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.