(b) CHRONIC ABSCESS first appears as an indistinct tumour, the fluctuation being more or less marked according to the distance from the surface. The inflammatory symptoms of the acute variety are altogether absent, unless the disease be far advanced or accidentally irritated.
ABSCESS AND DISEASED BONE- Chronic Abscess is sometimes a consequence of Inflammation of bone. This may be suspected whenever persistent inflammatory enlargement and tenderness exist, especially it it can be traced to an injury, and there is a fixed pain at one particular spot, which is increased at night. Often requires surgical measures for its relief and cure.
MAMMARY ABSCESS- gathered breast is specially treated of in “The Lady’s Homoeopathic Manual.”
CAUSES- Abscesses, with few exceptions, are indicative of constitutional debility, and are a frequent sequel of low exhausting fevers. Sometimes they result from blows, or from foreign bodies introduced into the skin or flesh splinters, thorns, etc.
Diseased bone, as stated above, may cause Abscess, or inflammatory enlargement of a part.
EPITOME OF TREATMENT:-
1. Before suppuration- Aconite, Belladonna, or Mercurius Lint saturated with a lotion of the same remedy as administered may be used locally.
2. During suppuration- Hep-S., Silicea, Arsenicum, China.
3. After suppuration- Calc-C., China, Ac-Phosphorus, Sulphur, etc.
LEADING INDICATIONS- Hepar Sulph. This remedy promotes the suppurative process in acute Abscesses, and is frequently sufficient. The local measures pointed out further on should be adopted.
Silicea- Tardy, long-continued discharge chronic Abscesses and Abscess of bone. It facilitates suppuration, or moderates it when excessive.
Mercurius- Painful Abscess, with copious discharge of thick matter; chilliness, with thirst, and nocturnal aggravation of the pains.
Belladonna- Severe pains, Headache, and much constitutional disturbance.
Arsenicum- Severe burning pain, with symptoms of general vital depression Abscess having a gangrenous appearance, or discharging pus tinged with blood.
China- Abscesses following prolonged disease; prostration, from excessive discharge of matter or blood, Diarrhoea, etc. It generally sustains the constitution during suppuration.
Calcarea- This remedy assists the healing of the Abscess after suppuration is completed, and the elimination of disease from the constitution.
Aconitum- Well-marked, feverish symptoms, during any stage of the disease.
LOCAL TREATMENT- In the early stage, when suppuration is doubtful, treat as for acute inflammation with hot fomentations frequently repeated. Abscesses arising from local injury should be freed from all sources of irritation, such as thorns, splinters, etc. Fomentations relax tension, and, consequently, relieve pain; if applied directly an Abscess begins to develop, they will either disperse or restrict the formation of pus. If suppuration have proceeded too far to be arrested, fomentations facilitate the progress of the pus to the surface and its ultimate expulsion.
OPENING OF ABSCESSES- When the presence of pus is clearly indicated, it ought to be let out by incision. The latter relieves all the symptoms quicker, accelerates healing, and much less scarring will remain when healing is complete than if the abscess be left to burst spontaneously. An abscess left to itself may, moreover, discharge into some internal cavity, where the result may be serious. For those who dread pain even in the trifling operation here referred to, the use of local anaesthetic agents is recommended.
After an Abscess has been opened, and it contents discharged, the Calendula lotion (one teaspoonful of the tincture to three tablespoonfuls of water) greatly expedites recovery. It may be applied on a fomentation, covering it with oil-silk. The dressing should be renewed two or three times a day.
DIET AND HYGIENE- As Abscesses are generally indications of debility, a liberal allowance of nourishing food is of great importance it should include good animal broths, broiled mutton chops, chocolate or cocoa, and, in some cases, but rarely, good bear or wine. Change of air, with residence by the sea-side or in the country, forms an important part of the hygienic treatment.
233. Ganglion.
DEFINITION- A Ganglion is a small swelling, filled with fluid or jelly, formed on one or more of the tendons, frequently of the back of the wrists, rarely larger than a child’s marble, generally smaller, attended with weakness, but free from pain.
CAUSES- Protrusion of the lining synovial membrane through the fibrous tendon sheath. Ganglions are often seen in pianists who practise many hours daily. But they are not confined exclusively to this class of persons.
TREATMENT- (1) Subcutaneous rupture by pressure. (2) Puncture followed by pressure. (3) Excision. A method suggested by Dr. Clifton, of Northampton, is the internal and external use of Benzoic Acid; 2 drops of the 2x dil. thrice daily. For external use Benzoic Acid, gr. iij. Glycerine Cerate, 3zj.; to be well rubbed into the part morning or night. Phyto. and Mez. are also efficient.
234. Obesity Corpulence.
DEFINITION- The excessive accumulation of fat under the skin and around the organs of the body, so as to exercise a prejudicial influence on the health, usefulness, or comfort of the patient. It is not a favourable condition for resisting disease.
Obesity may be said to exist only when fat is present in such large quantities as to disqualify the person for performing the various duties of life, by occasioning difficulty of breathing, panting on slight exertion, deranging the circulation, and causing various functional disturbances, with diminution of mental and bodily activity. The term Corpulence is restricted to cases in which the quantity of fat is not so great as to amount to positive inconvenience or discomfort.
CAUSES- Hereditary tendency or constitutional predisposition can alone account for the excessive accumulation of fat in many instances. Some persons are naturally fat, others lean; some become corpulent on a moderate diet, others spare in the lap of luxury. These are matters of common observation, but which we can offer no explanation. Age exercises considerable influence; children are usually fatter than adults after the middle period of life, fat often accumulates in considerable quantities. In old age, however, the adipose tissue, and the fat it contains, generally diminish. Race, again, is an important element in the question. The Americans are remarkable for their leanness, and the Arab is almost destitute of fat; Europeans, and especially the English and the Dutch, on the other hand, are proverbially fat; hence, John Bull is always pictured excessively corpulent.
Besides individual or accidental causes of corpulency, the following circumstances directly influence the production of fat. Food, rich in hydrocarbons; for although a certain amount of such food is necessary to maintain the temperature of the body, if it be taken in excess, such excess is often stored up as fat. Ease of mind and repose of body are conditions highly favourable to the formation and accumulation of fat; whereas anxiety, fretfulness, night-watching, etc., have a directly opposite effect. Thus science proves the truth of the adage “A contented mind is a continual feast.” A comfortable temperature is an important element in the production of corpulence; for although a high temperature does not directly engender fat, it is a condition favourable to the formation of fat, and one in which less is consumed.
TREATMENT- The treatment of Corpulence brought prominently before the public by the late Mr. Banting, ( *See the Fourth Edition of Mr. Banting’s pamphlet.) in the simple story of his remarkable experience, proves that a proper diet alone is sufficient to remove the condition, with its long train of evils, without the addition of nauseous drugs, or of those active exercises which it is in vain to instruct unwieldy patients to take.
The chief feature in the Banting dietary is the exclusion of two elements starch and sugar from the ordinary food of a well-to-do gentleman: Bread, (except toasted, or the crust off a common loaf), potatoes, sweet roots, butter, sugar, cream, beer, port and champagne.
These articles of food and drink contain starch or saccharine matter and are the chief fat-producing elements in our dietary, and to relinquish them is often the only means necessary to escape the thralldom of corpulence. In one year, on this diet, Mr. Banting reduced his weight 46 lbs. and his bulk about 12 inches; at the same time his numerous corporeal infirmities were greatly mitigated or altogether removed. Seven years afterwards he wrote:-
“I can conscientiously assert that I never lived so well as under the new plan of dietary, which I should formerly have thought a dangerous, extravagant trespass upon health; I am very much better, bodily and mentally, pleased to believe that I hold the reins of health and comfort in my own hand.”
The “Plan of Dietary” suggested in Secale 2, with the sugar, butter, cocoa, superfluous bread, potatoes, etc., eliminated from it, would meet the requirements of most corpulent persons admirably. A Banting diet cannot, however, be recommended indiscriminately. Persons who may deem it necessary to make great changes in their diet should consult a physician.