2. Second stage- Arsenicum and Mercurius alt. 2 hours; Coffea (nervous and restless at night); China.
3. Third stage- Arsenicum and Crot. (alt. 2 hours; interposing only such remedies as are called for by urgent symptoms). Crot. is one of the best indicated and successful remedies for severe cases, and can be given early as well as late in the course of an attack. Black vomit, Cadmium Sulph.
4. Prophylactics- Aconite, Cimic., Baptisia
ACCESSORY TREATMENT- There is good reason to believe that the disease is not conveyed by clothing or fomites generally. Nevertheless naturally discharges from the patient, and all soiled articles should be quickly disinfected and removed, and the air of the apartment kept as fresh and untainted as possible. During the chill, a hot mustard foot-bath, repeated in a short time if necessary, often gives ease. A copious injection of warm soap-suds, to relieve the lower bowl, and frequent cold sponging of the whole body with tepid water acidulated with vinegar, to relieve the burning heat are also advisable. The diet in this stage should be a few water biscuits, soaked in weak black tea. In the second stage, rice, milk, and arrow-root may be added to the diet. In the prostration of the third stage, champagne, beef- tea, and wine-whey may be necessary.
256. Dengue.
DEFINITION- An acute infectious disease of tropical and sub- tropical regions, characterized by paroxysms of fever, pains in joints and muscles, and a variable skin eruption. It occurs in India, East Indies, and has occurred in Southern U.S.A. in various epidemics; also in Egypt. It spreads very rapidly, and is almost universal in its attack, but rarely fatal.
SYMPTOMS- A period of Incubation of three to five days is followed by headache and intense aching pains in joints and muscles. The temperature rises gradually and the usual accompaniments of fever, loss of appetite, coated tongue, etc., are present. The skin shows an erythema at first, and later usually a variable eruption, like measles or papular, or (rarely) vesicular. An attack lasts seven or eight days, and is followed by considerable prostration. Haemorrhage may occur from mucous membranes. From the occurrence of gastric haemorrhage, the disease has been mistaken for Yellow Fever now and then.
TREATMENT- The disease is very like Influenza in its symptoms, and the remedies likely to be useful can be compared with those generally indicated in Influenza. At first Baptisia or Gelseminum is likely to be required; later, Eupatorium, Cimicifuga, Arsenicum. For the subsequent prostration Ac-Phosphorus, Lecithin, Avena, Psorinum will come to be considered. The accessory treatment should be that common to febrile disorders.
257. Tropical Dysentery.
This is of two kinds: (a) Amoebic; (b) Bacillary.
A.- AMOEBIC DYSENTERY.
DEFINITION- An inflammation of the colon, or large bowel, caused by a specific amoeba. There is a special liability to abscess of the liver.
The disease is widely prevalent in India, Egypt, and tropical countries. It occurs also in the United States. The organism is readily found in the discharges and the diagnosis thus confirmed. The lesions consist of inflammation with ulceration of the mucous membrane of the large intestine. If the ulcers heal and recovery ensues stricture may result from the contraction of the scars.
SYMPTOMS- Acute cases begin suddenly, with pain and tenesmus. The stools are bloody or mucous and bloody. There may be nearly constant tenesmus and passage of a little blood and mucus every few minutes. The temperature is seldom high, but exhaustion and emaciation is rapid. Death may occur within a week from exhaustion, or from extensive haemorrhage or perforation and peritonitis. Recovery may ensue or the disease become chronic with alternating periods of constipation and diarrhoea, the later with frequent passages of blood and mucus and much pain. In these cases the nutrition is sometimes fairly well maintained. The tongue is often red and glazed. If the amoebae are conveyed to the liver by the portal vein an abscess may form. Its formation is accompanied by pain, fever and sweats, and the liver dulness will increase upwards or downwards. It may rupture into the lung with profuse expectoration of so-called “anchovy sauce” sputum.
TREATMENT- Rest in bed and liquid diet, or at least very light diet, is indicated. Hot application to the abdomen, especially flannels wrung out of very hot water with a drop or two of turpentine sprinkled on, are grateful.
MEDICINAL TREATMENT- Emetine is almost specific and should be given hypodermically in one grain doses for six to twelve doses repeated if necessary. Where abscess of the liver develops Emetine should also be given and surgical aid at once sought.
B.- BACILLARY DYSENTERY.
DEFINITION- An inflammation of the large intestine causing an acute disorder with frequent passages of blood and mucus. The intestine is not deeply ulcerated in this form as it is in form A, but acutely inflamed with superficial necrosis of tissue. The disease is caused by the bacillus dysenteriae. There are several varieties of the germ. By a blood test the diagnosis can be confirmed and by cultivation of the bacillus. This form of the disease occurs in temperate as well as in tropical climates, frequently in epidemics.
SYMPTOMS- There is a period of incubation of forty-eight hours. Then pain in the abdomen, slight fever, frequent stools; mucus appears in the stools almost at once, and blood very soon. The temperature rises, the tongue becomes coated, pain increases; delirium may ensue, and death on the third or fourth day. The patients become very emaciated. The attack may linger in a sub- acute form for weeks. Peritonitis or abscess of the liver is rare.
TREATMENT- Rest in bed and light diet or liquid diet. Warm applications to the abdomen. Large rectal injections have been extensively used.
MEDICINAL TREATMENT- Homoeopathists generally have found Mercurius Corr. a prime remedy, and Dr. Ringer has endorsed its value from the other side. Its special indications are: constant cutting pains; intolerable tenesmus and straining; frequent discharges of blood and mucus; (<) after midnight; scanty urine; pains in rectum unrelieved by stool. Other remedies to be considered for acute cases are Arsenicum (stools more watery and offensive, burning pains); Baptisia (great prostration and fever); Carbo-Veg. (collapse); Dioscorea (very violent pain and tenesmus); Kreosote, Lachesis Phosphorus (painless discharges).
258. Asiatic Cholera.
This disease though now rarely seen in temperate climates, has nevertheless at different times spread widely in Europe. It is therefore considered among the General Diseases in the earlier pages of this volume.
259. Plague.
DEFINITION- A specific disease, due to a bacillus (B. Pestus), characterised by inflammation of the lymphatic glands (buboes), carbuncles, pneumonia and frequently by haemorrhages.
This disease is of ancient date, having been known since the sixth century at least. At different times epidemics of it have devastated Europe; the most famous being the “black death” of the fourteenth century. After 1665 its ravages greatly lessened and in Europe it is now all but unknown, but in the East, especially during the last twenty years, it has been a great scourge, China and especially India are the chief seats of it, and in the latter it is a problem of the first importance. Outbreaks have occurred in Egypt, South Africa, San Francisco and Sydney, and cases have occurred in Glasgow (1900) and other English ports, but whenever sanitation is efficient the disease can be quickly checked, and not many Europeans contract it. The cause of the disease is a specific bacillus, and the rat appears to play a great part in the spread and transmission of the disease, by means of its parasitic fleas which carry the germ. Cleanliness, fresh air, and other sanitary measures are powerfully inimical to it.
SYMPTOMS- The disease begins with headache, back-ache, stiffness, anxiety, restlessness, depression. The temperature rises steadily for three or four days, then may drop slightly. A secondary fever rising even higher than the first may supervene. Collapse and death frequently follow. The swelling of the lymph glands (buboes) appears from the third to the fifth day. The glands in the groin are usually the ones affected, but glands elsewhere may suffer also. The glands may subside or suppurate, suppuration is regarded as a favourable feature. Defoe notes this in his account of the plague of 1665. Petechiae (haemorrhages under the skin) are very common, and may be large; haemorrhages occur often from mucous membranes.
A septicaemic form occurs with death in three or four days before the buboes appear. Haemorrhages are common with this form, and Pneumonic plague, with pneumonia, high fever and haemoptysis, is also very fatal (ninety-six per cent. of deaths). Sometimes there is diarrhoea and other symptoms analogous to those of typhoid may appear.
TREATMENT.- In the early stages of an outbreak the diagnosis turns on the recognition of the bacillus and the prompt segregation of infected and possibly infected persons. The disease has been acquired by bacteriologists working in laboratories, but with precaution the risk can be reduced. When the disease is recognised besides isolation of patients and contacts most thorough disinfection of clothes and all evacuations (stools, sputum, etc.) should be practised. Dead bodies should be cremated. As stated above sanitary measures have proved effective in Europe, America and Australia, but in India what has been done in this way has had less obvious results; but the difficulties in the way of efficient sanitation are great.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."