Back-Ache

Stiff Back. Crick in the Back. Sprains.

In nearly every instance back-ache is a symptom of some disease, and can be relieved only by treatment appropriate to the real difficulty. Sometimes severe back-ache is directly and positively traceable to a cold, caused by sitting in a draft, etc., and local treatment will afford permanent relief. A good liniment to rub over the back is: Tincture of capsicum^[1] and essence of origanum, each one dram; tincture of lobelia, one ounce; alcohol, three ounces. Placing dry, hot flannel over the back often gives quick relief. It is also a good plan to accompany such methods by a good drink of hot ginger tea. Many resort to a cold pack for relief. This is had by placing on the bed a double blanket and upon this a sheet folded up to the size of the back and saturated with cold water; place the patient on his back upon this and draw the blanket around him; and let him remain till the back feels very warm.

Back Sprains.

These are usually the result of violent exercise of unusual character, or of falls or other accidents. They oftenest occur in the loins or neck, and may be known from dislocations or fractures by the fact that in sprains the spine itself is straight, there is no bulging at any one point and tenderness is diffused and the patient is able, although usually with pain, to straighten himself out. Occasionally from strains there may be ecchymosis (black and blue appearance) and considerable swelling.

Treatment. — Quietude in the most comfortable position, usually lying bent upon the side. A capsicum plaster is very beneficial. The treatment given under back-ache should be employed. Sprains rarely confine a person to the bed more than two or three days, though occasionally they are obstinate in yielding to treatment when the ligaments are involved.

^[1] Capsaicin-based liniments irritate the skin which supposedly relieves pain. The efficacy of other rubefacients is not proven.

Atrophy

Under various circumstances and as the result of many different causes the condition known as atrophy may take place^[1]. It is the shrinkage or wasting away of tissues, and may take place in any part of the body. The brain, heart, liver, nerves, spinal cord and various organs, and the bones and skin and muscles are all subject to atrophy. The condition and the means taken to prevent it or overcome it are fully considered in the articles treating of the diseases of the various organs and tissues which may be thus affected.

^[1] Atrophy is not necessarily a pathological condition - it occurs naturally with aging in, for example, the thymus, tonsils and skeletal muscle.

Athetosis

Involuntary Muscular Contractions. — In this condition, which occasionally accompanies certain forms of paralysis, the extremities, especially fingers and toes, undergo uncontrollable spasms. These spasms may consist in the members being firmly separated or flexed. They may occur during sleep and may be increased by fright or other emotions. Treatment is in accordance with that for paralysis.^[1]

^[1] There is no standard treatment for the symptom.

Atelectasis

Pulmonary Collapse. — From compression or from obstructions in the lungs, air may be prohibited from entering the air cells, and the result will be collapse of the vesicles. It very frequently occurs in children during the course of whooping cough, bronchitis, measles and croup^[1]. It is exceedingly fatal in very young persons and in the aged. It is fully treated of as capillary bronchitis in the article on Bronchitis.

^[1] Wikipedia suggests that it most commonly occurs as post-surgical atelectasis.

Ataxy

Locomotor Ataxy. Tabes Dorsalis.

A very peculiar condition of the nervous system is known under this name^[1], characterized by loss of sensitiveness of the skin and inability to control movements of the limbs. It was formerly classed as a form of paralysis. It comes on insiduously. Pains of a neuralgic or rheumatic character, headache, impaired vision, frequent desire to urinate and "pricking" sensations of the limbs or extremities, are early symptoms. Soon inability to control the movements of the limbs becomes manifest, and trying to walk with the eyes shut will cause staggering. Applications of heat, pricking with pins, etc., on portions of the back fail to cause any sensations. Many other symptoms may be manifested. It is a disease of middle life, and its causes are various. Long exposure to cold and moisture, sexual excesses, syphilis, poisoning by lead, arsenic or ergot^[2], and injuries to the spine have been known causes.

Treatment. — If possible the patient should visit the southern mountains or seek an equable and dry climate. Electricity to the spine is of great advantage. The cause must be ascertained and remedial treatment based accordingly. Narcotics must be prohibited. Vapor baths and massage are of great value. The disease lasts from a few months to twenty-five years or even longer.

^[1] Ataxy isn't a term commonly used now - myelopathy is used to refer to pathology of the spinal cord.
^[2] Ergot poisoning, which is caused by the ingestion of ergot fungi most prominently found on rye, is uncommon now.

Asymbolia

Inability to Communicate. — A rare condition in which the person afflicted is unable to communicate in any way with others. It is a condition dependent upon brain lesions; and is usually a symptom of some pronounced difficulty, which must be appropriately treated^[1].

^[1] The word asymbolia now seems more frequently used in relation to pain asymbolia, in persons who do not react to painful stimuli. Those interested in the condition should refer to apraxia or agnosia.

Astigmatism

An irregularity of vision caused by lack of uniformity of the convexity of the lens or cornea. Described in the section of Eye Diseases.

Asthma

Phthisic Spasmodic Breathing.

This is a disease characterized by paroxysms of difficult breathing, and is due to contraction of the smaller bronchial tubes, brought about by spasms of the bronchial muscular fibres. It is a difficulty reflex in character, that is transmitted from a disturbance of a nerve center elsewhere. Often it is associated with valvular disease of the heart, and it should always be regarded as a constitutional malady and not one confined to the respiratory organs. Attacks may be caused by over eating - or over exertion, irritation at some point as in the stomach or bladder or upon the skin, or in the rectum by constipation, indulgence in highly seasoned food, liquors or indigestible foods. Sweets of all kinds are also provocative of attacks in those disposed to asthma^[1].

Symptoms. — An attack always comes on suddenly, although often preceded by an oppressed sensation in the chest and a wheezing which is annoying. As a rule the patient awakens in the night feeling as though being smothered. He can't get his breath and sits up or gets out of bed, throws his head back and opens his mouth gasping for air, the shoulders drawn up. The muscles of the neck and head and over the ribs are rigid, while the muscles of the abdomen which assist breathing are acting violently. The chest is enlarged, as well as the abdomen. There seems to be a stagnation of air in the lungs. In severe cases the extremities are cold and the face pale, the eyes having a terrorized expression, and the surface covered with perspiration. A fit of asthma may last a few minutes, two or three hours, a whole night, several days or for weeks. It is very rarely immediately fatal. As an attack passes away a slight cough commences and there is expectoration of mucus — sometimes frothy, sometimes viscid or in the form of little dark balls; and in severe cases streaked with blood. Recovery from the attack may be gradual, or it may terminate as suddenly as it commenced, especially if appropriate treatment is pursued.

It is important to distinguish true asthma from the disturbance of breathing caused by heart troubles. The difficult breathing connected with organic heart disease may likewise come on in paroxysms, but it is of a gasping and panting character and very shallow and there is no wheezing sound. The heart is likewise greatly disturbed and the pulse usually weak and irregular.

Treatment. — During a paroxysm of asthma an abundance of fresh air must be supplied and all tight clothing loosened. Dropping a little rosin on a hot stove will often cause relief by its vapor being inhaled^[2]. The most effectual remedy to be used is the following:

Take:

• Tincture of Lobelia ... 5 drachms.
• Fluid extract Cramp Bark ... 2 drachms.
• Essence of Ginger ... 1 drachm.

Mix. Take five drops in water every ten minutes until relief is obtained.

Nausea may follow the use of these drops, but such will only hasten the relief.

Asthmatic persons must avoid excesses of all kinds and use plain but nourishing diet. Usually it will not be found difficult to locate the disordered organ which is the actual seat of the disturbance, and its appropriate treatment may lessen the severity of attack and perhaps entirely obliterate them. As a rule the kidney's must be carefully watched and the bowels never allowed to become constipated. Very little encouragement can be given those who have seemingly inherited the condition, beyond the fact that it is not incompatible with a long life.

Asthma Of Hay Fever. — This is an entirely different malady from ordinary asthma, described above. Its causes, symptoms and treatment will be found in the article on Hay Fever.

^[1] There is a fairly recent study suggesting that a diet rich in sugar can increase the occurrence of allergic inflammations.
^[2] The vapours from rosin-based soldering fluxes are an asthma risk.

Asthenopia

This is weakness of vision and is often spoken of as weak sight. It is described in the section on Eye Diseases.

Asthenia

A condition which may arise during almost any disease, dependent upon a lack of tone in the nervous system. It is characterized by listlessness and inability. A low grade of fever is said to be asthenic when there is but feeble resistance made to the encroachments of disease.

Ascites

Hydro-peritoneum. — The accumulation of fluid in the cavity of the peritoneum^[1], a form of dropsy distinguished from anasarca, which is an accumulation in the cellular tissues. See Dropsy.

^[1] A number of societies have considered ascites as a divine punishment for oath-breaking.

Ascarus Scabies

This name^[1] is that of the insect which causes the disease known as Itch, by burrowing under the skin. Its description and treatment will be found in the article on Itch.

^[1] The name is no longer in use - the mite that causes scabies is known as Sarcoptes scabiei.

Ascaris Lumbricoides

This is the technical name for the plain round worm of the intestines so common in children. For full description and treatment see the article on Worms.

Appendicitis

Faecal Abscess. Typhlitis.

At the end of the small intestines above the right groin, just before the large intestines commence, there is an enlargement of the intestine called the cæcum, and running out from this pouch-like enlargement is a small appendage, called the vermiform appendix on account of its worm-like appearance. This appendix has a small canal in a portion of it, with an orifice in the cæcum. The exact use of the vermiform appendix has not yet been definitely agreed upon. By the accumulation of faecal material and rarely of small seeds, etc.^[1], in the cæcum, or in the canal of the appendix, or by inflammation extended from other parts, the cæcum and vermiform appendix may become inflamed, causing a condition termed typhlitis. Inflammation of the peritoneum about the cæcum is called perityphlitis, that of the cæcum's connective tissue is known as paratyphlitis, and inflammation of the vermiform appendix is termed appendicitis. The last term being most generally used and representing the most frequent form of the trouble.

Symptoms. — First of all will be very sharp pain in the region just above the right groin and intense suffering upon pressure or movement. At that point examination will reveal tenseness and soon considerable swelling, beneath which may be found an oval tumor, and the whole abdomen will become enlarged. The patient will be found on the right side with the limbs drawn up to relieve all tension of the muscles of the affected region. Constipation is marked, and the urine is partially suppressed; often there is vomiting of offensive material having a faecal odor, the pulse is wiry and frequent, the countenance distressed and the voice feeble.

If the appendix alone is inflamed, there will be no faecal odor to vomited material and the swelling and tumor will be less pronounced, although the pain will be intense. The danger in these cases lies in the liability of suppuration and perforation into the abdominal cavity. Sometimes there may be suppuration and evacuation outward, or through the bowels, or the suppurative materials may be absorbed.

Treatment. — If the inflammation is caused by accumulations of faeces in the cæcum, large injections of warm water or infusion of spearmint (three or four quarts in amount) should be given, and repeated if necessary until free evacuations are obtained. When inflammation of the appendix exists place over the affected region a large and hot mullein-leaf poultice, containing considerable lobelia herb and sprinkled lightly with ginger; and administer by the mouth teaspoonful doses of an infusion of lady slipper, one teaspoonful, and lobelia, half a teaspoonful, to a cup of boiling water, every half hour. Sustain the strength by broths or malted milk or other liquid foods. Enjoin perfect quietude in bed, and move the bowels by injections, never using cathartics.

The surgical operation for appendicitis is frequently resorted to, but in nearly all cases needlessly; the removal of the vermiform appendix being a fad^[2], very remunerative to the surgeon who can persuade others to submit to his desires. Persons who eat heartily after long abstinence or while the intestines are empty after catharsis or otherwise, are especially liable to be attacked by appendicitis.

^[1] Causes of appendicitis also include intestinal parasites.
^[2] The removal of an inflamed appendix is still very common due to the risk of peritonitis.

Apoplexy

Hemorrhage in the Brain.

So suddenly does an attack of apoplexy^[1] come upon a person that the ancients not inappropriately called it attonitus (thunder-struck). The difficulty always is the result of pressure upon the brain caused by an excessive amount of blood in the vessels or the rupturing of a blood vessel in the brain. Persons of any age may be affected, but those over fifty are the most frequent victims, and certain individuals are more liable than others to be stricken.
Persons with a florid complexion, short neck and large abdomen and a tendency to rapidly accumulate flesh have cause to fear apoplexy, especially if they live high and take little exercise. Indulgence in alcoholic liquors by such persons is highly dangerous. Excessive mental labor, sudden great excitement and continued exhaustive physical labor may bring on a stroke of apoplexy in anyone. Again, there are peculiar organizations whose blood vessels seem liable to become brittle, and prone to burst readily. Even very thin persons and those who live most carefully may thus suffer from apoplexy.

Warning Symptoms. — While a stroke of apoplexy comes on with great suddenness, still there are certain premonitory symptoms usually manifested which should be recognized and heeded as warnings by those who are especially inclined to the disease, and should cause them to be careful in their habits. These warning symptoms are: Headache, dizziness, especially when stooping, blurred vision, throbbing sensations in the neck or head, ringing in the ears, flushing of the face, especially after eating or slight exertion, bleeding of the nose. No one of the symptoms alone would indicate apoplexy, but many of them together, occurring in persons predisposed to the disease, should give occasion for great concern.

Peculiar Symptoms. — A stroke of apoplexy may come on in one of three ways. First, the victim experiences a sudden pain, darting through the head; he then becomes extremely pale, sick and faint, and perhaps vomits freely; his memory rapidly leaves him and his countenance appears deathly and his eyes have a vacant stare. He sinks into a most profound stupor and dies. These cases are almost hopeless, for there is little vitality to be aroused.

Second. — There may be a sudden paralysis upon one side of the body, loss of speech and apparent agony of mind. Such cases are slow in developing stupors and full recovery from the paralysis is highly improbable.

Third. — Usually the victim falls suddenly as though struck and lies in a stupid sleep, having no power of speech or thought, the face is flushed, the teeth clenched, the veins of the neck large and distended, the breathing slow and heavy and snoring, and the pulse slow and full and its stroke hard or violent beneath the fingers; the cheeks are distended and often the breath passes through them with a puffing sound. The pupils of the eyes remain unchanged as light is brought near.

Occasionally there are involuntary discharges from the bowels and bladder, though as a rule obstinate constipation follows an attack. In mild cases the patient endeavors to speak but seems to forget certain words necessary to convey his meaning. Swallowing in severe cases is extremely difficult.

Apoplexy from the bursting of a blood vessel gives sudden and complete unconsciousness, and is usually fatal, some patients dying in four or six hours, most living from three to nine days and a very small number recovering with the exception of more or less paralysis. But no person after a stroke of apoplexy can be considered out of danger until ten days after the attack. A third attack usually proves fatal; unless manifestly brought on by excessive eating. The. older the patient the less chance for recovery.

Treatment.— This depends upon the immediate cause of the attack. If from over-eating, the distended stomach is pressing upon the large blood vessels and causing an excessive amount of blood to go to the brain^[2]. Manifestly in such cases the patient must sit upright, and not be allowed to lie down — that would increase the pressure. Next, the stomach must be unloaded at once — warm water with salt and mustard is most useful. The hands and feet will usually be found cold; bathe them in hot water containing mustard or ginger. Always loosen the clothing about the neck and body and allow abundance of fresh air.

When it is known that the attack is not caused by over-eating, the patient may lie down with the head raised. Enforce quietude and bathe the extremities in hot water containing stimulation. The bowels must be moved — injections of warm water containing salt and ginger being excellent. Days may elapse before improvement is noticed. But the means of relief must be persisted in, and the patient sustained by frequent administration of broths or other soft or liquid nourishing foods. If swallowing is too difficult sustenance by injections must be resorted to. Feeble heart action may be sustained by small doses of an infusion of goldenseal and scullcap or cactus.

The rules to be observed by persons predisposed to apoplexy may be stated as follows: Avoid excessive labor, mental strain, anxiety and excitement. Eat plain food, and that very moderately; subsist mainly on fruits and vegetables. Leave all alcoholic liquors alone. Keep the bowels open, exercise moderately and keep a cheerful disposition— do not quarrel. Never lie down soon after eating, and don't retire at night with a full stomach. Avoid exercise before breakfast and immediately after meals. Avoid hard water, which often makes brittle the blood vessels in some persons; and do not indulge in foods or habits liable to produce fat.

^[1] Apoplexy here refers to what we now call a stroke. Apoplexy now refers generally to bleeding within a non-specific internal organ.
^[2] I did not find any evidence that a stroke could be caused by the immediate effects of over-eating (though obesity is a risk factor). Abdominal blood flow accounts for 25% of cardiac output after eating a meal, and interruptions to the blood supply in that area could cause distension.

Apnoea

This term literally means without breath, and is used to designate the condition which hinders air from entering the cells of the lungs in sufficient quantities to support life. It may occur in the course of many diseases — especially lung troubles. It is also frequent in heart affections, and may likewise be caused by spasmodic closures of the glottis by foreign substances or throat difficulties, or by the atmosphere inhaled being deficient in its proportion of oxygen or containing deleterious gases^[1]. All cases of apnoea must be treated in accordance with the cause of the difficulty as directed in the articles devoted to the various difficulties and diseases in which apnoea is likely to occur.

^[1] Apnea now refers solely to suspension of breathing, not simply oxygen deprivation (which might be better described as hypoxia).

Aphonia

This is a loss of voice caused by local disturbances. It is likely to occur in bronchitis, quinsy^[1], laryngitis and various other affections of the throat, and it must be regarded as a symptom of those difficulties^[2]. It will disappear under the treatment proper for the various diseases with which it is associated.

^[1] Quinsy is an abscess formation in the tonsil area.
^[2] The term dysphonia is typically used to describe the loss of voice resulting from the listed conditions, as some phonation is possible.

Aphasia

Loss of Power of Speech.

This is a loss of the power of speaking^[1], and is usually caused by a lesion in the brain — in the right side of the cerebrum^[2]; or by injuries to certain nerve fibres. In most cases the patient is entirely conscious of his inability and strives to otherwise communicate his thoughts. Tumors, injuries and diseased conditions may be the provoking causes of lesions producing aphasia. The difficulty can be treated only by ascertaining the character and seat of the lesion. Temporary aphasia is sometimes met with in apoplexy, epilepsy, meningitis, hysteria and St. Vitus dance (chorea). Occasionally the intestinal irritation caused by worms or constipation may be transmitted and result in temporary aphasia.^[3]

^[1] Aphasia now refers to losing the ability to speak, read or write - "disturbances in the comprehension and expression of language".
^[2] Prosodic language functions are generally found in the right hemisphere of the cerebrum, but vocabulary and definitions are more often found in the left hemisphere (though there is dependence on handedness).
^[3] I couldn't find any evidence of an intestinal irritation resulting in temporary aphasia. Parkinson's disease can result in both aphasia and intestinal dysfunction.

Anus

Fissures. Prolapsus. Ulceration.

Fissure Of the Anus. — Very pronounced fissures of the anus are frequent in women, the result of accident during labor; such belong to the domain of surgery. But often a fissure or crack in the ring of muscle about the anus may be the result of disease or habit. A small abscess may form and break and be the commencement of a fissure. Constipation and hardened faeces in the rectum may cause great straining in attempts at evacuation and thus lead to fissure. Eczema may also produce the trouble.

Symptoms. — Usually the first knowledge of a fissure is after a movement of the bowels — a smarting, stinging sensation being experienced, and a small particle of blood being noticed. In an hour or so after stool a dull pain, and burning and throbbing will be felt. This may continue for hours. Such sensations return as the result of every evacuation of the bowels, causing the sufferer to become negligent through dread, thus producing constipation and aggravating the difficulty. Persons suffering from fissure of the anus soon acquire an anxious, care-worn look and grow despondent, and serious ill health may follow neglect to remedy the trouble.

Treatment. — Cleanliness and regularity in going to stool are of the first importance. Hardened faeces should not be allowed to accumulate in the rectum, and may be prevented by a liberal diet of fruit and succulent vegetables and doses of physic^[1]. Small injections of warm water just before going to stool and retained half an hour will soften faeces already hardened. Some fissures will heal of themselves, though the rule is otherwise. Witch hazel ointment^[2] is most excellent, and in severe cases a drachm of tannic acid rubbed into an ounce of vaseline will be found serviceable. Some cases will not heal without an operation. The simplest method of restoration is to touch the fissure with lunar caustic^[3], though this may leave a scar which feels unpleasant. The usual operation for fissure of the anus is cutting into the fissure and superficial fibres to the depth of one-eighth of an inch and thus denuding the surfaces, when rest in bed for a week or nine days will permit perfect healing and a permanent cure. Oiling the anus or supporting it by pressure of the finger during evacuation will often prevent fissure.

Prolapsus. — This usually occurs during childhood or old age, and is due to a weakened and relaxed condition of the rectum and its mucous membrane. Constipation and irritation of the rectum or urinary organs may lead to it.

Symptoms. — Falling of the bowels (prolapsus) is readily recognized. During straining at evacuation the rectum seems to turn inside out, and form outside a round or pear-shaped tumor, with an opening in the center, the surface being usually dark red from distended venous capillaries. From one to possibly six inches of the rectum may protrude.

Treatment. — First of all return the bowel to its proper position. This can easily be done by placing the child on its back with the knees apart and after oiling the parts protruding, gently manipulating them back to their proper place. Cover the membrane with the ointment of tannin named for fissure. Keep the liver free and the bowels open. Goldenseal is a good tonic. Maintain proper habits, give nourishing food and plenty of fresh air. The use of a bed-pan is beneficial, preventing prolapsus being aided by gravitation.

Ulceration. — It not infrequently happens that ulceration occurs about the anus, and this may prove very annoying if left unattended to. The first symptoms will closely resemble those of piles, followed by a sense of relief when the ulceration becomes marked, although there will be pain during defecation, and the discharges will be found to contain traces of pus.

Treatment consists of keeping the parts thoroughly cleansed by frequent washing with warm water and castile soap and then annointing with equal parts of tincture of myrrh and fluid extract of goldenseal and applying witch hazel ointment.

Piles. — Hemorrhoids. — These are fully considered in the article on Piles.

^[1] A "physic" refers to a drug with cathartic or laxative effects.
^[2] Witch hazel is an astringent used to treat inflammation.
^[3] "Lunar caustic" refers to silver nitrate, which was used to cauterise skin and had antimicrobial properties.

Aneurism

Bloody Tumor. Tumor of the Artery.

This serious affection is in reality a bursting of the inner coats of an artery causing the force of the blood to bulge outward the remaining coat, thus forming a tumor^[1] or enlargement of the artery itself at some particular spot. The most usual place for an aneurism is somewhere in the course of the large blood vessel leading from the heart, termed the aorta. Some persons are so constituted by temperament, predisposition or disease that the walls of their arteries are unusually thin or brittle and aneurism with them may very easily occur. The most general sources of the difficulty, however, are the accidents incident to severe manual or physical labor. Consequently men in middle life and those engaged in trades requiring heavy lifting^[2] or great exertion are mostly affected. Tight clothing, especially about the chest or neck, may induce aneurism by interfering with free circulation.

Symptoms. — Occasionally there are no evidences of aneurism until the trouble is far advanced; this is especially so when the tumor is deep seated. As a rule there will be local heat, a sense of fullness and weight, throbbing, and tenderness on pressure. Often sufferers wear a peculiar look of illness and distress and appear anxious without knowing the cause of their trouble. They may become sallow and be easily irritated, and yet lose no amount of flesh. They prefer to keep off their back and to have their head pretty high while in bed. Leaning forward and then suddenly throwing the head backward has been mentioned as indicating aneurism when other signs are also present. Also feeling the pulse at both wrists will usually show that it differs in force on the two sides and that the beats are not in harmony. Often the tumor is so large and so located that its enlargement is manifested by external swelling in the region. Usually this swelling is at the lower part of the chest or on one side of the spine. Such a swelling, tender on pressure and throbbing and persistent in character, will point to aneurism.

Treatment. — Quietude and freedom from over exertion and excesses of all kinds are imperative. Avoid stimulation by drinks or foods. Do nothing that would increase the blood supply, though anaemia is not to be induced. Do not drink too freely, even of water. Rest must be secured by very mild nervines. All care must be taken against such circumstances as would increase distension of the vessels and thus lead to rupture of the remaining coats of the affected part. Sometimes the blood in the tumor may be coagulated, especially in small aneurisms, and this should be an object in treatment. Tannic acid has been used to advantage, but by far the best agent, promising the most marked results, is tincture of gum kino. This may be given in ten drop doses in water three times a day. Keep the bowels open and the skin warm and pliant so as to avoid crowding the blood inward. Anxiety, emotional excitement and anger must be avoided. Operations of various kinds are often resorted to and sometimes effectual. They are dangerous and difficult of performance.

^[1] "Tumor" is primarily used to describe neoplasms now, but here it is being used to simply mean swelling.
^[2] The internet has multiple articles linking aneurysms and weight lifting.

Anthrax

Malignant Pustule. Charbon. Wool-Sorters' Disease.

This disease is primarily caused by a micro-organism^[1] which in certain localities^[2] develops upon grass or stalks of grain or hay; thus it finds its way into animals by way of the lungs or stomach and goes through every portion of the body, soon causing death. Their dead bodies and everything the diseased animal came in contact with reeks with contagion. Men who handle them are extremely liable to be poisoned, and even flies from such animals may convey the poison to human beings.

Symptoms. — Wherever the poison of anthrax enters the system, usually at some abraded point on the skin, a malignant pustule is formed on the fourth day after inoculation, and quickly enlarges and ulcerates and looks malignant, and the nearest glands become enlarged. There is general fever and great prostration, which may be followed by collapse and death in four or five days. Cases not fatal do not show general constitutional symptoms greatly, the difficulty being confined to the ulcer, which without aid sometimes heals and the disease disappears, leaving a scar.

Treatment. — As soon as recognized the ulcer must be cauterized — burned out with caustic or red-hot iron. Composition (see formulas) and myrrh must be given internally; the bowels kept open, frequent bathing indulged in and plenty of fresh air provided. Locally compound tincture of myrrh should be applied about the ulcer and, with an equal quantity of hydrastis fluid extract, placed directly in the sore. Ulcers may form in the intestines; they have so far as known always proved fatal. The extreme contagiousness of anthrax should always be borne in mind and the greatest precautions taken in handling cases. The patients themselves should guard against the poison entering the mouth.

^[1] The bacterium that causes the anthrax disease was determined in 1875 by Robert Koch, who also determined the bacterium that caused tuberculosis and cholera.
^[2] Dormant anthrax endospores can even be found in Antarctica, according to Wikipedia.

Anosmia

Loss of Sense of Smell. — This may be caused by blows or falls, inhalations of pungent vapors or irritating substances, or it may be the result of chronic catarrh^[1] or of certain forms of paralysis. Treatment has been very unsatisfactory.

^[1] Catarrh is the inflammation of mucous membranes in cavities of the body.

Anidrosis

Anidrosis is the technical term for diminution of perspiration^[1]. It may be caused by disease of the sweat glands, or it may be a symptom of other diseases. See Perspiration.

^[1] Anidrosis, or anhidrosis, is more commonly known as hypohidrosis now.

Angina Pectoris

Chest Spasm. Breast Pang.

It is supposed that this dangerous and most frightful difficulty is due to spasm of the nerves of circulation and motion due to over stimulation of the vasomotor center. It is not regarded as a disease of itself, but as a consequence of diseased conditions, especially but not necessarily of the heart. There is always contraction of the blood vessels and consequent crowding of blood in the left side of the heart, causing the cavities to become distended and unable to perfectly empty themselves.

Symptoms. — Angina pectoris, or "Chest Spasm," is spasmodic and neuralgic in character. A first attack comes on without warning, usually after exertion, especially after eating, or walking up hill or against the wind, or bicycle riding by elderly persons soon after eating; or an attack may be caused by sudden and intense emotion. There is intense pain near the heart and under the breast-bone. The agony experienced is excruciating and indescribable. A sensation of pressure and constricture about the chest is felt; a feeling of suffocation, although breathing is not really interfered with. Pain may shoot from the region of the heart in various directions, and possibly tingling and numbness of the fingers may follow. There are indications of general disturbance. The pulse, at first strong, soon becomes feeble, or irregular. The countenance assumes an anxious and distressed expression, and the patient realizes the liability of death. The face is pale and covered with perspiration — cold and bead-like — while the rest of the body is cold and dry. Very nervous persons may have chattering of the teeth, and fainting or convulsions may follow. An attack may itself be made up of several spasms. The difficulty ceases as suddenly as it commences; but it is always liable to recur under very little excitement or over-exertion. Death rarely follows the first attack. A short attack may last only five minutes and a very long one two or more hours.

Treatment. — Nitrate of Amyl, or nitro-glycerine^[1] are often administered in very small doses, one or two drops of the former, or a single pellet of the latter. These give relief, but are not sanative agents. Five drop doses of equal parts of compound spirits of lavender and of third preparation of lobelia may be safely administered in frequent doses and will be found a valuable and efficient antispasmodic. In severe cases the same preparation in warm water may be used as an injection to the bowels. If the stomach is filled with indigestible food a quick emetic of salt water and mustard should be given^[2]. The patient should be placed upright in an open place and his clothing about the neck, chest and waist loosened. Hot water to the feet and hot applications or stimulating liniment over the chest will be found advisable. Between attacks persons subject to them should live most carefully and avoid all excesses in diet, habits and emotions. They should carry with them the antispasmodic mentioned in order to ward off the first symptoms of an attack. Rheumatism, gout or heart disease, often the cause of angina pectoris, should be treated appropriately.

False, or Pseudo Angina Pectoris. — This is a disease with symptoms similar to the above, only modified^[3]. It occurs chiefly in women, after a meal, in hysteria, or at the change of life. The absence of intense pain distinguishes it from true angina pectoris. Treatment should be similar in character, only milder. The false is never fatal, although the symptoms are very distressing. Angina pectoris seldom occurs in persons under forty-five years of age.

^[1] Nitroglycerine is a vasodilator that is still used to treat angina.
^[2] People often mistake this discomfort for stomach problems, as vomiting can decrease discomfort. I couldn't find any contemporary evidence in favour of inducing emesis or stomach pumping as a treatment, however.
^[3] Other sources at the time of the author suggest that the difference between "true" and "false", or "pseudo-", angina is the presence of lesions. These type of terms are uncommon now, as undiagnosed angina-like pain would be referred to as something like "left precordial chest pain" before a diagnosis was made.

Ankylosis

Note: The header for this article is listed as "Ankylosis. Anchylosis." in the text.

Stiffness of the Joints.

This is a stiffening of the joints or of some special joint, caused by diseases of the joints, rheumatism, and by keeping a limb fixed in one position. If the stiffness involves the bony union in the joint, nothing can be done to relieve it. If from deposits steaming the part and rubbing over it tincture of lobelia^[1] and then making motion vigorously may break up adhesions. When there is injury near a joint and anchylosis is feared, it is advisable to make proper passive motion frequently. Stiffness of fingers and limbs might thus often be prevented. Serious cases of anchylosis are often overcome by surgical operations.

^[1] I cannot find any evidence that lobeline, the natural alkaloid in lobelia inflata, would have any effect. Lobelia inflata, also known as "Indian tobacco" or "puke weed" is promoted by herbalists for smoking cessation (though is ineffective).

Anasarca

This term is used to designate extensive dropsy of the subcutaneous cellular tissue. See article on Dropsy.

Anaesthesia

Analgesia. Loss of Sensation.

This is a loss of sensation caused by disease of the nerves of sensation, and may therefore occur in any part of the body^[1]. Most commonly anaesthesia of the skin is met with — one half the surface, laterally, may be involved, or the upper or lower part of the body may be affected, or the whole surface. Anæsthesia may be confined to the sense of touch or the sense of pain. In testing for anæsthesia the patient should be blindfolded and various portions of the surface touched with the fingers, pencils, or heated keys or particles of ice. It will often be noticed that only some regions have lost feeling, and thus the exact nerves affected may be traced.

Analgesia is the term used to denote absence of power to realize pain. It may exist even when there is sensitiveness to touch, though usually loss of power to experience touch accompanies it. Blindfolding the patient and then running points of pins in him, or pinching him unawares, will give proof of analgesia. The cause of the difficulty must be ascertained and removed. When due to ''lethargy" of the skin or local causes, baths and friction and stimulating liniments are advisable. Electric baths^[2] are especially beneficial, and the electric brush attached to a battery and used freely over the skin will often accomplish permanent cure. For artificial anaesthesia see section on Remedies and Applications.

^[1] Anaesthesia and analgesia are currently used when discussing 'artificial' or medically induced states, with 'hypoesthesia' and 'hypoalgesia', indicating reduced sensation, now used to describe these somatosensory disorders.
^[2] I suspect the author is referring to what we now call galvanic baths, as opposed to early tanning beds.

Anaemia

Thin Blood. Chlorosis. Green Sickness.

From a great many causes the blood may become impoverished or be altered in character to such an extent as to prevent the proper sustenance of tissues and thus permit degenerate changes to take place. Sometimes the general amount of blood is less than it should be, and again there is a deficiency of albumen in the liquor sanguinis. As a rule the term anæmia is used to designate a deficiency of the red blood corpuscles. The causes of anæmia are numerous; improper diet; too great an amount of starchy foods and too little meats being eaten; deficiency of food; poor surroundings; too little sunlight^[1]; impure air; over study or too great mental exertion with insufficient bodily exercise; too rapid growth; excessive discharges, as in profuse menstruation or chronic abscesses, etc.; all these may bring about anæmia. But there is often anaemia with certain chronic diseases, such as cancer, scrofula, consumption, syphilis, Bright's disease, bleeding piles, etc.; also it may arise from impoverishment of the blood by the use of mercury, arsenic, antimony and other poisons. Men are not as liable to it as women. Girls just after puberty are peculiarly apt to manifest anæmia.^[2]

Symptoms. — Paleness of the face is always present, and general muscular weakness and a loss of energy are complained of, with exhaustion after slight exertion. Cold extremities, fainting, dizziness and palpitation are frequent, the pulse growing weaker and more easily varying as the condition advances. Constipation and headache are almost invariable symptoms. Girls are apt to have a waxy and greenish appearance of the face with the skin extremely soft and loose and the whites of the eyes looking pearly. In long continued cases dropsy may follow and functional derangements of various organs may become manifest; exhaustive diarrhœa may set in, and the peculiarities of appetite may become so great, or the stomach so sensitive that it may be impossible to take sufficient nourishment. Bleeding from the nose is common; and menstruation is interfered with, irregular and deficient in quantity and painful. It is possible for death to occur during a prolonged faint which may happen in severe cases of anæmia.

Treatment. — Rest from compulsory labors, such as business and study, must be obtained. An abundance of fresh air and moderate outdoor exercise should be provided. Going to the sea shore or up in the mountains is beneficial. Sunshine must be admitted freely to the house and must be courted outside. Salt water baths with friction^[3] are of advantage. Nourishing food must be supplied — broths, lean meats, game, eggnog (without alcoholic liquor) and other simple foods should be taken frequently. Care and hygienic measures can be almost entirely depended upon. Medicines may aid. The bowels should be kept open by mild but laxative liver pills. Iron is often praised as a maker of red blood corpuscles, but its reputation is not well founded.^[4] Tartrate of iron and potassa two grains and sulphate of hydrastia one grain, put together in a capsule and taken one hour after each meal, will aid intestinal digestion and thus nourishment will enter into the blood. The Compound Syrup of Mitchella (see formulas) often serves as a good tonic. Of course, if anæmia is the result of cancer, consumption, etc., no medication will avail, Often it is a result, as mentioned, of other troubles which may be overcome, and then the blood with proper care will return to its normal condition.

^[1] Vitamin D, synthesized in the skin with sun exposure, has been linked to red blood cell count in a number of studies.
^[2] Preschool-age children have the highest incidence of anaemia according to the World Health Organization.
^[3] "Friction" here refers to vigorous rubbing with a wet linen cloth.
^[4] Iron supplementation is often prescribed for anemia - iron deficiency is the most common cause of the disease.

Amyloid Disease

Frequently after prolonged suppuration, internal organs undergo a form of degeneration known as amyloid^[1] or lardaceous or waxy, which is liable to occur in phthisis^[2], syphilis and diseases of the kidneys, liver and spleen. It is more fully mentioned in the articles treating of those diseases.

^[1] The grammar here is inconsistent with contemporary use of the word - amyloidosis is the aggregation of amyloids, proteins that have folded and became insoluble.
^[2] Phthisis is more commonly referred to as tuberculosis.

Amimia

This is the loss of all ability to convey thoughts by the employment of gestures and may follow certain injuries or lesions in the brain^[1], the relief of which can alone overcome this peculiar loss of power.

^[1] Amimia appears to be most commonly associated with Parkinson's disease.

Allocheiria

Imperfect Sense of Touch. — This is a rare and peculiar nervous phenomenon in which impressions, such as handling or applications of heat, made upon one side of the body are recognized as though they were made upon the other side. It is caused by sclerosis of the spinal cord or cerebellum, and the treatment for myelitis (chronic inflammation of the spinal cord) is proper to be pursued.

Alexia

Inability to Read. — The loss of all power to read — written words conveying no idea to the patient. The result of lesion in the brain. See Myelitis.

Alcoholism

Acute. Chronic. Inebriety. Delirium Tremens.

The introduction of alcohol into the system always produces unnatural conditions; moderate quantities may cause no immediate appreciable symptoms because vitality may be able to overcome the effects, but in every instance vitality is weakened by the use of alcohol, and sooner or later must succumb in the effort to overcome the effects of the poison. When alcohol enters the circulation it is conveyed to every tissue, doing damage everywhere. It first irritates the nerves, which become depressed; it interferes with the proper oxydation of the blood, prevents normal tissue changes and interferes with nutrition.

Acute Alcoholism. — Persons unused to drinking alcoholic liquors, or those who consider themselves "moderate drinkers," are subject to acute alcoholism^[1], which is commonly known as intoxication. It often presents characteristics of disease which are intense and often dangerous.

Symptoms. — After a period of excitement, drowsiness occurs, more or less profound, and with persons accustomed to drinking recovery soon follows. But with others drowsiness may run into stupor, the extremities become icy cold, breathing is slow and stertorous, and the heart action weak and irregular, the face livid and the lips blue.

Treatment. — An emetic of mustard in warm salt water should be given, or the stomach pump used; then follow by strong coffee, arouse the patient by walking him about, slapping him, or by the application of electricity. Dashing cold water on the head is useful. Follow by small doses of third preparation of lobelia (see formulas), three drops in water; allow quiet after recovery.

Chronic Alcoholism. — Persons who have long been accustomed to the use of alcoholic liquors suffer from this disease in one form or another. All the organs of the body, chiefly the stomach and liver, being affected. Symptoms may be summed up as follows^[2]:

• The stomach is inflamed (gastritis), there is indigestion, disgust for food, nausea and thirst; retching and vomiting in the morning of stringy mucus, often containing blood or shreds of membrane. Ulceration of the stomach is common. Inflammation in the mouth, throat and pharynx is always present.
• The bowels are inflamed and irregular. Stools are very offensive and often contain blood.
• The liver becomes altered in character; the bile may enter the circulation or the organ may become enlarged and undergo fatty degeneration.
• The substance of the kidneys becomes inflamed or profoundly congested.
• The heart becomes weakened and the blood vessels degenerate; hemorrhages in the brain may occur, causing paralysis. The nerves are shattered and will power is lost. Trembling of the limbs and mental disturbances follow. Cowardice, treachery and untruthfulness take possession of the mind and the victim is a physical and mental wreck.
• The outward appearances are familiar to all — bloating, redness of the face and congested veins over the nose and cheeks.

Treatment. — Various combinations of poisonous drugs have been employed to overcome the desire for drink; such as strychnine, atropine, daturine, chloride of gold, etc. These destroy the nervous system and only add to the deplorable condition. The only hope seems to be to confine the victim in some retreat, and there to endeavor gradually to overcome the various disordered conditions of the liver, stomach, bowels, kidneys, etc., and sustain the strength by tonics and most nourishing food.

Delirium Tremens. — This usually occurs after a prolonged spell of drinking in persons already suffering from chronic alcoholism; sometimes it occurs with persons not in the habit of drinking, but who have taken perhaps their first large drink; and again, persons long accustomed to drink and who have been deprived of it may have an attack.

Symptoms. — Premonitory symptoms are usually manifested — sleeplessness, weakness, trembling, fear, bad taste in the mouth, constipation, and bad breath. The attack itself is accompanied by horrible delusions — usually most violent fear of reptiles, devils or other objects about to destroy the victim, who endeavors to escape them. The eyes stare, the body is covered with cold perspiration, the pulse is small and frequent, and violent trembling occurs. These symptoms may last several hours, and be followed by great physical and mental exhaustion.

Treatment. — Perfect quiet must be secured in a room well guarded, for the patient is liable to jump from the window or otherwise endeavor to escape imaginary enemies. For that reason a strong nurse should be present. Arguments are useless, strength alone can conquer. Often it is well to coincide with his ideas and bar the doors and windows and thus encourage the belief that the enemies are without, and he is safe within. Administer a strong infusion of scull-cap and cramp bark^[3] in tablespoonful doses every hour, or by injection every two hours. For the injection half an ounce of each in a pint of starch water is not too much. Give most nourishing food — broths, raw eggs, milk, etc., highly seasoned. Give no narcotic, and above all do not administer liquor to "gradually wean him." Sleep is to be desired, but never by narcotics. The following will be found most excellent to administer in a capsule every three hours for the general exhaustion and heart weakness following delirium tremens: Sulphate of hydrastia, capsicum and salicin, each one grain. Weeks may possibly be required for complete recovery from an attack of delirium tremens.^[4]

^[1] Acute alcoholism is an archaic term, as alcoholism implies dependence. The American Medical Association, for example, defines alcoholism as a chronic disease.
^[2] The list of symptoms remains accurate.
^[3] Scull-cap and cramp bark were both prescribed to treat muscle tension.
^[4] Omitting possible complications resulting from delirium tremens seems strange - the condition had a mortality rate of 35% prior to contemporary intensive care medicine.

Albino

Albinoism. Albinismus.

This is a condition where the coloring material is absent from the various tissues of the body, such as the skin, iris, middle coat of the eye and the hair.

Symptoms. — Partial Albinoism presents a mottled appearance of the skin and is most frequently met among negroes. Persons suffering from general albinoism are termed albinos, and may be of any race.

Their skin will be found very delicate and sensitive and of a peculiar lead white; the iris is pink, and there being no black coating within the eyes the pupil will appear red. The hair is very fine and a pure white or delicate straw color. All these appearances manifest themselves at birth.

Treatment. — So far it has been found impossible to devise any beneficial treatment for albinoism. Its sufferers are regarded as freaks of nature, but that does not imply that they are mentally different from others; only their extreme physical sensibility is apt to prove very annoying to them. They are very sensitive to heat and cold, and are far more liable than others to suffer from disease^[1]. For these reasons parents should take exceptional precautions in guarding albinos and in regulating their diet and clothing.

^[1] Albinism is associated with increased risk of skin cancer and vision defects, but not "disease" in general. Chédiak–Higashi syndrome, which presents with partial albinism, can increase susceptibility to infections.

Ague

Intermittent Fever. Chills and Fever.

Malaria (bad air) is responsible for the great number of cases of ague^[1]. The precise nature of the specific poison which causes ague is not fully known; but it is generally believed to be a vegetable spore^[2], the breathing of which into the lungs causes the poison to enter the circulation and produce disease — the nervous system, the liver and the spleen suffering most. Under the title of Malaria more will be found concerning this specific poison.

Ague proper, or intermittent fever, is a disease which, during its course, manifests itself in paroxysms which occur at regular intervals. The disease is most common in the fall, though when once the poison saturates the system ague may manifest itself at other times.

Symptoms. — Before a paroxysm of ague commences there are usually signs to warn of its approach. These are: A general feeling of lassitude, constipation, loss of appetite and perhaps nausea or sensitiveness of the stomach, a dull headache and dull aching pains in the lower part of the back and possibly in the joints, and a yellow colored fur on the tongue^[3]. These symptoms may last several hours or perhaps several days, and be followed by the paroxysm characteristic of the disease, which may be described as follows:

1. Cold Stage. — A creeping feeling along the back, increasing to decided chilliness, which no amount of heat or clothing overcomes, finally ending in a shaking chill, the teeth chattering, the hands and feet like ice, and the lips and finger tips blue, the face pinched and the whole skin seeming to be shrivelled. Great thirst and headache are present and sometimes nausea and vomiting. Breathing becomes difficult, and the pulse small and rapid and sometimes irregular. Altogether the condition seems to the patient a most deathly one. Its duration varies greatly from ten minutes to four or five hours, when gradually (sometimes suddenly) reaction commences.
2. Hot or Fever Stage. — Usually this starts in with alternate flushing and coldness over various parts of the body, soon developing into intense general fever. The face becomes red and hot and the lips dry and parched; thirst is intense and headache is violent, often causing delirium or convulsions in children; the urine is scanty and the pulse full and strong, the arteries of the neck seeming about to burst. This condition of high fever may last from two to eighteen hours, usually four or six hours.
3. Sweating Stage. — Gradually the skin becomes moist, and, commencing on the forehead, a warm perspiration breaks out and extends over the whole body, becoming very profuse and occasionally possessing a peculiar odor; the urine is passed freely and often has a reddish sediment; all the symptoms of fever subside and the patient usually falls asleep to awaken feeling comparatively well and with a good appetite. With the exception of a general feeling of weakness an intermission (varying in duration in different forms of ague) is enjoyed without any indications of disease.

The length of the intermission designates the class of the paroxysm.

1. Quotidian ague gives a paroxysm every twenty-four hours.
2. Tertian, every forty-eight hours, or every other day (the most common form).
3. Quartan, every seventy- two hours, or every third day.
4. Irregular ague, in which the paroxysms seem to have no definite time of attack.

Treatment. — Ague and quinine or other salts of Peruvian bark^[4] are usually associated in the minds of most people. In households where ague prevails the bottle of quinine will usually be found on the pantry shelf, and sole reliance is placed in from five to thirty grains daily, in small doses, during a "spell of ague." There is no question but that quinine or its equivalent form of Peruvian bark will aid in treatment of ague; but many can not take it, and there are better methods to be adopted. During a first paroxysm little can be done. Always during the cold stage rest and warmth should be provided, and, if the surface is very blue, composition should be given. During the hot stage, hot lemonade with ginger essence or infusion of pleurisy root will hasten the sweating stage of relief. Commencing as soon as the fever is gone tonics should be given in anticipation of another attack. The following will be found a prescription far superior to any salt of Peruvian bark.

Take:

• Fluid Ext. Gentian ... four drachms.
• Fluid Ext. Goldenseal - four drachms.^[5]
• Fluid Ext. Cascara ... two drachms.^[6]
• Salicin ... twenty grains.
• Comp. Tinct. Myrrh ... one drachm.
• Simple Syrup ... eight ounces.

Mix. Take one teaspoonful every three hours during the intermission, and every hour in the day of the paroxysms before the chill commences.

This is bitter, but can be relied upon. Complications may occur during ague, but they must be appropriately treated. Nourishing diet, fresh air and frequent baths should be provided. Removal from a malarial region is of course desirable. Under all circumstances keep the bowels from constipation.

Dumb Ague. — Occasionally a form of ague is met with where the chill or cold stage is not especially marked and the other stages perhaps but feebly manifested. Great depression and dull aching being pronounced in regular paroxysms. Such forms of the trouble require the same treatment as the regular forms.

Ague Cake. — Very often the spleen becomes enormously enlarged in those persons subject to ague, due to the crowding of blood upon the organs^[7], driven inward by the repeated chills and consequent contractions of the surface. In nearly every sufferer from ague the spleen will be found hardened and the liver enlarged.

Anemia following Ague. — Improper condition of the blood and excessive proportion of white corpuscles^[8] may follow ague; giving a pronounced and continued paleness to the countenance. Persons afflicted with ague and coming from a warm to a cold climate, perhaps to escape malaria, are very liable upon exposure to be attacked with pneumonia of a serious nature and often rapidly fatal. Such persons cannot be too cautious in guarding against such a difficulty.

^[1] Ague is an archaic term for the acute, intermittant fever typically associated with malaria.
^[2] Malaria is caused by parasitic micro-organisms. Mosquitoes were suspected to be the transmission vector for these parasites in the late 19th century, with the theory proved in 1987 by Sir Ronald Ross, who received the Nobel Prize for Physiology or Medicine for the discovery.
^[3] The "yellow colored fur" is probably a symptom of dehydration caused by the fever.
^[4] "Peruvian bark" refers to the Cinchona species, a source of quinine, which is still utilised in the treatment of malaria (and has been for almost 400 years).
^[5] Goldenseal, or tumeric root, contains berberine, which has been used in treating malaria.
^[6] Cascara is a common laxative - here used to prevent constipation.
^[7] The spleen is enlarged in chronic sufferers due to the destruction of red blood cells (hemolysis) carrying the parasite within the spleen.
^[8] Hemolytic anemia, again caused by the destruction of red blood cells carrying the parasite.

Agraphia

Inability to Write. — A condition following certain injuries of the brain^[1] by which the person afflicted loses the power of conveying his thoughts in writing. He may even be unable to form a single letter of the alphabet and still realize his inability.

^[1] Agraphia often appears with a number of disorders that can be caused by injuries: aphasia, dysarthria, agnosia, and apraxia. Albert Pitres, a french neurologist, presented a case of "pure" agraphia in 1884, which he saw as evidence of localisation of function within the cortex - function that could be impaired by injury.

Agoraphobia

Abnormal Fear of Strangers.

This is a species of nerve exhaustion, or rather a series of symptoms designating an ill-defined weakness of the brain or spinal cord, or of nerve-ganglia^[1]. The person afflicted fears to walk the streets or fields alone or to mingle in a crowd of strangers, or to travel where unacquainted. Such feelings are uncontrollable and agonizing; they may accompany other diseases, or they may be experienced by persons in apparently good health and for that reason call forth ridicule. But it should be remembered that the feelings are the result of nervous disturbance at some point.

Treatment. — Persons cannot be forced to overcome these feelings, and children especially should be treated with great kindness. The mind must be turned upon other thoughts and tact used in accustoming the person to situations dreaded. Diet should be nourishing; milk and eggs are good. Exercise should be regular in the open air^[2], and an interest awakened that will turn the thoughts to subjects other than self.

Agoraphobia was spelt as agorophobia in the text.

^[1] The attribution of an anxiety disorder to "ill-defined weakness" of the "nerve-ganglia" may seem strange, but the disorder had only been recently been named and described in 1871; and experimental psychology, psychoanalysis and psychotherapy were only recently receiving serious attention. A number of physicians believed that agoraphobia was a form of vertigo.
^[2] Perhaps the author had not encountered a patient with this form of anxiety?

Adenoma

Small Tumors. — These are morbid growths developed from tissues of glands; they are usually common around the throat and are about the size of a bean or pea. They are of no importance^[1]. The same character of growth may be found else-where involving glands that are important. See polypus, bronchocele, cysts, tumors.

^[1] Adenomas, which are benign tumours, may become malignant, or otherwise endanger the patient by compressing adjacent healthy structures.

Addison's Disease

Bronzed Skin. Degeneration of Renal Capsule.

By many this is known as bronzed skin. It is a disease of the capsules^[1] over the kidneys — they undergo cheesy degeneration^[2] and themselves become dark, enlarged and hardened. The cause of the disease is not definitely known^[3], but it is often present during cancer or tuberculosis.

Symptoms. — Great prostration and a bronzed olive-green hue to the skin are the prominent characteristics. The whites of the eyes assume a pearly look. The hands and feet become spotted, and dark spots may be seen about the mouth and on the lips. The heart beat is usually very feeble, especially in protracted cases. There is dyspepsia^[4] and pain over the stomach and in the back. Obstinate diarrhoea and vomiting may be present. Epilepsy or dementia may occur before death.

Treatment. — As far as known this disease is always fatal^[5]. Symptoms point to methods that might be resorted to for relief of diarrhoea, dyspepsia, etc. Hygienic surroundings, nourishing food, frequent baths and the use of tonics may prolong life, but recovery cannot be hoped for.

^[1] The "renal" or "supra-renal" capsules are now referred to as adrenal glands.
^[2] Cheesy degradation presumably meaning that the tissue becomes soft and dry, like cottage cheese (as can be the case with tissue affected by tuberculosis and syphilis).
^[3] The disease is caused by by insufficient steroid hormone production.
^[4] Dyspepsia is also known as indigestion.
^[5] Those with the disease are now treated with some form of cortisol replacement.

Actinomycosis

Disease from Vegetable Fungus.

This disease belongs properly to animals, and is caused by a fungus growth^[1] being established in the tissues and causing irritation and suppuration. Man cannot easily catch the disease directly from animals, the fungus requiring nourishment from vegetable fibre^[2] before it is dangerous to human beings; for that reason persons much about horses or cattle may become afflicted by the habit of eating bits of straws or hay taken from the manger. The fungus is made up of masses of very small particles, and altogether looks like a minute yellow chrysanthemum. The spores may get into the stomach or intestines or the lungs and cause fatal abscesses. Usually they are confined to the tissues beneath the jaw. Abscesses formed have a tendency to open outward. If they can be evacuated and the sacs thoroughly cleansed, recovery will follow; but if they are too deeply internal to be accessible the case is hopeless. Treatment consists of outward applications of compound tincture of myrrh, and the free internal use of composition infusion.

^[1] Actinomycosis was assumed to be a mycosis (fungal infection) because the bacteria responsible formed fungus-like colonies.
^[2] Actinomycosis cannot survive outside mammalian hosts.

Acromegaly

Englargement of Bones

This is an unusual disease, in which the prominences upon the bony structures of the body become enlarged to an enormous extent. The growth may be rapid or extend over several years. The lower jaw and the feet and hands are chiefly affected, though any bony prominence may be involved. The nose and ears may at the same time greatly increase in size. The skin and muscles of the body remain unchanged, which causes the morbid growths to appear Hideous. The sufferer grows distressed and his mind weakens. He usually leans his enlarged head forward, presenting an ungainly sight as it is carried between his enormous shoulders. Nothing is known regarding the cause of the trouble^[1], and no method of alleviation has yet been devised. The patient may live for years, though he is an easy prey to fatal disease; if not, exhaustion eventually causes death.

^[1] The link between pituitary enlargement and acromegaly had been found shortly before the publication of the book, in 1887, by Oscar Minkowski. The nature of the link was debated for some time: some thought that acromegaly was caused by pituitary hypersecretion, some thought hyposecretion, some thought that pituitary enlargement and acromegaly resulted from a nutritional disorder, and some didn't believe a correlation existed.

Acrodynia

Painful Joints. — Acrodynia is a name given to a peculiarly painful disease affecting the joints, causing swelling of the wrists and ankles, accompanied by an eruption and fever. It is mentioned by several authors as identical with breakbone fever or dengue, which is described elsewhere^[1].

^[1] We now know that Acrodynia was caused by mercury poisoning. It has become rare following the removal of mercury chloride (calomel) from teething powders in the 1950s (informed by the discovery of elevated mercury levels in children with acrodynia).

Acne

Blackheads, Pimples, Flesh Worms, Whiskey Nose.

There are several forms of skin disease included under the general name of Acne. They are never fatal, but are very annoying, and cause the afflicted person to present an unsightly appearance. The difficulty is also very persistent, often baffling every endeavor to overcome it.

Acne Punctata^[1] is caused by a retention in the skin of the secretion of the sebaceous glands. This secretion chokes up the little ducts and becomes hardened. These ducts are situated alongside of the hair follicles. The tips of the little masses of hardened secretion become black when exposed to the air, giving rise to the ordinary name of black heads or flesh worms^[2]. Some suppose these are actual worms in the skin, and they do look very much like them, for by pressure the ducts may be emptied of their contents, which look like yellowish worms with black heads. This form of acne is most common between the ages of fourteen and twenty-five, and usually makes its appearance over the face, and sometimes on the chest and back. Sometimes the retained secretion is deeper seated where air and dirt cannot reach it, and it remains white.

Treatment. — Permanent relief can not be obtained until the system is regulated. Over eating and improper diet are often causes^[3]. Eating fats or cheese or rich foods usually aggravate the trouble. Compound Syrup of Stillingia is an excellent internal remedy. Locally much may often be accomplished. Unskillful squeezing out of the "worms," is more detrimental than beneficial on account of increasing the inflammation present. First apply over the affected part a cloth wrung out of very hot water, let it remain a few minutes to relax the structures, then gently squeeze out the accumulations, taking care not to abrade the skin by pins or finger nails, then apply cloths wet with cold water and extract of witch. hazel in which borax has been dissolved.

Acne Rosacea, often spoken of as "whiskey nose," is a condition of enlargement and redness almost invariably at the tip of the nose, often causing the skin to look mottled by the dark blood in the minute venous capillaries of the parts. Indulgence in alcoholic liquors is the usual cause, though derangements through the system of special organs, such as the kidneys, liver and womb, may be indicated by its appearance. From whatever cause, this unsightly appearance of the nose is very annoying.

Treatment. — If from alcoholic drinking, it is an indication that should at once force the drinker to abandon his habit; for acne rosacea always indicates that damage is being done some organ or organs of the body. When caused by diseases of the kidneys, liver or other organic difficulty, the seat of the derangement must be found and attended to as mentioned under general diseases. Often this condition lasts for life despite all treatment, and occasionally it is seemingly inherited. Locally, but little can be accomplished. An ointment of sulphur and a very little boracic acid rubbed up in vaseline could be applied.

Acne Vulgaris very much resembles punctata and appears at the same places, but is a more aggravating difficulty. The retained secretions cause inflammation of a high degree, and as a result there is hardening of the parts or nodules formed in the skin, or else suppuration or pustules. Bad habits may cause acne vulgaris, but not always. Persons of scrofulous tendencies^[4] are most prone to be affected. The disease rarely exists or continues after the twenty-fifth year.

Treatment. — Constitutional treatment, as the use of Compound Syrup of Stillingia, is good. Locally use the treatment for acne punctata, but if the pustules are profuse or the tissues hardened and swollen, as is usually the case, a thin lancet should be plunged into the seat of each induration and then a rubber "cup" applied to draw out the pus and congested blood. This is a most effectual method and should be persisted in until relief is obtained.

Acne Sycosis is a form of acne attacking the hairy portions of the skin. Little tubercles or pustules are formed by suppuration of the hair follicles, and the exudated pus, drying in masses, forms scabs in which the hair becomes matted. Acne sycosis usually occurs on the chin in the follicles of the beard, from which it gets its name of "Barbers' Itch."^[5] It often follows eczema. After the scabs come off scars are left, upon which hair does not again grow, causing an unsightly appearance. By some this is regarded as a parasitic disease. It is contagious, and razors, combs, towels, etc., used by sufferers from it should be carefully kept from others. This disease of itself is never fatal, though erysipelas may follow^[6].

Treatment. — It must be treated about the same as acne punctata, though more energetically. The hairs about the roots of which pustules are formed should be drawn out early, and the pustules themselves pricked as soon as they "come to a head." Persons afflicted with barber's itch should keep well shaven and very cleanly. Borax and ammonia dissolved in water can be used freely to advantage. The following ointment is of great benefit: Take sublimed sulphur, 40 grains; starch, 1 drachm, and mix thoroughly, then add to it glycerine, 1 fluid ounce; borax, 20 grains, previously heated together; rub all these to the consistence of ointment with vaseline. Occasionally persons afflicted with acne sycosis bear the appearance at first glance of those afflicted with small-pox or with syphilis. But it may be always readily known because it attacks only hairy parts. Persons who never shave may have the disease, and women may have the difficulty make its appearance among the hairs of the temples.

^[1] Acne punctata seems to be an archaic term, referring to acne with black open comedo (blackheads).
^[2] There are surprisingly few hits in search engines for "flesh worms", thankfully. I refuse to believe that anyone was under the misapprehension that they were actually worms - the disease is just too common.
^[3] The role of diet in acne is still controversial.
^[4] "Scrofulous tendencies" referring to mycobacterial cervical lymphadenitis, or scrofula, as opposed to morally degenerate tendencies. Historically thought to be curable by a royal touch.
^[5] Acne sycosis also seems to be an archaic term, referring to a form of folliculitis known as sycosis vulgaris. Other conditions known as "Barber's itch" include pseudofolliculitis barbae (PFB) or tinea barbae.
^[6] Erysipelas is an acute infection of the upper dermis.

Abscess

Acute and Chronic, Superficial and Deep-Seated.

An abscess is an accumulation of pus at some particular spot, the pus being formed by the degeneration of tissue the result of congestion. Abscess may be caused by obstructions to the circulation, injury, irritation from foreign bodies or the absorption of poison, as in dissection work.

Acute Abscess.

Symptoms. — The formation of an abscess is preceded by pain, inflammation, redness, heat and swelling and in deep-seated abscess there may be general fever — the temperature perhaps reaching 104°^[1]. The swelling, hard at first, gradually softens before destruction commences. The brighter the redness the smaller will be the abscess, and the softer the feeling and the darker the appearance the more extensive will be the destruction of tissue. When pus begins to form there is usually a pronounced chill and a local throbbing, with increasing and constant pain. The pus always endeavors to get to the surface, causing elevation and a point to be raised which eventually ulcerates and bursts, allowing the pus to be naturally discharged. The deeper seated the abscess the longer will it be in "coming to a head," and the more liable is the pus to become poisonous. Thick yellow pus is termed "healthy," and after it is discharged healing is usually rapid. Thin, greenish or watery pus is always bad, indicating prostration and difficulty in after healing.

Treatment. — If there is much fever, sweating should be induced by the use of diffusive drinks, such as ginger and sage or pleurisy root tea. In large abscess where the surface is dark, composition (see formulas) should be used freely. Poultices of ground flax seed, sprinkled over with lobelia and golden seal will hasten pus toward the surface. After an abscess is opened dressing of poultices are usually sufficient. Keep the wound open by gentle pressure occasionally^[2], and if there is a tendency to degeneration, shown by a dark look of the part, compound tincture of myrrh should be used freely around the opening, and when the pus is poisonous, the tincture diluted can be injected into the wound by a small syringe. Deep seated or extensive abscesses should be opened with a thin and sharp pointed surgical knife as soon as pus forms, taking great care to avoid injuring blood vessels and important structures.

Chronic Abscess.

When the system is in an unhealthy condition during an ordinary abscess, a chronic abscess may result. Scrofulous persons are liable to be such sufferers. Decay of a bone, or of a small particle of bone broken off by fracture may likewise cause chronic abscess. The duration of such a trouble is very protracted, possibly continuing for years. When caused by bone decay there is usually considerable pain, and when there is an involvement of the nerve, spasms are liable to occur. Chronic abscesses may burrow into important structures and cause death, or decomposition of pus may cause fatal trouble, preceded by hectic fever, septicaemia, etc.

Treatment. — Ascertain the cause and remove it if possible. Pieces of decayed bone should be extracted. If there is a tendency to septicaemia, composition should be used freely, and the compound tincture of myrrh externally and internally. Do not open such abscesses prematurely. Let the diet be plain but nourishing, and keep the bowels open and the habits regular and temperate.

Abscesses in Special Localities.

An abscess may form in any organ as a result of injury or disease or obstructions to free circulation. The brain, stomach, liver, kidneys, spleen, bowels and lungs are especially liable to abscesses, and descriptions of these difficulties and their treatment are given in the articles upon diseases of those organs. Faecal abscess is mentioned under Appendicitis, and strumous abscess in the article on Scrofula.

^[1] 104° Farhrenheit is equivalent to 40° Celsius.
^[2] Conventional wisdom instead suggests that closing an abscess after draining improves healing.

Abortion

This accident^[1] not infrequently happens during the course of acute or chronic diseases. It is especially liable to occur during small-pox, relapsing fever, bilious-remittent fever, syphilis, St. Vitus dance^[2] and infectuous diseases. Its proper treatment is given in the article on Abortion in the section on Diseases of Women.

^[1] Spontaneous abortions are increasingly referred to as miscarriages, even in medical literature. There is a lot of literature discussing the use of "sensitive language".
^[2] St. Vitus Dance is a horrible archaic term for Sydenham's chorea, which is characterised by rapid, uncoordinated jerking movements.

Abdominal Injuries

Bruises, Contusions, Incisions, Lacerations.

The abdomen is liable to be injured in various ways; and if extensive injuries are neglected or improperly treated fatal results may follow. Falls and blows upon the abdomen may cause but slight external indications while they may severely injure internal organs. Deep seated pain, especially of a dull character, increased by pressure, and following - an injury to the abdomen, would point to internal difficulty. When pain becomes intense and of a throbbing nature, preceded by chills and some fever, several days after the injury, internal abscess should be suspected.

Incised wounds and larcerations are extremely liable to produce peritonitis^[1], which is fully described under the article on Peritonitis. In all such cases the greatest precautions for quietude and cleanliness should be taken, and the case placed in the hands of a skilful surgeon at once^[2].

Bruises and contusions require immediate applications of cold compresses; but if these have been neglected in the start hot compresses are best along with applications of stimulating liniment.

^[1] Peritonitis is an inflammation of the peritoneum, the tissue surrounding abdominal organs.
^[2] The first recorded laparotomy (done for exploration and lavage of the peritoneum) appears to have been performed "in the backwoods of Kentucky in 1807".

Abdominal Dropsy

This condition is technically known as Ascites^[1]. It is usually dependent upon diseases of the liver or portal vein, or of the kidney or the peritoneal membranes of the abdomen. In all cases the accumulation of fluid is the direct result of pressure upon the veins. For descriptions of symptoms and treatment, see article on Dropsy.

^[1] A number of societies have considered ascites as a divine punishment for oath-breaking.

Abdomen in Disease

Tenderness. Local and General Enlargement.

The abdomen is the portion of the body between the chest and pelvis, and encloses the large cavity containing the digestive and urinary organs and a portion of the generative organs. It is evident that many conditions of the organs mentioned will produce noticeable abdominal symptoms, and the observation of these and of their particular localities and characteristics will often lead to the recognition of the seat and nature of diseased conditions.

Tenderness usually denotes inflammation. If the tenderness is superficial the muscular structures only are involved; but if it is deep seated and increased by continued pressure the internal organs are affected.

Local enlargement of the abdomen is very frequent. If it is in the upper and center portion, the stomach is usually affected. If it is upon the right side, the liver is involved. If it is upon the left side spleenic trouble should be suspected. If it is toward the groins, ovarian troubles or appendicitis or obstructions of the bowels may be the cause. If it is low down, the bladder or the womb may be the source of trouble.

General enlargement of the abdomen may be due to inflammations of the bowels or womb or peritoneum (peritonitis). Dropsy^[1] may also give general enlargement; but in that case a doughy feeling and fluctuation may be readily recognized. Pregnancy will, of course, enlarge the abdomen, and in the cases of women, must always be borne in mind when no other cause of the enlargement is manifest.

Many acute diseases are at times accompanied by abdominal enlargements, and such enlargements are usually of serious import. They not infrequently occur in typhus and typhoid fever. But it must be remembered that abdominal enlargement does not always signify serious difficulties; for instance, it usually accompanies ordinary colic, from the intestines being distended with gas.

Treatment. — It is evident that no general treatment can be given for the removal of abdominal symptoms, as they may be the result of a variety of causes which must be removed according to the treatment given for the diseases of the special organs affected. But, as a rule, tenderness and pain in the abdomen, accompanied by enlargement may be relieved by the outward application of stimulating liniments or washes, or the laying on of flannel cloths wrung out of hot water, or the application of mustard^[2] or capsicum plasters^[3]. Such relief would, of course, be but temporary when deep seated organs are involved. To resort to the use of hypodermic injections or other methods of using opiates, would be more detrimental than beneficial.

The opening advice of the "diseases and treatment" section!

^[1] Dropsy, or what is now known as edema, is swelling due to an abnormal accumulation of fluid beneath the skin.
^[2] Mustard plasters, or sinapisms, can cause blistering of the skin. The intention is to improve circulation
^[3] Capsicum plasters seemingly remain in use within Korea for prevention of sore throats, vomiting and nausea, and post-operative pain.