\npression of the air in the auditory canal.\\nDo not pour oil or other substances into the ear without\\ncleansing soon afterward unless you want to make a nest for\\ngerms and set up inflammation.\\nDo not permit a child to breathe through its mouth unless\\nyou want it to get deaf. Mouth-breathing is a habit caused\\nby some obstruction of the nose or throat, and is a fruitful cause\\nof deafness by creating disorders that are conveyed by the\\nEustachian tubes to the middle ear. If necessary, to break the\\nhabit of mouth-breathing, bind a cloth over the mouth and thus\\nforce the patient to breathe through his nose.\\nDo not let a discharge from the ear continue weeks or\\nmonths, thus becoming chronic.\\nDo not try everything for a sore ear or eye that everybody\\ntells you. Anyone can tell you to do something, and the less\\nhe knows the more he can tell. It requires knowledge to sim-\\nplify. But little of the right thing is needed. A little of the\\nwrong thing may do great mischief.\\n27", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0439.jp2"}, "438": {"fulltext": "CHAPTER IX.\\nINTESTINAL PARASITES.\\nWORMS.\\nA great many parasites have been, found in the intestines of\\nman, but so many of them occur so rarely that it is necessary\\nhere to consider only four classes The Tape Worm, Round\\nWorm, Thread Worm, and Trichina.\\nTHE TAPE WORM.\\nThe tape worms or cestoids belong to the genus taenia and\\nconstitute a numerous family. Two hundred species have been\\ndescribed, ranging from a tiny form scarcely visible, to a creature\\nan inch in breadth and a hundred feet in length. They all\\nlive in the intestines of vertebrates, but only a few varieties have\\never been found in man. They have been known from very ancient\\ntimes, yet only recently has their mode of reproduction come to\\nbe understood.\\nAn egg of a tape worm never hatches in the intestine in\\nwhich that worm lives, but must first be taken into the stomach\\nof some suitable animal, where, with the aid of the gastric juices,\\nit is changed into an embryo infinitesimally small, which bores\\nits way into neighboring tissues, or into a blood vessel, whence it\\nmay be carried by the circulation to any part of the body. Hav-\\ning finally lodged, it develops into a larva, becomes encysted in the\\ntissues and, unless suppuration results, may remain dormant there\\nfor years, with little or no inconvenience to its host, provided that\\nas the cyst increases in size it does not press upon any very sensi-\\ntive or vital part, and does not become very large. A cyst thus\\nresulting from the development of the embryo of a tape worm\\nis called a hydatid. It sometimes contains more than one embryo,\\nand ranges in size from the bulk of a small pea to that of a child s\\nhead, but the embryo itself remains exceedingly minute.\\nMeasly pork is pork containing these hydatids. Heat de-\\nstroys them, but the man or other animal that eats raw or only\\npartially cooked meat containing hydatids becomes infested with\\n418", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0440.jp2"}, "439": {"fulltext": "GENERAL DISEASES.\\n419\\ntape worms. The hydatids are frequently found in cattle, hogs,\\nsheep, dogs and other animals, and not very rarely in man. There\\nare recorded about a hundred cases of death from the invasion of\\nthe human brain by echinococcus, a variety of hydatid, and for\\nwhich, when located in a vital part, especially the brain, no cure is\\nknown. Safely encysted in the muscular tissues of a healthy host,\\na larva may live from three to six years, then die and be absorbed or\\nundergo calcareous degeneration, but if at any previous time its\\nhost be eaten by another animal, this embryo will become active\\nand, passing through the stomach, will attach itself to the mucous\\nlining of the small intestine and grow so rapidly as to become\\na full sized tape worm in from three to eight months.\\nC\\nTape Worm.\\nA. Head and neck, natural size. B. Head greatly enlarged.\\nC. Segments from the neck and middle of the body.\\nThe head of a large worm is often only about as large as a\\npin head, is round, and furnished with two, four, or more suckers,\\nor hooks by which it clings, but has no mouth, the animal de-\\nriving its nourishment by absorption, or, more exactly, by ex-\\nmosis, from the intestinal juices in which it lies. It is never found\\nattached except in the small intestine; the contents of the larger\\nbowel will not sustain it. The very small and slender neck\\ngradually broadens to the segmented body, which usually reaches", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0441.jp2"}, "440": {"fulltext": "420 GENERAL DISEASES.\\na width of one-third of an inch, or even more, and a length of\\ntwelve to thirty feet, and consists of from 400 to 1,200 segments or\\njoints of various proportions, but generally longer than they are\\nbroad, though in a variety derived chiefly from fish they are\\nshorter than their width, except those near the neck. Each\\njoint fits into the one next behind it and each is attached to the\\nnext more feebly as distance from the head increases, until at the\\nrear end they separate very easily and are then voided with the\\nfeces. Each of the oldest of these segments, up to about the four\\nhundred and fiftieth from the head, is sexually mature and con-\\ntains, besides both the male and female organs of generation,\\nmembranous sacs packed with eggs, a single segment often con-\\ntaining as many as 30,000 of these exceedingly minute, but per-\\nfectly developed ova. It has been estimated that a single worm\\nproduces over 50,000,000 of them per year, also that the chances\\nof development, i. e., of an egg reaching a suitable stomach in\\nwhich to hatch, of the larva gaining a lodgment in suitable tissues,\\nand later through another stomach of reaching an intestine in\\nwhich to fully mature, are only one in many millions. With in-\\ntelligent care this possibility can be reduced much more, for as heat\\ndestroys the larva, he that eats no raw meat is not likely to ever\\nbe troubled with a tape worm. As much, however, cannot be said\\nof the danger from the formation of hydatids. Beyond cleanli-\\nness and care to partake only of clean food and pure water, there is\\nno way to guard against taking these minute eggs into the\\nstomach that begins to be as effective as the prevention of their for-\\nmation by protecting all domestic animals as far as possible from\\nbecoming infected. (See Precautions.\\nThe head is all of the worm that is essential to its life. As\\nthe body grows one segment after another is formed at the base\\nof the neck, the oldest joint always being the furthest from the\\nhead, and as any number of them may be broken off without in the\\nleast impairing the formation of new joints, the only way to get rid\\nof the worm is to get rid of its head. If let alone it may live\\nfor ten years, or even longer.\\nSymptoms. As sections of the worm become separated from\\nthe rest of the body they are voided with the feces, or passed un-\\nconsciously to the patient, and the first intimation that he has that\\nhe is carrying a tape worm may be his seeing these sections in\\nhis feces, or finding them in his clothing. On the other hand,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0442.jp2"}, "441": {"fulltext": "GEXERAL DISEASES. 421\\na mature tape worm in the intestinal canal may give rise to such\\ndisturbances as vertigo, noises in the head, impaired sight and\\nhearing, itching of the nose and anus, salivation, loss of appetite,\\nalternate constipation and diarrhea, colic, sensation of weight in\\nthe abdomen or of something moving in the bowels, pains and\\nlassitude in the limbs, headache, night sweats, palpitation, cramps,\\nand sometimes even hysterical fits, chorea, convulsions and mania.\\nThe worm produces no poisonous secretions or excretions, and\\nit is probable that nearly all the symptoms are only results of\\nnervous reflexes aroused through irritation of the intestine by the\\npresence of the worm.\\nThe symptoms are never all present in any one case, and as\\nmost of them may also be associated with other disorders, the\\nonly positive diagnosis is from finding parts of the worm. For\\nthis purpose, in suspected cases, examination of all the feces\\nshould be made, care being taken to distinguish any supposed\\nsegments of tape worm from shreds of mucous membrane, which in\\ncertain diseases are also passed with the stools.\\nLet it be remembered that the really serious danger is not\\nfrom the worm in the intestine, for that can easily be expelled, but\\nfrom getting its eggs into the stomach, there to hatch into the larvae\\nthat shall find their way by the blood into the lungs, liver, eye,\\nbrain or some other organ and, by the development of hydatids,\\nproduce most serious results. Hence all examinations of seg-\\nments of a tape worm should be made with great care not to con-\\ntaminate the hands, and all such segments, together with the\\nfeces in which they are found, should be thoroughly disinfected\\nor destroyed by fire. It is claimed that under favorable conditions\\nthe eggs may retain their vitality ten years, and then, if taken into\\na stomach, undergo development.\\nTreatment. Two days of preparatory fasting are necessary,\\nduring which the patient should eat very sparingly and only of\\nmilk, beef tea, white bread and such other light food as will produce\\nlittle residuum. A mild cathartic, such as a dose of castor oil or\\nsalts, should be taken on the evening of the second day to thor-\\noughly cleanse out the bowel. The expelling medicine should\\nthen be taken on the following morning. Maryott says the fol-\\nlowing remedy, if taken after such preparation and exactly as\\ndirected, will accomplish the work with absolute certainty and\\nwithout danger to the patient.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0443.jp2"}, "442": {"fulltext": "422 GENERAL DISEASES.\\nExtract of male fern ethereal three drams.\\nPure chloroform .one dram.\\nEmulsion of castor oil two ounces.\\nCroton oil two drops.\\nSyrup of spearmint one ounce.\\nShake thoroughly and take one-half on an empty stomach\\nthe morning of the third day of preparation, and after thirty\\nminutes take the other half, lie quietly while the medicine is doing\\nits work and when the bowels act the worm will be found in the\\nstool, and the drowsiness caused by the drugs will soon pass away.\\nIf the head is found the patient can be sure that he is cured,\\nalthough if very nervous or hysterical he may imagine for some\\ndays that he is still experiencing the old symptoms and has re-\\nceived no benefit. It is quite rare for more than one tape worm\\nto occupy the same intestine at the same time.\\nThe seeds of the common pumpkin are also often used as an\\nexpelling remedy, but the preceding prescription is considered\\nmore reliable. If the latter is preferred, bruise an ounce of the\\nseed kernels into a paste, add a half ounce of syrup of spearmint\\nand two ounces of hot water, and drink as hot as can be borne,\\nin the morning upon an empty stomach and after the preparation\\nas before indicated.\\nROUND WORMS.\\n(Ascaris Lumbricoides.)\\nThe round worm is the most common of all the parasites that\\ninfest human intestines and, next to the tape worm, is the\\nlargest. It is round, non-segmented, tapers toward both ends,\\nbut more gradually toward the head, is of a dirty yellowish red or\\nlight brown color, and much resembles the ordinary earth worm.\\nThe female is twice the size of the male, is about as large as a\\nturkey s quill, and is from ten to eighteen inches long. The\\nmouth is bounded by three thick lobular lips and cannot injure\\nthe mucous membrane of the intestines, some of the symptoms\\nattributed to the worms probably being due to their acrid ex-\\ncretions.\\nNot more than five or ten worms usually trouble a person\\nat one time, but they may be present in great numbers and a\\ncase is recorded in which there were 2,500 in one patient. They\\nare also found in the intestines of horses, cattle and other domestic\\nanimals.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0444.jp2"}, "443": {"fulltext": "GEXERAL DISEASES.\\n423\\nRound Worm natural size).\\nt The female lays upward of 60,-\\n000,000 eggs per year, an average of\\nmore than 170,000 a day, and as these\\nare carried from the bowels with the feces,\\nthe stools must always abound with them\\nwhen there are any worms in the intestines.\\nThese eggs may retain their vitality many\\nyears neither soaking in water, drying nor\\nfreezing injures them. It is thought that they\\nmust enter the stomach and pass into the in-\\ntestine before they can fully develop, but in\\nwhat form, whether as eggs or as embryos,\\nis not certainly known. They are probably\\ntaken with uncooked food, as lettuce, celery\\nand fruit, or in impure water, especially that\\ncontaminated with privy sewage. The cases\\nare more frequent in the country than in the\\ncity. The heat of cooking destroys the eggs.\\nRound worms find their favorite home\\nin the middle or lower part of the small in-\\ntestine, but they are prone to wander and\\nto crawl into any small passage they may find, and may make\\ntheir way into almost any part of the body connected either di-\\nrectly or indirectly with the intestinal canal, as the stomach, gall\\nducts, gall bladder, hepatic ducts, pancreatic ducts, throat, nares,\\nand Eustachian tubes; they may escape through the anus, and\\nthey sometimes crawl from the mouth and nose, provoking violent\\nvomiting, coughing or sneezing.\\nSymptoms. To a healthy person a few round worms may do\\nno apparent harm, but in a delicate person, or in large numbers in\\nanyone, they may, in addition to most of the symptoms of tape\\nworm, cause severe pain in the abdomen, dilated and often unequal\\npupils, dark and sometimes swollen eyelids, grinding of the teeth,\\nfoul breath, troubled dreams, etc. Finding some of the worms\\nis strong indication of more inside, but a positive diagnosis can\\nbe made only by finding eggs in the feces, by the aid of the\\nmicroscope.\\nTreatment. The best remedy is santonin. To a child it\\nshould be given in doses of one to three grains twice a day; to an\\nadult in doses of three to five grains with the same frequency, and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0445.jp2"}, "444": {"fulltext": "424\\nGENERAL DISEASES.\\nto both on the third day of treatment a dose of castor oil should\\nbe given. The tape worm remedies have very little effect upon\\nround worms. As preventive measures, use care as to cleanliness\\nof the hands and fingernails, partake only of well cooked food or\\nfruits that have been well cleansed, and water that has been boiled\\nor properly filtered, unless certain of its purity.\\nTHREAD WORMS.\\nThe thread worm, known also as the pin worm, seat\\nworm and maw worm, is slender, a half inch or less in length,\\nof a silvery white color, and one of the most common intesti-\\nnal parasites the world over. It is most\\noften found in children and the uncleanly,\\nbut may occur in adults and in all classes\\nof people. It infests the upper end of the\\nlarge intestine, the cecum, in great numbers,\\nbut is sometimes also found in the small\\nintestine. The females descend to the rec-\\nturn and deposit there an immense num-\\nber of eggs, which, having reached the ground with\\nthe feces, and dried, are carried far and near by winds\\nand other agencies. Some of these upon uncooked\\nfood, as vegetables and fruits, and in other ways,\\nA.-Great1yTn\u00e2\u0084\u00a2ged. are taken into the stomach, whence, having been\\nB.-Naturai size. quickened by the digestive fluids, they pass into the\\nintestine and down to the cecum, where they fully mature in\\nabout fifteen days. The greater frequency in children and the\\nuncleanly is probably due to their scratching to relieve the intense\\nitching at the anus, the fingers thus becoming contaminated with\\neggs, then borne to the mouth or used in handling food. The\\nfemale, having crawled from the intestine, sometimes deposits\\nher eggs upon the skin and hair of the parts bordering the anus,\\nand the bedding and clothing thus become infected. By sleep-\\ning with a patient, a healthy person is very liable to become in-\\nfested, and the danger is increased by eating while in bed.\\nWhen either dry or frozen the eggs retain their vitality a\\nlong time, but soaking in water a few days destroys them. They\\nseem to hatch only when they have entered a stomach. Cases are\\nrecorded in which the worms were so numerous as to cover the\\nwalls of the cecum like fur.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0446.jp2"}, "445": {"fulltext": "GENERAL DISEASES. 425\\nSymptoms. As long as they remain in the upper part of the\\nintestine these worms cause no symptoms, but their presence in\\nthe rectum is announced by intense itching in the anus, some-\\ntimes so severe as to become burning pain. This is likely to be\\nmost troublesome at night, and in either sex may cause abnormal\\nsexual excitement, sometimes leading to masturbation. Worms\\nare likely to appear in the stools. Should any doubt exist as to the\\ncause of the disorder, the diagnosis can be made positive by a\\nmicroscopic examination of the feces for the eggs.\\nTreatment. By entirely preventing self-infection, it is prob-\\nable that all the worms will pass out in a few weeks and the af-\\nfection thus run its course, but in severe cases treatment is\\nrequired. As many of the remedies used are likely to be absorbed\\nin the intestine before reaching the part containing the worms,\\nthe condition is sometimes a hard one to cure. First give a dose\\nof castor oil containing a few drops of turpentine, and, when the\\nbowels have been emptied, administer a large injection of strong\\nsuds made with castile soap and containing a little turpentine,\\nthe patient occupying the knee and elbow position or lying on\\nhis back with the hips higher than his head; at the same time all\\nthe rectal folds near the anus should be well washed. A little\\nmercurial ointment will relieve the itching. The injections\\nshould be repeated from day to day until the symptoms disappear,\\nand care should be taken meantime to guard against reinfection.\\nTRICHINOSIS.\\nTrichina spiralis is the name of a species of very minute hair-\\nlike worms occasionally found in an encysted state in the muscles\\nof man, also in those of the cat, coon, skunk, badger, and many\\nsimilar animals, but occurring by far the most frequently in the\\nmuscles (lean meat) of the hog and rat. When the young spirally\\ncoiled worms first appear in the tissues they are so small as to be\\nscarcely visible to the naked eye, often being less than one-six\\nhundredth of an inch in diameter, but, becoming encysted and\\ngradually increasing in size, they attain a length of from one-fiftieth\\nto one-twenty-fifth of an inch, and presently the cysts become im-\\npregnated with a limy substance that gives them the appearance\\nof little white specks which can be plainly seen.\\nIn this condition the embryo usually remains dormant the\\nrest of its life, which mav be for ten years or more, but if the flesh", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0447.jp2"}, "446": {"fulltext": "426 GENERAL DISEASES.\\ncontaining it be eaten raw by a suitable animal, the embryo is set\\nfree by the digestive processes, enlarges to about one-twentieth\\nof an inch in length, develops rapidly, becomes sexually mature\\nin two days, and in five or six days the female gives birth to great\\nnumbers of young embryos, then in four or live weeks perishes,\\nhaving completed the cycle of its life. In what way the young\\nembryos reach the muscles far distant from the intestinal canal\\nis uncertain, but it is probable that they bore their way into blood-\\nvessels and are then carried in the circulation to the parts they\\nare to inhabit, where, having lodged in small capillaries, they make\\ntheir way a little distance into the tissues, and each having pene-\\ntrated the sheath of a muscle fiber encysts itself therein a process\\nthat not only destroys the fibers, but tends to paralyze the muscles\\nof which they are parts. There may be only a few of them, but\\nsometimes they are present in enormous numbers. Leuckhart\\ncalculated that a single ounce of cat s flesh examined by him\\ncontained 325,000 trichina. The disturbances caused by a very\\ngreat number of these embryonic worms in the muscles constitute\\ntrichinosis.\\nIn the encysted state they are very tenacious of life, and the\\nprocesses for preserving meats, as salting, pickling, smoking and\\nfreezing, do not seem to affect them. They are, however, sus-\\nceptible to heat, and thorough cooking destroys them. In Ger-\\nmany and other European countries where trichinosis is very com-\\nmon, the people are much given to eating food composed at least\\nin part of raw or only partially cooked hashed pork. No one will\\never have trichinosis who never eats any but well cooked meat.\\nSymptoms. At first the symptoms resemble those of cholera\\nmorbus, and there may be great prostration, then as the embryos\\nenter the muscles there are rheumatic pains, swelling of the limbs\\nbut not of the joints, and contraction of the limbs. With the\\nearlier symptoms there may be fever, the temperature often reach-\\ning 102 to 105 degrees. If the patient is to recover he generally\\nbegins to improve within three weeks. Death may result from\\ndiarrhea and exhaustion or from paralysis of the respiratory\\nmuscles.\\nIf only a moderate number of trichina have been introduced\\ninto the system there will be hardly any disturbance of health, and\\nfrom a short time after they become imbedded in the muscles they\\nare ret likely to cause any inconvenience. The more frightful", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0448.jp2"}, "447": {"fulltext": "GENERAL DISEASES. 427\\nsymptoms occur only when from large masses of trichina taken\\ninto the stomach the still larger masses of embryos enter the mus-\\ncular tissues. If favorably situated a brood of these parasites act\\nlike poison, and a large dose of them is sure to kill.\\nTreatment. Beyond the prompt use of thorough emetics,\\ncathartics and injections, very soon after eating raw pork that\\nhas come to be suspected, very little can be done for trichinosis.\\nIf the patient has vitality enough to survive the ordeal from the\\nbirth of the embroyos until they become encysted in his flesh he\\nwill recover. To this end such measures should be employed as\\ntend to quiet nervous symptoms and sustain the strength as long\\nas possible.\\nPRECAUTIONS.\\nSince the United States government began its system of meat\\ninspection it has found that from one to two hogs in each hundred\\nkilled at the large abattoirs are trichinous. As every portion of\\nthe offal in such institutions is made into by-products through\\nprocesses of which thorough cooking is a prominent part, all the\\nova, cysts and embryos contained therein are destroyed. Were\\nall the meats that are used for food prepared at such places, trichi-\\nnosis would soon be greatly diminished, if not entirely stamped\\nout.\\nSmall slaughter houses with incomplete equipment, unable\\nto work up all their offal, make a common practice of feeding it to\\nhogs. Any hog or rat that eats scraps of refuse containing\\ntrichina itself becomes trichinous and, as, by the law of propor-\\ntions, some of the hogs slaughtered at these places are sure to be\\ninfested, many of the hogs that feed upon the offal will become\\ndiseased.\\nBy a series of investigations Prof. Stiles, of the Bureau of\\nAnimal Industry, to whom we are indebted for many facts bearing\\nupon this subject, ascertained that 55 per cent of the rats living\\nupon the refuse of such slaughter houses are affected with trichi-\\nnosis, and it is not probable that its proportion is smaller in the\\nhogs that are fed upon the same food. Scarcely less perilous than\\nthe custom of feeding animal refuse to hogs is the tolerance of\\nrats at slaughter houses, where 55 per cent of them become most\\ndangerous agents in spreading incurable disease, inasmuch as a\\nhog that eats a slaughter house rat stands fifty-five chances in a", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0449.jp2"}, "448": {"fulltext": "428 GENERAL DISEASES.\\nhundred of becoming infested with trichina. While it is true that\\nhogs will not always eat rats, they sometimes do, and it is likely\\nthat under certain conditions all would. Nor is this danger con-\\nfined to the slaughter house yards, for, spreading to the neighbor-\\ning farms, these rats become a menace to the hogs of the entire\\ncommunity, and, indirectly, to its inhabitants as well.\\nBut trichinosis is not the only danger at the village slaughter\\nhouse. Of each hundred hogs and cattle killed there, one or two\\nis probably tuberculous; the offal of these subjects transmits the\\ndisease to the animals eating it, and when in turn their flesh comes\\nto be used as food it is likely to transmit tuberculosis to human\\nbeings.\\nThe dog is another menace. Although he seems to be\\ntrichina proof, by eating slaughter house refuse he often becomes\\ninfected with various other parasites, of which the following are\\nthe most important: The Echinococcus hydatid, found in the\\nliver, lungs and other organs of cattle, hogs and sheep. This\\ncyst contains numerous embryos or tape worm heads, and, when\\neaten by a dog, each head becomes a tape worm, whose millions\\nof eggs are scattered by the dog in pastures and elsewhere on the\\nfarm, some of which will find their way into the stomachs of\\ndomestic animals and from their flesh be transmitted to man.\\nIn Iceland, where each family keeps eight or ten dogs and literally\\nlives with them, about one-seventh of the people have echinococ-\\ncus worms and in Abyssinia, where the inhabitants use no privies\\nand eat their beef raw, often so soon after it is killed that it is still\\nwarm, the prevalence of tape worm is so great as to sometimes be\\nconsidered epidemic.\\nThe thin-necked bladder worm, and the Gid worm found in\\nthe brain of sheep, if eaten while in the larval state by dogs,\\ndevelop into tape worms that produce numerous eggs to be scat-\\ntered over farms and infect the unfortunate animal that chances\\nto swallow one with its food and the tongue worm found in the\\nviscera of cattle and sheep is transmissible in the same way to\\ndomestic animals and to man.\\nMore than to anyone else these facts are of concern to the\\nfarmer, for although he can, as well as his city friend, by careful\\ncooking, guard against the parasitical infection of himself and\\nfamily, the value, health and sometimes the lives of his domestic\\nanimals are jeopardized by the village slaughter house. It should", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0450.jp2"}, "449": {"fulltext": "GEXERAL DISEASES. 429\\nbe placed under strict statutory control. Xo slaughter house\\nshould be permitted where it will drain into a small stream or ravine\\nand. by polluting its waters with disease germs, endanger animals\\nand men living down the stream; its offal should never be fed to\\nhogs, or left within reach of dogs, unless it has been thoroughly\\ncooked and its rats should be destroyed. A dog should never be\\npermitted to eat a rat. The farmer who dresses meat for his own\\nuse should burn the offal or thoroughly cook it before allowing\\nit to be eaten by hogs, cats, or dogs.\\nPrivy sewage, the contents of privy vaults and hog manure\\nshould never be used on ground to which cattle, sheep and hogs\\nhave access, nor upon land that is to be planted to vegetables\\nthat are to be eaten uncooked. Raw vegetables and fruits should\\nnever be eaten until thoroughly washed and rinsed.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0451.jp2"}, "450": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0452.jp2"}, "451": {"fulltext": "DISEASES OF CHILDREN.\\nBy Theodore W. Peers, M. D.\\nCHAPTER I.\\nIt is said that no other animal comes into the world as help-\\nless, and remains in a dependent condition as long, as the human\\nbeing. This helplessness renders it particularly liable to disease\\nand accident, and we find infancy and childhood a period of\\nspecial danger.\\nNot only are there diseases to which children alone are sub-\\nject, but the disorders which may occur at any period of life are,\\nmost of them, very common among the little ones. With disease\\nso frequent, and children unable to resist as stronger adults can,\\nwe should expect to find the messenger whom we all dread en-\\ntering our homes most often for the babies. And such is the\\ncase.\\nLet us suppose that one hundred infants are born to-day.\\nBefore one month has gone, the lives of ten will have returned\\nto the God who gave them. At the end of a year we count and\\ncan find but seventy-four. Another year goes and there are sixty-\\nsix left. One-third of all the children born die before they are\\ntwo years old. At the end of five years we count again and find\\nfifty-nine. To put it differently Of every five children only\\nthree reach the age of five years.\\nWe begin in this way, hoping to impress the gravity of our\\nsubject and to secure for it careful consideration. What can\\nbetter show the importance of a knowledge of the diseases of chil-\\ndren than such a plain statement of facts, unless it be to add an-\\nother fact, in which the best qualified physicians agree, viz., that\\nabout half of ail the infants that die might be saved if their parents\\nknew how to properly care for them.\\nThe first thing to know about disease is to know when a per-\\nson is free from it, and the first thing to be known about the dis-\\neases of children is to know when a child is well. Our first con-\\nsideration therefore is\\n43i", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0453.jp2"}, "452": {"fulltext": "432 DISEASES OF CHILDREN.\\nA HEALTHY CHILD.\\nWhen a baby first comes into the world several most im-\\nportant changes occur. While the mother is carrying the child\\nit gets all its nourishment from her blood. Her heart sends the\\nblood into its heart and body, and her lungs purify it as it comes\\nback from the baby s body. Its lungs are not in use, and its heart\\ndoes not act as it will after birth. Except in very rare instances,\\nthe bowels do not move before birth, neither do the kidneys.\\nAs soon as a healthy child is born, it begins to breathe and,\\nusually, to cry lustily. In this way the lungs commence, for the\\nfirst time, to take in air and to purify the blood, which the heart\\nnow begins to send into the lungs, and into the other parts of the\\nbody; and the baby takes up its battle of life, an individual.\\nAt birth a child is usually partially covered with a very soft,\\nwhite, sticky substance called vernix caseosa. This varies greatly\\non different children. In one case the babe will be completely\\ncovered, and in some places, usually the small of the back, to a\\ndepth of nearly an eighth of an inch. Another baby will be almost\\nfree from it only showing traces of it in the folds of the skin\\nunder the knees, in the groins, on the neck, under the arms, or in\\nthe folds at the elbows.\\nA perfectly healthy baby is of a pinkish or red color all over\\nits body; but it frequently happens that, right at first, the breath-\\ning is not perfect, or the circulation is not thoroughly established,\\nand we then have a white or bluish white baby, for a day or two,\\nuntil the normal healthy pink color comes.\\nSIZE AND WEIGHT.\\nThe average length of a girl baby is nineteen and a half\\nto twenty and a half inches, and of a boy it is from twenty to twenty\\none inches. Dr. Holt, from a record of 1,158 infants, gives the\\naverage weight of girls as 7.16 lbs., and of boys as 7.55 lbs. These\\nstatistics are for hospital babies and are a little small. For the\\nbabies of those likely to read this book, I should say that 7.5 lbs.\\nfor girls and 8 lbs. for boys would be about right. Let it be\\nremembered that these are averages and are made from healthy\\nchildren who may have varied from 5 lbs. to 14 lbs., and that\\nwhile averages are desirable, too much stress must not be put upon\\nthem.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0454.jp2"}, "453": {"fulltext": "DISEASES OF CHILDREN. 433\\nSHAPE AND PROPORTIONS.\\nA baby at birth has a proportionally large head, small chest\\nand big abdomen. The body is shaped something like an Qgg,\\nthe chest representing the small and the abdomen the large end.\\nThe arms are small and the legs still smaller, as compared with the\\nproportions of an adult. The head is often out of shape at first,\\nbut, unless something is wrong, assumes the proper rounded ap-\\npearance in two or three days. A healthy baby should be covered\\nevenly with fat, giving it a well rounded, somewhat fleshy\\nappearance.\\nIf, then, your child is pink and plump, from sixteen to twenty\\ninches long, weighs from six to fourteen pounds and cries lustily\\nwhen it first comes yon may be reasonably sure that you have a\\nperfect, healthy baby.\\nMATERNAL IMPRESSIONS.\\nThe doctor or nurse usually looks the child over to see if\\nthere are any blemishes, and if this has been neglected attention\\nshould be called to it. Fortunately it is of rare occurrence that a\\nbaby comes into the world seriously deformed, and when de-\\nformed in a way to seriously cripple its usefulness it does not, as a\\nrule, live more than a few days. Red or purplish discolorations of\\nthe skin, commonly called birth-marks, are more frequent, but not\\ndisfiguring or important, unless upon the face.\\nThese marks are usually supposed to be caused by some\\nfright or shock received by the mother while carrying the child,\\nand there are numerous cases that can be best explained in this\\nway, but I want to impress the fact that, where one mother marks\\nher child, thirty others have each expected that her baby would\\nhave certain marks, only to find, at birth, that it was not marked\\nat all. In my own practice perhaps a hundred women have anx-\\niously asked me: Doctor, is the baby marked? then described\\nsome event which they thought would produce that result but not\\none of them was right. In only one case was the child marked and\\nin this one the mother had not expected it. She had rescued from\\na savage dog a little child, the left side of whose head and face was\\ncovered with blood. Her baby boy, born five months later, had\\na purplish red mark on the side of his face and head which cor-\\nresponded closely with the blood upon the injured child.\\nMaternal impressions undoubtedly are sometimes causes of\\n28", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0455.jp2"}, "454": {"fulltext": "434 DISEASES OF CHILDREN.\\nmalformations, therefore women should be careful, especially dur-\\ning the early months of pregnancy; but a mother so seldom marks\\nher child, even after a severe shock, that it is folly to worry over a\\nfright received during pregnancy.\\nTRAINING.\\nSuppose now that we have this healthy baby in our family,\\nwhat shall we do with it? What a helpless little thing it is Our\\nhearts warm toward it for this very reason, and the father or\\nmother within us yearns over it. We resolve that it shall have\\nbetter care and opportunities than we had, or at least shall have the\\nbest that we can give. Well, it will need care, just lots of it every\\nday, and sometimes night, too. It will tire out its mother many,\\nmany times, and if its father is a father it will often tire him out also.\\nYes, your baby will train you whether you train it or not, and that\\nsuggests: What shall we do with the baby?\\nLet us train it. Of course you know the meaning of train,\\nbut it should have a new, fuller and more definite meaning to you\\nnow than ever before, so we will define it. To train is to bring\\nor raise to a definite standard, as of conduct, knowledge or skill,\\nby protracted and careful instruction and practice. Another\\ndefinition is, to bring into a required physical condition\\nby means of diet and exercise. To properly train a\\nbaby then is to carefully instruct it and have it do\\nthings for so long a time that we shall eventually bring it to the\\nstandard that we think a baby ought to reach. Its accomplish-\\nments should include conduct, knowledge, skill and physical con-\\ndition. Our part has to do with the physical condition and to that\\nwe will direct our remarks.\\nSome wise man has said: Give me the first five years of a\\nchild s life and I will fix his religious belief. Applying this to our\\nsubject I say that the physical training a child gets during his\\nfirst five years usually determines his after life. When should\\ntraining begin? Dr. Holmes said it should commence two\\nhundred years before the child is born. This statement sets forth\\na most important truth in a striking manner, and let us not forget\\nthat we may have a part to play in the history of the world two\\nhundred or more years hence.\\nBut the baby we are talking about is here and our training\\nof it can only begin now. It is astonishing to one, who has not", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0456.jp2"}, "455": {"fulltext": "DISEASES OF CHILDREN. 435\\nbeen used to a baby to see how soon it can be trained to do certain\\nthings. Before it is a week old it knows that it is nice to be\\nheld and that crying will get more people to hold it.\\nThe foundation principle in the training of infants is regular-\\nity, for habits are thus formed, and it is largely on habit that we\\nmust depend. Regularity is the watchword, and the following\\norder is suggestive: Nursing, sleeping, bathing, holding, defe-\\ncation, temperature and exercise.\\nNURSING.\\nRegularity in nursing is very important for two reasons Be-\\ncause it aids and establishes proper digestion and because it helps\\nto keep the flow of milk regular in quantity and quality. Diges-\\ntion is the process of so dissolving food that it can be assimilated\\nby the blood and used to build up the body. In the digestion of\\nthe milk a child takes, it is first curdled, then gradually dissolved\\nand assimilated. This process takes nearly two hours for human\\nmilk and almost three hours for cow s milk, hence a baby should\\nnot nurse at closer intervals than two hours. When cow s milk\\nmust be used a still longer time should intervene.\\nWe must think of digestion as a chemical process requiring a\\ncertain length of time, and remember that it should be completed\\nwithout interruption. What would a cook say to putting a cus-\\ntard pie into the oven and, when it was half done, pouring in more\\nof the raw material? This is not an exact parallel, but illustrates\\nthe point. If food be taken at regular intervals and time enough\\nbe given for its digestion before any more is taken, the stomach will\\nbe trained in such a way as to usually do its part. But if food be\\ntaken at the whim of the child, or the convenience of the mother,\\nthe stomach will rebel and indigestion will soon annoy the baby.\\nThe following table shows the frequency and average amount\\nfor babies at different ages\\nAge of Infant. Intervals. Times in 24 hrs. Amount per Meal. Amount in 24 hrs.\\n1 week 2 hours\\n2 to 3 weeks 2\\n4 2\\n6 2^\\n8 2 y 2\\n3 to 5 months 3\\n6 to 12 3\\nEleven\\nz ounces.\\n15 to 20 ounces\\nTen\\n2 to 2.y 2\\n20 to 25\\nTen\\n2 to 3\\n25 to 30\\nEight\\n4 to 4^\\n30 to 35\\nEight\\n5\\n35 to 40\\nSeven-Six\\n6 to 7\\n40 to 45\\nSix-five\\n7 to 8\\n45 to 50", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0457.jp2"}, "456": {"fulltext": "436 DISEASES OF CHILDREN.\\nWhen a baby is less than a month old it needs only about\\na pint of milk in twenty-four hours, but by the time it is a year old\\nit needs three pints, and it is an interesting fact that the mother\\nfurnishes only the amount the baby needs, no matter what its age.\\nThe milk varies, too, in its constituents, as the baby s needs\\nrequire, and as its powers of digestion increase. But this is true\\nonly when the child is nursed regularly and the mother cares for\\nherself properly. If the child nurses too frequently, the milk\\nbecomes smaller in quantity and stronger in albuminoids, or flesh\\nforming food, and is more likely to disagree with it. Irregularity\\nmakes the flow and quality of milk differ. We therefore see the\\nimportance of nursing w r ith sufficient and regular intervals.\\nThe flow of milk can be increased in several ways First, by\\nthe mother taking large amounts of fluid, either alone or with her\\nfood. Water alone will increase its quantity, and but slightly\\nchange its quality. The best time for drinking it is a half-hour to\\nan hour before, and from one to two hours after eating. If water\\nis taken at meals it should be while the mouth is empty. It\\nshould not be used to wash down food.\\nMilk will also increase the quantity of milk and, if it agrees\\nw 7 ith the mother, is an excellent food for her. If cold milk dis-\\nagrees it is well to try it hot, as some can digest it in that form\\nreadily who cannot if taken cold. Adding a little salt is sometimes\\na help, and occasionally, diluting with hot water, one part of water\\nto two of milk, is an advantage.\\nCoffee and tea increase the flow T but principally on account\\nof the water they contain. Cocoa or chocolate seem to have real\\nmilk-producing qualities and, where the mother likes it and it\\nagrees with her, it is well for her to take it in place of tea and coffee.\\nThere are times when benefit is derived from the malt extract\\npreparations. They sharpen the appetite, aid digestion and some-\\ntimes directly increase the flow of milk. The thick extracts, such\\nas Maltine, Trommer s malt, etc., have more nutritious properties\\nand also aid in the digestion of starchy food. The liquid extracts\\ncontain alcohol and carbonic acid and are more pleasant than some\\nto the taste, but have few if any digestive properties and very\\nlittle food value.\\nFew T if any, drugs can be relied upon to increase the flow of\\nmilk. If the mother is not well, medicines, by increasing her di-\\ngestion and blood supply, are benefits, but more by their action\\nupon the general health than by their effect upon the milk.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0458.jp2"}, "457": {"fulltext": "DISEASES OF CHILDREN. 437\\nHuman milk is stronger in proteids when the mother takes\\nlittle exercise than when she is busy. If the baby s passages show\\ncurds., and it has colic and indigestion, the mother can, at times,\\ncorrect the difficulty by taking more exercise. Nothing is better\\nfor this purpose than walking in the open air. If her milk is lack-\\ning in fat, she can increase it by using more proteid food; such as\\nmeat, fish and eggs.\\nIf for any reason it becomes necessary to dry up the milk,\\nor decrease its flow, the mother should follow the opposite course\\nfrom that suggested to increase it, using little fluid, either as drink\\nor food, and rather small amounts of food of any kind. Her\\nbowels should be moved freely with Epsom or Rochelle salts. An\\nointment of a teaspoonful of tincture of belladonna, a teaspoon-\\nful of spirits of camphor and a tablespoonful of lard should be\\nmade and a half teaspoonful rubbed on each breast two or three\\ntimes a day, care being used not to touch the nipples. If the\\npupils of her eyes enlarge it should be discontinued. A bandage,\\neight or ten inches wide, should be wrapped around the body\\nunder the arms and pinned as tightly as can be easily borne.\\nSLEEPING.\\nFor the first three months of the baby s life it should do little\\nbut eat and sleep. Unless it sleeps a large part of the time, the\\nprobabilities are that it is not well, or at least not comfortable.\\nFor the first month it should sleep about twenty hours out of the\\ntwenty-four; at three months it should have twelve to fifteen hours\\nsleep from three months to a year about twelve hours and from\\none to three years ten to twelve hours is none too much. An in-\\nfant should be taught to sleep on its side, preferably the right side.\\nThere should be a regular time for sleeping, and this should be\\nvaried as little as possible. In putting it to sleep the mother\\nshould remember that it is a matter of habit and that she can train\\nthe baby to go to sleep by itself almost as easily as rocking it.\\nEven were this not the case and it required much more effort to\\nteach it this habit, it would still be worth while, for the saving of\\ntime and annoyance later. Sleep is easy for a baby, and by\\nremembering two simple rules there will be little difficulty.\\nFirst. Be regular. Put it to sleep the same way, and at\\nabout the same time every clay.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0459.jp2"}, "458": {"fulltext": "438 DISEASES OF CHILDREN.\\nSecond. When yon attempt to put it to sleep, persevere\\nuntil you succeed.\\nSome babies require more sleep than others, hence a little\\ncommon sense must be used as to how much each one needs. The\\neasiest times for a child to go to sleep are after eating or nursing,\\nafter a warm bath and after a vigorous play-spell. When it per-\\nsistently wakes up cross and fretful, you may be sure that some-\\nthing is wrong; such as pain, too little sleep, hunger, or some\\ndisease.\\nA baby should not sleep with its parents, but in a bed by itself;\\nand when it sleeps in the daytime should be put in its own bed,\\nwhich should always occupy the same place. If there be difficulty\\nin keeping the child warm, don t depend entirely upon more cov-\\nering, but use artificial heat.\\nBATHING.\\nAs a rule an infant should be bathed every morn-\\ning, but there are a few whom bathing seems to chill and injure.\\nThe mother should notice closely, and if, after the bath, the baby s\\nskin and nails have a bluish color, and the feet, hands and nose\\nare cold and the child breathes fast and seems exhausted, it\\nwill be better to simply sponge it with warm water as often as\\ncleanliness requires. Let the bathing be done quickly, in a warm\\nroom, and care be taken not to get the baby in a draft. Every-\\nthing should be prepared before it is undressed, and a thermometer\\nbe used to test the temperature of the water, as the hand is not\\naccurate enough. At birth the bath should be 99 degrees, and\\ngradually lowered until at one month it is 95 degrees. From one\\nto twelve months it should fail one degree for each two months,\\nso that at one year it is 90 degrees. Some people need this tem-\\nperature through life, but if the baby stands it well, and is warm\\nand lively after the bath, the temperature may be reduced one\\ndegree every three months, so that at two years its bath is 86 de-\\ngrees. Some children can stand even yet cooler water, in which\\ncase there is no objection to gradually reducing the temperature\\nin summer to 75 degrees. As babies are individuals, no absolute\\nrule can be made for all. If a child thrives with a cool bath use it\\nbut if it depresses and annoys him use the warm one.\\nThe face should first be washed in warm water, while the\\nwhole body is wrapped in a flannel blanket. The scalp should then", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0460.jp2"}, "459": {"fulltext": "DISEASES OF CHILDREN. 439\\nbe washed with castile soap and dried with a soft towel. Next,\\nsponge the body and extremities with a soapy sponge, using\\nspecial care to cleanse the folds at the neck, under and about\\nthe arms, and the genitals and groins. The child should then be\\nlowered slowly and gently into the bath tub filled with clear\\nwater, and, after the soap has been washed off, taken out, care-\\nfully rubbed and dressed, care being used to have the clothes\\nwarm. If the skin shows a tendency to soreness a dusting powder\\nshould be used, composed of equal parts of powdered corn starch\\nand boracic acid. The morning is the best time for this bath and\\nit should be given regularly at about the same hour each day,\\nafter which the child should be nursed and put to sleep.\\nHOLDING.\\nOne of the delights of motherhood, and one of the\\ngreatest favors to visiting admirers, is holding the baby.\\nLet this be done with care. Xever lift a baby by its arms extended\\nover its head, and especially do not lift it by one of its arms.\\nIf you must kiss it, let it be upon the cheek or forehead or, bet-\\nter still, upon the hand, never upon its lips.\\nDEFECATION.\\nThis is a subject of so much importance that it must be\\nconsidered. Many a patient is forced to consult a doctor be-\\ncause this matter did not receive proper attention in infancy.\\nJust as a stopped-up sewer brings sickness to a household, so\\nconstipation brings illness to an individual. If the waste matter be\\nnot excreted it will be absorbed and poisons be drawn into the\\nblood. As the best cure is prevention, the best remedy for consti-\\npation is regularity, from infancy, in emptying the bowels.\\nIt is surprising how quickly some babies learn to attend\\nto the calls of nature, and how regular they become by proper\\ntraining. They have been taught to indicate their desire to\\nevacuate the bowels when only four months old, and the added\\ncomfort and lessened work for the mother are so great that she\\nmay well make the effort necessary to train her child. It should\\nbe placed upon the chamber soon after its morning meal and, if\\nthe bowels are not soon emptied, a pencil of soap inserted in the\\nrectum, or a rectal injection given of two teaspoonfuls of a mix-\\nture of one part glycerin and two parts water. Either treatment", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0461.jp2"}, "460": {"fulltext": "440 DISEASES OF CHILDREN.\\nis likely to cause prompt action. The soap pencil may be made\\nfrom a piece of soap two inches long by trimming it into a taper-\\ning cylinder, whose small end is one-fourth inch and large end\\none-half inch in diameter.\\nThe training of the bladder is not quite as easy and im-\\nportant, but is desirable, and efforts in this direction are often very\\nsuccessful. Here, as in the former case, regularity is the prin-\\ncipal factor in the training.\\nTEMPERATURE.\\nBabies are very susceptible to changes in temperature, espe-\\ncially to cold, and many mothers make the grave mistake of sup-\\nposing that when a child is cold they can warm it by adding cov-\\ners. Let it be remembered always that a cold baby should never be\\nwarmed in that way, but in every case by applying heat. It is\\ntrue that a baby s circulation is active and that at times it ac-\\nquires warmth more rapidly than an adult, but this is not always\\ntrue and, as a child takes cold so readily and its colds are liable\\nto result so seriously, great care should be taken to keep the baby\\nwarm.\\nHere again regularity is the key note. Keep the baby and\\nthe room at as even temperatures as possible; that of the latter,\\nwhen artificial heat is employed, at from 70 degrees to 75 de-\\ngrees. It is not best for a child less than a year old to sleep in\\na cold room but if it must do so some artificial heat should be\\nplaced in the bed, as a hot water bottle, a hot brick, or a bag of\\nhot sand or salt. Colic is often caused in very small children by\\ncold, and is immediately relieved by thoroughly warming them.\\nThe feet should be uncovered and well warmed by the fireplace\\nor stove. Many teas are used for colicky babies, some of which\\nhave medicinal value, but the relief afforded by them is chiefly due\\nto their being given warm. A warm baby is almost always a\\nhappy baby and one easy to care for and, if kept uniformly warm,\\ndigests its food better and grows faster than a cold one.\\nEXERCISE.\\nFew people pay any thoughtful attention to exercise for their\\nlittle ones, yet, how important it is that they have the strong,\\nhealthy bodies which can be secured only through proper and\\nsystematic exercise. This is not the department in which to", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0462.jp2"}, "461": {"fulltext": "DISEASES OF CHILDREN. 441\\ngive extended and minute directions as to its kinds and times,\\nbut a fewgeneral statements may not be inappropriate.\\nExercise should be taken as largely as possible in the open\\nair. If taken within doors, the room should first be thoroughly\\naired and, if not too cold, the windows should be open during\\nthe exercise. Exertion should be sufficiently vigorous to bring a\\nhealthy glow to the body, but not to tire, and never violent enough\\nto cause exhaustion or strain. It should be regular, too, for it is\\nthe everyday work that tells. Many start vigorously, doing even\\ntoo much, perhaps, for a week or two, then give it up entirely.\\nThe correct plan is to spend a certain definite time every day\\nin exercise, keeping it up by the year. It is surprising what an\\nimprovement, in a child unaccustomed to it, fifteen minutes daily\\nwill soon make. The exercise should be varied and as pleasant\\nas possible. It is far better if regarded as fun than if thought a\\ntask.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0463.jp2"}, "462": {"fulltext": "CHAPTER II.\\nARTIFICIAL FOODS.\\nOf the many parts of our subject, this one is of the very\\ngreatest importance. There is more sickness and loss of life\\namong infants because of improper food and feeding than from\\nany other cause, if not from all other causes combined. Not\\nonly this, but in every illness from any cause, feeding is a most\\nimportant factor of the treatment, often turning the balance\\nbetween life and death. We have spoken of maternal feeding\\nand shown how desirable it is for a mother to nurse her babe, and\\nthat it is better, not only for the child, but for her, to nurse it,\\nat least a few times a day, if her milk is good, even if artificial\\nfoods must also be given. It now becomes necessary to show\\nhow a child should be fed, if, for any reason, the mother is not\\nable to nurse it. So many infant foods are on the market, each\\npictured as the best, and so many different kinds will be recom-\\nmended by well meaning friends, it is very necessary to be in-\\nformed and able to act intelligently in this matter.\\nFor convenience we will consider artificial foods as of five\\nclasses\\nMILK.\\ni. Milk always contains about the same materials, no mat-\\nter from what animal it comes, the main difference being only one\\nof proportions. There are several animals whose milk is more\\nlike human milk than is that of the cow, the mare, ass and goat\\nbeing among them; but cows milk is so much the easiest to ob-\\ntain it is most often used. The following is an average analysis\\nof human milk and that taken from the cow:\\nReaction. Fat. Sugar.. Proteids. Salts. Water.\\nCows milk acid 3.50 4.30 4.00 0.70 87.00\\nHuman milk... alkaline 4.00 7.00 1.50 0.20 87.30\\nFrom this comparison we see that the main difference be-\\ntween cows milk and human milk is that cows milk has TOO\\nMUCH OF THE PROTEIDS AND NOT ENOUGH SUGAR.\\n442", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0464.jp2"}, "463": {"fulltext": "DISEASES OF CHILD REX. 443\\nWe put this fact in capitals that it may not be forgotten, as it is\\nthe basis of all the modifications of cows milk to make it fit for\\ninfants food. Of the two ingredients, the proteids are, decidedly,\\nthe hardest to manage. They are the tissue-forming and strength-\\ngiving part of food and therefore valuable, but if present in too\\ngreat quantities are not digested, and form irritating curds in the\\ninfant s stomach and bowels. This proteid material differs in\\nthe two kinds of milk, not only in quantity but also in quality.\\nThe formation of curds is the first step in the digestion of milk,\\nand takes place upon its admixture with the acid of the stomach.\\nThis acid has been found to closely resemble hydrochloric acid.\\nNow, if we add a little dilute hydrochloric acid to cows milk we\\nwill find that it produces a hard curd (the so-called cottage cheese\\nor schmierkase of the Germans) but if we add the acid to hu-\\nman milk it produces a curd consisting only of fine flakes, easily\\nbroken up and not one-fourth as great in amount as that from\\nthe cows milk. We must understand, too, that not all of the\\nproteids form curd; part of them remain in a soluble condition,\\nand are therefore much more easily digested.\\nThe question now arises How can we modify cows milk\\nso that it will be good food for the baby? There are four ways:\\n1. Dilute with water and add sugar and cream.\\n2. Use whey with sugar and cream.\\n3. Digest the proteids with pepsin, pancreatin or papoid.\\n4. Dilute by adding some cereal or lime water to prevent a\\nfirm or hard curd.\\nNo. 1. Dilution. Various degrees of dilution have been sug-\\ngested, most of which have worked well with some babies. If we\\nadd to a measure of cows milk an equal amount of water (boiled\\nand strained), we have in the mixture about two per cent of pro-\\nteids, which is a little more than the average found in human milk,\\nbut in reducing the proteids we have also reduced the amount of\\nsugar and cream (fat) hence we will have to add enough of these\\ningredients to get the right proportions. They can be very\\nnearly obtained by using the following rule One-half pint of\\nfresh milk one-half pint of water, one and one-half tablespoonfuls\\ncream and two heaping teaspoonfuls of milk sugar. This is proper\\nfor a child six months old. For a younger child more water should\\nbe added, and as it grows older the water may be lessened, but\\nnot verv much, as most infants thrive best when the milk is", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0465.jp2"}, "464": {"fulltext": "444- DISEASES OF CHILDREN.\\ndiluted as indicated. Whenever small pieces of curd appear in\\nthe stools, they mean indigestion or too much proteids, and in\\neither case the proteids should be lessened by adding more wa-\\nter. If the child be constipated, the addition of cream will\\noften aid in correcting the difficulty.\\nIt may be well to mention the necessity of procuring good\\nmilk. Cows milk varies greatly, and while one cow gives a milk\\neasy of digestion, that given by another may be difficult. The\\ndigestibility of any particular milk may be learned either by chem-\\nical analysis or by its effect upon the child. As an analysis is\\nexpensive most people rely upon the effect. There is a widespread\\nbelief that the milk from one cow is better for a child than is the\\nmixed milk from a herd, but quite as generally it is believed\\nby the profession that the mixed milk is preferable.\\nMy own opinion is that if the right cow can be obtained\\nit is better to have milk from her alone, but if one cow s milk\\nthat agrees with the child cannot be found, it is of course better\\nto use milk from the herd. Milk fresh from the cow is decidedly\\neasier to digest than when it has stood even one hour. A baby\\nwill at times retain and digest milk if the cow be milked every\\ntwo hours and the milk fed to it at once, when, were the milk\\nallowed to get cold before being fed, the child would vomit very\\nsoon after taking it.\\nThe stoppings contain more cream and less proteids than\\neither the first milk or mixed milk, and where it can be done\\nit is an excellent plan to keep the last quart separate for the baby.\\nNo. 2. Use of Whey. The whey of cows milk contains\\nlittle proteids, but as it is the proteids that usually disturb diges-\\ntion in children, we sometimes use whey in feeding them, to\\ntide over a dangerous period. A teaspoonful of sour wine is\\nstirred into a half pint of fresh milk and when it has stood half\\nan hour the curd formed is strained out. To the whey thus\\nobtained are added a teaspoonful of milk sugar (cane sugar is\\nnot good) and a tablespoonful of cream; then it is warmed to\\n100 degrees and fed with a bottle or spoon. Sometimes a table-\\nspoonful of fresh milk is added to supply the lacking proteids\\nand the proportion gradually increased as the child s digestion\\nimproves.\\nNo. 3. Digestion of Proteids. We may take care of the\\ncasein (one of the proteids) in milk by wholly or partially", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0466.jp2"}, "465": {"fulltext": "DISEASES OF CHILDREN. 445\\ndigesting it. This is done by putting into a bottle a pint of\\nfresh cows milk, one-fourth of a pint of water and a powder\\nconsisting of five grains of extract of pancreatin and fifteen\\ngrains of bicarbonate of soda then placing it in a pail of\\nwater at no degrees, or as warm as the hand can comfortably\\nbear. The milk begins to digest at this temperature and the\\nprocess can be carried as far as the needs of the infant require.\\nFor one in ordinary health fifteen minutes is usually long\\nenough. If digested more than this the milk becomes bitter\\nand the child refuses to take it. The bitterness is due to the\\nformation of peptones, and although it gives it a disagreeable\\ntaste it makes it easier to digest. If the milk be kept in warm\\nwater two hours the casein will be completely digested and the\\nmilk will not curdle when an acid is added. This process is a\\nvaluable one in certain emergencies and for a child under three\\nmonths of age, but there is danger that the stomach so fed\\nwill not have enough to do to keep up the growth of its digestive\\npowers. This artificial digestion can be stopped at any point,\\neither temporarily, by placing the milk upon ice, in which case\\nthe digestion of casein can be resumed by warming the milk to\\n80 degrees or more, or permanently, by heating the milk until\\nit boils, thus destroying the digestive ferment.\\nFor convenience digestive tablets and peptonizing tubes have\\nbeen devised, and can be procured at the drug stores, containing\\nthe soda and extract of pancreatin ready for use. Seeing the\\nutility of this process, Fairchild, Bro. Foster have prepared a\\npeptogenic milk powder composed of the above ingredients with\\nmilk sugar added. This makes a preparation very much like breast\\nmilk and, in my hands, has proved a most excellent food for an\\ninfant less than five months of age. Directions accompany each\\nbottle of the powder.\\nNo. 4. Cereals and Lime Water. Cereals are the foods\\nobtained from various kinds of grain, such as wheat, oats, rice,\\nbarley and corn, and are made up very largely of starch. The\\nterm is also applied to the starchy foods derived from potatoes,\\narrowroot and sago. Until a child is from three to six months\\nold he cannot digest starch and it should not be given him.\\nIt has been learned that milk mixed either with starchy material\\nor with lime water will not curdle into as hard lumps, while\\nbeing digested, as milk will if taken pure, and this principle", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0467.jp2"}, "466": {"fulltext": "446 DISEASES OF CHILDREN.\\nis often employed in preparing food for babies. The materials\\nmost often used for this purpose are oatmeal, barley meal, flour\\nand corn starch, and they must always be very thoroughly cooked.\\nUpon a heaping tablespoonful of any one of these,, preferably\\noat or barley meal, pour a quart of cold water, then boil steadily\\nfor at least two hours, adding water from time to time, so that\\nat the end there shall still be a quart. Strain through absorbent\\ncotton or cheesecloth. Equal parts of this water and milk, with\\nsugar and cream added as in No. i, make an excellent food\\nfor infants over six months old.\\nCONDENSED MILK.\\nThis is made in two ways. The oldest process is that of\\nadding sugar and boiling the milk, then evaporating it to a\\nsemi-solid condition, the object of the sugar being to keep the\\nmilk from fermenting quickly after the can is opened. In recent\\nyears certain manufacturers have left out the sugar and simply\\nevaporated the milk to a thick liquid consistency.\\nMuch has been written about condensed milk as a food\\nand there seems to be a great fondness for it among the laity,\\nbut chemical analysis shows it to be lacking in fat and to have\\ntoo much sugar in proportion to its fat and proteids. It is\\nevaporated to about one-fourth the weight of the milk, and\\nas about twelve parts of water are usually added to one part of\\ncondensed milk, the result is the same as adding three parts of\\nwater to one part of fresh milk.\\nAlthough the sugar is liable to ferment, it is easy for a baby\\nto digest, and a baby fed upon condensed milk usually gets fat\\nand has a fair and clear complexion, leading the mother to think\\nthat her child is doing well but doctors know that such chil-\\ndren are especially liable to disease, and when sick are less likely\\nthan other children to recover. Dr. Holt says that he never\\nsaw a child that was raised upon condensed milk that did not\\nshow some signs of rickets.\\nSweetened condensed milk is therefore not a suitable food\\nfor babies. It serves a very useful purpose when, for a time, an\\neasily digested food is needed, as when the child is sick, or when\\none is traveling, or cannot obtain good cows milk, or when the\\nbaby is less than two months old even then cream, if it can be\\nobtained, should be added.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0468.jp2"}, "467": {"fulltext": "DISEASES OF CHILDREN. 447\\nCondensed milk without sugar is little more than sterilized\\ncows milk evaporated to one-fourth its weight hence, after\\nadding three parts of water it should be treated as was directed\\nfor cows milk. Because of its liability to ferment in hot weather,\\ncondensed milk with sugar is better diet for winter than for\\nsummer.\\nMISCELLANEOUS FOODS.\\nUnder this head we will speak of the prepared foods, which\\nare principally of two kinds.\\nFirst. The Cereal Foods Partly Digested by Heat. By\\ncooking cereals a long time at a high temperature the starch is\\nchanged and rendered more easily digestible. Taking advan-\\ntage of this fact, manufacturers have prepared and placed upon\\nthe market such products for babies food. Mellin s, Ridge s\\nand Imperial Granum belong to this class. Aside from the fact\\nthat some of them contain starch, their greatest deficiency is\\nthe small amount of fat they contain. Cream should therefore\\nbe added and they should be reserved for children over six\\nmonths of age.\\nSecond. Cooked Cereal Foods with Condensed Milk Added.\\nThe addition of condensed milk slightly increases the amount of\\nfat, but there is still a deficiency. Malted milk and Xestle s food\\nare of this class.\\nA preparation has been introduced recently from Germany,\\ncalled Gardner s Mother s Milk, which is an attempt to so\\nmanipulate cows milk as to make it like mother s milk.\\nWe are sometimes compelled to exercise all our ingenuity\\nto find a food that the baby can digest. Many things besides\\nthe above have been tried with varying success.\\nBeef juice, obtained by cutting lean steak into small pieces\\nand warmed enough to thoroughly heat it through, but\\nnot to cook it, then pressing out the juice with a lemon\\nsqueezer or press, is sometimes very useful.\\nThe white of an tgg beaten up in a glass of water is valuable,\\nespecially where vomiting is persistent.\\nWhey, made by adding a teaspoonful of sour wine or vinegar\\nto a cup of milk, and straining, is also used. Unfermented grape\\njuice is often very grateful, and koumiss is also good at times.\\nThe subject of infant feeding is a very large one, and cannot", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0469.jp2"}, "468": {"fulltext": "448 DISEASES OF CHILDREN.\\nbe treated exhaustively here; we have only attempted to\\ngive some general principles and to be specific enough to enable\\nmothers and nurses to feed correctly in emergencies, but they\\nmust remember to consult a physician when possible as to which\\nfood is most appropriate for each child.\\nAs already shown, digestion is a chemical process greatly\\naided by taking the food at proper intervals and in proper\\nquantities. It should also be understood that the kinds of food\\nmust vary but little, and when the kind that agrees with the baby\\nhas been found, it should be relied upon and not changed except\\nfor cause. There may be a little variety occasionally to whet\\nthe appetite, but this is generally best done by a relish or des-\\nsert, given after the regular meal and in small quantity. By\\nthis method a child may be trained not only to eat the proper\\nfood but also to enjoy it. The numerous patients who come\\nto the doctors complaining that they cannot eat this, that and\\nthe other wholesome and nutritious article of food, prove in\\nso doing that when children they were not properly taught\\nwhat to eat. Its individual taste is not the infallible guide to\\nwhat the child needs. With proper training it may be taught\\nto relish and enjoy most of the staple foods.\\nADMINISTERING FOOD.\\nA few things should also be said in regard to the adminis-\\ntration of food. Absolute cleanliness of food and of the utensils\\nused in preparing and giving it is of the first importance. In\\ncountry districts where the cow can be properly cared for,\\nand the milk can be cooled quickly and kept cool, sterilization\\nis not necessary unless the baby is sick. In a large city it is\\nimpossible to get absolutely fresh milk, hence all milk used\\nthere for babies should be sterilized. This may be done by\\nboiling in a double kettle twenty minutes, or Pasteurized by\\nkeeping it for thirty minutes at a temperature of about 165\\ndegrees Fahrenheit. The latter process is to be preferred, as\\nit does not alter the milk in taste and chemical composition\\nas much as the other method. After having been thus treated,\\nthe milk must be kept in air-tight vessels, as fruit jars, in a cool\\nplace until used.\\nBoiling water is the best cleanser and all utensils used for\\nthe babv should be boiled. Washing: in warm water does not kill", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0470.jp2"}, "469": {"fulltext": "DISEASES OF CHILDREN. 449\\nthe germs which cause disease. The nursing bottle should be\\nrounded inside to leave no corners where the food can\\ncollect and prevent easy and thorough cleansing. Alter it has\\nbeen used it should be boiled, then filled with a solution either\\nof bicarbonate of soda, borax or boric acid, a teaspoonful to\\nthe quart of boiled water. A rubber tube should never be\\nused and the nipple should always be a plain one. Several\\nnipples should be procured at one time, and, after scalding,\\nshould be kept in one of the solutions above mentioned.\\nAs it is best for the baby to take its food slowly, select\\nnipples with small openings that will require ten minutes for\\nit to get its meal. A little patience and tact will usually get\\nit to nurse a bottle, although it may refuse at first. There\\nis no objection, however, to feeding with a spoon. It is better\\nnot to give it from a cup, for, because of gulping it down too\\nfast, the child is more likelv to be troubled with indio-estion.\\nDENTITION.\\nDentition, or cutting of teeth, was once regarded as the\\nprincipal cause of a number of diseases, especially diarrhea, con-\\nvulsions, fever, and, at times, affections of the lungs; but, by the\\nbest authorities, it is now regarded as only occasionally a cause\\nof disease. It may lead to restlessness, fever, indigestion, or even\\nto convulsions, but in most cases is attended by no special symp-\\ntoms and there is danger that, from regarding it as a cause, the\\nserious and real causes will be overlooked hence, always inves-\\ntigate these diseases carefully, although the child be teething at\\nthe time.\\nAt birth the teeth are enclosed in sacs, occupying depressions\\nin the jaws, and, as growth progresses, they pierce the gums.\\nThese first teeth, called deciduous or milk teeth, are twenty in\\nnumber and, although they may vary in the time, they rarely\\nvary in the order of their coming. The following is an average\\nof the order and time of their first appearance\\nNumber. Name. Months after birth.\\n2 Lower incisors 6 to o\\n4 Upper incisors 8 to 12\\n2 Lower lateral incisors 12 to is\\n4 First molars I2 to I5\\n4 Cuspids, also called canines 18 to 24\\n4 Second molars 24 to 30\\n29", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0471.jp2"}, "470": {"fulltext": "450 DISEASES OF CHILDREN.\\nThere are many variations to this rule. The teeth may be-\\ngin to appear during the third or fourth month, or may be de-\\nlayed until the eleventh or twelfth month. In a weak, poorly\\nnourished child, teething is nearly always delayed.\\nThe teeth may appear without any noticeable disturbance, but\\nusually there is redness and swelling of the gums and increase of\\nthe saliva. The child wants to bite something hard and may want\\nto keep its fingers in its mouth it may become restless and fret-\\nful, and sleep less than usual, and there may be loss of appetite.\\nThere is often constipation, and there may be diarrhea, either of\\nwhich conditions should receive attention. If a child be forced\\nto take more food than it desires, attacks of indigestion, vomiting\\nor diarrhea may follow. In some cases there is high fever and\\na hot, dry condition of the mouth and gums. Earache may also\\naccompany the teething stage, and gradually leave as the teeth\\nappear. These symptoms usually last two or three days, then\\nsubside as the teeth make their appearance, but they may last a\\nweek, and, if severe, a physician should be consulted. In some\\ncases that have not received proper attention convulsions may\\noccur, for which a hot mustard bath should be given and a doctor\\ncalled immediately.\\nChildren should not be exposed during the period of denti-\\ntion, for they are then very susceptible to cold, and only a little\\nexposure may result in bronchitis or pneumonia. The gums very\\nrarely need lancing, and when required it should be done only\\nby one, who is skillful.\\nCare of the teeth should begin in infancy. As soon as they\\nfirst appear, the mother or nurse should cleanse them daily with\\na soft linen or muslin rag, and as soon as they have all appeared\\na small, soft brush should be used. It should early form the habit\\nof caring for its own teeth. It must not be allowed to suck its\\nfingers, as this habit may cause the teeth to assume an abnormal\\nposition. The constant weight of the thumb, or fingers, in the\\nmouth may cause the lower front teeth to point in, and force\\nthe upper ones outward, thus causing an unsightly deformity\\nof both jaws.\\nDecay of the teeth, whether of the temporary or permanent\\nset, should receive prompt attention. A child two years old\\nshould have its teeth examined by a dentist and treated if neces-\\nsary; after which they should be examined every six or eight", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0472.jp2"}, "471": {"fulltext": "DISEASES OF CHILDREN. 451\\nmonths and kept in repair until they drop out, and are replaced\\nby the permanent set. Dentifrices, except as recommended by a\\nreliable dentist, should not be used.\\nThe permanent teeth begin to appear about the sixth year,\\nnumber thirty-two and come about as follows\\nFirst molars, at about 6 vears of asre\\nIncisors, at about 7 to 8 years of age\\nBicuspids, at about 9 to 10 years of age\\nCuspids, at about 12 to 14 years of age\\nSecond molars, at about 12 to 15 years of age\\nThird molars, at about 17 to 25 years of age", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0473.jp2"}, "472": {"fulltext": "CHAPTER III.\\nDISEASES OF THE MOUTH.\\nDisease of the mouth, of an inflammatory character, is called,\\nin medical works, stomatitis. There are five forms of this disease\\nwhich we will describe: (i) Catarrhal stomatitis; (2) Ulcerative\\nstomatitis (3) Aphthous stomatitis (4) Noma, or gangrenous\\nstomatitis; (5) Thrush.\\nCATARRHAL STOMATITIS.\\nThis begins with reddened patches in the mouth,\\nwhich is apt to spread until the entire mucous mem-\\nbrane of the mouth and tongue is involved. The mouth be-\\ncomes swollen, hot and sore, and soon raw places appear which\\nare painful and irritating. At first the mouth is dry, but soon the\\nsaliva flows freely and, with babies, the drooling is often excessive.\\nThe excreted fluid is acid in its reaction and so irritating that the\\nskin around the mouth is made sore by it. If the inflammation\\nis not soon arrested ulcers begin to appear and the ulcerative\\nform of the disease follows.\\nThe usual causes of the catarrhal form are lack of cleanliness,,\\nbad teeth, irritating food and the various things covered with\\npaint or other irritating material which a baby is likely to put in\\nits mouth.\\nTreatment. Only simple remedies are needed. Borax wa-\\nter, one teaspoonful of borax to a pint of water, used on a swab is\\nusually sufficient. One end of a stick, the size of a slate pencil and\\nsix or eight inches long, is wrapped with a little piece of soft\\nlinen or absorbent cotton and dipped in the solution, or better, a\\nlittle of the solution is poured over it, and with this the sore mouth\\nis gently, but thoroughly washed. This should be repeated every\\none to three hours. In some cases alum is better than borax.\\nListerine, euthymol and borolyptol are proprietary articles which,\\nat times, are useful.\\n452", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0474.jp2"}, "473": {"fulltext": "DISEASES OF CHILDREN. 453\\nULCERATIVE STOMATITIS.\\nThis form usually occurs after the child has teeth, .and is\\nlikely to be confined to the gums. They become red, swollen and\\nsore and bleed very easily. The gums soften, the teeth loosen,\\nand the child becomes irritable and sometimes feverish. The\\nglands about the neck may become enlarged and sore, or may\\neven suppurate. This form of the disease usually requires con-\\nstitutional treatment as well as local applications.\\nTreatment. A half teaspoonful of Parke, Davis Co. s syrup\\nof the hypophosphites three times a day, for a child four years\\nold, is useful. It is of the first importance that the ulcers be kept\\nclean by frequent rinsing with one of the preparations above\\nmentioned. At times an astringent powder, composed of one\\npart powdered alum to three parts of powdered boric acid or bis-\\nmuth, is useful.\\nAPHTHOUS STOMATITIS.\\nAphthous Stomatitis, or canker sore mouth, is characterized\\nby from one to twenty small ulcers on the mucous membrane of the\\nmouth. They are usually round, but sometimes oblong, and vary\\nin size, from that of a pinhead to a pea, are of a yellowish white\\ncolor, looking as if a little piece had been dug from the membrane,\\nleaving a small hole, and are quite painful. The mouth becomes\\nhot and tender, and the saliva is increased, acid and irritating.\\nThis trouble is usually caused by indigestion, and by certain\\nfoods, as tomatoes and articles prepared with vinegar. It often\\noccurs during dentition, but may come at any age.\\nTreatment. Regulate the diet, particularly as to sour food,\\nsugar and starchy articles. A plain diet, limited in amount, will\\nusually effect a cure in a week or so. If there is constipation, a\\ndose of Epsom salts, taken in hot water before breakfast, is ad-\\nvised. One-tenth grain calomel triturates, one taken every hour\\nfor six to ten hours, and, if the bowels do not move freely, followed\\nby salts the next morning, are very efficient. For local application,\\na solution of chlorate of potash, alum, sulphate of zinc, or sul-\\nphate of copper, is useful.\\nNOMA, OR GANGRENOUS STOMATITIS.\\nThis is a dreadful disease but, fortunately, is very rare. As\\na rule it occurs only in children already weakened by measles or", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0475.jp2"}, "474": {"fulltext": "454 DISEASES OF CHILDREN.\\nsome other disease, and therefore unable to resist as a healthy\\nchild would. It appears on the inside of the cheek as a sore lump\\nabout as large as a pea. This rapidly enlarges, turns black and\\nbegins to slough. The odor is extremely offensive and the dis-\\ncharge from the sore very irritating. All the tissues of the cheek\\nare soon involved, and a hole made, through which the teeth can\\nbe seen. As it progresses, all the tissues of the mouth are at-\\ntacked, the gums drop away, the teeth come out and at last death\\ncloses the scene, unless the progress of the disease is stopped.\\nNo one, not specially fitted, should attempt to treat this\\ndisease. The child should be taken to a good physician as soon\\nas the malady is recognized. With the most skillful over half\\nof the cases prove fatal.\\nTHRUSH.\\nThis is a disease caused by fungus, growth. It formerly was\\nmore common than it is to-day, unless the name was also given to\\nother mouth diseases. It is found only in young, sickly babies,\\nwho are poorly nourished. As long as a child is reasonably well,\\nnature protects the mucous membrane of its mouth from growths\\nof this kind. It is of vegetable character, appears as a thin, white\\ncovering on the membrane of the mouth, very much as mold ap-\\npears on food that has long been left in a damp, warm place, and\\nspreads in every direction. At first, while upon the surface\\nof the membrane, it can be brushed off, but it gradually makes\\n;the membrane sore and, if neglected, finally destroys it. It may\\ndescend into the stomach, and even into the intestines, in which\\ncase it is said to have gone through the baby. There is a com-\\nmon belief that such an occurrence is surely fatal, but it is not.\\nTreatment. The treatment of thrush is both local and con-\\nstitutional.\\nEverything possible must be done for the general health of the\\nchild. Great care must be used to secure for it a good nourishing\\nfood that it can digest. Cod-liver oil should be given internally and\\nit is a wise plan to bathe the child in it two or three times a day,\\nrubbing until absorbed it disappears in the skin. A good tonic,\\nas the hypophosphites, is also useful.\\nFor local treatment, chlorate of potash has the most indorsers.\\nA solution, in the proportion of one teaspoonful of it to a pint of\\nwater, is used every hour or two to wash the mouth. Boro-gly-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0476.jp2"}, "475": {"fulltext": "DISEASES OF CHILD REX. 455\\ncerite is also good for this purpose. Some mild antiseptic solution\\nshould be used gently and often.\\nDISEASES OF THE STOMACH.\\nThe diseases of the stomach and intestines of children are\\nvery closely allied, and we cannot make their diagnosis as clearly\\nand closely as to exact location and condition, as we can in adults.\\nFortunately, this is not usually necessary, as the treatment for\\neither condition is similar to that for the other. Many babies lose\\ntheir lives from stomach and intestinal diseases, and this, too,\\nalthough it is possible for the mother to treat her child success-\\nfully by doing the right thing at the very beginning of the symp-\\ntoms. Of course, it is not safe for her to trust her own skill too\\nfar, lest the disease finally get such headway as to baffle even the\\nmost skillful physician. The instructions I shall give are for emer-\\ngency cases, where it is impossible to get a physician, or where\\nthe symptoms are mild. If, however, relief is not at once ob-\\ntained, it is better to consult a physician, when one can be ob-\\ntained.\\nACUTE DYSPEPSIA. GASTRALGIA. GASTRIC FEVER.\\nThis is an acute affection of the stomach, which is quite com-\\nmon among babies during the summer months. It is usually\\ncaused by improper feeding, combined with teething, hot weather\\nand fretfulness. It comes on with vomiting, which is soon followed\\nby fever. As a rule the baby is in distress and pain for a few min-\\nutes to an hour or more before it vomits, and the pain often con-\\ntinues an hour, or longer, afterward. The pulse is quick and\\nusually the abdomen is full. It is not a severe affection and is\\nlikely to last but a few hours to a few days, unless it is neglected\\nand the intestines become affected.\\nTreatment. The treatment consists in regulating the baby s\\nfood, and o-ettinof rid of the irritating matter in the stomach.\\nFor a child over one year of age, scalded milk, barley water and\\nmilk, white of an egg in boiled water, or boiling milk poured over\\na cracker, then covered and allowed to steam for five or ten min-\\nutes, are proper foods. They should be given in small quantities\\nand not too often, and not at all if they excite vomiting. A\\nmother is sometimes distressed because her baby has not eaten\\na thing, or, has thrown up everything it has eaten all day.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0477.jp2"}, "476": {"fulltext": "45G DISEASES OF CHILDREN.\\nShe seems to be afraid it will starve but a moment s thought\\nshould quiet her fears. We have authentic records of persons liv-\\ning forty days without food, and many have gone a week without\\ntaking nourishment, and that, too, when they were already weak\\nfrom sickness. If, then, it is possible to go from one to six or\\nseven weeks without food, we may feel perfectly at ease when the\\nbaby goes without food from twelve to forty-eight hours. In-\\ndeed, one of the best treatments possible in stomach and bowel\\ndiseases of children is to have them s go a day or two without\\nfood. In regard to remedies, there are no specifics, that is, no\\nmedicines that will always cure, or that it is always best to give.\\nIf the child vomits freely and is relieved, no further treatment is\\nnecessary, but if it continues to strain and throw up sour or bad\\nsmelling matter, it is well to give it warm water, containing a lit-\\ntle soda and peppermint. To a half teaspoonful of soda, a tea-\\nspoonful of sugar, and from three to ten drops of essence of pep-\\npermint add a teacupful of warm water, and have the child take\\nall it can. This usually empties the stomach and quiets it after-\\nward. If the child vomits with great difficulty it is well to give\\na cathartic instead, such as a one-tenth grain calomel triturate\\nevery hour until ten have been taken, or one teaspoonful of Epsom\\nsalts in a half cup of warm, sweetened water, flavored with pepper-\\nVOMITING.\\nVomiting is of such frequent occurrence with children as to\\ndeserve a few words. It may be discussed under two forms: (i)\\nHarmless, and (2) Dangerous. Harmless vomiting is that which\\noccurs in healthy babies soon after eating, where they throw up\\nonly a little food, and that not very often. Dangerous vomiting\\nis that form which makes the child ill, and occurs at any time\\nafter feeding, the child throwing up all its food and continuing to\\ndo so for some time.\\nThe first form is so well recognized as harmless that there is\\na saying that a baby that throws up after nursing is a healthy\\none. It is very easy for a baby to vomit and, if the stomach\\nis overloaded, that usually makes it vomit, so when it gets too\\nmuch milk and throws part of it up, the baby is more apt to be\\nhealthy than if the stomach retained it and could not digest it;\\nbut if a child digests its food it is better for it not to vomit. It", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0478.jp2"}, "477": {"fulltext": "DISEASES OF CHILDREN. 457\\nis also better to give the child only such a quantity as it can digest,\\nthan to give it too much and let it vomit the excess.\\nIf the baby vomits persistently, loses flesh and appears sick,\\nit is in a dangerous condition, and must be treated. At such a\\ntime the flesh usually becomes flabby, the skin has a scurfy appear-\\nance, often the stomach is distended, the face is pinched, and,\\nunless the process can be arrested, the child eventually starves\\nto death.\\nTreatment. The treatment is very largely one of feeding,\\nalthough medicinal remedies are often helpful in arresting vomit-\\ning, and, at times, digestants are temporarily useful. To stop\\nthe vomiting and to help digest the food, Ingluvin has proven\\nvaluable one grain for a baby one year old, repeated every one to\\nthree hours. Very small doses of calomel are helpful one-\\ntwentieth of a grain every half hour for six or eight doses, then\\nonce every four hours, will relieve. Equal parts of lime water\\nand cinnamonwater have many advocates. To a child two years old\\nit should be given in teaspoonful doses. Small doses of Fowler s\\nsolution of arsenic not only control the vomiting, but are a good\\ntonic, as well one drop doses repeated every four hours for a\\nchild one year old.\\nIn regard to foods at this time, see the article on Infant\\nFeeding.\\nVomiting may be a symptom of a coming disease\\ni. When the pulse is quick, the stomach full, accompanied,\\nperhaps, by either diarrhea or constipation, it indicates indigestion.\\n2. If the vomiting comes on suddenly, and is followed in\\nan hour or so by fever, and the throat is red and sore, scarlet\\nfever is indicated.\\n3. If the vomiting is free without much straining or effort,\\nand the pulse is very slow, and at times irregular, and the abdo-\\nmen is retracted, and there is constipation, it is an indication of\\nbrain disease.\\n4. Vomiting attended by severe pain and retching, followed\\nby a collapsed condition, is an indication of intussusception, which\\nmeans that a portion of the intestine has slipped into another por-\\ntion of itself, stopping it up, just as part of a glove finger can be\\nslipped into another part.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0479.jp2"}, "478": {"fulltext": "458 DISEASES OF CHILDREN.\\nEVACUATIONS FROM THE BOWELS.\\nBefore taking up the intestinal diseases, we desire to say a\\nfew things as to the passages being indicative of certain diseases\\nand conditions. A healthy baby, less than a year old, nursing or\\nbeing fed upon milk only, should have from one to four evacu-\\nations in twenty-four hours, usually about four for the first two\\nmonths; three for the next two months; two per day between\\nthe ages of four and ten months; and after that one per day.\\nThere are many exceptions to this rule, even in healthy children,\\nbut every infant should have at least one evacuation each day.\\nThe feces of a healthy infant vary in color from a pale yellow\\nto an orange yellow; they are smooth and about the consistency\\nof cream sometimes being quite fluid, while at other times are\\nalmost stiff enough to keep form. Any decided variation\\nfrom this, either in color or consistency, is an indication of some\\ndiseased condition.\\nWhen little white lumps (curdled milk) appear, scattered\\nthrough the feces, and the latter are somewhat formed and are\\nlumpy and of a yellowish or brownish color, they indicate an ap-\\nproaching attack of indigestion.\\nIn catarrhal inflammation of the bowels the movements be-\\ncome frequent, and the feces have a green color, are partly wa-\\ntery, and partly formed and lumpy. Mucus resembling the white\\nof an gg is mixed through the feces, a result of the inflammation\\nin the mucous membrane.\\nIt has long been a subject of investigation and discussion\\nas to the cause of this green color. Some believe it is caused by\\nthe bile, some, that it is of bacterial origin, and others, that it is\\na chemical change and of no pathological importance. The fact\\nthat, sometimes, the color does not show much until after the\\npassage points toward a chemical origin, but, whatever the cause,\\nthe green is indicative of catarrhal inflammation.\\nIf the discharges are very watery and contain much mucus,\\nthey indicate that a large surface is affected. The green color\\nand slimy appearance are supposed by many to indicate a cold.\\nThis has arisen from the fact that a cold will often produce the\\ndisease, but, as other causes will also do this, it is better to re-\\ngard the trouble as catarrhal inflammation.\\nWhen blood appears in the stools, it indicates that the inflam-\\nmation has destroyed the mucous membrane and opened one or\\nmore small blood vessels.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0480.jp2"}, "479": {"fulltext": "DISEASES OF CHILDREN. 459\\nThere are several medicines, often given to babies, which\\nchange the color of the stools so decidedly as to alarm the mother,\\nunless she knows the cause. The two remedies most likely to do\\nthis are iron and bismuth. They cause black, or greenish black\\nstools which, as a rule, can easily be distinguished from the green\\nof catarrhal inflammation.\\nBlood appears more frequently in the feces of infants than in\\nthose of adults, but is not as dangerous, usually, as one would nat-\\nurally expect. It may appear as a bright red, which anyone\\nwould at once recognize as blood, or it may be black and in little\\nlumps, not appearing to be blood unless closely examined and\\nit may even require a microscope to decide that it is blood. If\\nthe blood is of a bright red, and covers or streaks the feces, rather\\nthan mixing intimately with them, it indicates that there is a\\ndiseased condition near the anus, in the rectum, or lower end of\\nthe large intestine. If the blood is black and has a coffee-grounds\\nappearance, the disease is probably in the small intestine, or even\\nin the stomach. A physician should be consulted if the blood per-\\nsists, but if it appears only once or twice no treatment is necessary.\\nAt times the feces have a very foul odor, as of decaying mat-\\nter. This is produced by the contents of the intestines fermenting\\nor decaying, and poisonous compounds are often thus produced\\nthat cause very serious diarrheal troubles, including cholera in-\\nfantum. One of the best ways of treating this condition is to give\\na one-tenth of a grain calomel triturate every half hour until from\\neight to twelve have been taken, then give sufficient salts\\n(Epsom, Glauber s or Rochelle) to produce a free movement\\nof the bowels, thus washing out the decaying matter. The baby\\nshould be given no food at all for from twelve to twenty-four\\nhours.\\nCOLIC.\\nColic is so frequent with children, less than three months of\\nage, that a separate description seems desirable. It is a painful\\ndisease of early infancy, the pain being produced by gas collecting\\nin the intestines or stomach. It is usually caused by -foods difficult\\nof digestion, and is often attended by fermentative changes in the\\nfood. As a rule, the attack comes on soon after the baby has taken\\nits food, but it may come at any time and may last from a few min-\\nutes to hours. The child frets, groans and twists for a little while,\\nthen opens its mouth and yells, as if in the greatest agony. The", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0481.jp2"}, "480": {"fulltext": "460 DISEASES OF CHILDREN.\\nabdomen is distended and firm the hands clinched the legs drawn\\nup and the whole body very rigid not continuously so, however,\\nfor at times the baby kicks and squirms. Often the attack termi-\\nnates by the belching up of a little gas from the stomach or the\\nescape of wind from the bowels, after which the baby seems per-\\nfectly well and smiles and coos as if nothing at all had happened.\\nSo often is this the case that parents are led to believe that the\\nbaby is only cross and ugly, and cries merely to secure attention\\nand be held or carried. Children undoubtedly do this sometimes,\\nbut their cries are then different more coaxing and less continu-\\nous, and not attended with such a rigid condition of the body.\\nTreatment. The treatment of colic is by no means an easy\\nor simple matter, although everybody has something to recom-\\nmend as a sure cure. Of course, the first indication for treatment\\nis the pain, but we must remember that relieving the pain is not\\ncuring the colic, for it will surely return unless the cause is re-\\nmoved. This most frequently is indigestion. The proper treat-\\nment, therefore, will not stop when the pain is relieved. We\\nshould find just what form of indigestion is troubling the child\\nand treat it accordingly. See article on Infant Feeding.\\nIf a food is given which agrees with the baby, the colic usually\\ndisappears. At times some digestive preparation is useful, such\\nas peptonzyme, elixir lactopeptin, etc. The thing the parents\\nmost want and the baby first needs, however, is something to stop\\nthe pain. A multitude of drugs have been used for this purpose,\\nbut not one of them is uniformly successful. A remedy that acts\\nlike a charm at one time, at another fails entirely, or works beauti-\\nfully with one child and not at all with another. It is necessary,\\ntherefore, to try different remedies. The carminatives or pain\\nsoothing medicines are the ones generally used. If peppermint\\nor catnip can be obtained, it should be tried first. Make a tea\\nof the green leaves, sweeten with a little sugar, and give it warm\\nin teaspoonful doses every twenty minutes until the child is re-\\nlieved. The oils of anise, cinnamon, cloves, peppermint, fennel\\nand valerian are all useful. They should be greatly diluted,\\nsweetened and given in the same way as the tea above mentioned.\\nAsafetida, chloroform, whisky and opium, in some form, are\\nsometimes used, but all except the first are such dangerous poi-\\nsons they should not be given to a baby unless ordered by a", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0482.jp2"}, "481": {"fulltext": "DISEASES OF CHILDREN. 461\\nphysician. In severe cases either of the following prescriptions\\nmay be used\\nSweet spirits of ether one dram\\nSulphate of magnesia one dram\\nOil of cajuput one drop\\nSyrup of tolu one-half ounce\\nLiquor carbonate of magnesia enough to make two ounces.\\nDose, one-half teaspoonful two to four times a day.\\nDeodorized tincture of opium twenty drops\\nOil of anise, cloves and wintergreen three drops each\\nTincture of asafetida one dram\\nCarbonate of magnesia one dram\\nPeppermint water enough to make four ounces.\\nDose, ten to twenty drops, repeated in half an hour, if nec-\\nessary,\\nCONSTIPATION.\\nThis is a very prevalent ailment among people of all ages,\\nbut less common in infants than in adults, yet it is very prevalent\\namong babies that are brought up on artificial food. Much can\\nbe done to correct the condition in adults by using suitable foods,\\nbut with the baby our bill of fare is limited, and other means must\\nbe employed. Constipation may exist, even though the bowels\\nmove once each day, and it often alternates with diarrhea. We\\nmay define constipation as that condition of the bowels which\\ncauses infrequent, irregular or abnormally hard stools. Of course,\\nif the bowels are loose we call the condition diarrhea, but if the\\nusual condition is a hard, infrequent stool, it may be that the con-\\nstipation has caused the diarrhea, in which case it is constipation,\\nnot diarrhea, that needs treatment.\\nConstipation may be caused by malformation of the rectum\\nor anus, and whenever it exists from birth these parts of the body\\nshould be examined by a competent physician. The anus may\\nbe too tight and have to be stretched a condition producing\\nsevere pain whenever the bowels move, even though the feces be\\ncomparativly soft. Pain is also produced when there is a fissure\\nor tear of the anus.\\nIn treating a baby for constipation, we should have a large\\nknowledge of means, as no one treatment is always effective. We\\ntherefore mention a number of plans, one or more of which may", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0483.jp2"}, "482": {"fulltext": "462 DISEASES OF CHILDREN.\\nbe tried at one time. Rubbing the bowels in a circular direction\\nfrom right to left, with or without some oily preparation, is some-\\ntimes effective. If the baby is thin, pure cod-liver oil is best,\\nbut if it is plump and healthy, lard, sweet oil or cocoa butter are\\nsuitable. A soap pencil, from two to three inches long and from\\none-fourth to one-third of an inch thick, dipped in warm water\\nor glycerin and inserted into the rectum and held there until the\\nchild begins to strain, is often effective. Wyeth Brothers of\\nPhiladelphia put up glycerin suppositories, similar in shape to the\\nsoap pencil and used in the same way, that are often better. An-\\nother plan is to mix one part of glycerin and three parts of water\\nand inject from two to four teaspoonfuls into the rectum; done\\nmost conveniently by using a small rubber syringe that will hold\\njust the required amount. Warm water or soapy water injections\\nare sometimes employed, but we doubt their value for everyday\\nuse, our observation being that they create necessity for their con-\\ntinuance instead of aiding in the cure of the constipation. Their\\noccasional use, however, is proper. These means of securing\\npassages are harmless and should be tried before resorting to\\nmedicines, and sometimes continued while medicine is being used.\\nIn the way of drugs we have obtained the best results from\\neither cascara aromatic, fifteen drops sodium phosphate, three to\\nfive grains syrup of senna, half a teaspoonful, or a pill, composed\\nof aloin, belladonna and strychnia, on sale at the drugstores. The\\nabove doses are for a baby one year old, and any one of them\\nshould be given at bedtime.\\nAfter the baby is a year old we may aid in the correction\\nof this difficulty by giving it certain foods. Oatmeal water, made\\nby boiling a heaping tablespoonful of oat flakes or meal in a\\nquart of water for two or more hours, adding water from time to\\ntime that there may be a quart at the end, should be strained and\\nadded to the baby s milk, equal parts of each. Scraped apples\\nare useful so is grape juice, or prune juice, or other fruit juices.\\nThe pulp and seeds should not be used.\\nINTESTINAL DISEASES.\\nIn medical works these diseases are described under a good\\nmany different names. To attempt an exhaustive description of\\nthem here would be to confuse rather than to help. I shall there-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0484.jp2"}, "483": {"fulltext": "DISEASES OF CHILDREN. 463\\nfore simplify by putting what I have to say under three heads (i)\\nDiarrheas. (2) Catarrhal inflammation of the intestines. (3)\\nCholera infantum.\\nDIARRHEA.\\nDiarrhea may be defined as being too frequent and too liquid\\ndischarges from the bowels. This condition may exist in a child\\nfor some time without producing any serious symptoms indeed,\\nI have seen infants who have not been free from it Ave days in\\nsuccession for three or four months, yet have not been in bed a\\nsingle day because of it. These, however, are exceptional cases.\\nThe rule is that whenever the discharges grow thin, watery and\\nfrequent, the child becomes weak, emaciated and sick.\\nThere is a distinct tendency toward a chronic condition in\\nthis disease, and it is very likely to take on severer forms unless\\npromptly checked. With this form there is little or no fever, very\\nlittle pain, and not very much weakness, the diarrhea being the\\nmost prominent symptom. The causes are hot weather, filth,\\nputrefaction, sudden barometric changes, overfeeding, improper\\nfeeding, teething and overexertion or excitement.\\nTreatment. The treatment is usually simple and quickly ef-\\nfective if used early in the attack. There are two things to do.\\nFirst: Empty the bowels of all irritating material. Second: Give\\nsome antiseptic and soothing medicine, which will stop fermenta-\\ntion and allay irritation.\\nPerhaps the best and quickest way to accomplish the former\\nobject is to give an even teaspoonful of Epsom or Glauber s salts\\nin one-third of a glass of sweetened water, to a baby from one to\\ntwo years old, and repeat every hour until the bowels move freely.\\nIf the child objects too vigorously to the salts, give, instead, a\\none-tenth grain calomel triturate every half-hour until a free move-\\nment is secured. Castor oil, rhubarb or senna may be used if\\npreferred. During the administration of the cathartic, and for\\nseveral hours after its action, it is advisable to give no food at all,\\nbut the child should be allowed all the cool water it wishes, unless\\nit causes vomiting:.\\nFor the second part of the treatment bismuth, either the sub-\\ncarbonate or subnitrate, stands at the head of the list, as a mild,\\nsoothing antiseptic for the bowels, and is usually sufficient. Sul-\\nphocarbolate of zinc or of soda are more recent drugs, and are", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0485.jp2"}, "484": {"fulltext": "464 DISEASES OF CHILDREN.\\nefficient, and euthymol, Hsterine or other similar preparations\\nare sometimes useful. For a week after an attack of diarrhea the\\ndiet of the child should be carefully regulated as to time of feed-\\ning and quantity and kinds of food. Sterilized milk is one of\\nthe best foods. Stale or toasted bread may be given babies over\\na year and a half old. Barley water and milk, white of eggs in\\nwater, beef juice, custard and blanche mange are all appropriate\\nfoods. Avoid fruits, vegetables, and too much sweet or starchy\\nfood.\\nCATARRHAL INFLAMMATION OF THE INTESTINES.\\nUnder this name we will describe those inflammatory condi-\\ntions of the intestines which occur so frequently during hot\\nweather, in infants from one to three years of age, and which are\\ncalled by many different names, as Summer Complaint, Gastro-\\nintestinal Infection, Entero-collitis, etc.\\nThis disease occurs most frequently in the most thickly in-\\nhabited portions of large cities, and amid filthy surroundings.\\nIt is most apt to attack children during their second summer,\\nbut may come at any time until the child has reached three or\\nfour years.\\nThe mucous lining of the intestines is the part involved, and\\nthe fact that it may be in any part of the intestinal tract and of\\nany degree of intensity, and is produced by a variety of causes,\\nhave led to the varied classification. Sometimes it is severe\\nenough to produce death, yet a postmortem examination may\\nshow very slight inflammation. At other times the inflamma-\\ntion may be so intense as to eat clear through the intestines. At\\nfirst the inflammation causes the cells of the mucous membrane\\nto become swollen, then softened, then destroyed, so that pieces\\nof the membrane sometimes slough off and are found in the stools.\\nThese pieces may be in shreds, and be mistaken for worms, or\\nthe whole inside coat of a portion of the intestine may come away\\nand look just as if a section of the entire intestine had come.\\nSometimes the symptoms are very severe, with much fever, brain\\ndisturbance and prostration, at other times the child does not\\nhave to go to bed; but, whatever the cause, and however much\\nthe manifestations may vary in intensity, the disease is an in-\\nflamed condition of the intestine.\\nPerhaps the most striking cause is hot weather, high av-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0486.jp2"}, "485": {"fulltext": "DISEASES OF CHILDREN. 465\\nerage heat for twenty-four hours. A high temperature for a few\\nhours, or a hot day followed by a cool night, does not seem to\\nbe as bad as continuous heat. It has been shown by statistics\\nthat by far the greatest average mortality from this disease occurs\\nduring the second and third weeks of July, and always during the\\nperiod of greatest heat. It has often- been regarded as a germ\\ndisease, but, while many kinds of bacilli are found in the feces,\\nno one variety has been shown to be always present or to produce\\nthe same disease in animals. That the disease chiefly occurs\\nunder conditions most favorable to the growth of germs, and, in\\ncertain forms, is quite similar in its course to other germ dis-\\neases, points strongly to a germ origin, but as yet we cannot\\ndemonstrate it.\\nA second cause is found in the age of the child, it being\\nmost common at two years or a little less probably because the\\nmembranes at this age are very tender and easily disturbed, and\\nbecause digestion is not yet thoroughly established.\\nA third cause is improper feeding. Most children having this\\ndisease are bottle-fed babies, and very frequently some improper\\nfood can be shown to have caused the attack. During hot\\nweather only a little food is needed, and that should be of a kind\\nthat is easily and quickly digested. The article on Infant Feed-\\ning shows the proper kinds of food and how they should be given.\\nDiarrhea and previous indigestion very often lead to this severer\\ndisease, for which reason no case of diarrhea or indigestion should\\nbe neglected. At times the passages, by their odor and by being\\nfull of little bubbles, show plainly that there is fermentation going\\non a frequent cause of the disease. Bacteria are particularly\\nnumerous in these cases, and doubtless play an important part in\\ntheir causation.\\nAlthough the symptoms of the disease vary considerably in\\nintensity and kind, diarrhea is always present, and usually there\\nis vomiting, fever and pain. A somewhat typical case is seen in\\na usually healthy baby that becomes cross and restless; it does\\nnot sleep as well as usual, wakes suddenly in the middle of its\\nday nap and begins to cry and twist refuses food, or perhaps takes\\nsome food and in a few minutes throws it up. This is usually\\nsour. We next notice that there is fever and the pulse is very\\nfast the palms of the hands and soles of the feet are hot and dry.\\nIn a time, varying from a few hours to twenty-four, the bowels\\n30", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0487.jp2"}, "486": {"fulltext": "466 DISEASES OF CHILDREN.\\nmove, and the passages are watery and smell either sour or foul.\\nThe abdomen is swollen and tense, and when tapped upon sounds\\ndrum-like, thus indicating that the intestines are full of gas.\\nUsually, too, there is much rumbling.\\nIf the case grows worse, the passages become quite frequent\\n(six to twenty in a day) and small in quantity; the child quickly\\nbecomes emaciated; the eyes, sunken; the muscles, flabby. If\\ndeath results, the end usually comes in one of two ways:\\nFirst. The child becomes drowsy, seems exhausted, is hard\\nto rouse; the hands and feet grow cold; the nose is cold; the\\nbreathing becomes slow, with a quick inspiration and a slow ex-\\npiration, and the child passes away quietly.\\nSecond. The child becomes very fretful, vomits often, cries\\nout with a piercing scream; the skin becomes very hot and dry;\\nthe head rolls from side to side the eyes become crossed convul-\\nsions come, and death relieves the little sufferer.\\nWhile most of the babies thus attacked recover, many die,\\nhence this should always be regarded as a serious disease, and\\nthe child should be attended to at once, even though at first it\\ndoes not seem very ill. The younger the baby, the more sudden\\nthe attack, the higher the fever, and the more numerous the\\nsymptoms of the graver disease. Relapses are very apt to occur,\\nand where a baby is attacked early in the summer it will require\\ncareful attention until fall, although it may not be sick all the\\ntime.\\nThe disease may prove fatal in a few days, or it may continue\\nfor months, and even then end in recovery. No case should be\\ngiven up to die. We must work as long as life lasts, for a child\\nsometimes recovers when it seems as if it must die.\\nTreatment. Before describing the medical treatment, it is\\ndesirable to speak of the general care of the baby, for its recovery\\ndepends upon that quite as much as upon the medicine it gets.\\nIf the mother is a competent nurse she should devote herself to\\nthe child and have as little other care as possible. If she is not a\\nskillful nurse (many most excellent mothers are not) she should\\neet someone who is able to care for it. A trained nurse is the best\\nhelp, but if one cannot be obtained, an efficient woman can usually\\nbe found.\\nRemembering that heat is a cause of the disease, we should\\ndo all we can to keep the little sufferer cool. When it can be", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0488.jp2"}, "487": {"fulltext": "DISEASES OF CHILDREN. 467\\nafforded, the baby should be taken to the seashore or mountains\\nbut, unfortunately, this cannot often be done, and many times\\nwe have to do the best we can with very limited means. Some-\\ntimes it can be taken into the country for a few days. In some\\ncities the public park offers a place that is cooler than the home.\\nIf no such resort is accessible, the coolest room in the home should\\nbe selected and made as comfortable as possible. Wet towels,\\nhung in front of the windows where the draught will cause rapid\\nevaporation, will help. Sometimes a large shade tree in the\\nyard offers a cool place, and at times the gentle swing of a ham-\\nmock is a real comfort. In many homes electric fans can be used\\nto advantage. We can mention here only a few ways, but hope\\nthat these may lead parents and friends to devise others.\\nWhen there is fever, the bath is often the best means of\\nrelief. The baby can be put in a tub of warm (99 degrees) water,\\nthen cool water be added until the temperature is about 75 de-\\ngrees or 80 degrees. If the child does not enjoy this, it can be\\nsponged with cool (85 degrees to 90 degrees) water, or a cloth\\nwrung out of cold (60 degrees) water can be placed over the\\nforehead and crown of the head, and frequently changed. The\\nclothing should be very light and simple. A flannel or silk band,\\na dress of thin flannel or woolen goods, and diapers of some soft\\nmaterial, are usually enough.\\nThe baby generally craves cold water, and should get it often.\\nLet the water be boiled for thirty minutes and aerated, and one\\nor two tablespoonfuls given at a time. The water replaces that\\ndrained from the tissues by the diarrhea, and helps to control the\\nfever. Sometimes the stomach is so irritable that even water\\ncannot be retained; in which case the white of an tgg may be\\nmixed with a pint of boiled water, and a teaspoonful given every\\nfive or ten minutes. If this is not retained, wait from one to four\\nhours, then try again. If it still vomits, an injection of salt water,\\na teaspoonful to the quart, should be used, and the buttocks held\\ntogether to retain it as long as possible.\\nThe food of the baby is very important, and the article on\\nInfant Feeding should be consulted. If the milk comes through\\ncurdled and foul-smelling, and the baby is cross and feverish., the\\nmilk should be withheld from twenty-four to forty-eight hours,\\nand beet juice, Bovenine, white of eggs or Panopepton given\\nin its place. If they do not agree grape juice or blackberry juice", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0489.jp2"}, "488": {"fulltext": "46S DISEASES OF CHILDREN.\\nmay be tried. At times it is well to give nothing; the tendency\\nin hot weather is to overfeed. The baby often cries as if hun-\\ngry, when only thirsty. When we return to the milk, we should\\ngive it in a diluted form and very gradually restore the normal\\namount of food.\\nMedical treatment has four things to do: (i) Clear the\\nbowels of irritating matter. (2) Stop decomposition. (3) Re-\\nstore the normal action of the bow r els. (4) Heal the inflamed\\nmucous membrane.\\n(1.) A brisk, quick cathartic is the best means of washing\\nout the bowels. Epsom, Glauber s or Rochelle salts are ex-\\ncellent, because of their speedy action and the watery passages\\nthey produce. They are particularly indicated early in the attack.\\nIf the diarrhea has lasted a day or more, one-tenth grain calomel\\ntriturates are better, and should be given every half-hour until\\nsix or eight are taken by a child one year old. If they do not pro-\\nduce free action of the bowels, salts should be given after the\\ncalomel has been taken. Castor oil is efficient aromatic syrup of\\nrhubarb is also good.\\n(2.) We stop decomposition by the means of antiseptic medi-\\ncines. There have been so many kinds tried that we will not\\nattempt to name them, but will mention a few that have been well\\nproven: Subnitrate of bismuth stands at the head, and should\\nbe given in one to five grain doses to a child one year old. Sul-\\nphocarbolate of zinc or of sodium is now largely used, either\\nalone or combined. I use the sodium when there is much fer-\\nmentation, but the zinc when the passages incline to be serous\\nin character. The dose for a year-old baby is one-half to one\\ngrain of the zinc salt, or one to three grains of the sodium. Ar-\\nsenite of copper in very small doses (one five-hundredth of a\\ngrain) is quite useful where the nervous symptoms prevail. Boro-\\nlyptol, listerine and euthymol are useful subgallate of bismuth,\\nsalol and resorcin are also employed.\\n(3.) Diarrheal diseases weaken a child very rapidly, and are\\nlikely to leave the digestive organs in a weakened condition, hence\\nthe food should be very carefully regulated for at least a week\\nafter an attack, and it is usually desirable to give a tonic and\\ndigestive preparation for a while to restore the normal condition.\\nAs a tonic, some preparation of iron, strychnia or arsenic is de-\\nsirable, either in combination or separately. Hypophosphites are", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0490.jp2"}, "489": {"fulltext": "DISEASES OF CHILDREN. 469\\ngood arsenite of iron or strychnia is also useful. Pepsin and pan-\\ncreatin, in any of the many good preparations, are to be used\\nwhen the food is not digested. Peptonzyme is largely used, also\\nlactopeptine.\\n(4.) When the disease has been severe or long continued,\\nulcers or patches denuded of mucous membrane are sometimes\\nproduced and require attention. A whitewash composed of\\nthin starch water and bismuth subnitrate, is very useful, employed\\nas an injection. Of course, injections can reach only places in\\nthe large intestine for those in the small intestine medicines\\nthrough the mouth must be used, subnitrate of bismuth being one\\ncf the best. The buttocks of the baby sometimes become in-\\nflamed from irritating discharges, for which oxide of zinc oint-\\nment, benzoated, is one of the best applications, except in a few\\ncases, when a dry preparation is better. Powdered boric acid\\nor bismuth subgallate are excellent, either alone or mixed with\\nan equal quantity of corn starch or powdered talc.\\nCHOLERA INFANTUM.\\nCholera infantum is one of the most fatal, and, therefore, one\\nof the most dreaded of children s diseases. It comes during the\\nhot months of summer, particularly when the mean temperature\\nfor the twenty-four hours is above 70 degrees, and is caused\\nby a poison which is developed in milk, and probably is the\\nptomain, tyrotoxicon, discovered by Dr. Vaughn of Ann Arbor.\\nHis experiments show that it is especially likely to appear in milk\\nthat is put into cans while warm, then closed and allowed to\\nstand in a warm place. It has been found in cheese, as well as in\\nmilk, though infrequently. When this tyrotoxicon is given to\\nanimals they have symptoms very much like the child that has\\ncholera infantum.\\nSymptoms. Attacks of cholera infantum always come sud-\\ndenly and with great severity, even when preceded by a diarrheal\\ndifficulty. A healthy child, suddenly and without any warning,\\nmay come down with cholera infantum, or in an unhealthy one,\\nwho has but recently recovered from a diarrhea, or is still suffering\\nwith it, an attack of cholera infantum may suddenly develop, either\\nin addition to, or taking the place of the other disease. Purging\\nsuddenly begins, and the feces become watery and cf a musty\\nodor, and although at times at the beginning of the attack the odor\\nmay be very foul, its characteristic smell is musty.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0491.jp2"}, "490": {"fulltext": "470 DISEASES OF C HIED REN.\\nAlong with the purging comes severe vomiting, the vomiting\\nusually accompanying each movement of the bowels. The stools\\nat first are copious, but as the disease progresses and the child\\ngrows weaker they become less in quantity. The frequency of\\nthe bowel movements is so great as to be very indicative of the\\ndisease they sometimes reach as many as thirty or forty in twenty-\\nfour hours, and for a while may occur every few minutes. The\\nvomiting is severe and nausea is almost continuous. If at the be-\\nginning of the attack there is food or mucus in the stomach it is\\nfirst vomited, then a serous watery material is thrown out, after\\nwhich there may be retching and vigorous attempts at vomiting\\nwithout results. Food and water only increase the vomiting and\\nnausea, and although thirst is intense ail through the disease we\\ncannot give the baby drink because that increases the vomiting.\\nSo much serous matter is vomited and thrown of! by the\\nbowels as to produce great prostration, and emaciation progresses\\nat a fearful rate. A baby, fat and healthy one day, may become\\nso emaciated the next that its skin becomes wrinkled and its\\nmuscles flabby. The most frequent cause of death is exhaustion,\\ndue to this terrible waste. At first the child is irritable and throws\\nitself about, but gradually goes into a comatose condition from\\nwhich it rarely recovers.\\nThe nervous symptoms are usually marked and convulsions\\nare not infrequent. The eyes become sunken and have the vacant\\nstare so characteristic of brain disease. Often the baby rolls its\\nmead from side to side with a jerky, uncertain movement, and in-\\nterrupts its fretful, peevish cry with a piercing scream.\\nThe temperature is almost always high, ranging from 103\\ndegrees to 107 degrees per rectum, but at the same time the face,\\nhands and feet, and sometimes even the body, may feel cool. This\\nmeans that the surface temperature may be sub-normal (below\\n98.6 degrees), while the rectal temperature is 103 degrees or more.\\nSuch are the symptoms of this dread disease, and while they\\nmay not all exist in a typical form in every case, there are usually\\nenough of them to make the diagnosis easy and positive.\\nTreatment. First and best of all is preventive treatment. It\\nmay be set down as a fact that the baby will not have cholera in-\\nfantum unless it be given infected milk. Some physicians believe\\nthat it has been taken from milk left on the mother s nipple after\\nnursing, which, having become infected, evaporates, leaving its", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0492.jp2"}, "491": {"fulltext": "DISEASES OF CHILDREN. 471\\ninfectious poison to be taken into the mouth of the child at the\\nnext nursing. It. is also believed that a child, by sucking its own\\nfingers, may get this poison, developed by milk, with which they\\nhave been wet, becoming infected. Such a thing is certainly pos-\\nsible, but, in our opinion, exceedingly rare.\\nThe most frequent source of infection is found in milk im-\\nproperly cared for in some stage of its transition from the cow to\\nthe baby, hence, the importance of intelligent preventive treat-\\nment. Milk, as it comes from the cow, is practically sterile, and\\nif we can keep it so until the baby gets it there will be no cholera\\ninfantum, and very much less summer complaint.\\nThe important factors in keeping milk sterile are these: (i)\\nMake the time from cow to baby as short as possible. (2) Cool\\nthe milk quickly and keep it cool, unless it can be fed immediately\\nafter the milking. (3) Thoroughly boil all vessels used for the\\nmilk. (4) Keep the milk in a clean place, as well while at the stable\\nas while in the ice chest. (5) Sterilize the milk in all cases of\\ndoubt, by keeping it for thirty minutes at about 165 degrees\\nFahrenheit.\\nTreatment of the Attack. The first thing is to get rid of the\\npoison. As it comes from milk, we should give the child no milk\\nduring the attack, and in some cases it should be withheld for a\\nmonth afterward. Beef juice, albumen water and broths are the\\nbest substitutes. If the disease is detected early in the attack, an\\nactive cathartic should be given, consisting of six or eight one-\\ntenth of a grain calomel triturates given a half hour apart to a\\nchild a year old, or a teaspoonful of castor oil, either of which is\\nto be followed two hours later by a teaspoonful of Epsom or\\nGlauber s salts, the latter being preferable.\\nIf the bowels have been moving very frequently and the de-\\njections had the musty smell and serous character, the cathartic\\nshould not be given, but the bowels should be washed out with\\nan antiseptic injection, such as two teaspoonfuls of borolyptol or\\neuthymol or bismuth in a pint of sterilized water, and this should\\nbe clone every two to four hours.\\nFor the exhaustion stimulants are necessary and small doses\\nof brandy, repeated every thirty minutes to an hour, are recom-\\nmended by many authors, but my temperance convictions lead\\nme to substitute in its stead, strychnia one two-hundredth of a\\ngrain of strychnia sulphate, given a baby one year old, every half", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0493.jp2"}, "492": {"fulltext": "472 DISEASES OF CHILDREN.\\nhour, being of greatest value. The hot pack or bath, with or with-\\nout mustard, is helpful in bringing the blood to the surface and\\nthereby lessening the internal congestion. Digitalis is also used,\\nand at times a hypodermic injection of morphia and atropia is\\nuseful in controlling the vomiting, and copper arsenates and car-\\nbolic acid are used sometimes with benefit, but the frequent irriga-\\ntion of the rectum with some antiseptic wash, as recommended\\nabove, is perhaps the best treatment. The child needs careful\\nwatching as to food and exercise for weeks after the acute attack,\\nand milk should not again be given it until it has regained its\\nstrength, or at least until its digestion has become good.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0494.jp2"}, "493": {"fulltext": "CHAPTER IV.\\nSCARLET FEVER.\\nScarlet fever is a germ disease and a very contagious one.\\nNot only will the patient give it from the time of its first appear-\\nance until the scaling period is past and he has been washed in a\\ndisinfectant, but all articles handled by him, such as furniture,\\nbooks and toys, are likely to become mediums of contagion. It\\nhas often been carried by letters hundreds of miles. Infected\\nclothing is a frequent means of spreading the disease and retains\\nthe virus a very long time. Hildebrand contracted scarlet fever\\nfrom a cloak that had been put away after exposure, eighteen\\nmonths before, and a case is reported in which the source of con-\\ntagion was traced to an infected picture book that had been packed\\naway in a trunk for twenty-six years.\\nIt may be taken at any time, but is most frequent in children\\nfrom eighteen months to six years of age. The older a person\\ngrows the less likely is he to contract this disease, or to suffer\\nseriously in case he does take it. Children with fresh wounds and\\nwomen just after delivery are especially liable to scarlet fever.\\nWhen patients have fully recovered the cases of recurrence are\\nrare.\\nThe onset is sudden and occurs from two to eight days after\\nexposure.\\nThe first symptoms are chilliness, fever, sore throat, lassitude,\\nheadache, coated tongue, nausea, vomiting, delirium and in small\\nchildren sometimes convulsions. Sore throat is usually, if not\\nalways, present and often is the first symptom noticed in adults.\\nThe rash appears the second day and consists of bright scarlet red\\ndots or points, in countless numbers, at first separate and distinct,\\nbut soon running together and covering the entire surface, except\\nthe nose and lips, which, from contrast with the rest of the face,\\npresent a strangely pallid appearance. It is first seen upon the\\nsides of the neck, then upon the chest and abdomen and later upon\\nthe extremities and face, attains its maximum in two or three days\\n473", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0495.jp2"}, "494": {"fulltext": "474 DISEASES OF CHILDREN.\\nand remains stationary from twenty-four to thirty-six hours, then\\ngradually subsides. The color disappears under slight pressure.\\nWhen the finger-nail is drawn over the surface a white streak\\nappears, which soon resumes the same hue as before.\\nThere is usually very high fever, the temperature often reach-\\ning J 05 degrees the first day, going a little higher the next, then\\nremaining high every day until the eruption fades away, when\\nthe fever also begins to subside. The scaling or peeling begins\\nfrom three to five days later and generally continues from four to\\nfive weeks, not often less than two or more than eight weeks, dur-\\ning which period the fever all disappears and the tonsils resume\\ntheir normal size.\\nSore throat is at times the most serious feature of the disease\\nand should always receive careful attention. The mucous mem-\\nbrane of the soft palate, uvula and pillars of the fauces are red-\\ndened and swollen, the redness often extending forward over the\\ninner surface of the mouth. The tonsils may also be swollen and\\ntheir follicles distended by a reddish white exudate, which some-\\ntimes passes over the surface, forming a false membrane. In\\nmoderately severe cases there may be ulceration and even slight\\ngangrene, while in others an abscess may form in the tonsil itself.\\nMeasles may be distinguished from scarlet fever by the milder\\ncharacter of the symptoms in the former disease and the longer\\ntime between the exposure and their first appearance. In measles\\nthere are more catarrhal symptoms and likely to be more cough,\\nbut not as high temperature, and the rash is papular in character,\\nwhile that of scarlet fever is punctate. The membrane which ap-\\npears on the throat in scarlet fever is distinct in character from\\nthat of other diseases, and less amenable to treatment than that of\\ndiphtheria, which may either accompany or follow scarlet fever,\\nfor not one of the contagious diseases is any protection against\\nthe others or renders the patient at all immune, but rather in-\\ncreases his liability to contract them if exposed either during his\\nillness or while convalescent.\\nTreatment. The patient should be kept in a large, well ven-\\ntilated room, with a south exposure, in the upper story of the\\nhouse. One of the windows should be constantly open at the top\\nand bottom, and if the weather permits an open fire should be\\nkept burning. The temperature should remain as near 70 degrees\\nas possible and the room should be very clean. From it should be", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0496.jp2"}, "495": {"fulltext": "iinMriiiTmn Tii", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0497.jp2"}, "496": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0498.jp2"}, "497": {"fulltext": "DISEASES OF CHILDREN. 475\\nmoved all carpets, curtains, upholstered furniture and porous\\nmaterials, and a sheet saturated in a disinfectant should he hung\\nover the outside of the door. Only those really needed to care\\nfor the patient should enter it. The bed linen should be changed\\noften, and cleanliness, both of person and surroundings, carefully\\nmaintained. All the sputa and dejections should be immediately\\nand thoroughly disinfected. (See Department on Disinfectants.)\\nThe first thing to be done, when the patient is taken ill, is to\\ngive him a bath at about 88 degrees, lasting fifteen or twenty\\nminutes, during which soap should be freely used over the entire\\nbody, and the skin well cleaned. If there is high fever, sponge the\\nbody with tepid water every ten or fifteen minutes, continuing\\nuntil the temperature is reduced from one to two degrees or give\\nfrom one to two and a half grains of phenacetin every four hours to\\nsecure reduction of temperature and moisture of skin, and to\\nquiet the patient. Tincture of aconite root, from one-sixth to\\none-half drop, may be used instead. If profuse sweating follows,\\nreduce the dose or discontinue it. A warm bath should be given\\neach day, after which anoint the skin with carbolized vaseline\\ncontaining two per cent of tartaric acid.\\nWhere there are bad throat symptoms, spray the throat with\\nperoxide of hydrogen and follow with the almond oil mixture, as\\nper directions in the treatment of diphtheria. Hot water may\\nbe used as a gargle a listerine solution, one part of listerine to\\nseven of water, may also be used in the same way, and a half tea-\\nspoonful swallowed once an hour to disinfect the throat.\\nAbscesses of the tonsil should be lanced. Indeed, this should be\\nthe prompt treatment of an abscess appearing anywhere during\\nthis disease, as delay often results very seriously.\\nIf catarrhal symptoms appear in the nose, a pint of warm\\nwater, containing as many boric acid crystals as the water will\\ndissolve, while cool, should be run into one nostril and allowed to\\npass out through the other. In doing this use a fountain syringe\\nand very mild pressure, elevating the bag only just enough to al-\\nlow the water to run through easily and thus avoiding the danger\\nto the ears, which arises with much pressure, having first cautioned\\nthe patient against trying to swallow.\\nObstinate vomiting at the beginning indicates a grave form\\nof the disease, and is best controlled by hydrate of chloral, five\\nto ten grains in an ounce of water. If the stomach refuses to", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0499.jp2"}, "498": {"fulltext": "476 DISEASES OF CHILDREN.\\nretain it, give the same amount by injection every three hours un-\\ntil the symptom is controlled.\\nFor convulsions give one grain of hydrate of chloral every\\nhour. If there is scant urine, give from one to five grains of bro-\\nmide of potassium every four hours to act upon the kidneys.\\nSponging with warm water is of great value in cases of continuous\\nhigh fever. Warm water applied to the head is often excellent,\\nboth to relieve delirium and to induce sleep.\\nThe ears should be closely watched, and in case of a dis-\\norder there, they should be washed out with water as warm as\\ncan be borne, after which, if there be any discharge, they should\\nbe filled with powdered boric acid. Should the discharge become\\nchronic, it is best treated with dilute sulphuric acid and quinine.\\nThe same is true of chronic discharges from the nose.\\nIn case of very scant urine, the food should consist entirely\\nof milk, but, if the stomach will not tolerate it, soft poached eggs\\nmay be eaten. This to guard against the development of Bright s\\ndisease. (See Nephritis.)\\nOnly in cases of exhaustion should stimulants be given.\\nStrong coffee is one of the most highly recommended for such\\noccasions, but brandy may be used instead.\\nIt should be more generally understood that scarletina and\\nscarlet fever are one and the same thing, and that, however mild\\nthe attack, the patient is liable to all the sequelae of the disease\\nand that the contagion he imparts may, in the next case, assume\\nthe most virulent form.\\nThe patient should remain in bed three weeks, and should\\nstay in his room three more even then he will not have passed\\nall danger from the ills that follow scarlet fever. He should ab-\\nstain from meat and live chiefly upon milk for a month after re-\\ncovery, as a precaution against kidney disease, and not until he\\nhas had three or four warm baths in which carbolic soap, or some\\nother good antiseptic soap, is freely used, and has been dressed\\nin clothing free from infection, should he be permitted to resume\\nhis place with the rest of the family. All bedding and clothing\\nthat have been used about him should be boiled thirty minutes,\\nand his room must be most thoroughly disinfected.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0500.jp2"}, "499": {"fulltext": "DISEASES OE C El I ED REX. 477\\nMEASLES.\\nMeasles is an acute, infectious disease characterized by a\\npapular eruption. It is due to a germ, and mostly occurs in epi-\\ndemics. It may come on so slowly as to make it impossible to\\ndetermine the first day of attack, but is likely to come suddenly.\\nSymptoms. Usually in nine or ten days after exposure, ca-\\ntarrhal symptoms begin, a watery fluid runs from the nose, the\\neyes begin to water, the child rubs them and they become inflamed,\\nred and sensitive to light. These symptoms gradually grow\\nAvorse until about the third or fourth day, when small spots, vary-\\ning in size from a pinhead to a navy bean, begin to appear on\\nthe face, and in about twenty-four hours are scattered over the\\nwhole body. During the catarrhal symptoms there is very little\\nif any fever, but as soon as the spots commence to show the\\ntemperature begins to rise, and continues to increase until the\\nrash reaches its height; the fever then remains about the same\\nfor twenty-four to thirty-six hours, after which it gradually\\ndeclines lasting from three to six days.\\nThe eruption is generally of a brick-red color, sometimes\\nbluish red, but never scarlet. It is first seen on the forehead and\\nchin, then spreads over the face and the entire body, giving it\\na rough feeling to the hand, and reaches its height in about twenty-\\nfour hours. As this rash peels orY the other symptoms decline,\\nexcepting the cough, which is likely to continue harsh and dry\\nuntil the rash disappears, and may last several weeks. Usually\\nthe time from the attack to full recovery is about two weeks.\\nMeasles alone is not a fatal disease, but it is liable to various ac-\\ncompaniments, which may lead to very dangerous complications,\\nthe most serious of which are bronchitis and broncho-pneumonia.\\nTreatment. There is no way after exposure to prevent or\\nabort measles. It will run its course. The treatment should be\\nmild and guard against the appearance of other diseases. Great\\ncare should be used to prevent the patient from taking cold. He\\nmust be kept out of damp, cold air and all draughts. To a child\\nfive years old give two grains of muriate of ammonia every three\\nhours, and, if the eruption is slow to appear, he may be put in\\na warm bath containing one tablespoonful of mustard to each\\ntwo gallons of water. Let him drink freely of cold water, since\\nit not only slakes thirst but reacts upon the skin. Warm drinks,\\nsuch as sage and catnip tea, are also good to assist in bringing\\nout the rash.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0501.jp2"}, "500": {"fulltext": "478 DISEASES OF CHILDREN.\\nKeep the bowels open by mild remedies, such as Castoria,\\nor tea made from senna, or, for a child of five years, a teaspoonful\\nof Glauber s or Epsom salts, every four hours until the bowels\\nmove freely. It should be remembered that in this disease the\\nbowels are easily influenced and that care should therefore be\\ntaken in the use of medicines. In case of diarrhea give from\\nthree to five grains of subnitrate of bismuth every four hours.\\nThe eyes should not be used much, and if light irritates them\\nthe room should be darkened.\\nIf the symptoms are grave and indicate bronchitis or pneu-\\nmonia, give from one to three grains of carbonate of ammonia\\nin a teaspoonful of syrup of tolu every two hours, or, if the\\ncase is less urgent, once in four hours. Moderately strong tea\\nmade from thoroughwort or boneset, well, sweetened and hot,\\ntaken in large draughts, then covering the patient warmly to\\ninduce perspiration, is excellent in this complication, but it is\\nhard to get small children to drink it.\\nBroncho-pneumonia begins as ordinary bronchitis and grows\\nin severity; a snoring noise is made in breathing which increases\\nin pitch and becomes a dry, ringing sound, as the disease advances;\\nthe fever is usually high and breathing difficult. Broncho-pneu-\\nmonia is also contagious in its early stages, hence the patient\\nshould be separated immediately from the rest of the family, even\\nif the others have already had measles. As a preventive measure\\nand to protect the patient from secondary infection, Dr. Comby\\nof Paris recommends spraying, the mouth, throat and nose with\\na four per cent solution of boric acid once in six hours, and\\nwith the same kind of solution washing the genitals, anus and all\\nparts of the body soiled by the dejections, every morning and\\nevening. We will add that this is an excellent disinfectant, too,\\nfor measles, and that its use from the first is a wise precaution.\\nThe treatment includes anointing the pharynx and nostrils by\\ninserting in them wads of absorbent cotton, covered with borated\\nvaseline. This germ is short-lived and broncho-pneumonia is\\ncontagious during only the first two to four days after its appear-\\nance. Death from this malady may either occur soon or several\\nmonths after recovery from measles.\\nAs already stated, measles runs its course in two weeks, but\\nfrom bad hygiene, previously weak and run-down condition of\\nthe system, or from the presence of tuberculosis, syphilis or other", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0502.jp2"}, "501": {"fulltext": "DISEASES OF CHILDREN. 479\\nspecific taint, the recovery may be very much delayed and\\nserious results ensue.\\nThroughout this disease, milk, soups and soft eggs are the\\nbest diet.\\nOn the return to health precautions must be taken against\\ncatching cold, and warm flannels should be worn next the skin,\\nfor deafness, chronic bronchitis, enlargement of the tonsils and\\nmany other disorders are liable to follow even slight exposure\\nat this time.\\nBLACK MEASLES.\\nThis disease is only common measles in a very aggravated\\nform. The malignancy is caused by previous poor health, or a\\ndepraved condition of the system. The blackish or purplish color\\nassumed by the rash in this kind of measles is due to venous\\nbiood collecting in the capillaries near the surface of the skin,\\nand shows that the blood is in an impure and sluggish condition.\\nROTHELN.\\n(German Measles.)\\nRotheln is a specific, eruptive, highly infectious disease, in\\nmany points resembling both measles and scarlet fever, but with\\nqualities quite apart from those diseases, besides differing from\\nthem in incubation, invasion and eruption. Its period of incu-\\nbation varies from five to twenty-two days, and the time from\\nthe first symptoms to the height of the rash is from one to three\\ndays. The rash presents two principal forms, of which one resem-\\nbles measles, the other, scarlet fever. In either form it is likely\\nto leave one part of the body at the same time that it develops\\nin some other part, and although it may disappear entirely in a\\nday or two, it may remain four or five days.\\nThere is catarrh as in measles, but in measles the rash is longer\\nin reaching its height. In measles there is not much sore throat,\\nand no enlargement of the glands of the neck; but in rotheln\\nenlargement of these glands is the most prominent symptom, and\\nthere is also soreness and stiffness felt in moving the head. The\\nsore throat in rotheln resembles that of scarlet fever, but in\\nscarlet fever the constitutional symptoms are more severe, the\\nrash is more diffuse, and the tongue presents a peculiar straw-\\nberry appearance. As in measles, the germ is short lived and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0503.jp2"}, "502": {"fulltext": "480 DISEASES OF C HIED REN.\\nwhen the patient recovers he is no longer a source of danger to\\nhis neighbors. Neither disease is any protection against the\\nother.\\nTreatment. The same as for measles.\\nVARICELLA.\\n(Chicken-pox.)\\nThis was formerly supposed by many to be a modified form\\nof small-pox, but it is now positively known to be a distinct dis-\\nease due to a specific germ, which, like small-pox, may be trans-\\nmitted either with or without direct contact. It is a very mild\\ndisease, usually comes in epidemics, and never attacks one the\\nsecond time. It is usually seen in children only, but now and\\nthen occurs in young or adult women.\\nThe eruption is likely to appear in from ten to four-\\nteen days, but may appear as late as eighteen days\\nafter exposure, and usually is the first symptom, but,\\noccasionally, there are slight fever, headache and lassitude,\\nand it may be a little cough, for twelve to thirty-six\\nhours previously. At first the spots are few, and usually upon\\nthe body, especially about the shoulders and chest, but sometimes\\nthe eruption is abundant. It extends, as the disease progresses,\\nto the limbs, face and scalp, and is likely to become quite copious\\nupon the latter. The spots are likely to be separate, but occa-\\nsionally become confluent to the extent of several uniting in one.\\nFor five or six nights fresh crops appear, so that the eruption be-\\ncomes abundant and vesicles are present in all stages of maturity\\nat the same time, in marked contrast to those of small-pox, which\\nall mature at once; neither are they depressed in the center like\\nthose of small-pox, and when mature, if punctured, collapse com-\\npletely. In some cases they are said to cause the skin to look\\nas though it had been sprinkled with hot water. Sometimes the\\nsuccessive crops of vesicles continue to appear for ten or twelve\\ndays. Each vesicle either ruptures or dries up on the third to\\nfifth day, the thin, crumbly scab rubbing off in particles, but\\noccasionally a thick, tough crust is formed. Sometimes, but not\\noften, distinct round or elliptical pits are left. A good deal of\\nunpleasant itching is likely to be about the only disagreeable sen-\\nsation.\\nTreatment. The disease of itself is never fatal, and the only", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0504.jp2"}, "503": {"fulltext": "DISEASES OF CHILDREN. 481\\ntreatment required is to keep the patient quiet, to restrict the diet\\nto a few mild, easily digested articles of food, and to keep the\\nbowels open. If there is fever it may be controlled, and the\\ncomfort of the patient promoted by a tepid sponge bath, repeated\\nas often as may be required. All scratching should be restrained.\\nIf catarrh is present it should be treated. If the bronchial tubes\\nbecome extensively affected the condition may be rendered dan-\\ngerous, and an unsatisfactory state of health may cling to the\\npatient for some time following an attack of varicella.\\nPAROTIDITIS.\\n(Mumps.)\\nMumps is an acute, specific, infectious, self-limited disease\\nof the glands of the neck known as the parotid glands, and some-\\ntimes of the testicles, breasts and vulva, and, rarely, of the\\novaries. It is more common in boys than girls, and usually\\noccurs between the ages of five and fifteen years, but sometimes\\nattacks adults. Very young children are usually exempt. A\\nperson seldom has it more than once. It usually occurs in epi-\\ndemics, and in the spring or fall.\\nThe patient is attacked in from one to three weeks from\\nthe time of exposure. The first symptom is likely to be fever\\nand general malaise, lasting from one to three days before the neck\\nbegins to swell and become tender, but sometimes the fever and\\nswelling come at the same time. The swelling commences just\\nbelow the lobe of the ear and back of the angle of the jaw, and\\nextends in all directions, gradually increasing for two or three days\\nuntil the neck and cheek are greatly disfigured. There is not\\nlikely to be much pain, but more or less uneasiness and a sense of\\ntightness, which is increased by opening the mouth, chewing or\\nswallowing; and it becomes difficult to speak or take food. About\\nthe fifth or sixth clay the swelling begins to subside, and in two or\\nthree days more disappears but as one side recovers the other\\nis likely to become affected. In some cases both sides are attacked\\nat the same time. A mild fever is usually present throughout\\nthe attack, but sometimes subsides when the swelling begins.\\nThe swelling may become very tense and hard, but it is quite\\nrare that any pus forms. The hardness may last for some time,\\nand gradually passes away.\\nIn about one-third of the cases of mumps, in boys at puberty,\\n31", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0505.jp2"}, "504": {"fulltext": "482 DISEASES OF CHILDREN.\\nless often in those younger, one or both testicles are attacked;\\nand more rarely in girls the breasts and vulva, and sometimes the\\novaries, are affected. An inflammation in these glands is not\\nalways present with mumps, and, when it is, usually appears in\\nthem later than in the parotids; it was long thought to be due\\nto metastasis, which means leaving one part of the body to appear\\nin another. The most recent investigators regard this theory\\nas wholly insufficient to explain the fact, and with a better show\\nof reason maintain that when these glands suffer it is because\\nof their infection with the same germs that attack the glands of\\nthe neck and that, although they are usually attacked later than\\nthe parotids, they are often attacked at the same time, in some\\ncases are attacked first, and that there are cases in which in-\\nflammation of the testicles is the only manifestation of mumps.\\nIt is true that the inflammation is occasionally greater in one\\npart, then in the other, alternating several times, but generally\\nwhen it subsides in one part it does not appear in it again, and when\\nit does return it is in the nature of a relapse, as from having taken\\ncold. How the germs reach the testicles, and in fact any of the\\nother glands, is not known.\\nTreatment. The patient should be kept in a comfortable\\nroom and, if the disease be at all severe, he should be kept in bed.\\nNot much treatment is usually needed, but care must be used to\\nkeep him from taking cold. It may be well to give a mild cathar-\\ntic, preferably salts, to promote the action of the skin and kidneys.\\nThe bowels should be kept regular throughout the entire course of\\nthe disease. The application of hot fomentations to the swollen\\nneck was long recommended as the best treatment, but many now\\nprefer ice bags or cold compresses until they become uncomfort-\\nable, then to apply hot cloths for a little while, to be followed again\\nwith the cold, and so on alternately, until the inflammation sub-\\nsides.\\nShould a soft place, indicating the formation of an abscess,\\nappear in the middle of the swelling, hot fomentations only should\\nbe applied to hasten it as much as possible, and as soon as pus\\nhas formed the lance should be used. Warm sponge baths, fol-\\nlowed by brisk rubbing with dry towels, are an advantage. Any\\nhard places that remain when the swelling subsides may be re-\\nmoved by rubbing with oil. When the testicles, breasts, etc., are\\naffected the patient should be kept quiet in bed and the same", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0506.jp2"}, "505": {"fulltext": "DISEASES OF CHILDREN. 483\\ntreatment used as recommended for the neck. The inflamma-\\ntion may lead to a wasting of the testicles, but cases of this are\\nrare and it usually subsides without any serious results. A sus-\\npensory bandage should be worn for the support of the testicles,\\nwhen they are inflamed or swollen. Deafness sometimes, and\\nmeningitis very rarely, are caused by mumps.\\nPERTUSSIS.\\nhooping Cough.)\\nWhooping cough is an infectious disease, due to specific\\ngerms belonging to that class known as bacilli. The disease has\\nbeen transmitted to animals by inoculating them with these bacilli.\\nAlthough the bacilli may be borne some distance in the air,\\nthe disease is chiefly transmitted through a close association with\\na patient suffering with it, the germs being given off abundantly\\nin his breath and occurring also in his sputa and the secretions of\\nhis mucous membranes.\\nThere are now and then isolated cases, but it generally occurs\\nin epidemic form, and is most common between the ages of one\\nand eight years, but children of any age are subject to it. It\\nrarely attacks adults, and it has been found that girls are more\\nfrequently affected than boys of the same age. It generally runs\\nits course in from four to six weeks, but in rare cases has been\\nknown to last three or four months.\\nSymptoms. For convenience the symptoms have been di-\\nvided into three stages First. The Catarrhal Stage. The first\\nsymptoms are expected to appear in from six 10 fourteen days\\nafter exposure, but infants have sometimes shown the disease in\\nthree or four days. At the commencement there is usually some\\nfever and signs of catarrh, such as running from the nose, sneez-\\ning, redness of the eyes and frequent fits of severe coughing. At\\nthe beginning the cough is dry, but it is soon attended with ex-\\npectoration of a peculiar, tough, stringy, transparent mucus. This\\nstage lasts from a few days to two or three weeks, or even longer,\\nits duration and intensity indicating the probable length and\\nseverity of the entire attack.\\nSecond. The Spasmodic Stage. In this stage peculiar fits\\nof spasmodic coughing attended by whooping are the most promi-\\nnent features. The coughing spells come on suddenly and are\\nvery severe. The child is likely to run to some near object and,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0507.jp2"}, "506": {"fulltext": "484 DISEASES OF CHILDREN.\\nseizing it for support, to give a number of short, rapid, spasmodic\\nbarks or puffs, until the lungs are emptied of air, when\\na clear, shrill, whooping sound is heard, caused by a\\nspasmodic condition at the entrance of the windpipe while\\nair is drawn forcibly into the lungs. The coughing and\\nwhooping may be repeated a number of times in close succession\\nuntil the child turns blue in the face, the eyes bulge out, the tears\\nflow, the breath seems lost, and there is great exhaustion.\\nEach coughing spell generally ends with spitting a quantity\\nof thick, sticky, clear fluid or mucus, and sometimes with vomiting.\\nThe coughing may be so severe as to cause bleeding from the\\neyes, nose, mouth, ears or rectum; or to produce hernia or\\nrupture. The whooping above described is the most characteris-\\ntic sign and when heard dispels all doubt as to the nature of the\\ndisease. In infants of less than six months, and in very mild\\ncases in older children, whooping may not occur, but these patients\\ntransmit the disease to others as certainly as those who whoop.\\nThe diagnosis of a case of this kind must be determined by the fact\\nof exposure, the nature of the coughing spells, which are likely\\nto be more frequent at night, and the character of the expectora-\\ntion. If with the cough the infant spits abundant mucus whoop-\\ning cough is positively indicated.\\nThird. The Declining Stage. There is a gradual lessening\\nin the frequency and violence of the coughing spells, expectoration\\nbecomes more easy, and the mucus thrown out becomes opaque\\nor yellowish vomiting ceases the general health improves little\\nby little the coughing ceases until it is gone entirely and the pa-\\ntient may soon be well, but the disease is so prone to relapse great\\ncare must be taken to guard against a secondary attack.\\nTreatment. The patient should have two rooms, one for the\\nday, the other for the night, and each room when not in use must\\nbe thrown open and most thoroughly aired, and both rooms\\nat all times must be well ventilated. If impossible to give the\\npatient two rooms, he should be covered up warmly in bed and\\nhis head protected from draughts and cold air by a shield, as that\\nformed by a raised umbrella placed over him and covered with a\\nblanket, while the doors and windows are thrown open, twice every\\nday, until the room is well aired and again warmed to about 68\\ndegrees, at which temperature it should be kept as nearly as pos-\\nsible. There should be a current of pure air passing through", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0508.jp2"}, "507": {"fulltext": "DISEASES OF CHILDREN. 485\\nthe room at all times, care being used to protect the patient from\\ndraughts, and the bedding and clothing must be kept fresh and\\nclean by frequent changes.\\nThe patient should be dressed warmly with flannels next the\\nskin, and if the weather is warm should spend much of his time\\nin the open air. Long before the true nature of the disease was\\ndiscovered, outdoor life was known to be much more favorable\\nthan a close room to an early recovery.\\nMoncorvo, who has had large hospital experience in the\\ntreatment of this disease, believes that it begins in the larynx, and\\napplies resorcin to it with a throat brush having a flexible wire\\nhandle, introducing the brush four or five times at each treat-\\nment and using care to reach all parts in the back of the throat\\nand about the glottis. By this method he claims to have been\\nable to cut short an attack of whooping cough, often quite sud-\\ndenly and in some cases within twenty-four hours. If the chemi-\\ncally pure resorcin cannot be obtained, he uses instead a ten\\nper cent solution of citric acid as a spray by means of an atomizer.\\nSchmid advises the use of the following mixture as a spray\\nevery three hours, the nozzle of the atomizer being directed as\\nfar back in the mouth and throat as possible\\nCarbolic acid six grains\\nMenthol (4 per cent solution) four drams\\nCocaine (3 per cent solution) three drams\\nGlycerin one dram\\nCherry-laurel water one ounce\\nIn my own practice I use the following with good results\\nBelladonna one-half dram\\nSodium bromide one dram\\nCarbolic acid sixteen drops\\nGlycerin one-half ounce\\nEnough syrup of tolu to make two ounces.\\nDose. One-half teaspoonful every two hours for a child two\\nyears old.\\nBraro thinks the essential oil of cypress an excellent remedy,\\nand uses it by dropping some on the pillow and the patient s collar\\nso that he shall constantly inhale it.\\nThe best protection against attacks of other diseases is in", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0509.jp2"}, "508": {"fulltext": "486 DISEASES OF CHILDREN.\\nbuilding up the general health and making the surroundings as\\nperfect as possible.\\nThe diet should receive careful attention and consist of liquid\\nfoods and be nutritious, and the bowels should be kept regular.\\nMeans should also be used to prevent the patient from throwing\\noff the bed clothes at night and thus exposing himself to cold. A\\nmoist atmosphere, as that caused by steam escaping in the room,\\nis desirable, and vapor baths and inhalation of steam are often very\\nuseful. The child should be taught to suppress coughing as much\\nas possible, for, as it irritates, the more he coughs the more he\\nwill want to cough. Complete change of air, as a trip to the sea-\\nshore, or a sea voyage, is often very beneficial, but respect for the\\nrights of others and recognition of the dangers of spreading the\\ncontagion should prevent using any public conveyance for that\\npurpose.\\nMany careful investigators have inclined to the opinion that\\nwhooping cough is an auto-infectious disease, that is, that a patient\\nwhen nearly well may become infected again, from germs thrown\\noff by himself, and consider that the demonstration of this fact, first\\nadvanced by Musser, explains many of the most serious, prolonged\\nand relapsing cases, but this view is not fully established, and the\\nweight of authority is that the relapses are caused by exposure to\\ncold, in some cases very slight.\\nSPASMODIC OR FALSE CROUP.\\nOther names for this disease are Catarrhal Spasm of the\\nLarynx, Spasmodic Laryngitis and Catarrhal Croup. It is a dis-\\nease which may occur at any time, but is most prevalent during\\nspring and autumn, when the weather is changeable and rather\\ncool. Infants between six months and three years old are most\\nfrequently affected, although it is occasionally met in older and in\\nyounger children. There are certain ones who are prone to the dis-\\nease, especially rachitic children, and one attack is very apt to be\\nfollowed by another. Some families have it more often than\\nothers, although it is not contagious and cannot be communicated\\nfrom one child to another. Enlarged tonsils and adenoid growths\\nin the pharynx predispose a child to false croup. The disease at-\\ntacks the larynx just above the vocal cords.\\nSymptoms. At first there is a dry condition of the throat\\nwhich is followed by an abundant secretion of mucus. The", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0510.jp2"}, "509": {"fulltext": "DISEASES OF CHILDREN. 487\\nsymptoms are so marked and peculiar that anyone who sees a\\ncase can always recognize it thereafter. The child goes to bed\\nas well as usual, or with a slight cold, which shows itself by a\\nlittle hoarseness and, perhaps, by a slight running at the nose, the\\nthroat may be a trifle sore, and sometimes there is just a little\\nfever. Having slept until about midnight the child suddenly\\nawakes with a deep, hoarse, choking cough, and every inspiration\\nlabored, hoarse and noisy. The face usually has an alarmed ex-\\npression, and the patient often clutches at its throat as if to re-\\nmove some obstruction there. At times it grasps the bedstead\\nor the bed-clothes, or if its mother is near clings to her, as if that\\nafforded relief. Sometimes the distress is very great, but at other\\ntimes it may not be enough to keep the child awake. There may\\nbe a slightly livid condition of the lips and fingers, but at other\\ntimes the child is pale. Perspiration starts from the face and\\nbody and there is presented a most distressing picture.\\nThe attack may last from one to four hours, and when it\\nsubsides the child goes back to bed and to sleep, although there\\nis still some hoarseness in its breathing. Frequently a second\\nattack will come on the next night, similar to the first but less\\nsevere. The third night seldom brings another attack, and from\\nthis time the child rapidly recovers, and in from four to seven\\ndays is well. It does not appear very sick except during the\\nattack and the fever seldom rises above 101 degrees. Another\\nattack is very apt to occur the first time that the child takes cold.\\nFalse croup may be confounded with true or membranous\\ncroup and laryngismus stridulus. From membranous croup it\\nis distinguished by the sudden and nightly onset, also by the\\nmildness of the symptoms after the acute attack, and their\\ndaily remission. There having been a previous attack aids\\nin the diagnosis. The inhalation of chloroform quickly relieves\\nin false croup, but affects membranous croup very little.\\nFalse croup is distinguished from laryngismus stridulus by\\nthe facts that the latter attacks infants only, that it sometimes\\nstops the breathing entirely, and its attacks come on many times\\na day and may continue for weeks.\\nIn false croup the outlook is very favorable, as it is doubtful\\nif death ever occurs from it, unless it be complicated with some\\nother disease.\\nTreatment. This consists of the prompt use of emetics,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0511.jp2"}, "510": {"fulltext": "488 DISEASES OF CHILDREN.\\nsteam and hot fomentations around the neck. Hive syrup or the\\ncompound syrup of squills is the remedy most frequently used,\\nand it should be kept on hand constantly when in the family\\nthere is a child subject to this croup. One-half teaspoonful\\ncan be given a baby one year of age every ten or fifteen minutes\\nuntil vomiting occurs, or until the distressing symptoms subside.\\nIt is well, at the same time, to wrap a flannel cloth wrung out\\nof hot water around the throat, and if the croupy breathing\\ncontinues to have the child breathe steam. This may be accom-\\nplished by making a sort of tent over the child with a sheet\\nand allowing steam from boiling water to flow into it; or a large\\ncone can be made from a newspaper and held over the spout\\nof a tea-kettle, and the child allowed to breath the steam escaping\\nfrom the small end of the cone, care being used that the steam\\nshall not be hot enough to scald the patient.\\nThe following prescriptions are useful, either during the\\nsevere attack or after it\\nWine of ipecac one dram\\nTincture of aconite two drops\\nSyrup of tolu three drams\\nLiquid acetate of ammonia one ounce\\nDose. One teaspoonful every two hours to a child of three\\nyears.\\nAntipyrin sixteen grains\\nSyrup of ipecac one dram\\nBicarbonate of soda sixteen grains\\nSyrup of tolu enough to make two ounces\\nDose. One teaspoonful every two hours to a child three or\\nfour years old.\\nSCROFULA.\\nScrofula is a disease of the lymphatic glands, usually those\\nof the neck, which are thereby caused to enlarge and suppurate.\\nThe affection is so well known and so easily recognized that a\\ndescription is hardly necessary.\\nCausation. Scrofula is really a form of tuberculosis, being a\\ntuberculosis of the lymph glands, as consumption is a tuberculosis\\nof the lungs, and hip-joint disease a tuberculosis of the hip-joint.\\nAll are due to the germ known as the bacillus tuberculosis. The", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0512.jp2"}, "511": {"fulltext": "DISEASES OF CHILDREN.\\ndisease is very often hereditary, and attacks children between the\\nages of three and ten almost exclusively. Although so frequently\\nhanded down from parent to child, there are other factors which\\naid its development in those having the hereditary taint; such\\nas a cold, damp climate, poor food, bad air, crowded tenements,\\nand, in short, whatever tends to lower the vitality of the body.\\nIt is a disease frequently seen in the overcrowded poor quarters\\nof the city, but rarely in the pure air of the country. It may be\\nbrought on by tonsilitis, measles, scarlet fever or influenza.\\nSymptoms. Scrofula is always a chronic affection. In the\\ngreat majority of cases the glands of the neck only are affected,\\nbut it sometimes involves those of the arm-pit and groin. At\\nfirst the only symptom is the swelling of the glands of the neck,\\nand both sides are usually affected, though one side may begin\\nfirst or grow more rapidly. The enlargement does not go on\\ncontinuously, but at times increases rapidly (in which case the\\naffected glands are often painful), then again remains stationary.\\nThe progress of the disease is very slow, lasting from several\\nmonths to several years, three and a half years being the average\\nduration. The glands generally reach considerable size in three\\nor four months, and although at first they are smooth and reg-\\nular in shape, and move freely under the skin, later they grow into\\nthe surrounding parts, become immovable and take on irregular\\nnodular shapes. AYhen a chain of glands is affected, the course\\nis slower and the glands do not adhere to the neighboring parts.\\nSuppuration takes place in from one-half to two-thirds of\\nall cases. The cases which do not suppurate improve about the\\nage of puberty. When the tumor breaks down and discharges\\npus, there is formed a large open ulcer which is extremely diffi-\\ncult to heal, and when finally healed leaves a large, irregular,\\nunsightly scar, which may break down into another ulcer. Such\\nscars may contract to form prominent ridges which are as sensi-\\ntive and painful as burns. A child with scrofula may be otherwise\\nhealthy and remain in good condition throughout the disease.\\nPrognosis. This is not a fatal disease, and though the case\\nmay drag on for eight or ten years, recovery can be safely pre-\\ndicted neither does it often lead to tuberculosis of the lungs,\\nbut sometimes does.\\nTreatment. The treatment must be much like that of other\\nforms of tuberculosis. A drv climate and a moderately high", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0513.jp2"}, "512": {"fulltext": "490 DISEASES OF CHILDREN.\\naltitude are helpful. Plenty of pure air and nourishing food are\\nnecessary. Of medicines, cod liver oil and the syrup of iodide\\nof iron are the best combination, a dessertspoonful of the former\\nwith twenty to thirty drops of the latter, three times a day, may\\nbe given a child of five years. An emulsion of cod-liver oil may\\nbe more readily given a child, but it is not as efficient as the\\npure oil.\\nThe enlarged glands will often require the attention of a\\nsurgeon. When pus forms in a gland it should not be allowed\\nto go on till it breaks, but should be opened at once, for thus,\\nby a simple, timely operation, the course of the disease may be\\nshortened, and the formation of ugly, disfiguring scars prevented.\\nPoulticing and painting with iodine are harmful.\\nRACHITIS OR RICKETS.\\nRachitis is a disease of nutrition and is characterized by\\nchanges in the bones and a variety of nervous symptoms. It\\nis largely a disease of infancy, particularly of children from six\\nmonths to three years of age, but may occur earlier and some-\\ntimes later. It is far more frequent in the city than in the country,\\nand among the poor than among the well-to-do. It seldom\\noccurs in a child nursing a healthy mother, and is most likely to\\nbe found in one poorly cared for and fed upon improper food,\\nespecially food that is deficient in fat. Infants under one year\\nof age that are brought to the table and fed the same food as adults\\nare prone to the disease. While there is no evidence that rachitis\\nis inherited, children born of weak parents, or parents infected\\nwith syphilis or tuberculosis, or having some purulent discharge,\\nare more susceptible than those of healthy parentage.\\nSymptoms. The symptoms are many and varied, but cer-\\ntain ones are most likely to occur, and upon these we can usually\\nbase a diagnosis. The first one noticed is persistent fretfulness.\\nThe child acts as if it were sore all over, and any pressure or\\nsudden movement makes it cry. Its sleep is intermittent and\\ndisturbed and there is often a little fever at night. The child\\nalso sweats at night, or whenever it sleeps, the perspiration being\\nespecially profuse about the head. In its restlessness it is apt\\nto throw off the covers, and, being wet with sweat, to take cold.\\nIndeed, catarrhal diseases of all kinds, whether they affect the\\nnose, throat, lungs, stomach or intestines, are frequent and severe", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0514.jp2"}, "513": {"fulltext": "DISEASES OF CHILDREN. 491\\nin a rachitic child. It is pale and sometimes sallow. The veins\\nabout the face are enlarged and plainly visible. Craniotabes\\n(a thinning of the bones of the skull) sometimes occurs and is\\na serious symptom, because it often excites disease or injury of\\nthe brain. If such a child is laid upon a bed with a hard pillow,\\nthe weight of its head causes pressure on the brain that may give\\nrise to severe symptoms, and always causes it much pain. It is\\nalways desirable to change the position of such children often,\\nfor they are usually so young as to be unable to do it for them-\\nselves. It is probably this condition which makes rachitic chil-\\ndren so susceptible to nervous diseases of all kinds. Convulsions\\nare frequent among them, and at times tetanus occurs the teeth-\\ning is retarded; the fontanels remain open until the child is two\\nor three years old, and walking, and even creeping, is long delayed\\nand difficult.\\nTo the bones the rachitic condition proves extremely disas-\\ntrous and many and severe are the deformities. These result from\\ninability of the bones during the rachitis to appropriate the lime\\nsalts, which form the hard part of the bones, and they therefore\\nsoon assume a gristle-like condition, so that nearly every bone\\nin the body is liable to become bent out of shape. Those of\\nthe legs bend out or in, giving rise to bowlegs, and sometimes\\nthe shin-bone bends forward. The chest is likely to become dis-\\ntorted into the so-called pigeon breast, or an unsymmetrical one.\\nThe head bones also may bend and cause a square-shaped head,\\nor one with protrusions, making it look abnormally large.\\nIf these deformities become fixed, and they usually do after\\nthe third or fourth year, a surgical operation is needed to correct\\nthem. Much can thus be accomplished. The bone is cut or\\nbroken and done up correctly, and when the new bone forms,\\nbetween the severed ends, it fixes the bone in the proper position.\\nEarlier than the third or fourth year the legs and arms may be\\nbent and held in position by braces until they become fixed by\\nnew bone formation.\\nRickets is not of itself a fatal disease. Its great danger lies\\nin the deformities it causes, and its tendency to increase the\\nliability to other diseases of a severe and dangerous character.\\nIt is said that in Europe nearly thirty per cent of the infants\\nshow some symptoms of rachitis, and in the large cities of America\\nthe number thus affected is about twenty per cent. It is therefore", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0515.jp2"}, "514": {"fulltext": "492 DISEASES OF CHILDREN.\\ndesirable that we be able to early recognize the disease and\\nbegin its treatment promptly.\\nThe best treatment is the preventive treatment, and that\\nconsists of giving the proper food at proper times in proper quan-\\ntities amid the best possible hygienic surroundings. These things\\nhave been treated under the heads of Infant Feeding and Diet\\nof Infants, and to these the reader is referred. It is also of\\ngreat importance that the mother while carrying the babe should\\nhave good care. Good, nourishing food, fresh air, proper baths\\nand abundant sunlight, all are necessary for her.\\nAfter the disease has become established, medicinal treat-\\nment is important, and, fortunately, it is usually effective. As\\nthere is indigestion as a rule, some digestant is desirable, as pan-\\ncreatin and soda, or papoid tablets, one after each meal. In\\nolder children pepsin and muriatic acid are at times better\\nParke, Davis Co. s Pepsin Cordial, a teaspoonful before each\\nmeal. For infants, maltine with hypophosphites of lime, iron\\nand soda is excellent, both as a tonic and as a digestant of the\\nstarchy foods. One of the emulsions of cod liver oil is recom-\\nmended, not only on account of the fat it contains, but also for\\nits bile salts. Parke, Davis Co. s Egg Emulsion is especially\\nuseful, as it possesses food qualities also. Some form of phos-\\nphorus is useful in this connection to help the formation of bone,\\nand Fairchild Bros Elixir of Calisaya Phosphorized is a val-\\nuable one, being a good tonic in addition to its phosphorus.\\nEverything should be done to promote a good, healthy action\\nof the digestive organs and increase the nutrition of the child.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0516.jp2"}, "515": {"fulltext": "OBSTETRICS,\\nOR THE CARE OF WOMEN IN PREGNANCY, CHILDBIRTH AND\\nRECOVERY.\\nBy Ida C. Barnes, B.A., M.D.\\nCHAPTER I.\\nIn studying the subject of obstetrics, the phenomena at-\\ntendant upon pregnancy and childbirth will be considered, as also\\nthe relation of the fetus to the maternal surroundings.\\nWhenever to a woman comes the opportunity of presiding\\nover a home of her own, consequent upon matrimonial obligations,\\nshe must consider the almost certain, and certainly to be desired,\\nfamily which shall surround her in a few years, her own mental\\nand physical adaptation for such duties, and the fitness of the man,\\nmentally, morally and physically, whom she accepts as the father of\\nher children. If with tastes and mental attainments more or less\\nin opposition, there is yet a broad-minded tolerance of the opinions\\nof others, there may be a most pleasant marriage but if a spirit of\\nintolerance exists, sooner or later there will be discord to mar the\\notherwise pleasant relation.\\nPeople debilitated by constitutional disease, either hereditary\\nor acquired, ought not to entail their tendency to weakness upon\\nthe oncoming generations, and should make every effort for as\\ncomplete restoration to health as possible. Much can be done by\\nproper living to increase the power of resistance to exposure and\\ndisease, and it is the great duty of all, by working towards this end,\\nto raise both the physical and mental standard of the human race.\\nA nation is not what its strongest men are, but what its count-\\nless thousands average in ability and strength, and it should be\\nremembered that all excesses, whether in the pursuance of pleasure\\nor gain, that sap the health and impair vitality will prove a curse\\nto those to come.\\nPELVIC ANATOMY.\\nPreliminary to the consideration of obstetrics, it is important\\nto understand something of the anatomy of the pelvis the great\\n493", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0517.jp2"}, "516": {"fulltext": "494 OBSTETRICS.\\nbone framework of the lower part of the body and its adaptation\\nto childbirth. It is composed of four bones The two os in-\\nnominata or hip bones, forming its two sides and, by uniting,\\nalso forming its front the sacrum (consisting of live joints of the\\nspinal column fused together into a single bone) forming its\\nrear, and the coccyx (the rudimentary human tail composed of\\nthe last four sections of the spinal column, also fused together into\\none bone) attached to the lower end of the sacrum and helping\\nto form the pelvic cavity, although not a part of the pelvic brim.\\nIn addition to these, the obstetric pelvis also includes the last\\nlumbar vertebrae (the sections of the spinal column just above the\\nsacrum).\\nComplete union of any of these bones does not occur until\\nthe twentieth year, the sacral and coccygeal segments fuse still\\nlater, and the sacro-coccygeal joint does not unite until middle\\nlife. Do not be frightened by these large words they simply\\nmean that during the larger part of the child-bearing period, there\\nis more or less elasticity of the joints, capable of being utilized\\nduring childbirth.\\nThe mechanical part of labor resolves itself into two factors\\nwhich may be expressed as follows The size of the natural\\npelvis, with the possibilities of expansion under pressure, and the\\nsize of the fetal head, which is the largest part of the fetal body,\\nwith the possibilities of compression under pressure.\\nPELVIC DEFORMITY.\\nLike other portions of the body, the pelvis is modified by\\nheredity and mode of life. The pelvis of the average American\\nwoman, though not presenting the striking deformities found in\\nsome countries, is not perfect, and protracted labor is often due to\\nsome failure of development which has destroyed symmetry and\\nlessened a diameter at a point where full size is most needed to pro-\\nmote an easy delivery. A lack of nutrition before birth may be\\nfollowed by a similar deficiency after birth, from which all the\\nbones suffer imperfect development, and the pelvis, by a dimin-\\nished capacity, is so seriously crippled as to be unfitted for child-\\nbearing. .Again, a pelvis may present a fair degree of symmetry,\\nyet be so contracted in all its diameters as to seriously diminish\\nthe size of the birth canal. During infancy and childhood the\\nbones are so soft and pliable that continued pressure upon any", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0518.jp2"}, "517": {"fulltext": "OBSTETRICS. 495\\npoint will deflect some bone from its natural inclination and change\\nthe angle it should form with some other bone, and thus may\\nseriously interfere with the function of childbirth or labor.\\nThen there is the flat pelvis, narrowed from the front back\\nand the funnel-shaped, clue to restrained growth, resembling the\\ninfantile and the male pelvis. The pelvis of the female is essen-\\ntially like that of the male until puberty (about the fourteenth year\\nof age), when the uterus and ovaries develop rapidly and the bones\\nof the pelvis enlarge and expand; while the male pelvis remains\\ndeep and narrow, and its bones increase in strength and firmness.\\nA partial dwarfing of the body often results only in lack of pelvic\\ndevelopment, and the formation of a frame not totally unfit for\\nmaternity, but which will not permit normal labor. An oblique\\npelvis may be caused by a deformity in the spine or hip, or a short-\\nening of one \\\\tg by improper standing or sitting at work or study.\\nIn early infancy, any of the pelvic deformities may be caused, in an\\notherwise healthy individual, by allowing the baby to sit or stand\\nbefore it is able. Improper feeding may result in soft bones that\\nwill bend under the burdens borne by the average child of the\\nsame age. A woman with crooked bones may, with comfort to\\nherself, accomplish the ordinary duties of life, but she cannot bear\\na child through a deformed pelvis without great suffering and\\nmuch peril to herself and babe. Shall not woman crown her high-\\nest physical endowment with as perfect development as possible?\\nAlthough heredity may have marred with sad defects, it lies\\nwithin the power of every individual, by careful and wise observ-\\nance of nature s laws, to greatly modify the baneful results.\\nDiseases, especially those caused by lack of nourishment in early\\nlife, play havoc with the bone framework of the body, and here\\nagain, unless great care be taken, the female pelvis will suffer\\nas regards child-bearing; it may be one-sided, narrow or flat, yet\\nnot seriously interfere otherwise with its relations to the rest of the\\nbodv.\\nTHE ORGANS OF GENERATION.\\nThe immediate organs of generation, or child-bearing, are\\nthe ovaries and the uterus, or womb, situated just above the\\nplane of the strong muscular floor of the pelvis, slnd connecting\\nwith the external organs of generation by means of the vaginal\\ncanal, which penetrates this floor in its front portion. The exter-\\nnal organs of generation are the mons veneris, the labia majora", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0519.jp2"}, "518": {"fulltext": "496 OBSTETRICS.\\n(greater lips) and labia minora (lesser lips), the clitoris with its\\nprepuce, and the vestibule upon which is found the urethral open-\\ning.\\nThe labia majora are two thick folds of hairy skin extending\\nfrom the symphysis pubis backward to within an inch of the anal\\norifice, each lip having an outer and an inner surface, and including\\nwithin its folds blood vessels and a quantity of fat. When they\\nare best developed they unite in front in what is known as the\\nmons veneris, while posteriorly they join in a mere fold of skin\\nknown as the fourchette. In the adult the outer surface of both\\nlips is thickly covered with hair.\\nThe labia minora are two thin oblique folds of skin on the\\ninner surface of the larger lips, and blending with them at about\\nthe middle of their inner surface behind, but in front separating\\neach into two folds, of which one unites with the corresponding\\nfold of the opposite lip to form the prepuce of the clitoris, while\\nthe other joins with its opposing mate to form the suspensory liga-\\nment. As a rule the smaller lips do not project beyond the\\nlarger.\\nThe clitoris, covered by its prepuce, lies in the middle line and\\nat the apex of a piece of mucous membrane called the vestibule\\na smooth triangular surface bounded above by the clitoris, at the\\nsides by the lesser lips, and below by the upper edge of the vaginal\\nopening. In the middle at the base line can be seen the urethral\\norifice. There are mucous glands also upon its surface.\\nThe pelvic floor is a thick, fleshy, elastic layer of tissues\\nattached to the bony pelvic outlet, on the outer skin aspect of\\nwhich lie the external organs of generation just described, while\\non its inner, peritoneal surface lie the uterus and its appendages\\nthe Fallopian tubes and ovaries.\\nThe vaginal opening lies in the middle line between the lower\\nedge of the vestibule and the uniting folds of the larger lips behind.\\nStretched across the rear part of this opening and partially cover-\\ning it is the hymen, which consists of a thin fold of mucous mem-\\nbrane strengthened by some connective tissue, with blood vessels\\nand nerves. It varies in shape, and is generally, though not always,\\nruptured at the first copulation, and it may remain intact even\\nuntil childbirth arrives, then become a source of obstruction but\\nusually it is easily ruptured. It may be attached to the lower edge\\nof the vaginal opening, or it may be attached. all around and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0520.jp2"}, "519": {"fulltext": "OBSTETRICS. 497\\ncontain a small hole or vertical slit. Sometimes it has no opening,\\nin which case abnormal conditions result.\\nThe vagina is a muscular membranous canal, lying chiefly\\nwithin the pelvis, its lower end passing through the pelvic floor.\\nIt rises at an angle of 60 degrees with the horizon, when the body\\nis in the erect position, and is in relation with the bladder and\\nurethra in front, and the rectum behind, being separated from\\nthem only by partitions called the vesicovaginal and recto-vaginal\\nsepta. The vagina extends from the external opening below to\\nthe neck of the uterus above, and is very dilatable as by manipula-\\ntion or childbirth. Its front wall is about two and a half inches\\nin length, its back wall nearly three inches, and, ordinarily, the two\\nlie in contact. Its walls are composed of mucous membrane and\\na muscular and fibrous coat, and are abundantly supplied with\\nlymphatics, blood vessels and nerves.\\nThe female urethra is short, being only about two and two-\\nthirds inches in length; it lies beneath the front bone of the\\npelvis and is firmly imbedded in the front vaginal wall. The\\nbladder bears an important relation to the vagina and uterus.\\nWhen empty and relaxed it lies entirely within the true pelvis be-\\nhind the pubes (the front part of the two pelvic bones known as\\nthe os innominata), and usually to one side. When filled to its\\n\u00e2\u0080\u00a2greatest capacity the bladder, together with the peritoneum, is\\npressed well above the pubes, and has a consequent tendency to\\nbackward displacement of the body of the uterus. As disorders\\nof the rectum are often important factors in uterine disturbances\\nits location should also be remembered. It extends from the\\nupper part of the left side of the pelvis to the anus and in its\\ncourse curves backward and inward. The anus, its external\\nopening, is about an inch in length.\\nTHE UTERUS AND ITS CONNECTIONS.\\nIn shape the uterus is a triangular ovoid, consisting of a body\\nand neck, and containing a cavity whose front and back walls rest\\nupon each other. At each of its three angles there is an opening\\nthe Fallopian tubes at the two upper ones and the vagina at the\\nlower end. The neck of the uterus (cervix) opens into the uterus\\nabove and into the vagina below, and is divided into two portions,\\nthe vaginal, which extends down into the vagina, and that above\\nthe vagina. The virgin uterus measures about three inches in\\n32", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0521.jp2"}, "520": {"fulltext": "498\\nOBSTETRICS.\\nmm.\\nKM\\ni\\nO\\ni\\nA v\\nSi\\n*--v\\niP\\ni?\\n1\\n\u00e2\u0096\u00a04\\nA}\\nI d\\ncc\\nx v.\\nf*~\\n-W\\n-^1 I 1\\n!B\\nkN\\nCD\\nKf v_\\nD\\nl u\\nV.\\nU\\n3r\\n~M\\nn3\\nIF\\n1\\n\u00e2\u0096\u00a0--o\\ns\\n-K\\n.2\\na\\nCfl r-\\n2 o\\nO T3\\n3 a\\n\u00c2\u00a72\\n3", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0522.jp2"}, "521": {"fulltext": "OBSTETRICS. 499\\nlength, one and a half inches at its greatest width, and one inch in\\nthickness, and consists of two portions the body and neck.\\nThe proportion between them varies with age. In the adult vir-\\ngin the two parts are nearly equal, while in early life the neck\\npreponderates over the incompletely developed body; after child-\\nbirth the body remains nearly twice its original size, and in old\\nage the organ becomes diminished to less than its virginal pro-\\nportions. The cavity of the uterus is narrow and cleft-like, while that\\nof its neck tapers at both ends and is bounded by the internal and\\nexternal mouths, the internal mouth being the point of greatest\\ncontraction of the uterine canal.\\nThe uterus is composed of a serous or external coat called the\\nperitoneum, which covers only partially its external surface the\\nmucous membrane which lines the cavity of the body and neck,\\nand the muscular layer which is between the other two, makes\\nup the largest part of its constituency, and is of peculiar interest to\\nthe obstetrician because of its adaptation to the function of expell-\\ning the mature fetus, also because the contraction of this circular\\nlayer of muscular bands closes large blood vessels, thus preventing\\nserious hemorrhage after childbirth.\\nThe uterus is held in place by the broad, round, utero-sacral\\nand utero-vesical ligaments. The broad ligaments are formed\\nby layers of peritoneum, which partially cover the uterus in front\\nand behind, and at the sides extend outward and somewhat back-\\nward to the sides of the pelvis. In the upper free margins of these\\nligaments are found the Fallopian tubes and the ovaries, and be-\\ntween the layers of the ligaments lie connective tissue, muscles,\\nblood vessels and lymphatics.\\nWhen the uterus is in a normal position, that is, inclined\\nslightly forward, the broad ligaments extend out laterally and\\nbackward nearly horizontally, but displacement of the uterus\\ncauses their displacement, and in pregnancy they are drawn up-\\nward until they assume an almost vertical position. By scarring\\nand contracting the tissues, attacks of inflammation may also\\ndraw the uterus to one side and move the ligaments from their\\nnatural position.\\nThe round ligaments are two in number, and, attached to the\\nupper part of the uterus, extend obliquely forward and fasten\\nto the front part of the pelvic bones. They receive lateral support\\nfrom the folds of the broad ligament through which they pass.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0523.jp2"}, "522": {"fulltext": "500 OBSTETRICS.\\nThe utero-sacral ligaments are folds of peritoneum extending\\nfrom the lower part of the sides of the uterus, backward to the\\nsecond sacral vertebra. The peritoneum, as it passes between the\\nuterus and the bladder, forms the utero-vesical ligaments.\\nThe mucous membrane lining the cavity of the uterus is, in\\nthe unimpregnated, about one-twenty-fifth of an inch in thickness,\\nand is set upon the muscular layer without any intervening sub-\\nmucous tissue. There are numerous glands. The mucous mem-\\nbrane lining the uterus is different from that lining its neck, and\\nthat covering the vaginal portion of the neck externally differs\\nfrom both of them.\\nIn normal position, the uterus is toward the front of the\\npelvis, supported, as we have seen, by flexible ligaments on all\\nsides, and, resting with its top against the bladder, bends further\\nforward when that organ is empty, and straightens up with its\\ndistention. The great pliability of the uterus, designed as it is for\\nthe protection and nourishment of the fetus during intrauterine\\ndevelopment, renders it peculiarly liable to displacements and mal-\\npositions.\\nThe Oviducts or Fallopian Tubes extend from the upper\\nangles of the uterus, within and along the free margins of the\\nbroad ligaments for a distance of about four inches to the sides\\nof the pelvis and the vicinity of the ovaries, where they end in ex-\\npanded, funnel-shaped openings surrounded by a series of fringed\\nprocesses called fimbriae, one special fimbria running to each ovary.\\nThe function of the oviducts is to catch the ova as they come\\nfrom the ovaries, and convey them to the uterus, and, preparatory\\nto this, their fringed extremities have the peculiar faculty of at-\\ntaching themselves to the ovaries whenever an ovum has ripened\\nand is about to be expelled.\\nThe oviducts have the three coats, serous, muscular and\\nmucous, common to all cavities. The epithelium which lines these\\ntubes is continuous with the epithelium of the peritoneum which\\nlines the abdominal cavity, and thus indicates one source of in-\\nfection from the outside to which women are liable and men are\\nnot, since in the male sex the peritoneum is a closed sac. The\\ncaliber of an oviduct where it enters the uterus, which is its nar-\\nrowest point, will scarcely admit a bristle, but it gradually expands\\ntoward its outer extremity, where it becomes from fifteen to\\ntwenty-five hundredths of an inch in diameter.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0524.jp2"}, "523": {"fulltext": "OBSTETRICS. 501\\nTHE OVARIES.\\nThe two ovaries are flattened ovoid masses, usually about one\\nand a fourth inches long, three-fourths of an inch wide, and a half\\ninch thick, attached in front to folds of the broad ligaments which\\nextend from the uterus to the sides of the pelvis. The smaller end\\nof each ovary is also united to the uterus by a muscular band called\\nthe ovarian ligament, and a small ligament running from the\\noviduct to the side of the pelvis gives additional aid in retaining\\nthe ovary at its proper level in the pelvis. It may thus be readily\\nunderstood that contraction or relaxation of these ligaments leads\\nto serious results in the form of displacements.\\nEach ovary consists of the cortex or outer part and the\\nmedulla or central mass. The cortex includes the Grafhan folli-\\ncles, which are the most important part of the ovary, for within\\nthem are formed the ova (eggs). These are found in all stages\\nof development, but when mature the follicle reaches the surface\\nof the ovary and its ovum escapes through a rupture of the sac.\\nThe production of ova is very nearly complete at birth, few being\\nformed later, and perhaps none after the second year. The\\novaries of the child, therefore, possess the full quota, estimated\\nat about 70,000. It is probable that a variable number of them\\nreach partial development before puberty, but at the arrival of\\nsexual maturity the full and regular development of the Graffian\\nfollicles and their ova begins, attended by menstruation. During\\nthe child-bearing period these follicles are constantly developing\\nand end by bursting, thus liberating the ripened ova, each follicle\\nproducing one ovum. It is thought that this liberation of the\\nova coincides with the menstrual periods, although it has been\\nshown that ovulation may take place independently of it. The\\nripened human ovum is a spherical cell about seventy- five thou-\\nsandths of an inch in diameter, containing granular protoplasm\\nin which lies a nucleus (the germinal vesicle) containing a nucle-\\nolus (the germinal spot).\\nRELATION OF OVULATION AND MENSTRUATION.\\nAt regular intervals during the child-bearing period the\\nlining of the uterus undergoes changes, designed to prepare a\\nfavorable resting place for the ovum in case of conception. The\\nmenstrual cycle, usually occupying twenty-eight days, may, ac-\\ncording to Marshall, be divided into four stages, as follows", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0525.jp2"}, "524": {"fulltext": "502 OBSTETRICS.\\n(i) The constructive stage, a preparation for the reception\\nof the ovum, during which there is swelling of the mucous mem-\\nbrane, enlargement of the uterine glands and increase of con-\\nnective tissue. This stage lasts about a week, and when preg-\\nnancy does not occur is followed by:\\n(2) The destructive stage, in which there is a discharge of\\nmucus, blood and disintegrated mucous membrane. Five days\\nis the usual length of this period.\\n(3) The reparative stage, in which the deeper, unaffected\\nportion of the uterine mucous membrane forms a superficial\\nmembrane. This period lasts about four days.\\n(4) The quiescent stage, including the remaining twelve to\\nfourteen days preceding the beginning of the next cycle.\\nThe relation of ovulation and menstruation is of much inter-\\nest. It has been proven that menstruation can take place without\\nthe liberation of an ovum. Marshall believes that the constructive\\nstage is related not to the ovum of that period, but to the one\\ndischarged during the preceding cycle. The congestion of the\\novaries attending ovulation leads to stimulation and engorgement\\nof the uterus, which no doubt is a cause of menstruation.\\nFERTILIZATION OF THE OVUM.\\nThe ripe ovum is ready as soon as it leaves its follicle for\\nfertilization by the spermatozoon, or male element. The process\\nusually takes place in the upper portion of the oviduct. The\\nperiod during which the human egg retains the possibility of\\nfertilization is estimated at about eight days, since the death\\nof the unfertilized ovum usually occurs before reaching the uterus.\\nThe union of the male and female pronuclei (generative ele-\\nments) results in the formation of a new nucleus, called a segmenta-\\ntion-nucleus, in which the process of cell division at once begins\\nand multiplies until membranes, tissues, organs, bones, nerves\\nand muscles are formed and properly adjusted to make a perfect\\nphysical being. In this union of the male and female elements\\nto form the first cell we see why the child should partake of the\\ncharacteristics of both father and mother.\\nSTAGES OF THE EMBRYO AND FETUS.\\nVery few human ova have been examined in their first stages,\\nthe earliest reported being at the twelfth day. This ovum had", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0526.jp2"}, "525": {"fulltext": "OBSTETRICS. 503\\nbecome a flat, elongated vesicle one-fifth of an inch in length\\nand one-eighth of an inch in thickness. A patch of thickened\\ncells formed a rudimentary layer. The earlier processes of\\ncell division have never been observed in the human ovum.\\nOn the thirteenth and fourteenth days the expansion for the\\nhead first becomes apparent. In the third week the form of the\\nembryo becomes more definite, brain and optic vesicles and audi-\\ntory sacs are distinguished, and by the twenty-first day the first\\nrudiments of limbs appear. The fourth week is marked by\\nincreased size and more distinctive features; growth being more\\nactive at this period than at any other. With the third week\\nthe embryo is straight, but in the next few days the curves\\ncharacteristic of the fetus are formed very rapidly. The indi-\\nvidual brain cells, eyes, ears and nose, as well as the arches and\\nfurrows for the chest and abdomen, appear the heart has increased\\nin size and the limb buds have become more prominent. During\\nthe latter part of the fourth week a series of prominences along\\nthe line of the back is seen, indicating the position of the spine.\\nThe fifth and sixth weeks add to the size and general growth.\\nThe limbs are the most characteristic feature of the period, their\\nbuds developing into distinct parts. Toward the close of the\\nfifth week the flattened terminal parts, representing the future\\nhands and feet, show thin marginal plates and soon exhibit\\ntraces of fingers. The upper limbs appear sooner than the lower\\nones. By the middle of the sixth week the fingers project\\nbeyond the hand, although the toes are just beginning to be\\noutlined. The general development of the embryo has steadily\\ncontinued; the head, although proportionally large, has gained\\nlittle in size; the boundaries of the mouth are located, and the\\nexternal parts of the eye, nose and ear are well advanced, the\\nbend in the neck is disappearing and the face shows distinct\\nadvancement; the limbs project from the body and the fingers,\\nthumbs and toes are well defined.\\nAt the close of the second month the fetus is from one to\\none and three-eighths inches long and weighs from three-fourths\\nof an ounce to an ounce. The third month establishes the human\\nform, but the head greatly predominates in size; the limbs have\\ndefinite shape and imperfect nails are found upon the fingers\\nand toes. During this month the external organs of generation\\nbecome distinct, although they made their appearance several", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0527.jp2"}, "526": {"fulltext": "504 OBSTETRICS.\\nweeks earlier. At the end of the period the fetus measures two\\nand three-fourths inches in length and weighs about four ounces.\\nFourth month: Short hair appears on the scalp and other\\nportions of the body. The eyelids, nostrils and lips are closed,\\nthe anus opens and the coil of intestines, which before extended\\ninto the umbilical cord, now lies within the abdominal cavity.\\nThe head forms about one-fourth of the entire body, and the\\nbones of the skull, though hardening, are still widely separated.\\nThe sexual distinction in the external organs is well defined.\\nAt the end of this period the fetus weighs about seven and three-\\nfourths ounces and is five inches in length.\\nFifth month The heart, liver and head are unduly large\\nthe small intestines show traces of bile (a pale, yellowish green\\ncolor) the lower extremities are longer than the arms the nails\\nare well formed, and hair is plentiful but without color. At the\\nend of this month the fetus is eight inches long and weighs a\\npound. Its movements are plainly felt by the mother.\\nSixth month The surface of the fetal body is much\\nwrinkled; the sebaceous coating, composed of oily secretion and\\nepithelial scales, is beginning to appear, and protects the skin\\nfrom the amniotic fluid; eyebrows and eyelashes are also appear-\\ning. The length of the fetus at the end of this month is twelve\\ninches and its weight about two pounds. It is possible for\\nchildren at six months to live, but they very seldom do.\\nSeventh month The subcutaneous fat makes the fetus\\nappear somewhat plump; eyelids permanently open; the liver is\\ncomparatively large; meconium occupies the large intestine; the\\ntesticles have descended to points even with the inguinal canals.\\nAbout half of the children born at this time live. The fetus is\\nnow fourteen inches long and weighs three pounds.\\nEighth month There is increase in bulk rather than weight\\nthe skin becomes a brighter flesh color the scalp is supplied with\\nhair; the nails almost reach the finger tips; the vernix caseosa\\nforms a complete coating; the subcutaneous fat is increased.\\nAt the close of this month the fetus measures sixteen inches and\\nweighs four to five pounds.\\nNinth month At full term the fetus has a well rounded\\nbody the skin is less highly colored both testicles have descended\\ninto the scrotum, and in the female the greater labia are in con-\\ntact; the intestinal tract contains the dark greenish meconium;", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0528.jp2"}, "527": {"fulltext": "OBSTETRICS. 505\\nthe navel is almost in the center of the body. The full-term fetus\\nis twenty inches in length and weighs from six to seven pounds.\\n(a) Young mothers have the smallest children, and mothers\\nbetween thirty and thirty-five years the heaviest.\\n(b) The weight of the child increases with the number of\\nprevious pregnancies, if all of the same sex, that is, the first\\nchild is usually smaller than the next.\\n(c) The weight of the child increases with the weight and\\nlength of the mother. All causes adversely affecting the physical\\ncondition of either parent may exert an unfavorable influence\\non the vitality and development of the fetus.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0529.jp2"}, "528": {"fulltext": "CHAPTER II.\\nCHANGES IN THE MATERNAL ORGANISM CAUSED BY\\nPREGNANCY.\\nAs soon as the impregnated ovum escapes from the oviduct\\ninto the uterus it is caught by folds of the mucous lining which,\\nwith the membrane formed from the ovum itself, surrounds the\\ngerm and furnishes protection and nourishment. During the\\nfirst three months small blood vessels of the mucous membrane of\\nthe uterus, enlarged for the purpose, unite with similar vessels\\nof the fetal membranes, and thus furnish proper nourishment;\\nbut after this time there is a special development of a small por-\\ntion of the uterus, usually near its top, in which these vessels\\nbecome enormously enlarged, and communicate with similar\\nvessels in the fetal portion of the placenta, after which the entire\\nblood supply comes from this source and the small capillaries\\nover the other parts of the uterine membrane contract and close\\nup. The maternal vessels of the placenta are supplied with twigs\\nfrom the uterine artery and the placenta is drained by minute\\nbranches connecting with the larger uterine veins.\\nThe human placenta, as seen in the expulsion of the after-\\nbirth, is about eight inches in diameter and one and a fourth\\ninches in thickness.\\nThe placental blood vessels are the two umbilical arteries\\nand one umbilical vein which extend from the placenta through\\nthe umbilical (navel) cord and are continuous with the circu-\\nlatory system of the fetus. The umbilical cord is made up\\nprincipally of these vessels and a peculiar substance known as\\nthe jelly of Wharton. It is usually about twenty-two inches in\\nlength and a half inch thick. The amniotic liquid secreted\\nfrom the amniotic sac surrounding the fetus, sometimes called\\nthe bag of water, increases as the pregnancy advances until it\\nmay reach a quart in quantity. It preserves the fetus from harm\\nand furnishes a liquid medium from which it may absorb the\\nnecessary fluid.\\n506", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0530.jp2"}, "529": {"fulltext": "OBSTETRICS. 507\\nThe enlargement of the mucous membrane of the uterus,\\nwhich takes place on the liberation of a ripe ovum from the\\novary, is increased when impregnation occurs, but the greatest\\nchange is in the size of the uterus, which from the rigid and\\ntense virgin organ, two and three-fourths inches long, one and\\nthree-fourths inches wide and one inch thick, is transformed at\\nthe close of gestation into a soft, pliable sac fifteen inches long,\\nten and three-eighths inches wide and nine and three-fourths\\nthick; and from a weight in the virgin of one and a fourth\\nounces is increased to two pounds, with its capacity enlarged\\nto about eight pints.\\nThe blood vessels of the vagina increase in size and there\\nis thickening and softening of its mucous membrane and muscular\\ntissues. The larger amount of blood gives the vagina a dark\\nbluish color, which is one of the signs of probable pregnancy.\\nThe external generative organs are also much more developed\\nand prominent, with an increase in the secretion of the sebaceous\\nfollicles and sweat glands of the labia. The joints of the pelvis\\nand their cartilages are somewhat softened. The pelvic floor is\\nincreased from one to three and three-fourths inches at the\\nend of pregnancy and the diameter of the outlet or distance\\nfrom the front pelvic bone to the lower part of the spine is almost\\ndoubled, thus greatly facilitating delivery.\\nThe abdominal walls show the enormous distention by more\\nor less conspicuous lines, known as the striae gravidarum, which\\nare found in over ninety per cent of pregnant women. They\\nare bluish at first but gradually disappear after labor, leaving only\\na white scar-like appearance. These lines may also occur wher-\\never there is great stretching of the skin from tumors or dropsy,\\nand are due to displacement and partial rupture of the con-\\nnective tissue ot the deeper layers of the skin. They may also\\nbe seen on the buttocks, thighs and breasts. The navel is also\\naffected by the abdominal contents, becoming less deep by the\\nfifth month, effaced at the seventh and during the remaining\\nmonths protuberant.\\nThe breasts, too, undergo change in preparation for func-\\ntional activity. There is an increase in all the tissues of these\\nglands. They begin to enlarge as early as the second month,\\nbut not much until the middle of pregnancy. The nipples share\\nin the increase, becoming enlarged, sensitive and more erectile.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0531.jp2"}, "530": {"fulltext": "508 OBSTETRICS.\\nA dark areola surrounds each, and after the third month the\\nbreasts contain a thin fluid called the colostrum, which can be\\npressed out.\\nThe general changes of pregnancy depend upon the changes\\nin the blood and in the functional modifications of the nervous sys-\\ntem. The pregnant woman has to secure nourishment, breathe, se-\\ncrete and excrete for two herself and her fetus. If these are\\ncarried on in a fairly normal way health is maintained, but if\\nthese changes are developed in excess, disorders complicating\\nthe pregnancy are produced. The composition of the blood is\\naltered as well as increased in quantity. Its watery elements,\\nwhite corpuscles and fibrin are increased; its albumin and red\\ncorpuscles diminished. Poor hygiene and surroundings greatly\\nreduce its quality. The growing fetus, developing uterus, chang-\\ning pelvis and enlarging glands demand a large amount of material\\nand necessarily drain the maternal system, especially at the close\\nof pregnancy.\\nThe heart is almost uniformly enlarged, being one-fifth\\nmore in weight in the pregnant stage, and disturbances of the\\ncirculatory system are of frequent occurrence. Palpitation of\\nthe heart in the early months is purely sympathetic, but in the\\nlater ones is due to interference from the enlarged uterus. Other\\nblood changes may be so serious as to cause great swelling\\nof the feet and legs, and even of the thighs. There is enlarge-\\nment of the liver and spleen, the latter being due to its relation\\nto the circulatory system; the thyroid gland is also increased\\nin size.\\nThe respiration is somewhat embarrassed in the later months\\nby the upward pressure of the diaphragm because of the enlarged\\nuterus, and since more blood must be supplied, the pregnant\\nwoman has more to purify, and eliminates more carbonic acid\\nwith the lungs. In the earlier months she may have a sympa-\\nthetic nervous cough. To provide nutrition for herself and\\nincreasing organs, and the fetus and its appendages, she must\\ndigest more food and form more blood, hence must increase the\\nactivity of both secretory and excretory organs. Few women\\nescape nausea and vomiting and the capricious appetite during\\nthe earlier months of pregnancy; but later the digestion and\\nappetite improve, giving opportunity to improve the nutrition.\\nThe pregnant woman gains in weight irrespective of the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0532.jp2"}, "531": {"fulltext": "OBSTETRICS. 509\\nincrease from the uterus and fetus. The average increase is\\nabout fifteen pounds, which is uniform during the nine months\\nnotwithstanding the vomiting. This increase is stored up mate-\\nrial to be used after delivery. The activity of the sebaceous\\nglands, the sweat glands and hair follicles is also increased.\\nDiscolorations of the skin are numerous, being found upon the\\nabdomen, the navel, the face and around the nipples. Owing\\nto the drain by the fetus upon the elements of the blood there\\nis delay in the union of broken bones.\\nThe urine is more abundant and of lower specific gravity,\\nprobably because of the increased amount of blood. There are\\nalso changes in its quality and traces of albumen are often found.\\nAlbuminuria exists in many cases, more common in the latter\\nthan in the first half of pregnancy. It is aggravated by tight lacing\\nand heavy skirts also by diseases of the heart and lungs. So\\ngrave is the significance of albuminuria, the urine should be\\nclosely watched, particularly during the latter half of pregnancy.\\nProper treatment will relieve in the majority of cases and the\\ndisability may be entirely overcome. This belongs to the prov-\\nince of the physician to manage.\\nThe mental condition depends much upon the nutrition.\\nWomen who are naturally cheerful may become irritable and de-\\npressed at this time and even melancholic or insane, while others\\nfeel exhilarated and energetic, both physically and mentally.\\nDL-yCJNOSIS OF PREGNANCY.\\nThe first symptom in many women is nausea and vomiting.\\nThis comes in the morning upon assuming an upright position,\\nor may come after breakfast. It may occur a few days after\\nconception, but usually not until the fourth or fifth week, and\\ngenerally ends at the fourth month when the uterus begins to\\nrise out of the pelvis. The morning sickness is a sympathetic\\ndisorder reflected from the uterus, and aggravated by unpalatable\\nfood, sexual excitement or emotional disturbances. There may\\nbe cravings for indigestible food or substances. Excessive flow\\nof saliva is a frequent accompaniment, which may last longer than\\nthe nausea and vomiting.\\nThe second symptom is the stopping of the monthly sickness.\\nThis is so reliable that if to the date of the beginning of the last\\nmenstrual period 278 or 280 days be added, an approximate", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0533.jp2"}, "532": {"fulltext": "510 OBSTETRICS.\\nestimate of the time of the coming delivery is obtained. The\\nmenstruation may not cease until the second month of pregnancy,\\nbut the preceding menstruation being much diminished in quan-\\ntity would be a very good sign. So many things may cause\\nstopping of the menses that this symptom, unless corroborated\\nby other symptoms of pregnancy, cannot be considered positive.\\nThird. The breasts are in immediate sympathy with the\\nreproductive organs and there is, with the constant increase in\\nsize, frequently a sensation of weight or of pricking, the veins\\nbecome enlarged and more visible, the nipples enlarge and fol-\\nlicles are found in the areolae. A secretion after the second month,\\nupon pressure, is significant. Suppression of the milk in nursing\\nwomen is a strong indication of another pregnancy.\\nFourth. Disturbances of the bladder are common because\\nof its diminished capacity, due to the increased size and settling\\ndown of the uterus, so that there is frequent urination; and ina-\\nbility to retain the urine may occur from coughing or sneezing\\nwhen the bladder is distended.\\nFifth. The intrapelvic signs. These are (a) A softening of\\nthe neck of the uterus; (b) the dark blue color of the vulva and\\nvaginal mucous membrane (but this may come from congestion\\ndue to vaginal or uterine disease) (c) Hegar s sign, an enlarge-\\nment of the uterus in all directions (d) the position of the uterus\\nin the first and second months is lower, but in the third month\\nit begins to rise and tip forward.\\nSixth. Abdominal changes in size, shape and appearance,\\n(a) During the first eight weeks there is some -Rattening of the\\nabdomen, probably due to the descent of the uterus into the pelvis,\\ndragging with it the bladder and depressing the navel. At the\\nfourth month the uterus begins to rise for accommodation from\\nthe pelvic cavity, reaches the navel at six months, and touches\\nthe cartilage of the breastbone in eight and a half months.\\nLater it begins to sink in the pelvis as the ligaments relax. These\\nare changes that precede the coming delivery. The uterus is\\nmore symmetrical and contracts on being touched. There are\\nchanges in the color of the abdominal surface, markings due to\\nstretching and brown lines. Fetal movement can generally be\\nseen through the abdominal walls after the sixth month.\\nSeventh. Ballotment is the perception of the return of a\\nsolid body in a liquid when given a push from some external", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0534.jp2"}, "533": {"fulltext": "OBSTETRICS. 511\\nsource. The physician practices vaginal ballotment, but abdom-\\ninal ballotment may be secured by pressing lightly some portion of\\nthe abdominal wall and at the same time giving an impulse by\\ntapping from the opposite side. The abdomen must not be over-\\ndistended, the fetus must not be too large and there must be\\nsufficient amniotic fluid to get this sign. It is obtained only in\\nthe fifth, sixth and seventh months, but when secured is an abso-\\nlute sign of pregnancy, for no other condition presents a solid\\nbody floating in a liquid but if not obtained it does not preclude\\nthe possibility of pregnancy, for many conditions prevent it from\\nbeing distinctly felt.\\nEighth. Intermittent contractions of the uterus, continually\\nkept up independently of the will and perceptible to touch when the\\nhand rests upon the enlarged uterus for a short time. Other\\nconditions resemble this, even an overdistended bladder.\\nNinth. Quickening felt by the mother as the result of fetal\\nmovements. These usually first occur about the middle of preg-\\nnancy, but are uncertain. When felt by the physician, as they\\noften are by the sixth month, they are a very reliable sign. The\\npatient may think that she feels movements when she does not,\\nthe sensation being due to gas in the intestines, or some other\\ncause, giving rise to what is known as false pregnancy.\\nTenth. Uterine sounds caused by movement of the mother s\\nblood through the uterine blood vessels. It is heard after the\\nfourth month, but is uncertain and varies in pitch, duration and\\nlocation. Sounds may be heard when tumors are present.\\nEleventh. The fetal heart sound cannot, as a rule, be heard\\nearlier than the fifth month. Later it usually becomes quite dis-\\ntinct, but it may be feeble throughout the entire pregnancy. When\\nthe child is in the normal position this sound is best heard at a\\npoint on the left side of the abdomen, midway between the navel\\nand the front spine of the hip bone. The average frequency\\nof the pulsations of the fetal heart is 140 per minute. They may\\nbe less or more frequent, and the rate often varies temporarily.\\nThese sounds are heard earlier in a large fetus and, usually, earlier\\nin males.\\nTwelfth. It is often possible to detect the size, shape and\\nposition of the fetus by abdominal touch.\\nThirteenth. Mentally and emotionally women are somewhat\\nchanged during pregnancy. Usually they are irritable, fretful and\\nchangeable, though they may be buoyant and cheerful.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0535.jp2"}, "534": {"fulltext": "512 OBSTETRICS.\\nRELATIVE VALUE OF THE SIGNS OF PREGNANCY.\\nFirst. The presumptive evidences of pregnancy are men-\\nstrual suppression; morning sickness; irritable bladder; mental\\nand emotional phenomena.\\nSecond. The probable evidences are breast changes; bi-\\nmanual signs; abdominal changes in shape, size and color; also\\nchanges in shape, size, color and consistency of the neck of the\\nuterus uterine murmurs and intermittent contractions.\\nThird. Positive signs of pregnancy are the active move-\\nments of the fetus passive movements of the fetus and fetal heart\\nsounds.\\nMATERNAL IMPRESSIONS.\\nThere is a widely prevalent belief that impressions received\\nduring pregnancy will in some way mark or deform the child, and\\nmany instances are cited, but, as a matter of fact, in very many\\nof the cases to which reference is made, the impressions would\\nhave to have been received either before or after the time at\\nwhich they did occur, to have been able to cause the conditions\\nattributed to them. It has always been a great pleasure to me\\nwhen questioned on this subject to assure my patients that if\\nmaternal impressions ever do in any way mar a child they are\\ncertainly rare exceptions.\\nWhat a deformed and distorted people we would be were each\\nchild as seriously affected as supposed, by every disagreeable shock\\nreceived by the mother during pregnancy. At the same time it\\nis wise to avoid undue emotions and unpleasant shocks and scenes,\\nfor they are sometimes the causes of miscarriage.\\nAs there is little doubt that the mental and physical inherit-\\nance of the child is the sum of both parents attainments, natural\\nand acquired, good and bad, how necessary not only that the\\nmother lead an ideal life during the nine months, the father heart-\\nily assisting her, but that all their former months should have been\\njust as well spent, that the child to be shall have that highest ad-\\nvantage, a goodly heritage.\\nTHE DURATION OF PREGNANCY.\\nThe normal duration of pregnancy is nine calendar or about\\nten lunar months, or 270 to 280 days from the first day of the last\\nrecurring menstrual period. One of the best methods of comput-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0536.jp2"}, "535": {"fulltext": "OBSTETRICS. 513\\ning the end of pregnancy is to determine the exact day on which\\nthe menstruation last appeared, count forward nine months or\\nbackward three months, and add seven days.\\nThere are many exceptions and, even were the circumstances\\nsuch that there was but a single coitus, there is a difference\\nof time in different women, and in the same women at different\\ntimes, between insemination and the fertilization of the ovum.\\nY\\\\ nile it is not positively known for how long a time the ovum\\nis capable of fertilization, experiments upon the lower animals\\nhave justified the opinion that it is as long as it remains in the\\noviduct, or about eight days. The spermatozoa show remark-\\nable vitality even under less favorable circumstances and may re-\\ntain their function up to three weeks after being deposited in the\\nvagina. These facts render it impossible to fix with any certainty\\nthe beginning of pregnancy that is to determine positively the\\nmoment of fecundation. The length of pregnancy often becomes\\na serious question, affecting the moral character of the mother and\\nthe legitimate and hereditary rights of the child. The records\\nof many obstetricians show numerous cases of prolonged preg-\\nnancy. Since the development of certain portions of the body,\\nas the teeth, are often delayed, we are forced to believe that\\ngestation may be prolonged and delivery delayed.\\nTHE HYGIEXE AXD MANAGEMENT OF PREGNANCY.\\nIn order that the pregnant woman may be carried safely\\nthrough this the most trying period of her life, attention must be\\ngiven to diet, exercise, rest, sleep, clothing and bathing. To\\nmeet coming demands the breasts need preventive treatment.\\nEarly in pregnancy the desire for food is diminishd and there is\\ncraving for unnatural food. A fair amount of nourishment must\\nalways be taken. It should be easily digested and so prepared\\nas to make it palatable. Attention must be paid to desire for food\\nas far as possible, and associations made congenial. In this way\\nthe morning sickness may be much lessened. In the fourth month\\nthe stomach irritability usually ceases and the appetite increases.\\nAll foods, animal and vegetable, that are reasonably well digested\\nare suitable to her needs. The diet must still be. simple, A T ery nu-\\ntritious, easily digested and taken at regular intervals. It should\\ninclude a good supply of nitrogenous food, such as eggs, milk and\\neasily digested meats, and vegetables and fruits. A good supply\\n33", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0537.jp2"}, "536": {"fulltext": "514 OBSTETRICS.\\nof nutritious food improves the blood, increases functional activity,\\nprevents emotional and nervous irritability, and promotes the\\nhealthy growth of the fetus.\\nNo iron clad rules can be made as to just what any person\\nshould eat, but the pregnant woman must not eat a large amount\\nof sweets and stimulants. Vegetables are good for her, but in-\\nferior to fruits. An abundance of water is a necessity. Milk,\\nwhen it agrees, is a valuable addition to the diet, and sometimes\\nis greatly needed. In cases of albuminuria, the milk diet, strictly\\nenforced, will greatly lessen the danger of the complication known\\nas eclampsia or the spasms of pregnancy. In the latter part of\\npregnancy the enlarged uterus so presses upon the stomach that\\nthe food must be taken in smaller quantities and more frequently.\\nIf the intestines become torpid, such laxatives should be used\\nas will produce a free movement without purging. Compound\\nlicorice powder in small doses or mineral water, such as hunyadi, or\\na laxative, as cascara sagrada, five grains, or twenty drops of the\\nfluid extract, is useful. When the liver is inactive, one-fourth\\ngrain of calomel and soda tablets are advised, to be repeated every\\nhalf hour until four doses have been taken, then followed two hours\\nlater by a saline laxative, as a tablespoonful of Epsom salts, a tea-\\nspoonful of phosphate of soda, or a Seidlitz powder. The pre-\\nvention of constipation and toxemia requires such care of the skin\\nas will promote its free action. Frequent bathing in tepid water,\\nflannel, varying in weight according to the season and climate,\\nworn next the skin, massage and gentle exercise, should not be\\nneglected. The patient should have an abundance of fresh air,\\nand, properly clothed, may be outdoors in all weather.\\nWith few exceptions, all can take moderate exercise, but vio-\\nlent exercise and great fatigue should be avoided. There should\\nbe no riding over rough roads, or on horseback, or dancing or lift-\\ning heavy weights, and long journeys by land or water should not\\nbe taken. Without doubt women accustomed to active exercise,\\nif no complications arise, have easier labors, but those not ac-\\ncustomed to it should not then take more than they can com-\\nfortably bear. For those who cannot take active exercise passive\\nexercise is beneficial. Fresh air and sunlight should be obtained\\nby riding in the open air. The pregnant woman should not live\\nin crowded, ill-ventilated rooms. If there is much relaxation of the\\njoints exercise may be objectionable; it always is when there are\\nsymptoms of miscarriage.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0538.jp2"}, "537": {"fulltext": "OBSTETRICS. 515\\nThere must be plenty of sleep. A portion of each day, at least\\nan hour or two after the midday meal, should be set aside for sleep\\nor rest in the recumbent position.\\nThe clothing- should be so worn as not to compress the\\nabdomen or chest and is best suspended from the shoulders. Cor-\\nsets and tightly fitting skirts, by causing abnormal pressure upon\\nthe uterus and its contents, predispose to the complications of\\npregnancy, albuminuria and uremia. To women with relaxed ab-\\ndominal walls a bandage which supports gives great relief. Every\\nmeasure should be used to relieve pressure upon the renal and\\npelvic veins.\\nBathing should be kept up as in health, once a day in warm\\nweather, and twice a week in cold weather, using plenty of soap\\nand water, the temperature of the bath to be that which is most\\nagreeable. If the activity of the skin is impeded in the later\\nmonths of pregnancy the functional activity should be stimulated\\nby frequent baths. Vaginal injections are not needed unless there\\nis much leucorrhea, in which case a saturated solution of boric acid\\nshould be used from the fountain syringe with gentle flow.\\nSexual intercourse should be very carefully regulated, for it is\\noften injurious to the pregnant woman, giving rise not only to\\nmuch pelvic discomfort but being the primary cause of many\\nabortions. This is especially true of the first and last months of\\npregnancy. If the neck of the uterus becomes diseased, re-\\nquiring local treatment by the physician it may be safely given.\\nAbortions are more likely to result from diseased conditions that\\nhave been neglected and many nervous complications, nausea and\\neven greater dangers can often be avoided, and the delivery made\\neasier, by careful local treatment.\\nThe mind should be pleasantly occupied, cheerful and agree-\\nable associations provided, and plans of entertainment not neg-\\nlected, since many of the former occupations are beyond reach.\\nIt is the time for the husband to intelligently co-operate with the\\nwife.\\nFor disorders of the stomach koumiss sometimes gives good\\nresults. It may be necessary to resort to rectal feeding. Nausea\\nand vomiting can often be relieved or made bearable by judicious\\ntreatment. There are many preparations for this purpose but\\nthey should be taken only when prescribed by the physician in\\ncharge. The bowels should be moved at least once daily.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0539.jp2"}, "538": {"fulltext": "516 OBSTETRICS.\\nIn constipation a teaspoonful of phosphate of soda in a cup\\nof hot water before breakfast, or a Seidlitz powder, as needed, may\\nbe used but cascara sagrada in five-grain tablets, or twenty drops\\nof the fluid extract at bedtime, is a better remedy, in some cases.\\nIt is of still greater importance to examine the urine at least\\nonce a month during the last half of the pregnancy, for indications\\nare often thus obtained whereby spasms and uremia may either\\nbe avoided or modified.\\nThe breasts need plenty of room for development. If the\\nnipples are retracted they should be drawn out with the thumb\\nand finger for a few minutes each day for the last six weeks.\\nDaily washing with cold water is necessary. During the last\\nmonth, to prevent sore nipples, bathe them in strong alum water,\\nor a lotion made by adding a dram of tannic acid to a half ounce\\neach of glycerin and water. Apply once every day.\\nAs the pregnant woman is subject to all kinds of disorders\\nand her enfeebled system is rich soil for disease, anything added\\nto the burden of maternity may become a most serious menace\\nboth to herself and child, and as no two women are alike in preg-\\nnancy, and as no two pregnancies are alike in the same woman,\\nthe only safe way is to consult a good physician in case of ailments\\nand complications.\\nCONDITION OF THE UTERUS AND ITS APPENDAGES.\\nThe pregnant uterus naturally inclines to the right, and may\\nsometimes so rotate as to seem almost twisted. Its great enlarge-\\nment favors the increase of any tumors that may be within its\\ntissues or closely connected therewith. If small they may not be\\ndiscovered, or they may be the cause of early abortion, or give\\nrise later to bad results. Cancer increases very rapidly during preg-\\nnancy and is a serious complication in labor.\\nInflammation of the mucous membrane of the uterus is\\noften a cause of abortion, and of hemorrhages or watery discharges\\nshould the pregnancy continue. This condition is usually a result\\nof an inflammation which existed before conception. It may give\\nrise to adhesion of the afterbirth, also to intermittent fever from\\nblood poisoning. The treatment in such cases would be the\\nemptying and cleansing of the uterus under antiseptic precautions\\nby the physician in charge.\\nInflammation of the oviducts often causes much pain during", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0540.jp2"}, "539": {"fulltext": "OBSTETRICS. 517\\npregnancy by reason of the exudation and adhesions which restrain\\nthe uterus from increasing easily and normally, and thus becomes\\na cause of abortion. It may give rise to general peritonitis and\\nacute attacks of blood poisoning when labor occurs. A woman\\nwith this affection should avoid pregnancy. If it habitually exists\\na thorough course of treatment for recovery must be taken.\\nDiseases of the ovaries are generally made worse by preg-\\nnancy.\\nThe disorders of the vulva occurring during pregnancy are\\nusually due to injuries or constitutional disturbances, but are some-\\ntimes caused by lack of cleanliness, in which case local treatment\\nshould be applied.\\nPruritis, or itching of the vulva, is one of the most disagreeable\\ncomplications and, when not due to lack of cleanliness, is usually\\na result of digestive troubles or diabetes, though it may arise from\\nsome local cause. It is besi treated by frequent baths followed\\nby applications of soothing ointments, of which carbolic oint-\\nment and carbolized vaseline salve are good. The disorder may\\nalso require constitutional remedies.\\nDisplacement of the uterus may cause great discomfort, com-\\nplicating and even terminating pregnancy. Weakened uterine\\nsupports often follow frequent pregnancies and allow displace-\\nments to occur. The most frequent form is the retroverted uterus,\\nthat is, the body of the uterus is tipped back upon the rectum,\\ncausing a dragging sensation with a probability of impaction in\\nthe pelvis. Relief is obtained by lying upon the side or resting\\nupon the chest and knees. When there are no adhesions and\\nstill no tendency to right itself, manipulation by the physician will\\noften succeed. Sometimes it is necessary to retain the uterus in\\nthe proper position by wool pledgets, or a properly fitting pes-\\nsary, until the fourth or fifth month, when the uterus rises above\\nthe pelvis and further danger from this source is removed. Cases\\nof habitual abortion may be cured by thus raising the uterus.\\nWhen there are adhesions great care must be given to stretch-\\ning them gradually by the use of cotton or wool tampons. It\\nmust be borne in mind that where adhesions exist there is also a\\npossibility of inflammation that may give rise to blood poisoning.\\nThe urethra, bladder and ureters have an increased blood sup-\\nply during pregnancy and thus share in the disorders. The\\nurethra may be closed in some portion by pressure of the displaced", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0541.jp2"}, "540": {"fulltext": "518 OBSTETRICS.\\nuterus, and great distention of the bladder result with paralysis\\nof its muscular layer and decomposition of the urine, followed\\nby erosion, ulceration and, finally, perforation, unless relieved by\\nthe catheter.\\nCOMPLICATIONS DURING PREGNANCY.\\nIf inflammation of the bladder or bloody urine occurs during\\npregnancy, rest in bed is necessary. If there be gonorrheal in-\\nflammation of the urethra, careful treatment must be given, for\\nwhen labor comes pressure upon the urethra may liberate germs\\nthat until that time had been quiet and an inflammation of the\\nbladder follow which may extend to the ureters and kidneys, giv-\\ning rise to acute inflammation of the kidneys. This process\\nreaches its development only after several weeks, and the patient\\nusually dies from blood poisoning.\\nThe kidneys share with the other organs in the general\\ncongestion and enlargement at this time, and their diseases are\\naggravated by the pregnancy. This congestion is due to the\\ntension to which all the organs within the abdominal cavity are\\nnow subjected, to disturbances in the nutrition of the kidneys\\nbecause of the altered condition of the blood, and to engorgement\\nof the ureters from mechanical pressure. Convulsions may occur\\nwithout kidney trouble, but in most cases a diseased condition of\\nthe kidneys is easily shown. In acute kidney failure there is\\na great diminution in the amount of urea excreted and this means\\na quick fatality unless the condition can be remedied. The albumi-\\nnuria of pregnancy is of very frequent occurrence and is not of ser-\\nious import unless due to kidney inflammation a matter which\\ncan be decided by a microscopical examination of the urine.\\nThe treatment of the disorders of the urinary organs in-\\nvolves an examination of the position of the uterus with relation\\nto the bladder and ureters, and correction of all displacements, also\\nexamination for inflammation of the bladder, which disease may be\\ntreated by a douche of some antiseptic solution. There is danger\\nthat after labor a case of chronic Bright s disease may set in.\\nPeritonitis during pregnancy is usually the result of previous\\ninflammation, from germs or spores, of the mucous membrane of\\nthe uterus, of the oviducts, or of the connective tissue of the\\npelvis, A sudden exposure to cold or dampness, or a cold bath\\nwhen the patient is overheated, may give rise to a fatal peritonitis.\\nIt may also be caused by mechanical injury or severe strain.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0542.jp2"}, "541": {"fulltext": "OBSTETRICS. 519\\nConcealed hemorrhage into the abdomen, or into the uterus,\\nduring the last months of pregnancy is of serious import. It is\\nbest recognized by the collapse and general condition of the pa-\\ntient. Treatment must be applied very quickly.\\nA relaxation of the pelvic ligaments often occurs, sometimes\\nso great as to cause lameness and considerable pain. An ab-\\ndominal bandage, having padded perineal bands, is the most suc-\\ncessful treatment.\\nIn the changes during pregnancy there is often formed and\\ncarried into the blood a toxic material which may endanger the\\nlife of mother and child. The principle form of this poison is an\\nanimal alkaloid known as a toxine. The symptoms produced by it\\nare chiefly of a nervous variety. Several poisonous principles\\nhave been found in the urine. Poisons absorbed from the intes-\\ntines are closely related to the toxines of pregnancy, and this is\\nmore likely to occur when, from displacement, the uterus presses\\nupon the rectum. It has been noted that in such cases there is\\nvery little if any structural change in the kidneys. This trouble\\nduring pregnancy has been ascribed to the inactivity of the liver.\\nThe treatment is preventive by keeping the secretions up to the\\nnormal amount.\\nAll compression of the pelvic organs should be avoided by\\nwearing loose clothing suspended from the shoulders. The corset\\nshould be abandoned. Constriction of the blood vessels should\\nalso be avoided by guarding against constipation, and by wearing\\nloose shoes and no garters that encircle the legs. To prevent con-\\nstipation the patient must partake only moderately of heavy meats.\\nAbundance of fruits, cooked or raw, and, if the digestion is good,\\nwhole wheat, graham and rye bread are proper.\\nWomen may pass through pregnancy without serious trouble,\\nbut again may not, and as many grave complications may be\\navoided by the timely use of preventives, none can afford to be\\nnegligent. Vigilance is the price of safety, even though it cost\\nmuch inconvenience. The amount of urine should be observed and\\nif there be any decrease the physician should be notified.\\nThe amount and character of the excretions and the condi-\\ntion of the nervous system are two things of great importance in\\nthe diagnosis of toxemia. Its treatment consists of prompt stim-\\nulation of all the excretory organs.\\nWhen threatened with toxemia the diet should consist of milk,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0543.jp2"}, "542": {"fulltext": "520 OBSTETRICS.\\nfruit and bread, or fish, oysters and gruel. Avoid meat, eggs,\\nvegetables, pastries of all kinds and stimulants, including tea and\\ncoffee. The examination of the urine should note the quantity\\npassed daily and the amount of urea. If there is inflammation of\\nany importance the microscope will show granular casts.\\nSimple albuminuria is of little importance, but the circula-\\ntion of poisonous materials in the blood of the mother calls for\\nmost urgent treatment.\\nDISORDERS OF THE NERVOUS SYSTEM.\\nOften the neuralgias are of great annoyance. They have their\\nstarting point in some disordered condition of the nervous system,\\nor irritation from decayed teeth. If there is very much constipa-\\ntion and the fetus is large so as to press heavily on the pelvis, there\\nmay even be sciatic pain and obstinate cramps in the limbs, causing\\ngreat distress. If caused by a misplaced uterus that should be\\nremedied, and attention then be given the bowels, and the\\nlarge bowel thoroughly flushed and emptied. Anemia and\\nmalaria are also causes of neuralgia; the relief of the former con-\\nsists of building up the entire system; for the latter, antimalarial\\nremedies are in order. Neuralgias come at irregular times, some\\nat night, others in the morning or afternoon and attacks follow ex-\\nposure to dampness and cold. If painful spots can be located,\\nthey may be painted with iodine or rendered insensible by an\\nether spray. The constitutional treatment consists of freely\\nemptying the bowels that the system may be cleared of the poison\\nof retained feces, that may be depressing the nervous system.\\nSometimes absolute rest in a warm, room is necessary. Besides\\nsimple, easily digested food, tonics may be useful.\\nDerangement of the various secretory nerves during gestation\\nis seen in what is called the salivation of pregnancy, and the exces-\\nsive secretion of tears and perspiration in poorly nourished women.\\nHerpes is another of the annoyances. It usually occurs about the\\nfifth month and is apt to recur in succeeding pregnancies. Al-\\nthough an intense itching accompanies the eruption, the pregnancy\\nis in no way affected by it, the general health remaining good.\\nIt may also come after labor. The treatment consists in regulat-\\ning the bowels and other functions of the body.. The hypophos-\\nphites and iron are valuable in these cases. Local applications\\nto be made are borated vaseline, or lime water and olive oil. When", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0544.jp2"}, "543": {"fulltext": "OBSTETRICS. 521\\nthe eruption has fully developed subnitrate of bismuth or powdered\\nstarch are soothing and useful. For the itching, carbolic acid in\\ndiluted solution, or menthol, is effective. When a large part of the\\nbody is involved, baths containing starch or bran are very grateful.\\nUniversal pruritis may materially interfere with the patient s gen-\\neral health.\\nMania during pregnancy is seen in those women who are of a\\nvery nervous disposition, or who have inherited insanity. Alco-\\nholism and hysteria predispose to it, and it may be caused by great\\nmental shocks at this time.\\nUnhappy marriage is also an important factor in the causation\\nof the insanity of pregnancy. Toxemia may also be a cause, as as-\\ncertained by examining the excretions. The prospect for recovery\\ndepends upon the cause and whether it is removable or not. If\\nmania follows a severe shock and if the patient s general health\\nis good, the outlook is encouraging but if there is great physical\\ndisability, founded upon some diseased condition, the aspect is\\nmost serious. The treatment consists in the use of sedatives,\\ncomplete seclusion from all company and a building up of the gen-\\neral health by every available means. When due to toxemia se-\\ndatives should not be given, but remedies used to promptly elimi-\\nnate the poisons from the system.\\nTHE NAUSEA AND VOMITING OF PREGNANCY.\\nThe nausea and vomiting of pregnancy may be ascribed to\\nsome derangement of the uterus, such as malformation or dis-\\nplacement, or an injury to this or some other of the genital organs,\\nsudden shock, disease affecting the blood, movements of the fetus,\\nor violent peristalsis of the intestines. Distention of the bladder\\nand rectum is frequently present. An inherited tendency to ner-\\nvous irritability is often a predisposing cause.\\nThe vomiting usually comes early in the morning, just as the\\npatient lifts her head from the pillow, and is almost instantaneous.\\nIt may be repeated, and is without straining. After this the pa-\\ntient may take food and no more trouble occur until the next morn-\\ning. The more severe cases begin in the morning and are not re-\\nlieved by vomiting. The materials ejected are mucus, burning,\\nbitter, and often sour. Although food may be taken and retained,\\nthe nausea may persist until late in the day, or longer. Distress\\nof anv kind, or certain articles of food, may increase it, and if the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0545.jp2"}, "544": {"fulltext": "522 OBSTETRICS.\\nvomiting is repeated there is likely to be straining and retching.\\nAfter midday the patient is likely to be much better and able to eat\\na full meal.\\nIn another class of cases the nausea is persistent, continuing\\nthrough the waking hours. Various articles of food are craved\\nbut give no .satisfaction. There is much vomiting and retching,\\nwith either dryness of the mouth and throat, or salivation. The\\nvomit may first be mucus and food, then bile, and in more severe\\ncases blood, then a coffee-grounds material. Food is no sooner\\ntaken than ejected; yet there are times of tolerance which give op-\\nportunity for some nourishment. Later in the case there is dis-\\ntress beneath the breast bone emaciation is more or less rapid a\\nclammy sweat appears and there is great anemia. The signs of\\nimprovement are less vomiting and nausea, ability to retain food,\\nnatural excretions and considerable periods of sleep without vom-\\niting.\\nIt is hard to relieve cases of nausea and vomiting when the\\npregnant uterus is tipped back and bound down in the pelvis. This\\ncondition may be caused by persistently wearing tight clothing\\nbefore and after the beginning of pregnancy, or it may be con-\\ngenital. In order to properly treat this malady a thorough ex-\\namination of all external causes, as well as a knowledge of the\\nuterine condition, is necessary. When there is displacement, re-\\nplace if possible. The uterus is often retained in proper position\\nby tampons of wool inserted by the physician.\\nIn serious cases of vomiting the treatment consists of\\nputting the patient to bed, in the care, of a competent attendant\\nwho will secure nourishment by supplying a variety of foods,\\nand conserve the strength so much needed. The nourishment\\nshould be given by mouth if possible; if not, rectal feeding must\\nbe the next resort. The articles best given are beef in the form\\nof peptonoids, peptonized beef juice, peptonized milk, champagne\\nby stomach, and alcohol by rectum when necessary.\\nIn case of chronic catarrh of the stomach the stomach may\\nbe washed out with salt and water, a teaspoonful to the quart,\\nby means of a stomach tube. Solid food must not be given\\nuntil there is considerable improvement the patient s taste\\nmay be used as a guide. When only digestible articles are\\nallowed, scraped raw beef, oysters, junket, milk with lime water\\nand broths may be taken. A warm bath will often secure rest", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0546.jp2"}, "545": {"fulltext": "OBSTETRICS. 523\\nand stimulants can be given by the rectum when necessary.\\nSpontaneous cure of this trouble is no doubt due to a misplaced\\nuterus righting itself by some change of position.\\nBad conditions of the mouth and teeth often cause much dis-\\ntress. The gums may become very soft. The pain in the teeth is\\nsometimes a reflex from the uterus. The treatment lies in proper\\nattention to the general health. The decayed teeth should be\\nfilled with as little irritation to the patient as possible, or, if neces-\\nsary, extracted rather than allow continued suffering.\\nThe blood is frequently bad in ill-nourished women. The\\nanemia of pregnancy should be treated by tonics and proper diet.\\nUnless these women are built up in general health, alarming\\nsymptoms frequently develop as the pregnancy advances and the\\ndiseased conditions of the blood become more pronounced.\\nDuring the last months of pregnancy pressure upon the rec-\\ntum predisposes to piles. They are relieved by hot compresses,\\nor by an ice bag if more agreeable to the patient. Witch hazel\\non cotton and equal parts of belladonna and stramonium oint-\\nments are also efficient remedies.\\nINFECTIOUS DISEASES DURING PREGNANCY.\\nPregnancy renders the patient peculiarly liable to the devel-\\nopment of infectious germs, the excessive blood supply being\\nfavorable to their growth, so that complications of such a nature\\nat this time assume very severe forms. Gonorrhea is frequent.\\nWhen there is burning and difficulty in urination, with an irri-\\ntant discharge, there should be an examination for this disease,\\nalthough other causes exist for these symptoms. The attack is\\nmore virulent than in the nonpregnant, and the gonococci may\\nnot only infect the mucous membrane of the vagina, rectum and\\nsurrounding tissues, but also that of the uterus and the fetus itself.\\nChildren have been born with gonorrheal ophthalmia. The\\nmother s entire genital tract may be affected, including ovaries\\nand tubes. It does not always immediately show itself, but after\\nlabor may sometimes be the cause of death through virulent\\nblood poisoning. In every locality of the body affected strong\\nantiseptic measures must be adopted when it can be reached, or,\\nin extremity, surgery employed.\\nSyphilitic infection may run the ordinary course or may\\nbecome very malignant. Septic germs may be associated with", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0547.jp2"}, "546": {"fulltext": "524 OBSTETRICS.\\nsyphilis and give rise to blood poisoning after labor. Syphilis\\npredisposes to abortion and in 75 per cent of the cases the fetus\\nis lost. The disease is aggravated by pregnancy. To be effi-\\ncient anti-syphilitic treatment should begin as soon as infection\\noccurs.\\nThe local treatment consists of cleanliness and the mainte-\\nnance of local asepsis. Antiseptic douches should be used to\\ncleanse the parts, and ulcers should be dusted with calomel and\\niodoform. All discharges of such patients must be received in\\nabsorbent cotton and burned. The constitutional treatment be-\\nlongs to the physician to direct. In addition it is of great im-\\nportance that a liberal diet with stimulating tonics be persist-\\nently taken. Since the condition of the pregnant woman renders\\nher so liable to contract contagious and infectious diseases, she\\nshould not be exposed to scarlet fever, measles, diphtheria, ery-\\nsipelas, small-pox, varioloid, cholera or whooping cough, or live\\nin rooms where a consumptive is confined. The danger is es-\\npecially great when exposure to any contagion or infection occurs\\neither during labor or in the lying-in period.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0548.jp2"}, "547": {"fulltext": "CHAPTER III.\\nABORTION.\\nThe term abortion is generally applied to the termination\\nof pregnancy, by the expulsion of the ovum, before the expiration\\nof twenty-eight weeks expulsion of the fetus after that, and until\\na short time before full term, being called premature delivery\\nor miscarriage. Abortion occurs most frequently in the first\\nthree months of pregnancy, when the ovum is usually expelled\\nintact; the greater liability at this time being due to the greater\\nvascularity of the uterine mucous membrane, the feeble attach-\\nment of fetal membranes, and, in the third month, to the change\\nfrom the complete attachment of the ovum to the uterus to\\nthe partial attachment at the site of the placenta. Later the\\nplacental attachment becomes stronger and the uterus adjusts\\nitself to the new order of things.\\nAbortion is caused by fetal death or uterine contractions,\\nand may be referable to the father, mother or fetus. Exciting\\ncauses, when combined with predisposing causes, act more di-\\nrectly upon the ovum. They are violent coitus, blows, falls,\\ncontusions, jars of railroad traveling, long rides, rapid stair\\nclimbing, lifting heavy weights, running a sewing machine, sea\\nbathing, stretching the arms above the head, missteps, etc.\\nMany of the predisposing causes become effective only when\\njoined with some exciting cause. It is impossible to predict in any\\ncase that an abortion will occur under certain circumstances,\\nfor often a very slight cause is sufficient, then again most serious\\naccidents have occurred and the pregnancy remained undisturbed.\\nThe paternal causes of abortion are syphilis, extreme youth\\nor old age, debauchery and feebleness. The maternal causes are\\nsyphilis, tuberculosis, infectious diseases, disorders of the kid-\\nneys, lungs, liver and heart, excess of carbonic acid, convulsive\\ndiseases, excessive vomiting or coughing, chronic lead poisoning,\\ngreat physical exertion, fright, anxiety and other emotional ex-\\ncitement. The habit of abortion is probably due to a continu-\\n525", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0549.jp2"}, "548": {"fulltext": "520 OBSTETRICS.\\nance of the conditions which first led to it, and the prospects of\\nescape from it in future pregnancies depend upon the probability\\nof relief from these conditions.\\nLocal causes are chronic or acute inflammations of the uterus\\nand its appendages, tumors, adhesions and displacement. Retro-\\nflexion and endometritis are especially liable to give rise to uterine\\ncontractions. Attachment of the uterus to other organs, a con-\\ntracted pelvis and tight lacing may cause fetal death by prevent-\\ning the development of the uterus. Surgical operations upon dis-\\ntant parts have caused abortion; again very serious operations\\nhave been performed upon the pelvic organs without causing any\\ntrouble, but in such cases there is always danger.\\nThe fetal causes of abortion are any abnormal condition of\\nthe ovum or its appendages, which may produce death of the\\nfetus; as inflammation of the membranes, syphilis, placental ap-\\noplexy, abnormal positions of the placenta, especially when near\\nthe mouth of the uterus, too short a cord and knotting of the\\ncord.\\nThe death of the fetus may be caused by disease transmitted\\nby the mother, such as syphilis, small-pox and other infectious\\ndiseases. The symptoms indicating abortion are seldom to be\\ndepended upon before the third month of pregnancy and cannot\\nalways be relied upon after that time.\\nSome of the signs are shifting pains in the back and abdo-\\nmen, frequent urination, nausea and vomiting, and if with these\\nthere be a watery discharge from the uterus the probability of an\\nabortion should be considered and preventive treatment com-\\nmenced. An abortion is generally slower than a normal labor.\\nIts duration depends upon the cause, the conditions present and\\nthe frequency and energy of the contractions of the uterus.\\nIf caused by a shock or severe fall an abortion may be almost in-\\nstantaneous, or after a few gushes of blood, but this is not the rule.\\nIn early abortion hemorrhage is usually the first symptom.\\nIt is often excessive and may be sufficient to cause the death of\\nthe mother. It may precede pain for hours, days or even weeks;\\nor it may be accompanied by pain, but rarely so in the beginning.\\nThe hemorrhage may be slight at first and increase or decrease,\\nor stop entirely, to begin again upon some excitation. The blood\\nmay ooze continually from the uterine surface and collect in con-\\nsiderable quantities to be expelled in clots. The amount of blood", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0550.jp2"}, "549": {"fulltext": "OBSTETRICS. 527\\nlost varies with the time in the pregnancy, being less near its com-\\npletion, also with the extent of injured surface caused by the sepa-\\nration of the ovum from the uterine walls. The bleeding usually\\ncontinues until the uterus is emptied.\\nThe pains of abortion resemble labor pains, and vary accord-\\ning to the existing conditions. In rare cases pain may precede\\nthe hemorrhage and is then likely to be harder to bear than the\\nusual labor pains.\\nIn the expulsion of the uterine contents, instead of the pla-\\ncenta and membranes being expelled with the fetus, a portion or\\nall of the placenta or membranes may remain in the uterus and\\nthere be considerable delay, even days, weeks or months, before all\\nis expelled. As long as any portion of the ovum or membranes\\nremain in the uterus the patient is liable to hemorrhage and blood\\npoisoning. When abortion has taken place, and is supposed by\\nthe patient to have been completed, it is very essential that all\\nfragments of tissue and the ovum, or supposed ovum, be saved for\\ninspection by the family physician, since positive diagnosis from\\ntheir examination will enable her to avert future risks and to de-\\ntermine upon the best modes of procedure.\\nA threatened abortion may be averted by proper measures,\\nthe first of which is absolute rest in bed, even in the mildest cases,\\nand the next the care of the physician. During pregnancy even a\\nslight show of blood requires this quiet rest in bed, as almost in-\\nvariably matters go from bad to worse and, since in this condi-\\ntion, the life, both of mother and child, is at- stake, no woman\\nshould take any risks. For the child, in the earlier months, death\\nis certain, while to the mother a badly managed case of abortion,\\nwith the resultant pernicious consequences, is not nearly as amen-\\nable to treatment as the same condition after labor at full term.\\nThere may be anemia with great debility after severe hemorrhage\\nat the time of the abortion, or recurring hemorrhages may re-\\nsult from the failure of the uterus to return to its normal size,\\nor from retained fetal membranes.\\nSome of the common local results of abortion are inflamma-\\ntory diseases of the uterus, ovaries, tubes and adjacent structures,\\nwhich may lead to abscesses. If some of the membrane or pla-\\ncenta be left, moles or tumors of the uterus may be formed; or\\nthere may be secondary infection, resulting in abscesses in the\\njoints or any other part of the body. Abortion is disastrous also", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0551.jp2"}, "550": {"fulltext": "528 OBSTETRICS.\\nto the nervous system, the irritation often being due to reflex\\nmanifestations arising from local conditions, or to self-infection\\nfrom a continuous absorption of slightly poisonous materials\\nfrom a chronically inflamed mucous membrane.\\nThe preventive treatment in abortion consists of making the\\npatient as nearly perfect physically as possible, and from the be-\\nginning- of pregnancy carefully avoiding exciting causes. Local\\ncauses, such as tumors, uterine inflammations and displacement,\\nshould be treated and cured before conception, and general dis-\\neases, as tuberculosis, syphilis, anemia and nervous troubles, as\\nwell as chest and abdominal affections, remedied as far as possible.\\nSyphilis is responsible for a greater number of. abortions than\\nany other one disease. If present in one or both parents it should\\nreceive prompt and thorough treatment, and during pregnancy\\nthe greatest care should be taken to avoid all possible sources of\\nirritation, as fatiguing work, lifting, riding, dancing, too long\\nwalks, stair-climbing, reaching, jumping, sea-bathing, corsets,\\ntight clothes, contagious diseases, overheated or poorly ventilated\\nrooms, crowded theaters or congregations, emotional excitement,\\nlate hours, etc. The diet should be carefully selected that acute\\nindigestion, gas, nausea, colic, diarrhea and constipation may be\\navoided. The kidneys should be properly regulated, and coitus\\nprohibited. At the time corresponding to the menstrual period\\nthe patient should spend several days in bed. In cases of repeated\\nabortion it is wise to take from six months to a year for treatment\\nof causative conditions before entering upon another pregnancy.\\nIn a few cases confinement to the bed, practically during the whole\\npregnancy, seems the only way of prolonging it to full term.\\nIn the beginning of an abortion, if the pains are not too\\nhard or the hemorrhages too severe, there is hope, with quiet and\\nrest, of preventing a further separation of the ovum from the\\nuterus. The patient should be put to bed in the most quiet, best\\nventilated room in the house, and should remain in a recumbent\\nposition for several days, not rising even to a sitting position for\\nany purpose, a bed-pan being used for defecation and urination.\\nThere should be no talking, or visitors, or worry of any\\nkind. A free movement of the bowels must be secured each day\\nby a mild laxative or rectal injection. The clothing must be cool\\nand light, and the diet nutritious and easily digested, but not stim-\\nulating. All drugs and local treatment should be administered\\nunder the direction of a physician.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0552.jp2"}, "551": {"fulltext": "OBSTETRICS. 529\\nIn the after management of abortion there should be given\\nas much time for the repair of uterine lesion, and for the return of\\nthe uterus approximately to its former size, as in delivery at full\\nterm, and, owing to the imperfect development of the uterus at the\\ntime of abortion, even a longer period is often required for restor-\\nation. The treatment is quiet rest in bed, and such medicines and\\nlocal applications as may be needed.\\nThe province of this book is to point out the dangers and\\nshow how to avoid them, and, since to be forewarned is to be\\nforearmed and prevention is better than cure, the value of its\\ncounsel cannot be overestimated. Many times, too, it is able to\\nname the remedies that will aid in the restoration to health but so\\nmany combinations of complications occur in abortion as to make\\neach patient a law unto herself, and it is only upon careful diag-\\nnosis by a skillful physician that treatment can be minutely pre-\\nscribed; however, it is safe to say there would be a great de-\\ncrease in the number of pelvic disorders, and in the number of\\nabortions as well, were women always treated after abortion as\\nafter normal labor.\\nThe fetus may die and remain in the uterus for weeks and\\nmonths. This is called missed abortion. The symptoms of preg-\\nnancy then cease, the waters are absorbed, the abdomen becomes\\nsmaller and milk appears in the breasts. The child in the uterus,\\nwith the placenta and membranes, may become macerated or\\nmummified. It may not become putrid if the membranes are\\nunbroken, for the air with its load of poisonous germs cannot\\nthen gain access, but when air does find an entrance suppuration\\nwith its attendant ills soon follows. A dead fetus in the uterus,\\neven if it does not suppurate, impairs the general health and is\\nalways a source of danger, hence, after waiting a reasonable time,\\nshould be removed.\\nEXTRAUTERINE PREGNANCY.\\nExtrauterine pregnancy is the name given to a pregnancy oc-\\ncurring outside of the uterus, and although of sufficient importance\\nand interest to require mention here, let no woman, because of\\nhaving read this chapter, be frightened into believing that every\\nstrange sensation which she may hereafter experience is due to\\nsuch a pregnancy, for the condition is rare. When it does occur,\\nit may be either tubal, ovarian or abdominal.\\n34", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0553.jp2"}, "552": {"fulltext": "530 OBSTETRICS.\\nThe tubal pregnane} is the most frequent, and the abdom-\\ninal form is probably due to a rupture of the tubal variety. The\\ndevelopment of an ovum within a Fallopian tube is like that within\\nthe uterus, except that the tube, not being fitted for continuous en-\\nlargement, sooner or later ruptures beneath the broad ligament or\\ninto the abdominal cavity, at which time there is great danger of\\nexcessive internal hemorrhage with collapse and sudden death.\\nThe primary cause of extrauterine pregnancy is inflammation\\nof the Fallopian tubes, following uterine inflammations. The time\\nof the rupture depends upon the location. It usually comes from\\nthe second to the fourteenth week and, if there be no accident at\\nthe time of the first rupture, a second one may occur at any time\\nup to full term.\\nIf, at the end of the second month of extrauterine pregnancy,\\nthe death of the fetus occurs it may be entirely absorbed if after\\nthat time, it either undergoes mummification, or calcification, or\\nis converted into ammoniacal fat, or is decomposed. The mum-\\nmified fetus resembles an Egyptian mummy, and may turn into\\nstone, and remain indefinitely in the abdomen without causing dis-\\ncomfort. In case of rupture of the sac, so that air gains admit-\\ntance from the intestinal canal or other source, decomposition sets\\nin and an abscess may empty into the rectum, bladder or vagina,\\nor even burst through the abdominal walls and with the pus dis-\\ncharge the fetal bones. Should the fetus live until full term it\\ncould be delivered only by an opening through the abdominal\\nwalls. It is often feeble and after the delivery is not likely to live.\\nThe treatment usually consists in removal of the fetus by an\\nabdominal operation in order to save the mother s life, and this\\nmust often be done hastily to prevent death from hemorrhage a\\ncrisis that may occur at any time during the pregnancy.\\nThe symptoms of an extrauterine pregnancy may not differ\\nfrom those of a natural one, although at times the patient may\\nbe entirely unconscious of her condition. The breast changes, the\\ndisturbances of the stomach and pain in the affected side, with\\nabsence of menstruation, are the most frequent signs. There may,\\nhowever, be an increase of menstrual flow with discharge of small\\npieces of membrane. Pain may be almost constant, or entirely\\nabsent and the patient may or may not consider herself pregnant.\\nIf a vaginal examination is made before rupture the Fallopian\\ntube on that side will be found enlarged and, if the pregnancy is", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0554.jp2"}, "553": {"fulltext": "OBSTETRICS. 531\\nmuch advanced, the uterus will be pushed to one side. There\\nmay be pressure symptoms, but any tumor would cause such a\\ndisturbance.\\nThe symptoms of rupture are very marked. The patient,\\nusually well, or the subject either of but slight discomforts or of\\nthose attending pregnancy, is suddenly seized with severe abdom-\\ninal pain. The attack may come after only slight exertion, or even\\nwhen the patient is asleep in bed. If the hemorrhage is extensive\\nextreme collapse and unconsciousness occur. If the rupture is into\\nthe broad ligament the hemorrhage may cease, to recur later.\\nThe pulse, at first rapid, becomes weak and imperceptible; the\\nbreathing quickened and jerky. This condition terminates in\\nprofound shock and, if the bleeding be not soon stopped, in death.\\nThe case calls for a rapid, skillful surgical operation.\\nIf the tube ruptures early into the broad ligament, and the\\nfetus dies, there is usually no further trouble. Sometimes, in case\\nof slight hemorrhage, with the first rupture, the fetus continues to\\ngrow until full term, provided a second hemorrhage does not re-\\nsult disastrously, when there is an attempt at labor pains and\\nfeeble contractions. Prominent symptoms of pregnancy are al-\\nways present in the later months and at full term the fetus soon\\ndies, after which the fluids are absorbed, the abdomen lessens in\\nsize and the fetus, as before explained, may remain intact, resem-\\nbling a tumor, or change into a mummy or stone. There is danger\\nof decomposition and blood poisoning for months and years after\\nthe death of the fetus, unless mummification or petrification does\\ntake place. These cases are very rare and when they do occur it\\nis usually after several children have been born, and there has been\\na long interval following the last birth, or after an attack of pelvic\\ninflammation.\\nA tumor or an enlarged uterus tipped backward sometimes\\nresembles an early pregnancy, both in size and symptoms, and\\nunless life is in danger from inflammation or blood poisoning, the\\nplan of waiting until positive signs of pregnancy appear is\\nalways in order.\\nDISEASES OF THE FETUS.\\nThe fetus during its life in the uterus is protected from injury\\nand disease by the bony pelvis, uterine walls and the bag of waters;\\nbut on the other hand is subject to the diseases of the mother and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0555.jp2"}, "554": {"fulltext": "532 OBSTETRICS,\\nfather, nervous disturbances, high temperature, bad nutrition,\\ndiseases of the uterus and its appendages, and infectious diseases,\\nall of which exert their influence upon its growth and develop-\\nment and may cause its death before birth.\\nCertain tendencies to disease are inherited, such as unnatural\\nconditions of the nervous system and lack of nutrition, drunken-\\nness, epilepsy, diabetes, consumption and cancer of either parent,\\nand act unfavorably upon the development of the child and may\\ncause its death in the uterus.\\nIf the mother suffers from an infectious disease, the fetus\\nwill be affected, either indirectly from an impaired nutrition, or\\nfrom a direct transmission of the disease itself. In either case\\nthe pregnancy may be interrupted, or the child may die soon\\nafter birth.\\nInfections of the mother do not all appear to be equally\\nsevere. La grippe, cholera, diphtheria, typhoid and serious cases\\nof malarial fever are usually attended by miscarriage or prema-\\nture delivery, in many of which cases the fetus first dies of the\\ndisease, transmitted by the mother. The eruptive fevers are espe-\\ncially likely to affect the child before birth and to cause miscar-\\nriage. There are a good many instances of children being born\\nwith scarlet fever and measles.\\nIn about fifty per cent of the cases of pregnancy, complicated\\nby small-pox, abortion occurs. Erysipelas usually interrupts preg-\\nnancy. When the mother has consumption the child is generally\\npuny, feeble and predisposed to lung trouble.\\nThe most fatal disease which affects the child in the\\nuterus is syphilis. It may be transmitted by either parent.\\nIf the mother becomes infected during the last month of preg-\\nnancy the child may escape, unless infected at birth or while nurs-\\ning. The earlier in the pregnancy the mother is affected the\\nmore likely is the fetus to die. In the untreated cases in which\\nthe infection occurs during the first three months the fetal mor-\\ntality w 7 ithin the first few days after delivery is ioo per cent. The\\nchances are little better if the infection occurs during the fourth\\nand fifth months. As a rule infection of the mother is safer for the\\nfetus than infection of the father. All modern authorities assert\\ntheir belief that syphilis may be transmitted to the ovum through\\nthe spermatozoa without infecting the mother.\\nThe infection of the child may be taken for granted if either", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0556.jp2"}, "555": {"fulltext": "OBSTETRICS. 533\\nparent acquired syphilis shortly before or after conception. The\\nmore recently the father has suffered from the disease the more\\nlikely is he to transmit it in a severe form. Often the child is pre-\\nmaturely born, with traces of the disease. In other cases it is\\napparently healthy at birth, but symptoms of the disease appear\\nm from two to six weeks. There is usually marked general de-\\nbility. Among the first symptoms of hereditary syphilis is snuf-\\nfles. This is followed by a rash with red patches about the geni-\\ntals, thighs and forehead. The upper lip is likely to be sore and\\ncracked, and there may be inflammation and even ulceration of the\\nmucous membrane of the throat, giving rise to hoarseness. The\\nnasal catarrh may result in loss of the nasal bones. The child is\\nlikely to suffer from broncho-pneumonia. The liver is much in-\\ncreased in size and may be filled with hard nodules or spots of in-\\nflammation. These children are also subject to severe hemorrhage\\nunder the skin, in the internal organs and from the navel. Ten-\\nderness and swelling of the long bones is also symptomatic.\\nThe treatment of fetal syphilis is mainly in the use of pre-\\nventives. The parents may eradicate the disease by long-con-\\ntinued treatment. The child is greatly benefited by treatment of\\nthe mother during the pregnancy, and, if it be continued faithfully\\nthroughout the entire term, there is a possibility of immunity for\\nthe child, otherwise its chances will be very slight. Mercurv\\nand iodide of potassium are the most reliable remedies.\\nMANAGEMENT OF THE FETUS.\\nTo properly manage delivery at full term it is necessary to\\nstudy the health and habits of the patient during pregnancy and\\nto know the history of previous labors; thus it is better that the\\npregnant woman should be under the care of the physician from\\nthe earliest days of gestation, especially if it be her first. In the\\nlast month an examination should be made to ascertain the posi-\\ntion and presentation of the fetus and whether any complications\\nexist, also to learn the relative size of the pelvis of the mother\\nand the head of the child.\\nIt is usually possible, by external examination of the abdo-\\nmen, to determine the position of the child, whether its back is on\\nthe right or left side of the abdomen, or if, as sometimes happens,\\nwhen the. abdominal walls are much relaxed, it is lying across the\\nabdomen with its back toward either the front or back of the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0557.jp2"}, "556": {"fulltext": "534 OBSTETRICS.\\nmother. Often the physician, with her hands, can move the ex-\\ntremities, which appear to the touch as small nodules and when\\nfound serve to show the position of the back. The fetus lies\\ndoubled up, the chin and arms upon the chest and the legs upon\\nthe abdomen. In the normal position the head is down, for it is\\nthe heaviest portion of a body floating in water, and the back is to\\nthe mother s left side. If this relation be still maintained when\\nlabor comes, the largest diameter of the child s head will cor-\\nrespond with the largest diameter of the mother s pelvis and thus\\nfacilitate an easy delivery. The next most frequent position is\\nwith the back to the right side of the mother s abdomen, the larg-\\nest diameter of the head corresponding to a diameter of the pelvis,\\nwhich is a little less than that in the former case and therefore\\ncausing a longer labor. Less frequently there are other positions\\nof the Read, and, as they have to be changed into either the first\\nor second position, they result in much delayed deliveries.\\nThen, too, the breach or feet may come first, with the same\\nrelations of the back of the child to the sides of the mother.\\nThese are usually longer deliveries and more dangerous to the life\\nof the child, for, as its head, the largest portion, comes last, it\\nmust be delivered quickly in spite of the lack of dilatation of the\\nexternal outlet, for when the body comes in contact with the cooler\\nexternal air the child begins to breathe and thus draws water into\\nthe lungs, just as a drowning person does, and in a few minutes\\nis beyond recovery. The shoulders or side of the child sometimes\\npresents first, but in such a case there is no possibility of delivery\\nunless the fetus is very small and imperfect, and even then it is\\nbetter if changed by manipulation into one of the other forms.\\nA vaginal examination serves to confirm the external diagnosis\\nof presentation and position, and often is the only way of reaching\\na positive conclusion. The diameters of the pelvis are determined\\nby measurements with an instrument called a pelvimeter.\\nNormal labor is the separation of the fetal and uterine mem-\\nbranes, accompanied by contractions of the uterine muscle and\\nexpulsion of the fetus at full term. These contractions are called\\npains because of the pain associated with them, due to the pres-\\nsure on the uterine nerves during a contraction, to the stretching\\nof the ligaments and the neck of the uterus, which is sometimes\\nresistant, and to pressure upon neighboring organs.\\nThe susceptibility to pain varies in different individuals. The", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0558.jp2"}, "557": {"fulltext": "OBSTETRICS. 535\\nvery young mother and the woman who bears her first child late\\nin life usually suffer most. A painless labor is very rare. I have\\nattended just one a Polish woman of twenty-five in her second\\ndelivery. The contractions were quite as forcible as in any nor-\\nmal labor, but she persistently insisted that she felt no pain.\\nAt first the pain is in the back and sacrum, later in the abdo-\\nmen or down the thighs. The most severe pain is when the head\\npasses the external pelvic outlet. Signs of beginning labor usu-\\nally occur about two weeks before delivery. There is a sinking\\nof the fetus into the pelvis, thus allowing more breathing space,\\nand the patient feels and eats better. This may be followed by\\nirritability of the bladder and pressure upon the pelvic organs,\\nand there may be intermittent pains. Other signs are a show of\\nmucus streaked with blood, not constant, and increased vaginal\\nsecretions, but the most positive sign is regularly recurring pains,\\nincreasing in force with lessening intervals between. This is the\\nperiod of dilatation of the mouth of the uterus and adjustment of\\nthe head of the child to the pelvic canal of the mother. The length\\nof this time varies with the size of the mother s pelvis, the size of\\nthe child s head, the flexibility of the mother s joints and tissues,\\nand the compressibility of the head or presenting part of the child.\\nIt is usually shorter when the head comes first.\\nThe pains at the beginning are half an hour apart and give\\nbut little discomfort, but they gradually come nearer and nearer\\ntogether until there are but short intermissions. The average\\nduration of the first stage in first labors is fifteen hours, and in\\nother labors eight hours, but in the first labors of women about\\nforty years of age it is over thirty hours, and it has been known\\nto last several days. The second or expulsive stage lasts from ten\\nminutes to six hours, its average in first labors being two hours,\\nand in others one hour. The pains are now bearing down, tear-\\ning and hard, the result of nature s effort to drive down the fetus\\nregardless of injury to tissues. This is the time of the greatest\\nsuffering, but it is usually better borne than the longer, nagging\\npains of the first stage.\\nThe third is the placental stage, that in which the membranes\\nand placenta become separated from the uterus and expelled, and\\nthe uterus contracts. There is loss of blood, but usually it is not\\nexcessive. This stage generally lasts from twenty to thirty min-\\nutes, but may continue two hours, or longer, if the placenta or", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0559.jp2"}, "558": {"fulltext": "536 OBSTETRICS.\\nmembranes adhere to the uterus, in which case they must be re-\\nmoved by the physician. This is usually done within half an\\nhour.\\nANTISEPTIC PRECAUTIONS.\\nDuring the last twenty-five years the discovery and use of\\nantiseptics and the knowledge of asepsis has revolutionized the\\nart of surgery and obstetrics, so that the danger of child-bed fevers,\\nwhere proper and intelligent care has been taken, is now prac-\\ntically nothing.\\nPREPARATION OF THE ROOM.\\nThe room in which the patient is to be confined should be\\nwell ventilated and sunny, and should contain only the furniture\\nactually needed for comfort, as a bed, table, one or two chairs, a\\nsmall bed for the baby, some provision for heating, plain, clean\\nwalls, clean, bare floor, with one or two rugs, and plain window\\nshades, to moderate the light. All food and articles required for a\\nchange should, if possible, be kept in an adjoining room and be\\nbrought in as needed. As a means of heating, a stove in the room\\nanswers every purpose, aiding, too, in securing a gpod circulation\\nof air, and convenient for disposing of soiled dressings which, if not\\nburned, may be allowed to accumulate and become a breeding\\nplace for germs. The air should be as pure as possible and pre-\\nvented, by the evaporation of water, from becoming too dry. The\\nwater closet must never communicate directly with the lying-in\\nroom; must always be ventilated from the outside, and its door\\nshould close automatically.\\nPREPARATION OF THE BED.\\nThe bed should be made up with an absolutely clean mattress,\\nfresh blankets and sheets, and padding that has been prepared\\nby boiling, or subjection in an oven for an hour to a heat of 300\\ndegrees over the bed is the rubber or oilcloth that has been care-\\nfully cleaned by sponging with a solution of bichloride of mercury,\\none part of the bichloride to one thousand parts of water, and over\\nthis a second clean sheet and padding prepared like the first.\\nPREPARATION OF THE PATIENT.\\nAs soon as labor is certainly in progress the patient should be\\ngiven a full bath in warm water, be scrubbed thoroughly with", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0560.jp2"}, "559": {"fulltext": "OBSTETRICS. 537\\nsoap, have the bowels moved by an enema, the external genitals,\\nanus and neighboring parts washed with an antiseptic, be given\\nan antiseptic vaginal injection and dressed in clean clothes. For\\nthe vaginal injection a solution of corrosive sublimate (bichloride\\nof mercury), one part of the sublimate to five thousand parts of\\nwater (three grains to the quart) is effective, but as it is very\\npoisonous care must be taken not to leave any of the solution\\nwhere someone might drink it, and it must not be put into the\\nrectum, neither must the tablets, often used for making this solu-\\ntion, be left where children may handle or eat them.\\nOTHER SAFETY MEASURES.\\nAll instruments to be used should be boiled for thirty min-\\nutes before using and be touched only by hands that have been\\nthoroughly disinfected. If a catheter is used it may, after the dis-\\ninfection, be oiled with sterilized vaseline and should be intro-\\nduced by sight. No irritating antiseptic must be allowed to re-\\nmain upon the instrument lest it cause inflammation. All water\\nused about the patient or upon the hands of the attendants must\\nhave been recently and thoroughly boiled, and all towels, pads,\\nabsorbents, bandages, articles of clothing and other things used\\nat this time, and during the lying-in, must be carefully disin-\\nfected.\\nThe hands of the patient, nurse and physician should also\\nbe disinfected. To do this, first scrape and clean the nails while\\ndry, then scrub the hands and forearms for not less than ten\\nminutes in strong soap and water as hot as can be borne, after\\nwhich soak them three minutes in an antiseptic solution. That\\nformed of one part of corrosive sublimate to one thousand parts\\nof water is good.\\nThe nurse should have in readiness a table with basins of the\\nantiseptic solution, plenty of clean towels, sterilized vaseline, good\\nsoap, absorbent cotton, a saturated solution of boric acid crystals\\nfor the eyes and powdered boric acid for the cord, one or two\\npieces of unbleached muslin a half yard wide by one and a fourth\\nlong for abdominal bandages, a fountain syringe, safety pins, an\\nextra rubber sheet, a blanket for the child, and the child s cloth-\\ning, and see that there is plenty of previously boiled, and hot water\\nobtainable at all times.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0561.jp2"}, "560": {"fulltext": "538 OBSTETRICS.\\nTHE CARE OF THE CHILD.\\nImmediately after birth clear the child s air passages of mucus,\\nusing the finger if necessary, and sever the navel cord when it\\nstops pulsating; or before if any complication arises. Tie the cord\\ntwice, with narrow tape, about one inch and a half and two inches\\nand a half from the body, and cut midway between these ligatures.\\nThe newborn must be protected against sudden chilling. A change\\nof 30 degrees is usually fraught with danger. Wrap the child in a\\nwarm woolen blanket and immediately wash its eyes in warm wa-\\nter, containing all the boric acid crystals that it will dissolve, tak-\\ning great care to get out all the maternal secretions, then cover it,\\nhead and all, in the blanket and lay it in a warm place until the\\nmother can receive attention. As soon as she has been cared\\nfor, the nurse should cleanse the baby by anointing it with sweet\\noil, vaseline or even fresh lard; then, if it be strong and healthy,\\nby sponging it with warm water and a little non-irritating fluid\\nsoap but if the child is weak and feeble it should be cleansed with\\nthe oil or vaseline only, and kept a few days in warm flannels or\\ncotton. The room must be well ventilated and of a warm and uni-\\nform temperature, and a bath of water or oil given daily. Oil\\nshould always be used as a preliminary just before the first water\\nbath.\\nAfter the first bath, the best time for bathing is in the morn-\\ning midway between the feedings. After the stump falls off,\\ndaily sponging may be superseded by daily immersions in warm\\nwater. If any powder is needed for irritation between the folds\\nof the skin, equal parts of lycopodium and oxide of zinc form a\\ngood one.\\nThere is no occasion for worry if the child does not pass urine\\nfor several hours, for it will not secrete much until it begins to\\nnurse. In six or eight hours, when the mother has become well\\nrested, it should be put to the breast, not only for nourishment\\nand training to good habits, but for the tonic effect upon the\\nuterus of the mother. The nipples are to be washed, both before\\nand after nursing. Well-fed babies usually eat, sleep, grow and\\ngive little trouble, and rarely take contagious or infectious dis-\\neases; but the poorly nourished are nervous and irritable, fit sub-\\njects for all the prevalent ills.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0562.jp2"}, "561": {"fulltext": "OBSTETRICS. 539\\nTHE CARE OF THE MOTHER.\\nAfter the expulsion of the placenta the patient should be\\nwashed again and the vulva thoroughly cleansed. The use of a\\nvaginal injection at this time depends upon the termination of the\\ncase and whether or not there is a necessity for it. If used the\\nsyringe nozzle must first have been boiled, or disinfected by soak-\\ning in the corrosive sublimate solution, then rinsed well in boiled\\nwater. The dressing consists of an occlusion bandage fastened\\ntightly to the abdominal bandage.\\nFor the first few hours after labor the best position is upon\\nthe back, for if turned upon the side the heavy uterus falls for-\\nward and may draw air into the passages, exposing the patient to\\nthe risks of embolism. After the uterus has become firmly con-\\ntracted there is no more danger in this direction and the patient\\nmay occupy any position she pleases while lying down. A sound\\nsleep for several hours following labor is very favorable, and an\\nimportant element in the restoration of the patient, hence an op-\\nportunity for rest and sleep should be given as soon as mother\\nand child have received proper attention. Have the room quiet\\nand the light subdued. The child should not be allowed to dis-\\nturb the mother s rest, hence must not be placed in the same bed\\nand, if it cries, should be taken to another room. If after pains\\nkeep her awake a sedative is given according to the direction of\\nthe physician.\\nGreat care should be taken to keep clean the external genitals\\nof the patient, her own linen and the bed clothing. The vulvar\\ndressing should be changed every three or four hours for the\\nfirst four or five days, and as often thereafter as soiled. When-\\never it is changed the external genitals should be thoroughly\\ncleansed with soap and water, followed by some antiseptic solu-\\ntion. This is best applied with the fountain syringe, the water\\nbeing caught in the bed-pan. The patient ought to be sponged\\nfrequently with tepid water, or alcohol and water, because of the\\ngreat activity of the skin and a warm glow should be produced by\\nfriction with a towel. The draw sheet, a common sheet folded\\nto four thicknesses and placed beneath the hips, can be easily\\nremoved whenever soiled.\\nThe air must be very pure, and fresh air should be admitted\\nconstantly from the outside through open windows, care being\\nused to avoid draughts. The room must not be too dark, but the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0563.jp2"}, "562": {"fulltext": "540 OBSTETRICS.\\ninfant s eyes must be protected from strong light until two or\\nthree weeks old.\\nUrine should be passed in from six to eight hours after labor,\\nand if all other means fail, the catheter must be used, the utmost\\ncare being taken to preserve absolute asepsis. Boiling in water\\nfor thirty minutes makes the catheter safe. The parts are to be\\nwashed in soap and sterilized water, and bathed with an antiseptic\\nsolution, then the catheter, oiled with vaseline sterilized by heat,\\nshould be passed by sight.\\nThe bowels ought to be moved in about thirty-six hours by\\nsome mild laxative, as a Seidlitz powder, or by a rectal injection\\nof soap and water, a small injection of sweet oil, or a half pint of\\nglycerin solution of one-fourth strength.\\nDIET.\\nThe diet of the mother should be restricted for the first twen-\\nty-four hours to liquids. Food will not be tolerated after anesthe-\\ntics until their effects have worn off. On the second day soft\\nboiled eggs and semi-solid food may be taken, and thereafter a\\nmoderately full diet is permitted. The patient needs as liberal diet\\nas she can digest, both for her own nutrition and that of her\\nchild, for she should nurse her babe not only for its welfare, but\\nfor her own good, unless some complication arises that makes it\\nundesirable.\\nNURSING.\\nThe child is put to the breast after six or eight hours, and\\nnot oftener than once in four hours thereafter, until the secretion\\nof milk is well established, after which the baby should be nursed\\nonce in two hours by day and every three or four hours by night\\nfor the first five months. If the intervals are too long, the milk\\nbecomes too thin if too short, it becomes too rich and if of irreg-\\nular length the child s stomach is upset.\\nIf the breasts become overdistended they can be relieved by\\nmassage, by saline cathartics, by drinking less, or by wearing a\\ncompression bandage (a straight piece of cloth, cut out under\\nthe arms and for the neck, and pinned tightly around the body\\nacross the breasts), with circular openings for the nipples.\\nIf the nipples are small much trouble will be saved by putting\\nthe infant to the breasts before they become engorged. A little\\npatience and perseverance will usually succeed, even if it does", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0564.jp2"}, "563": {"fulltext": "OBSTETRICS. 541\\nnot take hold well at first. As the child usually falls asleep after\\nnursing, it is well to establish a regularity of feeding by waking it\\nat the proper time. Regurgitation generally means an overfilled\\nstomach. For the first two or three days a baby gets but little\\nnourishment from nursing and needs but little.\\nIf it seems hungry it may be pacified by a teaspoonful of warm\\nwater, or cows milk, one volume of milk to two of water. Give\\nup to one ounce at a feeding. From ten to twenty minutes is\\nenough for each nursing, and it is better to apply the child to both\\nbreasts each time, unless some complication intervenes. It is\\nwell to weigh the child once a week, for an increase in weight is\\na proof of good health. If it does not continuously gain, at least\\nfive ounces a week for the first five months, the reason must be\\nsought in the surroundings, or lack of nourishment or warmth.\\nIf, as often happens in weak women, the milk is deficient, the in-\\nfant s lack of nourishment is soon evident, and something must\\nbe done to improve the quality and quantity of the breast milk, or\\nartificial food be drawn upon to supply the deficiency.\\nARTIFICIAL FEEDING.\\nWhen the baby must be artificially fed, cows milk is best,\\nmodified to approximate human milk, then further modified by\\nexperiment to suit the individual child. Mixed milk from a herd\\nis more likely to be uniform in quality than the milk of one cow,\\nand less likely to spread disease. The following Meigs-Rotch\\nmixture is one of the best\\nCows milk, mixed herd two ounces\\nCream three ounces\\nWater, boiled ten ounces\\nSugar of milk three-fourths of an ounce\\nLime water one ounce\\nWhenever indicated by the condition of the child these pro-\\nportions should be changed to meet the emergency. The capac-\\nity of a child s stomach is about one ounce at birth and increases\\nat the average rate of one and a half drams a week for the first six\\nmonths. This, of course, is only a general average.\\nThe milk should be given at a temperature of ioo degrees.\\nMilk may be completely sterilized by long boiling, but this destroys\\nsome of its chemical constituents and makes it indigestible. A\\npartial sterilization at 167 degrees has been found to render milk", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0565.jp2"}, "564": {"fulltext": "542 OBSTETRICS.\\npractically sterile for twenty-four hours, without impairing its\\nqualities. If a wet nurse is to be obtained the selection depends\\nupon her health and age, and the age of her own child, which\\nshould be near that of the foster child. She must be free from\\nsyphilis, tuberculosis and all other contagious and infectious dis-\\neases. In the majority of cases good cows milk properly modified\\nis preferable to the wet nurse.\\nSince cows milk, modified according to the needs of each\\ncase, furnishes the most perfect food for infants deprived of the\\nmother s milk, the artificial foods with which the markets are\\nflooded should be avoided, except in some cases of intestinal trou-\\nbles, when a substitution for a week or two affords a change of\\ndiet and sufficient nourishment. A child will often grow fat while\\ntaking them as permanent food, but, as they contain a greater pro-\\nportion of sugar and starch than of albumen, they promote the\\nformation of fat cells rather than the growth of muscular and or-\\nganic tissues, thus entailing a diminished power of resistance to\\ndisease, with all its disastrous results.\\nCondensed milk, when diluted to give a proper proportion\\nof albumen, is deficient in fats, and, in the unsweetened brands, in\\nsugar also. If the sweetened brands contain cane sugar they pro-\\nmote acid fermentation. Cane sugar is not an ingredient of milk\\nand should never be used as a substitute for milk sugar. A con-\\ndensed milk, whose proportions are known, can be used as a base\\nupon which to construct a suitable food by the addition of the nec-\\nessary ingredients.\\nTHE CHILD S CLOTHING.\\nIt should be loose and easily changed. The belly band, used\\nto retain the navel dressings, is removed as soon as the cord is\\nhealed, and, while worn, must not be tight lest it favor navel pro-\\ntrusion. The customary triangular diaper of muslin or linen, fast-\\nened by a safety pin, is all that is needed for convenience. Rub-\\nber napkin covers are unsanitary and should not be used. The\\nundershirt should be of knit wool, or made of softest flannel and\\nopen in front. The next garment is a flannel dress, with high\\nneck and long sleeves, twenty-five inches in length and cut in\\nprincess style the outer dress of muslin is made in the same way.\\nThe feet and legs must be protected by woolen stockings reaching\\nto the knees. The underskirt and dresses may be fastened with", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0566.jp2"}, "565": {"fulltext": "OBSTETRICS. h\u00c2\u00b16\\ntapes. In warm weather the sleeves of the flannel dress may be\\nremoved. Some choose to lit a cotton waist, cut in princess\\nstyle, to the top of the flannel skirt. The outer dress may be made\\nwith a yoke if preferred, and as tastefully decorated as one may\\nplease, provided stiff ruffles and starched garments are not put\\nupon the baby. All the clothing must be changed daily.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0567.jp2"}, "566": {"fulltext": "CHAPTER IV.\\nCONVALESCENCE.\\nThe period of convalescence from childbirth is about six\\nweeks. It begins at the end of the third stage of labor and is the\\ntime occupied by the uterus and its appendages in returning to a\\nfairly normal condition. In exceptional cases it may last ten or\\ntwelve weeks, or even longer. While labor is a physiological\\nprocess, the excessive waste and repair which belong to this\\nperiod, united w 7 ith peculiar nervous irritability, make the patient\\nvery susceptible to outside influences and contagious and infec-\\ntious diseases, and require the most perfect neatness in a surgical\\nsense.\\nOften, after labor, there is a feeling of chilliness, or even a\\nrigor, which does not last over ten minutes and is not accompanied\\nby a rise of temperature. For this a warm drink, warm coverings\\nand hot water bottles should be provided.\\nUterine contractions continue a few days after the expulsion\\nof the afterbirth. They expel blood clots from the uterine cavity,\\naid in the return of the uterus to its normal size and prevent ex-\\ncessive bleeding, and as they are stronger when the child nurses,\\nthe mother recovers more quickly and completely from the effects\\nof pregnancy and labor when she can nurse her child. The nervous\\npains, which are often a complication at this time, are of no value\\nin recovery and ought to be relieved by medicinal remedies. The\\ndischarge from the uterus is called lochia and for the first three\\nor four days consists of blood with clots and shreds of the decidual\\nmembrane of the uterus, after which it is lighter in color and con-\\nsists mainly of blood serum, later still becoming a grayish yellow\\nof creamy consistency. Gradually diminishing it ceases entirely\\nin from two to six weeks.\\nThe breasts become enlarged during pregnancy, through the\\ngrowth of lobules and increase of fat and connective tissue. Their\\nsecretion the first few days after labor is like that in the latter days\\nof pregnancy and is called colostrum. It is more laxative than\\nmilk. In women who have borne children the milk secretion be-\\n544", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0568.jp2"}, "567": {"fulltext": "OBSTETRICS. 545\\ngins the second day, but with the first child it does not usually be-\\ngin until the third day. There is more or less nervous disturbance\\nat this time, with a little rise in temperature accompanied by thirst\\nand loss of appetite. The swollen, overdistended breasts may be\\npainful from pressure and must be relieved by nursing, or by arti-\\nficial draining with a breast pump, and by massage.\\nThe length of time that a lying-in patient should be kept at\\nrest depends upon the rapidity of the uterine involution (contrac-\\ntion to natural size). After the first nine days she may be allowed\\nto get up, but should keep the recumbent position most of the\\ntime. During the third week she may rest in the chair the greater\\npart of the day, but should keep her room until the end of the\\nfourth week, and during the next two weeks only the very lightest\\nduties are permissible. Of course, there are exceptions to all\\nrules, but this is the course to be pursued by the average woman,\\nand even the strongest can ill afford the hazard of imprudence and\\noverexertion at this time.\\nEFFECTS OF CHILDBIRTH.\\nThe great dilatation which takes place during the expulsion of\\nthe fetus tends to rend the adjacent tissues. During first labors\\nvery few escape without rents in the mouth of the uterus, the vagi-\\nnal membrane and perineum. The more expulsive the pains and\\nrapid the labor the greater the danger in this respect. There is a\\nvast difference in the elasticity of tissues, so that some women\\nwith small external genitals may bear children without any wounds,\\nwhile others, who are large and would seem likely to escape, suffer\\ngreat laceration. When the first labor occurs as late in life as the\\nthirty-fifth year there is the greatest danger of this complication,\\nbut by recognizing the coming peril it is often possible, by proper\\nmanipulation, to avoid it. In nine cases out of ten this can be\\ndone in all labors after the first, and the severity even of first labors\\ncan be greatly mitigated by proper care. Superficial tears will heal\\nwith only antiseptic treatment. All others, especially when\\nthere is hemorrhage, should be closed with stitches. Union by\\nfirst intention usually takes place. If there is much swelling about\\nthe urethra it may be necessary to use the catheter for a few days.\\nThe patient may be sufficiently relieved by hot water in a bed-pan\\nso placed that the steam will come in contact with the swollen\\nparts.\\n35", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0569.jp2"}, "568": {"fulltext": "546 OBSTETRICS.\\nLacerations of the perineum are the most common and they\\ndiffer much in extent. Chloroform inhalations and moist applica-\\ntions during labor will often soften this part. The after treatment\\nconsists in irrigating the wound with antiseptic washes, keeping\\nthe parts covered with the proper dressings and being careful that\\nthe nozzle of the syringe is made perfectly clean by being boiled\\nthoroughly before each using, and that it does not separate the\\nedges of the wound upon its introduction. With this kind of treat-\\nment a large majority of the cases will heal by first intention and\\nthe others, with some loss of tissue, by granulation. When there\\nhas been great pressure and contusion of the tissues it is sometimes\\nimpossible to save them all, and the antiseptic irrigation must be\\nkept up freely to prevent blood poisoning.\\nPUERPERAL INFECTION. CHILD-BED FEVER.\\nOne of the great dangers of childbirth which has been very\\nmaterially lessened in the last few years, by the knowledge and care\\nof the physician, is puerperal infection, which in certain places at\\ndifferent times has been so epidemic as to appall not only the preg-\\nnant woman, but the care-takers as well. The changes which oc-\\ncur in the tissues coincident with the growth of the fetus render\\nthe pregnant very susceptible to danger from without, and, later,\\nin connection with the swollen and lacerated birth-canal, furnish\\na condition most favorable for the invasion of poisonous germs.\\nThe most common germs of puerperal infection are few in num-\\nber and are detected by a bacteriological examinaton of the vaginal\\ndischarges and debris from the mucous membranes of the uterus.\\nThis infection may be general or only local. The iatter is confined\\nto the vagina and uterus, and is much less serious than the former,\\nwhich affects the whole system, and may prove so destructive as\\nto render recoverv impossible.\\nThe treatment lies mainly in prevention. The source of the\\ndisease being known, it is possible to avoid the cause. This lies\\nin a careful selection of the proper surroundings and painstaking\\ncare to secure surgical cleanliness. The most frequent cause of\\nseptic infection is the neglect of proper care of the hands, dress-\\nings, instruments, and room, and contaminations from foul air as\\nfrom water closets or defective drainage. In hospitals there is\\ndanger from suppurating wounds.\\nAs already stated, the mattress and all other parts of the bed,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0570.jp2"}, "569": {"fulltext": "OBSTETRICS. 547\\noccupied during confinement and the lying-in, should be abso-\\nlutely clean and we repeat that the pads and sheetings should be\\nthoroughly boiled and dried, the dressings made antiseptic by\\nboiline or dry heat, all utensils used cleansed bv boiling, and all\\nwater for cleaning or other purposes boiled for thirty minutes,\\nthen cooled to the proper temperature. Before dressing the pa-\\ntient or removing any bandages, the nurse should always cleanse\\nher hands with soap and hot water, paying particular attention to\\nthe nails, and the perfect cleanliness of her clothing must be main-\\ntained.\\nAll dressings should be burned on removal, or cleansed and\\nboiled for an hour before being used again, either by the patient or\\nanyone else, and let it be remembered that while infection usually\\ntakes place at the time of delivery it may occur either before or\\nafter.\\nConfinement either in the country or city is open to more\\ndangers from infection than it is in a hospital, because antiseptic\\nprecautions are less strict in private homes, their drainage is more\\nliable to be imperfect and refuse is not always promptly and en-\\ntirely removed.\\nSUBINVOLUTION.\\nUnder the most favorable conditions the uterus does not re-\\nturn to its normal size until from six to ten weeks after labor.\\nAn arrest of this process of retraction of the uterus or its ligaments\\nis known as subinvolution and gives rise later to much of the dis-\\ncomfort which falls to the lot of woman when the pelvic organs are\\nthe seat of disease. The changes in the uterus and its appendages,\\nbrought about after labor, are due to a lack of blood, the supply of\\nwhich is lessened by the contraction of the uterine muscular libers.\\nFailure of proper reduction is also due to some interference with\\nthe blood supply. The most common causes are changes in the\\nmucous membrane of the uterus from disease, an oversupply of\\nblood during the last months of pregnancy, inflammation coming\\non after labor, displacement and polypoid growths. Later the\\ncause may be chronic constipation, assuming too soon the erect\\nposition, too much exercise or hard work, and resuming sexual in-\\ntercourse too soon after labor. Any of these things may not only\\nretard, but arrest the changes so necessary to a healthy condition.\\nA failure to nurse the child may predispose to subinvolution, and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0571.jp2"}, "570": {"fulltext": "548 OBSTETRICS.\\nimmediately after labor large blood clots, a distended bladder, or\\ndisplacement of the uterus itself may do the same. It may occur\\nin women who lack muscular tone, or are predisposed to various\\ndiseases, but this is exceptional. Usually there is a local cause.\\nSubinvolution is often the cause of ill-health from pelvic disor-\\nders. The physician should be given an opportunity to correct\\nall such disorders as soon after labor as permissible, since later\\nthey are not nearly as amenable to treatment.\\nDuring the lying-in, abdominal palpation will show the prog-\\nress that the uterus is making in return to a normal size. A fair es-\\ntimation of its progress may be obtained by a daily examination\\nof the abdomen with the hand. In a general way it may be said\\nthat the day after delivery the body of the uterus is a finger above\\nthe navel, on the third and fourth days slightly below, on the fifth\\nand sixth days two fingers below, on the seventh, eighth and ninth\\ndays three or four fingers above the pubis, on the tenth, eleventh\\nand twelfth days slightly above, on a level or a little below the\\npubis. This decrease continues until the tenth or twelfth week,\\nwhen the size of the uterus will be found to be less than normal,\\nafter this, engorgements usually give a slight permanent enlarge-\\nment.\\nWhen the involution fails to properly take place there will\\nbe an increase and prolongation of the bloody discharge, a coated\\ntongue and constipation. If involution be permanently arrested\\nthere will be connective tissue development in the uterine walls\\nand changes of the mucous membrane, and chronic inflammation\\nwill be established in the linings of the cervix and uterus.\\nThe treatment consists of the removal of all causes which\\nmay prevent the return of the uterus to its normai condition. If\\nnot noticed until several weeks after labor there will be frequent\\nbleedings, leucorrheal discharges, dragging sensations, a feeling\\nof weight and distress in the back and loins, and finally the diges-\\ntive, circulatory and reflex nervous symptoms of subacute and\\nchronic inflammation will appear.\\nINCONTINENCE OF URINE.\\nAfter labor there may be inability either to retain the urine, or\\nto urinate at all. Either condition is annoying and may give rise\\nto serious consequences. The loss of power to empty the bladder\\nmay be due to the position lying on the back or to injury to the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0572.jp2"}, "571": {"fulltext": "OBSTETRICS. 549\\nurethra or to the front vaginal wall, and resultant swelling. The\\nbladder must then be emptied by a catheter because of the danger\\nof inflammation, or even of infection, if the bladder, from too great\\ndistention, loses its normal tone.\\nA constant dribbling of urine often means an overflow from\\na distended bladder, and partial paralysis of the sphincter of the\\nurethra caused by injury during labor. The trouble often disap-\\npears spontaneously, but may linger for some time. Recovery\\ncan be hastened by tonics and electricity.\\nNERVOUS COMPLICATIONS.\\nThe nervous system also suffers from the additional burden of\\npregnancy and the shock of labor. Apoplexy at this stage is more\\nfrequent in those who are pregnant, or have just been through de-\\nlivery. Paralysis following labor is due to injury from pressure by\\nthe head or instruments, and, again, from failure to use forceps at\\nthe proper time, thus allowing the pelvic nerves to be injured by\\ncontinued pressure. Septic neuritis gives rise to the same symp-\\ntoms as are seen in ordinary neuritis.\\nSORE NIPPLES.\\nSore nipples are very frequent in first pregnancies and are\\noften due to imperfect development. Small nipples can easily be\\nincreased in size by manipulation during the last months of preg-\\nnancy and much discomfort and danger thus be averted. Hiibner\\nstates that fifty-one per cent of nursing mothers have sore nipples\\nbetween the third and fifth days. The nipples should be protected\\nfrom pressure from corsets and tight clothing during pregnancy,\\nand, during the last months, washed twice daily with bland soap\\nand water, then anointed with cocoa butter or sweet oil, and, once\\neach day, treated with a saturated solution of alum or a 25 per\\ncent solution of glycerole of tannin. If the latter be used the un-\\nderclothing must not come in contact with it, because of its perma-\\nnent stain.\\nFrom the first nursing, close attention must be given to clean-\\nliness of the child s mouth. It should be washed out once a day or\\noftener with a saturated solution of boric acid, and after each nurs-\\ning the nipples should be washed with the same solution and dried.\\nIf at all inflamed they must be covered with a protective ointment\\nas follows", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0573.jp2"}, "572": {"fulltext": "550 OBSTETRICS.\\nBoric acid fifteen grains\\nCastor oil two drams\\nSubnitrate of bismuth two drams\\nThis may be alternated with extract of witch hazel, diluted\\nwith three or four times its volume of water. When there are raw\\nplaces or cracks on the surface of the nipples use a mixture made of\\ntwenty grains of boric acid and one ounce of oxide of zinc oint-\\nment also paint them with the compound tincture of benzoin. A\\nbreast-binder and a nipple-shield, made of a glass bulb and a soft\\nrubber nipple, should be used to save the mother as much pain\\nas possible. The nipple is cleansed thoroughly after nursing and\\nkept in a boric acid solution, and the glass bulb washed occa-\\nsionally in a five-per-cent solution of carbolic acid, or boiled for\\nthirty minutes. If the shield aggravates the trouble by pres-\\nsure upon a fissure, nursing may have to be given up for a day or\\ntwo, and artificial feeding resorted to, until healing takes place.\\nOnly the most serious circumstances and fear of certain abscess\\nshould lead to drying up the milk for relief, unless there is no\\nprospect of the nipples performing their duty because of deformity,\\nor of easy erosion upon any manipulation.\\nAbscess of the nipple should receive the proper surgical treat-\\nment, and eczema, herpes zoster and syphilitic ulcers must have\\nproper local and constitutional treatment.\\nEngorgement of the breasts may be prevented by skillful mas-\\nsage. If they become suddenly engorged by an oversecretion of\\nmilk or exposure to cold, they must be relieved by nursing the\\nchild more frequently, by massage or by the breast pump. In addi-\\ntion to this a free movement of the bowels by a cablespoonful of\\nEpsom salts in a half glass of warm water before breakfast, and\\ncompression of the breasts by a bandage will prevent further\\ntrouble.\\nABSCESS OF THE BREAST.\\nAbscesses of the breast are of three kinds: i. Those in the\\nglandular tissue itself, called the parenchymatous. 2. Those in the\\nconnective tissue just beneath the skin, called the subcutaneous.\\n3. Those in the deep connective tissue beneath the gland called\\nthe post mammary. The latter form is rare.\\nAll the forms are of microbic origin the germs entering\\nthrough the erosions or fissures upon the nipples and, as a rule,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0574.jp2"}, "573": {"fulltext": "OBSTETRICS. 551\\ncoming from the baby s mouth. A failure to properly empty the\\nmilk glands gives rise to a stoppage or stagnation which is a pre-\\ndisposing factor, in a mammary abscess. There is one other source\\nof infection, a rare one, and that is through the mother s blood sup-\\nply, excretions being thrown off by the mammary glands as well\\nas by the other glands of the body.\\nPreventive treatment consists, as we have already said, in\\ncare of the breasts during the- later months of pregnancy and in\\nstrict cleanliness in caring for the nipples. For the glandular\\nform, when inflammation is threatening, massage and the breast\\npump should be employed. These measures would be harmful\\nin a subcutaneous case. In that form an ice bag should be applied\\nto the inflamed part and alternated with a lead water and laudanum\\ncompress, and the patient should also take free saline cathartics.\\nAlthough these remedies constitute the best treatment they may\\nbe unable to arrest the abscess, and suppuration may follow. Mam-\\nmary abscesses are rarely dangerous to life, but if neglected a\\nlarge portion, or all of the gland may be rendered useless for fu-\\nture nursing. When, for any cause, it is necessary to stop the\\nsecretion of milk immediately after deliver} it may be done by a\\ncompression bandage and saline cathartics, and, if the patient can\\nstand it, by massage and the breast pump to prevent engorgement.\\nQUALITY OF THE MILK.\\nThe quality of the milk may be a source of great trouble. The\\nfats and albuminoids show the greatest changes, and this is often\\naggravated by the manner of putting the infant to the breast as\\ntoo frequent, or too prolonged and irregular feedings, alter the\\nmilk and render it either difficult of digestion or of little nutritional\\nvalue. When the baby is nursed oftener than once in two or\\nthree hours the milk becomes so concentrated that it is diffi-\\ncult to digest, and makes the child feverish and thirsty,\\nand when the interval between the feedings is prolonged beyond\\nthe usual time the milk becomes so reduced as to impair its nutri-\\ntion. The diet of the mother is also a large factor in influencing\\nthe quality of the milk.\\nLiving largely upon vegetables will increase the proportion\\nof sugar and diminish the fat and casein, while an excess of\\nalbuminous food will increase the fat and casein and diminish\\nthe suear. In each case the infant receives food ill-adapted to its", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0575.jp2"}, "574": {"fulltext": "552 OBSTETRICS.\\nneeds. The employment of alcohol and malt liquors increases the\\nfat and casein. While it is sometimes necessary to add some\\npreparation of malt to the mother s diet, the indiscriminate use of\\nit can only be productive of harm. The diet of the nursing woman\\nshould not differ from the plain mixed diet to which she has been\\naccustomed, with, however, a moderate excess of fluids. Of\\nthese, milk taken between meals is the best. Tea and coffee are\\nbetter withheld, or taken dilute and in small quantities. Cocoa\\nis sometimes useful.\\nIn some cases in spite of every variety of diet to secure a\\nproper consistency of milk for the child, it fails in nutrition and an\\nartificial diet must be substituted. Sudden fright, joy or great\\nanxiety have a peculiar effect upon the quality of the milk, giving\\nrise to indigestion in the infant. This should teach the mother to\\nlead, as far as possible, a quiet, unemotional life during lactation.\\nThe quantity of milk varies from total absence of secretion to\\nan excessive supply. Usually at the seventh day there are fourteen\\nounces in the twenty-four hours, at six weeks it reaches about two\\npints; at the seventh month three pints and after the eighth\\nmonth it gradually decreases.\\nA mother with tuberculosis should not nurse her child since\\nit would reduce her strength and expose the child to infection\\nneither should one having goiter, or a predisposition to it, for\\nnursing aggravates this disease and if anemia exists to any great\\nextent the welfare of both mother and child demands artificial\\nfeeding. The advisability of discontinuing nursing when the\\nmenses appear depends entirely upon its effect upon the child and\\nmother. Various drugs taken by the mother appear in the milk\\nand may produce an injurious effect upon the child.\\nWEANING THE CHILD.\\nWeaning the child aiso depends upon the quantity and quality\\nof the milk and the effect of nursing upon the mother s health. At\\nnine months the baby can usually be fed without trouble. At\\ntwelve months there are so great changes in the milk that weaning\\nis desirable, unless it is in midsummer, or the child is recovering\\nfrom severe illness. Most serious derangements of the system may\\nfollow prolonged nursing, particularly of the mother, who can\\nhardly escape feeling the strain of the unusual drain.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0576.jp2"}, "575": {"fulltext": "OBSTETRICS. 553\\nWEIGHT.\\nThe average new-born child at first weighs seven pounds, a\\nboy being about a half pound heavier than a girl. A child may\\nweigh much less, yet be perfectly formed, while a few weigh ten\\nor twelve pounds. The weight is affected by the length of the\\npregnancy, the nourishment of the fetus, the size of the mother,\\nher age (young mothers have small children), and the number of\\nprevious pregnancies the weight increasing up to the fourth or\\nfifth child. There is usually a loss of weight for two or three days\\nafter birth, but when the milk comes the infant begins to grow\\nand at the end of the first week is about as heavy as at birth. An\\naverage child will gain from one-half to three-fourths of an ounce\\ndaily for the first year. There may be periods when there is no\\ngain, followed by periods of increased gain. The average child\\nat three months weighs ten pounds, at six months from thirteen\\nto fourteen pounds; at nine months from sixteen to seventeen,\\nand at one year from nineteen to twenty pounds. Its length at\\nfirst is from nineteen to twenty inches and it gains from six to ten\\ninches the first year.\\nThe respirations of the new-born are irregular and rapid,\\nabout forty per minute. The air cells do not expand until the sec-\\nond day. There is in its respiration elevation of the ribs, a large\\npart of the work being done by the diaphragm. When the navel\\ncord is tied the entire circulation changes, the lungs now receiving\\nthe blood for aeration as well as for nourishment of their own\\ntissues. The vessels that connected the mother s circulation\\nthrough the placenta are immediately blocked with clots and ulti-\\nmately become fibrous cords. For the first lew months the pulse\\nis feeble and rapid, easily disturbed and quickened. During sleep\\nit is about 120 beats per minute, 130 while awake, and 140 or 150\\nif excited.\\nDIGESTION.\\nSaliva is secreted at birth, but in very small quantities. Its\\ndiastatic power is weak at first, but gradually increases during the\\nyear and at the end of that time is nearly equal to chat of the adult.\\nThe stomach is small, more cylindrical, more vertically situated\\nthan later in life, and of less muscular power. Food in the stomach\\ndiminishes rapidly the first hour and disappears entirely in two or\\ntwo and a half hours. Water assists in the digestion of casein.\\nThe liver is so large at birth as to occupy a very large", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0577.jp2"}, "576": {"fulltext": "554 OBSTETRICS.\\npart of the entire abdominal cavity. Bile is secreted early and\\ngives to the feces their light brown color. In the new-born they\\nconsist for the first few days of meconium, a dark, thick, blackish\\nsubstance, which, about the fourth day, is mixed with digested\\nmilk, so that after this time the feces consist of the residuum of\\ndigested milk. They are passed from two to four times daily.\\nThe kidneys are fully developed and functionally active at\\nbirth, the secretion of urine taking place before birth. The skin\\nat delivery, because of an interference with the circulation, is of\\na livid hue, which changes, on the establishment of respiration, to\\na deep red; later it becomes yellowish and finally in about three\\nweeks assumes the rosy tint common to infancy.\\nThe development of the nervous system depends largely upon\\nheredity, environment and the health of the child. Not until after\\nthe first month does the gray matter appear in the brain. The\\nmedulla and cord centers are much better developed at birth than\\nthe cerebrum. The special senses respond, to stimuli at this time,\\nbut in a limited degree. Taste and smell can be roused by strong\\nstimulation immediately after birth, but the hearing is imperfect,\\nthe sight is but feebly developed for the first two to six weeks, and\\nthe sense of feeling or touch is very feeble at first.\\nMost children walk when a year old, some earlier and others\\nlater. Speech is gradually developed, there being no distinct\\nwords until the end of the first year, and often not until much later.\\nPATHOLOGY.\\nSuch of the conditions and diseases as are treated elsewhere\\nin this work we mention here only to call attention to their liability\\nto appear in infancy, and to suggest precautions.\\nBruises. There are often bruises upon the presenting part\\nof the child, usually upon the head. They come in long con-\\ntinued labors from pressure in the adaptation of the head to the\\npelvic canal of the mother! There is localized swelling of the\\nscalp and connective tissue and some accumulation of blood,\\nlike the black and blue spot of an ordinary bruise. The affection\\nis present at birth, if at all, and usually disappears without treat-\\nment.\\nCephalhematoma may be single or double, and does not ap-\\npear until two to four days after birth. It is also caused by pressure\\nand is always confined to the surface of one of the cranial bones,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0578.jp2"}, "577": {"fulltext": "OBSTETRICS. 555\\nnever crossing a suture or fontanelle. It is possibly clue to a weak-\\nness of blood vessels, which allow a hemorrhage upon pressure.\\nThere is no discoloration of the scalp and the tumor is not pain-\\nful. It disappears in from four to ten weeks.\\nDiscolorations. During early life there is an exfoliation aris-\\ning from irritation of the very delicate skin and mucous mem-\\nbranes. Thus eczemas and eruptions are easily developed. The\\nicterus neonatorum, which occurs in about eighty per cent of the\\nnew-born, is not a disease, but simply a discoloration of the skin\\nwhich takes place during the first two weeks of the child s life\\nand disappears when the body has adjusted itself to its new sur-\\nroundings.\\nMastitis, accompanied by secretions in the breasts of both\\nmale and female children, occurs quite frequently during the\\nfirst two weeks after birth. There is swelling, redness and pain\\nwhich will subside in about two weeks without any treatment, ex-\\ncept to cover the breasts with vaseline and borated cotton, or, in\\ncase of much swelling and redness of the skin, to use an antiseptic\\nwet dressing.\\nThe Navel Cord dries up and drops off usually about the\\nfourth to sixth day, and the scar will then be clean, but will re-\\nmain soft until the twelfth day. In some cases the stump does\\nnot drop off until the fifteenth day or later. The navel wound is\\nthe most common spot of septic infection in the new-born, and\\nshould be dressed antiseptically under the physician s care.\\nIf the ligature is not properly tied there may be a hemorrhage\\nbefore the separation of the cord again there may be no hemor-\\nrhage even if the cord is not tied. But with asphyxia of the first\\ndegree, and a strong heart beat, there would be hemorrhage\\nfrom the cord if not properly secured.\\nThe pulsation first stops in that part of the cord next to the\\nplacenta, then gradually lessens along the whole line as the cir-\\nculation of the infant adjusts itself. If the cord dries up as it\\nshould a few days after birth, it effectually prevents hemorrhage,\\nbut should it become gangrenous the arteries might expand and\\npermit bleeding. To prevent hemorrhage the ligature should be\\ntied about an inch and a half from the navel, care being used to\\nmake it firm and not to cut into the tissue. If the navel end is\\ntoo short, or has been torn off, a compression bandage should be\\nused, or the individual vessels be secured by stitches. When the\\ncord is very soft and tender an elastic ligature may be used.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0579.jp2"}, "578": {"fulltext": "556 OBSTETRICS.\\nWhen the bleeding from the navel wound exceeds a few drops\\nit is usually constitutional and may be due to hereditary syphilis,\\nseptic poisoning, or acute fatty degeneration, but these causes\\nare exceedingly rare.\\nIf the navel wound does not heal readily, because of friction\\nor lack of cleanliness, ulceration may occur. This should be\\ntreated with an antiseptic solution, as a saturated solution of\\nboric acid, followed by a dressing of one part of powdered salicylic\\nacid to four parts of starch. The stump should thus be dressed\\nthree times daily.\\nShould the wound heal slowly and pus form there may be a\\ngranular growth, which, until removed, will prevent further heal-\\ning. This condition is best treated by touching the growth with\\nnitrate of silver, then applying a bandage wet in an antiseptic\\nsolution. If the growth be cut away hemorrhage is likely to\\nfollow.\\nNavel cord rupture (hernia) is caused by a partial failure\\nin the development of the abdominal walls in the first stages of\\nfetal life. The treatment consists of applying antiseptic dressings\\nto dry up the cord and, as soon as the stump becomes detached,\\nreducing the hernia and holding the parts in place by adhesive\\nbands or of the radical operation, which should be performed\\nshortly after birth, by the surgeon.\\nSeptic Infectio7i may take place before birth, and show itself,\\nthree or more days after birth, in a number of forms which are\\nhard to distinguish. When strict antiseptic precautions are not\\ntaken infection of the navel wound is likely to occur, which may\\nbe complicated by an inflammation of the neighboring arteries\\nand veins, and possibly of the surrounding tissues. Gangrene\\nmay be caused by ulcers of the navel if the patient be neglected.\\nThe treatment of all infectious wounds consists in the use of anti-\\nseptic dressings and such internal remedies as will keep up the\\nstrength and general health. These remedies are often best sup-\\nplied through the proper diet of the mother. Any injury to the\\nskin may become an infected sore if not antiseptically dressed.\\nPemphigus, aside from syphilis, is rare. It consists of vesi-\\ncles, varying in size from that of a pea to a hen s egg, and of\\nround or oval shape, of which there may be many or only a few.\\nIt differs from syphilis in appearing upon the body only, not also\\nupon the soles and palms. The vesicles look like blisters rilled", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0580.jp2"}, "579": {"fulltext": "OBSTETRICS. 557\\nwith serum. The disease is probably contagious, but is not easily\\ntransmitted to an adult. Its treatment consists in protecting the\\nblisters from injury and, upon their breaking, dusting upon the\\nraw surfaces a one to four mixture of salicylic acid and starch.\\nTetanus of the new-born is also a germ disease, the infection\\nentering through the navel wound. It is extremely rare, except\\nin most neglected cases, especially where moist filthy dressings\\nare used for the stump, by uncivilized people.\\nGonorrheal infection from the mother is often transmitted to\\nthe genital tract of the female child and is the cause of leucorrheal\\ndischarge in early life.\\nSyphilis is more often acquired than. is supposed. It may be\\ncontracted from a wet nurse, who may be uninfected herself, but\\nis also nursing a child that is infected. Infants may contract this\\ndisease from other members of the family, or may give it to them.\\nInfection most often takes place from sores around or within the\\nmouth, and is especially likely to be transmitted by kissing. None\\nbut intimate friends known to be pure should be allowed to kiss\\nthe baby. On the other hand a child with a syphilitic affection\\nis a constant source of danger to those with whom it comes in con-\\ntact. The treatment is similar to that for an adult, and should be\\nunder the direction of a physician.\\nInfantile Sore Eyes is a very serious disease, contracted usu-\\nally during birth, by infection getting into the eyes while passing\\nthrough the vaginal canal, but it may also be taken from in-\\nfected amniotic fluid before birth, from the water, utensils or cloths\\nused in bathing, from the hands of attendants, and from instru-\\nments. It may also be indirectly passed in many ways from the\\neyes of one child to those of another. The first symptoms usu-\\nally occur from the third to the fifth day. There is redness of the\\nlids and a thin secretion of pus, which later becomes very abun-\\ndant and thick. Thirty per cent of all blindness is said to be due\\nto this disease. As a preventive measure, in all cases of sus-\\npected gonorrhea, the vaginal canal must be made antiseptic by\\nvaginal douches, before delivery. (For treatment see Diseases of\\nthe Eye and Ear.)\\nLa Grippe r in very young infants is hard to diagnose, unless\\nother members of the family are thus afflicted, in which case it is\\nprobable that rise in temperature, accompanied by great depres-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0581.jp2"}, "580": {"fulltext": "558 OBSTETRICS.\\nsion, is due to this cause and treatment should be given along the\\nsame lines as those laid down for adults.\\nThrush is an infantile mouth disease due to a parasite and\\noccurs in poorly nourished and artificially fed children. The treat-\\nment consists of removing the patches by a saturated solution of\\nboric acid. The application should be made very gently to avoid\\nunnecessary scaling of the mucous membrane. If the child nurses\\nthe nipples should be washed in the same solution after each\\nnursing. When artificially fed the food should be made alkaline\\nwith lime water. Gonorrheal infection will produce a catarrhal\\naffection of the mouth, which should be treated in the same way\\nas thrush.\\nApthce is a more serious affection in which plainly discolored\\nspots appear in the mouth and change into shallow ulcers. They\\nare also probably due to germs and the treatment is essentially\\nthe same as for thrush, but must be more persistent and with\\nstronger remedies.\\nNasal Catarrh in very young infants is usually due to syphilis,\\nbut may arise from infection received while passing through the\\nbirth canal. The treatment consists of clearing the nasal passages\\nwith a mild solution of boric acid crystals by means of a small\\nsyringe or medicine dropper.\\nColic is an early cause of discomfort to infants and is usually\\ndue to imperfect digestion, caused by improper food. The symp-\\ntoms are sudden attacks of pain, shown by refusal to nurse, draw-\\ning up the limbs and crying, and are quickly relieved upon the\\nexpulsion of gas. Dry heat applied to the abdomen, friction\\nacross the lower part of the abdomen, or a warm bath, will give\\ngreat relief. A soft tube introduced into the rectum will allow the\\ngas to escape, and an injection of water or oil will secure a good\\nmovement if the bowels are constipated. The food must be care-\\nfully regulated. A drop of the essence of peppermint in a tea-\\nspoonful of hot water, or a grain of pepsin, or half teaspoonful\\nof the milk of asafetida is very effective for the relief of pain.\\nParegoric, opiates in any form, and soothing syrups of the vari-\\nous kinds, should never be used.\\nThe Diarrhea of the new-born is due to improper feeding or to\\nexposure to rapid changes of temperature. If not corrected by\\nthe substitution of the proper food with from one-twentieth to\\none-tenth of a grain of calomel three or four times a day, give", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0582.jp2"}, "581": {"fulltext": "OBSTETRICS. 559\\nthree grains of subnitrate of bismuth and two to four drops of\\naromatic sulphuric acid to check the frequent movements of the\\nbowels.\\nConstipation is very common, even in the new-born. The in-\\ntestines in children are larger proportionately than in the adult,\\nand their walls are thinner and weaker, because of the lack of de-\\nvelopment in the muscular coat. Excessive constipation in the\\nmother, the small residuum from a milk diet, deficient intestinal\\nsecretion, excessive perspiration, rupture, and intestinal deformity,\\nall are causes. The usual treatment is a change of diet, partially at\\nleast, if the child is artificially fed. The local effect of soap or\\nglycerin suppositories, or an enema of water and glycerin, a half\\npart solution, should also be obtained. Obstruction of the bowel\\ndemands surgical aid.\\nRuptures in children are usually remediable and curable by\\nmeans of properly fitting trusses.\\nUric Acid in the urine may be corrected by small doses of\\nsweet spirits of niter, and lime water in the milk.\\nPhimosis or elongation of the prepuce with contraction may\\ngive rise to irritation, or even to convulsions. Treatment consists\\nin cleanliness and a retraction every day, or, if this cannot be done,\\nin a dilatation with forceps and a breaking up of the adhesions with\\na probe. Should there still be irritation or further trouble re-\\nsulting from the elongation, circumcision should be performed.\\nPremature Birth is the term applied to a child born between\\nthe time at which it is capable of living and full term, whether\\nthe birth be natural or produced. Its possibilities of living will\\ndepend upon the supply of proper warmth and nourishment with-\\nout too great exhaustion. Other things being equal, the nearer\\nit has approached to full term the better its chances for living. A\\nhealthy child born prematurely when the time of full term has\\narrived has equal chances with one born through natural labor at\\nfull term.\\nAn incubator best provides the uniformity of temperature\\nrequired for a premature child. There must be as little disturb-\\nance as possible for feeding and bathing. If covered with cotton\\nwool it need not be dressed at all. It should be bathed only in\\nsweet oil, to secure cleanliness, and its napkins removed only when\\nnecessity requires. It should not be removed from the incubator\\nto be fed, but its mother s milk, or prepared food, must be given", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0583.jp2"}, "582": {"fulltext": "560 OBSTETRICS.\\nwith a dropper, a few drops at a time being slowly put upon the\\nback of the tongue until a dram or two of nourishment has been\\ntaken, the amount being increased as the child grows older.\\nPremature children, among the poor, often die from lack of\\ncare and proper appliances. With the help of the incubator\\ntwenty-two per cent of infants born at six months, thirty-eight\\nper cent at seven, eighty-nine per cent at eight, and ninety-five\\nper cent at eight and a half months have been saved.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0584.jp2"}, "583": {"fulltext": "DISEASES OF WOMEN.\\nBy Ida C. Barnes, B.A., M.D.\\nCHAPTER I.\\nHEREDITY.\\nTo begin life well, means to be born of healthy parents, not\\nnecessarily those of high mental endowments, but of strong bodies.\\nOften with healthy systematic growth, there has come at the\\nproper stage of maturity great mental power that could not have\\nbeen foreseen, and never could have developed, had the child by\\nadverse circumstances become weak and imperfect physically.\\nOn the other hand, the so-called great men and women are often\\nso weakened by excessive and unwisely directed labor that their\\nchildren succeed only to their frailties and never rise above the\\ncommonplace and so, too, the athlete, having injured his body\\nby overexertion, may transmit to his child a tendency to weakness\\ninstead of strength.\\nScience requires that only the healthy woman shall rear chil-\\ndren, but society ignores the demand, and all that can be done for\\nthe present generation lies along the lines of hygiene, careful\\nnursing, physical culture and such education as shall give a proper\\nknowledge of self, and self-control, without which more than ac-\\ncidental excellence can never be transmitted to those to come.\\nIt is surprising what changes can be wrought in the physical frame,\\nfor, by intelligent cooperation and carefully and constantly fol-\\nlowing rules obtained from a competent guide, unfortunate heredi-\\ntary deficiencies may be largely overcome, though it must often\\nbe at great cost of time and sadly limited achievements in life s\\nchosen field. The child can be made better or worse than the\\nparent, according to the care and training bestowed.\\nDIET.\\nBeginning then at. birth, proper food is the primary neces-\\nsity, and its kinds rank as follows: (i) The mother s milk; (2)\\nThe milk of a properly chosen wet nurse (3) Cows milk so modi-\\n36 561", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0585.jp2"}, "584": {"fulltext": "562 DISEASES OF WOMEN.\\nfied as to correspond as nearly as possible with the mother s milk.\\nThe child s desire alone should limit the quantity of proper food.\\nGirls must never be restricted in diet to make them delicate.\\nChildren will seldom eat too, much, unless there be too long a time\\nbetween meals. Food should be taken at frequent and regular\\nintervals, and, after the second year, both meats and vegetables\\nshould be abundantly supplied, and only those articles excluded\\nwhich are known to be harmful. At puberty the diet of a strong,\\nhealthy girl will not need to be changed much, time and atten-\\ntion being given to mastication and digestion, but if there be any\\nlack of development a diet adapted to the case must be rigidly\\nenforced, and more frequent, smaller meals may be an advantage.\\nA school girl who does not enjoy her food will not enjoy her\\nstudies, and unless she eats a fairly good breakfast ought not to\\nbe allowed to go to school. An ambitious scholar may struggle\\nalong for a while without food, but sooner or later will break\\ndown. Hurried eating must be avoided, also highly seasoned\\nfood and improper drinks. Ice water, soda water, and an excess-\\nive use of mineral waters, coffee and tea, are undoubtedly the\\ncause of much indigestion; but warm drinks in moderate quan-\\ntity, as a small amount of tea, coffee or cocoa, if not too strong,\\nare not so objectionable. To an unhealthy girl of capricious ap-\\npetite at breakfast, a cup of dilute coffee or tea, or coffee with a\\nlittle lemon juice and sugar, or a cup of good cocoa, will often\\ngive a relish for food. When solid food cannot be taken, soft\\nboiled eggs and warm oatmeal and milk make a good breakfast.\\nSmoked beef, or bacon nicely prepared, will often provoke a de-\\nsire for other food, but when the appetite is capricious the same\\narticles of diet must not be continually presented. Hot bread\\nand cakes, fried potatoes, sausage and salt fish are forbidden ani-\\nmal food may be taken once a day fatty foods are generally bene-\\nficial, and sweets and ice cream as desserts are good, but pastries\\nshould not be allowed. This diet is outlined for young women of\\nnervous temperament; those of a phlegmatic type (the stolid,\\nheavy, slow and lazy) require different fare. They should have\\nlittle starchy food and very little sugar, but plenty of lean meat,\\nbrown bread, oatmeal and fruit. Barley flour contains less starch\\nthan wheat flour, and is therefore better. The fluids should be\\nlimited in this class of cases, while large quantities of them are to\\nbe taken by the nervous, but principally between meals.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0586.jp2"}, "585": {"fulltext": "DISEASES OF WOMEN. 563\\nPure air is a constant necessity to which too little attention\\nis given. In the large cities and in our public schools the air is\\nalways contaminated. By proper attention to ventilation, at fre-\\nquent intervals, if it cannot be continuous, the air in the rooms\\ncan be greatly improved, and in the erection of all new school\\nbuildings ventilation should be made as easy and perfect as pos-\\nsible. Sleeping rooms should always have fresh air coming into\\nthem, and sitting rooms and parlors must also be ventilated, or\\nyoung girls kept out doors more. Wherever plumbing is used it\\nshould, of course, be of the best, and no sewer connection should\\never be allowed in a sleeping or living room. To unhealthy sur-\\nroundings in early life, quite as much, perhaps, as to heredity, are\\ndue premature decay, disease and death. The influence of bad\\nair is usually soon seen in adults, but in the young it is not\\nquickly apparent, although more permanent and disastrous re-\\nsults may follow.\\nCLOTHING.\\nThe clothing of women should secure an equable temper-\\nature, and for that purpose should equally cover all portions of\\nthe body. There is no excuse for wrapping the trunk excess-\\nively in heavy materials and leaving the legs and arms bare, or\\npractically so. The corset is best superseded by a waist to which\\nail skirts are buttoned, that by carrying their weight on the shoul-\\nders there may be no pressure upon the contents of the abdom-\\ninal cavity. It should be borne in mind that corsets or waists\\nthat are slightly tight when put on are injurious, although they\\nmay soon become loose under constant pressure, so flexible are\\nthe tissues under long-continued stress. It is this constriction\\nof the waist which prevents proper expansion/ of the ribs, over-\\ncomes deep natural abdominal breathing, and gives rise to the\\nchest breathing said to be characteristic of women. Again, what-\\never prevents a free movement of the diaphragm hinders the cir-\\nculation in the pelvic organs and harm comes thereby. Tight\\nlacing, whether from corsets, straps or belts, gives rise to displace-\\nment of all the abdominal organs liver, intestines, kidneys and\\nuterus. It also tends to make thick walls and to cause large,\\nprotuberant abdomens. Of a large number examined by a promi-\\nnent investigator, falling of the uterus was found in every case of\\ntight lacing, not always extensive, but existing to some degree,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0587.jp2"}, "586": {"fulltext": "564 DISEASES OF WOMEN.\\nand there were all varieties of displacement, backward and for-\\nward, as well as downward. There have been cases in which the\\nposition of the stomach was so changed by lacing as to provoke\\npermanent dyspepsia.\\nAnother argument in favor of loose clothing for a young\\ngrowing girl arises from the fact that, in proportion to her body,\\nher liver is twice the size of that of the mature woman, holds one-\\nfourth of her blood, and cannot be placed under pressure without\\ninviting serious consequences. There should be free movement,\\nfree breathing and free capacity for outdoor exercise or work in\\nthe gymnasium. In order to secure this there must be no com-\\npression of the feet by tight shoes nor lack of balance from high\\nheels. A girl has but a short time for development and must not\\nbe hampered, or deformities will result that cannot be corrected.\\nIt is well thought that many of the irregularities of development\\nare due to carelessness, or ignorant neglect of health during the\\ntwo or three years immediately preceding puberty, by which suf-\\nfering and deprivation are entailed for years to come. This state-\\nment is not intended to dwarf the importance of steady develop-\\nment from early childhood, but to secure better hygienic sur-\\nroundings, while the girl is merging into womanhood, and is\\nlikely to neglect physical exercise because of other crowding du-\\nties or the mistaken idea that society demands quiet indoor oc-\\ncupations.\\nSEXUAL DEVELOPMENT.\\nWith the sudden secondary development of the sexual or-\\ngans and the change in size and shape of the pelvis in girls just\\npreceding the beginning of menstruation, there comes a change in\\nmental aspirations, and a sexual instinct, which until now has\\nbeen dormant. If for any reason the physical development up to\\nthis time has been retarded, it may very seriously, affect the sec-\\nondary development of the sexual organs and give rise to many\\nof the ills of later life, which make semi-invalids of women. When\\nthere is great lack or total absence of development of these organs\\nthere is a corresponding lack of development in the entire body,\\nand lack of sexual instinct. Such individuals are neutral in type\\nand instinct, and incapable of the highest attainment either physi-\\ncal or mental. This class includes very few, but, unfortunately,\\nthe other class rhose of defectively developed sexual organiza-\\ntion is so large as to include many women, all of whom are suf-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0588.jp2"}, "587": {"fulltext": "DISEASES OF WOMEN. 565\\nferers to a greater or less degree. This is the more to be regretted\\nbecause so much of it could have been avoided by early care.\\nAt what age girls should be informed concerning the men-\\nstrual epoch is not easily decided, since some will menstruate at\\nten years, others not until several years later. We should, how-\\never, make it a rule to inform a child at least a year before her\\nfirst menstruation, which time, of course, depends upon her gen-\\neral development, the symptoms often being present many months\\nbefore. So great is the danger from taking cold at this time, and\\nfrom mental shock, this important crisis in a girl s life must not\\nbe overlooked. Girls should be informed earlier, too, than at\\nfirst may seem necessary, for another reason and that is, if al-\\nlowed to remain in ignorance too lone, thev will be enlightened\\nby some rude companion in the most sensational manner, rather\\nthan by the careful and interested mother, teacher, or physician,\\nwho will so explain the laws of nature as to show the function a\\nwise and indispensable provision by the all-wise architect thus\\npreventing shock and the unrest which comes at this time to so\\nmany girls.\\nThe time at which a girl should be informed of the higher\\nsocial relations likely to come to her sooner or later must also be\\nleft to the guardian and circumstances; but certainly a young\\nwoman should not be allowed to ignorantly transgress the rules of\\npropriety, as so many do, when a little explanation concerning\\nthe manner in which her forwardness and indiscretion will be trans-\\nlated by onlookers of both sexes, would serve to place her on her\\nguard as to her own protection and reputation. Incidentally it\\nmay be said that it is just as wrong for a man to take a liberty\\nas it is for a woman to allow one, but two wrongs do not make a\\nright.\\nEvery woman before entering the bonds of matrimony ought\\nto understand what her duties and privileges will be in the new\\nsphere, and to accept its pleasures and burdens with joy and hope,\\notherwise disenchantments, disillusions and dissensions will often\\nmar what might have been a happy home. It is certainly the duty\\nof parents and guardians of young women to properly train them\\nfor their greatest work in life.\\nAt the first appearance of her menses the girl must be pro-\\ntected from sudden changes of weather, exposure to cold or ex-\\nhausting heat, sea voyages and changes of climate, except to a more", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0589.jp2"}, "588": {"fulltext": "566 DISEASES OF WOMEN.\\nfavorable one, great nervous excitement, extreme muscular exer-\\ntion, exposure to contagion of any kind, and from indiscretions\\nof diet that can result in indigestion. The overfed, sluggish girl\\nshould have exercise, the book-worm should take fresh air, sun-\\nshine and mild exercise, while the overworked girl of active tem-\\nperament needs rest. If these rules be disregarded at puberty\\nthere will be danger of arresting the development of the sexual\\norgans and deranging their functions, thus impairing future\\nhealth and usefulness. As the general development is nearing\\ncompletion, it is absolutely necessary that the sexual organs take\\nup their function promptly and perfectly. Those in whom this is\\nnot done are apt to be delicate and sterile. Many of the incurable\\ndiseases peculiar to women are due to defective development.\\nThe well developed woman, though liable to accidents and dis-\\nease, is able to resist the causes of disease and to recuperate from\\nthe injuries of accident.\\nMENTAL DEVELOPMENT.\\nPrecocious mental development, not usually in any special\\ndirection, but in the acquisition, through association with their\\nelders, of a conglomeration of unconnected facts forming a fund\\nof general information, is characteristic of the children of to-day.\\nThey also possess a facility beyond their years of acquiring knowl-\\nedge, but, as should be expected, lack the permanence which\\ncomes of gradual development. A slower mental growth, cor-\\nresponding more uniformly with their physical development, and\\nnot acquired at the expense of the latter, is more likely to usher\\nin the larger life replete with usefulness in maturer years.\\nToo often the emotional nature is cultivated to the neglect of\\nthe judgment and the spirit of contentment, and longings for\\nease and pleasure inculcated at the expense of higher motives and\\ndesire to accomplish great and beneficent deeds. All these things\\ntend to the degeneration of correct ideals and to a womanhood\\nof discontent which is a prominent cause of the nervous condi-\\ntions into which so many women drift, even in their younger\\ndays. There is no question but that a right appreciation of cir-\\ncumstances and surroundings does much to secure one s general\\ngood.\\nUnfortunately, competition has crept into our public schools,\\nand children are pushed to the limit of their ability for a few years,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0590.jp2"}, "589": {"fulltext": "DISEASES OF WOMEN. 567\\nonly to finally dwarf their capacity and make of them mediocre\\nwomen. The object m school life should be to acquire a love for\\nlearning and the power of systematic mental concentration, rather\\nthan to gam an accumulation of facts soon to be forgotten. The\\nschool that does not arouse a desire for knowledge is a failure.\\nEach girl should be studied by her parents or guardian with spe-\\ncial reference to her abilities and deficiences, and given just that\\ncourse of study and that amount of exercise or work which will\\nsecure the best possible development of all her powers through\\na long life, and physical health must be regarded as the basis, for\\nwithout it the highest accomplishments can be of no avail. Any\\ncourse of study that exhausts the pupil and threatens physical\\ndisability is detrimental and should be abandoned.\\nMENSTRUATION.\\nThe conditions necessary for normal menstruation are a good\\ngeneral development of the individual, as well as of her organs of\\ngeneration. There must be freedom from marked organic disease,\\nand an abundant supply of nutrient materials, and there should\\nbe agreeable surroundings. Dependent upon so many conditions,\\nmenstruation when properly performed indicates fair health of the\\nindividual, and with derangement of the function some disease or\\nbad surroundings are usually discoverable.\\nMenstruation is governed by the following laws, which aid\\nin determining whether the individual is physically well (i) Men-\\nstruation should be established when the general organization\\nhas attained its growth and the sexual organs have undergone\\ntheir secondary development or are maturing. (2) The func-\\ntion should occur regularly and periodically about every twenty-\\neight days and mould continue from four to eight days, until the\\nchange in life, excepting during pregnancy and lactation. The\\nflow should be free, without clots, and contain the remains of the\\nexfoliated mucous membrane of the uterus.\\nIncidentally, it may be stated in this connection that an\\nerroneous impression prevails among a large class of women, that\\nthe danger of taking cold at this time forbids usual cleanliness,\\nlest a warm sponge bath, or the bathing of the external genitals\\nwith warm water, may result in a diminished or suppressed flow.\\nThat just the contrary plan gives best results cannot be denied.\\nThe external genitals should be washed with warm water as", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0591.jp2"}, "590": {"fulltext": "568 DISEASES OF WOMEN.\\noften as the napkin is changed, which should be at least twice\\ndaily, and oftener if required. After a warm sponge bath pre-\\ncautions must, of course, be taken to get a good reaction, and\\nfor a few hours to avoid exposure. Cold baths, in many cases,\\nwill cause suppression and, therefore, should not be taken at this\\ntime.\\nWhile, as already said, uniformity exists, there is great varia-\\ntion within the confines of health as to menstruation. The time\\nof its first appearance is modified by climate, heredity, surround-\\nings, hygiene, health and disease. Each indvidual is also a law\\nunto herself in regard to the time of recurrence, duration, quan-\\ntity and character of the flow, but when certain rules are once\\nestablished they should continue regularly during good health,\\nand any marked deviation is an indication of some defect which\\nmust be remedied. Derangements of menstruation are usually\\ndue to defective development of the generative organs.\\nPREMATURE MENSTRUATION.\\nThis term is applied to the appearance of the menstrual flow\\nbefore the general development is completed a condition deter-\\nmined by the girl s general appearance, which indicates immaturity,\\nalso a lack of development of the breasts, the pelvis and the ex-\\nternal generative organs. The flow in these cases may be scanty\\nor profuse, but is usually painful and irregular. It is apt to occur\\nin young girls, among both rich and poor, who are illy cared for,\\nand those exposed to immoral surroundings, or associated with\\nolder people of not the best character. The treatment consists\\nin building up the general health. If in school, the girl should\\nbe taken out for a time and given outdoor life with plenty of ex-\\nercise and little excitement.\\nAnother class, presenting some of the same characteristics,\\nconsists of those girls in which there is a true development of the\\nsexual organs before the general development is complete. Here\\nagain the menstrual epoch is irregular and painful, scanty or pro-\\nfuse. Heredity is a factor in premature menstruation, so also is\\nover excitabilit} of the brain and nervous system. It may also be\\ninduced by the excitement of masturbation. The treatment is the\\nremoval of all exciting causes, rest and pleasant mental occupa-\\ntion at home. The plan is to give nature an opportunity to com-\\nplete the physical development before menstruation is regularly", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0592.jp2"}, "591": {"fulltext": "DISEASES OF WOMEN. 569\\ncommenced. Premature development of the sexual organs is\\nabnormal only because the condition precedes the proper develop-\\nment of the general organization.\\nRETARDED PUBERTY WITH PARTIAL DEVELOPMENT OF THE\\nSEXUAL ORGANS.\\nCases are not rare in which there is a good general develop-\\nment and good health, but at the proper age there is no appear-\\nance of the menses. Time must be allowed for the difference m\\nclimates. The girl in the tropics menstruates three years earlier\\nthan her sister in the arctic regions. Hard physical or mental\\nlabor may cut oil nutrition from the generative organs, and this\\nis especially true in a quiet country life. There are also a few in\\nwhom the demand for general development supersedes that of\\nany special organ, and this class of persons will be found to be\\nwell nourished. The treatment lies in rest and a change of en-\\nvironment that social privileges may be enjoyed. If hereditary\\ncharacteristics be a factor the greatest effort must be made to cor-\\nrect these tendencies by suitable surroundings and the most pleas-\\nant social advantages attainable. Again, nutrition may be so in-\\nsufficient, the circulatory apparatus so small, the brain and nerv-\\nous system so predominate, or the general organization be so\\nimperfect or unbalanced, as to prevent functional activity in the\\ngenerative organs. Retarded puberty is seen most markedly in\\nthose in whom the uterus and ovaries are absent or rudimentary.\\nUsually the entire physical development is defective, so far at\\nleast that the girl is undersize, but in some cases the defect is in\\nthe generative organs only. The pelvis usually fails to broaden\\nand the hips remain of the masculine type.\\nAn individual minus internal ^generative organs is a neutral,\\npossessing the characteristics of neither sex, and, of course, is not\\namenable to treatment.\\nMALFORMATION OF THE ORGANS.\\nAs has been said, the ovaries are necessary to menstruation,\\nand any defect in them will derange this function. When they\\nare absent nothing can be clone. There are cases in which they\\nare imperfect, and menstruation comes only at long intervals,\\nand then only in small quantity. If these cases are seen early they\\nmay be partially relieved by measures recommended in delayed", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0593.jp2"}, "592": {"fulltext": "570 DISEASES OF WOMEN.\\npuberty; but they usually come to the physician too late to get\\nmuch help.\\nMalformations of the uterus are also causes of menstrual de-\\nrangement, and originate at some stage in its development in\\nthe embryo, or at puberty. They may be so extensive that there\\nis no possibility of menstruation, although the ovaries are intact.\\nMuch can be done by the physician in charge to ameliorate the\\ndisagreeable symptoms attending these cases; fortunately the\\ncondition is rare.\\nThe forms of incomplete development which result in the\\nsmall or infantile uterus and the flexed uterus (one unnaturally\\nbent upon itself) are usually attended by difficult and painful\\nmenstruation in the beginning, at puberty, or soon after. The\\nmenstruation is generally irregular with long intervals between\\nthe periods, and the flow scanty and of short duration. The\\npain is acute and colicky, comes and goes, and is usually relieved\\nas soon as the flow is free. If this be kept up for years, sooner or\\nlater there will be backache, pelvic tenesmus, occasional leucor-\\nrhea, and nervous disturbances in the form of headache, irritabil-\\nity and weakness of the nervous system as shown by easily induced\\nfatigue, and the digestive organs are usually impaired.\\nIf attention be given to this class of cases when they first be-\\ngin to menstruate, much can be done to aid in a better develop-\\nment, by treatment for the imperfect and painful menstrual func-\\ntion. This must be done through the general nutrition. If the\\nappetite is poor, and insufficient food is taken, every means should\\nbe tried to make the stomach do its duty. Tonics, laxatives and\\nappetizers are indicated, and when the general nutrition is fairly\\ngood, muscular exercise should be given with the hope of stimu-\\nlating the uterine muscles, after which apply the postural treat-\\nment. See page 583. For the difficult and painful menstruation of\\npatients who are otherwise strong give ten grains of the bromide\\nof soda and three to five grains of antipyrine in a teaspoonful of\\nmint or cherry laurel water, once in two, three or four hours;\\nbut those who are debilitated are often made worse by this pre-\\nscription, and for them a diffusive stimulant is better, as follows:\\nAromatic spirits of ammonia thirty drops\\nChloric ether .five drops\\nTincture Cannabis indica five drops", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0594.jp2"}, "593": {"fulltext": "DISEASES OF WOMEN. 571\\nGive it in syrup of acacia with some aromatic, as cardamon\\nor mint, every three or four hours, according to the severity of\\nthe suffering. Belladonna, in doses of the same size, may be sub-\\nstituted for the cannabis indica, if the latter does not do well.\\nThere are many other prescriptions which can be used, but un-\\nder a physician s direction.\\nCHLOROSIS.\\nChlorotic girls mature slowly and menstruate late. Chloro-\\nsis is a condition in which the blood vessels are imperfectly de-\\nveloped. The aorta is small and thin-walled there is often fatty\\ndegeneration of [he walls of the arteries; the ovaries and uterus\\nare small and the heart and sexual organs may show degenera-\\ntion. There is usually anemia, and poor muscular and bone de-\\nvelopment, bur a tendency to plumpness with abundant adipose\\ntissue. The face is putty, the mucous membranes are pale, and\\nthe countenance waxy, yellow or green. Menstruation occurs\\nlater than usual and is likely to be scanty. The disease is heredi-\\ntary, and usually manifests itself in infancy, but rarely attracts\\nattention until the beginning of puberty, when the anemia begins\\nto show itself. Although hereditary, chlorosis is greatly aggra-\\nvated by bad surroundings and insufficient food and exercise.\\nThese girls dislike an active life and incline to inactivity of the\\nbody, although they may be mentally bright. The treatment\\nconsists in a large amount of physical exercise, which should be\\nof a nature to produce more bone and muscle, and not fatty tis-\\nsue. Sluggish action of the bowels and kidneys should be cor-\\nrected, and some form of iron should be given to favor blood\\nformation. In cases that are not seen until late in the disease\\nand are much enfeebled, it may be necessary to give massage and\\nrest in Ded until the nutrition is so far improved that light exer-\\ncise may be taken. When menstruation has become regular and\\nthe appetite has improved under careful attention, these patients\\noften become much better. The cold bath and cold pack have\\nbeen advocated, but more benefit is obtained from a sponge bath,\\nof temperature agreeable to the patient, to keep the skin active,\\nthan from severer methods. If necessary the cold bath may be\\nused later for its tonic effects. The treatment should be con-\\ntinued even after the more prominent symptoms have disappeared.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0595.jp2"}, "594": {"fulltext": "CHAPTER II.\\nTHE ACTIVE PERIOD OF LIFE. ITS CHARACTERIS-\\nTICS AND DISEASES.\\nTo understand how to treat woman during that period when\\nshe must bear the strain and burden of her life, it is necessary\\nto consider her personal characteristics. If we believe that nerve\\ninfluence is the most potent factor in securing normal work from\\ncells and their protoplasm, it is easy to see how the extreme sen-\\nsitiveness of woman s nervous system may be made a force in\\npromoting the highest functional activity, or, if allowed to run\\nriot, may so interfere with the normal mechanism of the body as\\nto favor continued disease.\\nSince anatomy and physiology have become the basis of sur-\\ngery and medicine, the surgeon paying particular attention to the\\nformer, the physician to the latter, we find that both are equally\\ndependent, the one upon the other, and that it is impossible to\\nproperly treat the diseases of women without considering the\\nphysiology and functions directly bearing upon each case. Great\\nadvances are being made in the practice of medicine, not so much\\nin the discovery of new remedies as in new combinations of rem-\\nedies and new methods of managing disease. Less medicine is\\ngiven and more attention is paid to hygiene. Patients are in-\\nformed that they must just as carefully follow the directions of the\\ndoctor in regard to sanitation, diet, rest and exercise, as in taking\\nmedicines in the right quantity and at the right time, and that\\nthey must give sufficient attention each day to the accomplish-\\nment of these ends. We think there can be no more valuable\\nservice rendered in the majority of cases than to convince the\\npatient that each individual must be a law unto herself, with self-\\nlimitations, and that the highest art is in acquiring the ability to\\naccomplish the most possible, in any line, consistent with her own\\ngood health not the good health of some other woman. Were\\nthis rule followed there would be fewer cases of nervous prostra-\\ntion and fewer premature deaths.\\n572", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0596.jp2"}, "595": {"fulltext": "DISEASES OF WOMEN. 573\\nCONTRASTS IN MASCULINE AND FEMININE DEVELOPMENT.\\nAs compared with men the bones of women are smaller and\\nless abundantly furnished with lines and processes for the attach-\\nment of muscles; the bones of the pelvis, though larger, are\\nsmoother and not as strong as in man, and the arch in front is tri-\\nangular, and while the cavity is not as deep as in the male pelvis,\\nthere is more room in the pelvic cavity. The muscles, although\\nsmaller than in men, are not as inferior in quality as might be sup-\\nposed, It has been claimed that women are less sensitive to pain,\\nbut this probably only means that their endurance is greater, and\\nthat they learn to bear it because of the functions which make\\nit a necessity; they certainly possess greater mental and moral\\nsensitiveness. It is found that tissue changes, as far as disintegra-\\ntion is concerned, proceed more slowly in women than in men,\\nthat they recover sooner from shock and strain, and although they\\nrequire more sleep, they are able to endure the loss of sleep for\\nlonger intervals without breaking down.\\nTHE FEMININE BRAIN AND NERVOUS SYSTEM.\\nWhether the brain and nervous system of woman differs\\nfrom that of man has been a subject of much discussion. The\\ndevelopment of the brain is shown, not by weight or size, but by\\nits number of convolutions or folds, the infantile brain sur-\\nface being comparatively smooth, but, as its mental faculties de-\\nvelop, the sulci appear, shallow at first, but growing deeper and\\ndeeper as the years of experience are added. The anatomist has\\nfound very little difference in this respect, either in the brains or in\\nthe sympathetic nervous systems, of men and women, except\\nthat the ganglia and their connecting nerve filaments are larger\\nin the pelvic organs of women, and as this nerve supply is most\\nintimately connected with the process of nutrition, which is so\\nactive during pregnancy and lactation, it is reasonable to sup-\\npose that a higher development of this nerve force in woman al-\\nways exists.\\nAs to nervous affections, there is this peculiarity Women,\\nbeing more emotional than men, are more liable to functional\\nnervous derangements but men are more prone to nerve diseases\\nbased upon real organic lesions, and far more men than women\\ndie insane.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0597.jp2"}, "596": {"fulltext": "574 DISEASES OF WOMEN.\\nWOMAN S RECUPERATIVE POWER.\\nIt is well known that woman recuperates more quickly than\\nman, that she produces blood more rapidly after hemorrhage,\\nand that after exhaustion she regains her former standard sooner,\\nalso that her nutrition is maintained longer and with greater\\nactivity, and that, although woman is rendered liable to many and\\npeculiar diseases by the higher development of her sexual organs,\\nand the greater and special functional activity to which they are\\nsubject, her greater recuperative power and immunity from various\\nother maladies give her a longer average life than that allotted\\nto man. This law is said to also hold in the lower animals and\\nplants. Dr. Ough asserts that from two to six per cent more boys\\nthan girls are born, but that there are six per cent more women\\nthan men. Although not possessed of as great strength, woman\\nendures pain longer and lives where man -succumbs. Of course,\\ngreat loss of life results from war, but more men than women\\ndie from fevers and contagious diseases in times of peace.\\nTHE SEXUAL INSTINCT.\\nThe sexual instinct is born at puberty the period of\\nfull development of the sexual organs. This instinct is not\\nnearly as strong in women as in men, and many women, before\\nmarriage, are entirely destitute of the sexual desire. This is not\\na bar to fruitfulness indeed, the most passionate of women have\\nbeen barren. This appetite is lessened by menstruation, and is\\ndiminished by lactation, as well as by pregnancy; it usually also\\ngrows less as the change in life approaches, but there are striking\\nexceptions. In the earlier days men and women were polyga-\\nmous, but woman has always been monogamous in disposition,\\nand man is becoming more so a result of civilization which is\\never approaching the ideal.\\nTHE DANGER FROM UNCONTROLLED PASSIONS.\\nWe must admit that the sexual instinct, uninstructed and\\nuncontrolled, leads astray, else why so many prostitutes, divorces\\nand unhappy homes? Let a pure and proper knowledge of the\\nreproductive organs and their functions be early imparted to the\\nchildren by the parents, and, as they would shield their boy and\\ngirl from deadly disease by keeping contagion far away, so let\\nthem ever be alert for moral lepers, young and old, lest by con-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0598.jp2"}, "597": {"fulltext": "DISEASES OF WOMEN. 575\\ntact with them their lives be as truly poisoned as were deadly\\ndrugs administered in sufficient doses to gradually but ultimately\\ndetroy them. By early and correct training, direct and indirect,\\nthe mind while plastic and pure can be so imbued with the proper\\nestimation of the sexual relation as to prove a sure deliverance to\\nboth sexes in unprotected years to come; and, until the age of\\nunderstanding and responsibility is reached by each individual,\\nparents, guardians and teachers are more to be blamed for most\\nof the transgressions of the moral law than the offenders them-\\nselves. For the adult man or woman who would designedly\\nand seductively lead a young life astray there are no words of\\ncondemnation strong enough.\\nIt must not be forgotten that the impure and immoral is\\nmore apt to reach the average girl through the books she reads\\nthan through bad companions, and that the latter often follow\\nas a result of the former. It is much to be lamented that many\\nof the popular books of the day portray characters that belong\\nnot to the society of an innocent girl, and are of such a tone as,\\nby their perusal, to make even older people feel guilty of having\\ndescended to the companionship of the debased.\\nNATURAL AND SEXUAL SELECTION.\\nNatural selection enables individuals to select the surround-\\nings most suitable to their individual growth and, of course, has\\nits influence upon the characteristics of sex some perversions of\\nnatural selection being detrimental to sexual selection by develop-\\ning peculiarities of sex. Sexual selection develops characteristics\\nwhich enable animals to live. In considering it, all the features\\nwhich favor reproduction must be included. It has been said that\\nwoman, because of her less defined sexual instinct, is less capable\\nof selecting, but when to that is added the maternal instinct, with\\nwhich she is so fully credited, it remains to be determined whether\\nshe could not select a better lather for her children than often\\nfalls to the lot of woman, compelled to choose from the number\\noffering themselves. There is a long list of qualifications which,\\nin both sexes, should supplement the sexual instinct. Reproduc-\\ntion, alone, only brings added responsiblities and demands for\\nstrength to bear the burdens of training and support. Unless\\nthe animal instinct is based upon the higher quality of love, which\\nmakes each willing to yield much for the pleasure and comfort of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0599.jp2"}, "598": {"fulltext": "576 DISEASES OF WOMEN.\\nthe other, there will not be that peace and happiness which ought\\nto rule in every home.\\nThe great question as to woman s place in the world would\\nbe almost wholly solved were every individual boy and girl taught\\nto be self-supporting, and to this training were added the further\\nteaching that the highest physical function of man and woman\\nis the production of a healthy child of true proportions and un-\\nclouded mind, it being understood, of course, that in the majority\\nof cases a woman who assumes the responsibilties of home-keep-\\ning is to be exempt from other trades. To properly keep a home\\nis a large enough vocation for the average woman, who should\\nat the same time gain recreation from the outside world, and\\nkeep in touch with her husband s business and her country s wel-\\nfare. She ought to be an independent thinker, and follow some\\nline of research. Then will her children inherit from both father\\nand mother the abilities and talents for which all parents watch so\\neagerly as the young lives unfold.\\nEfforts to thwart nature s plans are always dangerous, often\\nexceedingly injurious. The child-bearing period should be early\\nin the married life. Devices for preventing conception often so\\nreduce or injure one or both parties that, later, when children are\\ngreatly desired, the would-be parents are unable to beget them,\\nor, at most, are able to produce but a weak and enfeebled\\nprogeny.\\nRELATION OF THE SEXES.\\nWe are indebted to Dr. J. R. Scott of Clay Center, Kan., for\\npermission to quote the following from a paper read by him at\\nDenver last December, before the convention of the Western\\nSurgical and Gynecological Association, and printed in their an-\\nnual report\\nA large number of women, as far as my observation ex-\\ntends, believe that man in his sexual life is an animal, whose pas-\\nsions must be gratified at all times and under all conditions, re-\\ngardless of the wife s likes or dislikes. I blush for my sex when\\nI say that a large number of men share in and act upon this be-\\nlief. I readily admit that man s passion is the more readily\\naroused and the more active. The male is the aggressor, always,\\nin all relations of the sexes. Women would hate and despise a\\ncreature fashioned in the likeness of man without his attributes", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0600.jp2"}, "599": {"fulltext": "DISEASES OF WOMEN. 577\\naggression, force and power, call them what you will the\\nqualities of manliness but were the male mind not wrongly edu-\\ncated, no such idea as I have stated would prevail. From early\\nboyhood the male, from his surroundings, and later by associa-\\ntion with men, impure in thought if not in practice, becomes\\nimpregnated with an idea of woman s sexual life which prevails\\nonly among women of the town. He therefore grows up believ-\\ning that women are sensual to an unwarranted degree, and the\\nsexual act, which should be looked upon by him as pure and\\nright, is associated with the baser side of his nature. I hold, and\\nthis applies to both sexes, that not one of nature s laws can be\\nbroken without disastrous results, near or remote. Hence, when\\nthe sexual act is indulged to gratify the animal in man, stimulated\\nperhaps to a greater activity by drugs, without mutual attraction\\nand the ready acceptance of the possible results of such an act,\\nthe individual moral tone is lowered. Particularly is this the\\ncase when one or both the parties to the act indulge with the de-\\nliberate intention of avoiding natural consequences. It is then on\\na level with drunkenness and gluttony. A man or woman might\\nbetter cheat, lie or steal for a reaction will come that will be as\\ndisastrous to a person with moral instincts as that following in-\\ndulgence in masturbation, and we have all seen its bad effects\\nupon both mind and body. We know how unhappy the lives of\\nwomen are who rind no enjoyment in the sexual act, and who\\nacquiesce only from a sense of duty. Many such wives are the\\nsubjects of melancholy, and their physical health is as poor as\\ntheir mental condition.\\nThen, too, there is the class whose passions are awakened but\\nnever satisfied because of the rapidity with which the male reaches\\nthe climax. These are all cases in which mankind have a right to\\nexpect the conservator of health to give instruction, and to also\\nbe a conservator of peace of mind and of morality. Do we, as\\nphysicians, do our full duty in this respect? Do we take the\\nsame serious view of a broken natural law that the iegal frater-\\nnity take of statutory infraction or that the moralist does of out-\\nraged morals?\\nA doctor should not countenance the idea that it is neces-\\nsary for young men to sow wild oats. A large percentage of\\nwomen s diseases are results of specific infection. Sowing wild\\noats is a most prolific means of spreading venereal diseases. Many", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0601.jp2"}, "600": {"fulltext": "578 DISEASES OF WOMEN.\\na woman has borne months of suffering and undergone surgical\\noperations because of her husband s carrying in his person infec-\\ntion acquired while sowing wild oats. It is a doctor s place to\\nrelieve suffering in saint and sinner; but he must also prevent\\ndisease by every possible means. I also believe that everyone,\\nsuffering from venereal disease, who goes into a doctor s office\\nshould go out feeling safe from exposure, but also feeling that he\\nhas committed such a crime against society that exposure could\\nadd nothing to his disgrace.\\nI believe that as morals are improved by moral suasion, and\\nby education along sexual lines, that by pointing out to every\\ninfected young man who conies to us that he has committed a\\ncrime against the honor of man and the virtue of woman, the per\\ncent of pelvic diseases will be perceptibly lowered. Venereal dis-\\neases should be dealt with as are other contagious diseases, but\\nthe relation of the doctor to the patient prevents quarantine, iso-\\nlation and danger signals. Silence is a duty we owe those who\\nentrust us with their secrets, but we also owe a duty to the in-\\nnocent who may suffer from our patient s moral deflection and its\\nvery unpleasant but to be expected results. We shut our eyes\\ntoo much to the consequences of these very prevalent diseases\\nin young men until confronted with a case of pelvic trouble un-\\ndoubtedly due to specific infection. We then denounce the\\nman in our heart, when he should have been read a moral lecture\\nin the office of the doctor who cured him. This\\nphase of the subject belongs rightly to the field of preventive medi-\\ncine, hence comes fairly under the subject chosen. Had we\\nphysicians, as a class, the moral stamina which we should have,\\nwe could limit very materially this form of moral obliquity, and\\nits attendant evils, thereby effectually preventing diseases which\\nwe can only imperfectly cure.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0602.jp2"}, "601": {"fulltext": "CHAPTER III.\\nGENERAL MEANS EMPLOYED.\\nWe will describe some of the simple methods used in the\\ntreatment of women s diseases and their application to them alone,\\nthat when mentioned in connection with the cure of any special\\ncondition there may be no misunderstanding.\\nHYDROPATHY.\\nThe use of water in various ways has in recent years acquired\\na large place in the treatment of disease. Its benign effects in\\nthe management of fevers have long been known, but the discovery\\nof its value in the treatment of nervous disorders is more recent.\\nFor our purposes, water will be considered principally as used for\\nbaths, hot and cold, and for douches. The direct result of a bath\\nis a shock to the cutaneous nervous system. When it is remem-\\nbered how extensively the surface is supplied with sensory nerves\\none can easily understand that a great impression can be made\\nupon the nerve centers by direct applications to the skin.\\nThe effects of water vary with its temperature and the mode\\nof its application. To the cutaneous nerves, water is either stimu-\\nlating or sedative and, secondarily, either a sedative or tonic to the\\nnerve centers. Action and reaction are obtained. Mild stimula-\\ntion may be followed by a sedative effect and, vice versa, a sedative\\neffect may bring on stimulation. Its action upon the circulation is\\nof the same order; the circulation may be equalized by the primary\\neffect of a warm bath which stimulates the capillary circulation and\\ninvites the warm blood from the deeper structures while the cold\\nbath, by lowering the surface circulation, drives the blood to the\\ndeeper structures, and puts more work upon the heart. When\\nthe reaction comes the effect of the warm bath is found to be just\\nthe opposite of that of the cold one. This change in the circula-\\ntion is not all mechanical and is a real help in the process of blood\\nmaking, probably due to the tonic and enervating effects of the\\ncold bath.\\n579", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0603.jp2"}, "602": {"fulltext": "580 DISEASES OF WOMEN.\\nThe first indication for the use of water in nervous diseases\\nis the need of its quieting effect. For this the warm or hot pack\\nwill be found most serviceable, when the patient is too weak or\\ntoo irritable to take an ordinary bath. To relieve wakefulness\\nand secure undisturbed sleep it is usually better given at bed time\\nbefore taking the last nourishment or dose, of medicine, but should\\nit excite the patient and drive away sleep it must be taken earlier\\nin the day. After the bath, administer either brisk or gentle\\nrubbing, whichever the patient will tolerate best, and if this does\\nnot produce the quieting effect, rub her with the following oint-\\nment\\nChloral hydrate one dram\\nCamphor one dram\\nRosewater ointment four ounces\\nTo give the bath, wrap the patient in a heavy woolen blanket\\nwrung from water at a temperature of 1 10 degrees Fahrenheit, and\\nplace over this a large dry blanket and rubber sheet. She may be al-\\nlowed to remain in this bath from thirty minutes to two hours.\\nThe small blood vessels of the skin are at once widely dilated, the\\ninternal blood vessels are relieved of pressure, the excretions from\\nthe skin are excited, and the general relaxation, known as a seda-\\ntive effect, follows.\\nAs soon as the patient can endure the tonic effect of the cold\\nbath, a linen sheet may be used wrung from cold water of a\\ntemperature of 70 to 50 degrees; better to commence with the\\nformer and work down to the latter. Wrap the patient in this\\nsheet, and wrap the head with a wet towel over the wet sheet\\nwrap a dry one, and the rubber blanket over all. At first there\\nis constriction of the small blood vessels of the skin. This lasts\\nbut for a moment, and is then followed by a flow of blood to the\\nentire surface not much heat can be given off because of the\\nblanket, and there is not as much perspiration as by the warm bath.\\nThe cold bath is tonic in its action, and is of much value in general\\nrestorative treatment.\\nTURKISH BATHS.\\nTurkish Baths are very effective in the treatment of rheu-\\nmatism and plethora, but are seldom well borne by patients who\\nare nervously depressed. Persons with inactive skins and slug-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0604.jp2"}, "603": {"fulltext": "DISEASES OF WOMEN. 581\\ngish elimination are benefited by an occasional Turkish bath,\\nespecially in the change from a hot summer to a cold winter, when\\nthe perspiration suddenly ceases and much work is thrown on the\\nkidneys. These baths are also good to relieve kidney diseases.\\nAlthough some can take them the year around and feel better in\\nconsequence, others are thereby rendered subjects of constant\\ncolds, and still others complain of faintness, fatigue and irritability\\nfollowing them. The two last classes are harmed rather than\\nbenefited by the Turkish bath.\\nCould this bath be robbed of some of its drawbacks it would\\nserve a better purpose. Proper ventilation is usually lacking and\\nthere is danger of exposure to infectious and contagious diseases.\\nThe attendants and rubbers are not careful in cleansing their hands,\\nor in going from one patient to another, scrubbing brushes are not\\ncleansed, and blankets upon which patients recline are used over\\nand over again. By furnishing her own blankets and brushes the\\npatient can lessen these dangers, but there will yet be liability to in-\\nfection from venereal diseases in fact, sufferers from such troubles\\nmost frequent these baths. There should be a room for the sep-\\narate cleansing of those who have been exposed to contagious and\\ninfectious diseases, and their clothes should be disinfected. The\\nTurkish bath is without doubt very valuable in many general dis-\\neases, but not noticeably so in women s diseases, unless they be\\ncomplicated with one or more of these general disorders.\\nELECTRICITY.\\nThis is of great value in the treatment of the nervous\\ncomplications accompanying and resulting from various\\nforms of pelvic disease, when it takes time to reach the seat of the\\ndisorder also for the relief of pain and to stimulate the absorption\\nof inflammatory products. Faradic, galvanic or static electricity\\nis used according to the needs of the case and its effect upon the\\nindividual, one responding best to one form, another to another.\\nElectrical treatment can be successfully and safely applied only by\\nthe physician, or under her direction, since if improperly used it\\nmay result in more harm than good.\\nEXERCISE.\\nIn the management of diseases of the pelvic organs,\\nand during convalescence it is often essential to employ", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0605.jp2"}, "604": {"fulltext": "582 DISEASES OF WOMEN.\\nmuscular exercise and, in order that the inflamed tissues shall not\\nbe injured, it is necessary that this exercise should be taken by the\\npatient while lying on her back. The extremities can be exercised\\nby first raising one leg so as to form an obtuse angle with the\\nbody, holding it there a minute, then slowly returning it to the bed\\nthis may be repeated several times as long as the patient does not\\nbecome tired. Next the leg may be flexed and extended slowly in\\nthe same manner, but not to the point of becoming tired; then\\nflex the leg upon the thigh, and the thigh upon the abdomen and\\nrepeat slowly. Each movement should be stopped short- of mus-\\ncular fatigue. The leg is also raised straight and turned in and out\\nas many times as the patient can easily stand it. The other leg is\\ngiven similar exercise; and the arms are exercised in a similar\\nway, except that both are used at the same time. They should\\nfirst be raised to form a right angle with the body and the move-\\nment repeated several times, then raised above the head and\\nbrought down in a line with the body. The forearms are next\\nflexed upon the arms. The hands are exercised by forcibly clos-\\ning and opening the fingers and bending the wrist in every pos-\\nsible direction. In cases of active pelvic disorders, it is well to\\nelevate the part of the bed upon which that portion of the body\\nlies. These movements are beneficial to those who have gotten\\nbeyond the need of massage and, but for the local pelvic condition,\\ncould take active outdoor exercise.\\nSome of the following exercises strengthen the muscles of the\\nback, abdomen, trunk and limbs when these have become weak-\\nened by long disease or sickness. For strengthening the abdomi-\\nnal muscles, Dr. Savage recommends the patient to lie on her back\\nin bed, to raise the head and shoulders a few inches from the\\npillow, hold steadily a moment, then slowly drop back; this is\\nrepeated immediately, then an interval of rest taken and the move-\\nment repeated again; five repetitions completing the exercise,\\nwhich must stop short of fatigue. Later the feet should be fixed\\nagainst the footboard and the patient rise to a sitting position, then\\ngradually fall back, at first reclining on the pillow, and afterward\\nlying flat on the bed, going through the exercise five times. Again,\\nthe patient lying on her back brings the bended knee toward the\\nface as far as possible without effort, then forces it toward the face\\nan inch or two. This is done with the other lesr also, the exercise", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0606.jp2"}, "605": {"fulltext": "DISEASES OF WOMEN. 583\\nconsisting of five such movements with each leg. A more difficult\\nfeat is for the woman, flat on her back, to raise first one leg, then\\nthe other, from a horizontal to the vertical position, repeating ten\\ntimes with each leg. Finally, the abdominal muscles are strength-\\nened by placing a weight upon the abdomen and drawing deep\\nabdominal breaths to lift the weight as high as possible, holding it\\nthere a few seconds, then allowing the air to slowly escape from\\nthe lungs.\\nTo strengthen the muscles of the back, the woman, lying on\\nher back with her feet drawn up, raises her hips until the thighs are\\nin a line with her body, keeps this position a moment, then slowly\\ndrops back; this is repeated five or ten times. Lying prone with\\narms at her side, the woman breathes deeply, raises face and\\nshoulders from the pillow, keeps this position a moment, then lets\\nthe head and shoulders fall back. The following is harder The\\nbody is lifted off the bed four or five times, with a rest after each\\neffort, the elbows and toes being the only points of support. The\\nlateral muscles can be strengthened, the woman lying on her side,\\nby lifting the hips and making the shoulder and lower leg the\\nonly points of support. It is hard to take systematic exercise alone,\\nand these movements are adapted to those only who are not able to\\nget outdoors. In commencing such exercise only a few move-\\nments should be taken at first, and never to the point of weariness,\\nand the number noted each day, that two or three movements may\\nbe added daily to each exercise. Next come riding and walking,\\nthen some daily occupation.\\nBaths should be continued all through the treatment to keep\\nthe skin active and clean, also for the exercise. The kind of bath\\nshould be suited to each case, and that most agreeable and fol-\\nlowed by the best results invariably used.\\nRULES FOR MUSCULAR EXERCISE FOR FAILURE OF MEN-\\nSTRUATION.\\nWe copy from Skene s Medical Gynecology the following\\nrules for muscular exercise for failure of menstruation, in young\\ngirls\\nFirst, with one foot forward a deep breath is drawn and the\\narms elevated above the head, parallel in front and palms facing in-\\nward then during expiration they are brought down laterally with\\npalms facing forward.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0607.jp2"}, "606": {"fulltext": "584 DISEASES OF WOMEN.\\nSecondly, lying on the back, the lower extremities unsup-\\nported and the legs crossed, the toes execute circles from within\\nout, the movement occurring in the ankle joint. This is repeated\\nreversely eight or ten times in each position.\\nA third exercise is for the patient to stand upright, with\\nfeet well apart, the buttocks resting against a table and arms above\\nthe head. The trunk is flexed en the pelvis sidewise and forward\\nslowly, five times to each side, pausing after each motion.\\nA fourth, with hands on the back of a chair and one foot\\nupon another chair behind her, the patient rises on the toes of the\\nother foot, then drops toward the ground by bending the knees,\\nthen resumes the extended position on the toes, finally dropping\\non her heel as before the start. This is done slowly five times with\\neach foot.\\nFifth. The patient stands upright with feet apart and arms\\nelevated, the body is bent forward, then backward, then pauses in\\nan upright position. Five times each.\\nSixth. Resting a hand upon the back of a chair before her\\nand standing on the leg of the same side, the other leg is raised,\\nand the knee rotated from within out then reverse the legs.\\nSeventh. With hands on the hips and body well back, a\\nrunning motion is executed, but the patient remains in the same\\nspot, each step bringing the thighs to a horizontal plane; ten\\ntimes rapidly, then three or four times with an interval between\\neach two. This sends a good current of blood to the pelvis.\\nEighth. Standing with feet apart and hands on the hips,\\nthe head describes a circle five times in each direction.\\nNinth. Kneeling on a cushion with knees apart, the body is\\nbent backward and returned slowly to the perpendicular, five to\\nseven times.\\nTenth. This is a passive motion, the patient in a semi-re-\\ncumbent position. The assistant lifts one leg by a hand in the\\npopliteal space (under side of the knee joint) and another on the\\nsole of the foot. The thigh is, flexed on the abdomen, carrying the\\nknee outward, and describing a small circle. Repeat the motion ten\\ntimes while increasing the rapidity of it. After a pause the assist-\\nant again commences, and thirty or forty movements are given\\nto each leg, the patient being absolutely relaxed. Flexion and ex-\\ntension can also be made against resistance.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0608.jp2"}, "607": {"fulltext": "DISEASES OF WOMEN. 585\\nDISCHARGES OF BLOOD BETWEEN THE REGULAR MENSTRUAL\\nPERIODS.\\nFor this disorder the same authority gives a line of exercises\\nquite as extensive\\nFirst. The patient sits facing the operator, with hands on\\nher hips and her knees apart. The operator puts one hand on her\\nshoulder and the other under the opposite axilla, drawing her\\nforward and simultaneously twisting her body in the pelvis. She\\nis to resist the forward motion and the operator is to resist the\\nbackward motion; six times for each side. Then a direct for-\\nward and backward pull is made, the patient keeping the back\\nmuscles very tense.\\nSecond. The patient is to kneel with her hands on her\\nhips, the operator behind her, puts a knee against her and her\\nhands under her armpits, she bends forward while the operator re-\\nsists, then the operator draws her upward while she resists. When\\nthe patient bends forward her body is rapidly twisted several times\\nabove the pelvis. This is done live times, with a rest after each\\nmaneuver.\\nThird. The patient stands in a doorway, the arms vertical,\\nhands against the top of the doorway, while the operator places\\none hand upon the abdomen and the other between the scapulae\\nand pushes her forward. As she regains her first position the\\noperator resists and pushes her hand upward, ten times.\\nFourth. The patient stands with her back against the wall,\\nher hands on her hips, and she places an ankle in the operator s\\nhand while the operator steadies her by placing her other hand\\nagainst the upper part of the hip bone of the same side; the leg\\nis drawn up and out, she resisting, then the operator resists while\\nshe lowers the leg. This pump-handle motion is repeated five\\ntimes for each side.\\nFifth. The patient leans against a chair or bedpost at as\\ngreat a slant with the floor as possible, while the operator, one hand\\nunder the abdomen, lifts the foot, the patient passive; then she de-\\npresses the leg while the patient resists. Five times for each side.\\nSixth. The patient leaning forward puts her hands against\\nthe wall, chest level, turns the elbows out and keeps the feet apart.\\nThe operator, one hand supporting the abdomen, taps lightly upon\\nthe sacral lumbar vertebrae (just below the small of the back) with\\nhalf closed hand.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0609.jp2"}, "608": {"fulltext": "586 DISEASES OF WOMEN.\\nSeventh. The patient draws her feet together under the\\nbended knees, lifting the hips clear of the couch, the operator re-\\nsisting an attempt to draw the knees together. Five times. Then\\nthe attempt to separate the knees is resisted. This strengthens\\nthe levator muscles.\\nEighth. If the patient is incapable of performing any of\\nthese movements, she reaches her hands to the operator, the el-\\nbows slightly bent, while her arms are moved at the shoulder\\njoints in all sorts of circling motions while she is passive. She\\nthen bends her arms the operator resisting flexion, she extension/\\nSWEDISH MOVEMENTS.\\nSwedish Movements are a branch of mechanical therapeu-\\ntics devised by Ling of Sweden in the earlier part of the present\\ncentury. A great many machines were made by which different\\ngroups of muscles were moved in many different ways, and if\\npatients could not or would not exercise, the machines did it for\\nthem with equal benefit to that acquired by natural exercise. In\\ndiseases of women, and of those also who are nervously exhausted,\\nthe only claim made for this system is that it develops muscle to its\\nfull capacity, by which undue nervous irritability is diminished,\\nand in chronic cases engorgements are relieved. Its best results\\nare obtained in chronic functional disorders. The system re-\\nquires very complicated apparatus, access to which can be had only\\nin large sanitariums, gymnasia and institutions especially devoted\\nto this work.\\nMASSAGE.\\nMassage is motion communicated to the tissues of the body\\nfrom some external source. It may be transmitted directly to the\\npart operated upon, or may be produced through some mechan-\\nism. Stroking, kneading, friction and percussion are the four\\nprincipal procedures. Stroking should be performed with the\\npalm of the hand and its motions should be toward the heart.\\nFriction is usually performed with the tips of the fingers over small\\nareas, but the thumb is far better. The skin ought not to be\\nirritated in this process. Kneading is the grasping of a muscle, or\\ngroup of muscles, by one or both hands, and rolling or squeezing\\nit or them upon the parts near them. When a limb is held be-\\ntween the palms a rapid to and fro movement is made, the iimb\\nbeing rolled back and forth between the hands. When alternate", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0610.jp2"}, "609": {"fulltext": "DISEASES OF WOMEN. 587\\npressure and relaxation are made very rapidly, the kneading process\\nis called vibration and requires great skill. Midway between\\nkneading and percussion is pressure with the linger tips or\\nknuckles. Percussion is the last distinct method in massage. The\\nhand may be used, or an instrument called a percusser or muscle\\nbeater. In percussion the operator may employ clapping, chop-\\nping and whipping.\\nA few of the applications of massage to women s diseases\\nmay here be considered. It may also be noted that massage fails\\nof its end if not given by a thoroughly trained and experienced\\nmanipulator, as well as when prescribed without a correct diag-\\nnosis, or when advocated as a cure-all. Abdominal massage\\nis helpful only when the abdominal muscles are relaxed. If\\nthere are fecal accumulations, massage about the cecum and sig-\\nmoid flexure is best by stroking. General massage will increase\\nperitoneal absorption and aid in the absorption of fluids in the\\nabdomen. Rapid circular strokes over the abdomen increase the\\nperistaltic action of the intestines. Functional derangements of\\nthe liver and spleen are much helped by massage. Stones in the\\ngall bladder may be dislodged by careful manipulation.\\nIn functional disorders of the digestive system, and in dys-\\npepsia, massage of the abdomen is of benefit, for with its help the\\nstomach does not retain food as long, and the secretions of the\\nstomach and liver are stimulated. It should not be administered\\nwhen the movements of the stomach are too great. Kneading\\nthe abdomen for constipation is one of the surest remedies; in\\nobstinate cases vibration may be used. It is useful in the dyspep-\\nsia of anemic girls, but if gastric ulcer is suspected it should not\\nbe employed.\\nIn some cases of obesity, massage and proper diet are\\nvery beneficial. In pelvic engorgements, and functional uterine\\ntroubles, massage and movements aid other treatments. One\\ntreatment in twenty-four hours is usually frequent enough, and it\\nshould be of forty to sixty minutes duration.\\nDIET IN DISEASE.\\nThe water taken in sickness should be known to be pure;\\nif it is not it should be boiled and filtered. Distilled water charged\\nwith carbonic acid gas is very agreeable to most patients and\\nwater may be medicated by adding cream of tartar, lemon juice,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0611.jp2"}, "610": {"fulltext": "588 DISEASES OF WOMEN.\\nor any mineral acid indicated. Alkalies or alkaline salts may be\\nadded and the water charged with carbonic acid to suit the taste.\\nTea and coffee, when there is sleeplessness or irritability, are to be\\ntaken in very small quantity, if at all, but in cases of exhaustion they\\nmay be used as mild stimulants. They are not restoratives but,\\nin a measure, prevent waste. There are no iron-clad rules to be\\nmade concerning these drinks some persons take tea best, others\\ncoffee, and some can take neither. The patient should be gov-\\nerned by her past experience.\\nTea elevates the bodily temperature, and, in cases of shock,\\nis often better than alcoholic stimulants, since it is followed by\\nno reactive depression. In women s diseases alcohol is seldom\\nneeded, unless after a very severe operation upon one accustomed\\nto such stimulants, and it is harmful then if long continued. No\\none form will suit every case; some doing better on beer, others\\non champagne, etc.\\nFLUID DIET.\\nIn cases of acute gastritis, the physician must consider the\\nkinds of food and their purity, rather than the quantity, that shall\\nbe given. This is often a difficult problem, but unless solved cor-\\nrectly, there may be a failure to tide the patient over to what might\\notherwise have been a favorable result. In acute cases the\\nstomach first rebels, and solid food cannot be given; but milk,\\ngruels, eggs in fluid, and beef extracts and juices, can usually b e\\nborne. In fevers milk is the best food, in spite of the fact that it\\nwill coagulate and is indigestible for some persons. Milk is often\\nbest brought to a boil, or even boiled and then diluted with vichy,\\napollinaris or distilled water charged with carbolic acid gas. It\\nis to be given in small quantities and at frequent intervals two\\nounces of milk in two ounces of water. Whey is milk from which the\\ncasein and much of the fat have been separated by coagulation\\nand straining. It can be given when milk is disagreeable, and can\\nbe made more nutritious by adding the beaten yolk of egg or beef\\njuice.\\nEggs are a complete food, as they contain all the necessary\\nelements for the nutrition of the body. They may be beaten up\\nwith hot water, strained, and added to clear soup or broth. The\\nEnglish beat up an egg in a cup of hot tea. The Germans like\\nslightly boiled eggs beaten up in hot broth, and also use eggs in", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0612.jp2"}, "611": {"fulltext": "DISEASES OF WOMEN. 589\\ncoffee. Beef juice, beef extracts, meat infusion, and other similar\\narticles are good in fever, but may be given in a too highly con-\\ncentrated form, and stimulate too much. They may be diluted\\nand flavored with the juice of fresh vegetables, as carrots, parsnips,\\netc. and these vegetable juices are a valuable addition. The pulp\\nor fine scrapings of meat may be added to dilute extracts of clear\\nsoups, in cases of a subacute type. Calf s foot jelly, rice and bar-\\nley water, chocolate, fruit, soups, oatmeal and the like answer\\nwell for a change.\\nMalt extracts and malted foods are only digested starches, and\\nusually contain ground malt, some wheat flour, a little bicar-\\nbonate of potash and milk. The salts and fats are not well repre-\\nsented in these foods, hence it is necessary to add them. Pepsin,\\nthe ferment of gastric juice, when properly given with the food in\\nacute cases, is frequently a large factor in saving life. Predigested\\nfoods, pancreatin and peptonized foods are very valuable, but often\\nobnoxious on account of their odor and taste. Peptonized food is\\nnow easily made in the sick room, from extracts of pepsin and\\npancreatin. Peptonized milk and peptonized milk gruel are re-\\ngarded as nearly equal to peptonized beef extracts.\\nFORCED FEEDING.\\nIt is well to describe here what is known as forced feeding.\\nThe patient is first put upon a milk diet, three or four ounces\\nevery two hours, increased in a few days to two quarts in the\\ntwenty-four hours, given in divided doses. In case there is con-\\nstipation a mild laxative, as a two to five grain tablet of cascara\\nsagrada, may be given once daily. At the end of a week a light\\nbreakfast is given, and soon three good meals a day are taken\\nin addition to the two quarts of milk at and between meals. There\\nmay be added thin lean-beef soup, to which has been added five\\ndrops of hydrochloric acid, cocoa, a quantity of butter and a half\\nounce of cod-liver oil may be given after each meal. If, as a result\\nof this forced feeding, diarrhea or dyspepsia occurs, give only half\\ndiet. The urine must be examined and when urates begin to be\\ndeposited return must be made to the simple milk diet or the\\nquantity of food reduced.\\nAnother method is to introduce into the stomach an excess\\nof food by an esophageal tube, it being retained and digested,\\nwhere previously all food had been rejected, much less digested", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0613.jp2"}, "612": {"fulltext": "590 DISEASES OF WOMEN.\\nDebove, who introduced this plan, said that he found no relation-\\nship between appetite and digestive power. Powdered raw meat\\ncan best be given through the tube, and this is the form of invalid\\nfeeding now in vogue in France.\\nA VEGETABLE DIET.\\nA vegetable diet can be either fulLor spare. It consists prin-\\ncipally of vegetables, fruits, milk and eggs unless a very low diet\\nis demanded to obtain a degree of starvation, m which case vege-\\ntables alone are used. Although this gives sufficient bulk, it is a\\ntax upon the organs of digestion. When there is more than nor-\\nmal sexual excitement, the vegetable diet answers well because\\nnon-stimulating and the stomach irritability detracts from the other\\ncenter of excitement. Persons having feeble digestive powers can-\\nnot take bulky, watery foods containing but little nutrition, as\\ncabbage, turnips, etc., nor be allowed food containing much starch\\nbecause of the unpleasant fermentation neither must the starches\\nbe given to a person who is very stout on account of their fat\\nforming properties.\\nTHE SPARE DIET.\\nThe spare diet does well where there is retention of ex-\\ncrementitious material, and may consist of vegetables without\\nmeat, or with meat in very limited quantity. It is in cases of op-\\npression rather than exhaustion that the forced feeding diet pro-\\nduces such disagreeable results. There are some foods, though\\nnot the same with every person, which must be omitted from the\\ndiet of the sick they are such articles as veal, young lamb, pork,\\nduck, goose, fat and oily fish, cabbage, turnips, nuts, dried fruits,\\nand fruits too richly preserved or seasoned. It is well known that\\nmore dyspetics suffer after eating the most digestible foods than\\nafter partaking of those articles which from their constitution must\\nbe considered not easily digestible. So each case must be studied\\nfor itself. The desire for certain food is a partial guide, if the ap-\\npetite has not been perverted by faulty eating.\\nFOR OBESITY.\\nFor obesity there are many diets, but they are all much alike\\nand depend upon a lessening of the foods which produce fat.\\nSugar, starches and fats should be discarded altogether if possible,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0614.jp2"}, "613": {"fulltext": "DISEASES OF THE SKIN. 591\\nor used very sparingly, and fluids of all kinds must be taken only in\\nsmall quantities; wine, beer, tea, coffee and chocolate should not\\nbe used at all.\\nFOR AGED PEOPLE.\\nFor aged people the diet should not be pushed, even if there\\nbe loss of flesh but the meals would better be given more fre-\\nquently, five or six times daily, light in quantity and very digestible\\nin quality.\\nTHE POWER OF MIND OVER DISEASE.\\nThere is perhaps no other stimulant that so excites the tissues\\nand glandular activities to their best work as the hope of recovery.\\nThis should be based on the fact that everything is being done,\\nscientifically, to place the tissues and glands in the best possible\\ncondition for the performance of their functions. There is no\\nlack of harmony between this and belief in our dependence upon a\\nhigher power, call it the Great Physician, the Divine Healer, or\\nwhat you will. Unsustained by the Creator there is no human\\nbeing who could live a minute. But in the plan of soul healing\\nthe- Lord uses instruments, even his people, to accomplish the\\nwork; and not only are they expected to employ earnestness, tact\\nand judgment, but in every proper way to use material things\\nto promote the cure of sin-sick souls.\\nWhy not so in bodily healing? Shall not the Christian phy-\\nsician, to alleviate suffering and combat disease, use his best ability\\nalso, and, while asking for divine guidance and blessing, apply\\nwell tested remedies with the skill born of study and experience,\\nrather than try to make the sufferer believe there is no such thing\\nas pain, or lie down supinely and ask God as a reward of faith to do\\nthe whole job by miracle? Why should not the declaration of\\nJames that faith without works is dead apply as well to the sick\\nas to the sinner?", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0615.jp2"}, "614": {"fulltext": "CHAPTER IV.\\nDERANGEMENTS OF MENSTRUATION.\\nIn all acute and chronic diseases of the general system there\\nmay be derangements of the menstrual function. In fever and\\npneumonia, either during the acute attack or in the convalescence,\\nthere is apt to be scanty or missed menstruation, but in a few cases\\nthere may be a profuse or frequent flow, due to the relaxation, or to\\na hemorrhagic condition. This may likewise occur in the eruptive\\ndiseases, as scarlet fever, measles, small-pox, and sometimes in\\nmalarial fever. The failure to menstruate in these diseases is\\nusually due to bad nutrition.\\nThe treatment must be directed to the management of the\\nconstitutional disease, and with recovery will come alleviation of\\nthese disagreeable symptoms. The same treatment usually an-\\nswers for uterine hemorrhage, in this class of cases.\\nHEMORRHAGE.\\nIf the hemorrhage is very severe, medicinal and mechanical\\nmeans must be used for its direct relief.\\nSuch cases should be under professional care, but in case the\\nbleeding is so sudden and profuse as to endanger the patient s life\\nbefore the doctor can arrive, the entire vagina should be filled im-\\nmediately with absorbent cotton. A one-fourth pound or more\\nis usually required, and it must be packed in so solidly and firmly\\nas to arrest the flow of blood, thus leading to the formation of\\nclots in the uterus.\\nAntiseptically prepared cotton is also very essential to\\nthe stanching of any hemorrhage and the proper dressing of\\nexternal wounds it costs but a trifle; and should always be kept in\\nevery home, tightly sealed and never opened until an emergency\\narises requiring its use.\\nThe chronic conditions which impair the nutrition and thus\\ncause menstrual irregularities are scrofula, tuberculosis and syph-\\nilis; then, too, there are the poisons caused by lead, tobacco, ma-\\n592", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0616.jp2"}, "615": {"fulltext": "DISEASES OF WOMEN. 593\\nlaria and foul air. Women who are scrofulous and inclined to fat,\\nand are phlegmatic in temperament, are especially likely to miss\\ntheir periods, or to have only a scanty flow. In the last stages of\\nconsumption menstruation always ceases on account of the malnu-\\ntrition caused by the disease. This may also occur in those pre-\\ndisposed to scanty menstruation, even in the earlier months of\\ntuberculosis. In the secondary stage of syphilis there is a marked\\nloss of red blood corpuscles, and in the consequent anemia, men-\\nstruation is often suppressed, or of short duration. The loss of red\\nblood corpuscles seems to be the cause of failure of menstruation\\nin chronic poisoning. The treatment should be directed to the\\nbuilding up of the system with tonics and proper diet under the\\nmost favorable surroundings that the patient can secure.\\nWhen the menstrual failure is due to imperfect digestion, lack\\nof assimilation, or imperfect elimination, it is very evident that\\nevery measure must be taken to bring all the organs and glands\\nof the body up to their best working possibility. The main\\ncauses are improper food, overwork and confinement indoors, or\\nthe opposite of this, over-indulgence in rich food, and a lack of\\nwholesome and necessary mental and physical occupation.\\nThe missing of the menstrual period may be due to some nerv-\\nous shock, excitement, unrest, anxiety, or change of residence.\\nThe symptoms of the approaching menses may be present in an\\nexaggerated form, as backache, headache, etc., also more or less\\nderangement of the digestive organs. By beginning early, such\\ncases can often be relieved by securing mental quiet and rest.\\nThe bromide of sodium or of potassium, in from ten to fifteen\\ngrain doses, is of great value unless the patient is very much de-\\npressed. At the same time stimulating food, bathing, friction of\\nthe skin, or artificial heat applied to the extremities, aid in the\\nrestoration. If mental excitement still prevails, massage, electri-\\ncity, frequent light meals and attention to the bowels give relief.\\nAt the time of the next period some diffusible stimulant should be\\ngiven, or the aromatic spirits of ammonia in half-teaspoonful doses\\nin a cup of hot water administered every two hours through the\\nday. If this fails, attention to the general health during the month\\nmust be given, and, just before the time for the next menstruation,\\nelectricity should be passed through the pelvis and the special\\nstimulative treatment renewed.\\n38", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0617.jp2"}, "616": {"fulltext": "594 DISEASES OF WOMEN.\\nNERVOUS EXHAUSTION.\\nThis is a fruitful cause of missed menses. This condition\\ncomes on gradually with the failing health, and no doubt is often a\\nconservative provision for preventing the more sudden loss of\\nstrength, by preserving the blood supply. Occasionally there is in-\\ncreased hemorrhage, which may occur at irregular intervals, where\\nthere is congestion of the brain. The flow is then usually accom-\\npanied with much pain. The treatment lies in the care of the gen-\\neral disease with stimulants and sedatives to aid the flow and\\ndiminish the pain.\\nNervous exhaustion, coming on during prolonged lactation,\\nis of frequent occurrence toward the end of the first year, in case\\nthe menses fail to appear after the eighth to tenth month, and all\\nthe disagreeable symptoms of this disease may appear in full force.\\nA gradual weaning of the child is the most important measure of\\ntreatment, and usually the prostration does not come until late,\\nabout the twelfth month, the time when the baby ought to be\\nweaned. All other means must also be used to restore the system\\nto its natural tone.\\nDERANGEMENT OF SEXUAL FUNCTIONS.\\nThere is often a premature sexual excitement in very young\\nchildren, even while in the cradle, probably due to chafing by the\\nnapkins, and later by the clothing, or to worms, or to eruptions\\nabout the genital organs. It is not Hard to discover this excita-\\ntion, because such children do not try to conceal their unnatural\\nbehavior, but when a little older they are likely to be fond of being\\nalone at least part of the time. If a child is irritable and fretful,\\nwith a capricious appetite and a headache that cannot be accounted\\nfor, it is well to learn if there is any handling of the genitals, or\\nfriction by rubbing against chairs or other furniture, with perspira-\\ntion and relaxation afterward. The treatment is to remove all\\ncauses of irritation and to keep the child under constant super-\\nvision night and day. Corporal punishment rarely does any good\\nin these cases, and the old-fashioned method of spanking may\\nonly increase the excitation. A great deal can be done by the\\nmother and teacher by drawing the child s attention from her-\\nself.\\nThis unnatural sexual excitement, as well as excess of the\\nnormal function, is attended by dire results. Even when the appe-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0618.jp2"}, "617": {"fulltext": "DISEASES OF WOMEN. 595\\ntite seems fairly good, and the stomach is capable of digesting\\nthe food in a creditable manner, there is a failure of assimilation\\nand the individual shows a lack of proper endurance, being easily\\nfatigued and exhausted. There is likewise inability to do concen-\\ntrated brain work, and, if forced to do it, symptoms of irritability\\npredominate. Sleep at first is good, but later there are wakeful\\nnights, especially following overwork. The symptoms are simply\\nthose of mere exhaustion. Strength is regained by cessation of\\nthe excess, to be lost again upon return to indulgence.\\nIgnorance of the result, in a majority of cases, leads to a grati-\\nfication of the sexual instinct which, with cultivation of the ex-\\ncitement, becomes an abnormal passion. In some it is the over-\\nflow of a precocious or very emotional nature in others there may\\nbe local diseases of the sexual organs. Perversion of this func-\\ntion by the adult may also lead to disease of these organs. The\\ntreatment for the single is to stop the indulgence; for the mar-\\nried, to modify it to the limit consistent w T ith good health. Tonics\\nand sedatives are indicated, and should be prescribed by the physi-\\ncian.\\nIf the people would only understand that it is within the\\nprovince of the physician to cure this disease, just as it is to cure\\nany other functional disorder, many a wretched individual might\\nbe restored to the full control of himself or herself, well, strong\\nand happy. The family physician should always be consulted\\nfreely and unreservedly, for this disease or inherited tendency will\\nbe as carefully guarded as any other ailment, and the public will\\nnever learn through him of the struggle for a better life, which is\\nthe privilege of all. The custom of consulting traveling quacks\\nand irresponsible advertising charlatans, masquerading under the\\nname of non-interested physicians, for advice and treatment\\nof these serious disabilities, results in great harm, and sometimes\\nin despair. These conditions are amenable to treatment, and, in\\nthe earlier stages, very satisfactory results are obtained and the\\nnormal functions restored even in cases in which there have been\\nmany years of sexual excitation and liberal indulgence, appropriate\\ntreatment will alleviate the distressing symptoms and restore\\nstrength and better health.\\nA few women have a morbid sexual excitation leading them to\\nbe loud in their manners, sometimes hysterical, and they are ren-\\ndered worse by society and lack of systematically arranged duties.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0619.jp2"}, "618": {"fulltext": "596 DISEASES OF WOMEN.\\nBy proper management, under the care of a physician, they also\\ncan be made comfortable and of value to themselves and the com-\\nmunity, instead of going to ruin, and becoming a curse to the\\nworld.\\nThere are many women who may go through life, if the sexual\\ninstinct be not aroused by evil associates, courtship or marriage,\\nwithout sexual desire, while others may suffer greatly through\\nwidowhood, or from the incomplete coitus designed to prevent\\npregnancy. There are some persons without sexual desire because\\nof defective generative organs, and such should not marry others\\nin whom it is tardily and slowly developed, if at all, and still\\nothers who have the appetite, but experience no gratification be-\\ncause of exhaustion, mental depression or melancholy.\\nWhen there is decided organic disease of the sexual organs,\\nwhich would interfere with the exercise of their functions, it con-\\nstitutes a barrier to marriage which must not be disregarded,\\nespecially if incurable. Functional diseases, as failure of menstrua-\\ntion, and the like, and the non-specific inflammatory diseases do\\nnot stand in the way of union.\\nACUTE INFLAMMATION OF THE PELVIC ORGANS.\\nAcute inflammation is the same everywhere, although its\\ncourse may be modified by the tissues or organs involved. Acute\\ninflammation of the cellular tissues, lymphatics, Fallopian tubes\\nand ovaries is likely to go on to suppuration, while pelvic periton-\\nitis usually ends with exudation. The first step in an inflammation\\nis congestion, accompanied by a deranged nervous condition, and\\nnext come its exudations. In some cases the inflammation stops\\nshort of suppuration and the products are carried away slowly\\nby the lymphatic system in others it goes on to suppuration,\\nand sometimes to the formation of adhesions and indurations,\\nbinding the pelvic organs down in abnormal positions and com-\\npressing their nerves, thus giving rise to reflex indigestion and\\nheadaches, and from constant irritation, paving the way to nervous\\nprostration with all its symptoms, as lack of strength, loss of en-\\nergy and ambition, and inability to accomplish even the most ordi-\\nnary tasks of life.\\nWhen there is pus in the pelvic cavity, a surgical operation is\\nusually the only safe procedure, for, if allowed to remain, there is\\nalways danger, in addition to that of blood poisoning, that a rup-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0620.jp2"}, "619": {"fulltext": "DISEASES OF WOMEN. 597\\nture may occur from some manipulation or strain and the pus\\nescape into the peritoneum, giving rise to a general peritonitis fol-\\nlowed with almost sure death. As long as there is no pus there is\\nno immediate need of an operation, unless the woman s life is ren-\\ndered unbearable by the irritable condition of the pelvic organs,\\nbound down in unnatural positions and rendered incapable of the\\nperformance of their functions but, if medicinal means fail, sur-\\ngery may have to be employed.\\nThe duration, termination and consequences of a pelvic peri-\\ntonitis depend upon the extent of the inflammation and its causes.\\nIn some cases, where the inflammation is limited, recovery will\\ntake place in a few weeks, with little after effect while in others\\nthe entire pelvic peritoneum becomes involved, the fimbriated ex-\\ntremities of the Fallopian tubes, being included by the exudation,\\nare practically destroyed, and the functions of the ovaries arrested,\\nbecause of the structural damage. Under these circumstances de-\\ngeneration of the ovaries often occurs sometimes they become\\ninflamed and soft, at other times atrophied, probably due to the\\ninterrupted circulation within them and the contracting action\\nof the exudation. In some of these cases the organs are so de-\\nstroyed, or so buried in inflammatory tissue, that at a post-mortem\\nit is impossible to distinguish them from it, a mass of inflammation,\\ncovering the uterus and broad ligaments, being about all that can\\nbe found. If such persons survive the attack of inflammation they\\nsuffer from pelvic pain, which is exaggerated at the menstrual\\nperiod, unless the flow is arrested entirely by destruction of the\\novaries.\\nIn all forms of acute pelvic inflammation, there is fever, pelvic\\npain and derangement of the functions of the pelvic organs, but\\nthe different cases vary as to the other symptoms, according to\\nthe degree of involvement; there is usually derangement of the\\ndigestive organs, and there may or may not be a chill. The pain\\nis most marked in ovaritis and peritonitis. If the attack comes on\\nat the time of menstruation there may be an increased flow. There\\nis often pain in the bladder and rectum, and tenderness upon pres-\\nsure in the groin. This pain is increased by movement, and there\\nis not much modification of it until the exudation is complete,\\nwhen the fever becomes lower. If pus forms there will be another\\nrise of temperature, usually preceded by a chill, and this fever will\\nbe continuous until the abscess opens and the pus is freely", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0621.jp2"}, "620": {"fulltext": "598 DISEASES OF WOMEN.\\ndischarged. If at this time the fever goes very high, it indicates\\nsevere blood poisoning.\\nThere is a form of pelvic inflammation in which blood poison-\\ning develops at the outset and is very dangerous. If the seat of\\nthe trouble can be located in the uterus, ovaries or tubes, removal\\nof the cause by a surgical operation is the proper treatment. Blood\\npoisoning, indeed, is one of the chief causes of acute inflammation,\\nand the other principal causes are venereal diseases and wounds.\\nCertain lowered conditions of vitality undoubtedly predispose to\\nacute pelvic inflammation. The treatment consists in giving relief\\nand hastening the termination as much as possible. The most\\ncomfortable position is on the back, with the thighs flexed rais-\\ning the foot of the bed is often beneficial. The extremities should\\nbe kept warm. Warm fomentations applied to the abdomen are\\ngratefully received. Counter-irritants, in the form of mustard paste,\\nturpentine stupes or capsicum plasters, relieve in some cases.\\nCathartics (saline cathartics are best) are essential to eliminate the\\nblood poisoning, and food that can be assimilated must be given\\nto sustain the strength.\\nThe stomach is invariably more or less upset at these times,\\nespecially when the peritoneum is involved. The thirst should be\\nrelieved by bits of pure ice or small amounts of sterilized water\\ntaken cold, but if that is not retained, try sips of hot water. If\\nvomiting continues, all fluids by the mouth must be stopped, an\\nenema of water given to relieve the thirst and one of peptonized\\nmilk to supply nourishment. To relieve the stomach various\\nmedicines are employed, the simplest of which is hot water, warm\\ntea or aerated water in small doses, with fifteen grains of bismuth\\nsubnitrate every two hours. No solid food should be given when\\nthe stomach is irritable.\\nWhen the acute symptoms have subsided and there is no evi-\\ndence of pus, the absorption of the exudate is favored by counter-\\nirritants, as iodine or blisters repeated. While any products of in-\\nflammation still remain in the pelvis the greatest care should be\\ntaken to guard the patient against exercise. Standing, walking\\nor riding may produce a relapse. The patient should very care-\\nfully feel her way in sitting up, and later in walking, especially\\nat the menstrual periods. Any exercise that excites pain should\\nbe avoided. These disorders are too serious to be managed en-\\ntirely by domestic treatment, and advice in each case should be\\nearly sought from a competent physician.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0622.jp2"}, "621": {"fulltext": "DISEASES OF WOMEN. 599\\nCHRONIC INFLAMMATION OF THE PELVIC ORGANS.\\nMetritis. Although chronic metritis may be due to septic\\nor to specific diseases, there are many cases winch are simply\\ncatarrh of the cervix, or of the body of the uterus, or of both com-\\nbined, and require medicinal treatment only. The specific and\\nseptic cases may also need this treatment in addition to surgical\\nrelief and constitutional remedies. Catarrh of the neck of the\\nuterus is more common than that of the body of the uterus, but the\\nformer, by extending is likely to involve the bodv also. The neck\\nand body differ both in structure and function, and there is a dif-\\nference in the inflammations that occur in them.\\nThe ordinary course of an inflammation in a mucous mem-\\nbrane is congestion and excessive secretion, then suppuration or\\na purulent secretion, sometimes, though rarely, ulceration, and in\\na specific case there may be exudation of plastic lymph, then re-\\ncovery. The amount of damage done depends upon whether the\\ninflammation ends in suppuration, ulceration or exudation. These\\nare typical endings of inflammation, but in a mucous membrane\\nthe process may stop at congestion and excessive secretion, and\\nremain there. If this be kept up there will be a change in the\\ntissues, but there will not often be suppuration or ulceration.\\nCervicitis. In inflammation of the cervix there is a very act-\\nive congestion and secretion from the glands. It is generally like\\nthe normal secretion but excessive in quantity. If the congestion\\ncontinues, the cells of the mucous membrane are shed faster than\\nthey are replaced by new cells, so that the surface becomes covered\\nonly by young cells, which give it a reddish color. This process\\nis not confined to the cervical canal, but extends outward about\\nhalf the width of the cervix and is often called ulceration of the\\ncervix uteri. There are other changes which appear in septic,\\nspecific and traumatic endometritis, but discoverable only by the\\nphysician.\\nEndometritis is the name given to an inflammation of the\\nmucous membrane lining the uterus. It may extend to only a\\npart of the lining, or it ma} spread over the entire membrane.\\nAs the inflammation increases, the mucous membrane in-\\ncreases in thickness by increase of tissue and thickness of blood\\nvessels, so that it is too large for the surface which it covers, hence\\nwrinkles, giving the surface a granular appearance. The conges-\\ntion sometimes extends to the middle coat of the cervix, in which", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0623.jp2"}, "622": {"fulltext": "600 DISEASES OF WOMEN.\\ncase the tissues are softened and swollen. Accompanying this con-\\ndition there is usually leucorrhea and increased menstrual flow;\\nvery rarely the menstrual flow is diminished. In cases where\\nthere is a laceration of the cervix this new tissue may become very\\nfirm and hard.\\nChronic inflammation of the body of the uterus is essentially\\nthe same as in the neck, except that in the former there is greater\\nliability to the formation of polypoid growths. Cervical catarrh\\nis not always attended by great constitutional disturbances, but\\nwhen they do appear they take the form of nervous debility, the\\npatient being easily fatigued, with a change in disposition and\\nlessened mental activity. The leucorrheal discharge is opaque,\\nthick and tenacious. If the disease is long continued backache\\ncomes on, the pain being in the sacral region, and there may be\\nsome pelvic pain. All these symptoms are aggravated by muscu-\\nlar exercise and by the menstrual period. If there is also corporeal\\nendometritis (inflammation of the entire mucous lining of the\\nuterus) there will be, in addition to these symptoms, greater de-\\nrangement of the digestive organs and of the menstrual function\\nthere usually being increased menstrual flow, except in cases\\nof long standing, where it may be decreased.\\nThe predisposing causes of endometritis are imperfections in\\nthe general organization and in the development and growth of\\nthe sexual organs, and scrofulous or tubercular tendencies. The\\nexciting causes of cervical endometritis are vaginitis and injuries\\nof the cervix the causes of the corporeal variety are imperfect re-\\ncovery from the menstrual period and derangements of menstrua-\\ntion. When the uterus is undersize, or malformed, even in a slight\\ndegree, so that menstruation is imperfectly performed, inflamma-\\ntion is very likely to come on sooner or later. Unsuitable cloth-\\ning, sedentary habits, over-fatigue in standing or walking, or any-\\nthing which interrupts the return pelvic circulation, favors it, and\\nthe chronic forms are encouraged by any impoverishment of the\\nblood, as from lack of food, overwork, prolonged lactation, fre-\\nquent childbearing, or deranged nutrition from any cause. In\\nmany instances the sewing machine, the typewriter or the bicycle\\nhas been the offending agent by increasing pelvic congestion.\\nOther exciting causes of uterine inflammation are an imperfect re-\\nturn of the uterus to its normal condition after labor or menstrua-\\ntion, injuries to the uterus during confinement or from displace-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0624.jp2"}, "623": {"fulltext": "DISEASES OF WOMEN. 601\\nment, abortion, especially if produced, intemperate sexual indul-\\ngence, and efforts to prevent conception.\\nTreatment. Attention should first be given to the general\\nhealth. In the earlier stages there is a possibility that this general\\ntreatment will answer every purpose if used in conjunction with\\nthe vaginal douche once or twice daily. A teaspoonful of pow-\\ndered borax should be added to the quart of water, which should\\nbe as hot as can be borne by the patient. A good douche consists\\nof two or three quarts of water thus prepared, and should be\\ngiven the patient while lying on her back with the hips elevated.\\nOne of the best ways is to have her lie across the bed, her hips well\\ndrawn over the edge of the bed, her feet resting on a chair op-\\nposite, and a piece of oilcloth to conduct the return ilow of water\\ninto a slop-jar at the edge of the bed. A douche taken by a pa-\\ntient in the sitting position over a chamber is of comparatively\\nlittle value, except for cleansing purposes while that given by the\\nother method and retained longer aids in the reduction of inflam-\\nmation.\\nAlong with constitutional remedies and the removal of the\\ncause belong attention to rest, diet and exercise. Those who are\\nexhausted require a restorative diet, while those who are of full\\nhabit should have a restricted diet. There are medicines which act\\ndirectly upon the sexual organs, but they must be used under the\\ndirection of the family physician, who must be the judge of the\\nadvisability of their use at any particular stage of the disease, the\\nquantity needed, and the drugs desirable in each case.\\nCONGESTION OF THE OVARIES.\\nOvarian congestion gives rise to functional troubles, which\\nresemble ovarian inflammation, but differ from it in that there is\\nno diseased condition found upon post-mortem, and that all the\\nsymptoms yield rapidly to treatment. The congestion may be of\\nlong or short duration. If the cause be removed it may disappear\\nwithout treatment, but, if continued, may go on to the change\\nof life, rendering the organs liable to more serious complications\\nin the form of inflammation at any time. This congestion occurs\\nmost frequently in the unmarried and in young widows who have\\nnever had children, and is usually found in both ovaries, with an\\nextension later to the uterus. It comes on slowly in those who\\nare nervous and emotional and who live a life favoring excitation.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0625.jp2"}, "624": {"fulltext": "602 DISEASES OF WOMEN.\\nIn the beginning there is pain and heaviness in the region of\\nthe ovaries, generally accompanied by nervous irritability and\\nweakness,, the patient being easily excited and quickly fatigued.\\nThe pain in the ovaries increases from four to six days before the\\nmenstrual period. Later the menstrual function becomes de-\\nranged, and there is usually an increased flow, which at first relieves\\nthe congestion causing it when it does not, weakness will soon fol-\\nlow from lack of blood, with nerve exhaustion which may last any\\nlength of time. There is often backache and pelvic pain on walk-\\ning. In the earlier stages, walking sometimes gives permanent\\nrelief, but not always. There may be an irritability of the bladder\\nwhich is purely nervous. Upon deep pressure in the region of the\\ngroin there is tenderness of a dull character, usually on both sides.\\nSometimes steady pressure in these regions gives relief.\\nThis condition yields very readily to the proper treatment.\\nThe majority of patients recover and, if the cause is removed, re-\\ncover without treatment. One of the chief causes is overstimu-\\nlation of the emotions in those of a nervous temperament, espe-\\ncially among those not usefully employed and permitted to turn\\ntheir attention to the procreative function, even before develop-\\nment is complete. Stimulating tonics and improper or evil social\\ninfluences favor ovarian congestion. It may also be secondary\\nto endometritis, sedentary habits or constipation.\\nTreatment consists in removal of the cause. Often the end-\\ning of an engagement in marriage has been sufficient for com-\\nplete relief. In young patients good results are obtained by direct-\\ning the attention to things outside of themselves a change from\\nsociety to books, the woods and fields and outdoor amusements.\\nBathing is good, either the sea or shower bath. Tonics to re-\\nstore the tone, with sedatives, are needed.\\nCHRONIC OVARITIS.\\nThe ovary is different from other organs of the body, since\\nits function is performed at the expense of a portion of its struc-\\nture, which is never restored to its former condition. The rupture\\nin ovulation of each Graffian vesicle means the destruction of that\\nvesicle. Rudimentary vesicles mature and repeat the function, and\\nare in turn destroyed. At least the supply ceases before the or-\\nganization as a whole has reached the end of its activities. In all\\nother organs of the body functional activity is the result of cell", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0626.jp2"}, "625": {"fulltext": "DISEASES OF WOMEN. 603\\ndestruction and restoration. The chronic inflammation of the\\novaries is more like a chronic inflammation of the kidneys, the\\npathological conditions being entirely different from those of acute\\novaritis, arising from puerperal or specific causes; as following\\nacute peritonitis.\\nThe first step from normal is irritability and nervous disturb-\\nances, which are the more frequent from the close connection\\nof the ovaries with other organs. These symptoms are usually\\ntemporary, but, if often repeated and prolonged, produce changes\\nin the circulation which finally impair nutrition. This congestion\\ncan be relieved by proper treatment, but, if allowed to continue,\\nthere will be an increase of connective tissue at the expense of the\\ntrue ovarian structure, which after a time will be crowded out,\\nand the ovary made useless for procreation. The first changes in\\nthe circulation give rise to a swelling of the ovary which makes it\\nlarger and softer than usual. Hemorrhage into the ovary some-\\ntimes occurs and clots may be found upon the surface. The\\novary that is large, tender and soft will, later, become much dimin-\\nished in size, and though the changes going, on may seem like\\nan increasing number of vesicles approaching maturity, they mean\\na loss of the proper substance of the ovary.\\nSymptoms are both constitutional and local. The former are\\ndepression of the digestive and nervous systems, and the reflex di-\\ngestive symptoms are a capricious appetite, nausea and some gas-\\ntralgia. The bowels are frequently constipated and filled with gas.\\nThe nervous debility is attended with oreat emotional disturbances\\nmore characteristic of chronic ovaritis than of any other chronic\\ndisease of the sexual organs. There is usually an increased men-\\nstrual flow, but, after the inflammation has lasted a long time, there\\nmay be a diminished flow. The ovarian pain due to ovulation\\nis increased a lew days before the flow, and is usually at least\\npartially relieved after the flow has lasted two or three days.\\nThe menstrual flow is more severe if there is also uterine inflam-\\nmation. The pain likewise depends upon the structure involved;\\nif it is the ovarian structure only, the pain is not as severe as\\nwhen the peritoneum covering the ovary is also implicated.\\nAll these symptoms are exaggerated by standing, walking,\\nriding or sitting in a stooped position for any length of time.\\nSexual excitation and coitus cause great suffering. The patient\\nis usually most comfortable lying down. Upon examination the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0627.jp2"}, "626": {"fulltext": "604 DISEASES OF WOMEN.\\novary is tender to touch. The symptoms coincide with those of\\novarian congestion to such a degree that we are forced to believe\\nthat the congestion is the beginning of the inflammation. The\\npain in ovarian neuralgia is also similar, but in that affection there\\nis no inflammation and the pain is not continuous. If the patient\\nis placed under treatment early, there is a chance for recovery,\\nespecially if but one ovary is affected. The disease in one ovary\\nmay go on to complete destruction and the pain then subside, ex-\\ncepting occasional attacks of neuralgia, while the other ovary may\\nremain well and keep up its function. If the ovarian inflammation\\nis accompanied by disease of the other organs, and there is much\\ndestruction of normal tissue, it may be necessary to remove the\\novaries. This operation is very rarely fatal, and, in the properly\\nselected cases, gives great relief.\\nOne cause of this condition is poorly developed ovaries which\\npredispose to disease, and another is imperfect menstruation.\\nWhen the uterus is undersize, or turned backward or forward, and\\nthe menstrual flow is small and attended with pain, the ovaries are\\nlikely to take on chronic inflammation. The eruptive fevers and\\ngonorrhea are factors in some instances. The scrofulous tendency\\nand inherited syphilis are other factors in its causation.\\nTreatment consists in lessening the blood supply and reliev-\\ning the pain. This means rest in bed in the earlier stages, with\\ngeneral exercise in the form of massage, or gymnastic movements\\nin the reclining position. This exercise is as necessary for the\\ngeneral health as is the postural position to relieve the local\\ncondition. The poor appetite, coated tongue and constipation, or\\nflatulence and diarrhea, can be removed by small doses of calomel,\\none-fourth of a grain every half hour until four doses have been\\ntaken, repeated daily, and followed in two hours after the last\\ndose each day with a Seidlitz powder. The elimination by the kid-\\nneys is improved by keeping the bowels well open. This espe-\\ncially applies to cases suffering from non-elimination of effete\\nproducts. The home treatment of these cases consists of the hot\\nsitz-bath, counter-irritation and the vaginal douche given as\\npreviously described. General baths are of service, but should be\\ngiven under the direction of a physician. Only a thorough study\\nof medicine will give judgment as to when certain medicines\\nshould be given or withheld in these cases, even though the rem-\\nedies and the proper average dose are well known. There is a", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0628.jp2"}, "627": {"fulltext": "DISEASES OF IV OMEN. 605\\nlong line of medicaments which must be left to the physician in\\norder to secure the best results. It is very important to exercise\\npatience and carefully watch the patient. When improvement\\ncomes, too many, forgetting that recovery from this disease is\\nslow, become lax in their care, and thus open the way to relapse.\\nINFLAMMATION OF THE FALLOPIAN TUBES.\\nThis disease is nearly always secondary to inflammation of the\\nbody of the uterus. There is first a congestion of all the structures\\nof the tube, then a secretion from the mucous membrane of a\\nthick, milky fluid, not containing pus. If the inflammation be\\nvery severe there will also be involvement of the peritoneum cov-\\nering it. As a rule both ends of the tube are closed by inflamma-\\ntory adhesions. Sometimes there are no traces of the inflammation\\nleft, except closure of the tubes, but at other times fluid collects\\nin the tubes and their walls become very thin. This is known\\nas tubal dropsy. The inflammatory obstruction of the uterine\\nend of the tube may give way and the fluid be discharged. This\\nmay end the trouble, or the fluid may again collect and discharge\\nfor several times, and recovery then take place, but this happy\\ntermination is an accident not to be expected with assurance,\\nfor rupture of the thin walls is apt to occur and to be followed by\\nless favorable results.\\nSymptoms. This trouble so follows chronic endometritis\\nthat its symptoms are not distinct from those of the latter disease\\nunless there is a complicating peritonitis. There is usually pain-\\nin the affected tube, which comes and goes, and is more decided at\\nthe menstrual period. Standing or walking increases the pain\\nthe nervous and nutritive systems are more or less disturbed, and\\nthere is no fever unless complicated with peritonitis. The tube\\nis tender to touch and can be felt as a hard, thick mass, or series\\nof masses, characteristic of the disease.\\nThe treatment must be applied to the removal of the cause of\\nthe primary disease, which almost invariably is endometritis. Sur-\\ngical means may be required if other procedure fails, or there is\\ndanger of rupture of the tube into the peritonum, with the prob-\\nability of peritonitis following.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0629.jp2"}, "628": {"fulltext": "CHAPTER V.\\nDISPLACEMENT OF THE UTERUS.\\nMany cases of displacement can be managed early by rest with\\nthe aid of the postural treatment and proper general medication.\\nIn order, however, to be successful the treatment must be begun\\nupon the slightest indication of trouble. The uterus is entirely\\nwithin the true pelvis. In the diagram (Fig. i, Plate VIII), the\\ntrue pelvis is bounded by the line A B, and the long diameter of the\\nuterus corresponds very nearly to the axis of the pelvis, which is\\nrepresented by the line C D, and is equally distant from all other\\nparts of the pelvis. As regards its relation to other organs within\\nthe pelvic structure, the uterus is in the center, a Fallopian tube\\nand ovary being on either side, the bladder in front, the rectum\\nbehind, and the vagina below. The broad ligaments are the part\\nof the peritoneum covering all these organs, excepting the vagina,\\nand are attached to the bony sides of the pelvis. The round liga-\\nments, containing muscular tissue, are usually outgrowths of the\\nmuscular tissue of the uterus, and, in the form of round cords,\\nstart from the uterus near the beginning of the Fallopian tubes,\\nsweep around the sides of the pelvis and attach in front. The\\nutero-vesical ligaments also extend from the uterus to the front\\nwalls of the pelvis and are indirectly connected with the front\\nvaginal wall through the connective tissue. The utero T sacral liga-\\nments are likewise attached to the back vaginal wall and to the\\nrectum in the back portion of the bony pelvic canal.\\nThe chief use of these ligaments is to keep the uterus and\\nbladder in position and, with the vagina and other pelvic organs,\\nis sufficient under ordinary circumstances; but, when a great\\nstrain is brought upon them, the pelvic floor aids these structures.\\nThe relation of the trunk to the pelvis helps in keeping the pelvic\\norgans in place, being so arranged that the line of equilibrium falls\\nin front of the pelvic cavity upon the front bone of the pelvis. This\\nis why it is so important that women stand and walk perfectly\\nerect. By bending they bring this line within the pelvic cavity\\n606", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0630.jp2"}, "629": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0631.jp2"}, "630": {"fulltext": "J/ormid.\\nRetroflexion\\nFIG. 1\\nFIG. 2.\\nJ rite version.\\nJ til e fie i on.\\nFIG. 3\\nFIG. 4.\\nPLATE VIM.", "height": "4144", "width": "2794", "jp2-path": "humanmachineitsc00mcve_0632.jp2"}, "631": {"fulltext": "DISEASES OF WOMEN. COT\\nand thus place the pressure of the abdominal contents fully upon\\nthe pelvic organs. The pelvic floor aids indirectly in supporting\\nthe uterus, which is a movable organ, being pushed backward by\\nthe distention of the bladder and allowed to fall forward when the\\nbladder is empty. The full rectum also pushes the uterus for-\\nward, and the abdominal contents by their continual changing\\nconstantly affect the position of the pelvic organs from above.\\nThese changes of position are natural, while limited, and tempo-\\nrary, but when the uterus is greatly displaced and permanently\\nremains so, there result disordered functions of the bladder, rectum\\nand general system, deranged menstruation and circulation, and in\\nsome cases sterility. In young girls the main cause of all displace-\\nments is lack of development during infancy and childhood, often\\ndue to defective nutrition and improper positions in sitting or\\nstanding, or to some strain as from lifting heavy furniture, at-\\ntempting difficult or impossible feats in calisthenics, etc. In mar-\\nried women, the great cause is pregnancy and its attendant\\nchanges, and lack of care immediately following delivery.\\nThe chief displacements are anteversion, anteflexion, pro-\\nlapsus, retroversion and retroflexion. Typical examples of these\\nconditions are shown by the diagrams of Plate VIII. which rep-\\nresent the uterus with its ligaments removed. To study the\\nligaments and their relation to the uterus, see page 498.\\nAnteversion is the tipping forward of the top of the uterus,\\nits neck lying in the back of the pelvis without making any bend\\nin the uterine canal.\\nAnteflexion is a tipping forward of the uterus, the neck also\\nlooking forward, but bending upon the body, thus creating a bend\\nin the uterine canal, which interferes with menstruation and proper\\ncirculation, and gives rise to passive congestion, followed by in-\\nflammation.\\nRetroversion is that form of displacement in which the uterus\\nand neck both bend backward and rest low upon the rectum. The\\nuterus may be temporarily retroverted by pressure from a full\\nbladder, and not give much cause for unpleasant symptoms, but,\\nif it becomes permanent, irritation usually results.\\nRetroflexion is a tipping backward of the uterus, while the\\nneck points forward it is usually the first stage of prolapsus.\\nProlapsus is simply a descent of the uterus, often called fall-\\ning of the womb. A prolapsus in which the uterus remains", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0633.jp2"}, "632": {"fulltext": "608 DISEASES OF WOMEN.\\nwithin the vulvae, is called incomplete where it extends partially\\nor wholly beyond the vulvae, it is called complete. There is al-\\nways some prolapsus with retroversion, and vice versa some ret-\\nroversion with every prolapsus. Displacements, as a rule, are\\nbrought about slowly months or years intervening before they\\ncome under the physician s care. The changes which take place\\nin the uterine supports are the same in all cases, but they vary as\\nregards the cause and the beginning disease. There are three\\nmethods of development of prolapsus: (i) The uterus leaves its\\nplace because it is too heavy, or the supports are weakened by\\ndisease. (2) By a loss of the pelvic floor the vagina, bladder and\\npart of the rectum are allowed to descend and the uterus follows.\\n(3) A class of cases made up of those in which the causes of the\\nfirst two methods act in conjunction.\\nThe changes in the supports are a lengthening of the liga-\\nments of the uterus after confinement the condition may also be\\ncaused by a heavy uterus, or by continued pressure from above\\nfrom long standing, stooping or lifting. The resulting pressure\\nupon the blood vessels is thought to interrupt the return circula-\\ntion. All of these changes are developed very gradually.\\nProlapsus of long standing changes the structure of all the\\ntissues. There is a degeneration of the muscular tissues of the\\nvagina, and the ligaments of the uterus lose their characteristics\\nuntil they cannot be restored. This occurs most fully in old and\\nvery feeble women. Where there is a loss of the pelvic floor, a\\nsurgical operation is necessary to effect repair. If the ligaments\\nare permanently relaxed, some form of support must be adjusted\\nor the uterus must be removed entirely.\\nSymptoms. The symptoms of these displacements are pain\\nin the bladder and rectum, due to pressure upon them by the\\nuterus. There is often a constant desire to empty the bladder and\\nrectum, which is increased by walking, lifting or coughing, and\\nespecially by long standing, but is completely relieved by assum-\\ning the recumbent position the position which gives relief in\\nother diseases of the pelvic organs also, but not such complete re-\\nlief as it affords in prolapsus. The irritation and deranged cir-\\nculation lead to inflammation of the uterus and other organs, not\\nto an acute, but to a chronic condition of congestion and inflam-\\nmation of the mucous membrane. It is probable that the endome-\\ntritis so common in displacement precedes it, but the inflammation", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0634.jp2"}, "633": {"fulltext": "DISEASES OF WOMEN. 609\\nis kept up by the displacement. Menstruation may be deranged,\\nthere often being too great a flow, and, in retroversion, the dis-\\ncharge may be offensive. Backache, deranged digestion and de-\\npression are also general symptoms.\\nIn considering the cause of uterine displacement, we should\\nbear in mind that the nice adjustment of the uterus which per-\\nmits the great changes it undergoes in pregnancy renders it ex-\\nceedingly liable to loss of equilibrium. The shape of the pelvis, if\\nlarge and shallow, favors the falling of the uterus, although it pro-\\nmotes easy labor; and if the pelvis is tipped forward, there is\\ngreater pressure upon the pelvic organs from above a condition\\nunfavorable to uterine stability.\\nThe tissues of the uterine supports are often imperfect, in\\nwhich cases they are incapable of doing their work. These im-\\nperfections may arise from failure of development, or may occur\\nfrom sedentary habits in youth, or from the debility of disease.\\nStanding or walking until fatigued brings undue strain and, if\\nkept up, will in time cause falling of the uterus, and a sudden jar,\\nas an imprudent spring from a swing or carriage, may cause it.\\nActive exercise, with plenty of rest between, will strengthen the\\nligaments, while fatigue will overcome the power of resistance.\\nAs already intimated, the habit of walking erect maintains the\\nproper relation between the abdominal and pelvic organs, but\\nstooping disturbs and may lead to their derangement, for it not\\nonly brings increased downward pressure, but interrupts the re-\\nturn circulation. The sewing machine, the typewriter, and bend-\\ning over in the easy chair, are alike harmful, but not as much so\\nas the bending over her desk by the schoolgirl while her body is\\ndeveloping. Heavy lifting, if continued, and abuse of corsets, are\\nfactors. General weakness from prolonged sickness, or from ex-\\ntreme old age, is another cause, but one of the most frequent\\ncauses is childbearing with imperfect return of the uterus and\\nligaments to their natural condition, due to laceration, improper\\ncare after confinement, and the persistency with which women\\nassume the ordinary duties of the household before recovery can\\npossibly be complete. Enlargement of the uterus from tumors or\\nfrom inflammation, will also cause prolapsus.\\nTreatment. Local applications and quiet rest will reduce the\\nenlargement of the uterus and its ligaments, when, in recent cases,\\nthe organ will return to its position. Later, surgical means may\\n39", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0635.jp2"}, "634": {"fulltext": "610 DISEASES OF WOMEN.\\nhave to be employed. First, correct any defects in the clothing\\nand habits of life that may have caused the displacement. Loose,\\nlight clothing should be worn, and sitting, standing, walking or\\nlifting heavy weights should be avoided. Next, restore the uterus\\nto its place by the knee-chest position, assumed three or four times\\ndaily for five or ten minutes, and the patient should then rest upon\\nher side with the pelvis raised. Proper external support with a\\nbandage is also beneficial. This treatment is certain only in early\\ncases and when persistent care can be secured. Later, all the at-\\ntention that the physician can give by local and surgical means\\nmust be used to secure any permanent effect.\\nDisplacements of the uterus give rise to the digestive and\\nnervous symptoms found in the inflammatory diseases of this or-\\ngan, and managed by restoration of the parts, proper diet and\\nproper medication directed to the stomach. In the majority of\\nthese cases the vaginal douche is of great benefit, and should be\\nmedicated according to the nature of the case. The simplest\\nmedication for a douche is a teaspoonful of powdered borax to a\\nquart of water, as hot as can be borne by the patient. The con-\\nstitutional derangements accompanying the inflammatory diseases\\nof the pelvic organs are principally disturbances of the digestive\\nand nervous systems the degree of disturbance depending upon\\nthe temperament and general health of the patient. Robust,\\nphlegmatic women may have an endometritis, especially of the\\ncervix, for years, without the manifestation of any reflex symp-\\ntoms, while the very sensitive patient suffers greatly. The im-\\npaired nutrition tends also to aggravate the local trouble and pre-\\nvent recovery.\\nThe appetite may be lacking for a time, then be abnormally\\nactive; this is most noticeable with inflammation of the body of\\nthe uterus, when there may be nausea as well. In some cases there\\nis a coated tongue, constipated bowels, and poor appetite all the\\ntime, with labored digestion indicated by a fullness, flatulence, dis-\\ntress and even pain after eating, and by a yellow tint to the eyes\\nand skin, showing a sluggish condition of the liver. In nervous\\nstomach troubles attended with dyspepsia there is often an over-\\nsecretion, or increased secretion, because of the increased move-\\nments of the muscular walls of the stomach. In the former condi-\\ntion there will often be a sense of burning in the stomach, while\\nin the latter acid eructations are frequent. Food is carried out", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0636.jp2"}, "635": {"fulltext": "DISEASES OF WOMEN. 611\\nof the stomach before it is digested, hence, there are intestinal gas\\nand disturbances of the bowels, with alternating constipation and\\ndiarrhea. The principal treatment of nervous dyspepsia in these\\ncases is to remove the uterine cause. While local and surgical\\nmeans are employed, relief for the stomach can be obtained by the\\nuse of twenty grains of subnitrate of bismuth, given half an hour\\nbefore meals; when the digestion is labored, pepsin and charcoal\\ntaken an hour after meals will give relief. There are a variety of\\ntonics and sedatives that may be used, but should be selected to\\nsuit the case at hand, and this must be done by the physician.\\nThe nervous disturbances differ according to the stage of the\\ndisease. At first there may be only occasional headaches, or un-\\ncomfortable or disagreeable feelings in the head, then a sense of\\nweight on top, and after a long time there may be found a diffi-\\nculty in collecting the thoughts, irritability, restlessness, disposi-\\ntion to become depressed, sleeplessness, or difficulty in getting to\\nsleep, then waking after a short nap. A sufficient dose of potas-\\nsium bromide, ten to twenty grains, in the afternoon and again\\nat bed-time, will often give the required rest until the local condi-\\ntions are remedied. Baths are very beneficial, but they should be\\nof warm or tepid water, then gradually cooled to get a tonic effect.\\nRest by lying down is very important in the relief of all in-\\nflammatory diseases of the pelvis. It is best to have short intervals\\nof exercise in cases in which it is permissible, followed by long\\nperiods of rest in the recumbent position, and long rest and sleep\\nat night with the pelvis elevated. In the more acute forms of\\ninflammation continuous rest in bed is often necessary, the exercise\\nthen being kept up by massage. Electricity is an aid in certain\\ncases.\\nNearly all medicines which aid in restoring the uterus to its\\nnormal function are those which build up the general nutrition,\\nand when the nutrition is fair better results are often obtained by\\na rather meager diet for a season discarding meats and rich\\nfood. This applies to cases where there is a failure of elimination\\nof the waste products.\\nDISEASES OF THE EXTERNAL GENITALS.\\nLittle children may have inflammation of the vulva in con-\\nsequence of the eruptive diseases, as measles, scarlet fever, etc., also\\nas a result of scrofula. In adults it is more likely to be septic and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0637.jp2"}, "636": {"fulltext": "612 DISEASES OF WOMEN.\\nspecific, but many of the mild forms are a result of uncleanliness.\\nIn little children the genitals may be neglected, or bathed in such\\na rough and careless way that more injury than good is done. It\\nis best to use powdered borax a teaspoonful to the quart of warm\\nwater, or soap and water, allowing a gentle stream to flow from a\\nfountain syringe, but being careful not to allow the stream to\\nstrike directly against the vulva, then carefully clean and dry all the\\nfolds with absorbent cotton and throw it away each time. Towels\\nare too rough for this purpose, and sponges are liable to retain\\ninfected matter, unless cleansed more carefully than is done in\\nthe ordinary household. This attention should be given by the\\nmother or nurse until the child is old enough to do it for herself,\\nwhich is usually about the time when the menstrual flow begins.\\nThe prepuce should receive attention since it is often adherent in\\ngirls, as in boys, and may give rise to much irritation and annoy-\\nance, and lead to evil results. The physician should see that\\nall these defects are overcome. In middle. life the same care must\\nbe exercised, especially after menstruation and when there is a\\nfree secretion by the glands of the vulva, which may be irritating\\nand offensive frequent bathing is necessary. Thorough bathing\\nand the vaginal douche before and after exposure will also greatly\\nlessen the danger of infection from diseased husbands.\\nVULVITIS.\\nInflammation of the vulva is usually caused by some other pre-\\nexisting disease, except in children, and the specific forms. A scro-\\nfulous predisposition, and certain skin diseases, may give rise to\\nan inflammation in this locality, and the small pinworms of chil-\\ndren are another source of irritation. If uncomplicated this in-\\nflammation may be simply a flush of the skin, or an erythema,\\nwhich usually does not last long and often passes away without\\ntreatment. The purulent form is more defined. The parts are then\\ncovered with a thick deposit of pus, and the surface of the mucous\\nmembrane, and the skin, if also involved, is raw and red. There\\nmay be small spots of ulceration and considerable itching. As the\\nsymptoms, heat, tenderness, discharge and itching, are similar to\\nthose of vaginitis and are not distinctive, an ocular examination\\nis required to ascertain the exact location of the disease.\\nTreatment. The chief thing in the treatment is to secure ex-\\ntreme, cleanliness and to keep the inflamed surfaces separated.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0638.jp2"}, "637": {"fulltext": "DISEASES OF WOMEN. 613\\nThere must be frequent washings of the vulva with solutions of\\nborax, or of boracic acid, and, after thoroughly drying the parts, an\\napplication made of the powder subnitratt of bismuth, or oxide of\\nzinc, and a very thin layer of absorbent cotton placed between the\\nsurfaces. In many cases the following solution answers instead of\\nthe powder:\\nSulphate of zinc four grains\\nFluid extract hydrastis Canadensis one ounce\\nWater three ounces\\nApply three or four times daily.\\nVulvitis is difficult to manage in children and unmarried\\nwomen, and unless the treatment is faithfully applied, results may\\nbe hard to obtain. For children, after the bathing heretofore pre-\\nscribed, sulphate of zinc, one to three grains to the ounce of water,\\nis best applied with an atomizer three or four times daily. When\\nthe inflammation extends up into the vagina, the vaginal douche\\nmust be used, and for children the soft rubber catheter should be\\nattached to the fountain syringe and a thorough douche of boiled\\nwater given. This may be followed by a mild solution of the sul-\\nphate of zinc, one grain lo the ounce. The patient ought to be\\nkept in bed and under the constant care of a competent nurse.\\nIf this inflammation appears during an attack of scarlet fever,\\nmeasles or diphtheria, it may show itself only in the form of a\\nmild rash which will disappear without treatment, or it may be-\\ncome permanent, suppurative and persistent. In cases due to in-\\nflammation of the rectum, worms, or specific and malignant causes,\\nthe primary treatment is the removal of the cause.\\nPRURITIS OR ITCHING OF THE VULVA.\\nThis is only a symptom, but may occur when it is almost im-\\npossible to discover the cause, hence has been given a place as a\\ndistinct affection. The patient first notices an itching of the parts\\nwhich is relieved by scratching and rubbing, but, after affording\\ntemporary relief, these measures only aggravate the trouble. Often\\nthe tickling, sharp, burning sensation becomes intolerable, and\\nobliges the patient to remain at home, and even lose sleep, unless\\nhypnotics are used. For the cause of pruritis we must look to the\\ncause of the disease which precedes it and gives rise to this symp-\\ntom. The list of such disorders is quite a long one.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0639.jp2"}, "638": {"fulltext": "614 DISEASES OF WOMEN.\\nDiabetes, or sugar in the urine, is one of the principal causes\\nof pruritis of the vulva, and any discharge of an irritating nature\\nfrom the vagina or urethra may likewise cause it; thus the dis-\\ncharges from inflammation of the vagina, from inflammation of\\nthe mucous membrane of the uterus, from cancer of the uterus,\\nand from inflammation of the urethra, are usually very irritating\\nand, therefore, especially causative of this disorder. Rectal dis-\\neases, and certain conditions or affections of the nerves, presum-\\nably give rise to some cases of pruritis; and it is possible that a\\nmicrobe, attending the debility from local disease and nerve de-\\npression, may yet be discovered and proven a cause.\\nTreatment. As already intimated, the treatment must first be\\ndirected to the cure of the disease giving rise to the pruritis, then\\nmeasures taken to protect the vulva from the discharges which\\nkeep up the irritation. Vaginal discharges can usually be stopped,\\nexcepting those from cancer, and from these relief can be ob-\\ntained by vaginal douches of carbolic acid solution, and afterward\\nplacing medicated cotton in the lower part of the vagina to catch\\nthe discharges. For the diabetic itching, separate the lips of the\\nvulva while urinating, to prevent contact with the urine, then dry\\nthe meatus with cotton. The parts may be further protected by\\nthoroughly applying an ointment of fifteen grains of boric acid\\npowder mixed with a half ounce of vaseline. This treatment must\\nbe thoroughly and persistently kept up if a good result is expected.\\nThe hardest cases to treat are those in which the symptoms cannot\\nbe ascribed to any special disease of these parts. In these cases\\nthe skin is often bleached in spots, and is hard and inelastic, and,\\nalthough they can always be relieved, some such cases are incur-\\nable. Bathing with hot water and borax usually does well, and\\nthirty grains of chloral hydrate and twenty grains of camphor with\\ntwo ounces of rose water ointment is very good where it does not\\ncause smarting. There are many other remedies, but they give\\nbest results when used under the careful management of the\\nphysician.\\nHYPERESTHESIA.\\nHyperesthesia, or an irritableness of the vulva, occurs usually\\nin young married, or sterile women, or after the menopause.\\nThere is great sensitiveness of the parts to touch, and pain in\\ncoition. While it may arise from a general nervous condition, it\\nprobably more frequently conies from incomplete coitus. At the\\nmenopause it seems to be due to a malnutrition of the parts.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0640.jp2"}, "639": {"fulltext": "DISEASES OF WOMEN. 615\\nTreatment. The treatment consists in temporarily reliev-\\ning the condition until pregnancy takes place, when it will be bet-\\nter and, after labor, will generally disappear. Boroglyceride, and\\ntannic acid and glycerin, applied to the parts, are good. When\\nthere is free secretion from the vulvovaginal glands, a wash of one\\npart of bichloride of mercury to two thousand parts of water an-\\nswers well. Constitutional remedies should be given for the de-\\nbility, and sometimes a surgical operation is necessary.\\nVAGINITIS.\\nThis is an inflammation of the vagina, caused by the extension\\nof inflammation from the vulva, or from the uterus, or due to an\\ninfectious fever, or to a specific venereal disease. The lining of\\nthe vagina is more like the skin than like the mucous membrane,\\nhence its inflammation resembles an inflammation of the skin\\nrather than that of a mucous membrane. In the acute cases the\\nsymptoms are a sense of internal heat and fullness, and, later, pain\\nin the vagina and uterus. In severe cases there will also often be\\npain in the bladder and rectum. There is slight fever and loss of\\nappetite with a profuse discharge.\\nTreatment. Use medicated douches, as for inflammation of\\nthe vulva, and treat any disease which may give rise to it, or with\\nwhich it is complicated. The remedies recommended are simply\\nfor home treatment stronger medicines must be applied only by\\nthe physician.\\nUTERINE FIBROIDS OR TUMORS OF THE UTERUS.\\nThese give rise to symptoms of disease through pressure upon\\nadjacent organs, and severe hemorrhages. They were formerly\\ntreated entirely by medicine, but now almost as exclusively by sur-\\ngery, which is the only means of a perfect cure. Relief, however,\\ncan be obtained by medicines and electricity, and often a patient\\nmay be tided over the menopause when, with the decreased sup-\\nply of blood to the pelvic organs, the tumor gradually decreases in\\nsize, but if there is excessive hemorrhage, she must be kept quiet\\nand off her feet. The medicinal treatment for hemorrhage must\\nbe pushed and should be under the physician s care. For a vaginal\\ninjection when there is much flow of blood, two quarts of hot wa-\\nter with an ounce of vinegar will often be helpful. Well fitting\\nabdominal supporters may give great relief.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0641.jp2"}, "640": {"fulltext": "616 DISEASES OF WOMEN.\\nCANCER.\\nCancers of the pelvic organs appear most frequently near the\\nmenopause, or after it, at a time when the eliminating power of the\\nbody is beginning to fail. The direct treatment is surgical, whether\\nby the knife or caustics. The former is to be preferred as less pain-\\nful and more sure. All articles of diet which prevent elimination\\nshould be avoided, as tea, coffee and alcoholic stimulants, and par-\\nticular attention should be given to the complete elimination of all\\nwaste products of the body, as a preventive treatment at this time\\nof life. The food taken must be easily and properly digested the\\nkidneys must do their whole duty; and the liver and intestinal\\ntract must be carefully looked after. Turkish baths are often of\\ngreat value in these cases. There should be taken a proper amount\\nof exercise. Undue elimination and over-exercise create debility\\nagain, and frustrate the very object sought. The medicines are\\nto be directed to the building up of the general health, the relief\\nof pain, and the removal of disagreeable odors.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0642.jp2"}, "641": {"fulltext": "CHAPTER VI.\\nDISEASES OF THE URINARY ORGANS.\\nThe urine is slowly secreted by the kidneys and collected\\nin the bladder drop by drop, the latter acting as a reservoir which\\nat stated intervals expels its contents. A healthy woman urinates\\nfrom four to six times in the twenty-four hours, and passes from\\nthirty-five to sixty ounces daily, varying with the season, more\\nbeing passed in the winter than in summer, and with the amount\\nof fluids imbibed. Neither concentrated nor limpid urine is well\\nborne by the bladder, and, unless emptied at the proper time,\\nthis organ is injured by distention, and bad results may follow if\\nthe retention continue. AYomen are very foolishly negligent of\\nthe urinary organs, and, as a consequence, not only the bladder,\\nbut the kidneys also in time become disordered, first by congestion\\nthen by catarrh. Sudden changes from heat to cold also give\\nrise to trouble by quickly changing the character of the urine and\\nthus causing an irritableness of the bladder. Under these condi-\\ntions all stimulating drinks and foods should be avoided, and, in\\nyouth and old age, particular attention must be given to cleanli-\\nness of the genitals to prevent extension of disease to the urethra\\nand bladder.\\nFunctional Diseases of the Bladder are due First To imper-\\nfect tone of the nerves controlling it and the urethra as in case\\nof the irritable bladder in which there is frequent urination, and\\nsometimes incontinence. Second To diseases and derangements\\nof the general nervous system, as in hysteria, and diseases of the\\nbrain and spinal cord. Third To diseases of the nutritive system\\nas in cases attendant upon, or following malaria, the eruptive\\nfevers, ana constitutional diseases. Fourth To diseases of the\\nether pelvic organs; as ovaritis, metritis, pelvic peritonitis, and\\ndisplacement of the uterus.\\nThe treatment must be directed to the relief of the original\\ncause, upon the accomplishment of which the bladder symptoms\\nwill disappear of themselves. The various manifestations of\\n617", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0643.jp2"}, "642": {"fulltext": "618 DISEASES OF WOMEN.\\nfunctional diseases of the bladder are frequent urination, difficult\\nurination and retention, painful urination, pain after urination, and\\ninability to retain urine. These symptoms also occur in organic dis-\\neases of the bladder.\\nNeuralgia of the Bladder or of the neck of the bladder, can\\ngenerally be traced to anemia, malaria or nerve exhaustion, and\\nmust be reached by general treatment for these diseases.\\nIncontinence or lack of power to retain the urine is usually\\na childhood disease, but may often become persistent and last into\\nlater years. It is due to defect in the sphincter muscle, which\\nkeeps the urine in the bladder until in response to an act of the\\nwill this muscle is relaxed and the urine voided. It may also be\\ncaused by excessive irritability of the bladder which overcomes the\\nsphincter and the two causes are sometimes combined, producing\\na still more obstinate case. The habit of unconsciously voiding\\nthe urine at night is not only distressing and annoying, but pre-\\ndisposes to bad habits and often causes the individual to catch\\ncold. It is sometimes caused by a defective nervous system, but\\nis undoubtedly more often due to lack of training in infancy.\\nOften, the exciting causes are worms, irritation of the bladder from\\nan eruptive fever, a cold, piles, and irritating urine from excess of\\nuric acid. Some cases are easily cured, while others resist all\\nforms of treatment. As a preventive, the heartiest meal should be\\ntaken in the middle of the day, but little fluid allowed toward\\nevening, and the food must be plain and unstimulating. The bow-\\nels must be kept regular, no coffee or tea permitted, and the pa-\\ntient put to bed only after the bladder has been thoroughly emp-\\ntied. The mattress should be hard and the covering slight; the\\nsleeping room must be well ventilated, and the genitals should\\nbe kept clean and dry; no places of amusement should be visited\\nafter dark, and the patient should be awakened to urinate when\\nthe family retire. If the bed is found wet the patient should be\\nawakened and reasoned with if able to understand. If due to im-\\nproper handling of the genitals, every means must be used to stop\\nthat bad habit. In women, partial inability to retain the urine is\\nusually due to some injury or displacement, for which the physician\\nmust carefully adjust the proper treatment to each patient medi-\\ncinal, and, perhaps, surgical as well.\\nIn some cases incontinence has been found clue to lack of\\nbladder capacity, and permanently cured by distending the blad-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0644.jp2"}, "643": {"fulltext": "DISEASES OF WOMEN. 619\\nder every other day for six weeks by injecting a four per cent so-\\nlution of boric acid to the point of discomfort, with a fountain\\nsyringe, but this must be done only under the directions of the.\\nphysician, who will use all the antiseptic precautions.\\nDue to a fault in the general nervous system, many women\\nare annoyed by frequent urination whenever excited in any way.\\nThey are sensitive and sympathetic, and joy, fear or sorrow causes\\nit, the oftener they urinate the oftener the necessity occurs. If\\nthe will power is strongly exerted to resist the inclination, recov-\\nery will usually follow.\\nParalysis of the Bladder.\\nThe principal functional derangements of the bladder due to\\nnutritive and nervous diseases are incontinence and paralysis; but\\nhysteria also is often a cause of retention, as well as of incontinence\\nof urine. Disease of the spinal cord may be a cause, giving rise\\nto permanent paralysis; and there ma} be a temporary paralysis\\ncaused by dysentery, diphtheria or disease of the bladder walls.\\nIn the latter case in elderly people, the prospect of recovery is fa-\\nvorable only under prolonged treatment. In cases where there is\\nfear of distention, the bladder should be emptied artificially at\\nstated intervals, and it is of the greatest importance that the\\ncatheter be surgically clean. If it be boiled for thirty minutes in\\nsoda water, there will be no clanger.\\nVarious Abnormal Conditions.\\nAbnormal urine constitutes one of the many factors of blad-\\nder derangement. Normal urine is of a certain character, and any\\nchange in it is quickly felt if too acid, too alkaline, too limpid, or\\ntoo greatly concentrated, the bladder inclines to expel it.\\nDeposits of urinary salts in the walls of the bladder may\\nirritate and tend to a chronic condition. Beginning with these\\nsmall deposits, their rough surfaces favor additional deposits,\\nuntil stones are formed, but this usually occurs only where there\\nis decomposing urine in the bladder. AYhen there is a deposit of\\nuric acid, there is either an excess of the salts in the urine, or a\\ncondition of the secretion which permits deposit when the uric\\nacid is present in normal, or even less than normal quantity. It is\\noften necessary to make several examinations of the urine in twen-\\nty-four hours to discover an abnormal specific gravity, for often", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0645.jp2"}, "644": {"fulltext": "620 DISEASES OF WOMEN.\\nat other times it may be in excess, and give rise to considerable\\nirritability. A bladder that is irritable at all times, even when the\\nurine is found to be normal, is likely to be so because of nervous\\ndisorders, and must be treated along that line.\\nThe symptoms arising from abnormal conditions of the urine\\nare frequent urination and pain after urination, and when these\\nabnormal conditions are allowed to persist for a long time there\\nis danger of a chronic inflammation of the bladder. In cases of\\nconcentrated urine, due to fever, the treatment consists in drink-\\ning a liberal amount of water, usually of some of the alkaline wa-\\nters if the urine is too acid. In digestive troubles, where there is\\nmuch acid or a saline deposit, attention must be given to diet,\\nbathing and regulation of the bowels, and to taking a proper\\namount of exercise. Where these deposits in the urine are found\\nthere is usually some defect in the assimilation which must be\\ncorrected.. Limpid urine is usually due to brain disease, or some\\nnervous trouble, and the treatment must be directed to this cause.\\nMalaria is another cause of derangement of the bladder, and is\\nmost easily discovered by noting its periodicity. The treatment, of\\ncourse, is for the malaria, the relief of which is promptly followed\\nby relief of the bladder trouble.\\nFunctional disease of the bladder, due to disease of the ad-\\njacent organs, often occurs. The symptoms are not unlike those\\ndue to organic trouble, except that they are cured by relieving\\nthe causative disease. Disorders of the rectum may cause pain\\nin the bladder, and chronic hemorrhoids often cause frequent\\nurination. A great many cases of spasms of the vagina are com-\\nplicated by an irritable bladder. Acute peritonitis and cellulitis\\ncause great pain in the bladder, giving rise to the desire to urinate\\nwithout the ability to make the straining effort later, the adhe-\\nsions of a pelvic peritonitis often prevent the normal filling of the\\nbladder, thus producing frequent urination. Occasionally, paraly-\\nsis of the bladder arises from a swelling which renders powerless\\nthe bladder muscles. This may occur in diseases of the mouth of\\nthe uterus, in inflammation around the uterus, or in a pelvic\\nperitonitis.\\nInflammation of the ovaries, or displacement of these organs,\\nmay occasion great pain in the bladder, or frequent urination fol-\\nlowed by great pain next come nervous depression and conse-\\nquent nutritive disorders, then danger of organic disease of the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0646.jp2"}, "645": {"fulltext": "DISEASES OF WOMEN. 621\\nbladder unless the cause be removed. The treatment lies in re-\\nmoving the ovarian trouble by medicinal remedies and care, or by\\nthe surgical removal of the organs themselves, whereupon the\\nbladder irritation will disappear.\\nOrganic Diseases of the Bladder.\\nWe have seen that many conditions give rise to symptoms\\nwhich also belong to real bladder disease. When the bladder itself\\nis diseased treatment must be applied directly to that organ. The\\nsimplest of the organic changes occurs in congestion of its mucous\\nmembrane, which, in the acute form, comes on suddenly, frequent\\npainful urination being the chief symptom, though there may be\\na sense of heat and heaviness in the region of the bladder, which is\\nincreased by walking or standing. When the urethra is involved,\\nthe patient complains of the urine scalding. Usually there is no\\ndisturbance of the general system.\\nCongestion of the Bladder is caused by exposure to cold, espe-\\ncially during the menstrual period, wetting the feet, over-exertion,\\nas in walking or using the sewing machine, constipation from slug-\\ngishness of the portal circulation, excessive venereal indulgence,\\ntoo free use of stimulants, and eating improper food. The treat-\\nment is warm foot baths, hot applications over the stomach, rest\\nin bed with the pelvis elevated, and laxatives for the bowels if con-\\nstipated. The vaginal douche of hot water often gives relief. Any\\nderangement of the urine must be corrected.\\nHemorrliage from the Bladder is usually caused by some\\ndisease of that organ. When due to congestion, the blood may\\nooze from the free surface of the bladder, or from varicose veins\\nof this organ, or from beneath the surface of the mucous mem-\\nbrane from places that appear as bruised spots. The blood may\\ncoagulate and pass in clots, or may serve to color the urine.\\nBleeding from this cause rarely prostrates the patient. The hemor-\\nrhage may also be caused by malaria, cancer, ulceration and slough-\\ning of the mucous membrane, and by the hemorrhagic habit which\\nis common to some women. In all cases the patient must lie still\\nin bed. The treatment depends upon the cause and must be man-\\naged by a competent physician.\\nCystitis, or Inflammation of the Bladder, is quite common\\namong women, and the term is usually applied to inflammation of\\nthe mucous membrane. The pathology of acute cystitis is the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0647.jp2"}, "646": {"fulltext": "622 DISEASES OF WOMEN.\\nsame as that of inflammation of any other mucous membrane in\\nthe body. The surface of the bladder is reddened and covered\\nwith thick mucus, and some pus cells are found within the folds.\\nIf the bladder be allowed to be distended too long with urine, the\\nentire mucous membrane may slough off. This is most apt to oc-\\ncur in the retention after childbirth.\\nThe first symptoms are those which belong to the organ\\nitself frequent urination, pain, and pain after urination, with a\\ndesire to strain. Often in acute attacks there is not much, if any,\\nchange in the urine the reaction at first is acid, but changes to\\nalkaline if long retained. If there be a little blood the urine will\\nappear smoky, and if decomposed it will look hazy. In the chronic\\nform it is of a pale, dirty yellowish hue, or it may be of a deep red\\nfrom the presence of blood. Flakes of pus and shreds of tissue\\nwith more or less abundant mucus make the sediment vary in dif-\\nferent cases, and in different degrees of inflammation.\\nWhen there is intense pain in the bladder, if the symptoms\\nare caused by neighboring organs, there may be great rectal irrita-\\ntion, or a congested uterus with free leucorrhea, or different forms\\nof uterine inflammation; menstruation may be disturbed, there\\nbeing too free flow from the congestion, or an entire failure of the\\nperiod because of reflex nervous disturbance. Neuralgia of the\\nuterus and ovaries may be brought on in this way. The symptoms\\nreferable to the general system may be abnormal ingredients in\\nthe blood, or a poor condition of the blood. The digestive sys-\\ntem is often more or less upset, there being some nausea, especially\\nat the early morning meal, a loss of appetite, and longing for pecu-\\nliar foods, which, when obtained are not wanted. The nervous\\nsymptoms are easily explained arising from the abnormal condi-\\ntion of the blood and broken rest at night. The bowels are usually\\nirregular and constipated, interrupted by attacks of diarrhea na-\\nture s method of relieving the system of poison. The skin of a pa-\\ntient with chronic cystitis is usually sallow, loose and of a lifeless\\nfeel. The perspiration may have a urinous odor. The causes of\\ncystitis are direct injuries, blows, fractures of the pelvic bones, dis-\\nplacement of other pelvic organs, thus causing pressure upon the\\nurethra, or dragging the bladder out of place, injury during labor,\\nand violent and exciting copulation.\\nAbnormal urine, if long continued, will cause cystitis even\\nin a healthy mucous membrane, but very much sooner when the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0648.jp2"}, "647": {"fulltext": "DISEASES OF WOMEN. 623\\nsurface is rough or tubercular. When there is an inflammation,\\nmucus is thrown out to alleviate it, but this in turn is decomposed\\nand then aggravates the disordered condition. Women often re-\\ntain the urine too long because of lack of convenient opportunity\\nto void it, and thus do themselves great injury by setting in motion\\na train of conditions leading to inflammation of the bladder. De-\\nposits of the different urinary salts also irritate the mucous mem-\\nbrane and their continued action may promote a cystitis. Inflam-\\nmation of adjacent organs may extend to the bladder, and some\\nconstitutional diseases, as the eruptive fevers and syphilis, may\\naffect this organ.\\nDrugs, improper food and the virus of gonorrhea are causes\\nof inflammation of the bladder. Cantharides is an exciting drug\\nturpentine and arsenic will produce active congestion; alcoholic\\nbeverages, continued a long time, give rise to a low grade of\\ncystitis; and large doses of the chlorate of potash may cause an\\nactive cystitis. Foods will not cause inflammation in a healthy\\nbladder, but may irritate an unhealthy one, hence all irritating con-\\ndiments, alcohol, asparagus, onions, etc., are better avoided in\\nthese diseases.\\nTreatment This disorder requires local, as well as con-\\nstitutional treatment. In this connection, as elsewhere, only the\\nmilder forms of treatment will be mentioned. Rest is always nec-\\nessary. The urine must be so modified as to alleviate irritation\\nand pain as far as possible. The skin should be kept in a healthy\\nand active condition, and the bowels open and free. Much benefit\\nis derived from the use of salts to the securing of great looseness\\nof the bowels. Indigestion, malnutrition from any cause, gouty,\\ntuberculous and rheumatic tendencies, all aggravate cystitis and\\nmust be treated in order to relieve a case caused by these condi-\\ntions. It is very important that a large quantity of pure water be\\ntaken milk is of great advantage, and a milk diet has been known\\nto entirely cure some cases. Not more than a pint of it must be\\ntaken at one time. Milk agrees better with some if boiled, than\\ntaken either cold or tepid and some are able to take a gallon of it\\nper day. If the cream disagrees, skimmed milk should be used,\\nand, when the bladder irritation has disappeared, gradual return\\nmay be made to a solid diet by combining food with the milk in\\nvarious proportions.\\nIn the beginning of an acute attack, vichy water or flaxseed", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0649.jp2"}, "648": {"fulltext": "624\\nDISEASES OF WOMEN.\\ntea will answer well. The infusion of buchu always acts favorably\\nwhen it can be borne by the stomach, or the fluid extract of buchu\\nin teaspoonful doses once in two or three hours may be used in-\\nstead. The benzoate of ammonia, in ten-grain closes, acts well\\nin proper cases. There are many other drugs which give great re-\\nlief and restore to health, but they must be administered by the\\nphysician.\\nTHE MENOPAUSE.\\nThe menopause or permanent suspension of the menstrual\\nfunction is usually known as the change of life. It usually occurs\\nbetween the ages of forty-five and fifty-five; it may come earlier\\nor later than these limits; the average is at fifty. It does not\\nfollow that because the menstrual function began early in the\\nlife of an individual it will therefore cease early. To women in\\ngood health the approach of the menopause is heralded by a les-\\nsening of the time of the periods, with a gradual diminution of the\\namount of the flow, then a period may be missed, followed again\\nby regular periods for a few times, and then the flow ceases en-\\ntirely. In other cases six weeks may intervene between the pe-\\nriods, which, when they do occur, are inclined to be excessive. The\\ntime consumed in the change to complete cessation varies from\\nsix months to two years, and sometimes more.\\nBeing a natural phenomenon the menopause ought not to\\ncause ill health, but there are manifestations of discomfort, due\\nto the change in the circulation and the cessation of the functional\\nactivities of the generative organs. Many increase in flesh and\\nbecome more or less inactive, both physically and mentally.\\nThere may be functional disturbances of the heart and digestive\\norgans and deranged secretions. The flushing of the face and\\nhot flashes, due to vasomotor disturbances, are very annoying.\\nFullness of the head, occasional headaches and sleeplessness at\\nnight are sometimes noticed, and in some cases there is a slight\\nloss of appetite, and with it a loss of weight. In some there is dis-\\nturbance of the circulation, nervous excitement, restlessness and\\nimpaired memory from lack of concentration. These are common\\nsymptoms in healthy women under ordinary circumstances at this\\ntime in life.\\nThe change in the sexual organs is a gradual breaking down\\nand diminution in size until when the menopause is completed the\\nuterus is no larger than that of a child, and the ovaries cor-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0650.jp2"}, "649": {"fulltext": "DISEASES OF WOMEN. 025\\nrespond with it in size. With each ovulation, the ovaries have\\ngradually deteriorated, and now no longer exert an influence\\nover the animal economy. There is not as great a demand for a\\nlarge blood supply, and the uterus soon shows the effect of the low-\\nered nutrition by diminution in size. There is lowered nutrition\\nof the external nerve centers, and the organic nerves which\\ngovern them, and to some extent the brain also withdraws its\\ninfluence. With this change menstruation ends.\\nCertain diseases may keep up a modified menstruation, thus\\ndraining the nervous and nutritive systems again, degeneration of\\nthe ovaries and uterus may cause suppression of the menses\\nwhile the cerebro-spinal system is yet very active, and a dis-\\nturbance of equilibrium with attendant ill symptoms follow.\\nTreatment is necessary to quiet mental disturbance and secure\\nproper rest. Sedatives and tonics have their place. For the di-\\ngestive disturbances subnitrate of bismuth in twenty-grain doses\\nis often an efficient remedy. The spinal irritation is relieved by\\ncupping, and by cold and hot douches alternating. Time is an\\neffective cure, so alleviation of the disagreeable features is all that\\nis necessary. When there are marked symptoms of plethora, with\\ninactive kidneys and liver, small doses of calomel followed by a\\ndose of saline water, or draughts of a natural cathartic water, are\\nhelps. Turkish baths and muscular exercise do good in some\\ncases. The diet should consist of milk, eggs and vegetables;\\nvery little meat is to be taken, and the quantity of food must be\\nlimited; under-eat rather than over-eat. As there is a tendency\\nto develop diseases of the nervous system at this time, it is of\\nmanifest importance to regulate all imperfections as far as possible.\\nWhen a woman is strong and healthy there is no reason for\\nalarm if the menopause is delayed, but when the general health\\nis impaired and the menopause extends beyond the usual time\\neffort should be made to discover whether any local cause for it\\nexists. Any tumor, a failure of the uterus to return to its normal\\nsize after labor, or old injuries, may keep up the menstrual flow.\\nScar tissue in the cervix, by keeping up irritation, may prevent\\nthe normal change. Liver, heart or kidney disease may prolong\\nmenstruation and give rise to increased hemorrhage about the\\ntime of the menopause. These conditions should all receive\\nproper treatment, which, if successful, will relieve the increased or\\nprolonged hemorrhage.\\n40", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0651.jp2"}, "650": {"fulltext": "626 DISEASES OF WOMEN.\\nINFLAMMATION OF THE UTERUS AFTER THE MENOPAUSE.\\nThis deserves special notice, because it is not only of frequent\\noccurrence, but varies from that of youth and middle life in being\\nmore of a degeneration than inflammation, and only yields to\\nmost persistent local treatment. These cases of endometritis\\nafter the menopause usually follow endometritis before the meno-\\npause, or are kept up by displacements, old lacerations, or small\\ntumors, which, even when removed, may leave an irritation\\nbehind that takes a long time to heal in fact, the cure in all these\\ncases requires patient and protracted treatment.\\nParticular attention must be given to diet and general tonics,\\nand much relief is obtained from vaginal douches containing from\\ntwo to three drams of powdered borax to the quart of water, or one\\ndram of sulphate of zinc to the quart of water. If all the local\\ntreatment to which the physician may resort fails, there may\\narise the question of complete removal of the uterus by surgery.\\nABDOMINAL DISPLACEMENT.\\nIt must be observed that very frequently there develops in\\nthe aged a tendency to failing not only of the uterus, but also of\\nthe abdominal contents, which then push down the uterus before\\nthem. The cause of this is wrong use of corsets and predisposition\\nto displacement. Bending over, as in reading, writing and the\\nuse of the sewing machine, actually produces this displacement for\\nthe time, but when the constriction is removed, or the nor-\\nmal position is again resumed, there is a return of the\\nabdominal contents to their proper place. In old age,\\nhowever, this elasticity of tissue is lost and the dislocation\\npersists. Replacement is obtained by manipulation with the\\nfingers and a position upon the back in which the hips are higher\\nthan any other part of the body. This replacement is retained by\\nrest in bed and by an abdominal bandage. When improvement\\nis noticed the patient may be allowed to sit up, the clothing about\\nthe waist being very loose. The knee-chest position should be\\npracticed several times daily, and a few short rests taken in the\\nreclining position the bowels should be kept free massage,\\nelectricity and tonic treatment are here of great benefit. Complete\\nrelief will be obtained by young women, but in the old this is\\nseldom attained.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0652.jp2"}, "651": {"fulltext": "DISEASES OE WOMEN. 627\\nCOMPLETE PROLAPSUS.\\nIn aged women complete prolapsus, or falling of the womb,\\nis also frequent. It comes from degeneration of the tissues of\\nthe pelvic cavity. This may be preceded by lacerations and in-\\nflammation during earlier years, or be found in those who develop\\ndisplacements after the menopause. Sedentary habits and im-\\npaired nutrition are the chief predisposing causes, and constipation\\nand delay in emptying the bladder are aids in bringing on the dis-\\nease. It is often found in those who have been obliged to be a\\ngreat deal upon their feet.\\nTreatment. It is far easier to prevent prolapsus than to\\ncure it. When the first symptoms of bearing down and of irri-\\ntable bladder are noticed, astringent douches should be given, a\\nteaspoonful of sulphate of zinc to the quart of hot water, or a table-\\nspoonful of tannic acid to the quart of hot water. Later in the\\ndisease it is often necessary to use plegets of cotton medicated\\nwith glycerin and tannic acid two teaspoons of tannic acid to a\\ntablespoon of glycerin. These plegets must be of just the right\\nsize to give support and not irritate. Pessaries often answer re-\\nmarkably well if properly fitted and give no pain or inconvenience\\nby their presence. They should never be worn if the patient is at\\nall conscious of their presence.\\nENLARGED PELVIC VEINS.\\nThe pelvic veins are especially prone to dilatation because\\nthey are without valves or support by fasciae or tissues, and are\\nunder constant pressure when the woman is in the erect position.\\nThese enlarged veins cause pressure upon the pelvic tissues and\\nnerves, and are thus a source of dull pain. This derangement of\\nthe circulation, if continued, will sooner or later result in disease\\nof the ovaries, rectum, uterus and bladder. The causes are un-\\nsuitable occupation, tight clothing, excessive activity of the\\nsexual function without satisfaction, lacerations, and a lack of\\nreturn of the uterus after childbearing or miscarriage. Any con-\\ndition that obstructs the return of the blood from the pelvis\\nfavors this condition.\\nTreatment. Many of these cases can be greatly relieved by\\nrest in bed with the hips elevated. Astringent douches, restora-\\ntion of all lacerations, plegets medicated with tannic acid and\\nglycerin, pessaries, all are useful. At night the pelvis should", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0653.jp2"}, "652": {"fulltext": "628 DISEASES OF WOMEN.\\nbe raised, and when on the side, Sims position should be taken, the\\nupper knee being placed on the bed above the lower knee. Elec-\\ntricity is also valuable in these cases.\\nIf women would consult the physician as soon as the earlier\\nsymptoms of pelvic disease present themselves, submit to the\\nproper course of treatment, and follow instructions not only in the\\nmedicinal line, but with regard to rest as well, many months of\\nsuffering would be avoided, and healthy womanhood result.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0654.jp2"}, "653": {"fulltext": "DISEASES OF THE SKIN.\\nBy R. E. McVey, M.D.\\nCHAPTER I.\\nANATOMY.\\nA knowledge of the structure of the skin is very important\\nto those who expect to understand the nature of its diseases.\\nThe skin is divided into the outer or scarf skin and the inner\\nor true skin. The scarf skin is divided into the horny and the\\nmucous layers, which are for the protection of the true skin under-\\nneath. The true skin is a flexible and highly elastic tissue, a part\\nof whose purpose is to defend the parts beneath from violence. It\\nalso is divided into two layers, the papillary and the reticular.\\nThe papillary layer is the superficial or outer of these two layers\\nand contains the nerves of sensation and the small blood vessels\\nfrom which the scarf skin draws its nutrition. The reticular\\nlayer is composed of connective tissue and contains the sebaceous\\nand sweat glands and the hair follicles. The openings of these\\nglands and follicles extend upward or outward through the other\\nlayers to the surface of the scarf skin.\\nThe skin varies in thickness, being thinnest upon the eyelids,\\nthe prepuce and the inner surface of the greater labia, and thickest\\nupon the back, soles and palms. The subdermic tissue (tissue\\nfound beneath the true skin) is composed of connective tissue so\\narranged as to form a network, enclosing fat cells, which have thin\\nelastic capsules or sheaths. These fat cells are separated, one\\nfrom another, by the connective tissue fibers and are furnished\\nwith a capillary plexus, or network, having an afferent artery and\\ntwo or three efferent veins. When abundant, this adipose\\nstructure beneath the skin gives to the features of young people\\ntheir symmetrical and healthful appearance. Connective tissue is\\nalso found in the corium, or true skin, but to only a limited ex-\\ntent.\\nThe sebaceous or oil glands pour out a secretion for the\\n629", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0655.jp2"}, "654": {"fulltext": "630 DISEASES OF THE SKIN.\\npurpose of keeping the skin moist, giving to the hair its oily\\nand glossy appearance, and protecting the skin against the ab-\\nsorption of excessive amounts of fluids and moisture, which other-\\nwise might reach the circulation.\\nThe sweat glands give off perspiration, and daily pour out\\nabout a quart of watery fluid containing some two per cent of\\nsolids, chiefly chloride of sodium, some fat, some cholesterine, urea\\ncarbonates, phosphates and organic acids. Sweating is probably\\nmore or less under nerve control and is the result of some stimulus\\nacting upon the surface of the skin and reflected to a spinal center.\\nThe skin is abundantly supplied with blood vessels, there being\\ntwo distinct, parallel, horizontal sets; one in the true skin just\\nbeneath the papillae, which receive nourishment from it through\\ntheir vascular loops; the other below, in the connective tissue of\\nthe reticular layer, among the fat and sweat coils.\\nThe muscles of the skin are of both varieties, the striated\\nand the smooth. The striated are found only in the face, neck,\\nchin, lips, nose and eyebrows. The smooth muscles are found in\\nconnection with the hair follicles and sebaceous glands and are\\narranged in bundles. The hair muscles (arrectores piiorum)\\nspring from the papillary layer and pass to their insertion in the\\nmiddle of the hair follicles to which they are fixed or joined. These\\nmuscles are surrounded and crossed by a network of elastic\\nfibers through which their action is transmitted. They are very\\nabundant upon the scalp and their contraction and movement are\\nfavored by their lying in lymph spaces. Their general contraction\\nover the surface of the body produces what is known as goose skin\\n(cutis anserina).\\nThese erector hair muscles also regulate the secretions and\\nexcretions of the skin, and furnish a protection against alterations\\nof temperature, by causing contraction and thickening of the\\nskin to prevent the action of cold, dampness and other deleterious\\neffects.\\nPigmentation of the skin depends upon a slight staining in\\nthe lower layer of cells in the rete (reticular layer). The true\\npigment is known as melanin and is found in fine granules, de-\\nposited in the cells to which we have just referred. Its color is\\nmodified by the vascularity of the skin and the coloring matter\\nof the blood. The sun has much to do with its color and quantity.\\nThus, in cold climates it is of light color and shades into deeper", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0656.jp2"}, "655": {"fulltext": "DISEASES OF THE SKIN. 631\\nand deeper hues as we go toward the equator, until a deep black\\nis reached, as found in the negro. The inference was the exist-\\nence of some relation between pigment and the rays of the sun, and\\nit has been proven that pigment is protection against heat rays.\\nDEFINITIONS.\\nThe following terms are used in discussing skin diseases and\\na little study of them will greatly aid in understanding their diag-\\nnosis.\\nA red spot upon the skin, due to a superabundant supply of\\nblood in that part, is called erythema, and the oversupply causing\\nit, and resulting in distention of the arteries and veins, is called\\nhyperemia.\\nA papule is a pimple, a small, solid elevation, not often larger\\nthan a split pea and located upon the surface of the skin. When\\ndeep seated it is called a tubercle. Such solid masses larger than\\na tubercle, but smaller than a cherry, are called nodules. If larger\\nthan cherries they are called tumors.\\nVesicles are small, cone-shaped elevations containing straw\\ncolored fluid. Blebs or bullae are large vesicles, such as are met\\nin cases of ivy poisoning.\\nPustules are small elevations containing pus or matter. A\\nvesicle in its later stages may become a pustule.\\nAn eruption consisting of pustules is called pustular, of pa-\\npules papular, and of mere dots or points punctate.\\nWheals are variously sized and shaped swellings, whitish or\\nreddish in color, usually pale at the center, and appear and dis-\\nappear quickly, as the lesions produced by mosquito bites, the\\nsting of a nettle, etc.\\nSquamae are scales of the epidermis or scarf skin. They are\\nsometimes called epithelial scales. Desquamation is the term\\nused to denote a natural casting off or loss of these scales.\\nCrusts or scabs are hard masses of dried pus, or other exuded\\nfluids, and dead skin.\\nExcoriations are portions of the skin denuded of epidermis\\nby chafing, rubbing, scratching, etc.\\nUlceration is destruction of a portion of the skin by disease\\nthrough suppuration the formation of pus.\\nFissure is a crack in the skin, such as occurs in cracked lips\\nor chapped hands. Cicatrix is a scar. Stains are discolorations\\nleft by skin disease and may be either transitory or permanent.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0657.jp2"}, "656": {"fulltext": "632 DISEASES OF THE SKIN.\\nA lesion is a hurt, injury or sore. A secondary lesion is one\\nresulting from another or primary lesion through accidental or\\nnatural change, modification or termination.\\nScales, crusts, excoriations, fissures, ulcers, scars and stains\\nare all included in the general term secondary lesions.\\nIt is a mistake to suppose that all skin diseases are results\\nof bad or impure blood, or that it will not do to heal them too\\nquickly. Like other disorders of the body, they should be cured\\nas quickly as possible.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0658.jp2"}, "657": {"fulltext": "CHAPTER II.\\nDISEASES OF THE SEBACEOUS GLANDS.\\nThe sebaceous or oil glands secrete sebum, which consists\\nof water, cast-off epithelial structures, fatty and granular matter,\\nalkaline and earthy phosphates, chlorides, palmitin, olein and\\ncholesterine.\\nThere are three sets of sebaceous glands situated within the\\ntrue skin.\\nSome occur as appendages of the hair system and are desig-\\nnated as glands of the hair follicles. The smaller set are append-\\nages of the long hairs. The larger set are mostly found over those\\nregions of the body covered with lanugo hairs. The third, al-\\nthough a variety of hair follicles, occur quite independently of the\\nhairs and are known as the glandulae odoriferae of the genitals in\\nboth sexes.\\nThe Meibomian glands are situated about the eyelids and\\nare liable to inflammation, injuries and pus formations, such as\\nsties, for which all the treatment needed is an opening up of the\\nglands affected.\\nThe arrectores pilorum are follicular muscles, which, by their\\nextension and contraction, undoubtedly aid in forcing out the\\nsebaceous matter from the ducts.\\nWhen the secretions are not eliminated, but collect in the\\nducts, the disease is known as comedo.\\nWhen little cysts form in the ducts and contain a little white,\\nhard, seed-like substance it is known as milium.\\nWhen cysts form in the ducts and grow to a large size,\\nwhether their contents be hard, soft, cheesy or fluid, they are\\ncalled steatoma.\\nWhen the secretions are increased the disease is known as\\nseborrhea.\\nWhen the secretions back up at the gland outlets and de-\\ncompose the condition is known as acne.\\nWhen the secretions are diminished the disease is called\\nasteatosis.\\n633", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0659.jp2"}, "658": {"fulltext": "634 DISEASES OF THE SKIN.\\nCOMEDO.\\n(Black Heads. Flesh Worms.)\\nThe comedo (dermodex folliculum) is a small parasite which is\\nfound in the sebaceous glands. Its favorite sites are the nose, chin,\\nforehead, cheeks, etc., but it has also been observed in many other\\nparts of the body.\\nThe parasite rests with the head downward in the follicle and\\nis easily pressed out from the large glands of the nose by a curette,\\nor by pinching them between the thumb nails. It is not known to\\nhave any injurious effect, but its presence is, by some, considered\\nthe first stage of acne. No treatment is needed except to press\\nthem out and paint the parts with fluid extract of ergot, or a\\nsaturated solution of boric acid.\\nMILIUM.\\n(Grutum.)\\nMilia are small, pearly, whitish or yellowish globular bodies\\nlying just below the surface of the skin. They are not painful, are\\npin head in size and most common in the face, just below the eyes,\\nbut are also found on other parts of the skin. Each of these little\\nbodies is an abnormal development of a sebaceous cyst whose out-\\nlet became clogged so that its secretion was retained and becam\\ndry and hard.\\nTreatment. Electrolysis is probably the best, but if that is\\nnot convenient break a coarse needle, sharpen the shaft to a chisel-\\nshaped edge and with it prick each globule and press out the con-\\ntents. Should they reappear repeat the treatment and touch each\\ncavity with tincture of iodine.\\nSTEATOMA.\\n(Wens.)\\nA wen has sometimes been called a large milium. Both af-\\nfections are probably due to the same cause, but they differ much\\nin character and development. The contents of a wen may be\\nhard, soft, cheesy or fluid. It is usually found upon the face, scalp\\nor back, and is movable and painless.\\nTreatment. A long incision is made and the mass dissected\\nout, care being taken to remove the enveloping sac, for if that be\\nleft the growth will be very sure to return.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0660.jp2"}, "659": {"fulltext": "DISEASES OF THE SKIN. 635\\nSEBORRHEA.\\n(Dandruff.)\\nSeborrhea is an affection of the sebaceous glands, character-\\nized by an increased flow of their secretion. It may be divided\\ninto two classes, that of the hairy parts and that of the smooth\\nparts of the body. Seborrhea of the hairy parts is divided into\\nfour varieties dry, concrete, oily and circinate.\\nDry seborrhea is really an excessive amount of epithelium of\\nthe scalp and is not properly a disease of the sebaceous glands, but\\nof the epithelium of the scarf skin. It is often called dry skin.\\nConcrete seborrhea is composed of greasy crusts formed from\\nsebum and epithelial scales. The crust varies from a grayish white\\nto a deep brown, and is adherent to the scalp. Under the crust\\nis a reddish moist surface. This form of seborrhea is found upon\\nthe scalp in the region of the temples, and may pass a little below\\nthe hairy border of the temples.\\nOily seborrhea, also known as seborrhea oleosa, greasy sebor-\\nrhea, or oily skin, is a mixed form of seborrhea and shows itself\\nupon the scalp and at the same time upon the face by a layer of\\noily, greasy matter in greater or less abundance. The skin is\\nmore or less red and congested.\\nCircinate seborrhea, eczema of the scalp, is probably a para-\\nsitic disease and should be classified as an eczema. It is char-\\nacterized by the appearance of greasy scales or crusts arranged in\\nfigure-of-eight forms., resting upon a red base, sometimes dry and\\nsometimes moist. There is usually found an oozing or weeping\\nsurface from the scabage raised. Upon the top of the scalp there\\nis more or less alopecia or baldness. This form of eruption is also\\nfound upon the trunk, between the shoulders, and upon the\\nsternum. When found upon the body it is called seborrhea cor-\\nporis. It is also known as lichen annnlatus serpiginosns.\\nBaldness is observed in all the varieties of seborrhea. It does\\nnot originate at the same time as the disease, but follows it after\\na longer or shorter period.\\nIn the first two forms, which are the kinds most frequently\\nmet. two stages may be observed. In the first stage there is more\\nor less scaling, and the hairs are dry, thin and gradually fall out\\nthe duration of the condition varying, according to the subject,\\nfrom one to ten years.\\nIn the second stage the hair falls rapidly. It becomes more", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0661.jp2"}, "660": {"fulltext": "636 DISEASES OF THE SKIN.\\nand more thin and fine, until there remains only a downy growth,\\nwhich in turn also vanishes.\\nThese two forms affect men between the ages of twenty and\\nthirty-five years. Sometimes this form of baldness is seen in\\nwomen also. The disease sometimes attacks the eyelashes and\\nbrows, producing alopecia of the lids and brows. Seborrhea of\\nthe scalp may be complicated by various other affections.\\nCause of seborrhea General debility, anemia, chlorosis, dys-\\npepsia and loss of tone in the glands and skin. It may be\\nparasitic and contagious, but the parasite has not yet been dis-\\ncovered.\\nDiagnosis. Seborrhea of the scalp may be confused with\\neczema and psoriasis. Upon the face it may be confounded with\\nlupus erythematosis and eczema, and upon the trunk with psoria-\\nsis and ring worm, but eczema, psoriasis and erythematosis are\\ndiseases in which there are more or less inflammatory symptoms,\\nsuch as thickening, infiltration and redness. These do not occur\\nin seborrhea.\\nAll the types are curable and those upon the non-hairy por-\\ntions of the body readily so. Those upon the hairy parts are ob-\\nstinate. In cases of seborrhea of the scalp, which have been of\\nlong standing or neglected, attended with loss of hair, the loss\\nmay be more or less permanent.\\nTreatment. Various tonics are recommended, such as iron,\\nquinine, strychnia, cod liver oil, arsenic and maltine in its various\\nforms. Shampoo with castile soap and hot soft water. When\\nthere are scales and crust formations the tincture of green soap\\nshould be used. Previous to shampooing, the scalp should be\\nsoaked with olive oil. The head should be kept clean. The treat-\\nment may be repeated every day, or every other day, according to\\nthe rapidity of the formation of scales or crusts. The affected\\nparts may be anointed with petroleum ointment, or bathed with\\na lotion composed of ten drops of glycerin to one ounce of dilute\\nalcohol. Water may be used in place of the alcohol, but is not as\\ngood.\\nAny of the following ointments are useful One dram sul-\\nphur to one ounce of lard 26 grains ammoniated mercury to an\\nounce lard 30 grains salicylic acid to an ounce lard 26 grains\\nresorcin to an ounce lard. Vaseline is preferred to lard, by some,\\nfor use in these ointments, but its medicinal properties are not as", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0662.jp2"}, "661": {"fulltext": "DISEASES OF THE SKIN. 637\\nvaluable. The following lotion is also used with good results\\nResorcin i dram, castor oil 20 drops, alcohol 4 ounces.\\nDo not use a stiff brush or a fine comb on scalps affected with\\nthis disease to remove dandruff, for they will only make the trouble\\nworse. Only a very soft brush should be applied.\\nACNE VULGARIS.\\nAcne vulgaris is a chronic, inflammatory affection of the se-\\nbaceous glands, caused by decomposition, or a backing up of the\\nsecretion of the glands at their outlets. The disease makes its ap-\\npearance about the fifteenth year, when the development or\\nchanges in the glands in general take place. In such persons we\\nfind more or less general debility, accompanied by dyspeptic\\nsymptoms and irregular habits of the bowels.\\nThe loss of tone in the muscular fibers of the glands of the\\nskin is an effect from the general debility of the system. This\\ngeneral muscular debility is probably associated with a modified\\nnervous tone through which the secretion in the glands undergoes\\nchemical changes which give rise to hyperemia and inflammation\\nin the follicles.\\nWhen the inflammation in the glands is intense and red it is\\ndesignated as acne punctata.\\nWhen the eruption is a little more elevated we call it acne\\npapulosa.\\nIf the base of the eruption is red and hard it is called acne\\nindurata.\\nIf pus forms in the center of the papule it is designated as\\nacne pustulosa.\\nIf the lesion disappears, leaving a pit-like depression, it is\\nknown as acne atrophica.\\nWhen there is connective tissue, new growth, it is known as\\nacne hypertrophica.\\nIn scrofulous or cachectic individuals, where there are dermic\\nabscesses of a cold and sluggish character, it is called acne cachec-\\nticorum.\\nTemporary acne is produced by certain medicines, such as the\\nbromides, the iodines and the external use of tar.\\nAcne is usually an obstinate disease but curable. Sometimes\\nit yields readily to treatment, but at other times is very rebellious.\\nEach case must be studied and treated by itself, as the indications\\ndemand. It is most common in persons of light complexion.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0663.jp2"}, "662": {"fulltext": "688, DISEASES OF THE SKIN.\\nFor the general debility, bitter tonics, alkalies, acids^ pepsin\\nand saline and vegetable laxatives are prescribed, as their use is\\nindicated by the various alterations in the digestive secretions. A\\nvery good remedy is\\nFluid extract cascara sagrada two drams\\nTincture nux vomica two drams\\nTincture gentian comp three and one-half ounces\\nTake one teaspoonful three times a day.\\nEqual parts of sulphate of iron and carbonate of potassium,\\npowdered and well mixed, form a good remedy. It should be\\ntaken in two-grain doses three times daily.\\nFor anemic patients preparations of iron are recommended;\\nand for scrofulous and debilitated subjects cod-liver oil is of great\\nvalue. Where there is a tendency to the pustular form of the\\neruption, Calx sulphurata in pill form, one-tenth of a grain four\\ntimes a day, should be taken.\\nFemales who have uterine disturbances in connection with\\nthis disease may be given fifteen drops of the fluid extract of\\nergot three times a day.\\nIn the slow, sluggish, papular form arsenic is invaluable.\\nProbably arseniated soda, one-twentieth of a grain three times\\ndaily, is the best. Washing the parts with warm water and soap,\\nthen rinsing and sponging for several minutes with hot water, is\\nvery important. In sluggish and non-irritable cases green soap\\nshould be used in place of ordinary toilet soap. If ointments are\\nused they should be rubbed in thoroughly.\\nThe following stock prescriptions are excellent\\nSulphur (precip) one dram\\nBenzoinated lard two drams\\nLanolin two drams\\nIf a lotion is preferred use\\nSulphur (precip.) one and one-half drams\\nPulverized gum tragacanth twenty grains\\nSpirits camphor two drams\\nLime water. .three and one-half ounces\\nOr Sulphur (precip.) one and one-half drams\\nEther four drams\\nAlcohol three and one-half ounces\\nResorcin,6o grains to an ounce of distilled water, is sometimes\\nvery good. All external applications should be used twice a day.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0664.jp2"}, "663": {"fulltext": "DISEASES OF THE SKIN. 639\\nPSORIASIS.\\nPsoriasis is a chronic inflammatory affection of the skin and is\\ndistinguished by red, roundish patches covered by silvery scales.\\nThe disease is usually found upon the scalp, elbows and extensor\\nmuscles. The affection begins as a small papule and enlarges at\\nthe margins. According to the development of the papules the\\ndisease is known as psoriasis punctata, psoriasis guttata, psoriasis\\nnummularis, psoriasis circinata and psoriasis gyrata, but we will\\nhere consider it under the general term psoriasis.\\nIt is not a contagious disease and is more common in winter\\nthan in summer. Sometimes it disappears altogether in warm\\nweather, only to come again when winter returns. Various\\ntheories have been advanced as to its cause. Some eminent\\nauthorities believe it to be of microbic origin. If so, the microbe\\ndoes not enter from without, but finds its way into the capillaries\\nof the papillary layer through the blood. This view is strength-\\nened by the fact that microbes have been found in the scales.\\nSome think it a hyperplasia of the cells of the rete, the over-\\nproduction of epithelial cells setting up inflammation. Still others\\nbelieve that it is due to a functional weakness of the nervous centers\\nregulating the nutrition of the skin and that the eruption depends\\nupon local irritation that the hat may have something to do with\\nits presence upon the scalp that its presence upon the elbows and\\nknees and the surface of the extensor muscles is the result of some\\nform of irritation, etc.\\nA strong diagnostic feature of psoriasis is the absence of dis-\\ncharge. The skin is dry through the whole course of the disease.\\nThe affection that most resembles it is eczema squamosum, but\\nthe eczema patches are seldom well defined, while those of psoria-\\nsis are. In psoriasis the scales are in a single layer, while those of\\neczema are in an adherent crust. The eczema crusts are composed\\nnot of scales only, but of dried exudation mixed with scales, and if\\nthese crusts are removed forcibly, an exudation of serum is more\\nlikely to ensue than one of blood, and bright red points are not\\nseen in the exposed surface.\\nIn lichen planus the patches resemble those of psoriasis, but in\\nlichen planus they are common on the front of the leg, the scales\\nare not in crusts, the infiltration is greater as a rule, the color of the\\neruption is a violet red, and the papules are flat and angular.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0665.jp2"}, "664": {"fulltext": "640 DISEASES OF THE SKIN.\\nPsoriasis also differs from seborrhea of the scalp, in that the\\nlatter is more diffuse, without redness and infiltration, and has\\ngreasy scales of a dirty gray or brownish color, while, the scales of\\npsoriasis are dry and whitish or of a mother-of-pearl color.\\nTreat7nent. Arsenic is an old remedy for the sluggish and\\nchronic forms of this disease. It is given in the form of Fowler s\\nsolution, two to five drops three times a day. Arsenic should\\nnever be given alone. If we wish to give two drops of the solution\\nthree times a day the best way is to put one dram of it into four\\nounces of water and give a teaspoonful.\\nPotassium iodide is a valuable remedy for this disease where\\nthere is a specific taint in ancestors. Salacine has given good re-\\nsults and salicylate of soda is good, if we take the view of it being\\nof microbic origin. Iron, quinine, strychnia and cod-liver oil are\\nrecommended if there be general debility. The scales may ordi-\\nnarily be removed by alkaline baths, or by washing in hot water\\nand soap, after which either of the following external remedies\\nmay be applied.\\nVaseline one ounce\\nChrysarobin one-half dram\\nSalicylic acid one-half dram\\nResorcin one dram\\nOr Ichthyol three drams\\nBismuth subnitrate one dram\\nVaseline one and one-half ounces\\nA 25 per cent solution of resorcin is a valuable lotion for this\\npurpose.\\nThe patient should be kept under observation and the treat-\\nment varied according to the intensity of the inflammation. The\\nuse of chrysarobin is likely to stain the clothes, and, when used\\nabout the head, to produce irritation of the eyes; hence, it is better\\nto confine the treatment to salicylic acid or pyrogalic acid, using it\\nin the prescription instead of chrysarobin, but the latter is the\\nbest remedy aside from these qualities. The disease is very obsti-\\nnate, and, under any form of treatment, will return from time t(\\ntime.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0666.jp2"}, "665": {"fulltext": "DISEASES OF THE SKIN. 641\\nLICHEN PLANUS.\\nLichen planus is an inflammatory affection of the skin. It\\nappears in red or violet colored, flat, angular papules, and is\\nusually found on the front surface of the wrists, the forearms, the\\nlower part of the abdomen, the back, neck, lower extremities,\\ngenitals, sides of the trunk, palms and soles. It also occurs inside\\nthe cheeks and upon the scalp. The papules run an unchangeable\\ncourse, never contain any fluid, and may be separate and distinct\\nor may run together.\\nThis disease does its work very slowly, and may persist with-\\nout change for many months or years. The eruption spreads\\nslowly, but progressively; sometimes there is slight inflammation,\\nand sometimes changes which seem to coincide with mental\\nshocks and over-fatigue, or some disturbance of the nervous sys-\\ntem. Left to itself, lichen planus may undergo spontaneous cure,\\nbut usually it lingers long. The papules undergo a gradual de-\\ncline and their centers become depressed and colored, there being\\nconsiderable coloring matter left after the eruption has dis-\\nappeared.\\nIt may be distinguished from papulary eczema by the an-\\ngularity and flatness of its lesions, their peculiar purplish red color,\\nand the absence of minute blood crusts. From psoriasis it differs\\nin possessing no tendency to the formation of gradually increasing\\ncircular patches, nor to the accumulation of epidermic scales. Un-\\nless his nerves are very badly disordered, a person afflicted with\\nlichen planus will always recover. He should be informed as to\\nthe severity of the disease and its variable course. Beyond the\\nannoyance from the itching, and the unsightly appearance of the\\neruption on the exposed parts, one need expect no serious dis-\\ncomfort, for in bad cases the general health suffers but slightly.\\nTreatment. Arsenic is the sovereign remedy in this disease,\\nand should be ^iven in water, in the form of Fowler s solution. To\\none dram of the solution add four ounces of distilled water, shake\\nthoroughly, and take two teaspoonfuls three times a day, after\\nmeals. The best local remedy is the following wash which should\\nbe used twice a day: Zinc sulphate one-half dram, sulphuret of\\npotassium one-half dram and rose water four ounces.\\n41", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0667.jp2"}, "666": {"fulltext": "642 DISEASES OF THE SKIN.\\nURTICARIA.\\n(Nettle Rash. Hives.)\\nUrticaria, from the Latin word for nettle, is an inflammatory\\naffection of the skin, characterized by firm, smooth, round, oval\\nor irregular shaped wheals, moderately elevated, having reddened\\nbases and flattened tops, which, as the wheals develop, usually lade\\nto whitish centers. Each wheal is small at first, but rapidly en-\\nlarges to an area from one-fourth to one inch in diameter, and has\\nsuch itching, pricking or stinging sensations as to generally lead\\nto severe scratching, but this relief is only temporary, is soon fol-\\nlowed by greater suffering and, sometimes, by the formation of\\nnew lesions as troublesome as the first. It is thought that the\\ndisorder is of nervous origin, for the wheals come and go, lasting\\nfrom an hour or two to a day or even longer, then disappearing,\\nleaving no scales or traces of any kind. The health of the gouty\\nis often improved by an attack, but one having had hives once\\nis more likely to have them again.\\nThe occurrence of urticaria implies a peculiar predisposition\\nof the individual to the disease, and where this is well marked the\\nattacks may be brought on by almost any form of friction of the\\nskin, as the chafing of coarse garments on the knees or other parts.\\nIt may also be induced by the action of heat and cold. Among its\\ninternal causes are emotional excitement, hysteria, digestive dis-\\nturbances and certain articles of food, such as fish, crabs, lobsters,\\nclams, oysters, pork, mutton, cheese, and sometimes eggs, cu-\\ncumbers and strawberries. Hives in children is probably due to\\nthe same cause.\\nTreatment. Salicylate of soda has a valuable effect upon the\\ndisease when associated with rheumatic conditions. From five to\\nten grains may be given every four hours to adults, and in smaller\\ndoses to children. When accompanied by irritation of the in-\\ntestines, salts or other saline cathartics should be given. Where\\nthere is much itching, atropine may be given in doses of one one-\\nhundred and fiftieth of a grain once in four hours. It first pro-\\nduces constriction of the blood vessels, but its secondary effect is\\nthat of dilatation, thus relieving the spasm of the muscles of the\\nskin. Through a similar action hot water or a Turkish bath is\\nsometimes successfully employed. Vinegar and water, lemon\\njuice, diluted acetic acid, diluted alcohol, or peppermint in alcohol,\\nthree grains of the former to an ounce of the latter, any of them,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0668.jp2"}, "667": {"fulltext": "DISEASES OF THE SKIN. 643\\nmay be applied externally. Dusting powders of starch and zinc\\noxide applied after an alkaline bath are useful. Those predisposed\\nto the disease should guard against those articles of food that are\\nlikely to arouse it.\\nHERPES SIMPLEX.\\n(Fever Blisters.)\\nHerpes simplex is an acute, noncontagious, benign affection\\nof the skin, occurring in one or more groups of vesicles on a\\nreddened base, and usually accompanies some other disease.\\nThere are two varieties, herpes facialis and herpes progeni-\\ntalis. The eruption is preceded by malaise or some constitutional\\ndisorder. The sense of chilliness or shivers precedes, and within\\na few hours a papular eruption develops which is readily trans-\\nformed into vesicles. These are from pin head to pea size and\\nstand closely together in groups, five or six forming a patch in\\nsome cases, but usually not more than one or two. The eruption\\nis most often found around the mouth, particular!) upon the lips\\nnear the junction of the skin and mucous membrane. When so\\nlocated it is called herpes labialis when on the side of the nose,\\nherpes nasalis when upon the genitals, herpes progenitalis, and\\nis divided into herpes preputialis and herpes vulvae.\\nHerpes simplex, or fever blisters, usually disappear in a few\\ndays, but may remain two weeks. Anointing the parts with cam-\\nphorated cold cream relieves the burning. Applications of spirits\\nof camphor or any similar lotion is also useful in hastening the\\ntermination of the trouble. Subnitrate of bismuth rubbed upon\\nthe eruption is excellent.\\nHerpes progenitalis is common in the uncleanly after inter-\\ncourse, occurs upon the genitals, is more frequent in men than in\\nwomen, and usually follows some disordered condition of the\\nsystem. It is sometimes preceded by chancroid or gonorrhea,\\ncoming out two or three weeks after the sore has been healed or\\nthe gonorrhea cured, and recurring quite regularly every few\\nweeks or months thereafter, especially if the organs be excited\\nas by coitus or the use of the catheter, but it may follow any of\\nthe causes that produce herpes upon the lips. It is probably a\\nresult of disordered nerves, but this has not been proven. Its\\ndiagnosis is important because it is often mistaken for chancroid.\\nAt the beginning no one should make this mistake, for this herpes", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0669.jp2"}, "668": {"fulltext": "644 DISEASES OF THE SKIN.\\nthen very closely resembles the other form in which the fever\\nblisters or cold sores appear on the lips and is preceded by simi-\\nlar symptoms itching or burning in the swollen spots that be-\\ncome the sites of the blisters which nearly always/begin as a cluster\\nof small vesicles; but after two or three days pus forms in the\\nsores and it may be that time alone can then positively decide,\\nalthough chancroid usually begins as a single vesicle and about\\nfour days after exposure through sexual contact. If in three or\\nfour days more the blisters heal, the trouble was herpes, for chan-\\ncroid spreads through self-inoculation, has greater destructive\\ntendencies and recovers more slowly. Herpes could hardly be\\nmistaken for the initial lesion of syphilis, since the latter almost\\nalways is a single small sore which matures slowly, hardens and\\nsecretes very little serous fluid, and is accompanied by enlarge-\\nment of the glands in the groins.\\nTreatment. \u00e2\u0080\u0094Proper hygiene of the parts; strict cleanliness;\\nthe separation of the opposing surfaces by slightly astringent and\\naseptic powders; regulation of the sexual habits, and, in men,\\nsometimes circumcision.\\nHERPES ZOSTER.\\n(Shii gles.)\\nHerpes zoster is an acute, inflammatory disease in which the\\nvesicles are tense and firm and situated upon inflammatory bases.\\nThe vesicles are closely pushed together and grouped into patches.\\nThey are at first filled with a clear fluid, which may soon take\\non a milky or yellowish appearance from the production of pus\\ncorpuscles. The lesions run together, bullae are formed, and large\\npatches of skin become elevated. As the groups may not all come\\nout at once, a few are likely to be seen at first. New ones begin\\nto come as the old ones begin to get dry. By the end of the\\nsecond week all the lesions are covered with a dry, brown crust.\\nPain is characteristic of zoster. It precedes the eruptive spots and\\nis of a neuralgic character.\\nThe typical zoster occupies one side of the trunk, following\\nthe course of the spinal nerves. The pain between the ribs may\\nresemble pleurisy, before the eruption appears. It may be at-\\ntended with mild fever, and by some has been thought to be in-\\nfectious. It usually disappears in from two to four weeks, but if\\nin the neighborhood of the eyes they may suffer permanent\\ndamage.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0670.jp2"}, "669": {"fulltext": "DISEASES OF THE SKIN. 645\\nTreatment. Give tonics. Quinine is good. The following\\npowder may be applied to the parts:\\nZinc oxide four drams\\nStarch four drams\\nPulverized camphor t one ounce\\nThe following ointment is better to relieve pain\\nZinc oxide four drams\\nOpium one dram\\nLard or vaseline one ounce\\nMILIARIA RUBRA.\\n(Prickly Heat.)\\nMiliaria rubra is an affection of the sweat glands, occurring in\\nthe heated term of summer. In children it is known as red gum.\\nThe eruption makes its appearance after unusual exertion or a\\nhearty meal. In children it is a result of too much clothing or\\noverfeeding. Any portion of the surface of the body is liable to\\nbe attacked. An examination of the affected parts will show them\\nto be studded with countless minute vesicles from the size of the\\npoint of a pin to that of a pinhead, accompanied by intense itch-\\ning. The vesicles are always discreet, that is they do not run into\\none another, and do not rupture spontaneously as in eczema.\\nThere is never any general discharge. The general health of the\\npatient is not affected by this disorder.\\nWhile the rash is out, a glass of wine or a cup of tea brings on\\na sudden and violent attack of itching. The main changes affect\\nthe epidermis. Scattered through the reticular layer are oval or\\ncircular cyst-like spaces sections of dilated sweat ducts, the con-\\ntents of which may be wholly fluid, or contain cellular elements in\\nconsiderable numbers. Some have tried to explain this disorder\\non the theory that by absorbing sweat the cells of the horny layer\\nof the skin are made to swell and so press upon the mouths of\\nthe sweat ducts as to tightly close them at a time when perspira-\\ntion has just ceased, and that any further secretion of sweat, while\\nthis condition lasts, must result in accumulations of liquid in the\\nobstructed ducts and, by their dilatation, cause the tingling pain\\ncharacteristic of prickly heat also that during this period of ob-\\nstruction anything which causes sweating brings on the attack.\\nThe disease bears a close resemblance to eczema, but in the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0671.jp2"}, "670": {"fulltext": "646 DISEASES OF THE SKIN.\\nlatter disease the skin over the whole patch is affected uniformly,\\nwhile in prickly heat the eruption is in patches and the skin is not\\nuniformly red over the whole surface. Eczema is persistent; but\\nprickly heat is only temporary, is a rash and occurs only in hot\\nweather.\\nTreatment. The bowels should be kept free and regular,\\nand the patient must restrain himself to a mild diet. Violent ex-\\nercise and heavy clothing should be avoided. A bath should be\\ntaken daily and the affected parts washed in a calamine lotion, or\\nin a saturated solution of boric acid. Alcohol and water, or\\nvinegar and water, will often give relief, which will be increased by\\nfollowing the wash with a cooling dusting powder composed of\\nequal parts of starch, boric acid, talc and zinc oxide, all pulver-\\nized. The patient should also take saline remedies to stimulate\\nthe kidneys. The acetate and nitrate of potash, an equal part of\\neach, form a good combination for this purpose, and should be\\ntaken in three-grain doses three times a day.\\nVERRUCA.\\n(Warts.)\\nWarts are morbid growths, varying much in size, shape and\\ncharacter.\\nThey are found upon people of all ages, occur chiefly from\\ncontagion, and are composed of a prolongation of connective tis-\\nsue, which contains a blood vessel and is covered by thickened\\nskin.\\nThe common wart, verruca vulgaris, is generally found upon\\nthe hands, feet, ears and face, but may be found upon any part\\nof the body. This form is most frequent in children. It may occur\\nsingly, or the fingers may be covered with them. They are from\\npinhead to pea size, and are hard, conical elevations with a flat-\\ntened top and composed of the horny tissue of the skin. Their\\nsurface is either smooth or rough and may be made up of closely\\ncrowded projections. At first they are of the same color as the\\nskin, but become darker with time and exposure. As a rule these\\nwarts appear slowly, but they may come on at once in considerable\\nnumbers. They may remain a long time, usually months or years,\\nbut in many cases disappear of their own accord, or from the action\\nof some irritating drug.\\nThere is a form of warts called verruca plana, so named be-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0672.jp2"}, "671": {"fulltext": "DISEASES OF THE SKIN. 647\\ncause they resemble lichen planus. They are smaller than com-\\nmon warts, and occur in greater numbers. They are found not\\nonly upon the hands, but upon the cheeks and other parts of the\\nface. They are caused by elongations of the papillae, and hyper-\\ntrophy of all the layers of the skin.\\nAnother variety, verruca senilis, is met principally upon those\\nof middle life to old age, and is more common in men than in\\nwomen. It is favored by the gradual degeneration of the skin tis-\\nsues in old people, by all irritating agencies, and by uncleanliness.\\nIt is found upon the back, arms, face, neck and trunk; is raised\\nabove the surface of the skin is round or irregular in shape and\\nmay be of the same color as the skin, or of a greenish yellow,\\nbrown or black. It may cause much annoyance by itching, and\\noften makes a rapid growth and ends in skin cancer, for which\\nreason it should be removed if any signs of increased growth ap-\\npear. From the fact that this wart is often of a fatty consistency,\\nit has sometimes been classed as a seborrhea.\\nVerruca filiformis is a form found upon the eyelids and chest\\nill people who ha^e attained adult age. In these warts the papillae\\ndo not seem to be involved, as the projection is made up of con-\\nnective tissue from the lower layers of the skin. They usually oc-\\ncur singly, and through the wart is a blood vessel.\\nVerruca perstans is a persistent wart which remains un-\\nchanged.\\nVerruca acuminata is a venereal wart. It is a soft, moist,\\npapilla form growth upon the smooth skin. They are the most\\ncommon in the sulcus and upon the penis, labia and perineum.\\nTreatment. Upon common warts, such as are seen upon chil-\\ndren, nitric acid, glacial acetic acid, and acid nitrate of mercury\\nmay be used with good, effect. Any of these acids should be ap-\\nplied with the point of a small stick, the surrounding skin being\\nprotected by a layer of collodion or some other film painted on\\nfor that purpose. Salicylic acid is one of the best remedies, as it\\nsoftens the horny layer without causing irritation. It should be\\nused in the proportion of one dram of the acid to one ounce of\\ncollodion, and be applied with a camelshair pencil twice daily for\\nthree days, then the wart should be carefully soaked in warm\\nwater and rubbed with pumice stone or sand soap.\\nThe acuminate form may be removed by keeping them dry\\nand clean. The salicylic acid preparation may also be used, and,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0673.jp2"}, "672": {"fulltext": "648 DISEASES OF THE SKIN.\\nin very obstinate cases, glacial acetic acid, but this remedy should\\nbe used in very small quantity and carefully.\\nFiliform warts should be clipped off. Senile warts should\\nbe thoroughly scraped, and their bases touched with nitrate of\\nsilver, or other caustic. Salicylic acid may be used, as for the other\\nforms. Electro-cautery may also be used, but electrolysis is better.\\nSulphate of magnesia, given internally in small doses for a\\nconsiderable time, is said to remove common warts, but experi-\\nence does not sustain the expectations of those who rely upon its\\nefficiency. Better use external remedies only.\\nECZEMA.\\n(Tetter. Salt Rheum.)\\nEczema means to boil out, and is the name applied to a\\ncertain acute, subacute or chronic inflammatory disease of the\\nskin, characterized at first by erythema, papules, vesicles, or pus-\\ntules, or a combination of these lesions, with a variable amount\\nof infiltration and thickening of the skin, terminating either in dis-\\ncharge, the formation of crusts, in absorption, or in scaling, and\\naccompanied by more or less intense itching.\\nThe disease is classified in several varieties, which are known\\nby the kind of lesions present, or, in cases where there are more\\nthan one kind of lesions, by the principal kind. The principal\\nvarieties are as follows\\ni. Erythematous Eczema, beginning with an irregular out-\\nline or hyperemic spot and more or less itching or burning. It\\nmay be limited to a certain region of the body, or be more or less\\ngenerally spread over the surface. When fully developed the\\nskin is harsh and dry, thickened and infiltrated and, usually,\\nslightly scaly, with a tendency to oozing patches. Scratch marks\\nmay usually be seen scattered over the affected surface. It is\\nmost common upon the face, but is frequently found upon other\\nparts. It is very likely to become chronic, in which case it is\\ncalled eczema squamosum.\\n2. Eczema Papillosum is characterized by numbers of dis-\\ntinct, closely crowded, reddish, pinhead size, sharp or rounded\\npapules (pimples), and was formerly known as lichen simplex.\\nVesicles and vesico-papules are often intermingled. It is most\\ncommon upon the extremities. There is intense itching, and the\\npatient can hardly refrain from scratching. The lesions tend", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0674.jp2"}, "673": {"fulltext": "DISEASES OF THE SKIN. 649\\nsooner or later to disappear, but are usually replaced by others.\\nThe disease persists for weeks or months. In places where it is\\nclosely crowded a solid, thickened, scaly covering of eruption may\\nresult in eczema squamosum.\\n3. Eczema vesiculosum, or the vesicular form, appears on\\none or several regions as diffused, inflammatory, reddened patches\\nwith closely crowded pinpoint to pinhead size vesicles, which\\ntend to run together and form a solid sheet of eruption. The\\nvesicles soon mature and burst, the discharge drying to a large\\nhoney-comb-like crust. The oozing is more or less continuous.\\nThe crusts may be cast off, to be followed quickly by another crop\\nof vesicles. This form of the disease is usually chronic. In in-\\nfants it is called milk crusts.\\n4. Eczema pustulosum has its site upon the face and scalp,\\nespecially in the young and those who are ill-nourished. There\\nis a marked tendency to a crusting of the lesions, the dis-\\ncharge drying in thick, brownish, yellowish or greenish crusts.\\nIn this form of eruption there are germs which cause pus forma-\\ntions.\\n5. Eczema fissam is a form in which a tendency to fissuring\\nor cracking of the skin is an important symptom. This tendency\\nto cracking varies considerably, according to the state of the\\nweather, often disappearing in summer to return in winter. The\\ndisease is very common upon the hands and fingers, in which loca-\\ntion it is known as chapped hands.\\n6. Eczema seborrkoicum is an inflammation resembling\\nboth eczema and seborrhea. It is probably caused by a parasitic\\ngerm. This form occurs in sharply defined, rounded or irregular\\npatches, and partakes of the nature of seborrhea, psoriasis and\\neczema, but most especially of seborrhea. There is not often any\\nfever with it. The eczematous eruption or patches merge gradu-\\nally and imperceptibly into the surrounding healthy skin. The\\ndisease is worse in cold, windy weather, and may be due to con-\\nstitutional or local causes or to both. The constitutional causes\\nare gout, rheumatism, indigestion, general debility, nervous ex-\\nhaustion, cutting teeth and scrofula and the local causes are heat\\nand cold, sharp, biting winds, excessive use of water, strong soaps,\\nchemical irritants and scratching.\\n7. Eczema mibrum is characterized by a red, raw-looking,\\nweeping or oozing surface, attended by more or less inflammatory", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0675.jp2"}, "674": {"fulltext": "650 DISEASES OF THE SKIN.\\nthickening, infiltration and swelling, the exudation consisting of\\nserum, sometimes bloody, which dries into thick, yellowish, or\\nreddish brown crusts. It is an important form, developing from the\\nvesicular, pustular or other primary form. It is chronic, and varies\\nin intensity from time to time.\\nIn appearance eczema resembles psoriasis, seborrhea, sycosis,\\nitch and ring-worm. But psoriasis occurs in variously sized,\\nrounded or sharply defined patches, usually scattered irregularly\\nover the general surface of the body, with an especial fondness\\nfor the elbows and knees. These patches are covered over with\\nwhitish silvery scales, and are always dry, and the itching is usu-\\nally slight. Eczema on the contrary is often localized and appears\\nas diffused patches, merging imperceptibly into the sound skin,\\nand there is itching, accompanied by more or less oozing.\\nThe difference in the symptoms of seborrhea and eczema is\\nthat seborrhea of the scalp is commonly over the whole region,\\nand is free from inflammation, the scales are of a greasy character,\\nand the itching is slight; but in eczema of the scalp the parts are\\nseldom entirely covered, inflammatory symptoms are usually\\nprominent, the scales are dry, there is generally severe itching,\\nand, at times, the serous or gummy oozing characteristic of this\\ndisease.\\nItch differs from eczema in its distribution, and by the bur-\\nrows and the absence of all tendency to patch formation; then,\\ntoo, itch is contagious and eczema is not.\\nSycosis differs from eczema in these respects Sycosis is\\nlimited to the hair region of the face, is distinctly a follicular in-\\nflammation, and is rarely very itchy, while eczema is diffused, in-\\nvolving other parts of the face, and is so itchy as to make itching\\nits most prominent symptom. It also appears upon the lips,\\nscrotum and legs. When accompanied by a swollen condition of\\nthe veins, a cure is effected only by a long and persistent course\\nof treatment.\\nEczema of the scrotum appears as a papular eruption, but is\\nnot a usual form of eczema. It gives the scrotum a raw appear-\\nance, as though the skin had been scraped off, with a sticky dis-\\ncharge.\\nIn eczema of the arms the skin is cracked. Eczema is cura-\\nable and does not leave scars, but its duration is indefinite. The\\nchronic form may continue for years.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0676.jp2"}, "675": {"fulltext": "DISEASES OF THE SKIN. 651\\nTreatment. Fresh air, exercise, regular habits, a plain, nutri-\\ntious diet, abstention from pork, salted meats, acid fruits, pastry,\\nsauces, pickles, condiments; excess of coffee and tea, beer, wine\\nand other stimulants are forbidden. Soap and water is to be\\navoided as much as possible in the acute forms, but in the chronic\\nand sluggish forms it may have a medicinal value. For chapped\\nhands wash in a thin mush of wheat bran and water, prepared a\\nfew hours before using, rub them over the fire until thoroughly\\ndry and draw on kid or thin leather gloves before retiring at\\nnight. In the acute stage black wash and oxide of zinc ointment\\nmay be used conjointly, the wash being thoroughly dabbed on\\nand allowed to dry, then the parts gently smeared with the oint-\\nment.\\nBlack Wash.\\nCalomel i 2 drams\\nMucilage tragacanth i ounce\\nLime water 8 ounces\\nOxide of Zinc Ointment.\\nOxide of Zinc ij4, drams\\nRose water y z ounce\\nVaseline ointment V ounce\\nFowler s solution 2 drams 1 Or use: Potas. iodide 3 drams\\nBitter wine of iron 4 ounces I Distilled water 4 ounces\\nMix 30 drops in water and take three times a day, after meals.\\nFor Eczema of the Scalp.\\nSalicylic acid 20 grains\\nZinc oxide 2 drams\\nVaseline 1 ounce\\nOr, Boric acid 2 drams\\nVaseline 1 ounce\\nMix well and rub on the head.\\nFor Vesicular Eczema. Or, Pulv. zinc oxide 1 dram\\nZinc oxide 1 ounce Rose ointment 4 drams\\nPulv. starch 4 ounces I Vaseline 4 drams\\nMix and use on the affected parts. To be rubbed on the eruption.\\nFor Eczema of the Nipple. To Relieve Itching.\\nAcetate of lead 1 dram Subnitrate of bismuth 1 dram\\nGlycerin 1 ounce Rose ointment 1 ounce\\nTo be rubbed on nipple after nursing. To be used on affected parts.\\nDERMATITIS.\\n(Inflammation of the Skin.)\\nDermatitis, or inflammation of the skin, is a term employed\\nto designate those cases of skin disturbances, acute in character,\\nwhich are due to the action of irritants, such as the various animal\\nparasites, and to scratching, resulting in an inflammatory thicken-\\ning of the skin.\\nThe inflammation varies from a slight erythema to intense af-\\nfections as seen in burns, scalds and frost bites.\\nTreatment. Apply common baking soda (not baking pow-\\nder) as a powder to the affected parts.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0677.jp2"}, "676": {"fulltext": "652 DISEASES OF THE SKIN.\\nOther soothing solutions, such as sugar of lead, may be em-\\nployed. In frost bites immediately after exposure the parts should\\nbe brought back to normal temperature by rubbing with snow or\\nby dipping into cold water, after which oil of turpentine may be\\napplied. Balsam of Peru is good, so is carbolic ointment. The\\nfollowing ichthyol ointment is excellent\\nIchthyol three drams\\nSubnitrate bismuth two drams\\nVaseline one and one-half ounces\\nTwo ounces of common baking soda dissolved in a quart of\\nhot water makes a good lotion for inflammation of the skin.\\nDERMATITIS MEDICAMENTOSA.\\n(Drug Eruptions.)\\nUnder this head is included all eruptions due to ingestion or\\nabsorption of drugs. Sometimes one dose will have such an effect\\ncommonly, however, an eruption results only after several days\\nor weeks of continued administration. It is produced by the\\nelimination of the drug through cutaneous structures, though it\\nmay sometimes be caused by the action of the drug upon the\\nnervous system. It may be erythematous, papular, urticarial, vesi-\\ncular, pustular, or bullous and, if the administration be continued,\\neven gangrenous.\\nSuch drugs as antipyrin, arsenic, atropia (or belladonna),\\nbromides, chloral, copaiba, cubebs, digitalis, iodides, mercury,\\nopium, morphia, salicylic acid and turpentine produce erythema-\\ntous and papular eruptions. Itching is usually present and a mod-\\nerate scaling (desquamation) may follow. Arsenic may produce\\nerythema and erythemato-papular eruptions.\\nAtropia may produce erythematous and scarletinoid erup-\\ntions. The bromides produce pustules, boils and carbuncles.\\nChloral hydrate may cause scarletinoid and urticaria, and some-\\ntimes purpuria. Copaiba produces urticaria, erythematous, papular\\nand scarletinoid eruptions. Cubebs cause erythematous and small\\npapular eruptions. Digitalis causes scarletinoid and papular erup-\\ntions. Iodide of potassium, pustular, papular, vesicular, bullous,\\ntuberous, purpuric and hemorrhagic eruptions. Mercury, erythe-\\nmatous and erysipelatous eruptions. Iodide of potassium and\\npotassium bitartrate, given together, are thought to have a. pre-\\nventive influence in the iodide eruptions.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0678.jp2"}, "677": {"fulltext": "DISEASES OF THE SKEW 653\\nERYTHEMA SIMPLEX.\\nErythema simplex is divided into two forms the idiopathic\\nand the symptomatic.\\nThe idiopathic form is that which arises independently of any\\nother affection. The symptomatic form is that which is due to\\nsome constitutional disturbance.\\nErythema simplex is a hyperemic disorder characterized by\\nredness, occurring in the form of variously formed and shaped,\\ndiffused or circumscribed, non-elevated patches. We include in\\nthe first class erythemas due to external causes, such as cold and\\nheat, the action of the sun (as sunburn), injuries to the skin, chemi-\\ncal poisons and chemical irritants.\\nWe include in the second class the erythemas due to disor-\\nders of the digestive tract and the ingestion of certain drugs. The\\nidiopathic rashes are usually limited to certain localities of the\\nskin, while the symptomatic erythemas are more or less general.\\nTreatment. In the idiopathic form the removal of the causes\\nis all that is needed, the erythema subsiding within itself in a short\\ntime, but if thought best some of the dusting powders may be\\nused, or mild, astringent, cooling lotions, such as are used in\\nacute eczemas. (See page 651.)\\nIn the symptomatic forms some laxative is needed to remove\\nthe irritating substance from the intestinal canal. Epsom salts is\\ngood for this purpose. An adult should take a tablespoonful every\\nfour hours until the bowels move freely. For a child reduce the\\ndose.\\nAlso use dusting powders and lotions the same as in the\\nidiopathic forms.\\nERYTHEMA INTERTRIGO.\\n(Chafing.)\\nThis occurs on the parts where the natural folds of the skin\\ncome in contact, and is characterized by redness, to which may\\nbe added an abraded surface, and maceration of the epidermis.\\nThere is a feeling of soreness. The perspiration and moisture of\\nthe parts give rise to maceration of the epidermis, and a mucoid\\ndischarge and inflammation may follow as results. The affection\\nmay pass away in a few days or last for weeks. The cause is usu-\\nally local and the trouble is chiefly found in the region of the but-\\ntocks and genitals of children and fat persons. It is often a result\\nof uncleanliness.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0679.jp2"}, "678": {"fulltext": "654 DISEASES OF THE SKIN.\\nTreatment. The folds are to be kept apart by lint or absorb-\\nent cotton, and dusting powders or cooling and astringent lotiorts\\napplied. One part of linseed oil to two of alcohol, applied after\\nthoroughly washing with cold water, will afford relief.\\nERYTHEMA MULTIFORMA.\\n(Blush.)\\nThis is an acute inflammatory disease, characterized by red-\\ndish, more or less variegated macules, papules and tubercules, oc-\\ncurring as separate lesions, or in patches of various size and shape.\\nThe eruption is usually found upon the extremities, upon the\\nbacks of the hands and forearms, and on the knees, elbows and\\nlegs. The disease comes without any warning or symptoms of\\nmalaise, gastric irritation or rheumatic pains, the eruption sud-\\ndenly making its appearance, and assuming an erythematous, pap-\\nular, tubercular or mixed character; but, as a rule, one type of\\nlesion predominates. The lesions tend to increase in size and in-\\ntensity, and may remain several days, then gradually fade away\\nbut, during this time, new lesions may make their appearance.\\nIn color they are pink, red and violaceous. Slight itching may or\\nmay not be present.\\nThe papular eruption is usually found upon the backs of the\\nhands and forearms and often upon the hands and feet. The\\ncauses are obscure. It is most frequent in the spring and autumn\\nmonths, and is a mild inflammatory disease, often called blush,\\nsomewhat similar to urticaria. The diagnostic points are the uni-\\nformity of the eruption, the size of the papules, the limitation to\\ncertain parts and the absence of itching. It resembles urticaria at\\ntimes, but the lesions of the latter disease are short-lived, disap-\\npearing and reappearing in the most capricious manner, are com-\\nmonly seated upon the trunk and are exceedingly itchy. The\\noutcome in blush is always favorable.\\nTreatment. Quinine and saline laxatives, and local cool-\\ning lotions of equal parts of alcohol and vinegar.\\nPEDICULOSIS.\\n(Lousiness.)\\nThree forms of lice are found upon the human skin, which\\nare named according to their habitats the head, the body and the\\npubis. They secure their nourishment by abstracting blood, thus", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0680.jp2"}, "679": {"fulltext": "DISEASES OF THE SKIN. 655\\nproducing an irritation of the skin which leads to scratching and\\ninflammation. These parasites always remain upon the surface,\\nand deposit their eggs upon the hair or clothing. The presence\\nof lice upon the head is very common among children, especially\\nthe poorer classes.\\nHead Lice. Associated with the eruption produced by the\\nhead louse, through the irritation of scratching, an eczema may be\\nestablished behind the ears and on the neck. The parasite is the\\nprimary cause of the whole trouble. It is of a whitish gray color\\nand easily recognizable. It moves slowly and holds on to the hair.\\nIt has six legs attached to the front part of its body, ending in pre-\\nhensile hooks. The female is larger than the male and lays a\\nlarge number of eggs, which hatch in about three days.\\nIt is stated that one can lay about fifty eggs in six days and\\nwould, were none destroyed, increase to 5,000 in six weeks. The\\neggs are deposited on the hairs, to which they are firmly attached\\nby some secretion from the insect.\\nTreatment. The best remedy is to saturate the head with\\ncoal oil.\\nIt should be done three times within twenty-four hours and\\na cap each time be placed over the head, and worn half an hour,\\nand the head then shampooed. If the treatment is not a success\\nit should be repeated from time to time until there are no longer\\nany parasites or their eggs.\\nMany other remedies are recommended, but none of them are\\nequal to the coal oil. Cutting the hair is unnecessary.\\nThe Indians of New Mexico destroy this parasite with a cap\\nmade of clay. After the clay cap has been worn a certain length\\nof time the parasites are all found dead and the hair is improved\\nin general appearance and nutrition. The arsenic in the clay\\ncauses the death of the parasite.\\nBody Lice. Unlike the head louse this insect is found more\\nfrequently among adults than among children, and among men\\nthan women. It is found especially among tramps. Its favorite\\nplaces are on the shoulders and hips and around the neck and\\nwaistbands. When we find an eruption from scratching in these\\ntwo regions we can suspect the presence of body lice. Always ex-\\namine the seams of the clothing for the diagnosis of this form of\\ninsect is not easy, as it hides in the seams of the under clothing,\\nwhere it deposits its eggs. This insect has a long proboscis which", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0681.jp2"}, "680": {"fulltext": "656 DISEASES OF THE SKIN.\\nit projects into a sweat gland from which it draws its nourishment.\\nAfter the proboscis is withdrawn a drop of blood is found in the\\nopening, there is more or less irritation and scratching and an\\neruption appears in the form of wheals, or a mosquito bite.\\nTreatment. Take a bath, then thoroughly boil the under\\nclothes and iron them, especially in the seams, with a very hot\\niron. As the habitat of the animal is within the clothes they need\\nthe closest scrutiny. This kind of lice always yields to cleanli-\\nness\\nCrabs. These animals may be found not only on the pubis,\\nbut in the axilla, on the hair of the abdomen and chest, and some-\\ntimes upon the whiskers, eyebrows and eyelashes. Sometimes the\\nhair of the legs is covered with them. The crab clings closely to\\nthe hair at the surface of the skin; resembles wheat bran in shape\\nand seems to assume the color of the skin, which it inhabits. It is\\nfound mostly with adults and is chiefly spread through sexual com-\\nmerce and clothing and bedding. On attempting to remove the\\nparasite it is found clinging firmly with its claws at the base of the\\nhair with its head within the follicle. Its eggs seem to be cemented\\nto the hair, close to the skin. Itching, with papules and inflam-\\nmation in the pubic regions, should always lead to the suspicion\\nof the presence of crabs.\\nThe diagnosis is between that of itch, eczema and pruritis.\\nTreatment.\\nBeta naphthol one-half dram\\nLard or vaseline one ounce\\nWhatever the treatment, the parts should afterward be well\\nbathed, and some anti-parasitic must be used to kill the insect and\\nits nits.\\nTobacco juice and fish berries are often used, but neither is as\\neffectual as bichloride of mercury, from three to five grains to an\\nounce of water, or ten grains of the bichloride to one ounce of\\nlard.\\nSCABIES.\\n(Itch.)\\nSarcoptes or acarus scabies is a small animal parasite that\\ngets its living from the human skin. It is a white insect, so small\\nas to be hardly visible to the naked eye, has eight legs and bur-\\nrows in the skin. It frequents the thinnest and most tender parts", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0682.jp2"}, "681": {"fulltext": "DISEASES OF THE SKIN. 657\\nof the skin, and is usually first observed between the fingers.\\nFrom the hands it is communicated to the genital organs. In\\nfemales the insect is especially found around the nipple and over\\nthe hips. The diagnosis is very easy from the burrows which the\\ninsect makes. Only the female is found in these burrows. She\\nenters the skin for the purpose of nutrition and depositing eggs.\\nThe burrows are in lines, sometimes straight and sometimes\\ncurved. The eggs are deposited along these burrows, which vary\\nfrom an eighth to a half inch in length and which, under a small\\nmagnifying glass, appear like finely dotted lines. The female is\\nfound at the end of the burrows and dies there unless scratched\\nout. The young follow the same course as the old ones, the irrita-\\ntion produced causes inflammation, and there are found papules,\\nvesicles and pustules.\\nThere are more than one variety of scabies, and some of them\\nare found upon sheep, horses, cattle, pigs, dogs and cats. The\\nsame remedies as used on the human body will prove effectual on\\nall lower animals, if properly applied.\\nTreatment. The patient should first be soaked all over in\\nwarm water, and soap should be rubbed freely and thoroughly into\\nhis skin for half an hour, or until the skin is well softened, after\\nwhich the following ointment should be well rubbed in:\\nSulphur precipitate one-half dram\\nBalsam of Peru one-half dram\\nLard or vaseline two ounces\\nOr use Beta naphthol two drams\\nLard or vaseline two ounces\\nEach of these should be thoroughly mixed. Bichloride of\\nmercury should not be used, since, by spreading it over a large\\nsurface, its absorption might poison the patient.\\nAfter the above treatment the patient should be dressed in\\nclean clothing and the infected clothes carefully cleansed and\\nironed with a hot iron or kept two hours in an oven in a heat of\\n300 to 350 degrees. As some of the eggs may not be reached by\\nthe first treatment, repetition may be necessary, but over-treatment\\nis not desirable, as it would keep up the irritation begun by the\\nparasite.\\nThere is a mystery in the vitality of lower animal life. The\\nlower forms are almost deathless, and the very lowest, if left to\\n42", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0683.jp2"}, "682": {"fulltext": "658 DISEASES OF THE SKIN.\\nthemselves, are immortal. The single cell does not die, but divides\\ninto two cells which again divide and subdivide to infinity. Death\\nis a result of complex or higher organization, and the higher the\\norganism the more easily it is destroyed. This fact should always\\nbe kept in view in using remedies. It is often easier to kill the pa-\\ntient with germicides than to kill the germs.\\nCIMEX LECTULARIUS.\\n(Bedbug.)\\nThe real habitat of this animal is not merely the bed and bed-\\nding, but cracks in the walls, floors, chairs, cushions, sofas and\\nseats in public conveyances. The bite produces itching, conse-\\nquently scratching, then an eruption which is ordinarily attributed\\nto bad blood. When the bug punctures the skin it injects an irri-\\ntating fluid, which causes an increased amount of blood in that\\nlocality. This puncture produces a stinging sensation and an erup-\\ntion in the form of wheals, which is liable to be mistaken for urti-\\ncaria. That from bedbugs is usually upon the back, while that\\nfrom urticaria is upon the front portions of the body. When the\\npests are removed the inflammation in the skin usually disappears.\\nThis inflammation is best treated by a saturated solution of\\nbicarbonate of soda, ammonia water or spirits of camphor. To\\nrid the home of these pests all cracks in the bedsteads, floors, walls\\nand furniture should be liberally treated with boiling water or a\\nstrong solution of bichloride of mercury. For cushions, sofas,\\netc., gasoline or kerosene should be freely used.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0684.jp2"}, "683": {"fulltext": "CHAPTER III.\\nTINEA TRICHOPHYTINA.\\n(Ringworm.)\\nThe two words tinea (gnawing) and trichophytina (hair-\\nplants) are used to designate a genus of very tiny plants, known to\\nscientists as microscopic fungi, which often effect an entrance into\\nthe human skin and there, in and beneath the epidermis and in\\nthe follicles, live as parasites, rapidly multiply, poison the tissues\\nand cause inflammation, resulting in the diseases of the skin\\nknown as follows\\nTinea trichophytina capitis, or ringworm of the scalp, scald-\\nhead.\\nTinea trichophytina circinata, or ringworm of the body, trunk\\nand limbs.\\nTinea trichophytina sycosis, or ringworm of the face, barber s\\nitch.\\nTinea trichophytina cruris, or ringworm of the crotch and\\naxilla.\\nTinea trichophytina unguium, or ringworm of the nails.\\nThere is a difference of opinion as to these diseases. Some in-\\nvestigators think that they are all really one and the same disease\\ncaused by identically the same fungus, the characteristic symp-\\ntoms varying in each case according to the part of the body at-\\ntacked; that the microscope discloses no difference in the germs,\\neither in shape or arrangement, and that experiments have proven\\nthat all forms of the disease may be produced from cultures de-\\nrived from one germ. Others incline to the opinion that there\\nare many varieties of these little plants, just as there are different\\nkinds of oaks, that each has its preference for certain tissues or\\nlocations on the body, and that each produces a poison that causes\\nits own peculiar type of ringworm. It is not of much importance\\nto know which view is correct, for the fungi in all the forms are\\ndestroyed by essentially the same germicides.\\n659", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0685.jp2"}, "684": {"fulltext": "660 DISEASES OF THE SKIN.\\nRINGWORM OF THE SCALP. SCALD-HEAD.\\nAs already indicated this disease is caused by a tricophyton\\nfinding a lodging place in the scalp and vegetating there. It is\\nmost often found among children, and begins as a small pale-red\\nor gray spot, slightly elevated, and covered with fine bran-like\\nscales. As fast as the follicles become much involved their hairs\\nget dry and brittle, and either break off near the skin or fall out.\\nIn mild cases the hair will grow again, but in the deep seated forms,\\nsuch as usually occur in scrofulous and other ill-conditioned pa-\\ntients, there is likely to be a pustular eruption, thick yellow crusts,\\nand superficial abscesses of the scalp, resulting in the destruction\\nof the follicles so that in the affected patches the hair is perma-\\nnently destroyed.\\nUnless arrested the disease may continue to slowly spread\\nuntil it extends over the entire scalp and down upon the neck, and,\\nalthough there is not much pain aside from the discomfort from\\nitching, the appearance of the scalp becomes repulsive in the ex-\\ntreme. Sometimes, though not often, it is difficult to distinguish\\nthis disease, in its earlier stages, from several other affections of\\nthe scalp, but by moistening a few of the affected hairs, or a small\\npiece of the outer skin, in liquor of potassium, then examining them\\nwith a lens, magnifying from 250 to 300 diameters, the fungi and\\ntheir spores will readily be detected if it be a case of trichophy-\\ntina. The chloroform test is also quite positive, and many rely\\nupon it instead of resorting to the microscope. It consists of dip-\\nping affected hairs in chloroform. If they turn white when thus\\ntreated, it can be depended upon that the trouble is ringworm of\\nthe scalp.\\nTreatment. There are two principles to be employed in the\\ntreatment of this disease:\\n1. The application to the scalp of some germicide which\\nwill destroy the parasites without doing much harm to the skin\\nitself. Mercury, iodine, sulphur, and many other substances will\\ndestroy the fungi when brought in contact with them, but the\\nproblem is to get the remedy to so penetrate as to reach the\\nmicrobes down within the epidermis and hair follicles.\\n2. The exclusion of air, for this fungus is known to require\\noxygen. To secure both of these ends penetration of the germi-\\ncide into the epidermis and the depths of the follicles, though at\\nthe same time filled with their diseased hairs, and smothering the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0686.jp2"}, "685": {"fulltext": "DISEASES OF THE SKIN. 661\\nmicrobes by the exclusion of air various means are used, all of\\nwhich require care.\\nFirst wash the scalp with tincture of green soap (saponis viri-\\ndis two ounces to one ounce of alcohol), made into a lather\\nwith warm, soft water, dry the scalp with hot towels immediately\\nafter, then thoroughly anoint with the following ointment\\nCarbolic acid five to twenty grains\\nRed oxide of mercury ointment one to two drams\\nNitrate of mercury ointment one to two drams\\nRose water one ounce\\nThis treatment should be applied every morning, and as heat\\nand moisture promote the growth of the fungi, the head should be\\nkept cool and dry, and washed only when preparing the scalp for\\nthe anointing.\\nSingle patches may sometimes be destroyed by tincture of\\niodine, well and frequently rubbed into the spots, and its drying\\nand hardening may be prevented by the addition of a little glycerin,\\nabout a dram to the ounce. The principal remedies which have\\nbeen employed in solution are bichloride of mercury, salicylic acid\\nand borax. From two to ten grains of the bichloride, dissolved m\\na half ounce each of water and alcohol, are very efficient in de-\\nstroying the fungus, but there is difficulty in getting it to pene-\\ntrate deeply enough to reach the germs in the lower tissues, al-\\nthough there is some danger from absorption of the poison. It\\nshould never be used over a very large surface, especially if of a\\nstrength of five or more grains to the ounce of water or alcohol,\\nand should there be increased tenderness in the parts to which it\\nis applied, or a green diarrheal discharge from the bowels, the\\nbichloride treatment must be discontinued immediately, for these\\nsymptoms indicate mercurial poisoning.\\nDr. Shoemaker, who has had large experience, says in his\\nDiseases of the Skin, D. Appleton Co. I usually begin by di-\\nrecting the diseased spots to be sponged every day or two with a\\nweak alcoholic solution of thymol, borax, naphthol, or mercuric\\nbichloride, and to be then thoroughly saturated with a fifty-per-\\ncent solution of boro-glyceride. The latter solution cannot be\\nrecommended too highly. In the early stages of ringworm of the\\nscalp I have obtained many rapid cures from its use alone. Borax\\nis one of the most efficient antiseptic and antiparasitic agents. It", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0687.jp2"}, "686": {"fulltext": "662 DISEASES OF THE SKIN.\\nalso possesses mild astringent powers, and tends to allay the itch-\\ning and irritation of the disease. The glycerin has great penetrat-\\ning properties, and carries the parasiticide deep into the follicles.\\nIt also has great affinity for water, which it withdraws from the\\ntissues, thus depriving the fungus of one of the elements most\\ncontributive to its existence. The boro-glyceride solution may be\\napplied night and morning with a little sponge or mop, and should\\nbe well rubbed into the skin with the tips of the fingers. It is desti-\\ntute of any poisonous or irritating qualities^ and acts as a prevent-\\nive of further contagion, as the parasite adheres to the glycerin and\\nis not cast off to be wafted about in the air.\\nSalicylic acid, either as a solution or in an ointment, is de-\\nstructive to the fungus and may be safely used. It is also valuable\\nin collodion, ten to thirty grains of the acid to the ounce of collo-\\ndion, painted over and around the spot, after shaving off the hair,\\nbut many are averse to shaving the hair, as likely to increase the\\nitching without affording any substantial advantage. The follow-\\ning are formulae for the solution and ointment\\nSalicylic acid one to four drams\\nRectified spirits of wine one-half ounce\\nGlycerin one ounce\\nDistilled water two ounces\\nSalicylic acid one to two drams\\nVaseline one ounce\\nThe following is an excellent remedy, but for reasons already\\ngiven must be used sparingly and with care\\nBichloride of mercury ten to twenty grains\\nGreen soap two ounces\\nRectified spirits of wine one ounce\\nIt must be remembered that this disease is not only con-\\ntagious, but that it is sometimes disseminated by spores borne for\\nsome feet through the air. To prevent the latter danger the scalp\\nshould be kept anointed that spores and dried fungi may not es-\\ncape into the air, and as a safeguard against contagion, the pa-\\ntient should be isolated as far as practicable from other children,\\nshould sleep in a separate room, and should not touch the clothes,\\nbrushes, combs, wash-basins or towels of other persons (and all\\ntowels used upon him should be boiled to prevent them from be-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0688.jp2"}, "687": {"fulltext": "DISEASES OF THE SKIN. 663\\ncoming mediums of contagion). The spores retain their vitality\\nfor many months, and special care must be taken against the in-\\nfection getting into woolens of any kind, since such fabrics make\\nthe best hiding places for germs. After treating the patient, the\\nnurse should, each time, thoroughly wash her hands with the\\ntincture of green soap and water. If the green soap cannot be ob-\\ntained, the old-fashioned soft soap is the best substitute.\\nRINGWORM OF THE BODY, TRUNK AND LIMBS.\\nRingworm of the body varies greatly in form and appearance\\nin the different cases, from a single small spot which may be easily\\nchecked, to an extensive eruption, covering much of the surface.\\nThe small red spot with which it begins cannot be distinguished\\nat first from other lesions, but it soon becomes a little scaly, en-\\nlarges with considerable rapidity, and in from two days to a week\\nmay be a half-inch in diameter. As it increases m size there is a\\ntendency to clear in the center, so that the inflamed portion as-\\nsumes the form of a ring, leaving the skin at the center, however,\\nnot perfectly healthy, but of a yellowish hue and more or less\\nscaly. As the diameter of this cleared place continues to increase,\\nan affected spot may likewise appear in its center and follow a\\ncourse similar to that of the first one, and, by several repetitions of\\nthe process, as many concentric rings be formed on the surface of\\nthe body. Itching may or may not be an accompaniment, but\\nusually there is enough of it to cause discomfort, and sometimes\\nis so excessive as to be quite painful. The affection is very much\\nlike the other forms of ringworm, and is a superficial inflammation\\nof the skin wholly due to the development in its outer layers of\\nsome form of the trichophyton already described. Its gravity\\nprincipally depends upon the physical condition of the patient.\\nSometimes it runs its course and disappears without any treatment,\\nin other cases it may become chronic and remain a long time, even\\ndisappearing in summer only to reappear in winter. The cases\\ncontracted from lower animals are likely to be more severe and\\nlast longer than those taken from persons.\\nTreatment. Any application that will destroy the life of the\\nparasite without causing much inflammation of the skin will be of\\nservice. The preparations of mercury, iodine, sulphur and a few\\nother substances are the remedies most used. An ointment of the\\nwhite precipitate, red oxide, or nitrate of mercury, one part of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0689.jp2"}, "688": {"fulltext": "664 DISEASES OF THE SKIN.\\neither to five parts by weight of lard, well mixed, with five drops\\nof carbolic acid and a half-dram of sulphur added to each ounce\\nof the mixture, is an excellent application if well rubbed in. Two\\ndrams of hyposulphite of soda in an ounce of water will often\\nquickly destroy the parasite and from two to ten grains of bi-\\nchloride of mercury to a half ounce each of water and alcohol, care\\nbeing taken to apply it only to small areas, and to reduce the\\nstrength or discontinue the remedy in case of symptoms of poison-\\ning appearing, as described in the treatment for ringworm of the\\nscalp. Ten to forty grains of chrysarobin to the ounce of lard is\\nvery effective, but the disagreeable stain it imparts to clothing is\\nan objection.\\nThe patient finally gets well but the disease may be so ob-\\nstinate as to require very faithful and persistent treatment, for\\nuntil the last germs are killed there is likely to be a relapse.\\nThere should be frequent changes of clothing, and as soon as re-\\nmoved the soiled clothing should be boiled.\\nRINGWORM OF THE FACE. BARBERS ITCH.\\nIn its earlier stages this affection is confined to the outer\\nlayers of the skin. It begins as one or more red points, each of\\nwhich gradually enlarges and becomes an inflamed area, as in\\nringworm of the body, which it resembles more than it does ring-\\nworm of the scalp, both in the greater severity of the inflammation\\nand in the rapidity with which it spreads over considerable sur-\\nfaces. The beard does not show the same tendency to break that\\nis seen in the hair in ringworm of the scalp, but, as the disease\\nprogresses and the fungi penetrate the deep follicles of the beard,\\ntheir hairs die and become so loose as to be easily rubbed out with\\na towel, or removed with forceps without pain to the patient, and\\nthis peculiarity is a very strong diagnostic feature of the disease.\\nAt this stage the inflammation has become deeply seated, the af-\\nfected places painful, swollen and puffed, giving a boggy sensa-\\ntion to the touch, and an impression that there may be pus within\\nthat should be let out with the lance. The nodules, or inflamed\\nplaces, may run together and form one or more large swellings or\\nlumps, the surface of which may be covered with a yellowish crust.\\nAs to severity, the disease varies greatly in different cases, but it is\\nlikely to be very persistent and hard to get rid of, for until the last\\ngerms are destroyed they may multiply and cause a return of the\\ntrouble. It often takes months, sometimes years, to effect a cure.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0690.jp2"}, "689": {"fulltext": "DISEASES OF THE SKIN. 665\\nTreatment. Each morning wash the hands, face, neck and\\nlastly the affected parts carefully and very thoroughly with suds\\nof soft water and tincture of green soap, dry with a clean, warm\\ntowel, with forceps carefully remove all loose hairs, and with cot-\\nton or a soft cloth immediately apply to the swollen places the\\nbichloride solution as recommended for ringworm of the body,\\nthen cover with a little absorbent cotton, binding it on loosely. It\\nis well to begin with a two-grain solution, and in case the disease\\nseems stubborn, increase its strength up to ten grains to the ounce,\\nalways remembering that bichloride solutions are deadly poisons\\nand are safely applied to only small areas. Every evening at\\nbedtime the parts should be washed in a saturated solution of\\nboric acid, dried and anointed freely with the following\\nCarbolic acid five to ten grains\\nTannic acid, pulverized one-half dram\\nGlycerite of tannin one-half dram\\nSulphur precip one-half to one dram\\nRose ointment one ounce\\nThe boro-glyceride treatment recommended for ringworm of\\nthe scalp is excellent also for this form of trichophytina.\\nDo not lance. Be very thorough and regular in the treat-\\nment. Unless the patient is in a bad constitutional condition, he\\nwill require no internal remedies. The same caution must be ob-\\nserved in regard to the contagion in this as in other forms of ring-\\nworm, for it is claimed that the fungus of barber s itch will cause\\nboth ringworm of the scalp and ringworm of the body, and there\\nis more danger of children contracting either of these two diseases\\nfrom this source than there is of one man acquiring barber s itch\\nfrom another. As a medium of the contagion it is thought that\\nthe shaving brush is much more dangerous than the razor. Like\\nthe other forms of ringworm, it is sometimes contracted from the\\nlower animals.\\nRINGWORM OF THE CROTCH AND AXILLA\\nThis is the same disease as ringworm of the body, differing\\nfrom it in appearance and intensity only because of the greater\\nwarmth and moisture and perhaps thinner skin at the armpits, the\\nfold between the buttocks, and the adjacent parts conditions fa-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0691.jp2"}, "690": {"fulltext": "DISEASES OF THE SKIN.\\nvoring the rapid growth and multiplication of the fungi. The in-\\nflammation in this form is much greater than in the ringworms of\\nthe other locations, and the itching and suffering therefrom are\\nsometimes very severe.\\nTreatment. The same treatment as that recommended for\\nringworm of the face will be found efficient here. The addition of\\nthirty grains of salicylic acid to an ounce of the carbolic ointment,\\nwell mixed and applied morning and evening by thoroughly rub-\\nbing it into the skin of the affected parts, will often cure, but, like\\nthe other ringworms, this form is also liable to be troublesome for\\na long time. Thorough and frequent disinfection of the clothing\\nby boiling, and disinfection of the parts and their surroundings,\\nby washing with the green soap tincture, then applying the bi-\\nchloride solution to small surfaces, or, considerably diluted, to\\nlarger ones, will greatly assist in overcoming the parasite.\\nRINGWORM OF THE NAILS.\\nThis is so rare as not to demand a separate consideration here.\\nIt must be treated by germicides very persistently, for the diffi-\\nculty of reaching the fungi under the nails often results in their\\ndoing mischief a long time. Scratching to relieve the itching from\\nother forms of ringworm is a fruitful cause of this aggravating\\ntrouble. As a precaution, the hands should be carefully washed\\nwith soap and water, and the nails well cleaned after treating any\\nform of ringworm.\\nCHILBLAINS.\\nA chilblain is an inflammation of the skin and is characterized\\nby redness, and intense itching and burning. It is found most\\noften upon the heels and toes, but may occur upon the nose and\\nears. It is caused by exposure to cold.\\nTreatment. Soak the feet in water as hot as can be borne,\\nthen shower them in cold water, rub dry, and apply carbolic oint-\\nment, made by adding ten drops of carbolic acid to an ounce of\\nmelted lard or vaseline and stirring until cold. If the blains are\\nulcerated, wash well with warm water and castile soap, dry them\\nand apply the ointment. Some prefer to wash the parts three\\ntimes a day in the following lotion Oil of turpentine, two ounces\\nspirits of camphor, three drams.\\nBathing the feet in warm salt water every morning and even-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0692.jp2"}, "691": {"fulltext": "DISEASES OF THE SKIN. 667\\ning is said to prevent chilblains. Wearing warm woolen stockings,\\nby stimulating the circulation, affords an additional safeguard.\\nCLAVUS.\\n(Corn.)\\nA clavus or corn is a small, flattened, deep-seated formation,\\nusually upon the toes, but sometimes upon the soles or other parts\\nof the feet. It appears like a callous and is a thickening and hard-\\nening of the scarf skin, caused by friction or pressure, and generally\\na result of tight or ill-fitting shoes. Soft corns are formed in the\\nsame way as hard corns, but are between the toes where the mois-\\nture of the foot keeps them from drying and hardening.\\nTreatment. Soak the feet fifteen minutes in hot water, then\\nscrape away as much of the thickened tissue as can be removed\\nwithout pain or bleeding, and paint the corn, but not the surround-\\ning skin, with the following\\nSalicylic acid thirty grains\\nExtract Indian hemp ten grains\\nCollodion six to twelve drams\\nRepeat the painting morning and evening for three days, then\\nsoak the feet again in hot water and the entire corn, in most cases,\\ncan be easily removed, but care must be taken not to try to remove\\nit too soon, or to make it bleed, as peeling down into the live\\nflesh would make it very sore, hence proceed carefully, and if\\nnecessary paint again. Soft corns may require searing with a stick\\nof nitrate of silver, or a little acetic acid. It is a severe resort,\\nbut in case its use is required, oil the surrounding parts to prevent\\nthe healthy skin from being burned, then apply the acid with a\\nsmall stick, as a tooth-pick, after which cover the wound with\\nsoft cloth saturated in linseed oil and later remove the dead skin.\\nTincture of iodine, applied night and morning after carefully\\nscraping away all dead tissue, is recommended.\\nTo prevent further friction and pressure wear a piece of felt\\nor thick, soft leather, with a hole in the center, just over the corn.\\nRemove the cause and corns will usually get well without treat-\\nment. They can be avoided by wearing shoes of soft, pliable\\nleather, that properly fit the feet and by often bathing the feet and\\nkeeping the nails pared, and all dead skin and callouses removed.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0693.jp2"}, "692": {"fulltext": "668 DISEASES OF THE SKIN.\\nBUNIONS.\\nBunions are enlargements of the joints of the great toe, some-\\ntimes of the little toe, caused by wearing too tapering, narrow or\\nshort shoes, the pressure and irritation causing the skin to swell\\nand become very painful.\\nTreatment. Wear large, easy shoes, and, if the skin is not too\\nmuch inflamed, apply an adhesive plaster to the bunion and wear\\nit until there is no more trouble. If badly inflamed, apply a bread\\nand milk or other soothing poultice until the inflammation is gone,\\nthen apply iodine ointment, fifteen grains to the ounce of lard,\\nand rub it in thoroughly night and morning.\\nWear felt or leather plasters cut m the form of rings, as for\\ncorns, to protect the joint from pressure. Some advise bathing\\nthe part in biniodide of mercury, two grains to the ounce of water.\\nONYXIS.\\n(Ingrowing Nails.)\\nThis very painful ailment usually occurs upon the great toe,\\nand is caused by tight shoes or some injury to the toe that has\\ndistorted the matrix.\\nTreatment. Scrape the entire nail until as thin as it can be\\nmade without bleeding, soak the foot fifteen minutes in hot wa-\\nter, after which remove all dead skin and scrape the ingrowing\\nedge, and crowd under it a pledget of cotton, wet the cotton with\\na few drops of oerchloride of iron night and morning until the\\nover-reaching flesh has become so benumbed and deadened that\\nafter soaking in hot water it can be rubbed off.\\nAn old and good method, first used by Dr. Finch, is to take\\na small, thin piece of silver plate, bend one side to make an up-\\nturned flange and crowd it under the ingrowing edge, after the\\nnail has been well softened by poulticing twenty-four hours, then\\nbend the plate over the end and side of the toe and hold it in place\\nby adhesive plaster. In a few days the toe will be well.\\nONYCHIA.\\n(Run-around.)\\nThis disease is most common in children and is due to an un-\\nhealthy condition of the system, or to some slight injury. It be-\\ngins by inflammation in the matrix, and a small ulcer eats its\\nway through the soft tissues about the nail and, if unchecked, may", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0694.jp2"}, "693": {"fulltext": "DISEASES OF THE SKIN. 669\\nspread until the entire nail becomes involved, loosens and drops\\nout. The bone may also become affected and enlarged.\\nTreatment. Apply hot linseed meal poultices. Wet the part\\neach day in a strong solution of salt, alum or sulphate of zinc. If\\npus forms remove it and into the ulcer rub a little powdered salt\\nor alum. Also take measures to improve the general health by\\ndiet and observance of hygienic laws. The use of a gentle tonic\\nis recommended, such as ten to twenty drops of the syrup of the\\niodide of iron three times a day.\\nWHITLOW OR FELON.\\nA whitlow or felon is a very common form of inflammation\\nof the fingers. It is usually situated in the subcutaneous tissues,\\nor in the facias that bind the tendons and hold them in position\\nor it may be in the cellular tissues that connect with the bone and\\nthe tough inelastic membrane, called the periosteum, enveloping\\nthe bone; but in the more intense varieties the disease is usually\\nlocated within the periosteum itself. Again we And the inflam-\\nmation in the tissues around the margin of the nail, but this form\\nis generally mild and not likely to result in serious damage.\\nThe principal cause of a felon is some injury, often slight and\\nunnoticed at the time, to the affected tissues when the blood has\\nbecome impoverished, as from poor diet, bad air, dissipation, etc.\\nIt usually occurs on the inside of a finger, with sharp pain and\\nswelling of the pulp, the former increasing in intensity and the lat-\\nter in size until frequently it extends quite around the finger, and\\noften the entire hand becomes swollen, tense and hard. After the\\nthird or fourth day the pain assumes a throbbing character, and\\nthe patient can get neither rest nor sleep. There is but little fever,\\nthe temperature not rising more than one degree and the pulse\\nremaining nearly normal. From the fifth to the sixth day pus\\nforms which, if allowed to remain, is likely to burrow under the\\ntight, fibrous bands surrounding the periosteum, and may result\\nin its destruction and the death of the bone.\\nTreatment. Cleanse the part and soak it for a little while\\ntwo or three days, then, until the fifth or sixth day, use ichthyol\\nand vaseline in equal parts, to thoroughly soften the tissues, then\\nlance, using care to make a large incision and to carry it down to\\nthe bone. This can usually be done as well from the side of the\\nfinger, and with less danger to the tendons than by cutting", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0695.jp2"}, "694": {"fulltext": "670 DISEASES OF THE SKIN.\\nthrough the pafmar surface. Do not postpone lancing longer than\\nthe sixth clay or it may be too late to save the joint.\\nAfter the lancing and evacuation of pus, the cavity should be\\nwell cleansed every day with a solution of hydrogen peroxide, di-\\nluted with twice its volume of distilled water. An ounce of castor\\noil with sixteen drops of carbolic acid also forms a good cleansing\\nagent and may be used instead of the peroxide.\\nConstitutional treatment consists of quinine and iron, also in\\ngeneral improvement in diet and the securing of more hygienic\\nsurroundings. In old people the urine should be tested for sugar,\\nas this trouble is likely to be associated with some other depraved\\ncondition of the system.\\nNEVUS PIGMENTOSA.\\n(Mole.)\\nMoles are dark, circumscribed spots upon the skin, sometimes\\nsmooth, sometimes rough, either flat or elevated, and of the size\\nof a pinhead to a bean, or larger. They may be the seat of long,\\ncoarse hairs, are very common, are usually permanent and often\\ncause much disfigurement of the face and neck.\\nTreatment. The best way is to remove them by electrolysis,\\nas that is less likely to cause ugly scars than either the knife or\\ncaustics, both of which are often used. Any change in the appear-\\nance or growth of a mole should be followed by immediate re-\\nmoval, as melanotic cancers frequently develop from moles. The\\ndanger from this is greatest in persons in middle or later life.\\nFURUNCLES.\\n(Boils.)\\nA furuncle, or boil, begins as an acute deep-seated, inflamma-\\ntory, circumscribed, rounded or more or less accumulated, firm,\\npainful formation usually terminating in the formation of a cen-\\ntral core and its discharge by suppuration. Long before the ex-\\nciting cause of boils was understood, they were known to be asso-\\nciated with a depraved condition of the general health, but they\\nare now known to be due to either of two kinds of germs, of which\\none produces white, the other yellow pus. They are very common\\ngerms and are always liable to be upon the surface of the skin, but\\nit is thought that they can pass through into the tissues only when\\nthe skin is in an unhealthy condition, as when the patient is suffer-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0696.jp2"}, "695": {"fulltext": "DISEASES OF THE SKIN. 671\\ning from diabetes meiitus, anemia, blood poisoning, eczema or\\nother skin disease, or after an attack of fever or some other wast-\\ning disease, or from overeating or under exercise, or when the skin\\nhas suffered external injury, as from scratching or chafing. It is\\nprobable that their entrance is chiefly made through diseased folli-\\ncles. Boils usually appear singly at first, but may follow in crops,\\nand sometimes reappear for weeks or months.\\nTreatment. If treated early enough, a boil can usually be\\naborted, stopped by applying to its center a drop of strong car-\\nbolic acid with any small instrument, as a toothpick, once in five or\\nsix hours. If this fails to relieve, a five-per-cent solution of car-\\nbolic acid should be injected with a hypodermic syringe into\\nthe apex of the boil, care being used to reach the core. Instead of\\nthis, a sharpened hardwood toothpick may be dipped in strong car-\\nbolic acid, then quickly thrust to the center of the boil. If done\\nearly enough, either of these measures is likely to effect a cure, and\\nthe pain caused lasts but a short time. The use of the acid should\\nbe followed by a dressing of soft cloth, saturated in carbolized\\nvaseline or boric acid solution.\\nIf the boil has been allowed to go on until it is too late to stop\\nit, lance to the core as soon as pus is fully established, after which\\na boric acid solution, or better still, a solution of bichloride of mer-\\ncury, from one to three grains to the ounce of water, should be ap-\\nplied to prevent the formation of new boils after which the wound\\nmay be dressed with the carbolized vaseline. A boil should never\\nbe pinched or squeezed, and it should not be poulticed, for the\\nheat of a poultice only favors the development of germs, and its\\nsoftening the skin facilitates their penetration to the subdermic\\ntissues, thus helping in the production of more boils. It is often\\nbecause of such self-infection that successive crops of boils are due.\\nThe old idea that it was unsafe to scatter a boil lest it ap-\\npear elsewhere upon the patient or cause him serious illness, has\\nbeen discarded. To abort a boil does not mean to scatter it, but\\nto kill it by killing the bacteria producing it, before they have de-\\nveloped in sufficient numbers to cause suppuration. That the pa-\\ntient may almost immediately be troubled by other boils is not due\\nto the same bacteria that caused the aborted boil, but, usually, to\\na continuance of the same unhealthy condition of the skin, permit-\\nting the entrance of other pus germs from the outside. Neither is\\nit true that every boil is worth five dollars, for a boil depletes\\nand contaminates the blood instead of purifying it.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0697.jp2"}, "696": {"fulltext": "672 DISEASES OF THE SKIN.\\nCARBUNCLES.\\nA carbuncle is an acute, circumscribed, phlegmonous inflam-\\nmation of the skin and subcutaneous structures, terminating* in a\\nslough. They are seen in those of middle to advanced age, more\\ncommonly in men, and most frequently upon the nape of the neck\\nand upper part of the back. There is rarely more than one at a\\ntime. The carbuncle usually begins with malaise, chilliness and\\nfebrile disturbance. There is a firm, flat, inflammatory infiltration\\nin the deeper skin and subcutaneous tissue spreading laterally and\\nfinally involving an area of from one to several inches in diameter.\\nAs the infiltration and swelling increase the skin becomes of a\\ndark red color and, sooner or later, at the end of ten days or two\\nweeks, softening and suppuration begin to take place and the skin\\nfinally gives way at small points through which sanious pus exudes.\\nThe whole mass at last sloughs away, either in portions or in its\\nentirety, resulting in a deeper ulcer, which slowly heals, and leaves\\na permanent scar. In some cases, especially in old people, sympa-\\nthetic constitutional disturbance of a grave character is an accom-\\npaniment. Blood poisoning is sometimes developed and a fatal\\nresult may ensue.\\nThe same causes are considered operative in a carbuncle as in\\nfuruncles; general debility and depression predisposing to its\\nformation, and the introduction of the microbes peculiar to this\\naffection. Inflammation starts at the same time from several\\npoints from the hair follicles, sweat glands, or sebaceous glands\\nthe inflammatory centers break down and the pus finds its way\\nto the surface, the process ending in a general slough.\\nWhen carbuncles occur about the head their development\\nshould always be carefully watched and proper remedies applied.\\nTreatment. At the early stage the formation should be in-\\njected with a five or ten per cent solution of carbolic acid, or the\\nwhole surface may be covered with a twenty-five-per-cent ichthyol\\nointment. Where there is breaking down of the parts, a cupping\\nglass may be used to withdraw the pus, and carbolized glycerin or\\ncarbolized water introduced into each opening, and ichthyol oint-\\nment afterward rubbed in. If the process is slow, with a tendency\\nto sloughing, the ulcer should be scraped out and dressed anti-\\nseptically. Bathing the site of the carbuncle with the bichloride\\nsolution, as with boils, to prevent the formation of more carbuncles,\\nshould not be neglected. The constitutional treatment consists", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0698.jp2"}, "697": {"fulltext": "DISEASES OF THE SKIN. 073\\nof the free administration of the chloride of iron. Give ten to\\ntwenty drops in one-third of a glass of water every four hours.\\nANTHRAX.\\n(Malignant Pustules.)\\nMalignant pustule is a lesion, somewhat like a furuncle or car-\\nbuncle, resulting from virus generated in an animal suffering from\\nsplenic fever, and is accompanied by constitutional symptoms of\\nmore or less gravity. A fatal termination is not unfrequent. It\\nis due to the bacillus anthracis.\\nTreatment. The part containing the point of inoculation\\nshould be immediately cut out, care being used to remove all the\\ntissues that have become infiltrated with the poison, and to thor-\\noughly wash the wound in a one to one thousand solution of bi-\\nchloride of mercury, then to cover it with iodiform gauze. Some\\nprefer cauterizing with a hot iron, and injections of a hve-per-cent\\nsolution of carbolic acid are sometimes used, but, unless applied\\nat a very early stage of the disease, the knife is the surest remedy.\\nThis, however, cannot always be employed, as when the swelling\\nhas become great and the infiltration widely extended, so that ex-\\ncision is impracticable. In such cases injections may be the last\\nresort. The needle of the hypodermic syringe should be inserted\\nfull length and the fluid thrown in as the syringe is being with-\\ndrawn. This should be repeated a half dozen times or more, at\\ndifferent places within the border of the swelling, that the acid may\\nreach every portion of the affected tissues. These injections\\nshould be repeated every four or five hours, until the swelling is\\nchecked or there appear symptoms of carbolic poisoning. When\\nthere is edema, free, deep incisions should be made over the\\ninfected region and the wounds copiously irrigated with strong\\nantiseptics, care being taken to get them into the wounds very\\nthoroughly. The above named bichloride solution is probably as\\ngood as any for this purpose. Use ice bags over the part infected.\\nTonics and stimulants should be given internally. When there\\nare symptoms of general infection, alcohol is recommended in\\nlarge doses. Quinine may also be given. When the poison has\\nbeen subdued, poultices should be applied to the wound until the\\ndeadened parts slough away, after which it may be healed. One part\\nof carbolic acid in six of pure olive oil makes an excellent dressing.\\n43", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0699.jp2"}, "698": {"fulltext": "674 DISEASES OF THE SKIN.\\nERYSIPELAS.\\n(Rose. St. Anthony s Fire.)\\nErysipelas is an acute, infectious inflammation of the skin\\nand subcutaneous tissues, is characterized by shining redness,\\nsmoothness, swelling and heat of the part affected, and a ten-\\ndency in some cases to vesicles, and is accompanied by more\\nor less fever.\\nIt was formerly considered as of two kinds The idiopathic,\\nor that which first appears upon an unbroken skin and the\\ntraumatic, or that which begins in wounds or abrasions; but it\\nis now known that all cases of this disease are due to one and\\nthe same cause, the germ streptococcus erysipclatis, which, hav-\\ning gained an entrance to the skin, multiplies and produces a\\npoison that gives rise to the various manifestations seen in the\\ndifferent cases. Some hold that the germs are able to effect\\nan entrance through the skin only where it is broken and that\\nthis lesion may range from the slightest scratch to the severest\\nwound while others, seemingly with as good logic, contend that\\nit may also enter when there is no abrasion if the skin be in a\\nlow condition of vitality, as when the patient has been suffering\\nfrom some other disease, from poor nutrition, dissipation, bad\\nair, a long period of protracted heat, overfatigue, etc. Certain\\nit is that in this class of persons the disease is quite frequent\\nand that it seldom attacks those in robust health. It is most\\ncommon, however, in young infants and adults from twenty to\\nthirty years of age, in women during menstruation and the lying-\\nin period, and in those suffering from wounds. The navel of the\\nnewborn and the breasts and genitals of the parturient woman\\nare especially liable to its attacks in cases where proper attention\\nhas not been given to cleanliness or the surroundings are bad.\\nIt formerly swept through the surgical and lying-in wards of\\nhospitals with such mortality as to make hospital erysipelas\\na terror greatly to be feared, but now, thanks to the discov-\\nery of the germ causation of disease and of aseptic and anti-\\nseptic methods of controlling infections, it would be considered\\nan unpardonable disgrace to the management of any hospital\\nto permit even a few successive cases to occur within its walls.\\nA mild form of the disease is often seen at the outlet of\\nthe nostrils, taking its origin from an inflammation of the hair\\nfollicles just within the nose, but these cases are usually without", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0700.jp2"}, "699": {"fulltext": "DISEASES OF THE SKIN. 675\\nserious constitutional symptoms. A mild form of erysipelas is\\nalso sometimes seen upon the fingers and hands, starting in\\nsome little wound that becomes infected with the erysipelas\\ngerms; but in cases in which the deeper tissues and organs be-\\ncome involved the disease is a much more serious matter and is\\nlikely to be accompanied by grave constitutional manifestations.\\nSymptoms. The disease is ushered in by a feeling of chilliness\\nfollowed by fever, though for a period varying from a few to\\ntwenty-four hours there is likely to have been headache, gen-\\neral depression and poor appetite, if not vomiting. The eruption,\\nwhen first seen, is likely to be a patch an inch or more in diam-\\neter, of bright red color, slightly raised or swollen, smooth and\\nshining. The redness disappears when pressed, but reappears\\nas soon as the pressure is removed. Gradually increasing, the\\ninflamed area gains its greatest size in a week or ten days and\\nmay then vary from a patch three inches across to one very much\\nlarger; a day or two later it gradually subsides, loses its color\\nand ends in scaling or peeling. Dr. Hyde says Until the\\ninflamed area reaches its greatest extent the fever continues,\\nand may go as high as 106 degrees, is likely to be highest at night,\\nand to be accompanied by pain in the stomach, head and back.\\nSometimes pustules and small blisters form and gangrene of\\nthe skin may folloAv Sometimes the inflamed area seems\\nto advance, extending on one side as it heals on the other.\\nTreatment. Purge by giving the patient Epsom salts, a\\ntablespoonful every three hours, until the bowels move freely.\\nFollow with tincture of chloride of iron and quinine, one-half\\ndram quinine to one ounce tincture of chloride of iron, giving\\nten to twenty drops every four hours.\\nBathe the part with a saturated solution of boric acid, then\\nsmear it with ichtliyol ointment. The affected part may be painted\\nwith tincture of iodine, covering a margin of the healthy skin\\nto prevent the disease from spreading, for although this is not\\nalways successful it sometimes is. The remedy is a severe one\\nfor thin skinned people, hence for children and females whose\\nskin is delicate lotions of sugar of lead may be used instead.\\nThey relieve the burning and soothe the inflammation and are\\na most valuable remedy.\\nPowdered boric acid may be dusted upon the reddened\\npart, then a covering of several thicknesses of cloth, neatly cut", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0701.jp2"}, "700": {"fulltext": "676 DISEASES OF THE SKIN.\\nto the size and shape of the inflamed patch, may be wrung out\\nof cold water and so applied that its edges shall not extend beyond\\nthe borders of the reddened area. Patients to whom cold is agree-\\nable may place over this an ice bag. Unless accompanied by\\nsome other disorder erysipelas runs a favorable course and\\nterminates in recovery in from one to three weeks, but in cer-\\ntain conditions it is a very dangerous disease. Fortunately,\\nperfect safety can usually be obtained at these times by using\\nproper precautions against contracting this disorder.\\nFrom what has already been said it will be understood\\nthat it is very important that women recently delivered or about\\nto be confined, newborn infants, anyone suffering from wounds\\nor sores, and the weak and debilitated, should never be allowed\\nto remain in the same house with a case of erysipelas, unless the\\nsick-room be far removed and wholly cut off from the living\\nrooms, no one be allowed to pass from the sick room to the other\\nrooms, and unusually thorough and efficient precautions be taken\\nin the line of ventilation, cleanliness and disinfection, to prevent\\nthe dissemination of the disease.\\nIn days which we hope are all gone by, many a physician,\\nfrom failing to properly cleanse his hands, face, beard and hair,\\nor to don clean clothing in place of that infected with erysipelas,\\nhas carried death, in the form of so-called puerperal fever, to a\\npatient in labor or the lying-in, and, later, it may be, in common\\nwith the friends of the loved one, has wondered at the strange\\ndispensations of Providence in removing while in her prime the\\nlight and very life of her home. (See Care of Infectious Dis-\\neases in the department upon Nursing.)\\nLENTIGO.\\n(Freckles.)\\nFreckles are round and irregular, yellowish, brownish or\\nblackish spots, of pinhead to pea size, usually occurring on the face\\nand backs of the hands. The affection is a very common one and\\nvaries in degree of development. The spots may be few and in-\\nsignificant or may be so abundant as to greatly disfigure the com-\\nplexion. They are generally caused by exposure to heat and wind\\nduring the summer season. Those of light complexion, with light\\nor red hair, are most liable to this trouble, especially when the spots\\nare of a reddish brown color. Freckles consist of deposits of pig-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0702.jp2"}, "701": {"fulltext": "DISEASES OF THE SKIN. 677\\nment within the mucous layer of the skin They can be removed\\nby proper treatment, but are liable to return.\\nThree grains of corrosive sublimate in an ounce of water\\nmakes a wash that applied three times a day usually removes the\\nspots, and is one of the best remedies, but it is poisonous and\\nshould be used with care. It must not be applied to a very large\\nsurface.\\nFrom one to six parts of lactic acid to twenty parts of water\\nmav be used. Five to ten grains of salicylic acid in an ounce of\\nwater, and applied three times a day, has been recommended.\\nEither of the following stock prescriptions may be applied several\\ntimes a day\\nSubnitrate of bismuth one dram\\nAmmoniated mercury one dram\\nRose ointment one ounce\\nOr, Bichloride of mercury ten grains\\nAlmond emulsion six ounces\\nTincture of benzoin one dram\\nCHLOASMA.\\n(Liver Patches.)\\nThis disorder is characterized by single or multiple discolora-\\ntions of the skin, varying in shade from a light yellow to a reddish\\nbrown, or even a blackish hue. It occurs in well defined patches,\\nusually symmetrically distributed over the face, but sometimes\\nfound upon other parts of the body. Like freckles, the spots are\\nproduced by excess of pigment in the mucous layer of the scarf\\nskin. The corium is not involved, but in some cases the blood ves-\\nsels in the papilla? have been found in a somewhat dilated condi-\\ntion. By bringing an excess of blood to the skin, these vessels\\nwere agents of the disorder, for it is from the blood that the pig-\\nment is derived. Those parts naturally most shaded with pigment\\nare the places where the disease is most likely to appear.\\nThe causes are many and varied. External injury is one of\\nthem; disease of the suprarenal capsules, and of the liver, is an-\\nother very frequent one, and disease of the womb is sometimes\\ngiven as a cause, but it is likely that these cases are really due to\\nliver trouble, as diseases of the womb and liver often go together.\\nWhen due to inaction of internal organs, the spots are generally", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0703.jp2"}, "702": {"fulltext": "678 DISEASES OF THE SKIN.\\ndistributed over the body, but when caused by external injury,\\nthey are circumscribed and confined to the locality injured. Again\\nthe spots are sometimes due to micro-organisms.\\nThe treatment must vary according to the variety of the af-\\nfection. If caused by external injury, rubbing the part in warm\\nwater is usually sufficient, the spots disappearing after a few days.\\nIf of germ origin, the spots should be bathed three times a day in a\\nsolution of bichloride, of mercury from two to four grains to the\\nounce of water. If from a disordered liver, the treatment should\\nbe directed to that organ and the general health improved, when\\nthe spots will probably disappear. Always be careful in the use\\nof the bichloride of mercury and not spread it over a very large\\nsurface, lest poisoning result from absorption.\\nDISORDERS OF THE SWEAT GLANDS.\\nDefective Szveat. This is a disorder which may be local or\\ngeneral, congenital or acquired. There may be only slight diminu-\\ntion, or a complete absence of perspiration. Many people, for no\\napparent reason, sweat but little or none at all. The\\ndisorder is a symptom of some other disorder, as of\\nfever at certain stages, diabetes, Bright s disease, etc. Local and\\ncircumscribed anidrosis is due to some injury of the sweat glands.\\nIt produces no particular disturbance until the patient is placed\\nunder conditions that should cause perspiration. The treatment\\nshould be stimulation of the sweat glands of the skin with pilocar-\\npine, warm baths and massage. Do not resort to pilocar-\\npine until a thorough use of the other remedies has failed to give\\nrelief.\\nHyperidrosis (Excessive Sweat). This is a disturbance of\\nthe sweat glands in which the secretion of perspiration is excessive.\\nUnder many conditions a large amount of sweat is normal. All\\npersons should perspire freely after severe exercise, after drinking\\nmuch cold water, and when under the influence of strong emo-\\ntions. Excessive sweating is most common in the palms, soles\\nand axillae. Wherever it is very frequent and profuse it is asso-\\nciated with enfeebled condition and want of general tone. The\\nhorny layer of the skin of the parts affected has a translucent, lus-\\nterless appearance, due to its softening. When long continued,\\nthe softened epidermis loosens and peels off in Hakes, especially\\non the soles, causing discomfort. The borders of the soles are red-\\ndened and, in case there is much walking, blisters sometimes form.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0704.jp2"}, "703": {"fulltext": "DISEASES OE THE SKIN. 679\\nTreatment. Wet the affected parts with alcohol, containing\\none per cent of quinine, then rub upon them powdered starch or,\\nwhat is better, subnitrate of bismuth. If the trouble be with the\\nfeet, sprinkle bismuth freely in the stockings also. Another good\\ntreatment consists of soaking the feet in warm water, then pouring\\nover them a strong solution of salicylic acid, afterward rubbing\\nthem with one part powdered boric acid in live parts of talc. It is\\nwell to have several pairs of cork insoles for the shoes, that a fresh\\npair may be used every day. Each night take from the shoes\\nthose worn through the dav and, havine disinfected them, lav them\\naway to dry. The soldiers of the German army rub their soles\\neach night with a two-per-cent ointment of salicylic acid and mut-\\nton tallow, to check perspiration and toughen the skin.\\nBromidrosis. (Offensive Sweat). This affection is a de-\\nrangement of the functions of the sweat glands in which the per-\\nspiration has an offensive odor. It may be sweet, or sour like that\\nof beer, or of freshly baked bread, or wet straw. The offensive-\\nness is due to decomposition of the macerated portions of the\\nscarf skin and of the sweat after its excretion. As the perspira-\\ntion of different persons differs in composition and quantity, its de-\\ncomposition products will vary in character and odor. The sur-\\nfaces affected have a soaked and sodden appearance.\\nThe bromidrosis most often demanding attention is that of\\nthe feet and axillae. The feet of some young people, whose occu-\\npations require much standing or walking, perspire very freely\\nand, in bad cases, the resulting odor is so penetrating as to be offen-\\nsive, even through the shoes, so that the patient is forced to shun\\nsociety and is unfitted for many indoor vocations.\\nTreatment. After thoroughly washing with plenty of soap,\\none grain of bichloride of mercury in a pint of water is generally\\neffectual, for, by destroying the germs of putrefaction, it destroys\\nthe odors. It should be rubbed over the offending parts with a\\nsoft cloth, morning and evening.\\nPRURITIS ANI.\\n(Itching Piles.)\\nPruritus ani, or itching piles, is of rare occurrence in youth.\\nIt is frequent among the aged, especially those of a nervous condi-\\ntion, and the uncleanly, and is very common during middle life,\\nwhen people are most prone to excessive table indulgence. From", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0705.jp2"}, "704": {"fulltext": "680 DISEASES OF THE SKIN.\\noverfeeding and lack of sufficient muscular exercise there is dis-\\nturbance of the general circulation, especially where the blood ves-\\nsels are dependent, as in the anal region. Fullness of the veins re-\\nsults and, where there is fullness of veins, there frequently is weep-\\ning of the tissues, accompanied by more or less itching and tend-\\nency to scratching. If this condition be continued for any con-\\nsiderable time, the skin around the anus becomes thickened, and\\noften striated (gathered in folds). From the scratching, small, red\\npapules or points, seated in the papillary layer of the skin, arise in\\nthe folds.\\nThe affection gives little trouble through the day, but at night,\\nwhen the patient disrobes and cooler air strikes the body, the al-\\ntered temperature lights up the irritation and the itching becomes\\nalmost unbearable, and he scratches for relief. In this way he may\\nbe kept awake for hours, until the temperature of the bed having\\nbecome the same as that of the body the irritation gradually sub-\\nsides. In such cases there is likely to be imperfect metabolic action\\n(a clogged circulation in the liver and spleen).\\nThis condition is best relieved by a teaspoonful of sulphate of\\nsoda and ten drops of tincture of nux vomica, in a glass of water\\nat bedtime, which should cause a free evacuation of the bowels\\nthe next morning.\\nFor the irritation at the anus, five grains of menthol to the\\nounce of vaseline, applied after thoroughly washing the parts and\\ndrying with a soft towel, relieves the itching and is a good remedy.\\nTo get rid of the thickened condition of the skin, equal parts of\\nichthyol and vaseline should be used every night until the skin\\nis softened, when the excess of cuticle may be scraped away with\\na curette or dull knife, after which the ichthyol should be con-\\ntinued until the parts become normal. Worry and anxiety should\\nbe prevented and physical exercise regulated. With these meas-\\nures, elate the patient by promising a certain cure.\\nSymptoms similar to those of itching piles are sometimes due\\nto the presence of seat worms, in which case a sharp cathartic and\\ninjections of quassia tea will bring relief. (See Intestinal Para-\\nsites.)", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0706.jp2"}, "705": {"fulltext": "CHAPTER IV.\\nTHE HAIR.\\nA hair is an appendage of the skin and has two parts, the\\nshaft and the root. The transparent investment covering the shaft\\nand root is called the cuticle. Each hair is implanted in a sack\\nor pouch, which is called a follicle, is composed of connective tis-\\nsue, is formed from the skin and sometimes involves the subdermic\\nconnective tissue layer. It opens by a mouth upon the outer\\nsurface of the skin, and has a neck and a constricted part just be-\\nlow the papillary layer, where the duct of the sebaceous gland\\nenters, and ends in a wide base or extremity. It is really a\\ndipping clown of the papillary and reticular layers of the skin to\\nform a deep receptacle for the bulb-like root of the hair. Growing\\nfrom the central and lowest part of the follicle is found a papilla,\\nwhere this root is implanted. The follicle itself has two parts, an\\nexternal and an epidermic coat.\\nThe external coat consists of connective tissue and has arter-\\nies, veins, and nerves, and to this coat are attached the hair muscles.\\nThe epidermic coat is formed by a turning inward of the rete\\n(reticular layer). The horny layer of the skin reaches down only\\nto the opening of the sebaceous gland, but the mucous layer con-\\ntinues down to the papilla. The papilla is a connective tissue for-\\nmation and is joined to the main body of the true skin, through\\nthe bottom of the follicle, by a pedicle in which are blood vessels\\nfor carrying nutrition. The papilla of a hair follicle contains many\\npigmented and non-pigmented corpuscles, also blood vessels,\\nwhich at the apex form a loop similar to those in a derma papilla.\\nThe root sheath is made of two membranes. The outer one\\nconsists of finely granular pale cells with very indistinct nuclei.\\nThe inner layer is more coarsely granular and has shorter and\\nbroader many sided cells with distinct nuclei. The sheath ex-\\ntends from the opening of the sebaceous gland down to the hair\\nbulb, which is constituted by the reduplication of the inner layer in\\nthe bottom of the follicle, where it surrounds the papilla. The hair\\n68 1", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0707.jp2"}, "706": {"fulltext": "682 DISEASES OF THE SKIN.\\nis produced from this root sheath. It begins to develop about\\nthe third month of fetal life, and rises from the central portion of\\nthe sheath. The formation of the root is analogous to that of the\\nhorny layer of the epidermis from the rete.\\nThe color of the hair depends not alone upon pigment, but\\nalso upon the presence of air bubbles. Blond hair is usually lack-\\ning in pigment. Curl in the hair depends partly upon the curve\\nof implantation beneath the skin, and partly upon its shape.\\nStraight hair is round and curly hair is eliptical, sometimes flat.\\nThe hairs upon the head are estimated at 1,000 per square inch, or\\nabout 120,000 in all.\\nCare of the Hair. The health of the hair requires light and\\nair, hence heavy, unventilated hats are bad. Constant and severe\\nmental strain and anxiety may cause baldness. Harsh and power-\\nful chemicals, such as are often used in shampoos, are very injuri-\\nous. Use only soaps of finest quality. The white of an egg and\\nwarm soft water make an excellent shampoo, but a better one is\\nmade of pure soft water and castile soap. It should be used often,\\nafter which rinse thoroughly and dry the scalp with towels.\\nThe regular use of pomades upon the scalp is unwise. They\\nare dirty, soon become rancid, emitting a foul odor unless over-\\ncome by a strong perfume, and soil all with which the head comes\\nin contact. Oiling the hair is unnecessary and a filthy habit.\\nSousing the head frequently in water is also bad. Use a dry brush\\nfreely every day and keep the scalp clean and healthy, and nature\\nwill supply what oil is needed.\\nIt sometimes happens that the hair from improper treatment,\\ngeneral physical debility, or other causes, becomes dry, brittle\\nand apparently lifeless. The following tonic may then be rubbed\\non the scalp each morning\\nSulphate of quinine twenty grains\\nEnough dilute sulphuric acid to dissolve the quinine.\\nTincture of cantharides two drams\\nHazeline and glycerin each, one ounce\\nWater of orange flowers eight ounces\\nHair Dyes. Dyes are a disadvantage and injury to the hair.\\nWhen used once they must be continued or the growth of the\\nhair will reveal the true color at the roots, while the dyed portion\\ntells of the vanity of the possessor. Better let dyes alone, but, if", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0708.jp2"}, "707": {"fulltext": "DISEASES OF THE SKIN. 683\\none must be had, the following is as good as any: Saturate the\\nhair with a solution of nitrate of silver, five to ten grains to an\\nounce of distilled water, and let the hair dry in the sun. Applying\\na solution of sulphuret of potash, twenty to a hundred grains to the\\nounce of water, hastens the process.\\nALOPECIA.\\n(Baldness.)\\nBy alopecia is meant loss of hair, either partial or complete.\\nThere are various forms of this disease, of which the most im-\\nportant for our consideration are:\\ni. Congenital Alopecia in which the tendency to baldness\\nis hereditary. This is not very common, although a scanty\\ngrowth of hair is a family peculiarity very often seen. When loss\\nof hair begins with a person, one or more of whose ancestors were\\nbald, the prospect is discouraging, for although it seldom goes\\non to total baldness, no remedy yet discovered seems to have\\nmuch influence in checking its progress.\\n2. Premature Alopecia. Excepting the congenital cases,\\nloss of hair from natural causes before forty-five years of age is\\nknown as premature alopecia. There may be, or there may not\\nbe, external signs as to the cause. Anything that arrests the\\ngrowth of the hair will lead to it. The natural life of a hair is\\nthought to be from two to six years, after which it drops out,\\nhence, unless the growth of the new hair is maintained to take the\\nplace of the old, the daily shedding of old hairs will soon result\\nin baldness, more or less complete, according to the area involved\\nby the abnormal condition.\\nIt is very likely to follow severe attacks of fever or other\\nillness that greatly reduces the system, and sometimes results\\nfrom nervous shocks, also from intense mental activity and anx-\\niety, in which cases it may be permanent, but is likely to prove\\nonly temporary, the hair resuming its normal growth as soon as\\nthe system regains a healthy activity.\\nThe most frequent local cause of this form of alopecia is dry\\nseborrhea of the scalp, a disease said to be the principal cause of\\nall baldness in women and occurring in them more frequently\\nthan in men. Among other local causes are ringworm of the\\nscalp, erysipelas, small-pox and eczema, in fact, any disease long\\nand severely affecting the scalp, also syphilis, and injury to the\\nscalp, as from a bruise, bee-sting or friction.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0709.jp2"}, "708": {"fulltext": "684 DISEASES OF THE SKIN.\\nTreatment. This must consist of the removal of the cause\\nif it can be ascertained. More can be done by restoring the\\nhealth to the best possible condition than in any other way.\\nThe use of pilocarpine and jaborandi internally and externally,\\nis recommended by some. Lassar gives the following formula:\\nPilocarpine hydroclorate thirty grains\\nVaseline live drams\\nLanoline two ounces\\nOil of lavender thirty grains\\nCottle gives this formula:\\nAcetic acid one-half -ounce\\nPulverized borax one dram\\nGlycerin three drams\\nSpirits of wine one-half ounce\\nRose water eight ounces\\nHe also uses ammonia as follows\\nLiquor acetate of ammonia two ounces\\nCarbonate of ammonia one-half dram\\nGlycerin three drams\\nWater sambucus eight ounces\\nApply to the scalp two or three times a day.\\nThe prevention of baldness is generally much easier than its\\ncure; to this end the scalp should be kept clean by shampooing\\nonce or twice a month and by thorough brushing at least once\\nevery clay, but this must not be carried to the extent of irritating\\nthe skin. The head should not be soused in water, unless it be\\nfollowed by a careful drying of the scalp with towels. A fine-\\ntoothed comb should never be used upon the hair, either of children\\nor adults use instead a soft brush for children, a stirrer one for\\nadults. The hair of girls as well as of boys should be kept short\\nuntil they are eight years old. No attempt should be made to\\ncurl hair by the use of hot irons kinking in curl-papers and simi-\\nlar devices also injures it.\\n3. Senile Alopecia is the baldness that comes after forty-\\nfive. It may begin at the forehead and work back, but usually\\ncommences on the back part of the apex of the head and spreads\\nin all directions, though it does not usually extend over the en-\\ntire scalp. It is thought to be the first indication of the lessened", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0710.jp2"}, "709": {"fulltext": "DISEASES OF THE SKIN. 685\\nvitality of advancing years, and is much more common in men\\nthan in women. It very rarely affects the beard, but may extend\\nto the pubic region. There is very little use of trying to treat this\\nform of alopecia. No remedy is known for it, and the loss of hair is\\npermanent.\\n4. Alopecia Areata is a form of baldness which appears sud-\\ndenly in one or more small circumscribed patches upon an ap-\\nparently healthy skin. A slight itching or feeling of tension in\\nthe spots may precede, but usually there are no premonitory\\nsymptoms, and the appearance of a bald patch the size of a dime\\nor larger is the first indication that anything is wrong. The\\nspots are very white and smooth and a little depressed below the\\nsurrounding skin. Having thus begun, the disorder may spread\\nuntil every hair on the body is removed, but generally after\\nspreading a little goes no further.\\nIts cause is not known. By some it is believed to result from\\ndisordered nerves; others maintain that it is the work of an ex-\\nceedingly minute parasite and that, although good lenses and\\npatient investigation have thus far failed to discover it, the phe-\\nnomena attending the disease can be explained in no other way.\\nFortunately the loss of hair from this form of alopecia is not\\noften permanent, but after a time, varying from a few weeks to\\nten or more years, the hair is likely to grow again in the bald\\nplaces, and in many cases it will be as thick and luxuriant as\\nbefore the attack. Persons less than forty years old nearly al-\\nways regain their hair and many do at a much more advanced age,\\nbut the probability of their doing so diminishes as their years\\nincrease. The history of an early loss of hair by the ancestors\\nis an unfavorable indication in this as well as in other forms of\\nalopecia, but is by no means a positive sign that the patient will\\nnot fully recover.\\nTreatment. It is thought that internal remedies have very\\nlittle effect, but hair growth is known to be stimulated by perfect\\nhealth of the body, and for this reason as well as countless others,\\nthe general health should be made as perfect as possible. Alo-\\npecia areata tends to spontaneous recovery, and in many cases the\\nhair will grow again without any treatment, hence it is never\\nknown whether the use of a remedy hastens the process, but the\\nmajority of authorities advise the use of such applications as will\\nstimulate the scalp. For this purpose Crocker recommends", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0711.jp2"}, "710": {"fulltext": "686 DISEASES OF THE SKIN.\\nchrysarobin ointment a dram of the chrysarobin to the ounce of\\nl ar( l rubbing it into the skin of the bald patches well and thor-\\noughly night and morning. Its irritation of the patch, however,\\nis liable to extend so far as to alarm the patient, and this is the\\nchief objection to its use. It must not be used near the eyes in\\nany case.\\nBisquet recommends that the hair be cut short and frequently\\ndisinfected by a strong solution of carbolic acid, that the\\nscalp be kept dry at all other times, that the patches be\\ntreated with one part cinnamon oil to three parts sulphuric ether,\\nand that when the slight redness thus produced disappears, the\\noil and ether be applied again. It is a germicide and excludes\\nthe air.\\nLater, when the hair has ceased to fall out, the following\\nrecommended by Wilson is likely to do well\\nStrong ammonia liquor four drams\\nChloroform four drams\\nOil of sesamum four drams\\nOil of lemon one-half dram\\nSpirits of rosemary four ounces\\nApply once or twice a day.\\nCrocker advises the use of:\\nPerchloride of mercury two to five grains\\nBrandy one dram\\nOil of turpentine seven drams\\nTo be rubbed into and around the patches night and morning.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0712.jp2"}, "711": {"fulltext": "VENEREAL DISEASES.\\nBy R. E. McVey, M.D.\\nSYPHILIS.\\n(Pox.)\\nAn enumeration of the causes of suffering is often unpleasant,\\nbut doubly so when the evils under discussion are venereal dis-\\neases, for a correct understanding of which it is necessary to call\\nattention to the loathsome acts by which they are chiefly dissemi-\\nnated. Would that, in a popular work for the home, the con-\\nsideration of this class of subjects might be omitted, but these\\ndreadful penalties for broken law are so widespread and alarm-\\ningly frequent, as every physician of even limited practice will\\ntestify, and the first advances toward ruin are so often made ignor-\\nantly, we should fail in our duty to the rising generation did we not,\\nby pointing out these dangers, show to the innocent some of the\\nfearful consequences very likely to result from any turning aside\\nfrom virtue for if inoculation should not occur at the first trans-\\ngression, when the line has once been crossed, the barrier between\\npurity and vice been broken, the weakened offender, robbed of\\nself-respect and the restraints of conscience, will sin again and\\nagain, until chancroid, gonorrhea and syphilis may be among only\\nthe milder of the retributive consequences. The social evil is the\\ngreatest. blot of our times; and can it be explained on any other\\nhypothesis than that of ignorance that thousands of bright young\\npeople should annually enter upon lives of shame, so surely and\\nquickly leading to dishonor, disease and death? Shall we not,\\nrather, let them know, while pure and innocent and before it is\\ntoo late, where the uncurbed passions lead, and that verily it is\\nthe first step that costs?\\nAnd the warning should not stop here, for of all diseases syphilis\\nis the most transmissible to offspring, and the most fruitful cause\\nof miscarriage, abortion and infantile mortality. Those affected\\nwith this awful malady should not be allowed to marry until time\\nand treatment have thoroughly done their cleansing work, a\\n687", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0713.jp2"}, "712": {"fulltext": "688 VENEREAL DISEASES.\\nprocess usually accomplished in four years of vigorous continued\\nmedication, although instances are not wanting in which men,\\ninfected and supposedly cured in early life, after twenty years of ap-\\nparent freedom from the disease have begotten syphilitic children.\\nEvery syphilitic husband should be plainly told that he may in-\\nfect his wife directly by sexual contact, or indirectly through the\\nmedium of the fetus, and that if she fails to abort, she may be\\ndelivered at term of a wasted, wizened, deformed, feeble, snuf-\\nfling, blotchy child blasted from the beginning- which, if it does\\nnot die within a few months after birth, as nearly 50^ of all such\\ninfants do, is likely to succeed to a stunted development, mental\\nincapacity, and a heritage worse than death. Every wife should\\nbe informed that by permitting the approaches of a syphilitic hus-\\nband she herself becomes liable to the disease, and to a mother s\\nshare in the creation of such a being as just described; and all\\nadults should so fully understand the possibilities of contamination\\nas to be able to intelligently protect themselves, their children and\\nfriends from all indirect infection as from servants, playmates,\\nsoiled bedding, towels and utensils of every kind.\\nSyphilis is a very chronic as well as contagious disease. The\\nmildness or severity of its manifestations, their multiplicity, suc-\\ncession and duration, depend in great measure upon the con-\\nstitutional peculiarities of the patient. It has long been supposed\\nto be of microbic origin, but, though many skillful investigators\\nhave made patient search for it, the germ has not been found.\\nWhile we hope to give a good general idea of syphilis, and such\\ninformation as shall serve as a note of warning, we shall not in the\\nlimited space at our disposal attempt its full discussion. The com-\\nplete course of the disease consists of three parts The Primary,\\nSecondary and Tertiary Stages.\\nThe Primary Stage has been defined as the time during which\\nthe force of the disease seems to be concentrated at the point of\\ninfection, and in the adjacent lymphatic glands. When syphilitic\\nvirus is introduced into the system, there is no appreciable sign of\\nits action until from twenty to thirty days, or more, when a single\\nsore, called the primary sore, chancre, or initial lesion, appears\\nupon the skin or mucous membrane at or very near the place\\nwhere the virus entered. If inoculation occurred at more than one\\nplace, there will be more than one such sore. The chancre is\\nGenito-Urinary and Venereal Diseases, by White and Martin, D. Appleton Co.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0714.jp2"}, "713": {"fulltext": "VENEREAL DISEASES. 689\\nround or oval, usually ranges in size from a pin s head to a dime,\\nand has a dark red, somewhat depressed base, around which,\\nespecially in men, the tissues are apt to be firm and hard. Unless\\nirritated, this ulcer does not suppurate, but discharges a small\\nquantity of thin serous secretion which is very contagious. Unless\\nthe constitutional condition of the patient is bad, this ulceration is\\nnot likely to go very deep. It is not painful, and usually in three or\\nfour weeks disappears.\\nAt the same time that the chancre is developing, the lymph\\nvessels and lymph glands of the adjacent parts become involved,\\nswell and harden, and, extending back from the chancre, usually\\nappear to the touch like hard, painless cords. With the subsi-\\ndence of the chancre, these lymphatic enlargements, called syph-\\nilitic bubo, also disappear. The duration of this stage is from six\\nto eight weeks, rarely longer.\\nAn interval of from two weeks to six months now follows, and\\nas the general health has not been impaired, the patient may think\\nthat he is entirely free from the trouble, but is likely to find later\\nthat the poison has been slowly extending to the other lymph\\nglands and spreading through his system. Whether in the first\\nplace the poison enters through the lymphatic vessels or through\\nthe blood vessels is uncertain, but it is probable that the blood is\\ninfected through the lymph by way of the thoracic duct. As the\\nblood becomes infected its red corpuscles are diminished, and its\\nwhite ones increased in number, and the entire system, especially\\nthe skin, becomes saturated with the poison.\\nThe Secondary Stage. This and the tertiary stage, and the\\ninterval between them, make up the period during which the dis-\\nease is known as constitutional syphilis, because by the beginning\\nof the secondary stage the body has become so thoroughly im-\\npregnated with the virus.\\nIn some cases the first manifestation of this stage is a red\\nblush or rash, which, appearing mainly upon the chest, belly and\\nother parts covered by the clothing, and causing no itching or\\npain, may escape the patient s notice and pass off without his be-\\ning aware of any secondary symptoms, the disease having ex-\\nhausted itself without making any further skin manifestations. In\\nsuch a case we cannot be sure that the patient has had constitu-\\ntional syphilis.\\nWhen preceding the. rash there has been fever, accompanied", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0715.jp2"}, "714": {"fulltext": "690 VENEREAL DISEASES.\\nby pains, aching in the bones, and other neuralgic symptoms, and,\\nperhaps, enlargement of the lymphatics, we expect the first blush\\nwill be followed by the papular form of the eruption upon the\\nskin, which is the typical form of this secondary manifesta-\\ntion there is, however, great variety in the character and severity\\nof the eruptions in different cases. The papular eruption involves\\nthe deeper layers of the skin, and usually makes its appearance\\nin from three to four months after the initial lesion. Its duration\\nis from six months to two years. It is not likely to be painful, nor,\\nexcept upon the hairy parts, to cause much itching. At first it is\\nof a dark red hue, having the appearance of the chancre, but grad-\\nually changes to a paler color and assumes a more coppery or\\nlean ham appearance.\\nThe moist papules are of special importance, though they are\\nonly ordinary papules transformed. Their transformation is due\\nto their location, papular development being favored by fineness\\nof skin, thin epidermis, and the moisture of secretions or excre-\\ntions conditions which are found at the junctures of the skin\\nwith mucous membrane. Upon the skin side a papule is often dry\\nand scaly, while upon the mucous side its covering is softened by\\nmoisture and transformed into a grayish white, easily detachable\\nmembrane. In the mucous membrane of the mouth or throat\\nthese moist papules are known as mucous plaques or patches, and\\noccur upon the inner surface of the cheek, at the juncture of the\\ntonsil with the pharynx, sometimes on the tonsil, tongue, or lips.\\nThey are sometimes so large as to spread over a large part of the\\ntongue; they have red bases, are somewhat circumscribed, and\\ngray in appearance, as if they had been touched with a stick of\\nsilver nitrate. See Figs, i and 2, Plate IX.\\nThese mucous patches arrive early in the secondary stage,\\nsometimes even before the skin eruption, and are the most con-\\nstantly present of all the lesions of secondary syphilis, are quite\\ndiagnostic of the constitutional infection, and very contagious.\\nWhat is known as innocent syphilis is conveyed by them, and on\\nthis account great care should be taken about kissing. The cus-\\ntom may well be confined to special friends who are known to\\nbe pure. Much danger lurks in public drinking cups; if obliged\\nto use them, always rinse thoroughly before putting them to the\\nlips. In view of the fact that this, as well as many other most\\nserious diseases, may be disseminated by such means, what can", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0716.jp2"}, "715": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0717.jp2"}, "716": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0718.jp2"}, "717": {"fulltext": "VENEREAL DISEASES. 691\\nbe too strong a condemnation of the custom in many of our schools\\nof using public books and pencils, indiscriminately passing them\\nfrom one pupil to another?\\nInnocent syphilis may also be obtained by a wife from her\\ninfected husband, by a husband from his wife, by a wet nurse from\\na syphilitic child, by a healthy child from a syphilitic nurse, or\\nfrom a healthy nurse who at the same time is also nursing a\\nsyphilitic child, or by any person, through any agency, such as\\nan infected towel, brush, razor, pipe, knife, fork, bath tub, or\\nprivy seat, whereby virus from a syphilitic ulcer may be conveyed\\nto a scratch or abraded spot upon his skin. The blood of a pa-\\ntient suffering from constitutional syphilis will also impart the\\ncontagion.\\nIt may thus be seen that there are many ways of obtaining\\nthis disease, but the great majority of cases are acquired through\\nimpure sexual congress, so great, indeed, that but for this method\\nof dissemination, syphilis, in a few generations, could be banished\\nfrom the earth.\\nIn cases acquired through kissing, the initial lesion will be\\nfound on one of the lips, and will be readily transformed into\\na mucous patch, which may continue through the entire secondary\\nperiod of the disease, with tendencies to relapse. The changes\\nwhich occur in the mucous patches are of the same general nature\\nas those in the papules upon the skin, but the chronological or-\\nder in which these patches appear is by no means as regular as\\nin the skin manifestations.\\nThe Tertiary Stage. From the best information on the sub-\\nject, a large per cent of syphilitic cases terminate with the second-\\nary symptoms, the disease having been overcome by the vital\\nforces of the body. About seven per cent of all cases, however,\\npass into the tertiary stage. When this stage is reached the dis-\\nease has so lost its constitutional characteristics, that its manifesta-\\ntions are localized. This statement is difficult to harmonize with\\nthe accepted theories of the primary and secondary stages. The\\nimportant factor in the first stage is probably a germ. The mani-\\nfestations of the tertiary stage cannot be reconciled with the\\npresence of a germ, as in the first two stages. The impress of\\nthe disease has been more intense in some parts of the body than\\nin others, and we have proliferation of connective tissue cells,\\nwhich, losing their vitality while maturing, break down into the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0719.jp2"}, "718": {"fulltext": "692 VENEREAL DISEASES.\\ngummatous ulcer, or gumma, so-called because its contents re-\\nsemble gum. When these formations are situated upon the skin,\\nand often when upon a mucous membrane, they form large indolent\\nulcers with sharp cut-out edges surrounded by swollen, hardened,\\ninflamed tissue, affording little pain and varying greatly in size\\nand appearance, according to the peculiar bodily conditions of the\\npatient. Such a gumma is shown in Fig. 3, plate IX. They may\\nappear upon any part of the surface, but their favorite sites are\\nthe face, arms, the upper front portions of the legs, the breast,\\nscrotum, penis, and the external genital organs of women. They\\nmay be single or multiple. When two or more are near together\\nthey are likely to unite, forming one large irregular-shaped sore.\\nAny mucous membrane may likewise become the site of a gum-\\nmatous ulcer, but the throat, vagina, urethra, inner surface of the\\nprepuce, the labia and the anus are, perhaps, most often thus af-\\nfected; they are also quite frequently found in the nose and the\\nrectum in fact, any part of the alimentary canal may be visited in\\nthis manner.\\nThe muscular gummata are those formed deep in the tis-\\nsues, and instead of becoming soft in the center and ulcerating,\\nremain hard, increasing in size until they sometimes become\\nlarger than a full grown lemon.\\nThey are liable to form in the liver, mesentery, spleen, lungs,\\nheart, arteries, spinal cord, brain in short, no organ of the body\\nis exempt from them. Ulceration of the bones is also a mani-\\nfestation of tertiary syphilis.\\nThe diagnosis of syphilis in the primary and secondary forms\\nis not usually difficult, but this is not true of the tertiary stage,\\nunless there are scars from the primary or secondary lesions. It\\nmay rarely happen that a patient has had the first stages of\\nsyphilis without knowing it, and in such an instance it is very diffi-\\ncult to get a history of the case that is satisfactory. Many ob-\\nscure infectious symptoms, which also belong to the non-syphilitic,\\nmay be found in those who have had syphilis, and the difficulty\\nnow comes up, whether to attribute these vague symptoms to a\\nsyphilitic taint or to some other cause. The prospects for re-\\ncovery in syphilis are very good in the majority of cases, but not\\nso in those showing the brain and nervous manifestations. There\\nare very few deaths, in the acquired cases, arising -from the cir-\\ncumscribed gummatous form seen in the later stage of the dis-\\nease.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0720.jp2"}, "719": {"fulltext": "VENEREAL DISEASES. 693\\nTreatment. First local. At the first appearance of the\\nchancre the diagnosis is quite uncertain until after the drying or\\nhardening takes place. Simultaneous with this hardening the\\nlymphatic glands in the groin or axilla become inflamed and en-\\nlarged. This occurs about the beginning of the second week. A\\nsolution composed of one part of the bichloride of mercury to one\\nthousand parts of water may be injected hypodermically under the\\nchancre, or the chancre may be treated by electrolysis, if thought\\nto be a local disease, but in other cases treatment by mercury\\nshould not begin until the appearance of the second stage of the\\ndisease. It should be remembered that mercury is not eliminated\\nfrom the system in less than six months from its inception, and\\nthe poisonous effects of this remedy should be thoroughly under-\\nstood. These effects are first seen by alterations in the character\\nof the saliva, which becomes increased and stringy. When the\\nsystem becomes saturated with mercury, there is a metallic taste\\nin the mouth and a strong, offensive breath.\\nSlow mercurial poisoning gives rise to nervous troubles,\\ntrembling in the muscles, sclerotic plaques in the brain and spinal\\ncord, convulsive phenomena, epileptic attacks, choreic and apoplec-\\ntic symptoms, paralysis and disturbances of sensibility results\\nmore serious than syphilis itself. If with a one to one thousand\\nsolution of bichloride of mercury, we mix an equal quantity of\\nsyphilitic virus, the virus is rendered harmless. Many eminent au-\\nthorities agree that mercury cures syphilis, but, by common con-\\nsent of the profession, the large doses, as formerly given, have\\nbeen discarded and succeeded by small and more frequent ones.\\nPerhaps the best form of mercury for syphilis is mercury with\\nchalk (hydrargyrum cum creta). Where there is debility, com-\\nbine with this a little quinine, giving a grain of each three times a\\nday, and, if it produces griping or intestinal disturbances of any\\nkind, add a grain of opium to each dose. If mercury in any form\\nproduces griping or diarrhea, it may be combined with opium.\\nNever take mercury continuously. If the dose of syphilitic poison\\nhas been heavy and the constitutional symptoms are plain, con-\\ntinue the treatment twenty days, then stop ten. If the constitu-\\ntional symptoms are slight, continue the treatment ten days, then\\nleave off twenty. Never forget the serious danger of taking into\\nthe system too much of this powerful drug. I would rather have\\nsyphilis and trust to the resources of the system to eliminate and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0721.jp2"}, "720": {"fulltext": "694 VENEREAL DISEASES.\\ncure the disease, than be treated for syphilis by an inexperienced\\nphysician who does not see his way clearly in reference to its\\nelimination, the character of his remedies, and their subsequent\\neffects.\\nGreat patience, as well as careful treatment, is required; and\\nit is in this that many patients make very costly mistakes. Be-\\ncause the eruption has disappeared and the general health is not\\nimpaired, they conclude that they are rid of the poison and quit\\nthe remedies. Experience has shown that the mercury, as above\\nindicated, should be taken for two years; then during the first\\nsix months after the two years, what is called the mixed treat-\\nment should be taken, according to the following formula\\nBichloride of mercury two grains\\nIodide of potassium four drams\\nTincture of gentian compound four ounces\\nDose for an adult, a teaspoonful three times a day.\\nAfter six months of this treatment the iodide of potassium\\nshould be taken alone. There is quite a difference of opinion in\\nthe profession as to the amount of the iodide that should be given\\nfrom day to day. I do not think it should exceed three drams\\nper day three doses of one dram each.\\nIn the tertiary stage, if there be any uncertainty as to the\\nsymptoms being caused by the syphilitic virus, the tolerance of\\nthe iodide is considered evidence of the continuance of the dis-\\nease, for were it not for the presence of the virus the system\\nwould revolt and the indications of iodide poisoning would ap-\\npear. It is not quite settled as to how the iodide acts in removing\\nthe disease, but it is probable that the mercury destroys the germ\\nor virus during the active stages, and that the iodide causes the\\nelimination both of the mercury and the virus debris.\\nThe best method of taking the iodide is to combine an ounce\\nof iodide with an ounce of water, and commence with a small\\ndose, from five to ten drops, and increase it one drop each time\\nuntil a dram three times a day is reached. The circumscribed\\ngumma usually melts away under this treatment.\\nThe diffuse form, as found in the brain and spinal cord, does\\nnot yield to the iodides, and the question to decide is whether the\\npatient is suffering from local effects of the syphilis, or from the\\nmercury that has been absorbed. It may be with the mercury in-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0722.jp2"}, "721": {"fulltext": "VEXEREAL DISEASES. 695\\nstead of the syphilis that we have now to contend, in which case\\nthere is still hope. I have in these cases used one-sixtieth of a\\ngrain of strychnia and three or four drops of dilute phosphoric\\nacid after meals. This quickens the action of the ceils in the\\nbrain and spinal cord, producing a more healthy action, invigorat-\\ning them, and serving all purposes better than the iodides.\\nThe best authorities agree that only the brain and nervous\\nforms of syphilis are incurable. I believe it to be a disease of\\nself-limitation and that a large percentage of the cases will re-\\ncover without any treatment, but, as no one can foretell which\\ncases will terminate so happily, it would not be good practice\\nto rely upon this. Had I syphilitic iritis, I would be slow to let\\nanyone operate upon my eye. Such an operation is attended by\\nsuch great danger that it is safer to trust to nature s forces to\\nthrow off the disease.\\nThe old method of excision of the chancre has been discarded,\\nfor the virus was too often found to have already spread beyond\\nthe points that could be reached by the knife. Let no man give\\nyou mercury in the tertiary stage. Remember that the chancre\\nbelongs to the primary, the papule to the secondary, and the\\ngumma to the tertiary stage.\\nIn Spain they do not use mercury. The climate alone seems\\nto cure the disease, and during the seventeenth century, when\\nmercury failed, the patient was sent to that country. In the\\nUnited States, the various hot springs are the resort of all seriously\\nsyphilized patients. Hot water baths, ranging in temperature\\nfrom 98 degrees to 104 degrees Fahrenheit, by stimulating per-\\nspiration and the other excretions, greatly aid, especially in the\\nelimination of mercury, from those who have been heavily dosed\\nwith the drug, but excellent authorities have found hot air baths,\\nfrom 175 degrees to 200 degrees, and lasting from fifteen to\\ntwenty minutes, more valuable than hot water. They can be\\ntaken very easily in nearly the same way as described in this work\\nunder the head of vapor baths, but it must not be forgotten that\\nbaths alone will not cure syphilis. No matter how great the\\nbenefit thus derived, or how well the patient may feel for a little\\nwhile following, the medication must be continued the full time\\nto completely eradicate the poison from the system. The ad-\\nministration of mercurial vapor baths was never satisfactory, and\\nis no longer considered good practice.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0723.jp2"}, "722": {"fulltext": "696 VENEREAL DISEASES.\\nProbably no other class of unfortunates are so often imposed\\nupon, so financially bled, as those suffering from venereal dis-\\neases. Stung by remorse, fearing exposure, and alarmed by\\nvague terrors, they become the easy victims of extortionate quacks\\nand advertising charlatans. Next in importance to knowing that\\nthe only sure way of escaping the greatest danger of becoming\\ninfected is in living an absolutely pure life, is the knowledge that\\nyour own faithful and reliable family physician is the one to re-\\nceive your fullest confidence as soon as you learn that anything\\nis wrong. In the hands of no one else will you be as safe, for he\\nwill neither betray nor rob you, will be accessible at all times for\\ncounsel and guidance through the years of treatment which must\\nfollow, and is likely to be far more competent and skillful than\\nthe traveling mountebank who is unable to succeed by building\\nup a practice where he is known.\\nGONORRHEA.\\n(Clap.)\\nGonorrhea is a specific disease, contagious, and communicated\\nthrough impure contact between the sexes. It is considered a\\nlocal disease, caused by the germ gonococcus, which, in the male,\\ninsinuates itself within the mucous membrane of the urethra, where\\nit causes an inflammation, either mechanically from its presence,\\nor by a ptomain. In the earlier stages of the infection, the dis-\\nease is confined to the outer openings of the genital tract, but\\noften the deeper portions are soon invaded, especially in the\\nchronic forms of the disease.\\nIn the male the membranous and prostatic portions of the\\nurethra, and frequently the testicles, are involved by absorption.\\nThere is likely to be swelling, redness and soreness, and some-\\ntimes pain in the penis. The germ is also frequently found in\\nthe bladder and the pelvis of the kidney. The virus may be ab-\\nsorbed and taken up by the serous membranes of the joints, as is\\nfrequently seen in gonorrheal rheumatism in the ankles, knees,\\netc. It is also found in the heart.\\nIn the female the gonococcus is not confined to the urethra,\\nbeing often found in the mucous membrane of the vagina, but the\\ninflammation is not likely to cause her nearly as much trouble and\\nanxiety as occurs in male patients. The uterus is involved, and\\nespecially the Fallopian tubes, where it is known as pyosalpinx.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0724.jp2"}, "723": {"fulltext": "VENEREAL DISEASES. 697\\nWhen these tubes become affected there may be a discharge of\\npus for many years.\\nIn the urethra of the male the inflammation often results in\\ncontractions of the canal, which are known as strictures. These\\nare found about one and a half inches from the mouth of the\\nurethra, also in the membranous part of that organ. In the\\nchronic form the inflammation in the prostatic portion of the\\nurethra may be very slow and mild, continuing many years, with\\nmore or less pain during urination, finally in old age resulting\\nin obstruction of the urine and chronic inflammation of the bladder.\\nSymptoms. In from three to five days after the impure con-\\ntact the first symptom appears and is a distressing itching near\\nthe meatus of the urethra, with more or less burning during uri-\\nnation, which, in a short time, is followed by a peculiar yellowish,\\nmuco-purulent discharge, which, in the typical form of the dis-\\nease, continues three months, in some cases a year. There is\\nan abortive form, which may not be specific and is the result of\\nleucorrheal discharge, which mav continue only a few davs or a\\nweek, then disappear. One having gonorrhea, after handling the\\nparts, should always wash the hands with soap, or some disin-\\nfectant, to avoid infecting the eyes, for the germ or virus intro-\\nduced into the eye produces gonorrheal ophthalmia, an inflam-\\nmation which soon results in destruction of the tissues and total\\nblindness. The patient should be quarantined from the other\\nmembers of the family and his clothing should always be thor-\\noughly disinfected before being handled or sent to the wash.\\nTreatment. In the beginning the urethra should be injected\\nby a fountain syringe with a saturated solution of boric acid, every\\nmorning and evening for two or three weeks. If there be no im-\\nprovement, nitrate of silver may be used instead of the acid, from\\none to two grains to the ounce of water, injected in the same\\nway. Where inflammation in the urethra is very intense it is\\nsometimes better to use a solution of subnitrate of bismuth, one\\ndram to the ounce of distilled water. It coats the irritated parts\\nand has a very soothing effect. It should be used after urination.\\nSulphate of zinc and golden seal may be used when the inflam-\\nmation is not so great.\\nConstitutionally. During the first three or four weeks ben-\\nzoate of soda, five grains every four hours, should be given. It is an\\nantiseptic and keeps the bladder, kidneys and urethra antiseptic.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0725.jp2"}, "724": {"fulltext": "698 VENEREAL DISEASES.\\nFormerly balsam of copevia was used in teaspoonful doses three\\ntimes a day. It is a valuable remedy, but sometimes overstimu-\\nlates the kidneys and produces a rash upon the skin which alarms\\nthe patient. Strictures are best relieved by dilators. The diet\\nshould be light and unstimulating, and quiet rest in bed is im-\\nportant during the period of most active inflammation. The\\ntreatment for gonorrhea must often be continued faithfully for\\none or two years, and must be varied from time to time as the\\nsymptoms indicate. Sometimes the removal of testicles, or\\novaries and Fallopian tubes, is necessary to save life. Place no\\nconfidence in remedies advertised to knock it in three days.\\nThere are comparatively harmless forms of urethral inflammation\\nthat are easily overcome, but only thorough and persistent treat-\\nment long and intelligently administered cures gonorrhea.\\nMASTURBATION.\\n(Onanism. Self-abuse. Self-pollution.)\\nMasturbation (from manus, a hand; stupro, to commit adul-\\ntery.) The excitation of the genital organs by rubbing and titil-\\nlating them with the hand, or other instrument a horrid vice, pro-\\nductive of the most serious disturbances of the nervous system,\\nand derangement of health. Hoblyn s Med. Dictionary.\\nThe problem of self-abuse depends upon acuteness of sensibil-\\nity. We find the evil confined principally to youths whose sen-\\nsibilities are more or less blunted, so that, from dullness of per-\\nception, possibly from ignorance, they are unable to measure the\\nconsequences of the habit.\\nSexual desire at first is usually very strong and the passions\\nmore or less wild and undisciplined, but those of clear under-\\nstanding will control and correct them. It is only the stupid who,\\ninformed as to results, will let libidinous thoughts run unchecked\\nuntil the roused passions seek relief through self-abuse. The in-\\ntellectual boy or girl, knowing the relations of cause and effect, and\\nequipped with fair common sense, will hold these instincts and\\nthoughts in abeyance.\\nThis is easy at first, but sexual passion, like thirst for rum, if\\nleft uncurbed, becomes a pitiless master and drives its slave\\nthrough weakened organs, wasted vitality and loss of manhood to\\ndisease, despair and death.\\nCould every boy and girl for either needs the warning as\\nmuch as the other just advancing into puberty be fully informed", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0726.jp2"}, "725": {"fulltext": "VENEREAL DISEASES. 699\\nas to the loss of self-respect, self-control, ambition and noble pur-\\npose following in the train of self-abuse; also as to the transmis-\\nsion and character of venereal diseases, their loathsomeness and\\nthe disgrace, suffering and terror they entail, and be shown how\\nlarge a part of the insanity in the world is the fruit of improper\\nsexual indulgence, it is certain that fewer would be ruined.\\nThe guardian, more than the child, is to blame for vicious\\nhabits contracted through ignorance, but their curse to the victim\\nis no less damning. Masturbation, lewdness and adultery are in-\\ncreasing in this country. When will people awake to the gravity\\nof this matter? Parents who shrink from a confidential and full\\nexplanation to their children, at the proper time, of newly de-\\nveloping instincts and powers, their purpose, use and abuse, should\\nat least place in their hands good books upon the subject that they\\nmay acquire a correct understanding of these most important\\ntendencies and passions affecting character and health, rather than\\nleave them to pick up fragmentary knowledge and distorted facts\\nfrom impure companions at school and on the street.\\nMasturbation at first produces no change in the genital or-\\ngans. In healthy young men there is more or less plethora of\\nthe seminal vesicles, resulting in occasional emissions or night\\nlosses. This is the natural condition, but if the sexual impulse be\\nindulged too often it not only becomes a ruling passion, but patho-\\nlogical alterations result, the nervous system is exhausted and\\nthere is loss of equilibrium in the cells of the spinal center. When\\nthe nerves which are distributed to the seminal vesicles and the\\nprostate are exhausted there is more or less irritability in those\\nparts, rendering them liable to congestion and chronic inflamma-\\ntion. When these vesicles become supersensitive their normal\\ncontents, which are semen, cause irritability with ejaculation. This\\nsoon becomes involuntary and is known as spermatorrhea, which\\nis accompanied by a train of ills leading to chronic invalidism, some\\nof which are indigestion, constipation, dyspepsia, weak back,\\nweakened and irregular action of the heart, enfeebled vision, vari-\\ncocele and mental obtuseness.\\nTreatment. The mind must be kept free from unclean\\nthoughts. Associate only with those of pure character. En-\\nlarge the mental scope by schools and libraries, or by good litera-\\nture at home and by healthy occupation that will engross the\\nthoughts.\\nBathe the genitals with cold water on retiring at night, after", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0727.jp2"}, "726": {"fulltext": "700 VENEREAL DISEASES.\\nwhich keep the hands and all other excitants away from these or-\\ngans and permit the mind to dwell only upon pure and elevating\\nthemes. By this treatment and fully controlling the habit the pa-\\ntient is restored to perfect health.\\nSEMINAL LOSSES.\\nFrom a healthy, vigorous man, though at the time leading a\\ncontinent life, there may be emissions of semen during sleep.\\nGreat alarm is often experienced by a patient affected in this way,\\nand he is frequently made the victim of most shameful imposition\\nand fraud by so-called specialists, who, by taking advantage of his\\nignorance and fears, frighten him into such terror as to become an\\neasy prey to trickery worse than robbery itself. Although noc-\\nturnal emissions usually occur only in those who have sometime\\nbeen guilty of self-abuse or sexual excesses, or are in the habit of\\nindulging in impure reveries, or mental unchastity, if the losses oc-\\ncur but once in ten or fifteen days they are rather in the nature of\\nrelief of overdistended organs than cause for alarm. They are\\nmost frequent at the age of greatest sexual, activity and it is even\\nclaimed by some physicians that in well-fed persons who take lit-\\ntle exercise they may sometimes be conducive to health.\\nIt is, however, better to be free from them, for there is dan-\\nger in their liability to increase in frequency until they become a\\nhabit very difficult to overcome, and a serious drain upon the\\nsystem, but not until the losses occur so often as to cause feelings\\nof prostration the next day, headache and general dullness, both\\nphysical and mental, is there need for seeking medical advice. It\\nshould then be obtained from your family physician, who will\\ncharge you only a reasonable price and is likely to be far more\\ncompetent to prescribe for you than is the advertising quack,\\nwhose chief concern will be to frighten you into a course of treat-\\nment that will enable him to secure your purse.\\nOne who takes vigorous exercise, lives temperately in all\\nthings, and does not allow his mind to dwell upon sexual\\nthoughts, will be very rarely, if at all, troubled in this way. The\\nloss usually, but not always, occurs during lascivious dreams.\\nKeeping the thoughts pure while awake is the surest way of making\\nthe dreams pure. The character is the same while dreaming as\\nwhile thinking. It is not only a duty to repress sexual thoughts\\nand desires, but a privilege redounding greatly to the health and\\nadvantage of him who will be governed by this rule.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0728.jp2"}, "727": {"fulltext": "VENEREAL DISEASES. 701\\nThere is a tendency in all the functions of the body to estab-\\nlish habits and to act at regular intervals, and nocturnal emissions\\nfollow the general law. The oftener they occur the oftener they\\nare likely to occur, until they become an almost uncontrollable\\nhabit, destructive alike of body and mind. The secret lies in\\nbreaking the habit; the sooner the easier and better for the pa-\\ntient.\\nTreatment. In healthy men, losses occurring once a week\\ncan generally be overcome by avoiding hearty food, especially\\nhearty suppers, discarding tea, coffee and tobacco, and sleeping\\non a reasonably hard bed, with only a moderate amount of cover-\\ning. It is also a help to take but little drink in the evening, none\\nafter eight o clock, and to empty the bladder just before retiring\\nand as often through the night as the patient awakes.\\nHe should rise early, not allowing himself to doze off into\\na second sleep, for it is in this second sleep that the emissions are\\nmost likely to occur. Acton says An early call, or an alarm\\nclock, may cure many a patient better than all the medicines in the\\npharmacopeia. It is in early morning, while the bladder is full,\\nthat the loss takes place. The precaution of keeping the bladder\\nempty at night is very important, but we can hardly exaggerate\\nthe importance of the will and keeping the thoughts pure, for in-\\ncontinence of thought is a most powerful cause of irritation of\\nthe sexual organs. The mind must be kept clean to effect a\\ncure.\\nOne or two grains of monobromate of camphor, taken at bed-\\ntime, produces a soothing effect upon the vesicles, causing them to\\nretain their contents. From ten to fifteen grains of bromide of\\npotassium, taken every four hours through the day, the last dose\\nat bed-time, may be used instead of the camphor and is a good\\nremedy. Cold sponging of the whole body at bed-time often\\nserves a good purpose, but sometimes bathing the genitals in cold\\nwater does as well. The patient should have abundant exercise\\nin the open air, and his diet should consist of easily digestible food.\\nWhen it agrees with the patient, milk is excellent.\\nThis trouble may also arise from gravel or catarrh of the\\nbladder, in which case the remedy lies in the removal of the cause.\\nIt may result from too great length and narrowness of the fore-\\nskin, making it difficult or impossible to uncover, wash and cleanse\\nthe glans penis. In this case circumcision, or some other surgical\\noperation, is the remedy.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0729.jp2"}, "728": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0730.jp2"}, "729": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM.\\nBy~B. D. Eastman, M.D.\\nCHAPTER I.\\nINANIMATE MACHINERY.\\nA complicated, ingenious and successful piece of machinery\\nexcites everyone to admiration. Take the locomotive, for in-\\nstance Xote its capacity for movement forward or backward\\nfor going at a snail s pace or with the speed of the wind for moving\\nthe lightest car or for hauling a heavily loaded train. How won-\\nderful and various its capacities and powers. But after all the\\nskill, experience, time and money spent in perfecting and building\\na locomotive, it is, if left to itself, an inert, ineffective, useless\\ncontrivance. It requires the services of a competent fireman to\\nattend to its needs of water and fuel, a skilled engineer to direct,\\ncontrol and bring out its powers, and an experienced machinist s\\ndaily attention to keep it in repair. In short, the locomotive is\\npowerless and useless, unless served and controlled by an intelli-\\ngence which does not belong to itself and is wholly extraneous and\\nforeign to it.\\nTHE HUMAN MACHINE.\\nCompared with a locomotive, the human machine is far more\\ndelicate, complicated and wonderful. To be sure it cannot exert\\nthe force of an engine, but, in its range of capabilities, multitude\\nof movements, and wonderful adaptation to complicated sur-\\nroundings viewed simply as a machine it vastly exceeds the\\nlocomotive, as well as every other mechanical contrivance. But far\\nand away, above and beyond the purely mechanical complexity and\\nadaptability of the human machine, stands the wonderful, inherent,\\nvital principle, by which the various complicated functions and\\nprocesses of the body are controlled and carried on, and through\\nwhich the human machine is rendered self-controlling, self-direct-\\ning and self-repairing.\\n703", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0731.jp2"}, "730": {"fulltext": "704 DISEASES OF THE NERVOUS SYSTEM.\\nTHE NERVOUS SYSTEM.\\nThe different processes and functions of animal life are carried\\non and developed by various organs, to each of which is delegated\\ncertain duties. Thus, the countless movements of the body de-\\nvolve upon the muscular system; the preparation of food, to fit it\\nto minister to original growth and to repair the waste caused by\\nvital action, is the duty of the stomach and other digestive organs\\nrespiration is carried on by the lungs, circulation by the heart, and\\nso on; but the highest, most complex and most important duty,\\nnamely, the regulating, controlling and directing of all the organs\\nand functions, is confided to the Nervous System.\\nIt is the nervous system which marks the distinction between\\nthe vegetable and animal kingdoms. Vegetable life, in common\\nwith animal life, is possessed of nutrition, circulation, growth\\nand reproduction but only animal life is endowed with a nervous\\nsystem, controlling the various functions of the body and placing\\nit in conscious communication with the outer world. The lower\\nanimals possess nervous systems, which, in some special directions,\\nmay exceed in acuteness the corresponding functions of the human\\norganism, but they fall short of the latter in the completeness, per-\\nfection and development of their powers as a whole.\\nGRAY MATTER AND WHITE MATTER.\\nThe nervous system, using the term in its widest sense, is\\ncomposed of two varieties of nerve matter, called the gray matter\\nand the white matter, each of which has its own functions and a\\nstructure peculiar to itself.\\nThe Gray Matter is distinctively cellular in structure that\\nis, it is made up of very minute microscopic bodies called cells,\\nwhich, in the main, are of an irregular, rounded form, with two,\\nthree, or more, long, slender projections, or processes, as they are\\ncalled, by which they are connected with each other and with the\\nnerve fibers. This gray matter, wherever found, has a tendency\\nto gather itself into irregular somewhat globular form, and its\\nfunctions are to receive impressions, act upon them and direct the\\nactivities.\\nThe White Matter, although developed from cells, appears to\\nbe made up of long slender fibers, and its office is to carry im-\\npressions to and convey orders from the gray matter. These deli-\\ncate fibers penetrate the gray matter and interlace with the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0732.jp2"}, "731": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 705\\nprocesses of the cells, thereby forming nervous connection with\\nthem.\\nThe nervous system, thus constituted, is divided into several\\ndifferent parts; namely, the brain, which is contained within the\\nskull the spinal cord, situated in the spinal canal the long, bony\\ntube formed in the back bone or spinal column the bundles of\\nnerve fibers which radiate from the brain and cord; the specially\\ndeveloped ends of these nerves, called end organs; and certain\\nconnected nerves and nerve gatherings, called the sympathetic\\nsystem and ganglions.\\nIt is by means of these end organs, especially adapted to\\ndiffering requirements, that we have the sense of touch and other\\nspecial senses, that the stomach appreciates the presence of food\\nand performs the function of digestion, and that the wants and\\nneeds of the body generally are made known to the central con-\\ntrolling power. Furthermore, that which places man far above all\\nthe brute creation, gives him his standing at the head of all\\nearthly creations, and enables him to command so widely and\\nsuccessfully the resources of the mineral, vegetable and animal\\nkingdoms, is his brain function, mind power, mentality. Mental-\\nity is the highest and most complex of nervous phenomena, and is\\na function of the brain, that part of the nervous system con-\\ntained within the skull.\\nIn the further consideration of this subject it will be conducive\\nto convenience and clearness to consider\\nFirst. The general anatomy of the whole nervous system,\\nand its general functions.\\nSecond. The functions and diseases of the nerves and nerv-\\nous system (as distinguished from the brain).\\nThird. The functions and diseases of the brain itself, as con-\\nnected with mere nervous action and, more especially, with mental\\naction.\\nIt will not be practicable to entirely separate these three divi-\\nsions. They will unavoidably run into each other to some extent,\\nbut the classification is natural and desirable.\\nCEREBRO-SPINAL AXIS, CRANIAL AND SPINAL NERVES.\\nThe central portion of the nervous system, consisting of the\\nbrain and spinal cord, is called the cerebro-spinal axis. At certain\\npoints along this axis bundles of nerve fibers emerge. Those\\n45", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0733.jp2"}, "732": {"fulltext": "706 DISEASES OF THE NERVOUS SYSTEM.\\nwhich appear to emerge from the brain are called cranial nerves;\\nthose from the spinal cord, spinal nerves. In general these nerves\\nare bundles composed of two kinds of fibers, some nerves being\\nof one kind, some of the other, while some are made up of both\\nkinds. These two kinds of fibers have different functions. The\\none, which we may call the incoming nerve, is charged with con-\\nveying messages (sensations or impulses) from without inward.\\nThrough these nerves the central nervous organization receives\\nimpressions from without of pain, touch, heat, cold, location, pres-\\nsure, weight, space, sight, hearing, smell and taste. Some only\\nawaken latent energy in the spinal centers, and are called excito-\\nreflex nerves, a term which will be explained hereafter.\\nThe other nerve fibers are charged with carrying messages\\nfrom within outward, and are called outgoing nerves. The nerves\\nwhich carry impulses to the muscles are called motor nerves; those\\n.which affect the blood vessels, vaso-motor; those which control\\nthe action of the glands, secretory nerves and those which regu-\\nlate nutrition, trophic nerves. It is through the two kinds of\\nnerves, called in general sensory and motor nerves, that man is\\nput in appreciative connection and association with his surround-\\nings.\\nNERVE TERMINALS.\\nThe main nerve trunks divide and subdivide until they reach\\nall the elements of the parts which they supply, and their terminal\\nfilaments are fitted for the work they have to do by development\\ninto end organs. For instance, the nerves of touch terminate\\nin small, rounded bodies, very sensitive to the character of surface\\nwith which the skin comes in contact the nerves of taste are spread\\nout on the inside of little sacks opening upon the surface of the\\ntongue, into which the articles tested find their way. So, too,\\nthe motor nerves have their peculiar endings, those going to the\\nvoluntary muscles terminating in the minute muscular fibers by\\nthin, flat enlargements, called end plates. The nerves which go\\nto the glands terminate more abruptly; while those to the blood\\nvessels, and other involuntary muscular fibers, terminate in minute\\ninterlacing fibers. The main nerve trunks with their ramifications,\\nreaching all the elements of the parts which they supply, are known\\nas the peripheral (outside) nerves.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0734.jp2"}, "733": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 707\\nSUBDIVISIONS OF THE BRAIN.\\nThe important subdivisions of the brain, as far as they need\\nbe mentioned here, are the cerebrum, meaning great brain; the\\ncerebellum, small or hinder brain the pons, or bridge and the\\noblongata, or oblong body.\\nThe Cerebrum constitutes nearly seven-eighths of the whole\\nbrain, and occupies the entire upper part of the brain cavity. From\\nthe top downward, for about two-thirds of its depth, it is divided\\nby a fissure into two parts, which are reversed duplicates of each\\nother, called the right and left brain, or right and left hemispheres.\\nThese two halves are separated by a crescent-shaped membranous\\npartition, called the falx, which is attached to the skull above and\\nserves to separate the two halves, as well as to protect and to hold\\nthem in proper place. At the bottom of this fissure the two sides\\nof the cerebrum are connected together by a band of nerve fibers\\nwhich serve to connect similar parts of the right and left hemisphere,\\nand the front and back portions of each hemisphere. Below this\\nconnecting band, which from its color is called the corpus callosum\\n(white body), fibers from the two hemispheres pass into and\\nthrough two small divisions, the pons and oblongata, which will be\\ndescribed later.\\nThe Cerebellum, situated behind and below the cerebrum, is\\nalso divided, but less completely, into a right and left lobe, and is\\njoined by bands of connecting fibers to the cerebrum, pons and\\noblongata.\\nThe Poiis and the Oblongata are situated at the base of the\\nbrain between the cerebrum above, the spinal cord below, and\\nthe cerebellum behind. The pons (bridge) is a small body, about\\none and a quarter inches from right to left and three-quarters of\\nan inch from front to back, and is so called because it appears to\\nspring across from side to side, like an arch, over the beginning\\nof the oblongata. These two subdivisions serve the very im-\\nportant function of joining the cerebrum, cerebellum and spinal\\ncord, one with another, by bundles of fibers through which motor,\\nsensory, vaso-motor and trophic impulses are sent from the brain\\nto the body and from the body to the brain.\\nThis gathering and distributing function of the pons may be\\nillustrated by the working of a telephone exchange. Subscrib-\\ners from different portions of the city desire to be put in com-\\nmunication with other subscribers; the central office is notified", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0735.jp2"}, "734": {"fulltext": "708 DISEASES OF THE NERVOUS SYSTEM.\\nand suitable connection made at the switchboard, to which all\\nthe wires converge. The pons, which as part of its function con-\\nnects the different parts, has been called the switchboard of the\\nbrain.\\nThe passage of all these connecting fibers through the small\\npons and oblongata renders them very important parts of the\\nbrain structure, and it follows that diseases or injuries (lesions) in\\nthese organs, by interfering with the transmission of the various\\nimpulses, cause symptoms of wide extent and very serious nature.\\nMoreover, these parts of the brain are not simply organs of\\ntransmission. They contain centers of very great importance,\\nwhich preside over deglutition, respiration, heart action, and other\\nimportant vital functions, as we shall notice more fully further\\non.\\nDECUSSATION OF NERVES\\nA remarkable peculiarity in the general arrangement of\\nnerve fibers, between the brain and the body, is that the left side\\nof the brain is connected to the right side of the body and the\\nright side of the brain is connected with the left side of the body.\\nThis is brought about by a decussation (crossing over) of the lines\\nof communication from each side of the brain to the other side of\\nthe spinal cord. About ten per cent of the nerve fibers form an\\nexception to this rule and pass to the same side of the brain and\\ncord.\\nIt follows from this general arrangement that injury or dis-\\nease of the left side of the brain produces paralysis, or other\\nnervous disturbance, on the right side of the body, and injury\\nor disease in the right side of the brain produces paralysis, etc.,\\nin the left side of the body.\\nThe facts and clinical observations upon which this principle\\nis founded need not be introduced here. Suffice it to say the\\ndemonstration is complete and in cases of cerebral hemorrhage\\nor brain tumor producing paralysis of one side, the surgeon un-\\nhesitatingly operates on the side of the brain opposite the paraly-\\nsis. The motor fibers and the sensory fibers cross over in dif-\\nferent ways and at different places.\\nMOTOR NERVES.\\nThe motor fibers, which carry impulses from the cerebrum to\\nall parts of the body, cross over, that is about ninety per cent of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0736.jp2"}, "735": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 709\\nthem do, from left to right and from right to left, in passing\\nthrough the pons and the oblongata. The crossing of nerves going\\nto different parts occurs at different places or at different levels, as\\nit is termed. The peculiar routes which the different nerve\\ntracts take in passing through and crossing over in these organs\\nare important and have a special interest to the neurologist, as\\nthey enable him to determine the particular location of diseases\\nof this region. For instance, the motor fibers from each side\\nof the brain which move the muscles of the face, the arm, and the\\nleg, in passing through these tracts, cross over in the order named\\nThe fibers for the lace first, for the arm lower down, and for the\\nleg lowest. Hence a lesion in the upper part of the pons affects\\nall these fibers and causes paralysis of the whole opposite side\\na lesion in the middle or lower third of the pons causes paralysis\\nof the face on the side of the lesion, and of the arm and leg on the\\nopposite side.\\nSENSORY NERVES.\\nAs to the sensory fibers, which carry impressions from with-\\nout inward from the general body to the brain they cross over\\nfrom left to right and from right to left, not in any one small part\\nof the cerebro-spinal axis, but along the whole length of the\\nspinal cord, hence a lesion extending completely across the cord\\ngives rise to loss of sensation and of voluntary motion to all parts\\nof the body which are supplied with nerves from that portion of\\nthe cord below the disease, or injury. If the lesion is limited to\\none lateral half of the cord the sensations of touch, pain, tem-\\nperature and tickling are lost on the side of the body opposite\\nthe disease, while the muscular sense and voluntary motion are\\nlost on the same side as the disease.\\nSURFACE OF THE BRAIN.\\nThe surface of the brain is divided by fissures into several\\nlobes and is made up of many foldings, called convolutions, which\\nif they could be spread out would cover an area twice or thrice\\nas large as the apparent surface. This whole outer surface of the\\nbrain, following all its convolutions, is called the cortex or, on\\naccount of its color, the gray matter. The essential element of the\\ngray matter is a mass of microscopic bodies called nerve cells.\\nThese cells, making up the cortex, are the active elements in", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0737.jp2"}, "736": {"fulltext": "710 DISEASES OF THE NERVOUS SYSTEM.\\nreceiving and recording impressions, in directing voluntary move-\\nments, and in general mental activity. These nerve cells are pecu-\\nliar in having two, three or more prolongations, several times\\nlonger than the diameter of the cells themselves. It is through\\nthe interlacing of these processes, as they are technically called,\\nthat sensorial and mental operations are supposed to be carried\\non. Indeed, the essential element of all nerve structure is the\\nnerve cell in its modifications. In the gray matter the cells re-\\ntain the form of a central body with prolongations, or processes,\\nhence the gray matter is sometimes called cellular.\\nIn the white matter the cells take on such an elongated, min-\\nute, cord-like structure, that it is called nerve fiber. Thus we\\nspeak of the gray or cellular structure, and of the white or fibrilla\\nstructure, but the nerve cell is the essential element in both.\\nUnder this cellular layer of gray matter, which is about one-\\neighth of an inch in thickness, is found the white brain matter,\\nmade up principally of nerve fibers, which connect the various\\nparts of the brain together, and also connect the brain with the\\nspinal cord and, through the cranial nerves and spinal nerves, with\\nall the organs of the body. These white fibers are the medium\\nfor conducting nerve impulses to and fro. In passing through\\nthe oblongata and in the cord they are gathered into certain\\nbundles or columns the motor columns and the sensory columns.\\nAt the base of the brain there are also several masses of gray\\nmatter, and an L-shaped mass of gray matter runs through each\\nside of the spinal cord, the joining together of the two by their\\nshort sides giving an H-shape to the whole mass; and gray mat-\\nter is found in small masses, called ganglii in connection with\\nnerves of sensation. The office of the white matter or nerve fibers\\nis to convey impulses; that of the gray matter to receive the im-\\npulses and interpret or act upon them.\\nNERVE TRUNKS.\\nThe central nervous system is connected to the various or-\\ngans and parts of the body by cords of nerve fibers, technically\\ncalled nerves. Part of these principal nerve trunks are in direct\\nconnection with the brain and are called cranial nerves; and part\\nare in direct connection with the spinal cord and are known as\\nspinal nerves.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0738.jp2"}, "737": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM.\\n711\\nCRANIAL NERVES.\\nThere are twelve pairs of cranial nerves which have their\\norigin, or brain beginning, in different portions of the inner com-\\nplicated structure of the cerebrum, the pons, the oblongata and\\nthe upper portion of the spinal cord. Some of these nerves are\\nexclusively sensory, that is, they convey sensations inward some\\nare exclusively motor that is, they convey orders for muscular\\nmovements outward; and some are mixed that is, a part of\\nthe fibers convey messages inward, and a part convey messages\\noutward. No fiber ever conveys messages in both directions.\\nThe pairs of cranial nerves, beginning in front and counting\\nbackward in the order in which they appear on the under surface\\nof the brain, upon either side of and near to the middle line, are\\nnumbered from one to twelve inclusive, and are also named accord-\\ning to their function or according to their distribution that is, ac-\\ncording to the parts to which they go. As the special functions of\\nthese nerves are of prime importance in considering their diseases,\\nthe following table is introduced, giving their number, name, dis-\\ntribution and function.\\nTABLE OF CRANIAL NERVES.\\nNUMBER AND NAME.\\nI. Olfactory\\nII. Optic.\\nIII. Motor Oculi Com-\\nmunis. (General\\neye mover).\\nIV. Patheticus.\\nV. Trifacial (having\\nsensory and motor\\ndivisions).\\nVI. Abducens (to pull\\noutward).\\nVII. Facial.\\nVIII. Auditory.\\nIX. Glosso-pharyngeal.\\nX. Pneumogastric.\\nXI. Spinal accessory.\\nXII. Hypoglossal.\\nGENERAL DISTRIBUTION.\\nGeneral membrane of the nose.\\nRetina of the eye.\\nMuscles of the eye, except two that\\nturn it downward and outward.\\nOne muscle which rotates the eye\\ndownward and outward.\\nSensory: Face, forehead, eye, nose,\\near, mouth, tongue and teeth.\\nMotor: Muscles of mastication.\\nTo outer muscle of the eye.\\nMuscles of the ear, face, palate, etc.\\nInner apparatus of the ear.\\nTongue, pharynx (throat), ear, etc.\\nLung, heart, diaphragm, stomach\\nand adjoining parts.\\nMuscles of the neck, pharynx and\\nlarynx.\\nMuscles of the tongue, etc.\\nFUNCTION.\\nSense of smell.\\nSense of light.\\nMotor.\\nMotor.\\nMixed; mainly\\nsensory.\\nMotor.\\nMotor.\\nSense of hearing.\\nMixed; mainly\\nsensory.\\nMixed; mainly\\nsensory.\\nMixed; mainly\\nmotor\\nMotor.\\nSPINAL NERVES.\\nThe spinal nerves are those which emanate wholly from the\\nspinal cord.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0739.jp2"}, "738": {"fulltext": "712 DISEASES OF THE NERVOUS SYSTEM.\\nThey are practically uniform and regular in their structure\\nand arrangement, and occur in pairs, coming out from the cord on\\neither side through passages between the bones which form the\\nspinal column. Each nerve is made up of two parts; roots, as\\nthey are called. The root which is furthest back, called the\\nposterior root, comes from the sensory columns of the cord and\\nhas sensory functions only. The one at the front, called the an-\\nterior root, comes from the motor columns, and has motor func-\\ntions only. They unite before passing out through the inter-\\nvertebral opening, and the spinal nerves are therefore mixed,\\nhaving both sensory and motor functions.\\nThe spinal nerves, not counting rudimentary ones, number\\nthirty-one pairs. They are classified and numbered according\\nto the divisions of the bony spinal column (vertebra) as follows\\nCervical nerves, eight (neck).\\nDorsal nerves, twelve (upper back).\\nLumbar nerves, five (small of back).\\nSacral nerves, five (between the hip bones).\\nCoccygeal nerves, one (extreme end of the spine).\\nThe spinal nerves are distributed to the muscles and integu-\\nment (skin) upon a definite plan, all the details of which it is im-\\nportant for the physician to understand, because it is by knowing\\njust what nerve goes to each part, that disease affecting the cord\\nis located. For all present purposes a very general and brief\\nconsideration of their distribution will suffice. Some of these\\nnerves send out their branches with but little intercommunication,\\nbut others, by a kind of interlacing and crossing, form a network\\nof nerve trunks, called a plexus, and from this plexus branches\\nare distributed to different parts. The four upper cervical nerves\\nform the cervical plexus, from which branches are distributed to\\nthe muscles and the skin of the back of the head, neck, shoulders,\\netc. Branches from this plexus also unite to form the phrenic\\nnerve, which is the principal motor nerve of the diaphragm. The\\ngreat clinical importance of this nerve rests upon the fact that the\\ndiaphragm, which is the principal muscle of respiration, is im-\\nmediately paralyzed by injury to the phrenic nerve, causing im-\\nmediate and very dangerous interference with the breathing.\\nThe fifth, sixth, seventh and eighth cervical nerves and the\\nfirst dorsal nerve, by an interlacing, form the brachial (arm)", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0740.jp2"}, "739": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 713\\nplexus, situated under the arm, from which branches go to the\\nneck, shoulders, chest and the arm, forearm and hand. These\\ntwo are connected and are sometimes called the cervico-brachial\\nplexus. The remainder of the dorsal nerves, except the twelfth,\\nsend out branches to the muscles and skin of the trunk without\\nuniting to such an extent as to form a plexus, but it should be\\nstated that, in common with all the spinal nerves, each one con-\\nnects to some extent with the nerves above and below. The\\nlumbar, sacral and coccygeal nerves unite to form the great lumbo-\\nsacral plexus, which distributes branches to the lower portion of\\nthe body and to the legs.\\nCENTERS OF NERVOUS ACTION.\\nTo a person unfamiliar with the details of operation, a large\\nmodern union railway station is a most bewildering and confus-\\ning place. Trains constantly come and go, cross from one track\\nto another and take different sidings, with no apparent system\\nor control. The novice, observing the seeming confusion, is sur-\\nprised at the freedom from accidents and wrecks. Upon investiga-\\ntion he finds, at some convenient central point, the switch tower,\\nfrom which all these movements are directed, and learns that it is\\nequipped with groups of keys or levers, each of which is in con-\\nnection, by electricity or compressed air, with a switch or signal,\\nso that when its key is operated the switch is thrown or signal\\nshown as required. This tower, with its lines of communication\\nradiating in every direction, is the central agency through which\\nthe whole complex system is made obedient, and each of its keys\\nmay be called the center of control for that part of the system to\\nwhich it is connected. Furthermore, it is easily understood that\\nthe mechanism may be so arranged that certain movements or\\ncombinations cannot be made unless preceded by certain other\\nmovements; and that injury to the central mechanism, or to the\\nconnecting device controlling any portion, prevents communica-\\ntion to that part and renders it inoperative. This crude illustra-\\ntion may serve to aid in understanding the centers of the brain\\nand spinal cord.\\nThe word center is very frequently used in connection with\\nhealthful action of the brain, cord and nerves, and in diseased\\nconditions as well. As commonly used, a center is a collection of\\ngray and white matter, of nerve cells and nerve fibers, of varying", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0741.jp2"}, "740": {"fulltext": "714 DISEASES OF THE NERVOUS SYSTEM.\\nsize and complexity, having control of some physiological action.\\nIf one of these centers is destroyed the phenomena which it con-\\ntrols ceases; if the center is irritated by mechanical, chemical or\\nelectrical action, the phenomena appear. These centers exist all\\nalong the cerebro-spinal axis and appertain to all the functions of\\nthe whole nervous system. They are termed lower or higher,\\naccordingly as the phenomena which they control are compara-\\ntively simple or complex.\\nAs to location, they are designated as brain centers and spinal\\ncenters; as to methods of action, they are volitional when they\\ncan be set in motion by the will; automatic when they act in-\\ndependently of the will and reflex when they act in a peculiar\\nautomatic manner. They are also called sensory, motor, vaso-\\nmotor and trophic, according to their special action, and certain\\nones, whose integrity is essential to life, are called vital.\\nBRAIN CENTERS.\\nThe brain centers of which we have the most practical\\nknowledge are situated on its surface and are. therefore called\\ncortical centers. It is but a few years since it was determined that\\ncertain parts of the brain cortex have direct control over the\\nmovements of definite groups of muscles. By carefully observing\\nand recording the symptoms in cases of impaired power of the\\nuse of certain groups of muscles, and by studying the evidences\\nof brain disease found after death, it was ascertained that a definite\\n^relation exists between the two. This discovery has been\\nstrengthened and extended by experiments performed upon the\\nlower animals, and by the results of surgical operations\\nupon the human brain. The outcome of all these studies confirms\\nthe theory that definite circumscribed areas of the brain cortex,\\nthe cortical centers, have special functions.\\nIn general the frontal portion of the cerebrum, comprising\\na little less than one-quarter, has control of the higher mental\\noperations; the next section, considerably more than one-quarter,\\nhas control of the voluntary muscles and is called the motor area\\nthe third section, less than one-quarter, is the general sensory\\nzone; and the hindermost part contains the centers for vision, etc.\\nThe motor area, second section, is the one most clearly un-\\nderstood, and regarding which our knowledge is the most prac-\\ntically useful. In this area the centers for movements of the arm,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0742.jp2"}, "741": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 715\\nleg, hand, foot, thumb, great toe and many other parts have been\\ndefinitely located and mapped.\\nCorresponding with the right and left divisions of the brain\\nand body, these cortical centers are found on both sides of the\\nbrain, actuating, of course, the muscles of the opposite side. For\\nparts that act separately, as, for instance, the legs, the right and\\nleft centers act independently, and a lesion of one of them affects\\nonly the muscles on the opposite side. It is doubtful if under any\\ncircumstancs the center for one leg ever controls the other. In\\ncases where the muscles of the two sides act in concert, as in\\nbreathing and talking, the centers are intimately connected and,\\nin case of injury to one, the other acts for both. In still other in-\\nstances, where the function is of a highly elaborated and complex\\ncharacter, such as speech, the center on the left side is especially\\ndeveloped, and takes precedence in control, the center on\\nthe right side being held in abeyance. If such centers on the left\\nside be injured, the one on the right can probably be educated\\nto act as a substitute.\\nSPINAL CENTERS.\\nThe spinal cord may be considered as made up of successive\\nsegments, one for each pair of spinal nerves. Each of these seg-\\nments may be considered as a special center, giving out nerves\\ngoing to certain zones or regions. A thorough knowledge of\\nsuch distribution is important to the neurologist, as it enables him\\nto determine the location of disease in the cord from the muscles\\nand parts involved.\\nAlong each side of the spinal column runs a chain of nerves\\nand ganglia, connected by filaments with the spinal nerves, and\\ncalled the sympathetic nerve, the two chains, with their rami-\\nfications, constituting the sympathetic nervous system. It has\\nchiefly to do with those functions which are carried on involun-\\ntarily, without any effort or will of the person, as the dilatation\\nor contraction of the blood vessels in blushing, the processes of\\ndigestion and nutrition, secretion by glands, etc.\\nREFLEX ACTION.\\nVery many functions of different organs, as well as move-\\nments of the muscular system, are more or less under the control\\nof the cerebro-spinal axis, through what is called reflex action.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0743.jp2"}, "742": {"fulltext": "716 DISEASES OF THE NERVOUS SYSTEM.\\nTheir phenomena are called reflex or, sometimes, the reflexes.\\nThese reflex phenomena occur in connection with movements\\nor functions which ordinarily are under the control of the will,\\nare partially under such control, or are always wholly independent\\nof the will. The following are examples of reflex action ordinarily\\nunder the control of the will. A foreign substance touching the\\neyeball, or rapidly approaching it, will cause the eyelids to sud-\\ndenly close without any voluntary effort. If one leg be thrown\\nover the other and allowed to hang loosely, with no muscular\\ncontraction, and a slight blow be struck upon the tendon just be-\\nlow the knee-pan, the muscles of the front of the thigh will in-\\nvoluntarily contract and the foot be thrown forward. This is\\ncalled the patella reflex. The explanation of this phenomenon\\nis as follows: The blow over the tendon sends a message by the\\nsensory nerve to the spinal cord, where this message is trans-\\nformed from the sensory side to the nerve on the motor side which\\ntakes it to the muscle as a message or notification to contract.\\nIn illustration of reflex action affecting functions partially\\nunder control of the will, the functions of the bowels, the bladder\\nand of respiration may be cited. In the young infant the action of\\nthe bowels and bladder are entirely automatic, and not at all under\\nthe control of the will. As the brain develops and its power in-\\ncreases the child is enabled, to some extent, to control these func-\\ntions.\\nIn health the principal functions of the gastro-intestinal\\ncanal, in the processes of digestion, are carried on wholly auto-\\nmatically, that is, without any appreciation or control by the in-\\ndividual. When, however, the nutriment has all been absorbed\\nfrom the food in its passage through the bowel and a certain\\namount of residuum and excrementitious matter has accumulated\\nin the lower part of the bowel, a certain automatic reflex action\\nis set up and the individual feels the desire to evacuate the bowels.\\nPrompt attention to this call of nature facilitates the con-\\ntinuation of the automatic action and the bowel will be evacuated\\nwithout any conscious effort. If, however, the will be exercised to\\nrestrain this action the call can be postponed. 13y continued re-\\npetition of this restraint, the reflex susceptibility becomes blunted\\nand finally may be almost completely suppressed, resulting in\\nchronic torpor of the bowels, a condition which underlies a great\\ndeal of ill-health. Conversely, if due attention is given to nature s", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0744.jp2"}, "743": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 717\\npromptings, a regularity of habit can be acquired which will prove\\nvery useful. Quite similar in many respects, is the reflex function\\nof the bladder. When a certain distention is reached, the sensory\\nnerves announce the fact to the spinal cord and demand relief.\\nThis request can be voluntarily controlled and disobeyed for a\\ntime, but not as continuously, or harmfully, as with the bowel.\\nAnother interesting example of partial control is that of res-\\npiration, the continuation of which, with but brief interruption, is\\nessential to life, being one of the vital processes and under an au-\\ntomatic control from a center in the oblongata, whose vigilance,\\nwaking or sleeping, is always alert; yet the exigencies of speak-\\ning, singing, etc., require a voluntary control now and then of\\nthis function. We are able, therefore, within very narrow limits,\\nto modify the breathing and even to suspend it for a brief period\\nbut in a short time the reflex demand for air in the lungs becomes\\nso urgent that the will is forced to give way and breathing is re-\\nsumed. It is impossible, therefore, for one to hold his breath\\nlong enough to bring about a fatal issue.\\nReflex action in organs and functions always wholly inde-\\npendent of the will is well illustrated in the heart and circulation.\\nThe action of the heart is entirely independent of will power, yet\\nvery susceptible to various reflex influences. Thus muscular ex-\\nertion stimulates the heart to increased activity; and joy, fear,\\nfright, physical injury, ingestion of poisons or stimulants, etc.,\\nproduce sudden change in the frequency and force of the heart s\\naction.\\nOf course, a great deal regarding the anatomy and physiology\\nof the brain and nervous system must, here be omitted, there be-\\ning space for only so much as is necessary to a general, non-pro-\\nfessional understanding of nervous and mental diseases.\\nINVESTING MEMBRANE AND BLOOD VESSELS.\\nTwo points pertaining to the nervous system require elucida-\\ntion before going on with its diseases, to wit Its investing mem-\\nbranes and blood vessels.\\nThe bony cavity which contains the brain is lined with a\\nstrong, firm, adherent membrane, smooth and glistening on the\\nside next the brain, called by the old anatomists, who imagined it\\nproduced the brain, the dura mater (hard mother). The outer cov-\\nering of the brain itself, called the arachnoid (cob-web-like), is", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0745.jp2"}, "744": {"fulltext": "718 DISEASES OF THE NERVOUS SYSTEM.\\na thin, delicate, transparent membrane, through which the con-\\nvolutions can easily be seen. It comes in contact with the dura,\\nbut does not adhere to it. Under the arachnoid is another de-\\nlicate covering, made up principally of very small blood vessels\\nwhich furnish blood to the cortex, to the superficial gray matter\\nand to the adjacent white matter. It is called the pia mater\\n(tender mother) because of its peculiar office.\\nThe lower part of the brain is supplied with blood by a dif-\\nferent set of vessels penetrating from below. In general, the ar-\\nrangement of the blood vessels of the brain differs from that in\\nother parts of the body by not having any provision for anastomo-\\nsis (opening into each other). In other parts the small arterial\\nbranches open into each other, or connect together. Hence, if a\\nvessel of considerable size ever becomes obstructed by accident,\\ndisease or surgical operation, the region which it nourished will\\nstill be supplied by what is termed collateral circulation that is, the\\nblood will find its way to the region by the communications with\\nother arteries. Thus the hand is supplied by two vessels, one on\\neither side, which come together in a loop if one becomes ob-\\nstructed the other supplies the entire loop. Not so in the brain,\\nfor there the arterioles (small arteries) do not communicate. The\\nconsequence is that if one of the arterioles becomes obstructed\\nthe region which it supplied is no longer nourished and speedily\\ndisintegrates a very important clinical fact. The investing mem-\\nbranes of the spinal cord are similar to those of the brain. These\\nmembranes taken together are called the meninges (coverings).\\nHOW NERVES ARE FORMED,\\nThe conducting part of a nerve fiber is called the axis cylin-\\nder, and is a grayish, slender cord. Surrounding this is a fatty\\nsubstance called the medullary sheath. Surrounding the medul-\\nlary, and the contained axis cylinder, like a glove finger, is a\\ndelicate, transparent membrane called, after the name of its dis-\\ncoverer, the sheath of Schwann. In the brain and spinal cord the\\nsheath of Schwann is not found, but it is always present with the\\noutside nerves. When the nerves enter the terminal end organs\\nthe medullary, sheath stops and only the axis cylinder goes on.\\nThe fibers are gathered into bundles, each of which is surrounded\\nby its sheath, and finally these bundles are grouped together and\\ncovered by an investing membrane. It is this latter collection of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0746.jp2"}, "745": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 719\\nbundles which is usually called a nerve. Both the conducting\\nelements of such a nerve and the investing membranes are sub-\\nject to disease; the latter by inflammation, or other causes, may\\nbecome so swollen, or thickened, as to produce destructive pres-\\nsure upon the axis cylinder.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0747.jp2"}, "746": {"fulltext": "CHAPTER II.\\nREGENERATION AND REPAIR.\\nAs a general rule the processes of regeneration and repair in\\nthe lower forms of animal life are, comparatively, more complete\\nand extensive than in the higher animals. Thus some of the\\nsimplest of animal organizations, if divided in twain, immediately\\nrearrange the parts of either half into two complete and perfect\\norganizations. Somewhat higher in the scale, we find a class called\\nthe crustaceans (covered with a shell-like crust), of which the lob-\\nster, crab and shrimp are examples, having the power of reproduc-\\ning lost parts, as legs or claws.\\nIn the highest types of animal life, among which man stands\\npre-eminently first, these wholesale methods of repair do not\\nexist. The very elaborate and complicated organs of the body\\ncannot be reproduced or even repaired as a whole, but repair of\\ninjury or disease goes on in the microscopic cells which make up\\nthe widely differentiated structures. We find, too, as might nat-\\nurally be expected, that in these higher organizations, with their\\nrefinements of structure and function, the diseases to which they\\nare subject are correspondingly more varied and complicated.\\nFurthermore, the nervous system, being the most highly de-\\nveloped, is especially liable to both functional and organic de-\\nrangement or disease, and the complete restoration of function\\nor repair of lesion is not as readily accomplished here as in some\\nof the less complicated organs. It follows clearly from the fore-\\ngoing considerations, together with the fact that the nervous sys-\\ntem holds such important and controlling powers and functions,\\nthat the study of its diseases is alike the most important and the\\nmost difficult of pathological problems.\\nBefore taking up the diseases of the special nerves, or special\\ndepartments of the nervous system, it is desirable to briefly con-\\nsider, in a general way, the different forms of disease to which\\nthe nervous system is subject. These diseases may be considered\\nunder a few general heads, as follows: (i) Malformations of\\n720", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0748.jp2"}, "747": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 721\\ndevelopment; (2) Inflammations; (3) Degenerations; (4) Tumors\\nand adventitious products; (5) Diseases of the blood vessels; (6)\\nVascular disturbances, and (7) Functional disorders.\\nMALFORMATIONS OF DEVELOPMENT.\\nThe normal development of the nervous system begins very\\nsoon after the first manifestation of vitality in the ovum and pro-\\nceeds, step by step, until the cerebro-spinal axis and the whole\\nnervous system is anatomically perfected, before birth. This nor-\\nmal development may, however, be arrested more or less com-\\npletely at almost any stage, or the development may proceed\\nalong unnatural lines. Such arrested or abnormal development\\ngives rise to malformations or monstrosities, which may be so\\ncomparatively insignificant as not to be demonstrable during life;\\nor they may be so extensive as to prohibit independent existence.\\nThese arrests and deviations of growth and development ordi-\\nnarily affect both the bodily structure and the mental capacity,\\nso that mental deficiency usually accompanies both arrest of de-\\nvelopment and unnatural excess of growth. This statement is\\nclearly substantiated by cases of feeble-mindedness, imbecility\\nand idiocy, by dwarfism, gigantism, cretinism, and other similar\\nconditions.\\nThe normal brain, at birth, is structurally perfected, but it\\nhas not reached its full growth, and arrest of development may\\noccur at any time before growth is complete. Practically, such ar-\\nrest almost always occurs before the period of adolescence, and\\nmay consist of an imperfect development of the whole brain or\\nof some particular portion of it, or the whole cerebro-spinal axis\\nmay be abnormally small. Hypertrophy (overgrowth) of the\\nbrain is rare, and may be total or partial. Sometimes parts of the\\nbrain may be misplaced, or its natural cavities may be dilated and\\nfilled with serous fluid, and sometimes the bony brain case may\\nbe wanting, or it may be so firm and solid as to prevent expansion\\nand opportunity of brain growth.\\nINFLAMMATION.\\nWhen living tissue is irritated, the process or state which\\nis set up, or which follows, is called inflammation. The general\\nsymptoms of inflammation, pain, heat, redness and swelling, are\\napparent to persons inexperienced in medicine. But some of\\n46", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0749.jp2"}, "748": {"fulltext": "722 DISEASES OF THE NERVOUS SYSTEM.\\nthe most important results of inflammation are not readily ap-\\nparent, or easily understood, by a superficial observer. Any por-\\ntion of the nervous system, or of the structures which envelop it,\\nmay be attacked by inflammation. This disease, primarily con-\\nfined to the blood vessels and similar structures, may attack the\\nnervous tissues, either quickly or slowly. The attack may be\\nupon the nerve elements themselves, or upon the connective\\ntissues, which surround, cover or separate the nerve elements\\nproper, or it may attack both. It may pass away without seri-\\nously impairing the nerve structure or its functions, or it may lead\\nto degeneration and total loss of function. It is often of infectious\\nor toxic origin. In common with inflammation of other struc-\\ntures, inflammation of nervous tissue may result in an exudation,\\nor pouring out from the blood vessels of an unnatural material,\\ncalled an exudate. This exudate may be serous, a clear yellow-\\nish fluid; fibrous, a soft, solid, adherent mass; or purulent, having\\nthe well-known appearance of pus or matter as seen in an\\nabscess or boil. These conditions may or may not be ac-\\ncompanied by the death of the tissue affected. Such exudate\\nmay make its way into the substance of the brain, spinal cord\\nor nerves, with, of course, very damaging results.\\nInflammatory action may be limited to a small place or\\nspot, it may be found in many spots (multiple), or it may spread\\nover a large area, as the entire surface of the brain. It may be\\ncaused by syphilis, when new tissue may be slowly formed by\\nexcessive cell growth, called proliferation, without any exudation.\\nInflammation of nerve tissue may be acute, subacute, or chronic\\nthat is, of a violent, rapid movement; a less rapid, moderate\\nmovement or an especially slow, insidious movement.\\nMeningitis. When the membranes covering the brain or\\nspinal cord are inflamed the disease is called meningitis, which is\\nusually included among the diseases of the nervous system, be-\\ncause its most important and serious symptoms appertain to the\\nnervous system, through the close connection and relation of\\nthe membranes (meninges) and the nervous structure. There\\nare several varieties of meningitis, depending upon the particular\\nregion and parts involved, the special causes of the inflammation,\\nor the character of the exudate.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0750.jp2"}, "749": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 723\\nDEGENERATIONS.\\nUnder certain conditions nerve cells and fibers are subject\\nto a gradual process of decay and death, called degeneration.\\nIn other conditions, as, for instance, arrest of blood supply by\\nocclusion of a blood vessel, the process of softening and death,\\nor necrosis, may be rapid and is termed acute degeneration.\\nThe principal varieties of degeneration are the granular or fatty,\\nwhen the nerve cells lose their proper character and become\\ngranular or fatty; pigmentary, when they become filled with\\nabnormal coloring matter; fibroid, when a fibrous tissue takes the\\nplace of the nerve element and calcareous, when the cells become\\nchanged into a chalky matter.\\nDegenerations may also be primary or secondary. In pri-\\nmary degeneration the bodies of the cells gradually grow smaller,\\nand irregular in shape, and their processes dwindle or disappear.\\nThis form may be caused by arrest of development in the early or\\nembryonic stage; or it may be caused by infections or poisons.\\nSecondary degeneration follows hemorrhage into the brain, tumor\\npressing upon both the nerve structure and the vessels which\\nnourish it, abscess, injury to the brain or spinal cord, etc., all\\nbeing conditions which interfere with the proper nutrition of the\\nnerve tissue by cutting off blood supply, by pressure, by direct\\ninjury, by disease, etc. Degeneration of the central nervous\\nsystem may also result from disordered blood, or from disease of\\nthe blood vessels, which interferes with the proper supply of\\nblood, either condition causing imperfect nutrition.\\nWhen degeneration of the nerve cells is complete or, in other\\nwords, when their nerve character is destroyed, they cannot be\\nreplaced, and such parts of the nervous system will always re-\\nmain useless. But when they have been only damaged, regenera-\\ntion may take place even after a long time. The capacity for such\\nrestoration is greater in the peripheral (outside) nerves than in\\nthe central portions. The nerves going to the extremities some-\\ntimes recover their functions after long periods of impairment,\\nbut brain structure less readily recuperates.\\nAnother form of degeneration is called sclerosis, a term de-\\nrived from a Greek word meaning hard. In sclerosis the con-\\nnective tissue which forms the delicate coverings of the nerve\\nfibers and bundles becomes thickened and hardened, presses upon\\nthe true nerve structure, and interferes with its nutrition, so that it\\nbecomes unable to properly perform its functions.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0751.jp2"}, "750": {"fulltext": "724 DISEASES OE THE NERVOUS SYSTEM.\\nThis interference with the function of the motor nerves\\ncauses various semi-paralytic disorders and, if the sensory nerves\\nare affected, causes impaired and deranged sensation. A similar\\ncondition may occur in the brain, causing an incurable form of\\ninsanity.\\nSenility. The natural condition of the nervous system in\\nold age is that of slow decay. The general nerve tissue becomes\\nshrunken, brain function becomes impaired, the power of the\\nnerves to conduct impressions is lessened and the blood vessels\\nnourishing nerve structure deteriorate. These are simply parts\\nof the general deterioration of the whole system during the period\\nof natural decline. These changes sometimes occur much earlier\\nin life than usual, constituting premature senility. Indeed, senil-\\nity is not marked by years, but by the changes in the brain.\\nSometimes this senile degeneration is so much exaggerated, either\\ngenerally or in special localities, as to be properly classed as\\ndisease.\\nTUMORS AND ADVENTITIOUS PRODUCTS.\\nVarious tumors, tuberculous, cancerous, syphilitic, etc., may\\ndevelop in the brain and spinal cord. Occasionally the eggs of\\ncertain parasites find their way into the brain through the cir-\\nculation, then develop into one phase of their cycle of growth,\\ncalled hydatids, which appear like cysts filled with transparent\\nfluid. Other cysts are sometimes found rilled with a watery fluid,\\nor with blood, and abscesses are not infrequent.\\nThese foreign growths, or bodies, damage the nerve tissue\\nby pressure, by interference with nutrition, or by destroying it,\\nand are likely, sooner or later, to cause death. Incidentally, it\\nmay be said that some of these growths can be cured by medicine,\\nsome can be removed by surgery, while others, from their location,\\nextent or character, are incurable and necessarily fatal.\\nVASCULAR DISTURBANCES.\\nThe brain is one of the most vascular organs of the body, re-\\nceiving a much larger proportional supply of blood than most\\nother parts. The vessels of the brain are also thinner and have\\nless resistance than the vessels in the body generally, hence the\\nbrain is especially liable to hemorrhage from giving way of the\\nblood vessels. These hemorrhages may be very small but", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0752.jp2"}, "751": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 725\\nnumerous and repeated, causing thickening and change of struc-\\nture of the meninges, or degenerations of the brain itself. When\\nthe vessels themselves have become diseased or weakened by bad\\nhabits, or old age, one of considerable size may give way, the out-\\npouring blood rending the brain structure, or compressing it like\\na foreign body, or both. On the other hand, disease of the vessels\\nmay lessen or even occlude their caliber, or clots, etc., may ob-\\nstruct them, leading to softening and death of parts of the\\nbrain by cutting off blood supply. Compression and concussion\\nmay also produce softening.\\nToo great an amount of blood in the brain (congestion or\\nhyperemia) may be caused by excitement, fever and alcohol or\\nother toxic agents; and may be followed by serious results. On\\nthe other hand the brain may suffer from anemia (lack of blood)\\nbecause of a general anemic condition of the whole body, or from\\nhemorrhage, or from local diseases, or from contractions in blood\\nvessels.\\nFUNCTIONAL DISEASES.\\nThis term means diseases not due to change of structure, but\\nto mode of action. The so-called functional diseases of the brain\\n(and of other organs as well) are growing less and less as our\\nmeans of investigation become more perfect and complete, and\\nenable us to determine changes of structure formerly unknown.\\nPREDISPOSING CAUSES.\\nOf these one of the most potent is heredity. Heredity may be\\neither direct or potential. Imbecile parents may have imbecile chil-\\ndren, or there maybe a marked family tendency to the development,\\nat about the same period of life, of similar forms of brain disease.\\nHeredity is therefore active in the embryonic and fetal states (con-\\nditions before birth) and potential later, being most likely to as-\\nsert itself in the developmental and critical periods of life. Hys-\\nteria, neurasthenia (nerve exhaustion), mania, melancholia, etc.,\\nare very likely to occur in families, alternating with alcoholism,\\nepilepsy, syphilis, tuberculosis, etc. Insanity, deafmutism, pau-\\nperism, criminality, etc., not infrequently show themselves as in-\\nheritances from remote ancestors. Age, sex, race, occupation,\\nhabits, social condition, poisons and infections constitute other\\npredisposing causes of nervous diseases.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0753.jp2"}, "752": {"fulltext": "726 DISEASES OF THE NERVOUS SYSTEM.\\nEXCITING CAUSES.\\nSome of the foregoing may act as exciting causes, as do\\nemotion, fright, mental strain, reflex irritation (irritation of the\\ncentral nervous system by local diseases or conditions), injury,\\nshock, etc. The mental causes, as a rule, produce functional de-\\nrangements, but they may cause such intense congestion as to\\nlead to organic disease, or even to fatal hemorrhage.\\nDEVELOPMENTAL INFLUENCES.\\nThese are of great importance. In the embryonic and fetal\\nperiods they result in arrest or aberration, giving rise to mal-\\nformations, idiocy and imbecility. During the stage of rapid\\nbrain growth, from infancy to about the seventh year, untoward\\ntendencies may be shown by convulsions, night terrors, brief\\ndelirium, ephemeral fever, meningitis, etc. Chorea, epilepsy and\\nfamily types are likely to appear during the second period of\\nseven years; while hysteria, epilepsy, insanity, sexual perversions,\\netc., develop during puberty and youth.\\nNo one can live to himself alone. The individual develops\\nfrom, and is dominated by, a long line of ancestors, and, in turn,\\ntransmits dominating tendencies to posterity. He may be likened\\nto the trunk of a tree, which receives support, development and\\npossibilities from its wide spreading roots and passes on its char-\\nacteristics and tendencies through its seeds.\\nIn infancy and early childhood the nerve centers are unstable\\nand irritable, hence the presence of spasms, brief but high fever,\\nchorea, and the like, often being reflex disturbances from teething,\\nindigestion, etc. In puberty and youth, when both the physical\\nand mental characteristics are being determined, come the marked\\nfamily tendencies. Later, under the burdens of business, family\\ncares, various excesses, severe mental strain, etc., the functional\\nneuroses appear, and finally, in old age, degeneration and hemor-\\nrhagic disturbances bring about senility and paralysis of different\\nforms.\\nThe female is more subject to hysteria, neurasthenia, head-\\nache, spineache and neuralgia. The motor paralyses are more\\nfrequent in the male, largely owing to the exposure incident to\\noccupation. Many occupations, as those of clerks, telegraphers,\\ntypewriters, musicians and teachers, cause special forms of nervous\\ndisease. Paralyses, neuralgias and neurites may be caused by", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0754.jp2"}, "753": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 727\\nmineral poisons, such as lead, mercury and arsenic. Eye strain\\nmay cause disabling headaches. Even idleness may lead to\\nhypochondria.\\nHABITS AND SOCIAL CONDITION.\\nAlcohol causes special types of nervous disease, often of the\\nmost serious character. It is especially detrimental to the young\\nbefore full bodily development has taken place, and the same is\\ntrue of tobacco. Sexual irregularities and abuses depress both\\nthe physical and the psychical powers, producing functional neuro-\\nses, disorders which may terminate in organic diseases; but the\\npopular idea that insanity, in either sex, is almost always due to\\nthe sexual apparatus is an error. Vicious habits of thought and\\naction, bad educational methods, the harassments of a high and\\nexacting society, the mental strain of the struggle for wealth and\\nposition, as well as the wear and tear of poverty, unceasing toil,\\nunhappy domestic relations, improvidence, the monotony of the\\nfarm and the alley, all tend to prematurely break down the nerv-\\nous system. Microbic agencies, imperfect excretion of poisons\\nnormally formed in the body, infectious processes, syphilitic poi-\\nson, self-infection and self-intoxication by poisonous substances,\\ngenerated within the system because of the transgression of\\nnature s laws of health, are still other causes of disease of the\\nnervous system, upon which space does not permit further com-\\nment.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0755.jp2"}, "754": {"fulltext": "CHAPTER III.\\nNEURALGIA.\\nNeuralgia means a nerve pain. It is a disorder of the sensory\\nfibers of the nerves, distributed to different parts of the body,\\nand called peripheral nerves. In some cases the motor fibers be-\\ncome involved, owing to their close association with the sensory\\nfibers. Neuralgia is classed as a functional disease, because we\\nare unable to determine, by any method at our command, that\\nthere is any change of structure in the painful nerve but it is very\\nprobable that changes of structure may some time be demon-\\nstrated.\\nThe term neuralgia is often misapplied, and it is important,\\ntherefore, to explain more fully the exact difference between ordi-\\nnary pain and nerve pain or neuralgia. Ordinary pain is the\\nnerve expression of local diseased conditions. Take, for instance,\\na case of injury to the hand, or of a felon on the finger. The\\nultimate nerve filaments of sensation are compressed by the\\nswelling and irritated by the presence of inflammatory products.\\nThese impressions of irritation are conducted to the brain and\\nare there translated into sensations of pain, which are referred to\\nor appear to come from the injured hand or the diseased finger,\\nand we say the hand or the finger is painful.\\nAs an illustration of a neuralgia, or nerve pain, may be cited\\nthe pain which a person who has suffered an amputation may feel\\nin the lost member. The popular idea is that when such pain is\\nfelt, it is an indication that the amputated member has been buried\\nin a cramped position, or is being cut up by the doctors, and\\nthat disinterment or rescue and careful re-burial in a natural\\nposition will relieve the pain. It goes without saying that to a\\nclear-headed, non-superstitious person, this notion is absurd, but\\nthe explanation of feeling pain in an amputated member is not\\nso clear.\\nThe fact is that persons often do feel pain in amputated mem-\\nbers, or rather they feel pain which is referred to such lost\\n728", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0756.jp2"}, "755": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 729\\nparts. The philosophy of this may be compared to the annuncia-\\ntor of a hotel. Each room is connected to it by electric wires.\\nWhen the proper pressure or contact is made in a room, the an-\\nnunciator records the number thereof but if the wires be cut any-\\nwhere between the room and the annunciator, and the cut ends\\nbe brought in contact, the annunciator bell will ring and the\\nnumber of the room will be indicated. In a somewhat similar\\nmanner the different parts of the body are connected, by means\\nof nerve fibers, with the brain. Local irritation of the end organs\\nof these nerves is transmitted to the brain, which locates the\\nsensation in the part affected. If, now, a limb be amputated and\\nthe nerve fibers which connected the lost limb with the brain be\\nirritated in the stump, this irritation will be conveyed to the brain,\\nwhere it will be translated into sensation, which will seem to come\\nfrom and be referred to the missing member. The person, there-\\nfore, really feels exactly the same sensation as if the limb were in its\\nproper place in fact, he actually feels his amputated toes or fingers.\\nIt is very evident that the condition of the amputated limb has\\nnothing whatever to do with this sensation. It depends entirely\\nupon that part of the nerve fibers which remain in connection with\\nthe brain. The sensation referred to in the lost member is a neu-\\nralgia or nerve pain.\\nReturning to the general consideration of neuralgia, the pain\\nvaries from a mild ache to a severe pain, and may run through the\\nwhole possible scale of variety boring, grinding, dragging, stab-\\nbing, burning, etc. The pain of neuralgia has peculiarities which\\ndistinguish it from pain due to organic disease, namely, it often\\nshifts from one nerve, or set of nerves, to another, and has certain\\npoints of tenderness along the affected nerve.\\nNeuralgia may affect any nerve in the body, but only the\\nmost important will be considered.\\nNEURALGIA OF THE HEAD.\\nThe important neuralgia of the head is that of the fifth pair\\nof cranial nerves. This nerve is of mixed function, being both\\nsensory and motor, and the largest of the cranial nerves. It is\\nthe great sensory nerve of the face, forehead and upper part of the\\nscalp to back of and including the ears. It divides into three\\nmain branches, the ophthalmic, which goes to the eye, brow, scalp,\\netc., the superior maxillary, which goes to the cheek, nose, upper", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0757.jp2"}, "756": {"fulltext": "730 DISEASES OF THE NERVOUS SYSTEM.\\nteeth, etc., and the inferior maxillary, which goes to the lower part\\nof the face, the under teeth, tongue, etc. It also supplies nerves\\nof sensation to the interior of the nose, mouth and throat. Fila-\\nments from the different branches interlace freely, but each nerve\\nis strictly confined to its own side of the face. The motor part of\\nthis nerve is in the third or inferior maxillary division, and is dis-\\ntributed to the muscles of mastication.\\nThe very large number of nerve filaments in the face and ad-\\njacent parts (among the most sensitive portions of the body)\\ncause any irritant to any part of this nerve to produce a profound\\nimpression. Pieces of glass, or other foreign substances, lodged\\nin the face, the irritation of decayed teeth, etc., sometimes cause\\nthe most fearful neuralgic pains, and even set up paralyses, tremor\\nand epilepsy. There is a peculiar association of action in the\\nnerves, both between the different branches upon the same side,\\nand also between the two opposite nerves. Thus irritation of the\\ninferior maxillary branch, from decayed teeth, may cause in-\\nflammation of the eye on the same side, earache, inflammation of\\nthe middle ear, etc. This nerve is sometimes called the sentry,\\nbecause its different branches at the orifice of the eye, nose,\\nmouth and ear stand guard to give warning of approach. In-\\nflammation and disorganization of one eye from injury is very\\nlikely to set up a similar process in the other. Upon the first in-\\ndication of such sympathetic inflammation the only proper pro-\\ncedure is removal of the diseased eye.\\nOrdinary simple neuralgia may be manifested in any or all\\nthe branches of this nerve, ranging from mild to very severe.\\nThere is also a special form of neuralgia of this nerve, called\\ntic douloureux, in which the pains come with the most intense\\nseverity, often accompanied by spasms, and driving the sufferer\\nwell nigh distracted.\\nThe back of the head and neck is subject to neuralgia affect-\\ning the four upper spinal nerves, called cervico-occipital. The\\nlower and front part of the chest and region of the ribs are\\nrespectively subject to neuralgias of the phrenic nerve (an im-\\nportant respiratory nerve) and the sensory branches of the dorsal\\nspinal nerves. Neuralgia of the lumbar nerves may be referred\\nto the small of the back, the lower part of the abdomen, the front\\nand inner part of the thigh, the front of the knee joint, the inner\\npart of the leg and of the foot.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0758.jp2"}, "757": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 731\\nIn the upper extremities, neuralgia of the brachial plexus\\naffects different parts of the arm and hand. The chief neuralgia\\nof the lower extremities is known as sciatica, or pain in the great\\nsciatic nerve, which passes into the leg a little behind the head\\nof the femur or bone of the thigh.\\nThis is often an excruciatingly painful neuralgia. The in-\\nternal organs are not free from neuralgic pains. In mild cases\\nonly the sensory parts of the nerves are affected, but all parts of\\nthe nerves may be affected, and there may be sensory, motor and\\nsympathetic disturbances.\\nCauses. The causes of neuralgia are many, among them\\nheredity, gout, neurasthenia, anemia, malaria, eye-strain, decayed\\nteeth, injury, influenza, changes of temperature, poisons, syphiiis,\\nhysteria, etc. The hereditary causation of neuralgia cannot be\\ndisputed, but a clear distinction should be made between those\\nwho have had occasional attacks, from efficient causes, and those\\nwho are constantly neuralgic. Probably no one escapes an at-\\ntack some time during life.\\nNeurasthenia and anemia act as causes by virtue of lowered\\nvitality malaria by a similar condition, dependent upon the mala-\\nrial poison in the blood eye-strain, injury and decayed teeth\\nact by direct strain or irritation of branches of the nerve in-\\nfluenza, poisons and syphilis, by poisonous and depressing action\\non the nerves changes of temperature, by impairing nerve re-\\nsistance. Many neuralgic cases are intimately connected with\\nbarometric disturbances. Some are affected on the approach of\\na storm, and can foretell its coming; others are most affected during\\nthe presence of the storm and still others during the clear, bright\\nweather following it.\\nThere are many other diseases which may be mistaken for\\nneuralgia, such as tumor of the brain or spine, disease of the\\nbones of the spinal column, inflammation of the nerves, etc., and\\nin all cases of neuralgic pain the patient should receive, in the\\nearly stages, competent medical advice.\\nThe majority of cases make good recoveries; but much\\ndepends upon the kind of neuralgia and the cause. If the cause\\nis one which cannot be removed, either by medical treatment or\\nsurgery, cure cannot be expected.\\nNeuralgia of the fifth nerve (one of the most common va-\\nrieties) is generally curable, except when in the severer spasmodic\\nform, called tic douloureux.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0759.jp2"}, "758": {"fulltext": "732 DISEASES OF THE NERVOUS SYSTEM.\\nTreatment. In a disorder of so varied causation, so likely\\nto be serious and assuming so many forms, home treatment is in-\\nexpedient and the best medical advice attainable should be sought\\nwithout delay. The first thing the physician will consider is whether\\nthe neuralgia is due to some general bodily ailment, anemia for\\ninstance, which weakens the whole system, or to some local irri-\\ntation, as defective teeth. He will look for the local irritation\\nfirst, remove it, if possible, and then, if the neuralgia persists, use\\nmeasures to bring vitality up to the plane of health.\\nThis is often a tedious and difficult task and will tax the\\nresources of the ablest physician. If there be anemia sufficient\\nto cause neuralgia it must be treated rigorously, with rest in bed,\\nfeeding and the best of nerve tonics. In gouty (rheumatic or li-\\nthemic) neuralgia, treatment must be directed to the constitutional\\ndisorders underlying these conditions.\\nWhen neuralgia can be clearly traced to malarial poisoning,\\nthe scientific use of quinine will prove curative. Five years ago,\\nthe writer cured a severe case of facial neuralgia, due to malaria,\\nwith three doses of quinine, and there has been no return.\\nIn many cases remedies must be used to relieve the pain\\nwhile the cause is being removed and the general health improved.\\nA warm and equable temperature often relieves neuralgic pains\\nand serves as an important aid to other remedies. A towel folded\\ninto many thicknesses, wrung out of water nearly boiling hot, then\\nclapped upon the back of the neck and held there, will sometimes\\nafford quick relief in cases of facial neuralgia, as well as in those\\naffecting the back of the head. Electricity, properly applied, is\\noften of great value, especially in the form affecting the back of\\nthe head. When the intercostal nerves are affected remedies\\nto relieve pain, galvanization of the spinal cord, local support,\\nliniments, rest in bed and quinine with salicylate of soda are the\\nbest means of treatment. For neuralgias of the arm, similar\\nremedies with rest for the limb in a soft sling.\\nNeuralgias of the lower extremities, principally sciatica, are\\nless satisfactory to treat because of the greater difficulty of putting\\nthe part at rest. To secure good results the patient must be kept\\nin bed, or at least on a couch, for four to twelve weeks, and\\nsuch remedies used as the case demands. In very obstinate cases\\nof neuralgia which have resisted all medical treatment, especially\\nin tic douloureux, or where there is pressure upon a nerve, it is", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0760.jp2"}, "759": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 733\\noften advisable to resort to surgical procedure for relief, such\\nas the stretching of the nerve, or the resection, or cutting out of a\\nportion of the nerve. Such means usually give relief for a time,\\nbut the pain is apt to recur. A case in which several surgical\\noperations had been performed on the fifth nerve, without material\\nimprovement, was completely cured, under the direction of the\\nwriter, by galvanism. Incidentally, it may be stated that in neu-\\nralgia of the maxillary branches of the fifth nerve, in which the\\npain is referred to sound teeth, the extraction of such teeth will not\\nrelieve the malady.\\nIt is often the case that the physician can give such directions\\nas to diet and mode of life as will have a strong influence in\\nlessening the frequency and severity of attacks, even if they can-\\nnot be altogether prevented. The very best treatment for neu-\\nralgia is preventive. Careful attention to the laws of hygiene and\\nkeeping up sound health will keep this malady far away.\\nNEURITIS.\\nNeuritis is an inflammatory affection of a nerve trunk, nerve\\nbranches, or nerve filaments, causing one or more of the follow-\\ning symptoms Pain, impaired sensation, motor paralysis and\\natrophy. There are two forms The simple, affecting a single\\nnerve; and the multiple, affecting different nerve trunks or fila-\\nments, often in an apparently capricious manner, and frequently\\nsymmetrical on the two sides. Simple neuritis may be caused by\\ninjury, such as contused or lacerated wounds by pressure upon the\\nbrachial plexus, as by sleeping with the arm thrown over the back\\nof a chair; by jar, as of railroad accident; by exposure to cold, by\\ngout, syphilis, cancer, typhoid fever, diphtheria and other general\\ndiseases; by extension of inflammation from pneumonia, pleurisy,\\nmeningitis, articular rheumatism, etc.\\nSymptoms. The symptoms of neuritis vary in different\\ncases, according to the function of the nerve affected. There is\\nalways pain, more or less paralysis when a motor nerve is affected,\\nimpaired sensation when a sensory nerve is attacked as, for in-\\nstance, neuritis of the optic nerve impairs and may destroy vision\\nof the auditory nerve may cause deafness, or false hearing of loud\\nnoises; while neuritis of the general sensory nerves produces de-\\nrangement of general sensation. The first symptom is generally\\npain more or less severe in the nerve itself, frequently intermittent.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0761.jp2"}, "760": {"fulltext": "734 DISEASES OF THE NERVOUS SYSTEM.\\nThis is likely to rapidly become very severe. Impairment of\\nmovement, as a rule, comes on quickly, followed by atrophy or\\nshrinking of the diseased muscles. There is also impairment of\\nsensation the sense of touch may be blunted or entirely lost sen-\\nsation of pain may be diminished or wholly lost in the part sup-\\nplied by the nerve; trophic changes, that is changes in nutrition,\\ntake place and the skin becomes glossy, parchment-like perspira-\\ntion may be increased or diminished, and electrical stimulation may\\nshow degeneration.\\nNeuritis may be acute (active and of rapid progress), subacute\\n(less active and slower) or chronic (moderate and long continued).\\nThe essential condition in neuritis is the disorganization of the\\naxis-cylinder that part of the nerve that is necessary to the\\ntransmitting of impulses. It has a natural tendency to recover,\\nvaries much in its duration, and can be greatly modified and bene-\\nfited by proper treatment.\\nIn neuritis from injury much depends upon the character of\\nthe injury.\\nTreatment. If a large nerve be cleanly cut across, the ends\\nshould be brought together by surgical operation, with expecta-\\ntion that function will be restored; if imprisoned in the callus\\nthrown out by a broken bone, or in the swelling of an inflamed\\njoint, such pressure must be removed, by surgical or natural pro-\\ncess, and the part put at rest, before improvement can take place.\\nThe line of treatment must be varied as required. In case of\\nthe arm it should be carried in a sling, and assistance be had in\\ndressing and undressing. In neuritis of the trunk, riding or walk-\\ning should be prohibited, and the movements of the trunk les-\\nsened by supports, or rest in bed. If the disease be in the lower\\nextremities, rest in bed should be the first consideration, and be\\nrigidly enforced, and the use of the legs be restricted, even through\\nconvalescence, until recovery is well assured. Pain must be con-\\ntrolled, proper reconstructives be used if the general health is poor,\\nand special remedies employed which have a favorable effect\\nupon the diseased nerve tissue. Electricity, properly applied, is\\nof great benefit in many cases, but should only be used under\\ncompetent medical advice. It goes without saying that the most\\ncareful attention should be given to the general health of the\\npatient, to the end that nature may be enabled to put forth its best\\nefforts, for in this, as in every disease, the real cure must come", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0762.jp2"}, "761": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 735\\nthrough vital action, to which the physician can render most effi-\\ncient aid, but without which he can do nothing.\\nMULTIPLE NEURITIS.\\nIn this form different nerve trunks or filaments throughout\\nthe body or extremities are affected, sometimes in a capricious\\nmanner, and sometimes symmetrically; that is, corresponding\\nnerves on opposite sides are affected simultaneously. Multiple\\nneuritis may be caused by poisonous agents, such as alcohol, lead,\\narsenic, etc. These agents may produce very serious effects upon\\nall parts of the nervous system, but in many cases their influence\\nis most pernicious on the peripheral nerves.\\nMost cases of alcoholic paralysis, lead palsy, etc., are\\ndue to multiple neuritis. This disease may also be caused by in-\\nfectious agents, or poisons developed within the body in diph-\\ntheria, typhoid fever, malaria, tuberculosis, etc. In the course of\\nthese diseases, or later, multiple neuritis may be developed. In\\ntropical countries a peculiar form of multiple neuritis is often epi-\\ndemic, due, probably, to an infectious micro-organism. Expo-\\nsure to cold and dampness and overexertion are also causative\\nof this disorder. It is more common in females than in males.\\nDiphtheritic cases occur mostly in childhood other cases appear\\nat all ages after puberty.\\nSymptoms. Multiple neuritis presents a wide variety of\\nsymptoms. Those connected with sensation are the first to\\nattract attention and the last to pass away. In most cases numb-\\nness, tingling or formication (a feeling as if ants were crawling on\\nthe skin) are first noticed. Generally these sensations begin in\\nthe feet and hands and extend to the knees and elbows, or some-\\ntimes beyond. There may also be very distressing burning,\\nstretching, boring or tearing sensations. Pain is generally pre-\\nsent, usualh moderate and not continuous, sometimes sharp, lan-\\ncinating and very severe.\\nTenderness of nerves and muscles is always present, some-\\ntimes so great as to prevent handling or moving the limb. Along\\nwith this painful feeling there is disturbance of normal sensation.\\nAt first there is oversensitiveness to touch later diminished\\nsensibility. In some cases the patient can feel that something is\\ntouching his limb, but cannot tell where. The special senses are\\nnot often affected.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0763.jp2"}, "762": {"fulltext": "736 DISEASES OF THE NERVOUS SYSTEM.\\nThe motor symptoms are as marked and important as the sen-\\nsory. In the beginning there is a sense of simple weakness or\\nfatigue which gradually increases until paralysis is complete, or\\nsometimes the paralysis is developed rapidly in a few days. This\\nparalysis may begin in a single muscle and gradually include\\nothers, and it may begin in one extremity and extend to all,\\nor otherwise. As a rule it is most severe in the muscles which\\nmove the hands and wrists and the feet and ankles. Occasion-\\nally it attacks the thighs and arms, rarely the muscles of the trunk,\\nbut when these are attacked respiration is suspended and death\\nfollows.\\nThe paralyzed muscles are relaxed, flabby and wasted, and\\nthe limbs assume abnormal positions, of which the wrist drop\\nof lead palsy is a common example. In this form of multiple\\nneuritis, when the patient attempts to hold out his hand, with\\npalms downward, they drop or hang downward at the wrist\\nand he is unable to raise them.\\nThere are certain types of this disease which may well\\nbe mentioned. If a person accustomed to use alcoholic liquors\\nin excess complains of muscular weakness, suddenly becomes\\nparalyzed in arms and legs, has fever, becomes delirious, shows\\ngreat tenderness of limbs, etc., the case is doubtless alcoholic multi-\\nple neuritis. If one who has been exposed to contamination by\\narsenic complains of numbness, tingling, clumsiness and fatigue,\\nshows inability to properly control the muscles of the hands\\nand feet, with tenderness along nerves and weak muscles, it is\\nmultiple neuritis from arsenic. Similar conditions, with marked\\nweakness of the extensor muscles of the forearm, causing wrist\\ndrop, indicate the same disease from lead poisoning.\\nA good proportion of cases of multiple neuritis recover.\\nVery severe cases caused by alcohol, and the infectious forms,\\nas found in the tropics, are not likely to recover. Cases have\\nbeen known to be restored in three months, others have required\\ntwo years to complete a cure.\\nTreatment. Inasmuch as most cases are toxic in origin,\\nthe first indication for treatment is to remove the cause. In\\nalcoholic cases, that poison must be abandoned, and resumption\\nof its use after recovery is likely to cause relapse. Lead and\\narsenic must be eliminated from the system by suitable medicines.\\nIn diphtheria and other causative diseases, hygienic and anti-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0764.jp2"}, "763": {"fulltext": "DISEASES OE THE XERl OUS SYSTEM. 787\\nseptic measures must be employed to counteract infectious influ-\\nences. General supporting treatments full, nutritious diet abound-\\ning in fat, reconstructive tonics and nerve stimulants, frequentlv\\nchanged, are advantageous. The scientific use of hot and cold\\ndouches, of the various electrical currents, and of skilled massage\\nafter tenderness has subsided, are of great benefit. At first rest\\nmust be had later, moderate exercise, not carried to fatigue.\\nFACIAL PARALYSIS.\\nA comparatively common and very interesting example of\\nneuritis in a peripheral nerve is that known as Facial Paralysis,\\nor Bell s Palsy.\\nThis is an inflammation of the seventh cranial nerve, or\\nfacial nerve, which has exclusively motor functions, and is dis-\\ntributed to the muscles of the middle ear, the face, the palate,\\netc. This paralysis is usually easy of recognition, as it attacks\\nbut one side of the face, as a rule, and the resulting change of\\nexpression is very characteristic.\\nFacial paralysis may be preceded by a sense of fullness or\\npuffiness of the face, or it may come on suddenly without pre-\\nmonitory symptoms, and the whole side of the face be at-\\ntacked within three or four hours. Sometimes a person, going\\nto bed well, may find one side of his face completely paralyzed\\nin the morning. The characteristic appearance of the face in\\nthis disease is caused by the paralysis of the muscles on the\\naffected side, and the normal tonicity and voluntary contraction\\non the sound side.\\nOn the affected side the eyebrow is elevated, the lids unnat-\\nurally separated, the lower lid drooping and allowing overflow\\nof tears the patient is unable to wink or close the lid, even\\nin sleep, which may cause irritation and inflammation, and the\\nlines of expression on that side are lost. The mouth is drawn\\nto the sound side by the unopposed action of the muscles of\\nthat side. The lips on the affected side cannot be brought\\ntogether, hence whistling is impossible, and, upon attempting\\nit. the cheek bellies out uselessly. On account of the paralysis\\nof the cheek, mastication is not naturally performed-- the food\\naccumulating between the teeth and the cheek. If the disease\\nextends along the nerve toward its origin sufficiently far, the\\nbranches which go to the muscles of the palate are involved,\\nand their paralysis embarrasses speaking and swallowing.\\n47", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0765.jp2"}, "764": {"fulltext": "738 DISEASES OF THE NERVOUS SYSTEM.\\nThe causes of facial paralysis are many, some of which\\noperate upon the nerve directly, others affecting it through central\\nlesions. In its exit from the cranial cavity, the facial nerve\\npasses through a long bony canal, wherein slight swelling of\\nits investing membrane, or slight effusion therein, will produce\\nserious pressure upon it, and, as it emerges from this canal a\\nlittle below the opening into the ear, its exposed situation ren-\\nders it particularly liable to injury from violence or exposure\\nto cold. Hence the most frequent cause is exposure to wind\\nor draught from an open door or window, especially a car window.\\nAmong other causes is a general rheumatic condition disease\\nof the middle ear, which operates by extension of the inflamma-\\ntion to the closely adjacent nerve; injury, as a blow upon the\\near; diphtheria, scarlet fever, etc., and lesions of the brain in\\nconnection with the origin of the nerve, or parts intimately con-\\nnected therewith.\\nThe outcome of facial paralysis varies widely, according to\\nthe cause and the special location of the lesion. Simple uncom-\\nplicated causes from exposure to cold recover, as a rule, in two\\nor three months, but cases due to central brain lesions are very\\nunfavorable.\\nTreatment. The treatment must depend largely upon the\\ncause. A superficial neuritis from exposure, etc., will require\\nthe treatment indicated for neuritis generally. If there be disease\\nof the middle ear, such disease must have prompt, efficient at-\\ntention. Rheumatic cases require anti-rheumatic treatment. If\\nit depends upon brain lesion, the outlook is serious and the treat-\\nment must be mainly directed to the brain, although local treat-\\nment will still be of service and should not be neglected.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0766.jp2"}, "765": {"fulltext": "CHAPTER IV.\\nDISEASES OF THE SPINAL CORD AND OBLONGATA.\\nCertain anatomical and physiological arrangements of the\\nspinal cord have such intimate bearing upon its diseases, and the\\nconsequences resulting therefrom, that it is important to bring\\nthem to mind. The motor and sensory fibers of the cord are\\narranged in separate bundles, or columns, as they are called,\\nso that there are motor columns and sensory columns. It may\\nbe said, with sufficient accuracy for our purpose, that the motor\\ncolumns occupy the anterior or front part of the cord, and\\nthe sensory columns the posterior or back part. It has already\\nbeen stated in describing the spinal nerves that they consist of\\na motor or anterior root and a sensory or posterior root, being\\nmixed nerves, and that the nerves from the upper part of the\\ncord go to the upper part of the body and upper extremities,\\nthe nerves from the midde portion go to the middle of the\\ntrunk, and those from the lower part to the lower portion of the\\nbcdy and the lower extremities. Tracing the motor nerves\\nfrom without into the cord, they spread out and pass through\\nthe front and side columns of the cord and enter the front\\nportions (anterior horns) of H-shaped gray matter which is in\\nthe anterior of the cord. In this gray matter these fibers, called\\nroots, make connection with the motor fibers from the brain,\\nwhich have also passed into the anterior horn. The motor\\nimpulse from the brain, therefore, follows the motor fibers, which,\\nit will be remembered, nearly all cross over in the oblongata,\\nthen pass down the anterior motor columns of the cord and\\nsuccessively penetrate to the anterior horn of gray matter.\\nHere the impulse is transmitted to the roots of the motor nerves\\nand thence to the muscular fibers.\\nThe sensory portion of the spinal nerves, constituting the\\nposterior roots, enter the cord at the back, pass almost entirely\\nand directly into the posterior sensory columns and then cross\\nover to the opposite side, by which they go on to the brain.\\n739", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0767.jp2"}, "766": {"fulltext": "740 DISEASES OF THE NERVOUS SYSTEM.\\nThe spinal cord is, therefore, the main channel of communica-\\ntion between the brain and all parts of the body supplied by\\nspinal nerves, both as to motor and sensory impulses. Hence,\\nit follows that disease of the cord at any point sufficient to inter-\\nrupt all its functions will produce paralysis both of motion and\\nof sensation in all parts of the body which receive their nerves from\\nthe spinal cord below the injury. If the disease affects one lateral\\nhalf of the cord there will be motor paralysis upon the side of\\nthe injury, and sensory paralysis on the side opposite the injury.\\nIf only certain parts or columns are diseased, the resulting phe-\\nnomena will depend upon the function of the diseased portions.\\nOf the oblongata it need only be said that all the connecting\\nfibers from the brain to the cord pass through it, the motor\\nfibers crossing over therein, and that several important cranial\\nnerves have their origin in it. Any considerable interference with\\nthe functions of the oblongata and upper part of the spinal\\ncord is incompatible with life, and incapacity of the spinal cord\\nto convey nerve impressions paralyzes those parts of the body\\nto which the spinal nerves involved are distributed. Inasmuch\\nas the nerves which control the so-called vital functions of\\nrespiration and circulation originate in or pass through the\\noblongata and beginning of the cord, the reason why marked\\ndisease or injury of this part of the cerebro-spinal axis is so\\nfatal to life is apparent. Extensive disease of the cerebrum\\nand cerebellum may exist without serious disturbance of res-\\npiration, circulation or digestion. Disease or injury of the spinal\\ncord produces more or less complete paralysis of the parts\\nsupplied by nerves given off by the cord below the point of\\ninjury, but if such disease or injury be below that part of the\\ncord directly connected with the vital functions, life may continue\\na long time.\\nThe diseases of the oblongata and spinal cord as recog-\\nnized, studied and classified in medical works are numerous\\nand of the greatest importance. They are brought about by\\na great variety of causes, are often very difficult of diagnosis\\nand their treatment may tax the resources of the best equipped\\nspecialist. It is not practical in a work intended for the general\\nreader to consider these diseases in detail. They will therefore\\nbe but briefly mentioned, grouped when possible, and only gen-\\neral outlines of treatment indicated, to the end that the reader", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0768.jp2"}, "767": {"fulltext": "DISEASES OE THE NERVOUS SYSTEM. 741\\nmay be led to appreciate their importance and induced to con-\\nsult a neurologist whenever any of the symptoms mentioned\\nare observed.\\nMYELITIS OR TRANSVERSE INFLAMMATION OF THE CORD.\\nAY hen a portion of the cord is attacked by inflammation,\\nwhich extends to all the columns and divisions, it is called\\nmyelitis, softening of the cord, transverse myelitis, or inflam-\\nmation of the cord. AYhen only a part of the columns are\\nimplicated, a specific name is used indicating the part affected.\\n[Myelitis may be acute, subacute or chronic in its onset.\\nAA hen acute there may be high temperature and rapid pulse, but\\nseldom convulsions except in children.\\nSymptoms. -The symptoms will vary widely according to\\nthe part of the spinal cord involved, but in all cases they group\\ninto four divisions, namely: Alotor, sensory, rectal and vesical.\\nAt first these symptoms are of an irritative character, passing\\nmore or less rapidly and completely into the destructive. AA hen\\nthis stage is fully set up there is complete motor and sensory\\nparalysis extending upward to the line of the nerve distribution\\ninvolved, with paralysis of the rectum and bladder. Usually\\nthere is a feeling about the abdomen or chest of a constricting\\nband, which indicates the main focus of the disease, just above\\nwhich is a zone of unnatural sensitiveness marking the irritated\\nportion of the cord just above the focus. The most frequent\\ncause of myelitis is exposure to cold and storms, injury by vio-\\nlence or muscular strain, infectious diseases, blood poisoning\\nfrom disease or introduced poisons, spinal meningitis, etc.\\nInflammation of the spinal cord, when acute, is usually\\nfatal; speedily so if it involves the upper portion. Subacute and\\nchronic cases, under favorable circumstances, sometimes make\\nfairly good recoveries, but at best the disease is serious, dis-\\nabling and likely to leave impairment behind.\\nTreatment. The proper treatment can only be conducted\\nby an able physician; but the efforts of the physician must be\\nsupplemented by the very best nursing and general care, often\\nfor a long time. In acute cases absolute rest, general measures\\nto check inflammation, and putting the patient on an air or\\nwater bed to prevent, if possible, the formation of bed sores,\\nwhich are very liable to complicate the case, are some of the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0769.jp2"}, "768": {"fulltext": "742 DISEASES OF THE NERVOUS SYSTEM.\\nessential points in care-taking. Chronic cases also require rest,\\nless pronounced, to be sure, to which general care, change of\\nscene, medicinal springs, etc., always within the limit of fatigue,\\nmay be added if practicable.\\nINFANTILE SPINAL PARALYSIS.\\nThis form of spinal disease occurs most frequently in young\\nchildren, especially during the period of first dentition. It is\\nthe most common form of paralysis to which children are sub-\\nject and is easily recognized.\\nIt may come on with suddenness and violence, acute it may\\nless violently and rapidly develop, subacute or it may slowly\\nand gradually make its appearance without active symptoms. In\\nthe most acute cases a healthy child, either with or without a\\npreliminary fever, loses completely or partially the use of one\\nor more extremities. Such loss may be sudden, the child going\\nto bed apparently well and found in the morning paralyzed,\\nor two to four days may be required to develop complete\\nparalysis.\\nConvulsions sometimes accompany the onset of the paraly-\\nsis, but sensibility is never lost it is always only motor paralysis.\\nAs a rule but one limb is affected, the leg about twice as often\\nas the arm. Occasionally both legs are paralyzed, more espe-\\ncially in the adult, and in a very few cases one arm and one leg\\nhave been involved. In subacute cases the attack comes on\\nAvith little or no force and progresses more slowly, the paralysis\\nrequiring from two to four weeks for complete development.\\nChronic cases move still more slowly.\\nAny of the voluntary muscles of the limbs or trunk may\\nbe affected, but the functions of the rectum and bladder are\\nnot impaired. After a few days the paralyzed muscles begin\\nto regain their power. Such recovery may be almost complete\\nand but few muscles remain permanently impaired, or nearly\\nall the muscles originally affected may remain paralyzed; but\\ncomplete recovery in all the muscles affected by infantile paralysis\\nnever takes place. All the muscles which remain paralyzed ulti-\\nmately become atrophied and degenerated. The growth of the\\nbones of the affected part is also retarded, with the result that\\nthe affected limb becomes shorter and smaller than its fellow,\\nas well as deformed, because of the unopposed action of the\\nhealthy muscles.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0770.jp2"}, "769": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 743\\nThe real underlying disease in this form of paralysis is\\ninflammation and degeneration of the anterior horns or projec-\\ntions of the H-shaped gray matter of the cord, these horns\\nbeing, as has already been described, the tract in which the\\nmotor fibers from the brain connect with the motor fibers\\nfrom the cord to the muscles. Disintegration of this tract, there-\\nfore, prevents motor impulses being sent from the brain to the\\nmuscles, which become withered or atrophied and degenerated,\\nbecause of disuse, and also because of deprivation of that nervous\\ninfluence which controls, guides and stimulates nutrition.\\nThe cause of this disease of the spinal cord is not clearly\\nestablished. It is by far the most frequent form of paralysis to\\nwhich children are subject, and in its acute form is peculiar\\nto childhood, affecting the sexes equally, and generally occurring\\nwithin the first three years of life rarely after the sixth year,\\nand has been known to attack an infant twelve days old. It is\\nfound all over the civilized world, often attacks strong, healthy\\nchildren, although most observers find a majority of cases in\\nthose who are weak and delicate. In many cases other members\\nof the same family are affected with some nervous disturbance.\\nAmong the apparent causes of the acute form in childhood\\nare exposure to cold and dampness, injury by fall, etc., disorders\\nfollowing such acute diseases as measles, scarlet fever, cerebro-\\nspinal meningitis, etc. Not infrequently parents ascribe this\\ndisease to a fever, when in fact the fever only marks the\\ninflammatory invasion of the cord, and is a consequence rather\\nthan a cause of the disorder. There is no doubt that the strain\\nupon the nervous system during the period of first dentition\\nbrings about a state of irritability shown by restlessness, disturbed\\nnutrition, sleeplessness, etc., in which the spinal cord is unusually\\nsensitive, and in which slight active causes, as cold, may pro-\\nvoke the next step in the process of inflammation. The chronic\\nform is seen in adults, usually between the eighteenth and\\nfortieth years. In adults, males are most affected, and injury,\\nmuscular or mental strain, syphilis, dissipation and sexual excess\\nare prominent causes.\\nIn cases ushered in by fever or convulsions it is impossible\\nto decide that one has to do with this disease until the paralysis\\nhas occurred. Hence, the fever, convulsions, etc., must be\\ntreated upon general principles and endeavor made to lessen", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0771.jp2"}, "770": {"fulltext": "744 DISEASES OF THE NERVOUS SYSTEM.\\nthe fever and control the convulsions or other reflex disturbances.\\nAs soon as the paralysis makes its appearance the physician\\ncan determine the nature of the disease and begin a rational\\ntreatment.\\nCounter-irritation to the region of the spine, or to the\\nwhole surface, purgatives to lessen congestion of the cord, etc.,\\nare advantageous.\\nFor the inflammation of the cord and the degenerations\\nthereby set up, but little can be done, but suitable medication\\nmay be of great benefit in preventing extension of the inflamma-\\ntion and in restoring to their proper function those parts of\\nthe cord which are congested and unnaturally irritable on account\\nof proximity to the inflamed portion. Dry cups to the spine\\nat the seat of the lesion will be useful in this direction.\\nElectricity properly applied to the paralyzed muscles is a\\nvery effective agent in keeping up their nutrition and integrity\\nuntil the cord resumes its functions. Under its long-continued\\nuse muscles which at first seemed to have hopelessly lost their\\npower may be restored.\\nThe deformities which result from infantile spinal paralysis\\nare varied and often incapacitating. While these cannot be\\ncured, a good deal can be done to mitigate them. Mechanical\\nappliances will sometimes enable sound muscles to supply, in\\npart, the movements of the disabled ones.\\nMassage, especially mechanical massage, will aid in restoring\\nnutrition and function to disabled muscles, and tenotomy (divid-\\ning the tendon) will relieve some contractions and sometimes\\nrestore mobility to joints; all of which must be undertaken only\\nunder competent medical direction.\\nThere are a number of diseases of the spinal cord and\\noblongata which, although not very common, are of serious\\nimportance to the patient and of great interest to the physician.\\nThey are too complicated and too difficult of comprehension to\\nwarrant a detailed description for the general reader, and they\\nwill therefore receive only brief mention.\\nACUTE ASCENDING PARALYSIS.\\nThis is a form of paralysis, almost wholly motor, commenc-\\ning, in the legs, ascending successively to the trunk, the arms,\\nand lastly to the neck and face. Most cases terminate fatally", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0772.jp2"}, "771": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 745\\nin from two or three clays to two or three weeks, because exten-\\nsion of the disease to the oblongata causes death by involving\\nthe vital centers of respiration, circulation and deglutition.\\nThis disease attacks males more frequently than females\\nand occurs chiefly between the ages of twenty and forty years.\\nIt appears to have been caused by severe exposure to cold, or\\nto have followed small-pox, diphtheria, typhoid fever, or some\\nother obscure febrile disease. Not infrequently the sufferers have\\nbeen subject to chronic alcoholism. It is very probable that the\\nimmediate factor in the nerve disturbance is some hitherto\\nunrecognized toxic agent. While the outlook, especially in\\nrapidly moving cases, is extremely bad, recoveries have some-\\ntimes taken place from conditions apparently hopeless.\\nSPINAL HEMORRHAGE.\\nExtravasations of blood sometimes occur into the spinal\\ncanal, rarely into the cord itself. Such hemorrhage may happen at\\nany age, the most frequent cause being injury, which may have\\nproduced fracture of the backbone and laceration of vessels, or\\nwhich may have been only a severe jar.\\nSpinal hemorrhage may also be brought on by prolonged\\nand severe muscular exertion, as, for instance, a typical case\\nwhich occurred in a man who had just won an eight-day, go-as-\\nyou-please walk. It may also occur in the course of certain hem-\\norrhagic diseases, as purpura, small-pox, yellow fever and typhoid\\nfever.\\nThe prominent symptoms arise from the pressure upon the\\ncord and consequent impairment of functions, and consist of\\nsudden and violent pain in the back and along the nerves in-\\nvolved in the pressure, various abnormal sensations, muscular\\nspasms, etc., followed by paralysis of the parts supplied by nerves\\nbelow the hemorrhage. The cerebral functions are not usually\\nimplicated. Spinal hemorrhage is a very dangerous disease and\\nmay prove fatal in a few hours. In cases from injury, and some\\nothers, when a satisfactory diagnosis can be made and the patient\\nis strong enough, a surgical operation is warranted. In slowly\\ndeveloping cases rest, remedies to divert the blood to other parts\\nand wet cupping of the back are indicated. If the patient sur-\\nvive long enough, inflammation of the cord below the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0773.jp2"}, "772": {"fulltext": "746 DISEASES OE TEIE NERVOUS SYSTEM.\\nhemorrhage will be set up and the treatment will be the same as for\\nmyelitis.\\nPROGRESSIVE MUSCULAR ATROPHY OR WASTING PALSY.\\nThis is a disease characterized by a chronic progressive\\natrophy (wasting away) of the muscles, accompanied by motor\\nparalysis, the atrophy and paralysis being almost always exactly\\nproportionate. Symmetrical bilateral muscles are often attacked;\\nsometimes muscles widely separated are attacked one after an-\\nother. This disease presents several varieties or types, as the\\nhand type, in which the atrophy generally begins in the muscles\\nof the thumb and little finger and progresses to the muscles\\nof the hand, producing the so-called claw hand, in which\\nthe fingers are drawn and bent somewhat like claws. After a\\nlong time, years perhaps, the atrophy extends to the forearm\\nand upper arm; ultimately the muscles of the shoulder become\\ninvolved, and sometimes those of the tongue, of deglutition and\\nof respiration, which may lead to inanition and disturbances in\\nthe breathing which may prove fatal.\\nThere are two forms seen especially in the young, the one\\nattacking almost always the muscles of the shoulder and upper\\narm first, and extending therefrom; the other beginning in the\\nmuscles of expression of the face; lastly, there is a form attacking\\nthe muscles of the leg and foot.\\nThis disease is of a slow character, running from five to\\nthirty years. The changes in the muscles depend upon a slow\\ndegeneration in the anterior horn of the H-shaped gray matter\\nof the cord the part of the cord whence the motor nerves arise\\nwhich leads to degeneration of the motor nerves and consequent\\natrophy of the muscles. The two forms especially seen in the\\nyoung are very largely hereditary, extending sometimes through\\nseveral generations. The hand and leg types are not often hered-\\nitary, but frequently depend upon muscular strain, prolonged\\nexposure to cold, etc., as in mechanics who use the right arm\\nexcessively and men working in refrigerators and handling ice.\\nProgressive muscular atrophy is seldom seen among the\\nwealthier classes, except in the hereditary form, the other forms\\nbeing practically limited to the working classes, on account of\\nthe greater use of muscles and greater exposure.. Acute dis-\\neases are sometimes followed by progressive muscular atrophy.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0774.jp2"}, "773": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 747\\nThe adult form is more common in men than in women. An\\nunfavorable outcome may be expected in this disease. It is\\nimportant, therefore, that in the beginning of any condition\\nsuggesting this malady a careful diagnosis be made. For reliev-\\ning the patient s condition and delaying the progress of the dis-\\nease, electricity., massage, rest, cod-liver oil, nerve stimulants\\nand a generous diet, in short, means to keep up the nutrition\\nand tone of the nerves should be employed.\\nLOCOMOTOR ATAXIA.\\nThe most common of the chronic diseases of the spinal cord\\nis generally called locomotor ataxia, which, freely translated,\\nmeans inability to walk. This inability does not depend upon\\natrophy or weakness of the muscles, but upon inability to\\nproperly combine their action so as to produce a desired result,\\nand this is what is meant by ataxia. Motor ataxia is the form\\naffecting the movements of the extremities. In static ataxia the\\npatient is unable to maintain a steady, upright position of the\\nbody when sitting, but continually sways from side to side\\nthe difficulty in both cases being of the same nature, but affecting\\ndifferent muscles. In attempting to walk the patient makes\\nunnatural, jerky, uncertain movements, his legs flop about, and\\nhe may be entirely unable to walk, or even to stand, although\\nhis legs cannot be flexed or extended by the strongest man.\\nThe disease is also called tabes dorsalis, which means wasting\\nof the back, and is sometimes known as consumption of the\\nspinal cord.\\nThe principal causes of locomotor ataxia are syphilis, injury,\\nalcoholism, other spinal diseases, chronic poisoning by ergot (seen\\nonly in foreign rye-eating countries) and chronic poisoning by\\narsenic. In addition to the ataxia, both motor and static, the\\npatient is affected with pains of a most violent, stabbing, lan-\\ncinating character, which come and go suddenly and irregularly,\\nand which are not confined to any one particular spot. There\\nis also a peculiar condition of the eye, due to atrophy of the\\noptic nerve, also sudden violent pains in the stomach, larynx,\\nor over the kidneys, liable to last some hours, and simulating\\ndiseases of the organs of those regions. The functions of the\\nbladder are frequently deranged, sometimes early in the disease,\\nand the patient may be aware only of bladder trouble. Changes", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0775.jp2"}, "774": {"fulltext": "748 DISEASES OF THE NERVOUS SYSTEM.\\nin nutrition occur, the bones may become brittle and break\\nunder any slight provocation the joints become impaired and\\nmovement may be either limited or too free, as in the knees,\\nwhich in attempting to stand may bend the wrong way, almost\\nas much as they bend the right way in normal walking.\\nThere are also other symptoms, not peculiar to this disease,\\nas zones of lessened sensibility, retardation of pain conduction\\nshown by pricking the patient with a pin, which he feels only\\nafter several seconds, a feeling as of a girdle encircling the body,\\netc. This disease is essentially chronic in nearly all cases and\\nmay extend over many years. Occasionally an acute case will\\nrun its course in a few months.\\nIt is not practical to go much into details as to the funda-\\nmental lesion or disorder of locomotor ataxia. It need only be\\nsaid that it is a degeneration of the spinal cord, and that other\\nparts of the nervous system are more or less involved.\\nTo the skilled neurologist the diagnosis of clearly cut cases\\nof this disease is not difficult, but in irregular cases and those\\ncomplicated with other disorders it may be very difficult, for a\\ntime at least, to determine the real condition. Locomotor ataxia\\nis a very incurable disease indeed, the best authorities claim\\nthat the degeneration of the cord, upon which it depends, is\\nnever cured, but there is no doubt that in many cases the prog-\\nress of the disease can be arrested and the patient relieved of a\\ngreat deal of suffering and in many ways made much more com-\\nfortable. To this end anti-syphilitic treatment should be used\\nin cases in which syphilis is a factor; galvanism, warmth and\\nsuspension are useful, together with remedies which directly\\naffect the cord and nerves. The food should be light, but nutri-\\ntious and easily digested; peptonized, if need be. The patient\\nshould avoid mental work, anxiety and bodily fatigue. In severe\\nacute cases rest in bed for a few weeks is often useful in the more\\nchronic forms exercise need not be_entirely suspended, but should\\nalways stop short of fatigue. Exposure to cold is injurious and\\nwinter is best spent in a warm, dry climate. The patient should\\nhave the best general surroundings practicable.\\nTRAUMATIC AFFECTION OF THE CORD.\\nThe spinal cord is liable to direct injuries and also to be\\nimplicated in injuries to the vertebral column the bony case in", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0776.jp2"}, "775": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 749\\nwhich it is suspended. Direct injuries to the cord may result\\nfrom concussion, as from a fall, railway jar or other violence\\nnot sufficient to fracture the r ertebra. Such injuries may result\\nin hemorrhage into or around the cord the substance of the\\ncord may be lacerated, causing inflammation and softening, or\\nthe jar to the cord may interfere with its functions without evi-\\ndence of actual gross lesion. In fracture or dislocation of the\\nvertebral column it is scarcely possible for the cord to escape\\ndamage, which may vary from very slight to such severe injury\\nas to produce complete paralysis below the damaged part, or if\\nthe injury be in the very upper part of the cord death may follow\\nat once.\\nThe symptoms of traumatic myelitis may not occur imme-\\ndiately after the injury, but come on gradually; still the symp-\\ntoms are those of more or less acute myelitis, depending in detail\\nupon the location of the injury.\\nThe cord is also liable to be affected in chronic diseases\\nof the bony canal, as Pott s disease, which is, essentially, disor-\\nganization of some of the vertebral bones, causing shortening\\nand sharp bends in the column, which may lead to pressure upon\\nthe cord, etc.\\nIf fracture of the vertebral column be of such a character\\nas to indicate clearly that the spinal cord has been severed, noth-\\ning will restore its functions; if the fracture produce such com-\\npression as to endanger the integrity of the cord, surgical inter-\\nference at once is required if there be little or no compression\\ngeneral treatment should be given at first; surgery may be\\nneeded later.\\nIt may not be amiss to remind the reader that the danger\\nto life of a fracture or dislocation of the back or neck depends\\nupon the injury done the spinal cord. Many persons have lived\\na long time, some of them in fairly comfortable health, with a\\nbroken back or neck others have lived years with the whole\\nlower part of the body paralyzed, while in other cases death is\\ninstantaneous.\\nThere are several other diseases of the spinal cord which\\nare very important and of great interest to the neurologist, but\\nwhich are so complicated in symptoms as to render it scarcely\\npracticable to give them extended notice in a popular work.\\nThey will, therefore, receive but brief mention.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0777.jp2"}, "776": {"fulltext": "750 DISEASES OF THE NERVOUS SYSTEM.\\nSPINAL SCLEROSIS.\\nThe motor portions of the spinal cord are liable to a peculiar\\ndegeneration called sclerosis, which consists essentially of a hard-\\nening of the nerve bundles and a degeneration of the axis cylinder\\nof the nerve fibers, which impair and finally destroy its functions.\\nThe symptoms of spinal sclerosis differ according to the\\nparticular portion of the cord affected; but in general, sclerosis\\nis characterized by a permanent contraction of the muscles, some-\\ntimes so marked as to disfigure the limbs, and sometimes only\\nso much as to produce a peculiar spasmodic gait in which the\\npatient scarcely touches his heel to the ground, but w r alks upon\\nhis toes and the ball of the foot, as if upon stiff springs, with a char-\\nacteristic jerky, jiggery motion. In some forms the functions\\nof the bladder are involved, in others not. Generally there are\\nneither cerebral, sensory nor rectal symptoms. Sometimes there\\nis muscular atrophy, with contraction, which gives rise to claw\\nhand, etc. All the forms of sclerosis are slow moving, chronic\\nin character and hopeless as to cure, although by proper treat-\\nment, good nursing and favorable surroundings the fatal issue\\nmay be long delayed. The duration may be said to extend\\nfrom three to fifty years.\\nBULBAR PARALYSIS.\\nSometimes the oblongata is affected with a degeneration of\\nits motor cells, which especially affects the motor cranial nerves\\nwhich spring from this region and are distributed to the tongue,\\nlips, larynx, etc. The impairment of function of the implicated\\nnerves leads to a difficulty in articulation, especially in pro-\\nnouncing words containing letters which require delicate co-or-\\ndinate movements of the tongue and lips. Indeed, it is gener-\\nally this interference with articulation which first attracts the\\npatient s attention. The paralysis increases, the palate becomes\\naffected and finally the voice is much enfeebled by reason of\\nparalysis of the muscles of the larynx. Mastication, deglutition,\\nrespiration and heart action become involved with the progress\\nof the disease. The lower part of the face loses its expression\\nand the tongue becomes atrophied. The original causes which\\nlead to this degeneration of the oblongata progressive bulbar\\nparalysis (the upper part of the cord and the oblongata are some-\\ntimes called the bulb) are not certainly known. The disease", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0778.jp2"}, "777": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 751\\nis essentially a progressive and fatal one, and although some\\ntimes there will be remissions and the symptoms apparently be\\nat a standstill, ultimately death ensues by interference with the\\nvital functions of respiration and circulation, as well as of nutri-\\ntion. Only palliative treatment is available, such as rest, care,\\nskillfully prepared food and a few drugs which seem to produce\\na temporary benefit.\\nPSEUDO HYPERTROPHIC MUSCULAR PARALYSIS.\\nA peculiar neuro-muscular disease called pseudo (false) hyper-\\ntrophic muscular paralysis is so called because of the great in-\\ncrease in size of the legs, occasionally the arms also, accom-\\npanied by paralysis, but without mental, sensory, rectal, vesical\\nor atrophic symptoms. This disease generally commences in\\nchildhood, most usually occurs in males, and is hereditary. The\\nfirst symptom is weakness of the legs; the child has difficulty in\\nwalking, the legs are braced apart, the gait becomes waddling,\\nthe difficulties in walking increase till the child becomes helpless,\\nalthough the legs are unnaturally large. The immediate cause\\nof this condition is increase of the connective tissue between\\nthe muscular fibers which gives the exaggerated size the mus-\\ncular fibers disappear and are replaced by fatty matter, and\\nthere is also degeneration of the nerve elements and of the spinal\\n.cord. No case of this disease has ever been known to be cured,\\nand treatment, thus far at least, has been of no curative avail;\\nso our efforts are limited to care and nursing.\\nINTRA-CRANIAL HEMORRHAGE, EMBOLISM AND\\nTHROMBOSIS.\\nThese three derangements of the circulation within the cra-\\nnium give rise to similar cerebral symptoms and will be con-\\nsidered together. By intracranial hemorrhage is meant the\\ngiving way of a blood vessel and the pouring out of blood\\ninto the brain substance or into one of its cavities, or upon\\nits surface. Embolism is the obstruction of a small blood vessel\\nby a blood clot formed elsewhere, as on the valves of the heart\\nin heart disease, or by some other foreign matter, in either case\\nswept on to its resting-place by the blood current. Thrombosis\\nis the obstruction of a blood vessel by coagulation of the blood\\ntherein.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0779.jp2"}, "778": {"fulltext": "752 DISEASES OF THE NERVOUS SYSTEM.\\nHemorrhage is the most common. The brain is very vascu-\\nlar and receives a proportionally large amount of blood. Its smaller\\nvessels are very delicate and it is especially liable to hemorrhage,\\nespecially after middle age, when the vessels are liable to become\\nweakened. Intracranial hemorrhage may also occur in various\\ndiseases which lead to changes in the blood as pyemia (blood\\npoisoning from pus), typhoid fever, etc. Heredity is an im-\\nportant factor on account of the tendency which exists in some\\nfamilies to arterial disease. It was formerly thought that a person\\nwith a short neck, broad chest and florid complexion was par-\\nticularly liable to cerebral hemorrhage, but it is clear that persons\\nof the exactly opposite type are equally liable. The use of alco-\\nholic drinks is a strongly predisposing cause, by producing dis-\\nease of the vessels.\\nThere are two classes of symptoms which attend each of\\nthe three disorders, cerebral hemorrhage, embolism and thrombo-\\nsis The reflex and the localizing. The reflex symptoms are\\nthose due to the shock which the cerebrum as a whole sustains.\\nThe localizing symptoms vary according to the location of the\\ndisease. The reflex symptoms are loss of consciousness, or coma,\\nmental disturbances, convulsions and alterations of temperature,\\nand will be more or less marked according to the rapidity of\\nthe hemorrhage or the amount of brain involved. Loss of\\nconsciousness may come suddenly without warning, and be com-\\nplete, in which case the attack is called apoplexy, or it may be\\npreceded by confusion, difficulty of speech, drowsiness, nausea,\\netc., and come on slowly and gradually. In the comatose state\\nthe face is usually swollen and flushed, or sometimes pale and\\nclammy, the eyes fixed, pupils dilated and sluggish, respiration\\nslow and noisy, with the cheeks puffing out, pulse slow and\\nfull, and the limbs useless. Convulsions frequently occur and\\nmay extend to all parts or be limited to one side, which is after-\\nwards found to be paralyzed. The localizing symptoms vary\\naccording to the precise location of the disease, but as consid-\\nerable knowledge pertaining to the nerves is required to under-\\nstand them they will not be enumerated.\\nCerebral hemorrhage may be of such extent and involve such\\nimportant structure as to lead to death, either immediately or\\nwithin a few days, without return to consciousness, or the pa-\\ntient may recover from the shock and nearly regain his former", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0780.jp2"}, "779": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 753\\nvigor; but as a rule there is left more or less paralysis, contraction\\nand mental impairment. It is not always possible to distinguish\\nbetween these three varieties of cerebral disease. In all cases with\\nsymptoms of cerebral hemorrhage, embolism or thrombosis the\\nservices of the physician should be sought at once.\\nThe patient should be kept quiet in bed, and not allowed to\\nrise up, until all the reflex symptoms have disappeared. In the\\nviolent, apoplectic form of attack, active cathartics are useful by\\nlessening blood pressure and thereby aiding to check the escape\\nof blood from the ruptured vessel. Indeed, in many cases, bleed-\\ning would be very advantageous for its immediate effect in ar-\\nresting the hemorrhage, but so great is the prejudice against it\\nthat it has almost wholly fallen into disuse. If the hemorrhage\\nceases, and the patient begins to improve, remedies to aid in the\\nabsorption of the blood clot and to lessen nervous irritability will\\nbe useful. The diet should be simple and moderate, and all the\\nbodily functions be kept in the best order possible. The best of\\nnursing will be required to prevent bed sores and other complica-\\ntions.\\nIf the patient improves and the more serious symptoms of\\nshock abate, there is still danger of fatal result from inflammation\\nand disorganization of the brain. If this danger be passed suc-\\ncessfully, there may still remain more or less paralysis, inability\\nto speak, and other mental impairment. Time will frequently re-\\nlieve these conditions, and general tonic medication with electric-\\nity may be of great service. Cerebral hemorrhage, if not fatal at\\nthe first attack, is likely to recur and ultimately to carry off the\\npatient.\\n48", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0781.jp2"}, "780": {"fulltext": "CHAPTER V.\\nDISEASES OF THE CEREBRUM, OR LARGER BRAIN.\\nCEREBRAL PALSIES OF CHILDREN.\\nChildren are subject to different forms of paralysis of cere-\\nbral origin. These palsies consist of hemiplegia (paralysis on one\\nside), double hemiplegia (on both sides) or paraplegia (both\\nlower limbs), with spasmodic symptoms, and some wasting of the\\nmuscles and contractions, to which is often added mental impair-\\nment, and speech defect, or mutism. These palsies may be a re-\\nsult of defects of fetal development, of excessive pressure upon the\\nbrain during the birth process, or of hemorrhage, embolism or\\nthrombosis, or sudden cellular disintegration, and other degenera-\\ntions not well understood, to which children are especially sub-\\nject during the first three or four years of life. Hemiplegia usu-\\nally occurs before the third year has passed, if at all, and the mental\\npowers may or may not be impaired. In cases resulting from con-\\ngenital causes (accidents at birth), there is frequently marked\\nmental defect, and the face is often expressionless.\\nThe outcome of these cases will depend largely upon the\\namount of damage done the brain. This damage may be so great\\nthat the mental powers will never develop and the limbs will be\\nuseless, or it may be so slight that the mind will not be injured,\\nnor the use of the palsied limb be entirely lost, although it will\\nbe smaller and weaker than its fellow.\\nBut little can be done directly in the way of treatment. Time\\nand good general health will lead to much improvement in some\\ncases, and the deformities can sometimes be lessened by surgery,\\nbut operations on the brain are not warrantable.\\nTUMOR OF THE BRAIN.\\nThe brain is subject to the growth therein of various forms of\\ntumor, among which are tubercle, sarcoma (the most common\\nform of cancer), glioma (an abnormal nerve growth), gumma (a\\nsyphilitic growth), parasitic cysts and bony growths; other rare\\n754", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0782.jp2"}, "781": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 755\\nforms need not be mentioned. Tumors of the brain are very much\\nmore common in men than in women. A few cases occur before\\nthe twentieth year, most cases between the twentieth and fortieth,\\nand more after forty than before twenty. In children, tubercle\\nis the most common, in young adults glioma, and after maturity\\nsarcoma and gumma.\\nThe general symptoms of brain tumor are headache, which\\nis one of the most constant, but varies greatly in character and lo-\\ncation; vertigo, generally slight and vague; nausea and vomiting,\\nwhich may be slight or so severe as to endanger life; neuritis of\\nthe optic nerve convulsions, general and due to disturbance of the\\ncerebrum or cerebellum as a whole, or limited to certain muscles\\nbecause of implication of certain motor tracts, and, finally, men-\\ntal disturbances, which may be slight or severe and tending to\\ndrowsiness and coma. There are also likely to be variations in\\nthe pulse, respiration and pupils later, derangement of many func-\\ntions, and, at last, paralysis of the bladder and bowel, bed sores,\\netc.\\nThe tendency of brain tumor is to a fatal issue, but in some\\ncases, especially of a syphilitic character, great improvement and\\narrest of progress may follow proper treatment. In some selected\\ncases brain tumors have been successfully removed by surgery\\nand the patient cured, perhaps the highest triumph of the neurolo-\\ngist and the surgeon.\\nHYDROCEPHALUS; DROPSY OF THE BRAIN; WATER ON THE BRAIN.\\nThe surface of the brain and spinal cord, and the natural in-\\nterior foldings of the brain constituting the ventricles, are bathed\\nand lubricated by a serous liquid called the cerebro-spinal fluid.\\nIt sometimes happens that because of some disease of the brain or\\nits membranes, or some imperfection in development, that this\\nfluid is secreted in excess and causes pressure, both upon the brain\\nand against the skull. This excess of water in the brain is called\\nhydrocephalus. It may be congenital and cause such intra-uterine\\nenlargement of the head as to impede, or even prevent, birth or\\nnot apparent at birth, it may develop soon after, or within the\\nfirst few years of childhood. Cases developing in childhood usu-\\nally depend upon meningitis of some kind. Occasionally it de-\\nvelops later, even in adults. Dean Swift died at seventy-eight, of\\nhydrocephalus of three years duration, dependent, doubtless,\\nupon obstruction in the venous circulation.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0783.jp2"}, "782": {"fulltext": "756 DISEASES OF THE NERVOUS SYSTEM.\\nThe most notable symptom of this disease is an unnatural\\ndistention of the skull, which has a peculiar shape, being rounded\\nin front, bulging above the eyes and rather overhanging them.\\nThe eyes themselves are pushed forward in their sockets and di-\\nrected downward. Sometimes the distention of the skull is so\\ngreat that the bones are separated and the soft spots, which in\\nthe healthy child become closed by bone, always remain open\\nand, in fact, grow larger. There is generally a good deal of men-\\ntal defect, frequently paralysis of one or more limbs, convulsions\\nand contractions. The vision may be impaired because of pres-\\nsure upon and disease of the optic nerve. Frequently the child\\nshows mental irritation, resembling a mild meningitis, such as\\nrestlessness, sharp cries, disturbed sleep, etc.\\nThe amount of fluid is usually one or two pints, although\\nfrom six to eight pints, and even more, have been reported. In\\ncongenital cases the fluid is in the ventricles (cavities) of the\\nbrain, and the brain substance is thinned and pressed against the\\nskull.\\nHydrocephalus is almost always a fatal disease, although\\nthose affected with it occasionally live to twenty or thirty years;\\nthe head sometimes becoming so large and heavy that the patient\\ncannot support it in the erect position, but has to continually lie\\nin bed, or have the head upheld by artificial support. In a few in-\\nstances the disease has been arrested and the patient has lived\\nmany years with good mental powers, but this is very unusual.\\nIn congenital cases medicinal treatment is almost never of any\\nbenefit. In cases occurring as sequels of meningitis medical treat-\\nment may be beneficial. Surgical procedure, by drawing off the\\nfluid by compressure of the head, has been tried, but without any\\nencouraging success.\\nDISEASES OF THE CEREBRO-SPINAL SYSTEM AND\\nITS MEMBRANES.\\nCEREBRO AND SPINAL MENINGITIS.\\nThe membranes inclosing the brain and cord are called\\nmeninges, and are subject to inflammation meningitis which is\\ndivided into different forms, according to the location or nature\\nof the disease, being called tubercular when caused by tubercular\\ndeposits; suppurative when accompanied by formation of pus;", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0784.jp2"}, "783": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 757\\ncerebrospinal when the membranes of both brain and spine are\\naffected. Other terms with special technical meanings need not\\nbe mentioned.\\nSUPPURATIVE MENINGITIS.\\nSuppurative meningitis is caused by extension of inflamma-\\ntion from ear disease, or nasal disease, by purulent pleurisy, and\\ninfection from other diseases, as well as from injury, exposure to\\ncold, and from sunstroke. The very close connection of the ear\\nwith the brain, the intercommunication between them by veins,\\narteries and connective tissue, and the nearness of the brain to\\nthe mastoid cells which so often become involved in suppuration\\nof the ear, render very liable the extension of the suppurative proc-\\ness to the brain. Indeed, ear disease is the most frequent of all\\nthe causes of suppurative meningitis. In a similar way disease\\nmay be communicated from the nasal passages. It may also fol-\\nlow suppurative pleurisy, and many other suppurative diseases,\\nby the passage of infection through the blood vessels. Injury\\nto the head, even though not apparently serious, may also cause\\nthis affection. Exposure to cold or heat, especially direct ex-\\nposure of the unprotected head to a very hot sun, are occasional\\ncauses.\\nIn meningitis from disease of the ear or nose, the base and\\nsides of the brain are most affected, but in infectious cases\\nand those from sunstroke the top is more implicated. The post-\\nmortem appearance of the brain is, in lighter cases, that of conges-\\ntion dotted with pus, but in severe cases the whole surface may be\\nbathed in pus.\\nSuppurative meningitis may occur at any age, and fatal cases,\\nfrom extension of chronic ear trouble, or from acute involvement\\nof the mastoid cells, are not uncommon. Senator Conkling of\\nNew York died from extension to the brain of ear disease caused,\\nor at least made active, by exposure in a very severe snowstorm.\\nSymptoms. The general symptoms are headache, delirium,\\nfever, coma, muscular twitchings, convulsions, paralysis. These\\nsymptoms also attend other forms of brain disease, and the history\\nof injury or of previous disease, and the condition of other organs,\\nmust be carefully examined, especially the ear, nostrils, heart and\\nlungs. It will not always be possible for the physician to make a\\nsatisfactory diagnosis at first. This disease is of a very serious\\nnature, although patients sometimes recover.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0785.jp2"}, "784": {"fulltext": "758 DISEASES OF THE NERVOUS SYSTEM.\\nTreatment. The treatment will depend largely upon the\\ncause. If there is disease of the ear, giving rise to an accumula-\\ntion of pus, it should be liberated by an operation. Disease of the\\nnasal bones should be removed, if possible. Suitable remedies to\\ncheck inflammation, and antiseptic treatment, together with the\\nbest care and nursing, are also required.\\nCEREBRO-SPINAL MENINGITIS.\\nCerebro-spinal meningitis, first recognized as a distinct dis-\\nease in Europe in 1805, has been known as spotted fever, sink-\\ning typhus, epidemic meningitis and many other names, but\\nsince its pathology has become well settled, it is known all over\\nthe world by the scientific name given at the beginning of this\\nparagraph. Its first recognized appearance in America was at\\nMedfield, Mass., in 1806, when it was known as sinking typhus.\\nIt was epidemic within the bounds of New England for about ten\\nyears. In 1822 it occurred in Middletown, Connecticut; in\\n1828 in Trumbull County, Ohio; in 1842 in Kentucky, Ten-\\nnessee and Alabama, and then became more widely scat-\\ntered. In 1864 it appeared in Carbondale, Pennsylvania, and\\ncaused the deaths of four hundred children in a population of\\nsix thousand. Various other epidemics, too numerous to men-\\ntion, have since occurred, both in Europe and this country, in\\nfact, in nearly every civilized land, and it now seems to have be-\\ncome naturalized in the cities of the United States, and occasion-\\nally appears in the country.\\nCerebro-spinal meningitis is what is termed a constitutional\\nmalady, that is, a disease which permeates the whole system, and\\nthe meningitis is simply one of its local manifestations the most\\nstriking and important one. The specific poison to which it is\\ndue has not been discovered, but the weight of opinion is that it\\nis caused by a micro-organism. As its name implies, the special\\nmanifestation from which the most serious symptoms arise is an\\ninflammation of the coverings (meninges) of the brain and ad-\\njacent spinal cord. This inflammation varies very greatly in ex-\\ntent, and in the stage to which it may attain. It may extend over\\nmost of the cerebral surfaces, or may be confined to small areas.\\nIn very acute, quickly fatal cases, the disease of the membranes\\nmay not have passed beyond the stage of hyperemia (the unnat-\\nural fullness and redness immediately preceding inflammation),", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0786.jp2"}, "785": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 759\\nbecause the vital powers are so overcome by the constitutional\\ndisease as to produce death, before the inflammatory process has\\nhad time to go on to other stages. It is generally found, how-\\never, that the inflammation has fully begun and free exudation,\\neither serous, fibrinous or purulent, is found in and beneath the\\npia mater (membrane investing the brain), together with inflam-\\nmation of the brain substance itself.\\nA study of the location of cases occurring in cities indicates\\nthat unhygienic conditions favor the development and spread of\\nthis disease, yet it sometimes attacks those who live with the very\\nbest city surroundings or in healthful country places. Nearly\\nthree-fourths of the cases occur in children under ten years of\\nage. As a rule the onset is sudden, generally with headache,\\nvomiting and a chill or convulsions, followed by fever; drowsiness\\noccurs in slight cases, delirium and coma in severe ones. In some\\nepidemics there is a mottled appearance of the skin, or a rash, or\\nnumerous minute extravasations of blood phenomena which\\nhave given the malady one of its names, spotted fever. As the\\ndisease goes on, the eyes are likely to be drawn and the pupils act\\nirregularly. The headache becomes very severe and the head\\nis drawn back, or the whole body is curved backward by the con-\\ntraction of the posterior muscles so only the back of the head\\nand the heels touch the bed. Sometimes there is muscular paraly-\\nsis, more or less marked, and other symptoms pointing to the in-\\nvolvement of various nerves.\\nIn very violent cases death may ensue within twenty-four\\nhours others last one or two weeks, and sometimes three or four\\nweeks. When recovery occurs it generally comes within four\\nweeks. About one-half the cases are fatal, and in many which\\nsurvive irreparable damage has been done the nervous system,\\nwhich is more likely to cause paralysis than mental impairment.\\nTreatment. The treatment is beset with difficulties. In very\\nsevere cases death comes before there is time for palliative treat-\\nment. In those of less violence there should be, first, the best\\nof nursing. No one should be allowed to see the patient but the\\nphysician and nurse. In no other disease is quiet more important.\\nGreat harm may be done by the officious meddling, so common\\nwhen kindly disposed neighbors run in to help. Even apparently\\nuncomfortable positions and lack of cleanliness would better be\\npermitted rather than disturb the patient. The strictly medical", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0787.jp2"}, "786": {"fulltext": "760 DISEASES OF THE NERVOUS SYSTEM.\\ntreatment will depend a good deal upon existing conditions. In\\ngeneral, cold to the head with warmth to the extremities is in-\\ndicated. Among drugs, those which contract the arterioles and\\nlessen the circulation in the brain, those which tend to lessen ex-\\nudation and later stimulate its absorption, and those which tend\\nto keep up the functions of respiration and circulation, together\\nwith such as have a soothing, quieting and hypnotic effect, are\\nof great value when intelligently used. Of course, so serious a\\ndisease demands the best efforts of the most skillful physician.\\nThe most careful attention should be given to the diet,\\nwhich should be light and easily digested. If convalescence be\\nestablished, remedies to promote absorption and to stimulate di-\\ngestion and nutrition should be employed, as usual.\\nTUBERCULAR MENINGITIS.\\nThat the general reader may gain a clear understanding of\\ntubercular meningitis, brief attention must be given to what tuber-\\nculosis really is.\\nTuberculosis is an infectious disease, caused by the tubercle\\nbacillus, and characterized by the production of tissue and inflam-\\nmatory products, which appear in the form of nodules, and also\\nas a more diffused infiltration, and which rapidly undergo a\\ncheesy degeneration. The tubercle bacillus is a micro-organism\\nwhich may find its way into the system through the air passages\\nthrough the food passages, by contact with abraded surfaces, etc.\\nThis bacillus is so common and abundant that it no doubt finds\\nentrance into every individual. In the strong and vigorous it\\nfinds no suitable soil and makes no lodgment, but when the sys-\\ntem is susceptible, on account of hereditary weakness, debility\\nfrom acute disease, impaired nutrition, exhaustion from any cause,\\netc., the germ gains a hold and the infection is accomplished. The\\nbacillus now multiplies in the different tissues, according to cir-\\ncumstances, causing the formation of tubercular nodules, inflam-\\nmation, destruction of tissues, etc. These nodules vary in size,\\nbut, scattered through the substance of the part affected, they\\nare often about as large as a millet seed, hence are called miliary\\nby a process of aggravation or extension, they may become much\\nlarger.\\nThe whole system becomes more or less infected and the\\nbacilli are carried to all parts through the blood. In certain cases", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0788.jp2"}, "787": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 761\\nthey lodge in the pia mater (the delicate membrane covering the\\nbrain) and miliary tubercles develop therein, setting up a form of\\ninflammation called tubercular meningitis, which, as will be un-\\nderstood in the light of the foregoing statements, is not an inde-\\npendent affection, but one of the most important phases of a most\\nformidable malady acute miliary tuberculosis.\\nIn attacking so vital an organ as the brain and causing serious\\nsymptoms and fatal issue with great rapidity, the local disease so\\nfar outweighs the immediate danger from the general infection as\\nto warrant a special name and special attention.\\nTubercular meningitis is, therefore, an acute inflammation\\nof the pia mater of the brain caused by a deposit of miliary tuber-\\ncular granules, and characterized by an effusion of pus and lymph.\\nThere are two forms of this disease (i) The primary, in which at-\\ntention is first called to the tubercular infection by the develop-\\nment of the meningitis, and (2) the secondary, in which the in-\\nvolvement of the brain is subsequent to well marked tuberculosis\\nof other organs and near the close of the illness. It is only the\\nprimary form which will be considered here.\\nTubercular meningitis, primary, is a disease of childhood,\\ngenerally occurring between the ages of two and ten, and is one\\nof the most important and most fatal organic diseases of the\\ncerebro-spinal system. The symptoms which precede its full de-\\nvelopment are usually vague. There is a tendency to emaciation\\nand paleness the child becomes peevish and listless, and loses\\nits interest in its usual pleasures. It is likely to sleep poorly and\\nto complain of local headache. Digestion is impaired, with occa-\\nsional regurgitant vomiting. The eyes become impatient of light,\\nthere is a little fever and the pulse becomes irregular. After a\\nweek, or several weeks, symptoms become more marked. Res-\\npiration becomes irregular, the eyes half close and move slowly\\nfrom side to side, and one or both pupils dilate. As the disease\\nprogresses there are more decided evidences of the damage done\\nthe brain, such as twitching of the muscles of the face, turning\\nin of the eyes, convulsions and paralysis of the face and extremi-\\nties. The fever increases, the head is drawn back, the pulse grows\\nmore frequent and full, the respiration is disturbed and death\\ncloses the scene in from three or four days to four weeks. The\\nbase of the brain is most usually affected, especially the region\\nwhere the olfactory, optic and third nerves are situated, and this", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0789.jp2"}, "788": {"fulltext": "762 DISEASES OF THE NERVOUS SYSTEM.\\naccounts for some of the earlier symptoms involving the eye\\nthe later symptoms arise from pressure and disorganization of the\\nbrain. In examinations after death, the delicate, transparent,\\nglistening pia mater is found to be thickened, opaque, studded\\nwith tubercles, which look like little grains of rice, and bathed\\nin an exudation of serum, lymph or pus. The brain substance\\nshows marked changes under the microscope.\\nIn many cases it is not difficult for the physician to determine\\nwhen a child has tubercular meningitis; in other cases it may be\\nvery difficult. But very few cases of this disease recover. Indeed,\\nmany of the best practitioners, especially skilled in this class of\\ndiseases, declare they have never seen recovery. But the bare\\npossibility of recovery, as well as the comfort of the patient and\\nsatisfaction of friends, unite to induce the most careful and intel-\\nligent treatment and nursing. Absolute rest, guarding against\\nany disturbance which may in any way affect the sensations, the\\nministrations of a competent, careful nurse, who has a good deal\\nof tact, a darkened room, medicines and food to be given with the\\nutmost regularity, are of great importance. The physician will\\nprescribe such medicines as the symptoms indicate.\\nLEAD POISONING.\\nCertain peculiar nerve and brain lesions are caused by poison-\\ning by lead, which may find its way into the system by the mouth,\\nskin and lungs.\\nThere are many occupations which cause exposure to the\\npoisonous action of lead, such as working in lead factories, paint-\\ning, plumbing, typesetting, etc. There are also occasional sources\\nof lead poisoning, as the use of water conveyed in lead pipe, the\\nglaze of earthenware vessels and fruits preserved in cans, the tin\\nof which is adulterated with lead, When slowly taken into the\\nbody it is stored up in muscles, kidneys, brain and bones.\\nSymptoms. The general symptoms of lead poisoning are the\\nso-called lead cachexia (due to impairment of the blood and weak-\\nness of the muscles), the lead line on the gums (an irregular blu-\\nish-black line at the junction of the teeth and gums), colic, pains,\\nparalysis, cerebral complications and other nervous phenomena.\\nLead colic is a very obstinate, painful colic, dependent upon\\nthe action of the lead upon the intestinal nerves, attended by\\nvomiting and obstinate constipation, and pains which are variable", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0790.jp2"}, "789": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 763\\nand appear to be in the muscles near the joints. But the\\nsymptoms of lead poisoning to which special attention will be\\ngiven are the muscular paralysis and cerebral complications. The\\ntypical paralysis from lead poisoning is popularly known as\\nwrist drop. When the wrist drop is complete the patient s\\nhands, when extended palms downward, drop at the wrist and\\ncannot be held straight out. This is because of paralysis of the\\nextensor muscles, as they are called, of the wrist, that move the\\nhand in the direction of its back. Sometimes the muscles of the\\narm and shoulder are affected, also those extending the foot,\\ncausing ankle drop. The affected muscles become atrophied\\nsometimes with cramps and tremor. There is also likely to be\\nsome impairment of sensation. In severe cases the brain is at-\\ntacked and there may be convulsions, delirium, coma, loss of\\nsensation, and of motion of part of the body, chronic mental dis-\\nturbance simulating melancholia or general paralysis and some-\\ntimes an active inflammation of the brain, called lead encephalitis\\n(lead inflammation), which may be followed by coma and is likely\\nto prove fatal.\\nThe method by which lead poisoning causes the paralysis\\nmentioned is by setting up a neuritis and thus cutting off the\\nmuscles from the nervous stimulation necessary to muscular ac-\\ntion. The muscles atrophy from disuse. Similar processes in the\\nbrain produce the general cerebral symptoms mentioned. The\\nphysician, ordinarily, has little or no difficulty in recognizing lead\\npoisoning, although similar manifestations may follow poisoning\\nby other metals, as arsenic and silver. A positive diagnosis can\\nsometimes be made in doubtful cases by a careful chemical ex-\\namination of the urine, from which lead can be recovered.\\nCases of ordinary simple lead poisoning, that is, of neuritis\\ncaused by lead, are almost always curable by removing the lead\\nfrom the system, building up the general health, and stimulating\\nthe impaired muscles and nerves by galvanism. The drugs more\\nespecially useful are iodide of potassium to increase the excretion\\nof lead by the kidneys, sulphate of magnesia to counteract and\\ncarry it off by the bowels, and iron, quinine, good food, etc., to\\nbuild up the system. Severe pain in the attacks of colic must be\\nrelieved by anodynes, such as opium, hyoscyamus, etc. When\\nthe system has been thoroughly saturated by lead, so long con-\\ntinued as to produce the severe cerebral symptoms, the outlook is\\nless favorable.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0791.jp2"}, "790": {"fulltext": "CHAPTER VI.\\nTHE NEUROSES.\\nThere are certain diseases which appear to have their seat in\\nthe nervous system, which are indicated by disordered sensation,\\nvolition or mental manifestation, without any evident lesion in\\nthe nervous structure and without any material agency acting to\\nproduce them in other words, they are functional disorders which\\nare called neuroses.\\nIt is true that with the great advances in our knowledge of\\npathology the lesions causing some classes of these diseases have\\nbeen determined, and it is likely that more may be known of the\\nsubtle elements of causation, in the future, but it still seems best,\\nespecially in a popular work, to follow the old way and group these\\ndiseases under the old name.\\nEPILEPSY.\\n(Fits.)\\nThe term epilepsy is derived from a Greek word, which\\nmeans to seize upon, and is applied to this disease because of\\nthe convulsions which seize upon the victim. There are several\\nforms of epilepsy, the most common of which is called grand mal,\\na term transferred from the French and meaning great sickness,\\nor major epilepsy.\\nIn a typical attack of epilepsy there is a sudden loss of con-\\nsciousness, a sudden sharp outcry (this symptom is sometimes\\nmissing), a fall, convulsion, blueness of the face, partial regain-\\ning of consciousness and then deep sleep for an hour or more.\\nIn falling the patient is likely to injure himself. In the convulsive\\nstage the tongue is frequently bitter, and with return of respira-\\ntion (which was arrested in the first part of the convulsion) the\\nretained saliva is whipped into a foam, causing frothing at the\\nmouth. There are almost numberless variations from this type,\\nthe most frequent of which consists of brief loss of consciousness\\nwithout falling and with little or no convulsive movement. This\\nform is known as petite mal, the little sickness, or minor epilepsy.\\n764", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0792.jp2"}, "791": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 765\\nThe epileptic seizures may come on without any warning, or\\nthey may be preceded by peculiar sensations in different parts of\\nthe body. Each case is a law unto itself in relation to this pre-\\nliminary warning, called aura, meaning a sensation as of a gentle\\nair current, commencing in a foot, hand, pit of the stomach or\\nother part, and seeming to move toward the brain.\\nAlthough epilepsy is classed among the neuroses functional\\nnervous diseases modern research has shown many cases to be\\ndue to demonstrable disease. Probably in every case there is\\nsome modifying, morbid condition of the nervous system, al-\\nthough not recognizable bv anv means vet devised.\\nPractically, therefore, epilepsy is divided into two great\\nclasses the one where it is a symptom of some recognizable or-\\nganic disease, the other where no disease can be recognized, called\\nrespectively symptomatic epilepsy and idiopathic epilepsy.\\nSymptomatic epilepsy may be caused by tumors of the brain\\nand cord, by meningitis of any kind, by cerebral palsies and many\\nother forms of brain disease. It may also be due to traumatic\\ncauses (injuries), especially such as produce depression of the skull\\nand irritation of the brain from sharp pieces of displaced bone. A\\ncase of long continued epilepsy under my care in which no cause\\ncould be discovered during life was after death found to be caused\\nby the formation of a bony growth in the membranes of the brain,\\nnot connected with the skull, and which irritated the brain by its\\npressure and sharp points.\\nIn many cases epilepsy is brought about, originally at least,\\nby irritation at some peripheral point, and is a reflex phenomenon.\\nAs an illustration, which will show this mode of causation and ex-\\nplain the use of reflex, the case of convulsions from teething\\nmay be cited. A child inherits a susceptible, unstable nervous or-\\nganization teething comes, perhaps in hot weather, when the child\\nhas become unusually susceptible from heat, sleeplessness, etc. in\\nthe tooth-cutting process the gums become swollen and tender, the\\nnerve filaments are involved and in turn the brain becomes irri-\\ntated and discharges nervous shocks along the motor lines, caus-\\ning convulsions. Such convulsions are called reflex. Continued\\nirritation from the same or other sources may produce successive\\nconvulsions until at length the habit is set up, the nervous force\\ncontinues to be discharged in shocks along the same lines, now\\nthe lines of least resistance, and full-fledged epilepsy is estab-\\nlished.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0793.jp2"}, "792": {"fulltext": "766 DISEASES OF THE NERVOUS SYSTEM.\\nThe causes of idiopathic epilepsy are not well understood;\\neven careful investigation after death fails to find pathological\\ncauses for the disease. Epileptic seizures in many cases occur\\nwith something akin to periodicity. Nocturnal epilepsy, as its\\nname implies, occurs only at night and may long be unsuspected\\nby the patient or his friends. The seizures are likely to cluster\\naround the menstrual period, or to be grouped at irregular inter-\\nvals. Even when they occur daily there will be times of increas-\\ning and diminishing numbers. The frequency of attacks when\\non-coming or when fully established is very variable. The first\\nseizures may be years apart, growing nearer together with a\\ngeometrical ratio, as time goes on. When fully established there\\nmay be many attacks daily or only occasional seizures. In\\nchronic cases the seizures may become very frequent, a great many\\nin a day. Sometimes the patient goes into a state of continued\\nconvulsion, which may last for days, called status epilepticus,\\nwhich is generally fatal.\\nTreatment. The treatment of epilepsy will depend largely\\nupon the peculiarities of the case and the cause. In cases arising\\nfrom determinable brain lesion, tumor, abscess, injury, etc., within\\nthe scope of modern brain surgery, operation should be had but\\nit is plainly useless to attempt surgery in cases caused by con-\\ngenital defect. If there be reflex irritation from the teeth, stom-\\nach, genital organs, etc., the cause of irritation should be removed,\\nif possible, by medicines or surgery; but removal of the cause is\\nnot sufficient, for whenever epilepsy is once set up it has a tend-\\nency to become permanent.\\nThere are various remedies which often have a favorable ef-\\nfect upon epilepsy in a way not well understood. The most valu-\\nable of these are the bromides of potassium, sodium, ammonium,\\netc. To produce beneficial results the bromides must be given in\\ndoses sufficient to show constitutional effect, and for a long time.\\nSuch long-continued use of these remedies is apt to depress the\\ngeneral health. Hence, it is important to combine the different\\nsalts, and to use with them other remedies to counteract their ef-\\nfect. Occasionally there is found a case in which the bromides\\nare harmful, and they cannot be continued. Sometimes the long-\\ncontinued use of bromides causes disagreeable eruptions, especially\\non the face. Judicious use of correctives will do much to prevent\\nthis complication. Many other drugs prove serviceable at times.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0794.jp2"}, "793": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 767\\nIndeed, improvement for a time is frequently seen to follow the\\nuse of any new medicine, or even a change of residence. The ad-\\nvertising quack who gets his wares before the notice of epileptics\\nreaps a golden harvest. Far better to depend upon the family\\nphysician, who can see the case frequently and watch it carefully,\\nand whose treatment will be scientific and trustworthy.\\nStrict attention should be paid to diet. Chronic epileptics are\\nprone to be hearty eaters, which tendency is harmful. The food\\nshould be mild, unstimulating and limited to the requirements of\\nthe system. In those cases which experience a distinct aura, or\\nwarning of the approach of a fit, the inhalation of nitrite of amyl\\nwill prevent the seizure. From a mistaken sympathy, parents are\\ninclined to neglect proper control of an epileptic child, to pet it too\\nmuch and allow it to dominate the family until it develops into a\\nwayward, cruel, family and neighborhood terror. No harshness\\nshould be shown these unfortunates, but gentle, continuous, tact-\\nful, moral control is very necessary, to the end that the higher\\nmoral sentiments be cherished and developed. Too often epilepsy\\ndevelops in families affected with insanity, intemperance and the\\nnervous and other constitutional disorders which render the pa-\\nrents undesirable care-takers for the defective child. The tendency\\nto transmit epilepsy is so great that no epileptic ought to marry.\\nThe cure of epilepsy is a very uncertain problem. Certain\\nsurgical and reflex cases promptly treated are cured other cases\\nmay be much benefited and the seizures greatly mitigated, both in\\nfrequency and severity still other cases cannot be materially bene-\\nfited. Minor epilepsy is very rarely helped by treatment. The\\ngeneral effect of epilepsy is to produce mental deterioration, but\\nthere are exceptions to this rule, and some notable persons who\\nhave won distinction have been subject all their lives to occasional\\nepileptic seizures. Epileptic insanity and the peculiar automatic\\nmental condition due to epilepsy will be considered with the in-\\nsanities.\\nCHOREA.\\n(St. Anthony s Dance. St. Vitus Dance.)\\nChorea is a functional nervous disease characterized by invol-\\nuntary muscular twitchings, jerky movements or wavy undula-\\ntions. These phenomena may be confined to one side, but sooner\\nor later involve all the muscles.\\nThey may be slight in character, so as to require careful and", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0795.jp2"}, "794": {"fulltext": "768 DISEASES OF THE NERVOUS SYSTEM.\\npatient examination to discover them, or so violent as to throw\\nthe patient out of bed, unless secured or guarded. The first at-\\ntack usually occurs in childhood, and more frequently in girls than\\nm boys. Chorea may prove curable in the first two or three\\nmonths, but in most cases some odd-styled movements remain\\nthrough life as a legacy from the disease in childhood. Not a few\\ncases take on a rapid development, and may sooner or later prove\\nfatal from exhaustion. Indeed, certain types of this disease are\\nspeedily fatal.\\nChorea attacks children of active and energetic bodies and\\nminds; dullards are not subject to it. The choreic child is using\\nits energy too fast, exhausting itself. The first indication for\\ntreatment, therefore, is to lessen this overexpenditure of energy;\\nand the second, to strengthen the system by good food, iron,\\narsenic, cod-liver oil and electricity. The little patient should be\\nput to bed for one, two or three weeks in a sunny, well ventilated\\nroom, well warmed if it be cold weather. As the child improves\\nit may be permitted to be up and dressed an hour in the after-\\nnoon, increasing the time according to circumstances, but it\\nshould get up late, retire early and not be allowed to fatigue itself\\nfor one, two or three months. While all the remedies mentioned\\nare important, the combination of iron and the arsenical prepara-\\ntions have the most specific effect upon this disease. It is im-\\nportant that during this period of enforced idleness the patient\\nshould have sunshine and fresh air and sufficient diversion to pre-\\nvent mental discomfort. After recovery he should be carefully\\nwatched for indications of return, and put under treatment again\\nif any symptoms be manifested. Acute cases with rapid pulse\\nand quickened respiration are very serious and usually fatal.\\nChronic chorea is very intractable and renders the victim help-\\nless and pitiable, and ultimately leads to fatal exhaustion.\\nHYSTERIA.\\nHysteria, included among the functional nervous diseases, is\\na disorder with the most remarkably varied manifestations, which\\ndepend upon a peculiar increased reflex excitability of the cerebro-\\nspinal i nervous system, with decrease of the natural controlling\\nwill power. It is very commonly supposed that the symptoms of\\nthis disorder are an alternation of laughing and crying, with a\\nchoking sensation, as if something were coming up in the throat", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0796.jp2"}, "795": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 769\\nbut only in a very small proportion of cases are these symptoms\\nmanifested. Among the causes of hysteria heredity is very fre-\\nquent. This does not mean that the disease in parent and child\\nis always the same but that in the parent there existed some\\nneurotic or psychic disease. Indeed, hysteria, epilepsy, insanity,\\nintemperance and other similar manifestations run through gen-\\neration after generation in varied succession.\\nVarious diseases, injuries, unrestrained emotion, mental and\\nphysical strain, etc., are likely to cause hysteria, both in those\\nwho are predisposed and those who are not. Imitation and men-\\ntal contagion account for hysterical epidemics sometimes seen in\\nschools for girls, or in neighborhoods. It is much more frequent\\nin women than in men.\\nThe general symptoms may be divided into mental, sensory,\\nmotor, visceral and convulsive. The mental manifestations may\\nvary from apparently simple caprice or lack of self-control to\\nthe severity of epilepsy, the stupor of coma or the excitement\\nof the most violent acute mania. In the hysterical subject the\\nemotions are not under natural control or check, there is lack of\\nself-restraint, the appreciation of the fitness of things is deranged,\\nand the judgment is impaired. Hence slight and ordinarily insuf-\\nficient influences cause the hysterical individual to laugh or cry,\\nto be pleased or angry, elated or depressed, charmed or fright-\\nened. Everything runs to excess.\\nThe sensory symptoms are equally changeable, infinite in\\ncharacter and variety, and referable to both sensory and motor\\nnerves and all parts of the body. There may be unnaturally acute\\nsensation so that the slightest nerve irritation produces profound\\ndisturbance, or sensibility may be so in abeyance that the thrust-\\ning of needles through the rlesh is not noticed.\\nThe visceral symptoms are varied and may simulate almost\\nany form of abdominal disease. The convulsions of hysteria dif-\\nfer from those of epilepsy; the loss of consciousness is not com-\\nplete, the patients do not fall in such a way as to injure them-\\nselves, the convulsive movements are of a different character and\\nthe circulation and respiration are less affected.\\nHereditary forms of hysteria are very rarely cured, although\\ngreat improvement may be brought about by removing the excit-\\ning cause and building up the general health. What may be called\\naccidental cases in those not predisposed are curable.\\n49", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0797.jp2"}, "796": {"fulltext": "770 DISEASES OF THE NERVOUS SYSTEM.\\nTo successfully treat hysteria the physician must be a broad-\\ngauged, many-sided man. No disease calls for more intelligence*\\nknowledge of human nature, tact and skill in medicine. Both the\\nindividual and the surroundings must be most thoroughly studied,\\nthe confidence of the patient gained and the will roused to energy\\nby skillful suggestion, emphatic command or some other method.\\nHysteria is a most deceptive disease to one who has it. Every\\nlittle actual ailment, and even imaginary ones, are magnified\\nand dwelt upon till the mind is wrought into the same condition\\nas if weighed down by actual organic disease. Well meaning\\nbut misguided relatives and friends, who do not understand the\\ntrue state of affairs, by dwelling upon the case and showing their\\nanxiety, add fuel to the flame, and the mental incubus growing\\nby what it feeds upon obtains complete control, the patient re-\\nsigns herself to an imaginary fate, or turns to suicide. Many a\\nyoung person brought face to face with some civil or personal\\nresponsibility and harassed by hysterical fears of incapacity, no-\\ntions of unfitness or apprehensions of results, seeks surcease\\nof sorrow by a wild fling into the unknown beyond. While\\nwriting this article, I see in the daily paper an account of a young\\ngirl who, expecting to graduate from the high school she has\\nbeen attending, is informed by the principal that she has failed\\nto pass in one of her studies, and in a state of hysterical depression\\ncommits suicide with rat poison.\\nThe hysterical field yields a rich harvest to the quack, whose\\nsometimes genuine cures do not prove that there is no such thing\\nas disease, or material body, and that everything is spiritual but\\nit does show that mental energy aroused through confidence may\\nabate the morbid belief and allow the ordinary functions and power\\nto resume their normal sway.\\nIn former times, when hysteria was not recognized as a dis-\\nease, but was looked upon as a misdemeanor (to use a very mild\\nterm), the attempt was often made to eradicate the evil by harsh\\nmeans, even severe punishment, but such a course is altogether\\nindefensible. Sagacious ways of impressing the patient, tactful\\nturning of the mind into normal channels, or even a harmless shock\\nto arouse self-control, are admissible and often very beneficial.\\nSuch aid judiciously selected and timed not infrequently proves\\nto be the moral stimulus which enables the patient to regain men-\\ntal balance and thus promotes a cure.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0798.jp2"}, "797": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 771\\nA sagacious and experienced medical friend was once called\\nto one of this class of patients, who was thought by her family\\nto be very ill and who apparently had been unable to speak for\\nseveral weeks. The girl was found lying in bed with a wealth\\nof beautiful hair sweeping the floor, seemingly unconscious of\\nher surroundings and unable to speak. Taking in the real situa-\\ntion, with that acumen for which the physician was noted, he gath-\\nered the hair in his hand and said slowly: What a burden this\\nheavy hair must be in this hot weather; nurse bring me the shears.\\nThe patient instantly roused up and exclaimed You are not\\ngoing to cut off my hair, are you? These were the first words\\nshe had spoken for weeks but she had found her tongue and\\nquickly regained her normal self-control.\\nA very intelligent practitioner in a neighboring county, while\\nmaking a professional visit, was incidentally asked by a lady who\\nhad been unable to walk for a year how best to bandage her\\noffending foot. Upon examination the doctor became satisfied\\nthat no real disease was there and that her inability to use it was\\nhysterical. He fixed the patient s attention and impressively told\\nher that he would cure her disabled foot then and there. With a\\nfew brief authoritative commands, in a few minutes he had her\\nput her foot to the floor, bear her weight, take a step, walk across\\nthe floor, out into the yard and back and the cure was complete.\\nA young woman of exceptionally fine physique, but who had\\ninherited an unstable, neurotic temperament, was brought to my\\ncare by her physician, who with the help of a companion carried\\nher in and laid her upon a bed, because of her supposed inability\\nto walk. The doctor had told me in her hearing that she was\\ncontinually having convulsions and that it required one or two\\npersons to keep her from falling off the bed. After she was\\nplaced upon the bed I directed all to withdraw to the adjoining\\nconnecting room. The physician exclaimed, It will not do to\\nleave her alone; she will throw herself off. We will leave her,\\nI replied. Then turning to the nurse in charge I said in a dis-\\ntinct voice: If she throws herself off the bed, put the mattress\\non the floor and let her lie there. After we had gone she threw\\nherself off the bed and was put upon the mattress on the floor,\\nbut she never repeated the performance. The next day she had\\nfull control of all her limbs, and never again fell off the bed or\\nhad any difficulty in walking.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0799.jp2"}, "798": {"fulltext": "772 DISEASES OF THE NERVOUS SYSTEM.\\nIt sometimes happens that a patient becomes fixed in some\\nerroneous belief because of a mistaken diagnosis by the physi-\\ncian. A case of this kind is reported by a well-known physician\\nof New York. A bedridden young lady, daughter of an eminent\\nclergyman, was declared by a surgeon to be suffering from a\\ndisease of the breastbone and ribs that would require a difficult\\noperation. Finally another physician was called who after a\\ncritical examination exclaimed: Get out of bed, put on your\\nclothes, go down stairs and meet your mother in the parlor.\\nShe mechanically obeyed him, was soon entirely well and no re-\\nlapse followed. The doctor had recognized in her an obstinate\\ncase of hysteria, which needed the stimulus of a sudden com-\\nmand from a will stronger than her own. These are examples\\nof the class of cases which are cured by the faith healer, and the\\ncures claimed to be scarcely short of the miraculous.\\nSOMNAMBULISM.\\nThere are several abnormal mental conditions of unconscious\\nor sub-conscious cerebration, as somnambulism, trance, catalepsy,\\nnight terrors, hypnotism, etc., which may properly receive brief\\nmention. Somnambulism, or sleep walking, is a curious phase\\nof unconscious, nocturnal cerebration somewhat analogous to\\nhypnotism and to the double consciousness which is sometimes\\nseen in epilepsy. The somnambulist carries on mental processes\\nand performs physical acts unconsciously, while in a sleeping state.\\nThese operations are generally a continuation or completion of\\nsome study, work or undertaking in which the subject has been\\nactively engaged and deeply interested but sometimes the pro-\\ncesses and acts are without precedent and entirely foreign to the\\npatient s usual habits of thinking and acting.\\nStudents have arisen in the night and completed essays or\\nsolved difficult problems in mathematics a boy while asleep has\\nmade an accustomed trip to a neighbor s for milk a farmer has\\ngone to his barn and worked for several hours at his old-fashioned\\nthreshing, all unconscious of what they were doing. In other\\ninstances the somnambulist has attempted to put out an imag-\\ninary fire, to save his wife and child from a supposed wild beast,\\nor plunged into a pond to rescue a fictitious sister from drown-\\ning. Criminal acts have also been attempted or accomplished in\\nthis state. A pupil, while somnambulistic, attempting to stab his", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0800.jp2"}, "799": {"fulltext": "DISEASES OE THE NERVOUS SYSTEM. 773\\nteacher, was disarmed and taken to another room, where he slept\\nuntil morning, when he had no recollection of what had taken\\nplace. A man in this condition imagined that he saw, a wild\\nbeast attack his child who was in bed, and that he seized the\\nbeast and dashed it to the floor, only to find, when awakened,\\nthat he had killed his child. A most worthy tradesman of good\\nhabits was once under my care for somnambulistic attacks in which\\nhe repeatedly attempted to strangle his wife, to whom he was\\ndevotedly attached.\\nIn most cases of somnambulism there has been exhaustion\\nof the mental or physical strength, or both, the general health\\nhas run down, there is special mental anxiety, or there has been\\nsome reflex irritation to which is usually added some immediate\\nexciting cause.\\nTreatment. Treatment is usually successful in breaking up\\nthe habit, but it must be judicious, founded upon a thorough\\nunderstanding of all the elements of the case, and be varied as\\nthe conditions indicate. Rest or change of occupation to relieve\\nphysical or mental stress and medicines to lessen nervous irrita-\\nbility and to build up the general health, may one or all be re-\\nquired. Normal suggestion, peremptory command, or even hyp-\\nnotic suggestion may serve a useful purpose by mental impres-\\nsion. Sometimes a case is very obstinate and measures must be\\ntaken to prevent injury to the patient or to others. The occa-\\nsional slight attacks experienced by a great many once or twice\\nin a lifetime are of no consequence, and it is only when the attacks\\nare frequent, habitual or dangerous that they require special\\nattention.\\nTRANCE.\\nTrance or lethargy, a rare form of nervous disorder, is a peculiar\\nsleep-like state from which the patient cannot be roused, or can be\\nonly partially roused, and is not due to organic disease of the brain,\\nor to any poison, and is not dependent upon any general bodily\\ndisease. Cases of paroxysmal attacks of real sleep from which\\nthe patient can be completely aroused ought not to be confounded\\nwith trance. It is closely allied to catalepsy, somnambulism and\\nhysteria, has the same general causes as hysteria, and sometimes\\noccurs in connection therewith. A similar condition is some-\\ntimes seen in the insane, especiallv in chronic delusional insanity.\\nTrance usually comes on suddenly, or it may follow typhoid", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0801.jp2"}, "800": {"fulltext": "774 DISEASES OF THE NERVOUS SYSTEM.\\nfever, influenza or similar diseases, and may last from a few hours\\nto several weeks. During the attack, especially if prolonged, all\\nthe vital forces are depressed. In some cases the mental func-\\ntions seem to be in complete abeyance, in others the patient may\\nbe aware of what is going on around him but be unable to speak\\nor move or manifest any consciousness. Indeed, the special\\nsenses may be preternaturally acute. Sometimes exclamations\\nand movements indicate a mental condition similar to dreaming\\nand in some cases actions can be excited by suggestions made to\\nthe patient. Most cases of trance recover physical and mental\\nhealth; but in cases which follow severe exhausting disease, or\\nwhich accompany insanity, the outcome is less favorable.\\nIn the treatment of this disorder there are two distinct ends\\nTo sustain the bodily powers and to arrest the seizure. For the\\nfirst, advantage should be taken of any semi-conscious periods to\\ngive food, otherwise recourse must be had to feeding with the\\nstomach tube. The most careful attention to the condition of\\nthe bowels and bladder, to keeping the extremities warm, to pre-\\nventing bedsores, etc., must be given. In severe cases nothing\\nwhich can be done will rouse from the lethargy, and the slow\\nprogress of nature must be awaited but in mild cases external\\nstimulants may rouse the patient more or less quickly and com-\\npletely and cut short the attack.\\nCATALEPSY.\\nCatalepsy is more frequent in women than in men, and during\\nearly adult life than in more mature years. In many respects\\nit is akin to hysteria and is brought about by similar causes.\\nNervous exhaustion is the general predisposing factor, and emo-\\ntional disturbance, sudden alarm or injury the usual exciting cause.\\nIt is frequently seen in connection with melancholia.\\nCatalepsy is frequently preceded by headache, giddiness, etc.,\\nbut the onset of the special symptoms is usually sudden and\\naccompanied by loss of consciousness. The muscular system, in\\nwhole or in part, becomes rigid; the limbs remain in the position\\nin which they were at the onset, as if petrified. After a while\\nthe rigidity becomes less and the limbs can be moved and placed\\nin any desired position which they retain for a time, gradually\\nyielding to gravitation. The countenance is usually expression-\\nless and the respiration and circulation are weakened. In pro-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0802.jp2"}, "801": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 775\\nfound catalepsy sensibility to touch, pain and electricity is lost\\neven the eye does not respond when touched. In other cases the\\nsymptoms are not so marked, partial sensibility remains and con-\\nsciousness is not entirely lost. Attacks may last a few minutes\\nor may continue for several hours. In cases connected with mel-\\nancholia I have known catalepsy to continue more or less com-\\nplete for weeks or months:\\nRecovery may be sudden or gradual. Sometimes there is\\na peculiar periodicity in the attacks. Between the attacks various\\nnervous conditions may be present, or the patient may appear\\nperfectly well. During the acute attack but little can be done\\nin the way of treatment except external stimulation, as by ammo-\\nnia, dashing cold water into the face, and especially giving a good\\npinch of snuff, with a view to arousing consciousness. Emetics,\\nespecially such as can be given by subcutaneous injection, will\\nbreak up paroxysmal conditions. In connection with insanity,\\nlong continued cases require very careful nursing and feeding.\\nI have seen these cases recover after long and severe attacks in\\nwhich the patient was wasted almost to a skeleton in other cases,\\nin spite of the best care and nursing, a fatal result could not be\\navoided.\\nNIGHT TERRORS.\\nChildren are sometimes subject to attacks in which they,\\nsuddenly start up in sleep with an agonized cry, staring eyes\\nand twitching face, and appear to be thoroughly frightened.\\nNeither persuasion or soothing have any effect for a considerable\\ntime. Such attacks, called night terrors, are similar to somnam-\\nbulism, but affect children only and do not lead to sleep walk-\\ning. The causes are much the same as those of somnambulism,\\nbarring those which are excluded by the tender age of the subject.\\nHeredity, bad health, indigestion, constipation and worry pre-\\ndispose, and overeating, worms, mental strain, etc., bring on\\nthe immediate attack.\\nThe treatment is usually less difficult than that of somnam-\\nbulism. Any physical disorder or irritation should be corrected,\\nthe diet carefully regulated, the evening meal especially should\\nbe a light one, the mind should be soothed and the nervous sys-\\ntem quieted by bromides, belladonna, tepid baths, etc.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0803.jp2"}, "802": {"fulltext": "776 DISEASES OF THE NERVOUS SYSTEM.\\nHYPNOTISM.\\nIt is not intended to give an exhaustive account of hyp-\\nnotism and its allied conditions, but simply to briefly state some\\nwell recognized and generally admitted facts- regarding these con-\\nditions, from the standpoint of candor, conservatism and honesty.\\nAnd first, it may be said that it is somewhat difficult to select\\nfacts well recognized and generally admitted, for it is true that\\ngreat diversity of opinion regarding hypnotism and its congeners\\nexists among those who claim to practice it and to explain its\\nprinciples. There is a wide distinction between knowing and un-\\nderstanding. Furthermore, those who claim to know and to\\nunderstand may be, and often are, mistaken or self-deceived, or\\nthey may be conscious hypocrites and intentional deceivers. Be-\\nsides, many people say they will not believe what they cannot\\nunderstand, thus confusing knowing with understanding. They\\nare so accustomed to the ordinary natural phenomena that they\\nare led to think them easily understood. They know that seeds\\nunder favorable conditions will germinate and bring forth their\\nkind, but they understand nothing whatever of the vital prin-\\nciple which directs in turn the reproduction of plants and the\\nformation of seeds.\\nThe scientist may go a long series of steps beyond the lay-\\nman in his studies of various phenomena; may determine the\\nnervous stimulation and method of contraction by which muscles\\nperform their work, demonstrate that mental action is carried\\non by the cortical gray matter of the brain and show that nervous\\nimpulses are transmitted by the white nerve fibers, but the subtle\\nelement of vitality which bridges the chasm between the inert-\\nness of lifeless clay and the physical and mental activities of the\\nliving body remains an unsolvable mystery. If, then, no one\\ncan thoroughly comprehend normal and usual mental activity,\\nhow much less can anyone be expected to understand the peculiar,\\nchanged and uncommon if not unnatural phenomena of hypno-\\ntism for after eliminating fraud and self-deception, on the part\\nof both operator and subject, there no doubt remains sufficient\\nevidence to establish the existence of the hypnotic state.\\nHypnotism appears to be allied to somnambulism, trance, -cat-\\nalepsy and hysteria. Its phenomena, formerly known as mesmer-\\nism, have been more or less observed, under different names,\\nfor many centuries. The supposed supernatural manifestations", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0804.jp2"}, "803": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 777\\nby the fakirs of India, the magicians of Persia, the oracles of\\nGreece, the seers of Rome, the priests and priestesses of Egypt,\\nthe monastic recluses of the Middle Ages, the ecstatics of the\\nseventeenth and early part of the eighteenth century, and many\\nother similar phenomena, not classed as supernatural, are readily\\nexplained by what we know as hypnotism.\\nThere is a great difference in persons as to susceptibility to\\nhypnotic influences some yield easily, others cannot be affected.\\nThere are various ways of hypnotizing which need not be dwelt\\nupon here, but in order to succeed the patient must be in a state\\nof receptive expectancy. With repetition the hypnotic state is\\nmore and more easily induced until in some susceptible subjects\\nthe snapping of the finger, a single word or even a glance will\\ncause complete hypnosis. In the full hypnotic state the will\\nof the subject appears to be completely under the control of\\nthe operator and he obeys the most absurd commands and per-\\nforms the most ridiculous antics when suggested by the hypnotist.\\nTo most individuals who have passed into the hypnotic condition,\\nsuggestions may be made of the most curious character, which\\nwill be carried out after the subject is awakened. It is a dis-\\nputed point as to what extent a hypnotized person can be induced\\nto do things, or commit crimes which are repugnant to his nat-\\nural moral sentiments. It is claimed by many that the moral\\nsensibilities of the subject may be brought entirely under the\\ndomination of the operator, who can compel him to carry out\\ncriminal commands, though they be entirely foreign to his natural\\ninclinations. Others contend that the hypnotist can put no new\\nthought into the mind, but can only bring to the surface some-\\nthing which is held therein.\\nThe exact condition of the brain and nervous system, of the\\norgans of special sense and of mentality in the hypnotic condi-\\ntion are not understood, although many of the professors of\\nhypnotism, who give public exhibitions, talk glibly of what it is.\\nHypnotism, in many respects, resembles somnambulism, cata-\\nlepsy and trance, and we are doubtless justified in saying that\\nin the hypnotic condition the highest mental functions are in\\nabeyance and dissociated from the lower functions which they\\nordinarily control and direct, and that these lower functions are\\nfor the time under the control of the higher functions of another.\\nIn other words, in the normal, natural state a person controls", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0805.jp2"}, "804": {"fulltext": "778 DISEASES OF THE NERVOUS SYSTEM.\\nor plays upon his own nervous instrument, in the hypnotic state\\nanother controls and plays upon it.\\nThe legitimate medical benefits to be derived from hypnotism\\nare not as extensive as some enthusiasts have been led to believe,\\nbut in certain cases it may be made useful. There are many\\nvarieties and adjuncts of hypnotism. Many persons get certain\\nideas fixed in their minds by a process of auto-suggestion, that is,\\nby taking up these erroneous ideas, as, for instance, regarding\\ntheir own health, and dwelling upon them until they are firmly\\nfixed in their mind, and can be removed only by counter sug-\\ngestion when the mind is in a receptive condition. It is among\\nthis class of persons that christian scientists, mind healers and\\nlayers-on of hands work their seemingly wonderful and miraculous\\ncures.\\nThe conscientious physician can and does often make use\\nof counter suggestion, normal suggestion and mental impression\\nto induce his patient to give up an absurd controlling idea and\\nto swing back from the realms of fancy to the domain of reality.\\nNo doctor doubts that the mind has great control over the\\nbody. A patient with a buoyant, hopeful mind may recover\\nhealth when mental depression, doubt and worry might turn the\\nscale against him. A calm, hopeful person with a broken leg\\nmay get along much more comfortably and even more rapidly\\nthan a worried, discontented, restless one, but no amount of hope,\\nresignation or faith can immediately reunite a broken bone.\\nThese facts indicate the benefits, bounds and limitations of mind\\nhealing, christian science, etc. Cases of hysterical paralysis, of\\ndisuse of limbs from mental inability to set them going, of imag-\\ninary inability to eat, etc., may be cured by any process which\\nmakes sufficient impression to start the mental machinery in a\\nnew direction. So far, too, as any of these cures or faiths, or\\nconfidence in the physician, gives the patient hope and courage,\\nto such extent may he be helped in overcoming acute curable\\ndisease, or buoyed up in sustaining chronic and incurable affec-\\ntions. The claim that there is no such thing as disease and the\\nclaim of being able to treat and cure the self-same disease are\\nsufficiently contradictory to show absurdity; but still more absurd\\nis the claim, which I have heard made, that a devotee of faith\\nhealing could take deadly poison and not be harmed.\\nHypnotism may be successfully invoked in the cure of many", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0806.jp2"}, "805": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 779\\nmorbid habits and states, but its range of usefulness is limited\\nand the danger that may follow is not trivial. As exhibited in\\npublic by the traveling operator, or as practiced by the amateur,\\nhypnotism is demoralizing and dangerous. Public exhibitions\\nshould be prohibited by law; neither should private exhibitions\\nbe allowed for other than scientific purposes and by persons fully\\ncompetent, from observation and experience, to guard against\\nmisadventure.\\nPARALYSIS AGITANS.\\n(Shaking Palsy.)\\nThis is a disease which is especially prone to appear in the\\nsecond half of life, the great majority of cases occurring after\\nforty or forty-five, although it has been known in patients twenty\\nor even twelve years of age. As its name indicates, it is char-\\nacterized by muscular weakness and tremor and by muscular\\nrigidity. It is not, properly speaking, an indication of senility,\\nbut rather of a functional derangement of the nerves. It is very\\noften difficult to determine just when the disease began slight\\noccasional tremors may exist for some time before the patient\\nis aware of his real condition. It is not a very common disease\\nand occurs with about the same frequency in the two sexes,\\nprobably slightly oftener in men than in women. In the causa-\\ntion of shaking palsy heredity does not play an important part,\\nbut may be traced in a small proportion of the cases neither\\ndoes station in life, nor occupation, have material influence.\\nThe exciting causes cannot be determined in more than one-\\nthird or one-half the cases, and when found vary much in char-\\nacter, the most frequent being severe emotional shock, prolonged\\nanxiety, injury and acute disease.\\nIt is well known that sudden alarm may cause trembling,\\nwhich usually subsides when the alarm is over, but sometimes\\npersists and may develop into this disease. A lady on a ferry-\\nboat saw a baby spring out of its mother s arms into the river.\\nAlthough the child was buoyed up by its clothing and soon res-\\ncued, the lady who had been watching it was surprised to find\\non returning to the cabin that her upper lip was, as she expressed\\nit, going like a rabbit s. This proved to be the beginning of\\na typical paralysis agitans that culminated in death fifty years\\nafterwards. The connection between the emotional shock and\\nthe subsequent palsy is not as a rule so marked as in this instance.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0807.jp2"}, "806": {"fulltext": "780 DISEASES OF THE NERVOUS SYSTEM.\\nA lady thrown from a carriage was not aware of any injury\\nbeyond a slight bruising, but in a few months began to feel a\\nweakness in her left upper arm, when raising it to dress her hair.\\nThis weakness was soon accompanied by tremor which extended\\nuntil all the muscles of the body were involved and a case of\\nparalysis agitans developed. Dysentery, typhoid fever, exposure\\nto cold and damp, etc., are also sometimes followed by shaking*\\npalsy.\\nThe onset of this disease is generally very gradual occasion-\\nally it comes suddenly. As a rule some slight tremor is discov-\\nered in the muscles of the hands, limbs or face, and this, grad-\\nually increasing, extends to the muscles of all the limbs, the\\nhead, neck, face and tongue. When the disease becomes well\\nmarked the appearance of the patient is characteristic. The head\\nis bent forward and stiffly held, the face wears an anxious expres-\\nsion, the arms are slightly flexed so that the hands are brought\\nnear together in front of the body, and the fingers flexed so\\nas to bring their ends against the ends of the thumbs; the knees\\nare also somewhat flexed and the patient walks with a short\\nshuffling step. Because of the tendency to stoop forward, thus\\nbringing the center of gravity in front of the support, the patient\\nhas an inclination to go forward sometimes so great that when\\nstarted he cannot stop but passes into a shuffling run.\\nThe tremor is now almost always present but much increased\\nwhen a voluntary muscular movement is attempted. This is\\nwell seen when the patient tries to feed himself and the rhythmic\\nswaying of the hands becomes so great and persistent as to defeat\\nthe attempt. There is also contraction and painful rigidity of\\nthe muscles; and generally a tinge of color in the face which\\ngives the appearance of health, but which is really due to vaso-\\nmotor paralysis, that is enfeeblement of the nerves which con-\\ntrol the amount of blood in the vessels. This condition is accom-\\npanied by a feeling of fullness in the head, or dizziness, arising\\nfrom the same cause. The mental faculties are not usually im-\\npaired and persons have had this disease for forty or fifty years,\\nyet retained all their natural mental vigor; but sometimes there\\nis slight dullness, peevishness or irritability, or even decided men-\\ntal deterioration. The patient may die at an advanced age, the\\npalsy seeming to have scarcely any effect upon the duration of", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0808.jp2"}, "807": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 781\\nlife, but in other cases the continued agitation has a decided influ-\\nence in wearing- out the patient. There are likely to be periods\\nof increased trembling followed by remissions. During these\\nviolent periods the patient may become for a time entirely help-\\nless, even comatose, which may lead the physician to fear imme-\\ndiate death.\\nWhile the prospect of cure of this affection is not at all prom-\\nising, much may be done by proper treatment to improve the\\npatient s condition and render him more comfortable. His en-\\nergy should be conserved by very late rising and avoidance of\\nphysical and mental fatigue. The diet must be nutritious and\\nabundant, to which some constant but moderate alcoholic stim-\\nulant should be added. Tonics of various kinds to keep up\\nthe general tone of the system, together with bromides, hyoscine,\\ngalvanism, etc., to control the tremor. The patient should un-\\nderstand that cure is not expected but that improvement can\\nwell nigh be assured, and also be informed that exacerbations,\\nor bad turns, are to be expected, and must not be looked upon\\nas necessarily indicating hopeless loss of control.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0809.jp2"}, "808": {"fulltext": "CHAPTER VII.\\nNERVOUS DISEASES OF GERM ORIGIN.\\nThere are three diseases of the nervous system which are of\\nmicrobic origin, i. e., are caused by germs. They are diphtheritic\\nparalysis, hydrophobia and tetanus.\\nThe first two have been considered under other headings,\\nhence will only be briefly noticed here. Diphtheritic paralysis,\\nas its name implies, follows diphtheria and is due to poisonous\\nmatter, developed by the bacteria of the disease, circulating in\\nthe blood and attacking the nerve tissues. The paralysis may\\naffect almost any part of the muscular structure; may attack\\nthe muscles of deglutition, of the heart, or of respiration, and,\\nwhile most cases recover, may prove fatal.\\nHydrophobia is another disease of the nervous system de-\\npendent upon specific microbic infection. There is very great\\npopular misconception about hydrophobia. It is a rare disease\\nand but a very small percentage of those bitten by dogs, that\\nappear to be mad, are affected with it but many who are thus\\nbitten are frightened into a state of nervous agitation, a spurious\\nhydrophobia which may cause death.\\nTETANUS.\\nTetanus, frequently called lockjaw, is an infectious disease,\\ncharacterized by persistent spasm of the muscles and trunk, sub-\\nsequently involving the muscles of the limbs. It may occur\\nwithout any preceding disease, or it may follow an injury; the\\nformer being idiopathic, the latter traumatic. It is caused by\\na bacillus which is found in the earth, and sometimes in manure\\nand other putrefying substances. The germs are likely to be\\nintroduced into punctured or contused wounds, especially of\\nthe hands or feet. The popular belief that a wound by a rusty\\nnail or rough splinter from a floor is especially liable to be fol-\\nlowed by lockjaw is not unfounded, for such articles are very\\nlikely to harbor the tetanus bacillus. The frequency with which\\n782", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0810.jp2"}, "809": {"fulltext": "DISEASES OF THE XERVOUS SYSTEM. 783\\ntetanus follows burns and other injuries from fireworks is due to\\nthe prevalence of its germs in the dust with which the hands,\\nespecially of children, become soiled while celebrating, and is\\nrubbed by the sufferer into the smarting wound. The germs them-\\nselves do not invade the blood and general system, but grow in\\nthe wound and there form a most virulent poison which circulates\\nin the blood and thus sets up the nervous disturbance.\\nWhen tetanus follows an injury it usually begins within ten\\nto fifteen days. First there is slight stiffness about the neck and\\njaws, with difficulty in chewing; spasm of the muscles of these\\nparts develops and the patient becomes unable to open his mouth,\\nhence the popular name lockjaw. The spasms go on to involve all\\nthe muscles of the body, those of the back being most affected, so\\nthat during a spasm the patient takes the form of a bow and\\nrests only upon his head and heels. Even between spasms the\\nmuscles are more or less stiffened, and the slightest irritation\\nbrings a recurrence of spasm. During the spasm the patient\\nsuffers great pain, but may not be able to speak. He is usually\\nbathed in profuse perspiration. In some cases there may be\\nscarcely any rise in temperature, in others the temperature runs\\nvery high. Death may occur from heart failure, or suspension\\nof respiration during a paroxysm, or from general exhaustion.\\nTetanus is a very fatal disease. Hippocrates, who is called\\nthe father of medicine, and who wrote about 400 B. C, says:\\nThe spasm supervening on a wound is fatal, and such persons\\nas are seized with tetanus die within four days or if they pass\\nthese they recover. Indeed, at the present day the mortality in\\ntraumatic cases is eighty per cent, and in idiopathic cases, fifty per\\ncent.\\nTreatment. To be of avail the treatment should be prompt\\nand thorough, under the best obtainable medical advice. In trau-\\nmatic cases thorough excision and antiseptic treatment of the\\nwound must be carried out the patient should be kept in a quiet,\\ndark room, with a single nurse, and all sources of irritation excluded.\\nThe spasms must be controlled by chloroform, chloral, bromide of\\npotassium, morphine, etc. When the lockjaw prevents ordinary\\nfeeding, food can be conveyed to the stomach by the nasal tube,\\nor rectal injection can be used. Idiopathic cases require the\\nsame line of treatment, excepting, of course, that part which\\nconcerns the wound itself.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0811.jp2"}, "810": {"fulltext": "784 DISEASES OF THE NERVOUS SYSTEM\\nThe greater number of cases of this dreadful disease could\\nbe avoided by promptly and thoroughly bathing all wounds\\nliable to be infected, in a twenty per cent solution of carbolic\\nacid, or some other effective germicide, then preventing further\\ninfection by wrapping the part in a clean cloth saturated in the\\nsame solution, the hands of the operator having first been cleansed\\nby a careful washing in soap and water. It is not in the severity\\nof the wound, but in its infection that the danger lies a very\\nslight lesion being sufficient to admit the germs.\\nNERVOUS SYMPTOMS.\\nThere are certain nervous symptoms, common to different\\ndiseases, which are of sufficient importance to merit special though\\nnecessarily brief consideration.\\nVERTIGO.\\nVertigo, or dizziness, means a sensation of loss of equilibrium,\\nwith momentary partial loss of consciousness. It may be caused\\nby, or be a symptom of, several quite different disorders. The\\ntreatment will, of course, be the treatment of the disease of which\\nit is a symptom. One of the most frequent causes of vertigo\\nis that condition of the system called lithemia, a state in which\\nthe nutritive functions are deranged and the system loaded with\\neffete matter. Lithemia is to be treated by remedies which\\nstimulate proper nutritional change and free the blood from\\nwaste and imperfectly oxidized matter. Disease of the kidneys\\nis an occasional cause of vertigo, which can be determined by\\nproper examination of the urine, and treated by remedies directed\\nto the restoration of the functions of the organs involved.\\nDisease of the ear may cause vertigo, in some cases of a\\nvery severe type, which requires treatment suited to the char-\\nacter of the ear disease.\\nEye strain, itself caused by muscular imperfection or defect\\nin the apparatus for adjustment, sometimes causes vertigo. This\\ncondition should be remedied by operation, or by proper glasses,\\nas required.\\nA depraved state of the blood, or disease of the heart or\\nblood vessels may cause vertigo by affecting the quality or quan-\\ntity of blood supplied to the brain. Treatment should be directed", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0812.jp2"}, "811": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 785\\nto restoring the quality of the blood, or regulating the action of\\nthe heart, or improving the condition of the vessels.\\nBoth gout and the excessive use of alcoholic liquors are\\nsometimes chargeable with vertigo. Occasionally vertigo is\\ncaused by various brain diseases. The popular idea, however,\\nthat vertigo is especially indicative of brain disorder is not cor-\\nrect, and it is often a relief to patients to know this. Vertigo\\nis also a symptom of locomotor ataxia, but is not common in\\nother spinal diseases.\\nSo far as vertigo itself is concerned, the outcome depends\\na great deal upon the special condition of which it is a symptom.\\nIn lithemia it is frequently hard to overcome and may annoy\\nthe patient many years; for the lithemia itself is difficult to\\ncompletely eradicate but it is annoying only, not serious. In\\nacute kidney disease, especially in the young, the vertigo may be\\ncured along with the disease itself but in chronic kidney disease\\nthe outlook is grave. The ear and eye cases are sometimes cura-\\nble, sometimes not, depending upon the character of the ear and\\neye diseases. Impaired condition of the blood can generally be\\ncured and the vertigo with it. With vertigo, dependent upon\\nalcohol, if the alcoholism can be cured and no organic damage\\nhas been done, the result is generally good- When vertigo is a\\nsymptom of brain disease, or spinal disease, the prospect is gen-\\nerally serious.\\nHEADACHE.\\nHeadache is a symptom of many forms of nervous disease,\\nand is also very frequent in other diseases and disorders. Some-\\ntimes the disease of which headache is a symptom is easily de-\\ntermined, and sometimes the headache is about all that can be\\nmade out. It is answerable for a large share of human suffering,\\nand may vary from simply a disagreeable dull feeling to the most\\nintense pain which can only be described as agony. It may be\\npersistent for hours or even months, or it may be evanescent,\\nlasting but a moment. It may be a continuous uniform pain,\\nit may come in paroxysms, it may be intermittent or it may be\\nthrobbing. It may affect the whole head, or one-half of it, or\\nbe confined to a small area, or change from point to point.\\nSometimes the scalp may be very tender to the touch, and comb-\\ning the hair or any jarring of the head may greatly increase the\\npain. The eyes may be very sensitive to light, or vision may\\n50", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0813.jp2"}, "812": {"fulltext": "786 DISEASES OF THE NERVOUS SYSTEM.\\nbe impaired and loud or even ordinary sounds may be very\\npainful and exasperating.\\nDuring an attack of headache the feet and hands, and fre-\\nquently the general surface of the body, are likely to be cool,\\nunless fever is present, and the head may be either cool or hot.\\nThe pulse may be rapid or slow the appetite lessened or in-\\ncreased, and eating may sometimes afford relief, but more\\ngenerally increases the pain and is followed by vomiting. In\\nsome cases a person may continue both mental and physical exer-\\ncise when affected with headache, in others either mental or\\nphysical activity so increases the suffering as to enforce the utmost\\nquiet. Of the many forms of this disorder, the most important\\nwill be considered.\\nHeadache is a symptom of many of the brain and nervous\\ndiseases which have already been described, and as such the treat-\\nment is included in that of the respective disorders. Many\\nnervous persons are much troubled by headache from overwork,\\nmental or physical, from stress of care and responsibility, from\\nworry, disappointment, etc. This is called nervous headache\\nand may be almost continuous or come in paroxysms. When\\nparoxysmal it may be severe and accompanied by intolerance of\\nlight and sound, sometimes by marked irritability, and occasion-\\nally by vomiting. In these instances it is much like sick headache\\nbut more preventable by hygiene and calmness. Nervous head-\\nache is most common in women and children of feeble constitu-\\ntion who are poorly nourished. The treatment for this form is\\nbuilding up the health by improving digestion and nutrition\\nand avoiding worry and nervous excitment.\\nHeadache is not uncommon from eye-strain, which itself\\nmay be due to astigmatism, distorted shape of the eyeball, un-\\nequal action of the muscles or oversensitiveness of internal parts.\\nFor these conditions relief may be had from properly fitted glasses\\nand rest.\\nA very common form of headache is that generally known\\nas sick headache. This form is more or less periodical, or at\\nleast recurrent. Many persons, about equally divided as to sex,\\nare subject to attacks during all their lives and the disorder is\\nmarkedly hereditary. The manner in which the attacks come on\\ndiffers in different persons, but in each patient it generally begins\\nevery time in the same way. The pain may affect one or both", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0814.jp2"}, "813": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 787\\nsides of the head, may change from side to side, be general\\nover the head or confined to the forehead, temples or base; it\\nmay come on at any time of the day and may be preceded by an\\nunusual appetite. After several hours there may be vomiting\\nand relief, or after emptying the stomach the pain may not sub-\\nside until the patient has slept. When he awakes the pain and\\ndistress will usually be gone and only a feeling of soreness remain\\nfor a few hours. The vomited matter consists of undigested food\\nand mucus. Some persons rarely vomit, some do with nearly\\nevery attack, while with others vomiting is repeated many times\\nwith great nausea and the bringing up of bile.\\nThe victim of sick headache is very likely to think the attacks\\ndue to indiscretions of diet, of eating at irregular times, or hur-\\nriedly, or when the mind is intensely occupied, etc. but while\\ncareful attention to regular habits in this direction will lessen\\nthe frequency and severity of the attacks, it will not altogether\\nprevent them. The real difficulty lies in the peculiarly susceptible\\nnervous organization.\\nAnother form of headache is caused by acute indigestion.\\nIt is usually severe, of a snapping character, coming on sud-\\ndenly after overeating or freely partaking of indigestible food\\nand alcoholic drinks. Indeed, this is the headache which follows\\nbanquets and wine suppers. Because of the nausea and vomiting\\nwhich is likely to go with this headache, it is frequently called\\nsick-headache, but it is very different from the proper periodical\\nsick-headache. Headache from acute indigestion is generally re-\\nlieved soon after the stomach has been unloaded; the vomiting\\nis often accompanied by diarrhea a real cholera morbus.\\nWith some persons whose digestion is weak and whose\\nnervous system is easily perturbed, slight errors or excesses may\\nbring on the headache of acute indigestion; others can eat and\\ndrink almost anything without inconvenience. Certain dyspep-\\ntics have very frequent, sometimes daily, headache, accompanied\\nby dyspeptic symptoms, coated tongue, acid stomach and con-\\nstipation. The headache may be felt at waking in the morning\\nand disappear during the day or it may come on in the after-\\nnoon and disappear at night. As a rule this headache does not\\ninterfere with ordinary duties, but occasionally an unusually severe\\nattack will be disabling.\\nMalarial headache depends upon malarial poison, and comes", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0815.jp2"}, "814": {"fulltext": "788 DISEASES OF THE NERVOUS SYSTEM.\\nin paroxysms with the regularity of ague. It is generally con-\\nfined to one side of the head, comes suddenly, is very severe for\\na few hours and passes away leaving a feeling of soreness.\\nHeadache is a frequent accompaniment of anemia and great\\ndebility, and in intense cases is almost constant. When the\\npatient is in a state of rest both of body and mind the headache\\nmay disappear, only to recur on the least bodily or mental exertion.\\nGENERAL TREATMENT OF HEADACHE.\\nIn the treatment of headache the first thing is to determine\\nwhat causes it, and the next to remove or correct such cause.\\nThis may be a comparatively easy matter, or a very difficult one.\\nIf the headache depends upon acute disease, fever, rheumatism,\\npneumonia, etc., the proper treatment of such acute disease may\\nbe all that will be required for the headache, or remedies\\nmay be needed which will directly lessen the pain.\\nFor the headache of eye-strain, use proper glasses fitted\\nby a competent oculist. In brain diseases, and some nervous\\ndiseases, the headache symptom depends directly upon the impli-\\ncation of the nervous tissue. Here, too, will often be required\\nnot only the general treatment of the brain or nerve disorder,\\nbut the painful symptoms will require the use of remedies to\\novercome or soothe the pain, as an opiate or other anodyne.\\nMalarial headache will best be treated by full doses of quinine\\ntill the periodicity is broken up, then strengthen the system with\\niron, arsenic, strychnia, etc.\\nWhen headache depends upon anemia, the blood must be\\nrestored to a healthy condition. This is often a difficult task,\\nfor the anemia may be caused by disorder of the stomach, by\\nexhausting discharges, by impaired action of certain glands, by\\nderangement of the blood-forming apparatus, etc. The discov-\\nery of the ultimate causation of anemia and its treatment is a\\nproblem to be solved only by a skillful physician.\\nIn the treatment of nervous headache the headaches of\\nacute indigestion and of dyspepsia, sick-headache and the at-\\ntacks of other recognized and unrecognized varieties there is\\nconsiderable scope for hygienic and preventive measures, for the\\nlessening of discomfort by domestic remedies and for nursing,\\nas well as for the curative treatment of the physician. Between\\nthe attacks efforts should be directed to lessening the tendency", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0816.jp2"}, "815": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 789\\nto recurrence and extending the intervals between them by im-\\nproving the general condition of the system and bringing it up\\nto a high standard of vigor. In the established periodical head-\\naches it is generally impossible to entirely prevent them, though\\nmuch may be done to render them less frequent and less severe.\\nThose subject to constitutional headaches are in a condition below\\nthe normal standard, and a regulation of diet, exercise and habits,\\nwith suitable medicines to keep the excretions active and to stimu-\\nlate and tone up the system, will strengthen the powers of re-\\nsistance and increase the intervals between the attacks and render\\nthem lighter. To this end defects in hygienic surroundings and\\ninfluences should be thoroughly corrected, requiring, it may be,\\na complete change in location or business, often difficult or im-\\npossible to accomplish. Much may be done by the patient if\\nhe will courageously and systematically correct his diet by dis-\\ncarding pastry, indigestible foods, stimulants, tea and coffee. The\\nlatter is often looked upon by these patients as a necessary\\nnerve tonic, when in fact it is the reaction following its stimula-\\ntion which really causes the headache. The victim of sick-head-\\nache should, under judicious advice, abandon the articles of food\\nand drink at all likely to produce nervous disorder, and limit\\nhis diet to the most easily digested foods, and to those especial\\narticles which careful experiment shows to be best fitted for\\nhim, for to some extent each case is a law to itself.\\nIt follows with even greater force that one who is subject\\nto the headache of acute indigestion caused by wine suppers,\\ncloying refreshments served at parties, or even wholesome food\\ntaken out of season, should carefully avoid what, to him at least,\\nare baneful excesses; while the habitual dyspeptic should strictly\\nregulate the quality and quantity of his food, as well as the time\\nof taking it. Dyspepsia may be caused by monotonous or coarse\\nfoods, or by a diet not generally objectionable but not adapted\\nto the individual. A hasty plate of oatmeal in the morning\\nand an inadequate lunch, postponed by business, may bring the\\npatient to his evening meal with a headache, exhaustion and\\nnervousness which well nigh preclude eating; the dyspepsia\\nof insufficient nutrition ere long leading to complete break-\\ndown. Such dyspepsia may be cured by a generous beefsteak\\nwith toast slowly eaten in the morning, a nourishing lunch at\\na regular hour in the middle of the day, and a hearty but digestible", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0817.jp2"}, "816": {"fulltext": "790 DISEASES OF THE NERVOUS SYSTEM.\\nmeal when the day s work is done. Cooks, by continual eating,\\noften develop dyspeptic headache, and servant girls acquire dys-\\npeptic anemia from limiting their meals to tea and bread,\\nconditions to be respectively cured by regularity and a generous\\nmixed diet. Emotional and nervous excitement is very likely\\nto precipitate an attack of headache, and those who are subject\\nto this malady should cultivate self-control and uniformity of\\ntemper.\\nThe medical requirements will be met by bitter tonics, bark,\\nnux vomica, quinine, iron, gentian, etc., in various combinations.\\nMost patients are constipated and the bowels should be moved\\nonce daily by gentle agents suited to the particular case. Various\\nmineral waters, or salines in hot or cold water, before breakfast,\\nphosphate of soda as a liver stimulant, or aloes, rhubarb, podo-\\nphyllum laptondrin, in various combinations, with strychnia or\\nbelladonna, may be used according to the nature of the case and\\nidiosyncrasy of the patient. The preparations of cascara sagrada\\n(sacral bark) are most excellent in relieving chronic constipa-\\ntion. While violent purgation by large doses of salts, pills,\\netc., is decidedly injurious, suitable combinations to persuade the\\nbowels to a daily movement may be taken indefinitely without\\nharm.\\nWhen symptoms of an approaching attack are felt, there is\\na wide difference as to what can be done to ward off or mitigate\\nit. If the attack depends upon acute indigestion or simply fol-\\nlows a hearty meal, prompt evacuation of the stomach by warm\\nwater and mustard, or by ipecac, or by a hypodermic injection\\nof apomorphia, followed if need be by movement of the bowels\\nand a nervous sedative, may cut short the pain.\\nIn the nervous and periodical varieties seclusion in bed in\\na quiet dark room, with a cooling lotion or tight band on the\\nhead, sleeping if possible, and abstaining from food, may abort\\nthe attack. With others a hearty stimulating meal may do better.\\nGentle exercise is sometimes favorable violent exertion is almost\\nalways unfavorable. When the extremities are cool a hot mus-\\ntard footbath for an hour or more will be very useful and com-\\nforting. Certain nervines may ward off an attack, as guarana,\\none of the bromides, valerian, caffeine, etc. For a person not\\naccustomed to using them a cup of strong coffee, or an alcoholic\\nstimulant, spirits of chloroform, etc., may be helpful. These reme-", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0818.jp2"}, "817": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 791\\ndies must, however, be taken before the stomach becomes too\\nirritable to retain them. Indeed, sometimes they are entirely\\nuseless except as an emetic.\\nIf the attack has fully set in, efforts must be restricted to\\nlessening its severity and shortening its duration. Sometimes noth-\\ning will be of any particular benefit and the attack must simply\\nbe allowed to wear itself out. In others some relief can be had\\nby hastening the evacuation of the stomach and bowels by emet-\\nics and injections, by rest and quiet, by freedom from light, sound\\nand mental action, by heat to the extremities and cooling lotions\\nand pressure to the head such measures as have already been\\nmentioned. In a few cases hot applications to the head are grate-\\nful. When the stomach is irritable sleep can be procured by the\\nuse of chloral in a rectal injection; this is especially serviceable\\nin children. After the stomach is emptied, nausea may be allayed\\nby very hot water, aromatic spirits of ammonia, spirits of chlo-\\nroform, etc. Opium and its preparations should be avoided,\\nbecause they often disagree, and because of danger of promoting\\nthe opium habit.\\nINSOMNIA OR SLEEPLESSNESS.\\nInability to get proper sleep is an annoying and ever serious\\ncondition. Inasmuch as the physiology of sleep is not well un-\\nderstood, insomnia must be studied in connection with the con-\\ndition by which it is caused, and its treatment will vary according\\nto its causation. It may be caused by worry, anxiety, grief, etc.,\\nand in this form is often very intractable. It requires a good\\ndeal of tact and judgment on the part of the physician to deter-\\nmine how much dependence should be placed in drugs and how\\nmuch in hygiene and diet. Indeed, where there is chronic busi-\\nness anxiety, or family or personal worry, it may be impossible\\nto overcome the insomnia until the cause is abated. Sleepless-\\nness from pain may depend upon neuralgia or neuritis, the first\\nstage of certain inflammatory diseases, as pleurisy, pneumonia,\\nperitonitis or rheumatism, or upon eye diseases, influenza and\\nsundry brain affections.\\nTreatment. The first step in treatment of insomnia due to\\nthe pain of acute disease is to properly treat the disease which\\ncauses the pain and to ascertain how much such treatment may\\nrelieve the sleeplessness. If the insomnia still continues the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0819.jp2"}, "818": {"fulltext": "792 DISEASES OF THE NERVOUS SYSTEM.\\nhypnotics chloral, sulphonal, trional, etc. may be used alone or\\nwith bromide of potassium.\\nFevers are frequently attended with sleeplessness, for which\\nbathing, food and stimulants should be tried if these are not suc-\\ncessful, bromides and more active hypnotics may be needed. Nerv-\\nous prostration is often accompanied with sleeplessness for which\\nattention to diet, rest, general hygiene and simple quieting meas-\\nures will be preferable to sleeping medicines. The sleeplessness\\nof incipient melancholia is often one of the first symptoms of that\\ndisease and the treatment is that of melancholia.\\nA very common cause of sleeplessness is the use of tea, coffee,\\ntobacco, alcoholic drinks, disagreeable foods, etc. It is very\\ncommonly recognized that many persons cannot drink coffee at\\nnight without lying awake afterward, but strong coffee in the\\nmorning only will prevent some persons from sleeping well.\\nSome susceptible individuals may be rendered sleepless by tobacco,\\nsome by certain wines or liquors, others by particular foods.\\nThe use of dumb bells, Indian clubs, or any form of vigorous\\nexercise which quickens the circulation, thereby drawing the ex-\\ncess of blood from the brain, often quickly induces sleep in those\\nsuffering from study or too much mental work.\\nFor sleeplessness attributable to errors in diet or drink, such\\nerrors must be corrected. When due to nervous restlessness\\nwithout manifest disease, certain expedients may be useful. A\\nwarm bath, or in some cases a cold bath, at bedtime will materially\\n,aid in procuring sound sleep. Some persons sleep best after a\\nvery light supper; but the old-fashioned idea that one should go\\nto bed hungry is often misleading. Many persons in fairly good\\nhealth, others who are weakly or nervous, and many in in-\\ncipient or even in settled melancholia, will sleep better for taking\\nsome light stimulating food at bedtime, like hot milk, milk and\\negg, egg-nog, etc.\\nBathing, regulation of diet, exercise, avoiding disturbing in-\\nfluences and even food on retiring, may be tried as home remedies\\nin simple sleeplessness, but if not successful the physician should\\nbe consulted. In acute diseases, fevers, etc., very little should be\\nattempted, except under the direction of the medical practitioner.\\nIt is a most pernicious practice for one to attempt to doctor himself\\nfor chronic sleeplessness dangerous drug habits are often acquired\\nby so doing.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0820.jp2"}, "819": {"fulltext": "DISEASES OF THE NERVOUS SYSTEM. 793\\nCOMA.\\nComa, a state of unconsciousness, is attendant upon several\\ndiseases which require immediate medicai attention, and will re-\\nceive only brief enumeration. The treatment will depend upon\\nthe condition which causes the coma.\\nInjury may produce either slight and brief, or very profound\\nand prolonged coma. The injured person should be placed upon\\na bed in as comfortable position as possible, and prevented from\\ngetting chilled, and bleeding should be controlled by pressure\\nuntil the arrival of the physician. Coma is one of the symptoms\\nof disease of the kidneys. The victim of chronic kidney disease is\\nlikely to die comatose. Alcoholic liquors in excessive quantity\\nwill produce alcoholic coma, which ordinarily will pass away in\\na few hours, requiring only watching, protection from cold, or\\nsustaining of the strength but it may prove fatal.\\nComa is also a symptom of brain hemorrhage atrophy as it\\nis usually called and of other brain diseases, which will require\\nthe prompt attention of the physician, the patient receiving mean-\\ntime the customary friendly ministrations. Coma, from any\\ncause, shows a profound impression on the nervous system and\\nmust always be regarded as a serious symptom.\\nFAINTING.\\nFainting is a temporary loss of control of the mental and\\nbodily functions. In any case of fainting the patient should im-\\nmediately be placed in a horizontal position in a draught of fresh\\nair, and all tight clothing about the throat, chest and waist loos-\\nened. In many cases this will be all that will be required to re-\\nstore consciousness, but if the restoration does not come very\\nsoon, cold water may be dashed into the face and upon the chest,\\nand the extremities briskly rubbed to aid the circulation. A\\ndinner plate may be dipped in hot water and quickly applied to\\nthe stomach, care being taken not to burn the patient. Too liberal\\nuse of ammonia, or other smelling salts, may do harm.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0821.jp2"}, "820": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0822.jp2"}, "821": {"fulltext": "INSANITY.\\nBy B. D. Eastman, M.D.\\nIn some of the lower animals the several parts of the organism\\ndiffer but little in structure or in function but as we look higher\\nin the scale we find the various parts of the body differing more\\nand more, both as to anatomical structure and physiological func-\\ntion, until in man we see the widest differentiation and the most\\ncomplex function the various organs of the body each having in-\\ndividual offices to perform in the complicated association of\\nphenomena called life.\\nThe function of the stomach and digestive apparatus is to\\ndigest food and furnish nutrients to the tissues that of the heart\\nand blood vessels, to circulate the blood that of the eye, to give\\nvision, etc., but the most important and distinguishing attribute\\nof man is the function of mentality carried on by the brain, espe-\\ncially by the superficial gray matter called the cortex. When\\nthe stomach and digestive apparatus are sound we have good di-\\ngestion if the heart and vessels are in good order we have good\\ncirculation if the eye is normal there is distinct vision, and when\\nthe brain is sound we have healthy mentality or sanity. Indiges-\\ntion, imperfect circulation, indistinct vision and insanity are re-\\nsults of diseased conditions of the respective organs, but these dis-\\neases do not necessarily imply entire annihilation of these func-\\ntions. A good deal of indigestion is not incompatible with a long\\nand useful life, but if the stomach be sufficiently diseased, its func-\\ntion will be entirely suspended and death will soon result. So,\\ntoo, insanity does not necessarily end all mentality, and insane per-\\nsons may live many years with their mental faculties deranged,\\nbut not destroyed or, on the other hand, the brain disease which\\ncauses insanity may be so serious as to lead to a speedy death.\\nThere is, however, a very important and wide-reaching pecu-\\nliarity of disease of the brain wherein it differs from derangement\\nof any other organ. Our mentality is that which distinguishes us\\nfrom the brute creation, establishes our relation to each other and\\n795", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0823.jp2"}, "822": {"fulltext": "796 INSANITY.\\nto our environment, defines our individuality, and constitutes our\\npersonality the ego and as the brain is the organ of mentality,\\nit follows that disease of this organ may change any or all the\\nmanifestations of the ego, not only in its relation to others and\\nto environment, but in relation to itself. It matters not, in con-\\nsidering psychological problems, whether this ego be called soul,\\nmind, matter or function all the knowledge we have of it is\\nthrough its manifestations, developed only through the action of\\nthe brain. It is sufficient to know that a diseased brain causes ab-\\nnormal manifestations of the ego the deranged mentality which\\nis insanity.\\nTo avoid confusion it should be mentioned here, that the brain\\nhas various departments and functions, as has been especially\\nnoted in a previous chapter. Serious, even fatal diseases of the\\nbrain may exist without attacking that part of the organ con-\\ncerned in mentality and without producing insanity; besides, not\\nevery disturbance of mentality is termed insanity, but only such\\ninterruptions as last a considerable time. The delirium of fever\\nand the incoherence of drunkenness are not considered varieties of\\ninsanity, although they may not essentially differ from it.\\nInsanity is a condition to be described, and one that cannot\\nbe satisfactorily defined, but it may be well to give such a definition\\nof it as in a few words will most clearly convey to the non-profes-\\nsional reader its meaning. For this purpose insanity may be said\\nto be morbid mental manifestations dependent upon disease of the\\nbrain.\\nThat the reader may have a clear understanding of this sub-\\nject, we will specify some conditions which are sometimes incor-\\nrectly considered as phases of insanity. Eccentricity is one of\\nthem. Not a few persons have during all their lives very peculiar,\\nqueer, but inoffensive ways of talking and acting ways that are\\nnatural to the individual. These peculiarities in these persons do\\nnot constitute insanity. Other individuals have vicious, danger-\\nous, criminal tendencies which are habitual and natural these are\\nnot insanity. But if a person who has always been in the habit of\\ntalking and acting in the ordinary conventional way common to\\nhis rank and station in life, changes in this respect and talks and\\nacts in a manner unusual and unnatural to him, it at once arouses\\nthe suspicion that he is insane. So, too, conduct that in one sta-\\ntion in life is usual and natural, would, in some other stations, be", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0824.jp2"}, "823": {"fulltext": "INSANITY. 797\\nvery unusual and unnatural, and presumptive evidence of insanity.\\nIt is common for the Hindoo mother to throw her child into the\\nGanges, a custom that indicates grossly perverted ideas, but not\\ninsanity. On the other hand, if an ordinarily happy, intelligent\\nAmerican mother drowns her child, it is strong evidence of mental\\nderangement.\\nThus, there are two general methods by which the question\\nof insanity may be determined The first is by comparing the\\nperson with his former self, the second, by comparing him with\\nwhat is customary in his station in life. If, therefore, a person\\nis found to have 1 changed mentally from what is natural to him,\\nor, provided his former personality is not known, he is found\\ntalking and acting in a manner not compatible with his station in\\nlife (sufficient moral causes, and the immediate effects of sickness\\nand drugs being eliminated), such change or incompatibility is\\npresumptive evidence of insanity. In applying the foregoing rules\\nit is always important to exclude the conditions cited as excep-\\ntions. The arousing of religious sentiments may cause complete\\nchange in a dissolute person, or getting into bad company may\\nchange an honorable, law-abiding individual into a reckless crimi-\\nnal, yet in neither instance, could the person be called insane but\\nsimilar change without any adequate external cause would indicate\\ninsanity. The acute delirium of fever, or other disease, and the\\nimmediate effect of alcohol and other poisons, may induce a men-\\ntal condition which is essentially the same as that of insanity, still\\nas such a state is temporary and directly due to toxic agents, it is\\nnot classed as insanity; but the effects of disease of other organs,\\nor the habitual use of alcohol or other drugs, may bring about a\\nserious and continued brain disease, causing that more permanent\\nmental derangement called insanity.\\nThe disease of the brain which causes insanity may assume\\ntwo fundamental forms: (i) Defective development. (2) Disease\\nsubsequent to development.\\nThe development of a human brain -structure and brain power\\nis a marvelous phenomenon, which distinctly marks the wide dif-\\nference between man and the brute. Of the lower animals the\\nyoung come into existence with the brain and brain-power fully\\ndeveloped, or complete development takes place within a very\\nshort time; thus, the chick upon leaving its shell immediately be-\\ngins to run about, to seek food and to care for itself. It is possessed", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0825.jp2"}, "824": {"fulltext": "798 INSANITY.\\nof all the brain power it will ever have; there is no further\\nbrain development for it, and it can never accomplish anything\\nmore than its parent has done. But the infant is born with a brain\\nincompletely developed physically, and without mental power. It\\nis stimulated to the act of sucking, by reflex nervous excitation,\\nwhen anything is placed between its lips, but it is only by a process\\nof education that it learns to walk, to care for itself, to provide its\\nfood, or to equal or perhaps surpass its parents in accomplish-\\nments. The period of brain development is very much longer in\\nthe child than in the chick, both before and after birth, and the\\nphysical and functional development, infinitely more complex.\\nThis great complexity of the human brain and long period of de-\\nvelopment render imperfection or arrest of the process very fre-\\nquent with resulting disorder of function hence insanity from de-\\nfective brain development. The complicated structure of a fully\\ndeveloped brain, its constant activity, the frequency with which it\\nis overtaxed, and the stress put upon it by transgressing the laws\\nof health, physical, mental and moral, render it especially liable\\nto physical disorders from which follows insanity from disease of\\nthe brain.\\nInsanity from either of these causes assumes different forms,\\nand it will aid us in their consideration to group them in a simple\\nand natural way, as follows:\\nIdiocy.\\nInsanity caused by defect in brain J Imbecility.\\ndevelopment. Feeble-mindedness.\\nf Melancholia.\\nMania.\\nInsanity caused by brain disease J Paranoia\\nafter development.\\nDementia.\\nParetic Dementia.\\nIdiocy, imbecility and feeble-mindedness are but different de-\\ngrees of the same general condition. The brain defect to which\\nthey are due may be congenital or acquired. In the congenital\\ncases, proper brain development is lacking, the child having been\\nborn with the brain more or less, imperfectly formed, or even lack-\\ning in important parts. In such a case it is plain that the normal\\ndevelopment of the brain, which should go on during infancy and\\nchildhood, is impossible, and that the subject of congenital brain", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0826.jp2"}, "825": {"fulltext": "INSANITY. 799\\ndefect must always remain defective mentally. In acquired cases,\\nthe brain at birth has reached its then normal condition, but injury\\nduring the birth process, or accident or disease during early child-\\nhood, damages the brain structure and prevents subsequent nor-\\nmal mental growth.\\nThere is no material difference in ultimate results between\\ncongenital and acquired defects of equal extent. In the most pro-\\nfound cases of idiocy there are practically no mental manifesta-\\ntions; only the vegetative, organic and simpler nervous functions\\nexist. The child performs only automatic actions and is a very\\npitiable object. The higher grades of idiocy frequently exhibit, in\\ncertain directions, a good deal of memory and astuteness. They\\nare often fond of music and may be extraordinary natural musi-\\ncians, learning by ear and repeating by note intricate composi-\\ntions, but they never become intelligent musicians. Blind Tom,\\nthe negro boy, exhibited a few years ago as a prodigy, was an ex-\\naniple of the musical idiot.\\nBy gradual steps idiocy passes into imbecility, and imbecility\\ninto feeble-mindedness, in the higher grades of which there is only\\nslowness of development, backwardness and slight lack of mental\\ncapacity.\\nThe causes of all these forms are varied. In congenital cases\\nthe immediate cause is arrest of development, but what underlies\\nsuch arrest is not well understood. Heredity counts for much,\\nand in certain families these defections are very common. Indeed,\\none of the best authorities says Idiocy is of all mental derange-\\nments the most frequently propagated by descent. Not unfre-\\nquently the heredity is not traced to the same condition in the\\nparent, but to insanity, intemperance, epilepsy and other neuroses.\\nSometimes parents who seem to be untainted by any imperfection\\nwill have a series of more or less idiotic children from some unex-\\nplained incompatibility or incapacity for perfect reproduction.\\nThere is a widespread belief that consanguineous marriages are\\namong the most common causes of idiocy and imbecility. In the\\npopular mind the marriage of cousins is almost sure to beget\\nidiocy; but the consensus of the best medical opinions is that con-\\nsanguinity alone has very little to do with the production of idiocy.\\nIf the stock be sound and healthy in body and mind, cousins may\\nmarry without extra risk, but the real point is, that when near re-\\nlations marry, any family tendency to physical or mental weakness", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0827.jp2"}, "826": {"fulltext": "800 INSANITY.\\nis greatly increased, because of the same influence from both\\nparents; hence if the members of a neurotic family intermarry,\\nthe prospect for the offspring- must be bad.\\nIt occasionally happens that an infant s brain is injured by ex-\\ncessive pressure or by internal hemorrhage during birth, which\\nleads to arrest of development. Meningitis, convulsions, epilepsy,\\nhydrocephalus, infantile palsy and injury to the brain by fall, blow\\nor other means, are the principal causes of acquired idiocy and\\nimbecility.\\nAs a rule neither medical nor surgical treatment of idiocy, im-\\nbecility or feeble-mindedness is of any avail. It is obvious that\\ncongenital brain defects cannot be remedied, but careful medical at-\\ntention may prevent disaster to the brain, and prompt operation in\\nsome cases of injury to the head may prevent brain complications.\\nIn a few cases the relief of pressure by operation on an unyielding\\nskull has proved beneficial. In most cases of defective mental de-\\nvelopment treatment is restricted to taking the best possible care\\nof the patient, and is divided into two departments the custodial\\nand the educative. For the lowest classes the custodial feature is\\nthe most important; for the least defective the educational fea-\\nture is of the most value.\\nThe presence of an idiot or imbecile is a great detriment to\\nthe welfare of a family, and with increasing strength and develop-\\ning propensities he may become a menace to the family and the\\nneighborhood. The impossibility in an ordinary family of giving an\\njdiot or imbecile proper control, protection and education, ren-\\nders it best that such defectives be cared for in an institution\\nespecially designed for such cases, where experienced and com-\\npetent custodians and teachers are provided. The amount of edu-\\ncation which they are capable of acquiring varies greatly, some\\nbeing able to make scarcely any improvement, while others can\\nbe made self-supporting. At the other extreme of these defectives\\nare the feeble-minded or backward children, some of whom do not\\nappear to be abnormal, excepting in their backwardness a youth\\nof ten or twelve may show only the capacity of a child of five or six.\\nIn an ordinary school these children are annoyed and embarrassed\\nby being classified with their juniors, and are therefore best edu-\\ncated in special schools.\\nIn some cases mental development is defective because de-\\nprivation of one or more of the special senses closes the usual", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0828.jp2"}, "827": {"fulltext": "INSANITY. 801\\ngateways of knowledge, and that part of the brain which carries\\non mental operations remains more or less inactive from lack of\\nmental stimulus. This is called idiocy by deprivation, and has been\\nlikened to a seed which does not sprout because kept away from\\nsunlight and moisture.\\nThe cases of Laura Bridgman and Helen Keller, in whom all\\nsenses but that of touch, were destroyed by disease in early child-\\nhood and who were educated through this one remaining sense,\\nshow what patience and perseverance can do in early life but if\\nthese cases are neglected till habits are formed little can be done\\nfor them.\\nWe now come to the consideration of our second group\\nInsanity caused by brain disease after development.\\nAlthough insanity properly includes the mental manifesta-\\ntions of brain defect as well as brain disease, it is this second\\ngroup to which the term insanity is usually applied. In this group\\nof mental diseases there has been normal brain development and\\ncorresponding mental capacity, but disease has attacked the brain,\\nit can no longer properly carry on its function, mentality, and the\\nresult is deranged brain function or insanity.\\nILLUSIONS, HALLUCINATIONS AND DELUSIONS.\\nBefore considering the different forms of insanity, it is de-\\nsirable to explain certain terms used to designate some of the\\nsymptoms of mental derangement illusion, hallucination and de-\\nlusion. These terms, often confounded, have in mental medicine\\ndistinct and different meanings. An illusion is a false interpreta-\\ntion of an object actually present an hallucination is a false percep-\\ntion of an object which has no real existence; a delusion is a false\\nbelief.\\nAny one of these forms of erroneous sensori-psychic activity\\nmay exist in a state of perfect sanity. The circle of fire seen when\\na burning stick is rapidly moved in a circle is an optical illusion,\\ndue to the physiological fact that an impression made upon the\\nretina of the eye remains for a brief interval of time after the\\nstimulation ceases; interpreting the moaning of the wind to be\\nvoices or noises of animals, is an example of auditory illusion.\\nHallucinations in health are most likely to occur in that half-\\nsleeping state we call dozing, or in reverie, or when the mind, as\\nof the artist or musician, is intensely occupied in its favorite study.\\n51", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0829.jp2"}, "828": {"fulltext": "802 INSANITY.\\nHallucinations are common in ordinary disease. A lady, when a\\nlittle run down in health, always saw, upon a certain stair, a black\\ncat which was soon banished by a course of tonics. A fever pa-\\ntient who had been furnished that never failing hypnotic, a hop\\npillow, saw two of his neighbors bring into the room a hop pillow\\nso large it would scarcely go through the door. As long as the\\nmind corrects the abnormal sense-impressions, or estimates them\\nat their true value, they are not indications of insanity, and do not\\nlead to the false belief termed delusion. Indeed, many sane per-\\nsons hold delusions which are due to faulty education, prevalent\\nerrors, station in life, etc. but when, because of brain disease,\\nthe mind is unable by reason and judgment to correct illusions or\\nhallucinations, they become evidences of insanity, and the belief\\nin their reality constitutes insane delusions.\\nDelusion has already been defined as a false belief, and when\\nsuch false belief is due to disease it becomes an insane delusion or,\\nas generally used in connection with insanity, simply delusion.\\nIt is the symptom of insanity which most strongly appeals to the\\nordinary observer, and was formerly thought to be essential to\\ninsanity; but although insane persons do not always manifest de-\\nlusions, when a person claims to be emperor of the world, Jesus\\nChrist or God, such delusions are striking symptoms of the mental\\ndisorder.\\nMELANCHOLIA.\\nMelancholia is a form of insanity in which there is great men-\\ntal depression or melancholy, with depression of the bodiry powers,\\nmental distress, and often accompanied by suicidal impulse.\\nMelancholia shows itself in four typical forms (i) simple melan-\\ncholia, (2) agitated melancholia, (3) hallucinatory melancholia, (4)\\nstuporous melancholia.\\nSimple melancholia, in its mildest form, appears very much\\nlike an ordinary depression of spirits, but the facial expression\\nof mingled woe, shadowy mental dullness and distrust, is so char-\\nacteristic as to be readily recognized by an expert. Intimate\\nfriends and relatives will detect something unusual in the patient,\\nbut may not be able to explain in words the changes. The usual\\nsources of pleasurable sensation, such as family associations, busi-\\nness responsibilities, accustomed recreations, pleasing sights,\\nsounds, odors, etc., become causes of mental distress and pain.\\nEvery sensory impression, which in health would give pleasure, is", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0830.jp2"}, "829": {"fulltext": "INSANITY. 803\\ndistorted by the deranged brain into something distressing and\\nmournful. Hence the patient evinces no pleasure in anything,\\nand can scarcely be induced to smile. There is also obstinate sleep-\\nlessness and a dull aching pain in the back of the head and neck\\nthe memory is not usually impaired and the occurrences of the\\nmelancholy period can generally be recalled. Most cases of simple\\nmelancholia are without hallucination or illusion.\\nIn hallucinatory melancholia the melancholy is much more\\nmarked. In addition to painful mental sensations, the patient has\\ndistressing hallucinations and illusions. Every sensory impres-\\nsion from the organs of special sense, and from every part of the\\nbody, are converted into terrorizing hallucinations and illusions.\\nDelusions of an introspective and self-accusative character take\\npossession of the patient, and he bemoans his imaginary undoing.\\nThese patients have the delusions that they have nothing to hope\\nfor, that they are excessively wicked, that they ought not to eat,\\nthat their food is mixed with poison or the most noxious and\\noffensive filth, that the meat given them is human flesh, that they\\nwill bring misery upon their friends, that they have committed the\\nunpardonable sin, etc. They also have delusions of personal in-\\njury, that they are to be tortured, and the like. One of my patients\\nhad the delusion that a circular brick room, like a cistern, with\\nseveral openings in the sides, was being built as a place of tor-\\nture for her; that she was to be placed therein, and that heated\\nirons were to be thrust through the holes into her person. Indeed,\\nthe variety of delusions which are entertained by melancholiacs is\\nwell nigh limitless. The fear of personal injury, the apprehension\\nof bringing disaster upon relatives and friends, the load of imagi-\\nnary crime, and the belief of utter spiritual hopelessness, frequently\\ncauses the patient to become excessively and almost constantly\\nagitated, constituting the third form of this disease, agitated\\nmelancholia. These patients are almost constantly agitated, wring-\\ning their hands, throwing themselves about, crying out, bewailing\\ntheir fate, incoherent, and perhaps violent.\\nIn stuporous melancholia the patient becomes inattentive,\\nmute and motionless early in the disease. The mental powers\\nappear to be benumbed by the terror which has seized upon him.\\nThere are certain important characteristics which appertain\\nmore or less markedly to all forms of melancholia and deserve brief\\nconsideration. These are insomnia, post-cervical ache, precordial", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0831.jp2"}, "830": {"fulltext": "804 INSANITY.\\nfear, loss of weight, violent outbreaks, suicidal and homicidal tend-\\nencies.\\nInsomnia (sleeplessness) is almost always a precursor of and\\nan attendant upon melancholia of any form, and is very commonly\\none of the earliest preliminary symptoms. In some cases it is al-\\nmost complete and is frequently very obstinate.\\nThe post-cervical ache is a dull, heavy, ill-defined, variable,\\naching pain in the back of the head and neck, and is generally\\npresent in the simpler cases of melancholia. Precordial fear is a\\nfeeling of apprehension or fear, referred to the breast over the\\nregion of the heart. This is a reflex nervous phenomenon, and\\nis similar to the feeling which any frightened person has in this\\nregion. These two nervous phenomena are more noticeable in the\\nsimple cases than in those of greater severity.\\nThe general impairment of the vital forces in melancholia\\ncauses derangement of the function of digestion and assimilation\\nand leads to interference with nutrition and loss of weight, which\\nis sometimes very great. In acute cases, increase of weight is a\\nvery encouraging indication; but in some chronic cases accom-\\npanied by loss of mental power (dementia) increase of weight oc-\\ncurs without mental improvement. In most cases of melancholia,\\nespecially those affected with precordial fear, there is liability of\\nviolent outbreak. The feeling of apprehension, fear of personal\\ninjury, etc., becomes so great that the patient seeks to save him-\\nself, or revenge himself, or blindly gives way to aimless violence.\\nThe most quiet and apparently apathetic case may become vio-\\nlently excited in an instant and prove very dangerous.\\nThe logical outcome of morbid mental depression is suicide.\\nThe victim sees no respite from his tortures, no relief from his\\nsufferings, and his thoughts naturally turn to escaping his trou-\\nbles by ending his life. This danger is always imminent in all\\ncases of melancholia, even of the mildest sort. It is extremely diffi-\\ncult to make the friends of patients appreciate this. Not only is\\nthere danger of suicide, but of homicide as well. The daily papers\\nfrequently record instances of a whole family being killed by a\\nparent who then takes his own life, although not previously con-\\nsidered sufficiently insane to be sequestered. In general, the under-\\nlying idea is some phase of the delusion that it is better to put the\\nwhole family out of the way than to let them live to suffer. A\\nvery worthy Christian woman in profound melancholia tried to", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0832.jp2"}, "831": {"fulltext": "INSANITY. 805\\nkill her attendant. After recovery she clearly remembered the\\nchain of reasoning, which impelled her to the act. She thought\\nthat as long as she herself lived she would bring sorrow, sin and\\nshame to all around her, and that she would be doing less harm\\nand committing less crime by taking her own life, even if she\\nhad to kill her attendant to accomplish it.\\nSimple melancholia, in many cases at least, seems to be a\\nself-limited disease, i. e., one that after a time tends of itself to\\nrecovery. This may take place in three months, or in twelve or\\neighteen. Other cases which at first seem to be simple, develop\\ninto more serious forms. The most experienced alienist cannot\\ntell in the beginning of a simple case to what form it ma}- change,\\nor what will be the final outcome.\\nThe causes of melancholia are heredity, grief, trouble, mental\\nand physical overstrain, disease of the digestive apparatus, fevers,\\nchildbirth, worry, etc. These causes act to produce insanity by the\\nstrain of overwork or the lack of proper nutrition which they put\\nupon the brain, and thus start the brain enfeeblement which is\\nmanifested in the insanity. The one word which best covers all\\nthese cases is stress. The brain is capable of doing a great deal\\nof work, provided it is properly nourished and gets proper oppor-\\ntunity for recuperation. Worry is rapidly exhaustive. Hence long\\nvigils at the bedside of sickness and the distress which follows the\\nloss of near friends, the sleeplessness and worry over financial loss,\\nthe imperfect nutrition dependent upon dyspepsia, the toxic effects\\nof fever, the exhaustion of childbirth and lactation, worry of do-\\nmestic trouble, etc., throw undue stress upon the brain, derange\\nthe proper relation of waste and repair, and thus bring about the\\ndisordered function which is insanity.\\nIn melancholia of the milder forms the prospect for recovery is\\nfavorable in the severer forms, less hopeful, although very severe\\ncases sometimes make good recoveries. Simple cases, especially\\nthose following fever, etc., may completely recover in a few weeks;\\nothers, after two or three years. I have known one case to re-\\ncover after seven years, and instances are on record of recovery\\nafter still longer periods. The average duration of curable cases\\nis about nine or ten months.\\nA case of melancholia should be treated by isolation, nursing\\nand watching. Occasionally an incipient case can be diverted and\\nhealth re-established by travel and change of scene, but if the case", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0833.jp2"}, "832": {"fulltext": "806 INSANITY.\\nhas become one of distinct melancholia, travel not only does no\\ngood, but is positively harmful. If the patient be in a condition to\\nhave the mind occupied and the attention taken up by travel and\\nnew scenes, good will be derived therefrom; otherwise, harm will\\nresult.\\nAsa rule it is far better that the nurses and attendants in care\\nof a case of melancholia be strangers, with experience in the care\\nof the insane. If the resources of the family warrant it, and isola-\\ntion, nursing, watching, and competent medical attendance can\\nbe had at home, home care can be undertaken and successful re-\\nsult expected; but this method is practicable only in wealthy\\nfamilies in large cities. In most cases the asylum offers the best\\nsolution. Many families, who are prosperous when all are well,\\nare entirely unequal in many respects to the demands of home\\ntreatment of the insane; hence the home treatment of melan-\\ncholia will be limited, practically, to the incipient stages. Even here\\nthe case should have very careful watching, and the family physi-\\ncian should be very attentive. The mild cases are even more\\ndangerous as to possible suicide, homicide, or arson, than the\\nseverer ones, for the latter plainly show their condition, while the\\nformer, retaining their reasoning power to a large extent, are\\nable to plan desperate schemes with as much cunning and deliber-\\nation as a person in sound mental health. Besides, such patients\\nare liable to suddenly develop morbid impulses, the sight of a\\nweapon may suggest suicide or homicide the sight of the chil-\\ndren suggest that it would be a blessing to them to be removed\\nfrom a world which seems to be shrouded in gloom and woe.\\nThe greatest care should be taken to prevent suicide by re-\\nmoving from the patient s domain everything liable to be used\\nfor this purpose, and watching most carefully against sudden pre-\\ncipitation out the window or downstairs. A melancholy patient\\nhas been known to disembowel herself with scissors, while her\\nnurse was sewing by her side.\\nIn nursing, three points are very important to keep up\\nnutrition, to keep the bowels open, and. to keep the function of\\nthe skin active. Acute melancholiacs generally take but little\\nfood willingly and often refuse it altogether, partly because the\\nmind is preoccupied, partly because the organic sensations are\\ndulled, but more especially because of delusions, that poison is\\nmixed with the food, or that the meat is human flesh, or that they", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0834.jp2"}, "833": {"fulltext": "INSANITY. 80 r\\nare too wicked to eat, or if they do eat there will not be enough\\nfor others. It requires a great deal of tact and experience to get\\nsuch a patient to take sufficient food. Sometimes it is impossible,\\nand recourse must be had to forced feeding by the stomach or\\nnasal tube. Milk, milk and eggs, clear soup slightly thickened\\nwith arrowroot, strained pea soup, etc., should be given with the\\ntube three or four times a day, to which stimulants, digestives, lax-\\natives, etc., can be added as required. Patients have been nourished\\nin this way for months, or even years, and ultimately restored to\\nhealth.\\nTo combat the constipation, laxatives, especially those which\\nincrease glandular secretions and stimulate the muscular move-\\nments of the intestine, enemas and massage of the bowels, are to\\nbe used. The frequent use of the ordinary warm bath, followed\\nby general massage with inunctions of oil, will keep the skin in\\nreasonably good order and aid the nutrition. Incidentally, it\\nmay be said that the hair in melancholia is generally dry, harsh and\\nrough, and that improvement in its condition is an indication of\\nmental gain.\\nIt will be clearly seen from the foregoing that, in the great\\nmajority of cases, home treatment will not be practicable, and that\\nrecourse must be had to some institution, especially adapted to\\nthe care of the insane. Having determined it to be best to send\\nthe patient to an institution, select one, if you can have a choice,\\nunder the care of an experienced and competent alienist, place the\\npatient therein, then follow the advice of the superintendent as to\\nvisiting, writing, etc. As a rule melancholy patients, especially\\nin the early part of treatment, are made worse by visiting and let-\\nters, and both should be prohibited. Later, a time may come when\\nboth visits and letters will be beneficial After recovery from an\\nattack of melancholia care should be taken to keep the general\\nbodily health good, and to avoid brain stress of every kind, lest\\nanother attack be provoked.\\nMANIA.\\nIn mania we have the exact opposite of melancholia. It is\\ncharacterized by an exalted emotional state, together with exalta-\\ntion of other mental and nervous functions and motor excitement.\\nThe patient appears to be unnaturally quick-witted and talkative\\nideas come so rapidly he may not be able to find words to express", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0835.jp2"}, "834": {"fulltext": "808 INSANITY.\\nthem and therefore seems confused he talks vehemently, with ex-\\naggerated facial expression and gestures, and he is restless and\\ncontinually on the move. The patient s appetite and digestion\\nare good and his spirits high. He is happy and contented, forgets\\ncare and trouble, and becomes oblivious to usages of society and\\nrestrictions of law. Both men and women throw to the winds\\ntheir natural reserve and modesty, and deport themselves with un-\\naccustomed freedom and inattention to propriety. In the early\\nstages of mania the patient appears as though slightly intoxicated.\\nSome cases may never go beyond this stage others may go on to\\na condition of furious, dangerous excitement in which the patient\\nyells, dances, tears his clothing, smashes windows and furniture,\\nbrooks no interference, and sometimes attacks others with great\\nfury and violence.\\nMania is sometimes preceded by an attack of melancholia\\nfrom which the patient appears to recover and regain his natural\\nspirits, but he passes the normal state and goes into a condition of\\nexcitement. In other cases there is a preliminary period, of from\\na few days to a few weeks, of restlessness, eccentric conduct, dis-\\nturbed sleep or sleeplessness, loss of appetite, and dull headache,\\nin which the patient is unable to properly concentrate his thoughts,\\nand feels an incapacity to attend to his usual business. In typical\\ncases this condition lasts from one to three months, although at\\nthe last there may be a sudden, violent explosion.\\nMania shows itself in two forms simple mania and hallucina-\\ntory or delusional mania.\\nIn simple mania there is excitement, quickened mental opera-\\ntion, unnatural good humor, excessive talkativeness, restlessness,\\netc. Delusions, illusions and hallucinations are absent, or if\\npresent at all, are slight and vague. In hallucinatory or delusional\\nmania the hallucinations and delusions are prominent, dominate\\nthe patient and control his actions.\\nMania may be acute, subacute or chronic. In acute mania\\nthere is generally great excitement, constant talking and motion,\\nwith tendency to violence, easily provoked to outrageous acts.\\nSubacute mania is less active and violent. Both the acute and sub-\\nacute forms may lapse into the chronic, persistent form.\\nThe duration of mania varies. Very intense cases may last\\nbut a few days, ending in recovery or death. Milder ones may last\\nfrom a few months to two years, and end in recovery. Of typical", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0836.jp2"}, "835": {"fulltext": "INSANITY. 809\\ncases of simple mania sixty to eighty per cent may be expected\\nto recover hallucinatory cases are not as likely to recover. About\\nfour or five per cent prove quickly fatal from the general bodily\\ndisorder, accompanying the mania, pneumonia, or other complicat-\\ning disorders, or from depression of all the vital forces called\\nmaniacal exhaustion. Cases which neither recover nor die, lapse\\ninto chronic mania or into dementia.\\nThe causes of mania are much the same as those of melan-\\ncholia heredity, mental and physical overexertion, febrile dis-\\neases, childbirth and intemperance being among the most com-\\nmon. In the treatment of mania very mild cases can be cared for\\nat home, provided the resources of the family are equal to the\\nexpense. There is even less danger of sudden exhibitions of vio-\\nlence than in melancholia, but the restless activity of these cases\\nis likely to create a great deal of disturbance. For the more\\nsevere cases home treatment is inapplicable. Taking it all in all,\\nmost cases will require asylum control. Occasionally a puerperal\\nwoman is suddenly seized with violent maniacal symptoms which\\nwill disappear in two or three days by proper home treatment;\\nbut if the symptoms do not quickly abate, isolation in an asylum\\nwill be best.\\nThe medical treatment should be directed to regulating any\\ndisordered bodily function, to the calming of nervous excitability,\\nrelieving sleeplessness and keeping up bodily nutrition. As a rule,\\nmild cases of mania take food well and maintain good digestion,\\nbut in the more violent cases food is neglected from inattention, or\\nrefused from delusions or absolute loss of appetite, and forced feed-\\ning may be required. As there is great activity of mental and\\nphysical processes, a large amount of easily digested food will be\\nrequired and alcoholic stimulants will often be necessary. The\\nnervous excitement must be quieted by suitable nerve sedatives\\nand the sleeplessness overcome by hypnotics. In cases of very high\\nmaniacal excitement the vital powers are greatly prostrated and\\nthe patient must be kept in bed by relays of nurses or, what is less\\nirritating to him, by some form of mechanical restraint. In these\\ncases great attention must be given to keeping up nutrition and\\nstrength to avoid death from exhaustion. On the other hand, if\\nthe excitement is not great and the strength is good, exercise to\\nthe point of fatigue will often be beneficial by keeping the diges-\\ntion good, and securing sleep.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0837.jp2"}, "836": {"fulltext": "810 INSANITY.\\nPARANOIA.\\nA form of insanity, which has been variously named, is now\\ngenerally called paranoia. It is classed by some writers with\\nidiocy and imbecility because of the defective nervous develop-\\nment, which is one of its peculiarities; others include it with the\\nforms of insanity, which depend upon brain disease. It really ap-\\npears to partake of both forms. Paranoia is a form of mental dis-\\nease, dependent upon a defective nervous organization, either\\ncongenital or acquired in early life, and characterized by delusions\\nand self-exaltation, which do not cause emotional or ideational ex-\\ncitement or impairment of memory, but which dominate the men-\\ntal operations.\\nThe victims of this form of insanity are peculiar, even in child-\\nhood. They may be good scholars, but are eccentric, conceited,\\nintrospective and not well balanced. Following some trifling sick-\\nness, disappointment, disagreement with a playmate, some business\\ncomplication, etc., or without any known cause, the patient be-\\ncomes vaguely suspicious and depressed, with feelings that others\\nare trying to deprive him of his property or rights. The natural\\nconsequences of inattention to business are thought to result from\\nconspiracy against him. A patient in this condition enlisted in\\nthe army. He felt himself watched and checked in his laudable\\nundertaking on every hand, and believed that the generals of the\\narmy Sherman and Grant were conspiring to keep him in the\\nposition of private, and to prevent that reward by promotion to\\n/which his abilities and meritorious conduct entitled him. This\\nstage of the disease is sometimes called the persecutory stage.\\nLater comes the transition stage, when some event, emotion,\\nhallucination, dream, paragraph, conversation, or the like, may fix\\nitself upon the patient s attention and seem to explain the whole\\nmovement of his life. Delusions multiply; he imagines his course\\nof life has been specially planned out for him, by occult processes,\\nfor some great end imagines himself to be of noble birth. or even\\na prophet, or Christ that he has a wonderful mission to perform.\\nHe studies the Bible for hidden meanings applicable to himself;\\nbelieves the cause of his having been persecuted, or tried, to\\nbe envy and maliciousness. He begins to formulate the great mis-\\nsion he is to accomplish. Some notion of his own, or some public\\nincident, claims his attention and dominates and controls his\\nactions.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0838.jp2"}, "837": {"fulltext": "INSANITY. 811\\nThese people are often looked upon as cranky, or harmlessly\\ninsane, but their quiet conduct, business ability, rational conversa-\\ntion on general topics, good memory, etc., hide their slumbering\\nfire of delusion and obscure the dangerous tendencies for these\\npatients are exceedingly dangerous and only require the stimula-\\ntion of some public event, personal collision or crystallizing delu-\\nsion, like a spark to gunpowder, to precipitate some appalling ex-\\nplosion. A good example of this form of insanity and its violent\\nculmination, is that of Prendergast, the assassin of Mayor Har-\\nrison of Chicago, who was stimulated to the deed by the idea that\\nhe had been appointed to champion the cause of the populace, to\\nrelease them from the oppression of the mayor, etc. In short, he\\nclaimed that he killed the mayor for the benefit of the people at\\nlarge, and not from any personal or selfish motive. Many other\\nassassins, and would-be assassins, of distinguished persons have\\nbeen paranoiacs.\\nThese patients sometimes follow and annoy ladies whom they\\nbelieve to be deeply in love with them, even though they have\\nnever exchanged a word with them. They may take the notion\\nthat the wealth in the possession of some noted millionaire is really\\ntheir own, and take measures to secure it by threat or force. Such\\npatients are f f ound in every rank of life, and often impose a long\\ntime on intelligent persons, especially on ladies, ministers and\\nlawyers, until they are rudely awakened to the person s real condi-\\ntion by some sudden desperate act. The only safe disposition of\\nthis class of insane is seclusion, which is sometimes impossible to\\nsecure till homicide has been accomplished. It follows as a mat-\\nter of coure that this form of insanity is not very curable, although\\na cure, or at least a remission for long years occasionally takes\\nplace.\\nDEMENTIA.\\nDementia signifies loss of mind. It is very commonly used by\\nthe public, and in legal proceedings, to signify any form of insanity,\\nbut by alienists, its use is restricted to certain forms of mental de-\\nrangement, which frequently follow more active types and which\\nshow, as the most prominent symptoms, an impairment of mental\\npower. The term is often confounded with idiocy, and while cer-\\ntain forms of dementia do not differ materially from idiocy, the\\ntwo conditions are reached by different routes. The idiot has\\nnever developed mentality he has always been weakminded the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0839.jp2"}, "838": {"fulltext": "812 INSANITY.\\ndement has been the possessor of normal mental power, which has\\nbecome impaired by brain disease.\\nDementia will be considered under three forms primary\\ndementia, terminal dementia, and senile dementia.\\nPrimary Dementia, also called stuporous insanity, is a form of\\nmental derangement evinced by a more or less marked weakening\\nof the mental powers, not secondary to any other form of insanity,\\nbut coming on as an original mental disorder in a person previously\\nof sound mind. This form of insanity may come suddenly from\\nsome overwhelming mental shock and reach its height in a very\\nshort time, or it may come on gradually, perhaps with periods of\\nremission or intermission. In the slowly developing cases the\\npatient loses interest in what has usually interested him he grows\\ncareless in dress and habits, displays excessive grief or joy at slight\\noccurrences, finds difficulty in fixing his attention, becomes for-\\ngetful, unable to attend to his usual occupation, and incoherent\\nboth in speech and writing, loses his sense of modesty and decency,\\nneglects the calls of nature, etc.\\nThis form of insanity is seen only in young persons, who, as a\\nrule, have not passed their twenty-fifth year, and have inherited\\ntendencies to insanity. It is very likely to depend for its immediate\\ncause upon masturbation, inanition, exhausting discharges, etc.,\\nor gradual or sudden exhaustion of the nervous system. It ends\\nin recovery in a majority of cases in from two or three to five or six\\nmonths the younger the patient and the more sudden the onset,\\nthe more rapid the recovery. Cases caused by masturbation are\\nthe least favorable. Cases which do not recover, lapse into the\\ndull, apathetic form of terminal dementia, frequently complicated\\nwith pulmonary disease.\\nThe treatment of these cases consists of good nursing and\\ngreat care-taking, liberal feeding, with reconstructive tonics and\\nstimulants to invigorate the weakened brain.\\nTerminal Dementia Cases of acute insanity may terminate\\nby recovery, by death from exhaustion, or by becoming chronic\\nand incurable. The first two classes are obviously removed from\\nthe ranks of the insane; the chronic and incurable residuum is\\nwhat constitutes the mass of insanity, which exists at any one time,\\nand which fills our asylums and receptacles. Cases of chronic in-\\nsanity sometimes retain to a greater or less degree the symptoms\\nwhich marked their acute stage and become, therefore, chronic", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0840.jp2"}, "839": {"fulltext": "INSANITY. 813\\nmelancholia, chronic mania, etc., but the majority of uncured cases\\ntend to an impairment or weakening of the mental powers that is,\\nto a decay of the mental faculties. This mental enfeeblement, con-\\nsequent upon a preexisting acute insanity, is called terminal de-\\nmentia.\\nTerminal dementia may vary in degree from but slight mental\\nimpairment to complete fatuity. Employment of both body and\\nmind helps to postpone mental decay, and in public institutions\\nfor the insane chronic cases are encouraged to work, mainly for\\nthe benefit which occupation brings to the patients and only in-\\ncidentally for the value of their labor. Many of these cases, under\\nthe guidance, control and support of the asylum, prove excellent\\nhelpers, but they rarely do as well at home, and are incompetent\\nto meet the exigencies of ordinary life. Those who are extremely\\ndemented require to be taken care of like children, and are often\\nvery untidy and destructive.\\nThere is no medical treatment for terminal dementia. The\\nbrain has suffered irreparable damage, and the most that can be\\ndone is to preserve, by judicious management, as long as possible,\\nwhat mental power is left. The illusions, hallucinations and de-\\nlusions, as well as the morbid impulses, fears and tendencies, which\\nexisted in the acute stage of the insanity, may continue to exist in\\nthe terminal dementia until the mind becomes too weak to retain\\nthem.\\nSenile Dementia. The natural history of the bodily organism\\nis a period of growth, a period of maturity and period of decay.\\nThis is especially marked in the brain, the most complex organ in\\nthe body. Keeping step with these material changes there is in\\ninfancy, youth and adolescence, a period of mental growth and de-\\nvelopment, in middle life a period of mental maturity, and in old\\nage a period of mental decay. This mental decay of old age is\\ncalled senile dementia. The first symptom noticed is almost al-\\nways a weakness of the memory which is followed by other evi-\\ndences of failing intelligence. The patient fails to recognize his\\nold acquaintances, or even his own children. He forgets where\\nhe lives, cannot find his way from room to room in his own house,\\nand repeats the same question or story over and over, forgetting\\nthat he has previously A T oiced the same words.\\nThe age at which senile dementia spontaneously makes its ap-\\npearance varies considerably it is rarely seen before the sixtieth", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0841.jp2"}, "840": {"fulltext": "814 INSANITY.\\nyear, generally not till the sixty-fifth or seventieth, and sometimes\\nnot until much later. There is also great difference in the degree\\nof senility and the rapidity with which it develops; some persons\\nat eighty-five being as vigorous as others at sixty. Wounds, in-\\njuries, westing diseases or excessive use (comparatively) of the\\nmind, may bring on senile changes as early as the fiftieth year.\\nThis ordinary senile mental decay can scarcely be regarded as\\npathological or as insanity but it not unfrequently happens that\\nradical changes in character and disposition are the first indica-\\ntions of senility. Such changes continue to be the most prominent\\nsymptoms and may take on a serious, dangerous or homicidal char-\\nacter. The liberal husband and father becomes penurious and\\nmiserly, refusing to provide his family and himself sufficient food\\nto prevent starvation; or he may become prodigal and squander\\nhis means on disreputable characters with whom he had never\\nbeen accustomed to associate. He may attempt to destroy prop-\\nerty by fire or otherwise, or may endanger the lives of his family.\\nWhen these unnatural and unusual mental symptoms occur,\\nit is clear that the brain changes have been of a pathological or\\ndiseased character, and that the condition is one of insanity in-\\nstead of natural decay. These cases of real insanity should be\\nprotected from doing harm to their property, to themselves and\\nto their families, by being adjudged insane, by having a guardian\\nappointed to look after their business interests, and by sequestra-\\ntion. Very old people do not, as a rule, well bear being sent to\\nan asylum. It seems to act upon them like the transplanting of\\nan old tree. The removal from long-time associations and sur-\\nroundings is a shock from which they may never rally, and they\\nmay survive but a short time.\\nIn a case of this kind in a wealthy family, to which I was\\ncalled in consultation, 1 had a whole house set apart for the in-\\nvalid, his nurses, housekeeper, etc., from which the other mem-\\nbers of the family were excluded. The result was satisfactory; the\\nold gentleman became quiet and manageable, and ere long passed\\naway at his own home. But it goes without saying that such a\\nmethod must be expensive, and that with people of limited re-\\nsources the restraint of the asylum offers the only practicable solu-\\ntion of such a problem. It also follows that senile decay, both of\\nthe bodv and mind, can terminate only in death, and that treat-\\nment must needs be limited to smoothing as much as possible the\\nrugged pathway.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0842.jp2"}, "841": {"fulltext": "INSANITY. 815\\nPARETIC DEMENTIA.\\n(Genera! Parab sis. Paresis.)\\nParetic dementia is a form of insanity characterized by pro-\\ngressive mental enfeeblement, muscular inco-ordination, delusions\\nof wealth and grandeur, ultimate decay of mental and bodily pow-\\ners, and death. It is a disease of the most vigorous period of adult\\nlife, occurring most frequently between thirty-five and fifty years of\\nage. It attacks men much more frequently than it does women,\\nthe proportion averaging about six men to one woman. Its vic-\\ntims are as a rule among the most active and vigorous it rarely\\nattacks the sickly and feeble, and rarely follows other forms of in-\\nsanity. It is most likely to occur in persons who have imposed too\\ngreat burdens upon the nervous system, by overwork, intemper-\\nance, sexual excess, etc., resulting in exhaustion of nerve force,\\nor from syphilis, which sets on foot subtle organic degenerative\\nchanges in the brain cells. The brain disease which underlies this\\nform of insanity is easily demonstrated as an inflammatory degen-\\neration of the cortex (gray outer portion of the brain), which is\\nthe portion essentially engaged in mental operations. A patient\\nattacked by paretic dementia, at first shows slight mental defects,\\nsuch as forgetfulness, carelessness in dress and behavior, irritability,\\nloss of delicate shades of refinement, etc. He soon becomes erratic\\nand visionary, full of expansive ideas of business and impractica-\\nble schemes. He becomes extravagant and wasteful of his means\\nand squanders property in foolish ventures. He begins to have a\\nthickness of speech, slurring or dropping letters or words like a\\npartially intoxicated person. Indeed, these early symptoms of\\nparesis are often mistaken by the patient s friends for evidences of\\nexcess in drinking. Then comes a tendency to appropriate any-\\nthing within his reach, under the idea that it belongs to him. The\\npatient, also, becomes very irritable and violently resents inter-\\nference and there may even be maniacal attacks of great violence.\\nDelusions of wealth and grandeur multiply apace, until he be-\\nlieves he is the strongest man in the world, that he controls every\\nbusiness, that he is possessed of untold millions, that he owns gold\\nand silver mines yielding him train loads of these metals daily,\\netc. These expansive delusions are likely to take a tinge from\\nthe patient s previous occupation, thus a stonemason thought he\\nwas to build a stone bridge across the Atlantic; a locomotive en-\\ngineer claimed to have an engine, the cab of which was hollowed", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0843.jp2"}, "842": {"fulltext": "816 INSANITY.\\nfrom an enormous diamond, which laid its own track and would\\nrun to England in twenty-four hours and another claimed to have\\nan engine with cylinders five hundred inches in diameter, driving\\nwheels live hundred feet across, and a flag-pole on the cab five\\nhundred miles high.\\nThe muscular inco-ordination and paralysis increase until the\\npatient is unable to articulate, to walk, or to help himself at all.\\nApoplectiform or epileptiform seizures occur. Death may come\\nsuddenly in one of these seizures, or gradually, from slow exhaus-\\ntion and general failure of nutrition, often with the development\\nof bedsores upon prominent points, or even the sloughing of an\\nankle where the other has lain across it. At last the patient is as\\nhelpless as an infant, and when unable to help himself and scarcely\\nable to speak, will still answer, in reply to the question: How are\\nyou? A all r ri right. Occasionally a case is seen in which\\nthe delusions are of a depressing nature.\\nThere is no cure for paretic dementia. Remissions sometimes\\noccur in which the patient, under control, may seem to be almost\\nrestored, but, on attempting to resume an active occupation,\\nbreaks down at once. The average duration of this disease is about\\nthree years, but occasionally a case runs, its course in a few months,\\nor on the other hand, may last ten or twelve years. It is well nigh\\nimpossible to care for this form of insanity in an ordinary home,\\nand the institution affords the best recourse.\\nGENERAL CONSIDERATIONS. PREVENTION.\\nThe classification of insanity as here given is considered suffi-\\ncient for our purposes. Much more elaborate classifications are\\nused by specialists. Certain views touching insanity, and* some\\npeculiarities which attend many cases, deserve a brief notice.\\nLunacy is an old name for mental derangement, founded upon\\nthe idea that it is caused by some malign influence of the moon\\n(luna). The only influence, however, that the moon has on in-\\nsanity, is the same that it has upon some sane persons who sleep\\nlightly namely, some sane as well as some insane people are more\\nwakeful in bright moonlight nights, simply because of the light.\\nCertain cases of insanity have a more or less marked periodic-\\nity. Melancholiacs are more depressed in the early morning, sim-\\nply because the vital forces are less active at that time, and the\\nworry of a sleepless night then culminates. Suicide is especially", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0844.jp2"}, "843": {"fulltext": "INSANITY. 817\\nto be guarded against in the early morning hours. In women men-\\nstruation is generally suspended during acute insanity. The arrest\\nof menstruation is not the cause of insanity, but a consequence of\\nit, or rather a consequence of the profound depression of the vital\\nforces which accompanies the insanity. Hence the restoration of\\nthis function is a good sign because it shows recuperation of vital\\nforce. In some cases of acute insanity and in many of chronic de-\\nrangement, menstruation continues and the manifestations of in-\\nsanity are intensified at the menstrual period.\\nCertain persons are subject to frequently recurring attacks of\\ninsanity recurrent melancholia or mania, the latter being more\\ncommon. Generally the attacks grow more frequent and of longer\\nduration, and finally produce more or less marked dementia. At\\nfirst these attacks may be several years apart and the patient be en-\\ntirely well in the intervals, but ultimately they have to remain con-\\ntinuously at the asylum.\\nThere is a form of insanity, manifested by the alternations of\\nexcitement and depression, called circular insanity. The circle of\\nchanges may occupy a few weeks or many months, and there may\\nbe a period of considerable duration, in which the patient appears\\nalmost natural; but whenever this vicious cycle is once set up re-\\ncovery is well nigh hopeless.\\nEpilepsy may continue many years without impairing the\\nmental faculties, but usually the mind soon becomes affected, and\\nepileptic insanity supervenes. Epileptic insanity and the automatic\\nmental state which may precede or follow epileptic attacks, con-\\nstitute a violent and very dangerous form of mental disease, and\\none very likely to lead to homicide.\\nThe stress of the puerperal state not unfrequently causes in-\\nsanity, especially in those predisposed thereto. This insanity may\\nassume the form of melancholia or mania. It is especially im-\\nportant in puerperal insanity to be very watchful, lest the woman\\ninjure herself or her child.\\nThe use of alcoholic drink may cause several different forms\\nof insanity: First The condition of acute inebriety, drunkenness,\\nnot usually classed as insanity because of its brief duration. Sec-\\nond Delirium tremens, a violent acute apprehensive delirium.\\nThird Ordinary acute mania. Fourth The so-called alcoholic\\ninsanity characterized by change of character, suspicions, marital\\njealousy, etc. Fifth Chronic degeneration, of the type of senile\\n52", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0845.jp2"}, "844": {"fulltext": "818 INSANITY.\\ndementia or general paralysis. Similar conditions follow the use\\nof other drugs, such as morphine, chloral and cocaine.\\nYears ago the belief was general that the insane were sub-\\njects of demoniacal possession, hence grew up a fear of the insane\\nand a tendency to cast them out of the realms of friendship and of\\nhope. It is now known that insanity is but the manifestation of\\nbodily disease, yet the old feelings regarding it have not all passed\\naway. By many, at the present day, insanity is looked upon as a\\ndisgrace and the going to an institution for the insane regarded as\\na stigma. But insanity is no more a disgrace than any other sick-\\nness. When other illness comes upon one as the result of evil-\\ndoing, of bad habits, of dissoluteness or dissipation, it is a disgrace\\ninasmuch as it is a badge of disreputableness but sickness that\\ncomes unavoidably is a misfortune, not a disgrace. Exactly the\\nsame distinction holds good with insanity. It is disgraceful when\\nthe causes which brought it on are discreditable, otherwise it is\\nsimply a misfortune, but as insanity affects the highest distinctive\\nhuman attribute, mentality, which is the gauge of the individual s\\npersonality, the ego, it is a much greater misfortune than ordinary\\nbodily disease. Furthermore, insanity is much the most trouble-\\nsome of all maladies to care for, because of the peculiar difficulties\\nand dangers which attend it. The delusions of the insane which\\nare liable to attach to their best friends, the refusal of food, the vio-\\nlence, the danger of arson, and of suicide and homicide, render the\\ncare of the insane particularly difficult, especially at home.\\nIn very young persons whose after-life might be clouded by\\nhaving been sent away as insane, in very old persons who have but\\na short time to live, in puerperal cases where convalescence may\\noccur in a few days, and in cases where mental failure in general\\nbodily disease evidently precedes dissolution but a short time, the\\npatient should be cared for at home if possible; but even here, the\\nquestion of financial resources, strength, house-room, etc., may be\\ncontrolling, and necessitate sending the patient away.\\nOriginally, institutions for the insane were only receptacles\\nfor secure custody, and chains and dungeons were of common use.\\nBut science and humanity have wrought great changes, and asy-\\nlums are now (generally) organized and conducted for the most en-\\nlightened and curative treatment of this unfortunate class. Years\\nago, when hospital was a rather forbidding word with unpleasant\\nassociations, it was avoided in connection with the insane and the,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0846.jp2"}, "845": {"fulltext": "INSANITY. 819\\nthen, softer word asylum was preferred. Now, that the public\\nis better educated as to hospital work, the tendency is reversed\\nand in many states asylum has been changed to hospital. Of late\\nyears there has been increasing attention given to the medical\\ntreatment of mental disease, nevertheless the chronic hopeless cases\\nwill always outnumber the acute and presumably curable ones,\\nten to one. The new cases, as they arise, necessarily speedily di-\\nvide into three classes those which soon die from the violence of\\ntheir disease, those which recover, and those which become chronic\\nand incurable. It is this residuum of unrecovered cases which con-\\nstitutes the great mass of existing insanity.\\nThere have been very widely divergent views as to the curabil-\\nity of insanity. At one time the popular belief was that it was\\nvery seldom, if ever, cured. In the early part of the nineteenth\\ncentury, the great improvement wrought by the modern humane\\ntreatment of chronic cases, together with the enthusiasm of asy-\\nlum superintendents, led to the claim that nearly ail could be cured,\\nprovided they were properly treated in the early stages. More\\nthorough and candid study shows that of the cases as they arise,\\njust about one-half recover. The public still holds erroneous ideas\\nas to the curable cases. Many, many times have patients been\\nbrought to me with the statement There is not much the mat-\\nter with this man, he has been acting a little queer for two or three\\nyears, but has been able to attend to his business until the last few\\nweeks; he will soon be all right again. The fact is, such cases are\\nvery unfavorable. On the other hand, cases of acute rapidly de-\\nveloping mania or melancholia give a large percentage of recov-\\neries.\\nThe asylum, or hospital in some form, has a twofold func-\\ntion the cure of the curable and the custody of the incurable. As\\na rule, it affords the best prospect of cure for several reasons The\\nmedical officers have had long experience in treating mental dis-\\neases the nurses, attendants and other employes are trained in\\nthe work the dangers are very largely eliminated, and the insane\\ngenerally accept care and control at the hands of strangers with\\nmuch less objection and irritation than from relatives and friends.*\\nWhen institutions for the insane, and other defectives are made political per-\\nquisites and with every change of administration a new set of campaign strikers, in-\\nexperienced and untrained in the work are put in charge, great wrong is done the\\ninsane, their friends and the state. The public should protect itself against such mal-\\nadministration.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0847.jp2"}, "846": {"fulltext": "820 INSANITY.\\nAs far as chronic and incurable cases are concerned, the func-\\ntion of the asylum is simply custodial. Generally, cases of chronic\\ninsanity are very troublesome, if not dangerous, at home, and exert\\na decidedly unfavorable influence, especially upon the young. As\\na rule, therefore, the chronic cases would better be in the asylum,\\nbut some cases under favorable conditions do well at home.\\nThe insane are the wards of the state, and the state therefore\\nestablishes and supports institutions for their care. These asylums\\ngenerally provide good treatment and good care for their inmates,\\nare generally managed by experienced superintendents for the\\nbenefit of the patients, and are worthy of confidence. There should\\nbe no exceptions to this rule. While public institutions should,\\nand generally do, give good care, they are necessarily managed\\neconomically and nothing is expended for luxuries. For those\\nwho have abundant means and desire to furnish insane friends\\nwith accustomed luxuries, there are private institutions worthy\\nof confidence.\\nThe insane are sick persons, and whether or not to send a\\nlunatic to an institution, is essentially a medical question which\\nshould be decided by the physician, just as he decides the ordering\\nto bed of a fever case, or the kind of splint to put upon a fractured\\nlimb. Unfortunately, in many states this purely medical question\\nhas been delegated to the courts and its solution savors of criminal\\njurisprudence. The victim of brain disease has to be tried for and\\nconvicted of insanity, and goes to the asylum with the idea that he\\nhas, been sentenced as a criminal. Inasmuch as property interests\\nare often affected by insanity, it is desirable that there be some\\njudicial cognizance of this condition when it exists. The best way\\nto meet the medical and judicial requirements in a case of sup-\\nposed insanity, would be to have the court appoint a medical com-\\nmission which should examine the case and report, then have the\\ncourt act upon their report.\\nInsanity is especially a disease of modern times and of high\\ncivilization. Uncivilized people put but slight tax upon their men-\\ntal machinery, hence develop very little insanity; but among the\\nleading nations of the world, emotional strain, business cares,\\nfinancial worry, dissipation, etc., are liable to lay that stress upon\\nthe brain which is the immediate cause of insanity. The propor-\\ntion of insane persons varies the maximum, about three in one", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0848.jp2"}, "847": {"fulltext": "INSANITY. 821\\nthousand of population, being found in the older and more densely\\nsettled states or countries.\\nAn ounce of prevention is better than a pound of cure, runs\\nan old adage, and to nothing does it apply better than to insanity.\\nA large proportion of mental derangement is hereditary. This\\ndoes not mean that in all cases of hereditary insanity, the subject\\nis born insane. The congenital idiot or imbecile is born defective,\\nbut children are not born insane, in the common acceptation of\\nthe word. But just as there runs in certain families a tendency\\nfor the children as they grow to adult life, to develop certain family\\npeculiarities as to hair, color of eyes, shape of features, tone of\\nvoice, and movement, so there runs in families a tendency to the\\ndevelopment of different diseases, as rheumatism, gout, consump-\\ntion and insanity. Persons who inherit a tendency to insanity\\nare much more liable to become insane than those who do not and\\ninsanity in such persons is very likely to be developed under the\\nstrain incident to the critical periods of life, as puberty, adolescence,\\nclimacteric, or the special stress of child-bearing, or of emotional\\nstrain.\\nIt goes without saying that if all persons who inherit tend-\\nencies to insanity were to refrain from entering the marital rela-\\ntion the result would greatly lessen the amount of insanity in com-\\ning generations. In a few instances we have known persons to\\ndeliberately determine against marriage on this account, but peo-\\nple generally are not controlled by such lofty ideas.\\nThe foundation for mental derangement is frequently laid in\\ninfancy and early childhood through failure of parents to teach\\ntheir children proper self-control. Allowed to grow up without\\nlearning the important lesson of self-denial and self-mastery, they\\nare liable, by vicious physical and mental indulgences, to sow the\\nwind, that in the harvest time of later life, becomes the whirlwind.\\nOverwork, the unrelenting tasks of poverty, unrestrained ambition,\\nirregular life, dissipation, struggle for supremacy, the exactions of\\ncomplicated and harassing business, inattention to the laws of\\nhealth, excessive grief, etc., are likely to prove excitants which\\nmay produce insanity with or without predisposing causes. With\\na sound body will be associated mental integrity. When all ob-\\nserve the laws of physical, mental and moral hygiene, insanity will\\nbe rare.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0849.jp2"}, "848": {"fulltext": "", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0850.jp2"}, "849": {"fulltext": "GLOSSARY.\\nFor -words defined in connection -with their use i?i this zcork, consult the index.\\nAbdomen, The part of f he body con-\\ntaining the stomach and intestines.\\nAbdominal, Pertaining to the abdomen.\\nAberration, A state of partial insanity.\\nAbnormal, Irregular; unnatural.\\nAbrasion, The act of rubbing away by\\nfriction.\\nAbsorbent, That which takes up or ab-\\nsorbs liquids.\\nAbsorption, Taking up substances from\\nwithin or without the body.\\nAcne, Pimples on the face, most com-\\nmon at puberty.\\nAcromegaly, A disease characterized\\nby excessive increase in the size of\\nthe bones.\\nAcromygalia, A rare nervous disease,\\nusually causing paralysis and death.\\nAcute, Active, with rapid progress and\\nviolent symptoms, the opposite of\\nchronic.\\nAdolescence, The time between puberty\\nand full development.\\nAdventitious, Added or acquired.\\nAeration, The process of mixing with\\nair.\\nAerobic, Pertaining to bacteria able to\\nlive in contact with air and to absorb\\noxygen.\\nAfferent, Conducting or bearing in as\\nan afferent artery.\\nAlbumin, A thick, sticky substance\\nforming a part of animal fluids and\\nsolids, and resembling the white of an\\negg-\\nAlbuminoid, Resembling albumin.\\nAlbuminuria, A disease of the kidneys,\\ncharacterized by albumin in the urine.\\nAlgea, A sea-weed.\\nAlienist, One skilled in the treatment\\nof mental diseases.\\nAlimentary, Pertaining to that which\\nnourishes.\\nAlkaloid. A compound of alkali and\\nsome other substance.\\nAlterative, A remedy which by de-\\ngrees changes the constitution, and re-\\nstores to health.\\nAmeba, One of the lowest forms of life.\\nAmputation, Cutting off a limb.\\nAnaemia, A lack of blood, or of red\\ncells in the blood.\\nAnarsarca, A diffusion of serous fluids\\ninto the connective tissues a general\\ndropsy.\\nAnastomosis, The opening of the ves-\\nsels of one system into those of an-\\nother, as the union of the arteries and\\nveins.\\nAnatomically, As regards structure;\\npertaining to anatomy.\\nAnatomy, The structure of the body\\nwith reference to its parts.\\nAnerobic, Pertaining to bacteria that\\nlive without air.\\nAnaesthetic. A medicine or agency that\\nprevents feeling.\\nAnglesia, Inability to feel pain.\\nAnodyne, A medicine which relieves\\npain.\\nAntidote, That which counteracts the\\neffect of a poison when taken into the\\nstomach.\\nAnterior, Before in the front position.\\nAntifebrile, A remedy which overcomes\\nor cures fever.\\nAnus, The opening at the lower end of\\nthe alimentary canal through which\\nthe excrement leaves the body.\\nAphasia, Loss of the use of words, both\\nspoken and written, without loss of\\nthe vocal organs or impairment of the\\nmind, resulting from a brain injury.\\nApoplexy, Pressure upon the brain\\ncaused by a ruptured blood vessel.\\nAqua, Water.\\nAreola, The colored ring around the\\nnipple.\\nAreolar tissue. The network of fibers\\nextending over the body and binding\\n23", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0851.jp2"}, "850": {"fulltext": "824\\nGLOSSARY.\\nits organs together, and connecting the\\nskin with the deeper tissues.\\nAromatic, A fragrant drug, usually hav-\\ning a pungent taste.\\nArrector, That which causes to stand.\\nArtery, A vessel which conveys blood\\nfrom the heart.\\nArthritis, Inflammation of the joints.\\nArticular, Pertaining to the joints.\\nArticulation, A joint.\\nAseptic, Free from the living germs of\\ndisease, fermentation or putrefaction.\\nAssimilation, Transformation into its\\nown substance of matters foreign to\\nthe body.\\nAstringents, Medicines which by con-\\ntracting the tissues restrain excessive\\nevacuations and hemorrhages; the op-\\nposite of laxatives.\\nAtrophic, Showing or undergoing\\natrophy.\\nAtrophy, Wasting away because of im-\\nperfect nourishment.\\nAuditory, Pertaining to the hearing.\\nAutomatic, Self-acting; not under con-\\ntrol of the will.\\nAutopsy, Post mortem the opening and\\nexamination of the body after death.\\nAxilla, The arm-pit.\\nAxis, An imaginary straight line pass-\\ning through the cenrer of a body and\\non which that body may be supposed\\nto revolve.\\nBacillus, Bacilli, A rod-shaped bac-\\nterium.\\nBacteria, Microscopic organisms; dis-\\nease germs.\\nBenign, Harmless.\\nBilateral, Having two sides.\\nBile, A bitter, yellow, sticky fluid secre-\\nted by the liver.\\nBiliary, Pertaining to the bile.\\nBilious, A deranged condition attended\\nby disordered bile.\\nBloody-flux, A disease characterized\\nby frequent bloody stools.\\nBrachial, Belonging to or resembling\\nthe arm.\\nBroad ligaments, The folds of the peri-\\ntoneum which support the uterus and\\ncontain the ovaries and fallopian\\ntubes.\\nBronchial, Pertaining to the bronchi,\\nor air tubes of the lungs.\\nCachexia, A morbid condition of the\\nbody resulting from disease.\\nCalcareous, Containing lime.\\nCalculus, calculi, A concretion formed\\nby the deposit of solid matter, as soda,\\nlime, uric acid, etc., usually in the\\nreservoirs of the body.\\nCapillary, A very minute passage or\\ncanal.\\nCarbolize, To impregnate with carbolic\\nacid.\\nCarburetted, Combined with carbon.\\nCarcinoma, A cancer.\\nCardiac, Pertaining to the heart.\\nCarotids, The large arteries in the sides\\nof the neck.\\nCartilage, A solid substance occurring\\nin the joints, at the ends of the ribs,\\nbreast bone, etc.\\nCasein, Cheese curd; the part of milk\\ncontaining nitrogen.\\nCatamenia, The discharge of f the\\nmenses.\\nCatarrh, An inflammation of a mucous\\nmembrane, especially those of the air\\npassages of the head and throat, ac-\\ncompanied by an exudation.\\nCatheter, An instrument for introduc-\\ntion into the urethra to empty the\\nbladder.\\nCaustic, A medicine which destroys\\nanimal tissues.\\nCauterize, To burn or sear by means\\nof heat or caustics.\\nCautery, A burning or searing of the\\nflesh.\\nCell, A minute vessel or sac having\\nmembranous walls or sides, and con-\\ntaining fluid. Cells constitute the cel-\\nlular tissues of animals and plants, and\\nby their growth and reproduction make\\nup the growth of these parts.\\nCellulitis, Inflammation of cellular tis-\\nsue.\\nCerebellum, The small or posterior\\nbrain.\\nCerebral, Pertaining to the cerebrum.\\nCerebrum, The upper larger portion of\\nthe brain.\\nCerebration, Action of the brain.\\nCervical, Pertaining to the neck.\\nCholesterine, A fatty substance found\\nin the bile.\\nChyle, Food digested and ready for ab-\\nsorption.\\nChyme, The food after it has been acted\\nupon by the gastric juices.\\nChronic, Moderate, slow, continuing a\\nlong time.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0852.jp2"}, "851": {"fulltext": "GLOSSARY.\\n825\\nCicatrix, A scar formed in the process\\nof healing.\\nCicatrization, The process of healing.\\nCilia, Small hairs.\\nCircumcision, Cutting off the prepuce\\nof males, or the lesser labia of females.\\nClavicle, The collar bone.\\nClinical, Belonging to the bed; bed-\\nside.\\nClyster, An injection.\\nCoagulants, Substances which cause\\ncoagulation or curdling.\\nCoagulate, To harden and thicken like\\nthe white of an egg under the action\\nof heat.\\nCoccus, pl., cocci, A kind of bacteria.\\nCoccygeal, Pertaining to the coccyx.\\nCoccyx, The four lowest vertebrae of\\nthe backbone.\\nComatose, Pertaining to coma sleepy.\\nConception, The first formation of the\\nembryo.\\nCondiments. Substances used to give\\nrelish to food.\\nCongenital, That which is born with\\none; a tendency dating from birth.\\nCongestion, An excessive supply of\\nblood in a part or organ.\\nContagion, Germs that transmit disease\\nby contact direct or indirect.\\nContusion, A bruise.\\nConvalescence, The period of recovery\\nfrom an illness.\\nConvulsion, An involuntary violent con-\\ntraction of the muscular parts of the\\nbody.\\nCopulation, Sexual intercourse.\\nCorollary, Something so closely follow-\\ning as to need no demonstration.\\nCorpuscle, An animal cell.\\nCortical, Pertaining to the outer part\\nor cortex.\\nCostal, Belonging to the ribs.\\nCranial, Of the cranium.\\nCranium, The skull.\\nCretinism, A state or disease of idiocy,\\noften found in the Alps.\\nCyanosis, A bluish or dark color of the\\nskin due to imperfect circulation.\\nCyst, A bladder-like sac usually contain-\\ning poisonous matter.\\nDebris, Broken pieces or rubbish left\\nafter the destruction of anything.\\nDecidual, Likely to be shed at a certain\\nstage of growth.\\nDefecation, Voiding of excrement\\nfrom the bowels.\\nDegeneration, The act of becoming\\nworse, or the state of being worse.\\nDeglutition, The power of swallowing.\\nDejections, Voided matter excrement.\\nDelirium, Insanity; frenzy; derange-\\nment.\\nDeleterious, Poisonous destructive.\\nDentition, The process of cutting\\nteeth.\\nDepressent, A medicine that allays irri-\\ntion and pain; a sedative.\\nDerma, The true skin or corium also\\nused of the skin in general.\\nDevitalize, To deprive of vitality or\\nlife.\\nDextra, The right side.\\nDiagnosis, The determination of a dis-\\nease by its characteristic signs.\\nDiaphoretic, That which causes perspir-\\nation.\\nDiaphragm, The muscle separating the\\nchest from the abdomen.\\nDtastase, A substance found in barley,\\noats and wheat after germination.\\nDiastatic, Pertaining to the separation\\nof the main shaft of a bone from its\\nepiphyses, separation of the skull bones\\nat the sutures; pertaining to diastase.\\nDiathesis, A predisposing condition; a\\ntendency.\\nDietary, Pertaining to diet.\\nDilitation, Enlargement of an opening\\nor organ.\\nDisinfectant, Anything capable of de-\\nstroying the life of disease germs.\\nDisinfection, The destruction of the\\nlife of infection.\\nDorsal. Of or pertaining to the back.\\nDouche, A dash of water; a current\\ndirected somewhat forcibly against\\nsome part of the body for cleansing\\nor medicinal purposes.\\nDysmenorrhea, Difficult or painful\\nmenstruation.\\nDyspnoea, Difficult or labored breath-\\ning.\\nEclampsia, A convulsive disorder at-\\ntending pregnancy.\\nEczematous, Like eczema.\\nEdema. A puffed or swollen condition\\ncaused by an accumulation of serous\\nfluid in the tissues.\\nEfferent, Bearing or conducting out.\\nEffete, Worn out; barren.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0853.jp2"}, "852": {"fulltext": "826\\nGLOSSARY.\\nEffusion, The pouring out of fluid into\\na cavity of the body.\\nElectrolysis, Chemical decomposition\\nby electricity.\\nEmaciation, Being lean from the loss\\nof flesh.\\nEmbryo, The first elements of a young\\nanimal developed in the womb.\\nEmollients, Medicines which allay\\noutside irritation by softening the\\nskin.\\nEndemic, Peculiar to the people of a\\ncertain nation or locality.\\nEnema, An injection thrown into the\\nrectum as a medicine or for nourish-\\nment.\\nEnteric, Belonging to the intestines.\\nEnvironment, The surroundings.\\nEpidermis, The outer layer of the skin.\\nEpigastrium, The upper central part of\\nthe abdomen the pit of the stomach.\\nEpithelioma, An epithelial cancer.\\nEpistaxis, Bleeding from the nose.\\nEpithelium, The layer of cells lining\\nthe alimentary canal and the passages\\nconnecting with it.\\nErosion, The condition of being eaten\\nor worn away.\\nEructation, A belching of wind from\\nthe stomach.\\nErysipelatous, Like erysipelas.\\nErythematous, Pertaining to erythema,\\na disease of the skin.\\nEsophagus, The food passage leading\\ninto the stomach.\\nExcrement, Matter discharged as use-\\nless from the body of an animal.\\nExcrete, To throw out or discharge.\\nExcretions, Effete matter thrown off\\nfrom the animal system.\\nExcretory, Pertaining to that which ex-\\ncretes or is excreted.\\nExfoliation, Scaling or peeling of the\\nskin.\\nExpiration, The act of breathing out\\nor expelling air from the lungs.\\nExsanguinate, To make bloodless.\\nExtravasation, Pouring out; effusion.\\nExudation. That which is discharged\\nthrough the pores, as sweat.\\nFacetted, Covered with facets or faces.\\nFascia, The thin covering which binds\\nthe muscles of the limbs to their\\nplaces.\\nFatuity, Imbecility; foolishness.\\nFarinaceous, Made of meal or flour.\\nFebrile, Feverish, like fever.\\nFeces, The excrement of an animal; the\\ndischarges from the bowels.\\nFermentation, A decomposition pro-\\nduced either by the action of living\\norganisms or by certain inorganic\\nagents.\\nFermentative, Causing fermentation.\\nFertilization, The act of impregnating\\nor making the ovum fruitful.\\nFetal, Pertaining to the fetus.\\nFetid, Having an offensive smell.\\nFetor, Offensive smell.\\nFetus, A young animal yet in the womb.\\nFibrin, A nitrogenous substance found\\nin the blood and chyle.\\nFibroid, Fibrous; like fiber.\\nFiliform, Having the form of a thread.\\nFimbria, A fringe or fringing process.\\nFimbriated, Fringed.\\nFlatulence, An accumulation of gas in\\nthe stomach or bowels.\\nFollicle, A little sac, gland or cavity in\\nan animal body, particularly in the\\nskin.\\nFomentation, A warm poultice, or warm\\nwet cloths applied to ease pain.\\nFunction, The peculiar action or pur-\\npose of a special organ or part.\\nFungus, pl. fungi, A low order of\\nplants a morbid growth.\\nGalvanism, Electricity produced by a\\nchemical battery, the same as voltaic\\nelectricity.\\nGalvanization, The process of subject-\\ning to the action of galvanic electric-\\nity.\\nGanglion, pl. ganglia, A collection of\\nnerve cells from which nerve fibers\\nradiate.\\nGangrene, The first stage of mortifica-\\ntion of the softer structures of the\\nbody.\\nGastralgia, A neuralgia of the stomach;\\nbellyache.\\nGastric, Pertaining to the stomach.\\nGastro-intestinal, Pertaining to the\\nstomach and the intestines.\\nGeneration, The act of begetting young.\\nGenitals, The organs of generation;\\nsexual organs.\\nGermicide, Anything capable of killing\\ngerms.\\nGerminal, Pertaining to a germ.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0854.jp2"}, "853": {"fulltext": "GLOSSARY.\\n827\\nGestation, Pregnancy.\\nGigantism, Of abnormally great size.\\nGlans, Apex of the penis.\\nGlottis, The opening from the throat\\ninto the windpipe.\\nGlycogen, Animal starch.\\nGranular, Composed of granules or\\ngrains.\\nGranulation, The process of forming\\ngrains or granules.\\nHabitue, One accustomed to a particu-\\nlar place or employment.\\nHaematuria, Blood in the urine.\\nHectic Fever, A fever accompanying\\ngreat exhaustion.\\nHemoglobin, The red substance of the\\nred blood corpuscles.\\nHemorrhage, A discharge of blood from\\na blood vessel.\\nHemorrhoids, The piles; painful\\nbunches or tubercles about the anus.\\nHepatic, Pertaining to the liver.\\nHereditary, Transmitted from parent to\\nchild.\\nHeredity, The transmission of a tend-\\nency from parent to child.\\nHyaline, Transparent, resembling glass.\\nHygiene, The principles or laws of\\nhealth.\\nHygrometer, An instrument for show-\\ning the proportion of moisture in the\\nair.\\nHyperplasia, Overgrowth of a part\\nfrom increase of cells.\\nHypertrophy, Overgrowth.\\nHyperemia, An over abundance of\\nblood in any part of the body, the un-\\nnatural fullness and redness imme-\\ndiately preceding inflammation.\\nHypertrophic, Tending to hypertrophy.\\nHypochondriasis, Low spirts; a morbid\\nstate of the mind.\\nHypodermic, Introduced or found under\\nthe skin.\\nHypogastrium, The lowest part of the\\nabdomen.\\nIdiopathic, Independent of any other\\ndisease.\\nIdiosyncrasy, The constitutional pecu-\\nliarities of an individual.\\nIliac Regions, The sides of the abdomen\\nbetween the ribs and hips.\\nImbecile, Weak feeble in body and\\nmind.\\nImmune, Exempt from a disease.\\nImplicate, To bring into connection\\nwith.\\nImpregnated, Made pregnant.\\nInanition, Exhaustion from lack of\\nfood or nutrition.\\nIncontinence, Inability to retain, as loss\\nof control over the urinary bladder.\\nIncubus, A sensation of trouble during\\nsleep; nightmare.\\nIndigenous, Born in or native of.\\nIncubation, The time between the ex-\\nposure to a contagious disease and the\\nbeginning of the resulting attack.\\nInfection. Living germs which leaving\\none animal and coming in contact with\\nanother may cause the disease in the\\nsecond with which the first was af-\\nfected, without the two animals com-\\ning in contact with each other either\\ndirectly or indirectly.\\nInfectious, Pertaining to infection.\\nInfiltrate, To enter through the pores.\\nInflammation, A morbid condition usu-\\nally characterized by pain, heat, red-\\nness and swelling. In scientific lan-\\nguage, inflammation is designated by\\nadding itis to the name of the part af-\\nfected, thus meningitis or inflamma-\\ntion of the meninges, tonsilitis or in-\\nflammation of the tonsils, etc.\\nInguinal Canal, A canal situated in the\\ngroin, through which the spermatic\\ncord passes.\\nInhalation, The breathing of steam or\\nsome medicated vapor.\\nInjection, A quantity of liquid thrown\\ninto a cavity of the body for medicine\\nor nourishment.\\nInoculation, The communication of a\\ndisease to a person by inserting virus\\ninto his skin or blood.\\nInspiration, The act of inhaling or\\nbreathing in air.\\nIntention. To heal by first intention is\\nto heal without suppuration.\\nIntercostal, Between the ribs, used of\\nmuscles, nerves etc.\\nIntermittent, With an interval. Ap-\\nplied to a fever that goes and returns,\\nor to a pulse that misses a beat.\\nIntestine, The canal or tube extending\\nfrom the stomach to the anus.\\nIntervertebral, Located between the\\nvertebrae.\\nIntrapelvic, Within the pelvis.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0855.jp2"}, "854": {"fulltext": "828\\nGLOSSARY.\\nInvolve, To implicate or include.\\nInvolution, Contraction 10 natural size.\\nIrritants, Things that irritate, causing\\npain, heat or tension.\\nKoumis, A liquor obtained from fer-\\nmenting mare s or camel s milk.\\nLabor, Childbirth.\\nLabia, Lips.\\nLacerate, To wound to tear.\\nLachrymal, Pertaining to tears, or se-\\ncreting or conveying tears.\\nLactation, The time of giving suck\\nnursing.\\nLacteal, One of the vessels which take\\nup and convey milk.\\nLanugo, The coat of downy hair cover-\\ning the human fetus.\\nLaryngitis, Inflammation of the lar-\\nynx.\\nLatrine, A camp privy.\\nLaxative, That which produces loose-\\nness of the bowels gently cathartic.\\nLesion, A morbid change in the tex-\\nture of an organ; an injury of struc-\\nture caused by disease.\\nLeucocite, A white blood cell.\\nLeucorrhoea, A uterine catarrh accom-\\npanied by a whitish or yellowish dis-\\ncharge from the vagina.\\nLevator, That which lifts up or erects.\\nLibidinous, Impure licentious.\\nLigament, A strong substance binding\\none bone to another.\\nLigature, A cord for tying a blood ves-\\nsel.\\nLithemia, A condition of the blood in\\nwhich uric acid is found in excess.\\nLithiasis, The formation of stony con-\\ncretions in any part of the body.\\nLumbar, Near the loins, or back part of\\nthe waist.\\nLumbosacral, Pertaining to the sacral\\nregion of the back.\\nLymph, A colorless animal fluid found\\nin the vessels called lymphatics.\\nLymphoidal, Having the nature of\\nlymph.\\nMacerate, To soften and separate the\\nparts, as by steeping.\\nMalaise, The discomfort often experi-\\nenced before or at the beginning of a\\ndisease.\\nMalaria, The poison caused by the\\ngerm Plasmodium malaria.\\nMalignant, Virulent, tending to cause\\ndeath.\\nMalpighi, The discoverer of the glands\\nin the kidneys which secrete the urine,\\nin honor of whom they are called the\\nMalpighian glands.\\nMammary Glands, The breasts or\\nmilk-secreting organs.\\nMarasmus, A wasting of the flesh with-\\nout any apparent disease.\\nMastoid, Resembling the breast or nip-\\nple of a woman.\\nMastication, The act of chewing the\\nfood and mixing it with the saliva.\\nMeatus, A duct or passage of the body.\\nMeconium, The first feces of infants.\\nMedulla, The central axis, pith or mar-\\nrow.\\nMedullary, Pertaining to the marrow.\\nMelanotic, Pertaining to a morbid de-\\nposit in the organs of the body.\\nMenorrhagia, An excessive menstrual\\ndischarge.\\nMenses, The periodic flow of bloody\\nfluid from the mucous lining of the\\nuterus.\\nMenstruation, The discharge of the\\nmenses.\\nMesentery, A membrane which holds\\nthe intestines in position.\\nMetastasis, A sudden change of disease\\nfrom one part of the body to another.\\nMetastatic, Of or pertaining to change\\nof substance or place.\\nMetritis, Inflammation of the middle\\ncoat of the uterus.\\nMicrobe, A microscopic organism a\\nbacterium.\\nMicro-organism, A disease germ, a mi-\\ncrobe.\\nMicroscopy, The art of using the micro-\\nscope.\\nMicturition, The act of urinating, or\\nmaking water.\\nMobility, Easily movable.\\nMucus, The sticky, slimy fluid secreted\\nby the mucous membranes.\\nMucous Membrane, The thin web-like\\nlining of the canals and cavities which\\nsecretes a mucilaginous fluid by which\\nit is kept lubricated.\\nMummified, Dried or become like a\\nmummy.\\nNarcotics, Medicines which by their op-\\neration on the brain and nerves dimin-\\nish sensibility and induce sleep.\\nNares, The nostrils.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0856.jp2"}, "855": {"fulltext": "GLOSSARY.\\n829\\nNausea, Sickness of the stomach with\\na tendency to vomit.\\nNecrosis, The death of a piece of tissue.\\nThe term is applied to bones as gan-\\ngrene is to flesh.\\nNephritis, Inflammation of the kidneys.\\nNeuritis, A disease of the nerves. See\\npage 733, Ner. Dis.\\nNeurologist, One who describes the\\nnerves.\\nNeuron, A nerve cell and its attached\\nfiber.\\nNeurosis, Pl. Neuroses, A disease of\\nthe nerves without lesion of the parts,\\nas neuralgia.\\nNodule, A rounded mass.\\nNormal, Healthy, natural.\\nNoxious, Harmful unwholesome.\\nNuclei, Plural of nucleus. A kernel\\nor center about which anything is\\nformed or collected.\\nNucleolus, A little nucleus, a nucleus\\nof a nucleus.\\nNutrients, Substances which nourish.\\nNutrition, The process by which food\\nis digested and assimilated.\\nObese, Very fat or corpulent.\\nObstetrics, The science of midwifery.\\nOcclusion, The act of closing up, or the\\nstate of being closed.\\nOcclusional, That which covers or\\ncloses up an opening.\\nOcular, Pertaining to the eye.\\nOlfactory, Of the sense of smell.\\nOphthalmia, Inflammation of the eye.\\nOpthalmic, Belonging to the eye.\\nOssification, The process of changing\\ninto bone.\\nOvarian, Pertaining to the ovaries.\\nOpiate, A medicine which produces\\nsleep.\\nOvoid, Shaped like an egg.\\nOvulation, The process of discharging\\nan ovum by an ovary.\\nOvum, The egg or body formed by the\\nfemale in which after impregnation\\nthe fetus develops.\\nOxidation, The process of uniting with\\noxygen.\\nPalliative, That which alleviates pain,\\nbut does not cure.\\nPaludal, Pertaining to marshes or\\nswamps.\\nPancreas, One of the digestive organs;\\nthe sweetbread.\\nPancreatin, One of the active ferments\\nof the pancreatic juice.\\nPapilloma, A kind of tumor.\\nPapillomatous, Of the nature of a pa-\\npilloma.\\nPapular, Covered with pimples.\\nParalysis, Loss of voluntary motion;\\npalsy.\\nParasite, A plant or animal which lives\\nupon and gets its nourishment wholly\\nor in part from some other plant or\\nanimal.\\nParasitic, Like a parasite.\\nParenchyma, The spongy porous mass\\nof an organ.\\nParietes, Walls, as the abdominal pari-\\netes.\\nPathogenic, Generative of diseases.\\nParoxysm, A sudden increase of symp-\\ntoms a fit.\\nPathological, Pertaining to pathology\\nor knowledge of diseases.\\nPathognomonic, Characteristic of dis-\\nease.\\nPathology, The science of diseases.\\nPelvis, The bone framework of the\\nlower part of the body, enclosing the\\ninternal urinary and sexual organs.\\nPepsin, A ferment formed in gastric\\njuice in the colon.\\nPeptinoid, A compound formed by the\\naction of pepsin upon nitrogenous\\nfood.\\nPerennial, Perpetual.\\nPericardium, The membrane which en-\\ncloses the heart.\\nPerineal, Pertaining to the perineum.\\nPerinaeum, The space at the lower end\\nof the body between the anus and the\\ngenital organs.\\nPeriodic, Returning regularly after a\\ncertain period of time.\\nPeriosteum, The membrane surround-\\ning the bones.\\nPeripheral, Pertaining to the periphera\\nor outside.\\nPeristalsis, An involuntary, contractile,\\nsuccessive movement of the alimentary\\ncanal, whereby its contents are gradu-\\nally driven toward the point of their\\nexpulsion.\\nPeritoneum, A serous membrane lining\\nthe abdominal walls and forming the", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0857.jp2"}, "856": {"fulltext": "830\\nGLOSSARY.\\nouter coat of the stomach, intestines,\\nliver, spleen, ovaries, uterus and blad-\\nder.\\nPerspiration, Sweat.\\nPessary, An instrument for holding the\\nuterus in its natural position.\\nPeyerian Glands, The agminate glands\\nof the small intestine, so named in\\nhonor of Peyer, their discoverer.\\nPhenomenon, Pl. Phenomena, any-\\nthing remarkable.\\nPhlegmatic, See page 562.\\nPhrenic, Pertaining to the diaphragm.\\nPhthisis, Consumption of the lungs.\\nPigment, Any organic coloring matter.\\nPigmentation, Discoloration by the de-\\nposit of pigment in the cells.\\nPlacenta, The afterbirth; the soft disc\\nby which the mother is connected with\\nthe fetus and through which she sup-\\nplies it air and nourishment.\\nPlasma, The liquid part of the blood as\\ndistinguished from its corpuscles.\\nPlethora, The state of being over full\\nexcess of blood.\\nPleura, The membrane which lines the\\ncavity of the chest and encloses the\\nlungs.\\nPlexus, A network of vessels or nerves.\\nPolyp, A many footed animal.\\nPolypoid, Like a polypus, or tumor hav-\\ning a small base.\\nPopliteal, Back part of the knee joint.\\nPosterior, Situated behind.\\nPost-mortem, After death.\\nPotential, That which may be possible.\\nPrecordial, Pertaining to the parts be-\\nfore the heart.\\nPregnant, Being with young.\\nPrepuce, A prolongation of the skin\\ncovering the penis or clitoris.\\nProcreation, The begetting of young.\\nProlapsus, A falling down of some in-\\nternal part of the body.\\nProliferate, To grow by multiplication\\nof cells or elementary parts.\\nProprietary, That belonging to a pro-\\nprietor or owner.\\nProstatic, Pertaining to the prostate.\\nProstate, A gland surrounding the\\nurethra, just below the neck of the\\nbladder, in males.\\nProtean, Very changeable.\\nProteid, A food-stuff whose principal\\nservice is to renew or build up the\\nsoft tissues of the body.\\nProtoplasm, The albuminoid substance\\nconstituting the physical basis of life.\\nProtozoa, A primary division of the ani-\\nmal kingdom, consisting of a single\\ncell, or group of cells.\\nProtuberant, Extending outward;\\nprotruding.\\nPsorospermosis, A kind of parasitic dis-\\nease.\\nPsychic, Psychical; Pertaining to the\\nmind or soul.\\nPtomaine, An alkaloid, usually poison-\\nous, derived from decomposing animal\\nmatter, or produced by disease germs\\nin a living body.\\nPuberty, The age at which persons be-\\ncome capable of begetting or bearing\\nchildren.\\nPubes, The part of the lower portion\\nof the body that is covered with hair\\nat puberty.\\nPuerperal, Pertaining to childbirth.\\nPulmonary, PertLning to the lungs.\\nPulsation, Throbbing, as the beating of\\nthe pulse.\\nPurge, To cause frequent and excessive\\nevacuations of the bowels.\\nPurulent, of the nature of pus or mat-\\nter.\\nPus, Purulent matter; the thick, sticky\\nfluid formed by the process of suppu-\\nration.\\nPustular, Covered with pustules or\\nblisters.\\nPutrefaction, A process of decay\\ncaused by minute organisms.\\nPutrescible, A body that decomposes at\\na certain temperature.\\nPyrogallic, Obtained from gallic acid\\nby the action of heat.\\nPylorus, The opening in the stomach\\nthrough which food passes into the\\nintestine.\\nRectal, Pertaining to the rectum or\\nlower part of the large intestine.\\nReflex, Turned or thrown backward;\\nreactive; a result of reaction.\\nRegeneration, To form into a new or\\nbetter state.\\nRegurgitant, Pertaining to regurgita-\\ntion.\\nRegurgitation, An easy vomiting of\\nfood.\\nRenal, Pertaining to the kidneys.\\nRemittent, That which has remissions,\\nor abates from time to time, applied", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0858.jp2"}, "857": {"fulltext": "GLOSSARY\\n831\\nto a fever which does not quite dis-\\nappear, and which increases again and\\nagain.\\nResiduum, That remaining after a proc-\\ness of separation.\\nRespiratory, Pertaining to respiration\\nor breathing.\\nRetch, To try to vomit to strain.\\nRete, A vascular network.\\nReticular, Like a net.\\nRetina, The expansion of the nerve of\\nsight, within the eye. on which the\\nimages of external objects are thrown.\\nRetixitis, Inflammation of the retina.\\nRigor, A chill a sudden coldness intro-\\nductory to many diseases.\\nSacral, Pertaining to the sacrum.\\nSacrum, The triangular bone forming\\nthe back part of the pelvis and termi-\\nnating the backbone the lowest part\\nof the spine.\\nSalines, Medicinal salts, mostly laxa-\\ntive.\\nSaliva, Secretion of the salivary glands;\\nspittle.\\nSalivation, A continued and unhealthy\\nflow of saliva.\\nSalubrious, Favorable to health;\\nhealthy.\\nSaxitation, Measures to secure and\\npreserve health.\\nSanious, Thin, serous and slightly\\nbloody, as the sanious discharge of\\nan ulcer.\\nScarletixoid, Like scarlet fever.\\nSclerosis, The hardening or thickening\\nof a tissue.\\nSclerotic, Hard, firm; the white outer\\ncoat of the eye.\\nScrotum, The bag containing the testi-\\ncles.\\nSebaceous, Like fat pertaining to fat.\\nSecrete, To form or separate from the\\ncirculating fluids of the body.\\nSecretiox. That which is secreted, or\\nproduced from the circulating fluids.\\nSecretory, Pertaining to that which se-\\ncretes.\\nSedatives, Medicines which diminish\\nthe power and velocity of the circula-\\ntion of the blood by their action on the\\nheart and large arteries.\\nSedextary, Accustomed to sitting.\\nSenility, Old age.\\nSensory, Connected with sensation.\\nSepsis, Decomposition, rot. Contamina-\\ntion of an animal organism from ill-\\nconditioned wounds, abscesses, or\\nother breeding places of bacterial\\ngerms.\\nSeptic, Pertaining to any substance that\\nproduces putrefaction.\\nSepticemia, or Septemia, A morbid\\ncondition of the blood due to the ab-\\nsorption of poison from putrefaction.\\nSequellae, Disorders resulting from a\\ndisease.\\nSerous, Watery.\\nSerous Membraxes, The membranes\\nlining the closed cavities and secreting\\na watery, lubricating fluid.\\nSerum, The clear yellowish liquid that\\nseparates from the clot when blood\\ncoagulates.\\nSigmoid Flexure, An S-shaped curve\\nin the large intestine.\\nSinistra, The left hand.\\nSitz-bath, A hip-bath.\\nSpecific, That which exerts special ac-\\ntion in the prevention or cure of dis-\\nease.\\nSpecific Disease, A communicable dis-\\nease a disease caused by living germs.\\nSpermatozoa, The male fertilizing ele-\\nment of an animal.\\nSpinal, Pertaining to the backbone.\\nSplenic, Pertaining to the spleen.\\nSphincter, A muscle which by contract-\\ning lessens or closes the opening of an\\norgan.\\nSputa, The salival discharges from the\\nmouth, including mucus from the\\nnose, throat and lungs.\\nStatic, Acting by weight only, without\\nmotion.\\nSterile, Barren, unfruitful.\\nStertor, Snoring hence stertorous\\nbreathing.\\nStimulant, An agent which increases\\nthe vital activity of an organ. When\\nthis effect is produced in all the organs\\nor functions the agent is called a gen-\\neral stimulant when limited to one or\\ntwo organs, a local stimulant when\\nit affects only the part to which it is\\napplied it is an irritant.\\nStrangury, Scanty or painful urination.\\nStriate, To mark with lines or grooves.\\nStricture, A contraction in some pas-\\nsage of the body.\\nStroma, The tissues forming the foun-\\ndation or framework upon which the\\nessential structures of an organ rest.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0859.jp2"}, "858": {"fulltext": "832\\nGLOSSARY.\\nStyptic, Astringent; tending to check\\nbleeding.\\nSubcutaneous, Under the skin hypo-\\ndermic.\\nSubinvolution, A hindered or incom-\\nplete return to normal dimensions, as\\nof the uterus after childbirth.\\nSuppository, A solid introduced into the\\nrectum or vagina to be dissolved there\\nfor purposes of medication.\\nSuppuration, The process of forming\\npus.\\nSuture, A stitch or fastening to unite\\nthe lips of a wound.\\nSymphysis Pubes, The union of the\\ntwo front pelvic bones.\\nSyncope, Fainting.\\nSyphilitic, Like syphilis; infected with\\nsyphilis.\\nSystemic, Pertaining to the system or\\nparts of the body.\\nTampon, A plug introduced into a nat-\\nural cavity of the body 10 prevent dis-\\ncharges.\\nTenesmus, A continued desire to empty\\nthe bowels or bladder, when there is\\nlittle or nothing to be discharged.\\nTension,, Stretch or strain.\\nTentacle, An organ of feeling or mo-\\ntion of an invertebrate animal.\\nTherapeutics, That branch of medicine\\nwhich relates to the treatment of dis-\\neases.\\nThoracic, Pertaining to the thorax or\\nchest.\\nThyroid Cartilage, A part of the\\ndarynx; Adam s apple.\\nThyroid Gland, A substance or gland\\non the upper part of the windpipe.\\nTonic, That which gives tone or\\nstrength to the system.\\nToxaemia, Poisoning of the blood.\\nToxic, Poisonous.\\nToxine, Poison especially poison pro-\\nduced by the action of germs.\\nTrachea, The windpipe.\\nTransfusion of Blood, The injection of\\nblood from the veins of one into those\\nof another.\\nTrait matic, Caused by wounds or in-\\njuries.\\nTrophic, Of or pertaining to nutrition.\\nTubercle, A small granular tumor or\\nnodule resulting from the presence of\\nthe bacillus tuberculosis.\\nTuberculosis, A diseased condition of\\nthe system due to the presence of\\ntubercles.\\nUmbilical Cord, The cord-like struc-\\nture which conveys blood from the\\nplacenta to the fetus the navel cord.\\nUmbilical Region, The central part of\\nthe abdomen, round the umbilicus.\\nAbove it is the epigastric region, and\\nbelow it the hypogastric.\\nUmbilicus, The navel.\\nUraemia, An accumulation in the blood\\nof poisons of the urine.\\nUrea, One of the constituents of urine,\\nseparated from the blood by the kid-\\nneys.\\nUreter, The tube or duct which conveys\\nthe urine from the kidneys to the\\nbladder.\\nUrethra, The canal by which the urine\\nis discharged from the bladder.\\nUrticarial, Stinging, as with nettles.\\nUterine, Pertaining to the uterus.\\nUterus, The womb.\\nVagina, The canal leading from the\\nvulva to the womb.\\nVaginal, Pertaining to the vagina.\\nVaginitis, Inflammation of the lining\\nmembrane of the vagina.\\nVaricose, Enlarged, as varicose veins.\\nVascular, Pertaining to the vessels of\\nthe body, as of veins, arteries, etc., or\\nconsisting of such vessels.\\nVaso-motor, See page 706.\\nVenereal, Pertaining to sexual inter-\\ncourse.\\nVenomous, Poisonous.\\nVernix Caseosa, A greasy protecting\\ncoat covering the skin of the fetus in\\nthe later months of pregnancy.\\nVertebrae, The twenty- four bones\\nwhich constitute the spinal column.\\nVertebral, Pertaining to the vertebrae\\nor backbone.\\nVertigo, Giddiness, dizziness.\\nVesicle, A cyst, sac, or cell.\\nVesicular, Of or pertaining to vesicles,\\nor small sacs or cysts.\\nVirus, Poisonous matter, the infection\\nor contagion of disease.\\nVirulent, Extremely poisonous.\\nViscera, Two or more of the internal\\norgans, more particularly the intes-\\ntines.\\nVivified, Quickened with life.\\nVulva, The external generative organs\\nof the female.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0860.jp2"}, "859": {"fulltext": "INDEX\\nAbdominal Breathing, 38.\\nDistention with gas, 268.\\nProtrusion, 39.\\nAbortion, 525.\\nTendency to, caused by tobacco, 58.\\nAccidents, see emergencies, 175.\\nBite of mad dog, 204.\\nBites and stings of insects, 202.\\nOf serpents, 202.\\nBruises, 228.\\nBurns and scalds, 199.\\nChoking, 193.\\nCuts, 220.\\nDislocations, 228.\\nDrowning, 194.\\nFainting, 793.\\nForeign bodies in the ear, 417.\\nIn the eye, 409.\\nFractured bones, 225.\\nFrost bites, 197.\\nHemorrhage from wounds, 220.\\nHernia, 230.\\nLacerations, 220.\\nLightning or electric shock, 201\\nObjects swallowed, 193.\\nPoisoning, 175.\\nRupture, 230.\\nSprains, 226.\\nSunstroke or heat stroke, 198.\\nSuffocation from smoke or gas, 197.\\nAcetanilide, 131.\\nAcid, boric, 133.\\nCarbolic as an antiseptic, 132.\\nAs a disinfectant, 113.\\nPoisoning, 190.\\nHydrochloric (muriatic) poisoning,\\n177.\\nHydrocyanic, poisoning, 177.\\nMineral, poisons, 176.\\nNitric, poisoning, 177.\\nPrussic, poisoning, 177.\\nSulphuric, poisoning, 177.\\nAcne, 637.\\nAction of the bowels, 241.\\nAconite, 132.\\nPoisoning, 184.\\nActive period of life, 572\\nAdenoid growths, 388.\\nAdministration of food to infants, 448.\\nTo the sick, 172.\\nOf medicines, 148.\\nAge at which the teeth appear, 349,\\n351.\\nWhich man should attain, 23.\\nAir, 52.\\nA medium of infection, 49.\\nAmount of breathed by an adult, 60.\\nBorne diseases, 49.\\nThe care of, 161.\\nCells, 359.\\nCurrents as atmospheric purifiers, 56.\\nAs factors of disease, 56.\\nDamp, injurious to health, 54.\\nGround and contaminated, to be\\navoided, 60.\\nHow to get the full benefit of pure,\\n40.\\nComposition of, 52.\\nResidual, 359.\\nSpace, amount of, needed in rooms,\\n61.\\nStandard of purity of, 52.\\nTidal, 359.\\nWhy damp, is lighter than dry, 54.\\nAlbuminoids, 236.\\nAlbuminous foods, 80.\\nAlbumin-water, 171.\\nAlcohol, 96.\\nEffects of, upon the brain, 102.\\nUpon the heart and kidneys.\\n101.\\nIjpon the liver, 100.\\nUpon the stomach, 98.\\nAlcoholic insanity, 817.\\nAlcoholic remedies, 129.\\nDangers in the use of, 84.\\nStrength of liquors, 129.\\nAle as a beverage, 83.\\nAlimentary canal, 235.\\nAlkalies, poisoning by, 178.\\nAlopecia, 683.\\nAreata, 685.\\nSenile, 684.\\nAltitude, influence of, upon health, 53.\\nMay aggravate heart disease, 54.\\nMay prevent or cure lung disease, 54.\\nAltona, Water supply of, 70.\\n53\\n833", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0861.jp2"}, "860": {"fulltext": "834\\nINDEX.\\nAlum, 143.\\nAs an emetic, 136.\\nAmaurosis from smoking, 106.\\nAmmonia, poisoning, 179.\\nAmniotic fluid, 506.\\nAmyl nitrite, 143.\\nAnatomy of the skin, 629.\\nAncestral errors increased in the off-\\nspring, 22.\\nAnemia, 355.\\nAneurism, 353.\\nAngina pectoris, 352.\\nAnimalisms, too often lived in by man,\\n22.\\nAnkle-drop, 763.\\nAnteflexion, 607.\\nAnteversion, 607.\\nAnthelmintics, 142.\\nAnthrax, 673.\\nAntidotes, classes of, 176.\\nAntipyretics, 129.\\nAntipyrin, 131.\\nAntiseptics, 132.\\nAntitoxine, how prepared, 282.\\nTreatment of diphtheria, 281.\\nOf disease, 211.\\nAorta, the, 343.\\nAperients, 139.\\nAphasia, 44.\\nApomorphine, 127.\\nApoplexy, see Intracranial Hemorrhage,\\n751-\\nApothecary s weights, 148.\\nAppendicitis, 253.\\nAptha, 558.\\nApthous, stomatitis, 453.\\nArnica, 142.\\nArachnoid, the, 717.\\nArrectores pilorum, 633.\\nArsenic, 127.\\nForms of, 179.\\nPoisoning, 179.\\nArterio sclerosis, 354.\\nArtesian water, 67.\\nArthritis rheumatoid, 324.\\nArtificial foods, 442, 542.\\nRespiration, 196.\\nAsafetida, 143.\\nAscaris lumbricoides, 422.\\nAsepsis, 401.\\nAsphyxia, from carbon monoxide, 57.\\nFrom drowning, 194.\\nAsthma, 360.\\nAstigmatism, 412.\\nAsylum, purposes of the, 819.\\nAtaxia locomotor, 747.\\nAthlete, the, 45.\\nDangers to from ceasing to exer-\\ncise, 46.\\nHeart or lung failure, 46.\\nThe college, 46.\\nAthletes who die from heart trouble, 36.\\nAtropine poisoning, 184.\\nAuto-infection, 23, 486.\\nAuto-suggestion, a cause of disease, 778.\\nAuricles, the, 342.\\nB.\\nBaby, size and weight of the, 432.\\nBacilli, Bacillus, 212.\\nBacillus tuberculosis, 370.\\nBacteria, a cause of disease, 49, 210.\\nAgency of in sand filtration. 69.\\nAnd equivalent terms, 212.\\nAs aids in diagnosis, 214.\\nDestroyed by disinfection, no.\\nHow they grow and multiply, 213.\\nProduce disease, 214.\\nIn putrefaction, 215.\\nIn teeth, 91.\\nIn water, 67.\\nIn wounds, 215.\\nSize of, 212.\\nThe discovery of, 209.\\nThe temperature which destroys,\\n213.\\nUniversal prevalence of, 214.\\nUseful varieties of, 214.\\nBag of water, the, 506.\\nBalance between the activities, 23.\\nBalanced rations, 88.\\nBaldness, 635, 683.\\nBallotment, 510.\\nBalsam of copiaba as a diuretic, 138.\\nBarber s itch, 664.\\nBarley water, 169.\\nBathing in a lake or stream, 24.\\nInfants, 438.\\nBath, the free public, 77.\\nThe rain, 77.\\nThe Roman, 76.\\nThings to be remembered about the,\\n78.\\nThe Turkish, 580.\\nBed bugs, 658.\\nBedding, how to disinfect, 120.\\nBed sores, 158.\\nBeef, composition of, 81.\\nJuice, 169.\\nFor infants, 447.\\nTea, 169.\\nBeer as a beverage, 83.\\nBelladonna, 144.\\nThe, group, 184.\\nPoisoning by, 184.\\nBeverages, 82.\\nBicycle, advantages and disadvantages\\nof the, 40.\\nHow to adjust the saddle of the, 44.\\nImproper saddles and positions on\\nthe, 41.\\nInsidious injuries wrought by the, 42.\\nBichloride of mercury as an antiseptic,\\n134-\\nAs a disinfectant, 113.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0862.jp2"}, "861": {"fulltext": "INDEX.\\n835\\nBiliary concretions, 311.\\nBills of fare for the healthy, 88.\\nFor the convalescent, 172.\\nBismuth, subnitrate, 133.\\nBites and stings of insects, 202.\\nOf serpents, 202.\\nBitters, 127.\\nBlack heads, 634.\\nMeasles, 479.\\nBladder, abnormal conditions of the,\\n619.\\nFunctional diseases of the, 617.\\nOrganic diseases of the, 621.\\nParalysis of the, 619.\\nWorm, the, 428.\\nBlebs, 631.\\nBleeding, how to stop, 220.\\nBlood, circulation of the, 342.\\nComposition of the, 344.\\nDiseases of the, 353.\\nVessels, diseases of the, 353.\\nBlush, 654.\\nBlue rocket, poisoning by, 184.\\nBody lice, 655.\\nBoiling to purify water, 72.\\nBoils, 670.\\nBones, broken, 224.\\nBoots and shoes, how to disinfect, 121.\\nBorax, boric acid, 133.\\nBowels, movements of, in infancy, 458.\\nBrachial plexus, the, 712.\\nBrain, anemia of the, 725.\\nCenters, 714.\\nCongestion of the, 725.\\nConvolutions of the, 709.\\nCortex of the, 709.\\nDiseases caused by alcohol, 102.\\nDevelopmental influences in, 726.\\nExciting causes of, 726.\\nPredisposing causes of, 725.\\nDropsy of the, 755.\\nFunctional diseases of the, 725.\\nHemorrhage of the, 724.\\nImproved by moral exercise, 35.\\nInfluence of tobacco upon the, 106.\\nSubdivisions of the, 707.\\nSurface of the, 709.\\nTumors of the, 724, 754.\\nBrandy as a beverage, 84.\\nBread, graham, for diabetics, 330.\\nWheat, value of, as food, 85.\\nBreast, abscess of the, 550/\\nBreathe, how we should, 37.\\nBreathing abdominally, 37.\\nExercises, 374.\\nThe function of, 358.\\nThoracically. 37.\\nThrough the mouth, effects of, 385.\\nTo develop the lungs, 37.\\nBright s disease, 334.\\nBromide of potassium, 143.\\nBromidrosis, 679.\\nBronchi, the, 358.\\nBronchial asthma, 362.\\nBronchioles, the, 358.\\nBronchitis, 360.\\nChronic, 361.\\nBroncho-pneumonia, 368.\\nWith measles, 478.\\nBrownsville, malaria at, 271.\\nBruises, 227.\\nOf the new born, 554.\\nBubo, syphilitic, 689.\\nBuchu, 138.\\nBuilding sites, two contrasted, 26.\\nBulb, the, 750.\\nBulbar paralysis, 750.\\nBullae, 631.\\nBurns and scalds, 199.\\nCaffeine, 128.\\nCalcareous degeneration, 723.\\nCalculus, salivary, 94.\\nCaloric, the unit of heat, 87.\\nCamp, care of the, 24.\\nFood and water supply of the, 24.\\nHygiene of the, 23.\\nSurgeon to have charge of the mili-\\ntary, 25.\\nCamphor, 144.\\nCanaliculi, the, 405.\\nCancer, 240.\\nCanker sore mouth, 453.\\nCapillaries, the, 343, 359.\\nCarbo-hydrates, 80.\\nCarbolic acid as an antiseptic, 132.\\nAs a disinfectant, 113.\\nPoisoning, 190.\\nCarbon dioxide, 53.\\nA product of explosions, 57.\\nPlow detected, 60.\\nPrecautions against, in wells, 57.\\nQuantity of, exhaled by an adult,\\n60.\\nCarbon monoxide, 57.\\nCarbuncles, 672.\\nCarburetted hydrogen, 57.\\nCare of the sick, 157.\\nSick-room, 161.\\nCarpets, dangers from, 29.\\nHow to disinfect. 121.\\nCastor oil, 139.\\nCatalepsy, 774.\\nCatarrhal inflammation of the intestines,\\n464.\\nCroup, 486.\\nStomatitis, 451.\\nCatarrh, common, 386.\\nDry,386.\\nIn adults, 384.\\nIn the new born, 558.\\nMucous, caused by alcohol, 99.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0863.jp2"}, "862": {"fulltext": "836\\nINDEX.\\nCathartics, 138.\\nWhat to take, 140.\\nCaustic potash poisoning, 178.\\nSoda poisoning, 178.\\nCaution in the use of germicides, 658.\\nCecum, the, 240.\\nCell, all life begins in a, 21.\\nCellar, ventilation and cleanliness of the,\\n28.\\nCells, destroyed, must be removed, 23.\\nOf the brain, how made better, 30.\\nCenters of nervous action, 713.\\nCereal foods, partly digested by heat,\\n447-\\nCerebellum, the, 707.\\nCerebro-spinal axis, 705.\\nFluid, 755.\\nMeningitis, 756.\\nCerebrum, the, 707.\\nDiseases of the, 754.\\nCerium oxalate, 144,\\nCephalhematoma, 554.\\nCervicitis, 599.\\nCervico-occipital nerves, 730.\\nCervix, the, 497.\\nCess pools, how to disinfect, 121.\\nChafing, 653.\\nChalazii, 401.\\nChancre, 688.\\nChange of life, 624.\\nChanges in the organism caused by\\npregnancy, 506.\\nChanging the clothing of the sick, 157.\\nSheets, 157.\\nCharcoal not fit for filters, 68.\\nCharcoal as an antiseptic, 135\\nChemical disinfectants, 112.\\nChicken-pox, 480.\\nChilblains, 666.\\nCnildbirth, convalescence from, 544.\\nEffects of, 545.\\nChild-bed fever, 546.\\nChild, care of the new born, 538.\\nClothing of the new born, 542.\\nChildren, diseases of, 431.\\nInjured by poor ventilation, 61.\\nParents should play with their, 36.\\nShape and proportion of at birth,\\n433-\\nTissue building in, 35.\\nChloasma, 677.\\nChloral hydrate, 141.\\nPoisoning, 190.\\nChloride of lime as a disinfectant, 114,\\n134-\\nChlorine, 114.\\nChloroform, 145.\\nChlorosis, 571, 356.\\nCholera epidemic at Hamburg, 71.\\nInfantum, 469.\\nMorbus, 247.\\nChologogues, 140.\\nChorea, 767.\\nChyme, 2.36.\\nCicatrix, 631.\\nCigarette smoking, 105.\\nCigar makers, average life of, 58.\\nCimex lectularius, 658.\\nCirculation, the collateral, 718.\\nCirrhosis, atrophic, 100.\\nCisterns, how to construct, 74.\\nClap, 696.\\nClavus, 667.\\nCleanliness, surgical, 219.\\nClimate, influence of, upon diseases, 56.\\nThe, required by consumptives, 54,\\n373-\\nClitoris, the, 496.\\nClothing, how to disinfect, 119.\\nOf girls and women, 563.\\nOf nurses and physicians, how to\\ndisinfect, 122.\\nCocaine, 144.\\nPoisoning, 188.\\nCocainized vaseline, 404.\\nCocci, 212.\\nCochlea, the, 413.\\nCocoa and chocolate as beverages, 83.\\nCod liver oil, 126.\\nCoffee, as a beverage, 83.\\nCold on the lungs, 360.\\nSores, 643.\\nColds, causes of, 381.\\nPrevention of, 382.\\nColic, 249.\\nHepatic, 311.\\nIn infants, 461, 558.\\nCollege athletics, 46.\\nCollodion, 144.\\nColon, the, 240.\\nComa, 793.\\nComedo, 634.\\nCondensed milk, unfit for infants, 446.\\nConditions, transmission of debased, 21.\\nConfinement, importance of cleanliness\\nduring, 546.\\nCongestion of the bladder, 621.\\nOf the liver, 308.\\nOf the brain, 725.\\nConium poisoning, 186.\\nConjunctivitis, 401.\\nConstipation, 240.\\nIn infancy, 462.\\nIn the new born, 559.\\nConstitutional syphilis, 689.\\nConsumption, 370.\\nCreosote as a remedy for, 376.\\nOf the spinal nerves, 747.\\nQuick, 378.\\nTo prevent the spread of, 50.\\nConsumptives, the best climate for, 373.\\nConsumptive parents, 22.\\nContagious diseases, 49.\\nCare of, 164.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0864.jp2"}, "863": {"fulltext": "INDEX.\\n837\\nContamination of water, dangers from\\nthe, 66.\\nContracted kidney, 101.\\nLiver, ioo.\\nContrasts in masculine and feminine\\ndevelopment, 573.\\nControl of the breath, 393.\\nConvalescence, the diet during, 172.\\nConvolutions of the brain, 709.\\nCooking for the sick, 167.\\nCopper poisoning, 188.\\nCorns, 667.\\nCorpses, preparation of, for burial, 165.\\nHow to disinfect, 119.\\nCorpulency, 331.\\nCorpus callosum, 707.\\nCorpuscles, the red and white, 344.\\nCorrosive sublimate as a disinfectant,\\n3-\\nCorsets, causes of uterine displacement,\\n38.\\nSources of weakness, 39.\\nCortex of the brain, 709.\\nOf the ovary, 501.\\nCost of various bills of fare, 88.\\nVersus health in the home, 26.\\nCostume of the nurse, 155.\\nCotton mill operatives, 59.\\nCoughing, 360.\\nCow-pox, 290.\\nCows milk, how modified for infants,\\n443-\\nCrabs, 406, 656.\\nCranial nerves, 705, 711.\\nCraniotabes, 491.\\nCreolin as a disinfectant, 113.\\nCreosote, 132.\\nAs a remedy for consumption, 376.\\nCresol, as a disinfectant, 113.\\nCroup, membraneous, 278.\\nSpasmodic or false, 486.\\nCrusts, 631.\\nCubebs, 138.\\nCutting teeth, 449.\\nCystitis, 621.\\nDandelion, 145.\\nDandruff, 635.\\nDeafness, can it be cured? 414.\\nDeaths, premature, 23.\\nDecoction, 125.\\nDecussation of nerves, 708.\\nDefecation, 439.\\nDefective sweat, 678.\\nDeformed teeth, how caused, 92.\\nDefeneration of nerves, 723.\\nDelirium tremens, 102.\\nDelusions, 801.\\nDementia. 811.\\nDensity of the air a factor of health, 53.\\nDental arch, preservation of the, 92.\\nDentition, 449.\\nDeodorizers, not disinfectants, 113.\\nDermatitis, 651.\\nMedicamentosis, 652.\\nDesquamation, 631.\\nDevelopment, defective from lack of ex-\\nercise, 30.\\nFaulty because of corsets, 38.\\nNeglected by man, 22.\\nOf both right and left sides, 44.\\nOf heart and lungs. 36.\\nOf man in line with his activities, 47.\\nOf muscle does not develop mind, 46.\\nOf muscle a secondary matter, 36.\\nOf the nerves, 44.\\nThe value of will power in, 45.\\nDiabetes, 328.\\nDiaphragm, the, 358.\\nDiarrhea, 442.\\nAcute, 443.\\nChronic, 245.\\nIn the new born, 558.\\nOf infants, 463.\\nDiastole, 344.\\nDiet, 80.\\nFluid, 588.\\nFor the aged, 591.\\nFor the school girl, 562.\\nFor the spare, 590.\\nIn disease, 168, 587.\\nOf the stomach and bowels, 170.\\nIn health, 84.\\nIn infancy and childhood, 561.\\nIn obesity, 333, 590.\\nIn wasting diseases, 170.\\nMeaning of the term, 239.\\nVegetable, 590.\\nDigestion, 235.\\nHow to aid, 90.\\nIn the new born, 553.\\nDigestibility of various foods, 89.\\nDigestive troubles, how to locate, 237.\\nDigitalis, as a diuretic, 137.\\nAs a heart stimulant, 128.\\nPoisoning, 190.\\nDiplococci, 212.\\nDiphtheria, 278.\\nDiscoloration from bruises, 228.\\nDiscolorations of the new born, 555.\\nDisease, a logical result of what, 23.\\nDiseases, air-borne and contagious, 49.\\nCauses of, 49.\\nNot hereditary, 22.\\nPeculiar to certain temperatures, 55.\\nPrecautions against the spread of,\\nWater-borne, 49.\\nDisinfectants, patent, 123.\\nQuantity of, required, 118.\\nVarious kinds of. 112.\\nWhat to use and how, 117.\\nWhere to apply, in.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0865.jp2"}, "864": {"fulltext": "838\\nINDEX.\\nDisinfecting solutions, 115.\\nDisinfection and disinfectants, no.\\nHigh temperature an aid in, 117.\\nPrinciples of, in.\\nTime an element in, 117.\\nDislocations, 228.\\nOf the back and neck, 749.\\nDisplacement of organs invites disease,\\n39-\\nOf the uterus, 606.\\nDistillation of water, 72.\\nDiuretics, 137.\\nDogs, danger from, fed upon slaughter\\nhouse refuse, 427.\\nMay spread disease, 51.\\nDose list, 150.\\nDoses for children, 149.\\nDrainage, house, 26.\\nDrastic purgatives, 139.\\nDraw sheets, 158.\\nDrinking at meals, 238.\\nDropsy, 339.\\nDropper, a, 404.\\nDrowning, 194.\\nDrug eruptions, 652.\\nDrunkenness, 103.\\nDry baths, 179.\\nWater closets, 63.\\nDust, a medium of infection, 50.\\nDanger from exposing food to, 56.\\nHow it may be kept out of rooms\\n61.\\nIn factories, 58.\\nOf country and city contrasted, 56.\\nDyeing the hair, 682.\\nDura mater, the, 717.\\nDysentery, 246.\\nDyspepsia, chronic, 238.\\nIn infants, 455.\\nEar, the, 413.\\nAbscess of the, 414.\\nBoils, 415.\\nThings not to be done to the, 417.\\nEarache, 414.\\nEchinococcus, 419.\\nEczema, 648.\\nOf the scalp, 635.\\nEgg-nog, 170.\\nEggs, how to cook for the sick, 167.\\nEgg-water, 170.\\nElectricity in treating disease, 581.\\nElectric shocks, 201.\\nEmbolism, 751.\\nEmergencies, 175.\\nEmergency or first aid packets, 217.\\nEmetics, 136.\\nEmpyema, 381.\\nEmulsion, 125, 237.\\nEndocarditis, 347.\\nEndometritis, 599.\\nEnd organs, 705.\\nEnema, 299.\\nEnlarged kidney, 101.\\nLiver, 100.\\nEntero-colitis, 464.\\nEpidermis, the, 631.\\nEpiglottis, the, 394.\\nEpilepsy, 764.\\nFrom intemperate parents, 103.\\nEruption, 631.\\nErysipelas, 674.\\nErythema, 631.\\nIntertrigo, 653.\\nMultiforma, 654.\\nSimplex, 653.\\nEther, sulphuric, 145.\\nEvacuations of the bowels, 458.\\nExcessive sweat, 678.\\nExcoriations, 631.\\nExcreta, disposition of, 164.\\nHow to disinfect, 121.\\nExercise, 30.\\nActive, 31,\\nDangers from improper, 32.\\nFor discharge of blood between men-\\nstrual periods, 585.\\nFor failure of menstruation, 583.\\nImproper just before or just after\\nmeals, 36.\\nIn infancy, 35, 439.\\nIn pelvic diseases, 581.\\nModel modes of, 34, 40.\\nOf both sides of the brain, 45.\\nOutdoor, for women and girls, 38.\\nPassive, 32.\\nPhysiological object of all, 35.\\nRegular hours for, 24.\\nRest an important part of, 34.\\nShould call into action the whole\\nbody, 33.\\nExpiration, 359.\\nExtract, 125.\\nExtraction of first teeth, 93.\\nExtra-uterine pregnancy, 529.\\nExudate, 722.\\nEye, the, 400.\\nContagious diseases of the, 402.\\nDiet in diseases of the, 409.\\nShades, 408.\\nSlight ailments of the, 407.\\nThings not to be done to the, 409.\\nTo remove foreign bodies from the,\\n409.\\nTrouble, how to find the cause of,\\n403-\\nF.\\nFacial paralysis, 737.\\nFainting, 793.\\nFaith healing, 778.\\nFalling of the womb, 607.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0866.jp2"}, "865": {"fulltext": "INDEX.\\n839\\nFallopian tubes, the, 500.\\nInflammation of the, 605.\\nFalse economy in the use of fuel, 63.\\nFalx, the, 707.\\nFatigue, a warning, 34.\\nFatness, 331.\\nFat of the beer drinker, 83.\\nFatty degeneration. 723.\\nHeart of alcoholism, 101.\\nFauces, the, 389.\\nFeces, appearance of, in health and dis-\\nease. 458.\\nImpaction of the, 252.\\nFeeble-mindedness, 798.\\nFelon, 669.\\nFemale generative organs, 498.\\nFeminine brain and nervous system, 573.\\nFerment, 236.\\nFermentation caused by bacteria, no.\\nFertilization of the ovum, 502.\\nFetus, diseases of the, 531.\\nManagement of the, 533.\\nFever blisters, 643.\\nBrain, 758.\\nChild-bed, 546.\\nDiet in, 168.\\nLung, 364.\\nMalarial. 270.\\nNervous, 274.\\nRheumatic. 316.\\nSpinal. 758.\\nSpotted, 758.\\nTyphoid, 258.\\nAt Hamburg, 71.\\nHow disseminated, 50.\\nYellow, 292.\\nFibroid degeneration, 723.\\nFilter galleries, 71.\\nFilters, domestic, 72.\\nFor rain water cisterns, 73.\\nKinds of, that are unreliable, 69.\\nSand. 67.\\nFilth, a factor in disease. 54.\\nFiltration. 67.\\nA bacteriological process, 68.\\nBy percolation. 71.\\nFirst aid to the injured, 217.\\nFissure. 631.\\nFits, 764.\\nFlashes. 401.\\nFlesh worms, 634.\\nFlies spread disease, 51, 164, 259.\\nFloors, hardwood and painted, 29.\\nFlues and registers, 62.\\nFluid measure, 148.\\nFly paper poisoning, 179.\\nFollicle. 681.\\nFood, fried, not fit for the sick, 167.\\nMaterials, the composition of, 85.\\nQuantity of, an adult should have,\\n85.\\nAn infant should have, 435.\\nFoods, administration of, 172.\\nTo infants, 448.\\nArtificial, for infants, 442.\\nAs a medium of infection, 49.\\nClasses of, 80, 82.\\nDigestibility of, 89.\\nInorganic, 82.\\nKinds of, to be avoided in fevers, 81.\\nThe heat producing. 87.\\nThe force producing, 80.\\nForced feeding, 589.\\nFormaldehyde, 115.\\nFormalin, 115.\\nFoundation, the most important part,\\n28.\\nFowler s solution, 127, 179.\\nFoxglove poisoning, 190.\\nFractured bones, 224.\\nFreckles, 676.\\nFrost bites, 197.\\nFruit, preparation of. for food, 429.\\nFunctions of the body begin and end in\\nwhat, 21.\\nFunerals, when to be private, 166.\\nFurniture, how to disinfect, 120.\\nOf the sick-room, 160.\\nFurs, how to disinfect, 121,\\nFuruncles, 670.\\nG.\\nGall stones, 311.\\nGanglii, 710.\\nGanglion. 705.\\nGangrenous stomatitis, 453.\\nGas in the bowels, 268, 455.\\nGastralgia. 455.\\nGastric catarrh, 238.\\nFever in infants, 455.\\nJuice, 236.\\nGeneration, the organs of, 495.\\nGenital organs, diseases of the external,\\n611,\\nGerm causation of disease, 49, 210.\\nDecay in teeth. 91.\\nSuppuration, 218.\\nGerm life destroyed by heat, 57.\\nInfluence of temperature upon, 51.\\nGerman measles, 479.\\nGermicides, all poisons, 112.\\nGerms and interchangeable terms, 212.\\nBreeding places of, 51.\\nNumber of, that render water unfit\\nfor use, 70.\\nOf diphtheria, kinds and growth of,\\n279.\\nGid worm, the, 428.\\nGin drinker s liver, 100.\\nGirls, diet for, 562.\\nTo be informed of the higher social\\nrelations when, 565.\\nMenstruation when, 565.\\nGlasses, ground and smoked, 408.\\nTesting the eyes for, 411.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0867.jp2"}, "866": {"fulltext": "840\\nINDEX.\\nGlaucoma, 401.\\nGlioma, 754.\\nGlycerine, 145.\\nGoggles, 408.\\nGonorrhea, 696.\\nIn the new born, 557.\\nGout, 326.\\nGrade of grounds about the home, 28.\\nGraffian follicles, the, 501.\\nGrand mal, 764.\\nGranulated eyelids, 402.\\nGravel, 336.\\nGray matter of the brain, 704, 709.\\nGreen sickness, 356.\\nGrip, the, 275.\\nGrutum, 634.\\nGuiacol, 132.\\nGumma, gummatous ulcer, 692.\\nGymnasium, advantages of the, 34.\\nH.\\nHabit, the influence of, in nervous dis-\\neases, J2J.\\nThe force of, 30.\\nHair, the, 681.\\nThe color of the, 682.\\nThe curl in, 682.\\nHallucinations, 801.\\nHamburg, cholera epidemic at, 71.\\nWater supply of, 70.\\nHands, care of the, 156.\\nHeadache, 785.\\nHead lice, 655.\\nHealth lies in activity, 23.\\nHealthy homes the cheapest, 25.\\nHeart, anatomy^ and physiology of the,\\n342.\\nCongenital defects of the, 345.\\nDegenerations of the, 351.\\n/Dilatation of the, 350.\\nDiseases of the, 342.\\nDiseases caused by alcohol, 101.\\nHypertrophy or enlargement of the,\\n350.\\nPalpitation of the, 351.\\nRupture of the, 351.\\nStimulants, 128.\\nValvular diseases of the, 348.\\nHeat as a disinfectant, 112.\\nAnd energy, amount of, required per\\nday, 87.\\nDiseases, 55.\\nStroke, 198.\\nHemiplegia, 754.\\nHemorrhage, cerebral, 752.\\nDuring pregnancy, 519.\\nFrom the bladder, 621.\\nNose, 316.\\nHow to stop, 220.\\nIn menstruation, 592.\\nIntracranial, 751.\\nOf the bowels, 264.\\nHenbane poisoning, 185.\\nHenle and Koch laws, 210.\\nHeredity, 22.\\nIn nervous affections, 725.\\nHernia, 229.\\nHerpes simplex, 643.\\nProgenitalis, 643.\\nZoster, 644.\\nHiccough, 360.\\nHives, 642.\\nHoarseness, 396.\\nHog manure, dangers from, 429.\\nHogs fed upon offal, 428.\\nHolding infants, 439.\\nHome, how made healthy, 122.\\nLocation and construction of the, 26.\\nMust be an educator, 27.\\nMust never be built upon made\\nsoil, 26.\\nSelection of the, in the city, 27.\\nHomes, healthy, 25.\\nHospital work in the Spanish war, 217.\\nHot water for the sick, 160.\\nHuman excreta, a source of danger, 65.\\nHumidity, 54.\\nHydatid, 418\\nHydragogues, 140.\\nHydrant water in homes, 65.\\nHydrocephalus, 755.\\nHydrochloric acid poisoning, 177.\\nHydrocyanic acid poisoning, 185.\\nHydrogen peroxide, 134.\\nHydropathy, 579.\\nHydrophobia. 204.\\nHygiene, the principles of, 22.\\nHymen, the, 496.\\nHyoscyamus poisoning, 185.\\nHyperemia, 631.\\nHyperidrosis, 678.\\nHypermetropia, 411.\\nHypertrophy of the brain, 721.\\nHypnotics, 141.\\nHypnotism, 776.\\nHysteria, 768.\\nI.\\nIcterus, 313.\\nIchthyol, 135.\\nIdiocy, 798.\\nIllusions, 801.\\nImbecility, 798.\\nImmersion for burns, 199.\\nImmune, how the system is made, 208.\\nImprovement from judicious mating, 22.\\nIncontinence, 618.\\nIndigestion, 22,7.\\nInfantile sore eyes, 406, 557.\\nSpinal paralysis, 742.\\nInfection of the new born, 556.\\nInfectious diseases, 49.\\nNursing in, 161.\\nInferior maxillary nerve, 729.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0868.jp2"}, "867": {"fulltext": "INDEX.\\n841\\nInflammation, 722.\\nDiet during, 168.\\nOf the bowels, 255.\\nOf the eyes, 402.\\nInfluenza, 275.\\nInfusion, 125.\\nIngrowing nails, 668.\\nInhalation of hot air, 201.\\nInjections, rectal, 141, 242.\\nInnocent syphilis, 691.\\nInoculation, 284.\\nInorganic foods, 82.\\nInsane, the, wards of the state, 820.\\nInsanity, 795.\\nFrom alcoholism, 817.\\nin parents, 103.\\nMenstruation in, 817.\\nPeriodicity in, 816.\\nInsomnia, 791.\\nInspiration, 359.\\nInstruments for testing air, 63.\\nIntestinal diseases in infancy, 462.\\nObstruction, 251.\\nParasites 418.\\nIntestine, the large, 240.\\nIntussusception, 251.\\nIodide of potassium 145.\\nIodine poisoning, 191.\\nTincture of, 135.\\nIodoform, 135.\\nIpecac, 136.\\nIron, chloride of, 126.\\nItch, the, 65c\\nItching piles, p79.\\nJ.\\nJaundice, 31I.\\nJimson weed poisoning, 185.\\nJoyous exercise, a factor of health, 34.\\nK.\\nKalsomine better than wall paper, 29.\\nKidney, contracted, 337.\\nDiseases caused by alcoholism, 101.\\nStone, 336.\\nKlebs-Loffler bacillus, 278.\\nKoch and Henle laws, 210.\\nLabia minora et majora, 496.\\nLabor, 534.\\nAntiseptic precautions before, 536.\\nPreparations for, 536.\\nThe pains of, 535.\\nLabyrinth, the, 413.\\nLachrymation, 405.\\nLa grippe, 275.\\nIn the new born, 557.\\nLarynx, the, 393.\\nDiseases of the, 396.\\nLatrines, the location and care of, 24.\\nLaws for the procreation of life, 23.\\nOf life and health date back, 22.\\nLaxatives, 139.\\nLead, 146.\\nEncephalitis, 763.\\nForms of, 181.\\nPoisoning, 191, 762.\\nLeft-handed people, 44.\\nLentigo, 676.\\nLesion, 636.\\nLeucorrhea of the pregnant, 406.\\nLichen planus, 641.\\nLife and death, the antagonism be-\\ntween, 23.\\nThe physiological purpose of, 21.\\nLigaments, the broad and the round,\\n499.\\nLightning, shocks from, 201.\\nLime, air-slacked is worthless, 117.\\nAs a disinfectant, 114.\\nLithium, 145.\\nLiver, the, 306.\\nChronic congestion of the, 308.\\nCirrhosis of the, 100.\\nDiseases caused by alcoholism, 100.\\nPatches, 677.\\nLobelia, 146.\\nLocomotor ataxia, 647.\\nLondon purple poisoning, 179.\\nLousiness, 654.\\nLow temperature, diseases characteristic\\nof, 56.\\nLozenge, the, 125.\\nLumbago, 323.\\nLungs, anatomy of the, 358.\\nAmenable to education, 36.\\nDeveloped by exercise, 2\\nDiseases of the, 358.\\nInfluence of tobacco upon the, 105.\\nLying-in, the, should last how long, 545.\\nM.\\nMachinery, inanimate, 703.\\nMad dogs, 204.\\nMad stones, objections to the use of,\\n206.\\nMalaria, 270.\\nWith typhoid, 266.\\nWith yellow fever, 298.\\nMale fern, 142.\\nMalformations of development, 721.\\nMalignant endocarditis, 347.\\nMalignant pustule, 673.\\nMalt preparations for nursing mothers,\\n.436.\\nMan differs from other animals how, 45.\\nMan s neglect of his own race, 22.\\nMania, 807.\\nMania during pregnancy, 521.\\nMassage, its advantages and defects, 32,\\n586.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0869.jp2"}, "868": {"fulltext": "842\\nINDEX.\\nMastication, 236.\\nMastitis, 555.\\nMastoid process, 413.\\nMasturbation, 698.\\nMateria medica, 125.\\nMaternal impressions, 432, 512.\\nMattresses, how to disinfect, 120.\\nMeasles, 477.\\nBlack, 479.\\nGerman, 479.\\nMeasly pork, 418.\\nMedicinal dose list, 150.\\nMedulla, the, 501.\\nMedullary sheath, the, 718.\\nMeibomian glands, the, 633.\\nMelancholia, 802.\\nMeninges, the, 756.\\nMeningitis, 722.\\nAlcoholic, 102.\\nCerebro-spinal, 756, 758.\\nSuppurative, 757.\\nTubercular, 760.\\nMental development, 566.\\nMenthol, 134.\\nMenopause, the, 624.\\nInflammation of the uterus after the,\\n626.\\nMenstrual cycle, stages of the, 502.\\nMenstruation, 567.\\nCare at first appearance of, 565.\\nDerangements of, 592.\\nHemorrhage in, 592.\\nPainful, 570.\\nPremature, 567.\\nWhen girls should first be informed\\nregarding, 565.\\nMercurial poisoning, 182.\\nPurgatives, 140.\\nMercury, forms of, 182.\\nMetastasis, 482.\\nMice as carriers of disease, 51.\\nMicrobes destroyed by disinfection, in.\\nIn the growth and decay of organic\\nmatter, no.\\nMicrococci, 212.\\nMicro-organisms, 49.\\nMicroscopic vegetable growths in water,\\n68.\\nMidriff, the, 358.\\nMiliaria rubra, 645.\\nMilium, 634.\\nMilk as a beverage, 82.\\nAs a medium of spreading disease,\\n259-\\nA perfect food, 85.\\nComposition of, 81, 441.\\nDiet, advantages of, 81.\\nLemonade, 170.\\nOf lime, 117.\\nPunch, 170.\\nQuality of the, 551.\\nTo dry up the, 437.\\nTo increase the, 436.\\nMillers, average life of, 58.\\nMind healers, 778.\\nPower of the, over disease, 591.\\nMineral acid poisons, 177.\\nMinor surgery, 217.\\nMiscarriage, 525.\\nMixture, 125.\\nMoles, 670.\\nMonkshead poisoning, 184.\\nMorphine habit, the, 108.\\nObjections to the use of, in colic,\\n251.\\nWhen, is to be used, 108.\\nMosquitoes as carriers of malaria, 271.\\nMother, care of the, 539.\\nDiet of the, 540.\\nMotor nerves, 706.\\nMountain sickness, 53.\\nMouth and throat, to disinfect the, 122.\\nDiseases of the, 452.\\nWashes, 93.\\nMucous patches, 690.\\nMultiple neuritis, 735.\\nMumps, 481.\\nMuriatic acid poisoning, 177.\\nMuscular coats of the stomach, 235.\\nDevelopment, a secondary matter,\\n36.\\nMushroom poisoning, 192.\\nMustard, 136.\\nMutism, 754.\\nMyalgia, 322.\\nMyelitis, 741.\\nMyopia, 411.\\nN.\\nNasal ducts, the, 405.\\nNatural and sexual selection, 575.\\nNausea, how to overcome, 299.\\nNavel cord, the, 555.\\nNecrosis, 723.\\nNephritis, acute, 334.\\nNephrolithiasis, 336.\\nNerve centers, 713.\\nForce, nerve fluid, 31\\nTerminals, 706.\\nTrunks, 710.\\nNerves, cranial, the, 711.\\nDecussation of, 708.\\nHow, are formed, 718.\\nMotor, 708.\\nSensory, 709.\\nSpinal, 711.\\nNervous diseases of germ origin, 782.\\nExhaustion, 594.\\nSymptoms, 784.\\nSystem, diseases of the, 703.\\nEnergized by good humor, 35.\\nNervousness in women overcome by\\noutdoor life, 39.\\nNettle rash, 642.\\nNeuralgia, 728.\\nNeurism, 31.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0870.jp2"}, "869": {"fulltext": "INDEX,\\n843\\nNeuritis, 733.\\nNeuroses, the, 764.\\nNevus pigmentosis, 670.\\nNecotianine, 104.\\nNicotine, 104.\\nPoisoning, 188.\\nNight air, avoidance of, 24.\\nTerrors, 755.\\nNipples, sore, 549.\\nNiter, sweet spirits of, 137.\\nNitric acid poisoning, 177.\\nNitrification, 71.\\nNitrogen, 52.\\nHow, is made a part of plants, ill.\\nNitrogenous and non-nitrogenous foods,\\n80.\\nNitroglycerine, 128.\\nNodules, 631.\\nNoma, or gangrenous stomatitis, 453.\\nNose and throat, diseases of the, 381.\\nBleed, 316.\\nNursing infants, 435.\\nThe sick, 155.\\nThe new born, 540.\\nNutrients, how, enter the blood. 237.\\nNux vomica poisoning, 189.\\nO.\\nObesity, 331.\\nObjects swallowed, 193.\\nOblongata, the, 707.\\nDiseases of the, 739.\\nObservation of symptoms, 166.\\nObstetrics, 493.\\nOffensive sweat, 679.\\nOiling the hair, 682.\\nOnanism, 698.\\nOnychia, 668.\\nOnyxis, 668.\\nOpthalmic nerve, 729.\\nOpium, 146.\\nHabit. 108.\\nPoisoning. 186.\\nOrgans, freedom of, in every position,\\n33-\\nDisplacement of. by constriction, 39.\\nOut buildings, 28.\\nOva. 501.\\nOvaries, the. 501.\\nCongestion of the, 601.\\nOvaritis, chronic. 602.\\nOviducts, the, 500.\\nOx bile, 147.\\nOxidation as a purifier, 72.\\nOxygen, 52.\\nP.\\nPain in amputated limbs, 728.\\nPaint, advantages of, 29.\\nPalate, the, 389.\\nPalpitation of the heart, 351.\\nPalsy, Bell s, 73J.\\nThe shaking, 779.\\nThe wasting, 746.\\nPancreatic secretion, 236, 237.\\nPancreatin, 147.\\nPapilla, 681.\\nPapule, 631.\\nParalysis, acute ascending, 744.\\nAgitans, 779.\\nBulbar, 750.\\nGeneral, 815.\\nInfantile spinal, 742.\\nPseudo hypertrophic muscular, 751.\\nParanoia. 810.\\nParaplegia, 754.\\nParesis, 815.\\nParetic dementia, 815.\\nParis green poisoning, 179.\\nParents should play with their children,\\n36.\\nParotiditis, 481.\\nPassion, the slave of, 22.\\nPassions, danger from the uncontrolled,\\n574-\\nPasteur treatment to prevent hydro-\\nphobia. 207.\\nPathogenic germs. 49.\\nPathology of infantile disorders. 554.\\nPediculosis. 654.\\nPelvic anatomy, 493.\\nDeformity, 494.\\nDiseases, how lessened. 578.\\nFloor, 496.\\nOrgans, acute inflammation of the,\\n599-\\nChronic inflammation of the, 596.\\nPemphigus. 556.\\nPepsin. 147.\\nPeptonizing tubes. 445.\\nPericarditis. 346.\\nPerineum, rents in the, 545.\\nPeripheral nerves, 706.\\nPeritoneum, the. 255.\\nPeritonitis. 255.\\nPermanent dressing of wounds, 224.\\nPermanganate of potash, 135.\\nTest of water, 75.\\nPersonal care of patients, 157.\\nPertussis. 483.\\nPharyngitis. 392.\\nPharynx, diseases of the, 389.\\nPhenacetin, 131.\\nPhenol poisoning, 190.\\nPhimosis. 559.\\nPhosphorous. 128.\\nPoisoning. 182.\\nPhotophobia. 405.\\nPhrenic nerve, the, 712.\\nPhthisis, 370.\\nPhysician s orders to be followed by the\\nnurse, 156.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0871.jp2"}, "870": {"fulltext": "844\\nINDEX.\\nPia mater, the, 718.\\nPictures in the sickroom, 161.\\nPiecing between meals, 242.\\nPigmentation of the skin, 630.\\nPiles, 679.\\nPimples, 631.\\nPin worms, 424.\\nPlants in the sick room, 161.\\nPlasmodium malaria, 270.\\nPleural cavity, the, 358.\\nPleurisy, 378.\\nPlexus, 712.\\nPneumonia, 364.\\nPoison apparatus of serpents, 203,\\nHemlock, 186.\\nIvy, 191.\\nOak, 191.\\nSumac, 192.\\nPoisoning, 175.\\nPoisons as medicines, 125.\\nModern uses of, 176.\\nQuantity of, that will produce\\ndeath, 177.\\nPoints to press to stop bleeding, 220.\\nPolyuria, 328.\\nPomegranate, 142.\\nPons, the, 707.\\nPorter as a beverage, 83.\\nPost cervical ache, 804.\\nPostures, correct in standing and sit-\\nting, 33-\\nPotash salts as diuretics, 137.\\nPott s disease, 749.\\nPower of the mind over the body, 163.\\nPrecautions against intestinal parasites,\\n427.\\nPrecordial fear, 804.\\nPregnancy, care of the teeth during, 94.\\nComplications during, 518.\\nCondition of the uterus in, 516.\\nDiagnosis of, 509.\\nDisorders of the nervous system dur-\\ning, 520.\\nDuration of, 512.\\nExtra-uterine, 529.\\nHygiene and management of, 513.\\nInfectious diseases during, 523.\\nNausea and vomiting of, 521.\\nNervous complications of, 549.\\nSigns of, 512.\\nPremature birth, 559.\\nDelivery, 525.\\nPreparation of foods, 167.\\nPrepuce, elongation of the, 559.\\nPresbyopia, 411.\\nPrevention of consumption, 377.\\nOf the spread of germ diseases, 50.\\nPrickly heat, 645.\\nPrimary dementia, 812.\\nPrivy vaults, 28.\\nHow to disinfect, 121.\\nProcreative act, the, 22,\\nProgressive muscular atrophy, 746.\\nProlapsus and procidentia, 232.\\nOf the uterus, 607.\\nProliferation, 722.\\nPronuclei, 502.\\nProstration from bruises, 228.\\nProteids, 80.\\nThe digestion of, 444.\\nProtoplasm, where created, 21.\\nPrudence necessary in children of weak\\nparents, 22.\\nPruritis, 613.\\nAni, 679.\\nPrussic acid poisoning, 185.\\nPsoriasis, 639.\\nPterygium, 402.\\nPtomaine, poisoning, 192.\\nPuberty, retarded, 569.\\nPublic baths, 77.\\nPuerperal infection, 546.\\nPulse, the, 343.\\nTo ascertain the, 166.\\nPumpkin seed, 142.\\nPuncta, 405\\nPurgatives, 139.\\nPus producing germs, 218.\\nPustule, 631.\\nPutrefaction caused by germs, no.\\nQuassia, 142;\\nQuick Consumption, 378.\\nQuinine, 127.\\nAs an antiseptic, 130.\\nAs a germicide, 130.\\nQuinsy, 390.\\nR.\\nRabies, 204.\\nRachitis, 490.\\nRag sorter s disease, 39.\\nRain baths, 77.\\nWater, 73.\\nRats, carriers of disease, 51.\\nSlaughter house, 427.\\nRectal prolapsus, 232.\\nRectum, the, 239.\\nRecuperative power of man, 22.\\nRed gum, 645.\\nReflex action, 715.\\nRegeneration and repair, 720.\\nRegularity in eating, 239.\\nRelation of ovulation and menstruation,\\n501.\\nOf the sexes, 576.\\nRemedies recommended by friends, 156.\\nRespiration artificial, 196.\\nOf the new born, 553.\\nRest, importance of, 34.\\nRete, the, 681.\\nRetina, the, 401.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0872.jp2"}, "871": {"fulltext": "INDEX.\\n845\\nRetroflexion, 607.\\nRetroversion, 607.\\nRheumatism, acute, 317.\\nChronic, 320.\\nDeforming, 324.\\nFavored by cold and damp, 54.\\nMuscular, 322.\\nRheumatoid arthritis, 324.\\nRhinitis, chronic, 383.\\nRickets, 490.\\nRingworm, 659.\\nOf the body, 663.\\nOf the crotch and axilla, 665.\\nOf the nails, 666.\\nRoman baths, 76.\\nRooms, how to disinfect, 118.\\nRose, 674.\\nRotheln, 479.\\nRound worms, 422.\\nRough on rats, poisoning by, 179.\\nRubber tubing, to stop hemorrhage by,\\n221.\\nRugs, how to disinfect, 121.\\nRun-around, 668.\\nRunning, posture of the body in, 33.\\nRupture, 229.\\nS.\\nSalicylate of sodium, 133.\\nSalicylic acid. 133.\\nSaline purgatives, 139.\\nSaliva, 236.\\nSalivation, 237.\\nSalol, 133.\\nSalt rheum, 648.\\nWhat it does for us, 82.\\nSand, action of, in germ destruction, 70.\\nFilters, 67.\\nSize of, required for filters, 70.\\nSandow, the athlete, 45.\\nSanitary science, embraces what, 23.\\nThe chief problem of, 63.\\nSantonin. 142.\\nSarcini. 212.\\nSarcoma, 754.\\nScabies. 656.\\nScald-head, 660.\\nScalds. 199.\\nScarlet fever. 473.\\nScarletina. 476.\\nScars prevented by skin grafts, 201.\\nSchoolrooms, the light of, 410.\\nThe ventilation of, 61.\\nSciatica. 731.\\nSclerosis, arterio. 354.\\nOf the nerves. 723.\\nSpinal. 750.\\nScreens in the sick-room. 160, 161.\\nMay prevent disease, 56.\\nScrofula. 488.\\nSea-sickness. 252.\\nSeasons, diseases peculiar to certain, 56.\\nSeat worms, 424.\\nSebaceous glands, diseases of the, 633.\\nSeborrhea, 635.\\nSecretory nerves, 706.\\nSedimentation, 66.\\nSegmentation, 271.\\nSegmentation-nucleus, the, 502.\\nSelf-abuse, self-pollution, 698.\\nSeminal losses, 700.\\nSenile dementia, 812.\\nSenility, the nerves in, 724.\\nSensory nerves, 706.\\nSerum treatment of consumption, 376.\\nOf the blood. 344.\\nSettling basins for purifying water, 66.\\nSewer connections, dangers from, 58.\\nGas, 58.\\nSewage manure, dangers from, 429.\\nSexes, relation of the, 576.\\nSexual development of girls. 564.\\nFunctions, derangements of the, 594,\\nInstinct, 574.\\nOrgans, malformation of. 569.\\nPartial development of, 569.\\nSelection. 575.\\nShafts.- ventilating. 60.\\nSheath, the medullary, 718.\\nOf Schwann. 718.\\nShingles, the. 644.\\nShoes, importance of well fitting, 40.\\nSick-headache, 768.\\nSickness, care of the teeth during. 94.\\nSick-room, arrangement of the, 159.\\nSighing, 360.\\nSigns of pregnancy, relative value of\\nthe. 512.\\nSilver nitrate. 147.\\nSinging, control of the breath in, 395.\\nSitting, correct posture in, 33.\\nSize of an infant determined by what,\\n505-\\nSkin diseases, 629.\\nTerms used in considering, 631.\\nGrafting to prevent scars, 201.\\nInflammation of the. 651.\\nSkins, how to disinfect, 121.\\nSlaughter house refuse, dangers from,\\n427.\\nSleeplessness, 791.\\nSleep of infants, 437.\\nOne-third of the time to be given to,\\n24.\\nSmall-pox, 283.\\nSnake bites, 202.\\nHow stimulants should be given\\nfor. 84.\\nSneezing. 360.\\nSnuff, effects of. 107.\\nSoap as a disinfectant, 114.\\nSocial condition, influence of. in nervous\\ndiseases. 727.\\nSoda as a disinfectant, 114.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0873.jp2"}, "872": {"fulltext": "846\\nINDEX.\\nSoil on which to build, 25.\\nSolution, 125.\\nSolutol as a disinfectant, 113.\\nSomnambulism, 772.\\nSore throat, 391, 392.\\nSowing wild oats, 577.\\nSpanish windlass to stop bleeding, 221.\\nSpeaking, control of the voice in, 395.\\nSpecial poisons, 177.\\nSpermatorrhea, 699.\\nSpinal canal, 705.\\nCenters, 715.\\nCord, diseases of the, 739\\nInjuries of the, 749.\\nHemorrhage, 745.\\nNerves, 706, 711.\\nSclerosis, 750.\\nSpirilla, 212.\\nSpitting, a source of danger, 50.\\nSplints, 224.\\nSpores, 213.\\nSpotted fever, 722.\\nHemlock, poisoning, 186.\\nSprains, 225.\\nSputa, how to disinfect, 122.\\nSquill as a diuretic, 138.\\nAs an emetic, 136.\\nSquamae, 631.\\nStages of the embryo and fetus, 502.\\nOf the menstrual cycle, 501.\\nStains upon the skin, 631.\\nStand erect, how to, S3-\\nSt. Anthony s dance, 767.\\nFire, 674.\\nStaphylococci, 212.\\nStaphylococcus albus, the producer of\\nwhite pus, 218.\\nAureus, the producer of yellow pus,\\n218.\\nStarch, the digestion of, 237.\\nStarches and sugars, 80.\\nStarchy foods, how to cook, 167.\\nSteam as a disinfectant, 118.\\nBaths, 79.\\nSteatoma, 633.\\nSties, 401, 633.\\nStimulants and narcotics, 96.\\nStings of insects, 202.\\nStomach, the, 235.\\nAnd bowel diseases, diet in, 170.\\nChildren s diseases of the, 4555.\\nDisorders caused by alcoholism, 99.\\nTube, how made and used, 239.\\nStomatitis, catarrhal, 452.\\nStoves, poisonous gases from, 57.\\nStoves, ventilation of houses warmed\\nby, 61, 63.\\nStramonium poisoning, 185.\\nStrangulated hernia, 231.\\nStrangulation, 251.\\nStrength and endurance caused by\\nwhat, 31,\\nStreptococci, 212.\\nStretcher, an improvised, 224.\\nStriae gravidarum, 507.\\nStrictures, 697.\\nStrychnia poisoning, 189.\\nSt. Vitus dance, 767.\\nSubinvolution, 547.\\nSudden changes tend to disease, 56.\\nSuffocation, 197.\\nSugar in urine, 328.\\nSulphate of copper, 136.\\nSulphonal, 141.\\nSulphur as a disinfectant, 114.\\nSulphuric acid poisoning, 177.\\nSummer complaint, 464.\\nSunlight as a disinfectant, 112.\\nAs a purifier of water, 72.\\nIn every room, 25.\\nSunstroke, 198.\\nCauses of, 55.\\nSuperior maxillary nerve, 729.\\nSuppurative otitis media, 414.\\nSurface water, danger from, 67.\\nSurgical cleanliness, 219.\\nSweat glands, disorders of the, 678.\\nSwedish movements, 586.\\nSwimming, 79.\\nSympathetic nervous system, 715.\\nSymptoms, the observation of, 166.\\nSyphilis, 687.\\nIn the new born, 557.\\nSystole, 344.\\nT.\\nTabes dorsalis, 747.\\nTable of alcoholic strength of liquors,\\n129.\\nComposition of food materials,\\n85, 86.\\nFuel values of food per pound, 87.\\nQuantity of nutrients one dollar\\nwill buy, 87.\\nTime required to digest various\\nfoods, 90.\\nTablet, the, 125.\\nTape worms, 418.\\nTartar emetic, 137.\\nTea as a beverage, 83.\\nTeeth, the, 91.\\nAt birth, 449.\\nCare of, in infancy, 450.\\nCare of the permanent, 94.\\nCare of the temporary, 92.\\n.Temperature, its influence upon health,\\n54-\\nOf infants, 440.\\nOf the sick room, 160.\\nHow to reduce the, 130, 286.\\nTemporary dressing of wounds, 220.\\nTenotomy, 744.\\nTerminal dementia, 812,\\nTetanus, 782,", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0874.jp2"}, "873": {"fulltext": "INDEX.\\n847\\nTetrads, 212.\\nTetter. 648.\\nThoracic breathing, 38.\\nThorn apple poisoning, 185.\\nThread worms, 424.\\nThrombosis, 751.\\nThrush, 4 54- 558.\\nTic douloureux, 731.\\nTincture, 125.\\nTinea trycophytina, 659.\\nTissue building foods, 80.\\nIn children. 35.\\nTobacco. 104.\\nHabit, treatment for the, 107.\\nIndian. 146.\\nPoisoning, 105.\\nTonics. 126.\\nTonsilitis. 390.\\nFollicular. 391.\\nTonsils, the. 389.\\nToothache, the control of, 95.\\nTooth powders, 93.\\nTourniquet, use of the, to stop bleed-\\ning. 221.\\nTrachea. 358.\\nTraining children, should begin when,\\n434-\\nTrance. 773.\\nTraumatic affections of the spinal cord,\\n748.\\nTrees about the home, 25.\\nTrichinosis, 425.\\nTricresol, 113.\\nTrional, 141.\\nTroches, 125.\\nTrophic nerves, 706.\\nTruss, how to cure hernia by a, 232.\\nHow to secure a perfect fitting. 229.\\nTubercle. 631.\\nTuberculosis of the lungs. 370.\\nTumor. 631.\\nOf the brain. 754.\\nTumors and adventitious products, 724.\\nTurbinate bodies, 384.\\nTurpentine, the oil of, 138.\\nPoisoning. 193.\\nToxine treatment of disease, 211.\\nToxines of dead cells, 23.\\nTwitching eyelids. 401.\\nType for testing sight, 412.\\nTyphlitis, 253.\\nU.\\nUlceration. 631.\\nUlcer of the eye, 402, 406.\\nOf the stomach, 240.\\nUlcerative stomatitis, 453.\\nUmbilical cord, the. 506.\\nUpholstery, how to disinfect, 120.\\nUrethra, the, 497.\\nUrinary organs, diseases of the, 617.\\nUrine, abnormal, 622.\\nIncontinence of, 548.\\nUrticaria, 642.\\nUterine contractions, 544.\\nFibroids or tumors, 615.\\nUterus, cancer of the, 616.\\nComplete prolapsus of the, 627.\\nDiameter of the, 606.\\nDisplacement of the. 606.\\nFalling of the, 607.\\nIn the aged, 626.\\nInflammation of the. after the meno-\\npause. 626.\\nRents in the mouth of. 545.\\nReturn of the. to normal size, 548.\\nThe, and its connections, 497.\\nTumors of the, 615.\\nUvula, the, 389.\\nVaccination. 291.\\nVaccinia. 290.\\nVagina, the, 497.\\nInflammation of the, 615.\\nVaginitis, 615.\\nValves of the heart, 343.\\nValvular diseases of the heart, 348.\\nVapor baths. 79.\\nVaricella, 480.\\nVaricose veins, 354.\\nVascular disturbances of the brain, 724.\\nVariola, 283.\\nVaso-motor nerves, 706.\\nVegetable diet, 81.\\nGrowths in sand filters, 6S.\\nRemedies, 176.\\nSpores in water, 68.\\nVegetables, preparation of, for food, 429.\\nVeins, enlarged. 354.\\nPelvic, 627.\\nVena cava, the, 343.\\nVenereal diseases, 687.\\nVentilation, 59.\\nIn infectious diseases, 162.\\nOf a girl s room, 563.\\nOf cellars, 28.\\nOf the sick-room, 159.\\nVentilating with cold air, 61.\\nFlues and registers, proper size of,\\n62.\\nVentricles, the, 343.\\nVerdigris poisoning, 188.\\nVermiform appendix, the, 253.\\nVernix caseosa, 432.\\nVerruca, 646.\\nVertigo. 784.\\nVesicles. 631.\\nThe air, 359.\\nVilli, the. 344.\\nVocal cords, the, 394.", "height": "4144", "width": "2542", "jp2-path": "humanmachineitsc00mcve_0875.jp2"}, "874": {"fulltext": "848\\nINDEX.\\nVoice, the, 393.\\nPrecautions in the care of the, 398.\\nVoight s tables, 85.\\nVomit, black, of yellow fever, 295.\\nVomiting caused by alcohol, 99.\\nIn infancy, 456.\\nHow to prevent, 289, 299.\\nVulva, hyperesthesia or irritableness of\\nthe, 614.\\nItching of the, 613.\\nVulvitis, 612.\\nW.\\nWalking, posture of the body in, 33.\\nWall papers, things preferable to, 29.\\nWalls, double to prevent dampness, 28,\\nWarts, 646.\\nWasp waists, 38.\\nWater, 65.\\nAs an antipyretic, 130\\nAs a beverage, 82.\\nBorne diseases, 49.\\nCare of, 164.\\nClosets, how to disinfect, 122.\\nAs a diuretic, 137.\\nDangers from impure, 65.\\nOn the brain, 755.\\nPurification of, by cold, 72.\\nFiltration, 67.\\nHeat, 72.\\nNitrification, 71.\\nRain, 73.\\nSources of supply of, 67.\\nSupply of Hamburg and Altona, 70.\\nThe home, 25.\\nTo reduce the temperature of the\\nbody by, 130, 268.\\nUse of, in treating disease, 579.\\nWarm, as an emetic, 136.\\nWatery eyes, 405.\\nWeaning the child, 552.\\nWeights and measures, 148.\\nWeight of the new born, 553.\\nWells, dangers from, in cities, 65.\\nDistance they must be from the\\nprivy, 66.\\nWhich should be condemned, 66.\\nWens, 634.\\nWetting the bed, 618.\\nWheals, 631.\\nWheat, the composition of, 81.\\nWhey as food for infants, 444.\\nWhite matter of the brain, 704.\\nWhitewash, 29.\\nWhisky as a beverage, 84.\\nWhitlow, 669.\\nWhooping cough, 483.\\nWill force, 31.\\nImportance of, in muscle build-\\ning, 46.\\nWinds as carriers of disease, 56.\\nHot and dry, injurious to health, 56.\\nWine as a beverage, 84.\\nWolfsbane poisoning, 184.\\nWoman s health in mountain districts,\\n40.\\nEndurance and recuperative powers,\\n574-\\nNervousness overcome by outdoor\\nlife, 39.\\nWomen, care of, in pregnancy, 493.\\nDiet for young, 562.\\nDiseases of, 561.\\nShould breathe abdominally, 38.\\nWhose floating ribs overlap the\\nstomach, 39.\\nWool and rag sorters disease, 59.\\nWorms, 418.\\nWounds, the permanent dressing of,\\n223.\\nThe temporary dressing of, 220.\\nWrist-drop, 763.\\nY.\\nYellow fever, 293.\\nYoung women, diet for,\\nZ.\\nZinc poisoning, 191.\\nSulphate, 136.\\nAs an emetic, 137\\nZoster, herpes, 644.\\n562.", "height": "4144", "width": "2542", "jp2-path": 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