CHAPTER I GENERAL DISEASES.
A: BLOOD DISEASES
6. Small Pox (Variola).
VARIETIES. This highly-contagious disease is termed discrete when the pustules are separate, and confluent, when they run into each other, and form continuous suppurating surfaces.
SYMPTOMS. The attack commences like most other fevers, and about twelve or fourteen days after the reception of the poison. There is chilliness, heat, headache, a thickly furred, white tongue, a deep flush upon the face, a feeling of bruised pain all over the body, but especially in the back and loins; more or less pain or tenderness at the pit of the stomach, and sometimes vomiting. When the pain in the back and vomiting are violent, they may be regarded as the precursors of a severe form of the disease. On the third day the eruption appears in the form of red spots, or small hard pimples, feeling as though they were shot in the skin. It first comes out on the forehead and front of the wrists, is gradually extended over the body, and may also be seen upon the palate. The eruption being completed, the fever subsides, the pustules begin to fill like boils, are depressed in the centre, and surrounded by a circular inflamed ring. The eyelids, face, and hands are swollen and often the features obliterated. A peculiar disagreeable odour now begins to emanate from the patient, which, once smelt, cannot easily be forgotten. In about eight days from the first appearance of the eruption, the pustules break and discharge their contents; scales then form, which dry up, and, in a healthy state of the constitution, fall off in the course of four or five days, leaving purplish spots, which do not fade away before the sixth or eighth week.
DIAGNOSIS. In the early stage, Small-pox is chiefly distinguishable form the other eruptive fevers by severe pain in the back, and vomiting; also by the sensation which is given by the dots to the finger, as if small shots were embedded in the skin: this latter is a most useful sign by which to determine Small-pox from Scarlatina and measles.
DANGERS. The greatest danger arises from the secondary fever, about the ninth to the twelfth day, when the pustules are ripening; for then the fever is likely to return, after the vital strength has already been much exhausted. In a confluent case, fatal chest symptoms, or Laryngitis, may arise; or the pox may be followed by Abscesses in various parts of the body; or there may be ulceration and opacity of the cornea and loss of sight.
TREATMENT. Antimonium Tart. This is a prominent remedy in the disease, and often strikingly relieves the spasmodic retching, nausea, and hoarse cough, which are often very distressing. Anti- Tart. should therefore be given directly if Small-pox is suspected, either alone or in alternation with one of the following remedies.
Aconitum, every third hour, for fever, headache, and restlessness if the pulse be not lowered or the skin moistened. Veratrum Viride (1x), in hourly drop doses, should be resorted to if there be much sickness with the fever, and very rapid pulse. See also Belladonna
Belladonna. Stupor or delirium, severe headache, or Ophthalmia, Belladonna has a direct action upon the brain: it also tends to retain the eruption upon the surface.
Apis. Considerable swelling of the face and eyelids. If the swelling be attended with hoarseness and pain in swallowing, Apis and Bell, should be alternated.
Mercurius. Ulcerated throat, enlarged glands, salivation, and diarrhoea, the stools being bloody.
Rhus Tox. Valuable during the eruptive stage, when there are severe pains in the loins and back, and marked prostration.
Coffea. Much restlessness and inability to sleep. A few doses only will be required.
Carbo Veg. Low typhoid symptoms, with a tendency to putrescence. Tincture of Sulphur is also very valuable. The latter should be administered during convalescence to prevent sequelae.
1 See also Nursing, Diet, etc., for the sick, pp. 73-87. As soon as the eruption appears, the patient should be placed in a moderately dark room, in which there is ample provision made for the uninterrupted admission of fresh air, and the free escape of tainted air; if possible in a room with opposite windows, and these should be kept open day and night in all seasons. If the weather is very cold, a good fire should be kept in the room, and the windows left open, the patient having an extra blanket to avert cold; if the weather is mild, the patient should be absolutely treated in the open air. “Nothing is of so much importance as pure air, and that in unlimited quantities.
In this hospital we have kept our windows open constantly by night and by day throughout the months of February, March, April, etc.; and this has been attended with the very best results, for our Mortality is the lowest of all the Small-pox hospitals in London, and we were receiving our patients from the same sources, and some time before this epidemic reached its height.” 1 Dr. A. Collie, formerly resident Medical Officer of the Homerton Fever Hospital. The patient should be kept cool, and the sheets and linen be frequently changed.
The posture of the patient in bed should be frequently changed, so as to avoid constantly lying on his back, or on particular parts, otherwise troublesome bed sores will be formed. The diet should be liberal, as the disease is an exhausting one, but it must be given in such a form as to be readily digested and absorbed; it should include a liberal allowance of milk diluted with about one-third soda- water, raw eggs beaten up with milk (cold), beef-tea, arrow-root, sago, etc. Tea or coffee, in moderation, is often graceful and useful; but to quench thirst, nothing is more pleasant and refreshing than pure cold water.
Any objection to cold water on the part of nurses or friends is to be firmly combated. Lemonade, soda-water, and other effervescing drinks may also be allowed. As soon as the eruption is well out, the whole surface should be smeared over with bacon-fat. the anointing being repeated twice or thrice daily. A piece of boiled bacon cut horizontally, leaving about a quarter of an inch of fat adhering to the skin, may be used to anoint the eruption. It completely prevents pitting, and allays irritation. As the pimples begin to ripen into pustules, and before they break, the skin should be sponged with glycerine and rosewater, in equal parts, and directly after- wards, by the aid of a soft puff, the skin covered with a powder prepared by mixing one part of the 1st trituration of Tart. Emetic with eight of violet powder.
The glycerine-water causes the powder to adhere, and pitting is effectually prevented. The process should be repeated as often as necessary. If the patient is a child, his hands should be muffed to keep him from scratching, which might lead to ulceration. Two or three times a day, whenever the skin becomes hot or irritable, great relief will be afforded by sponging it with tepid water, in which carbolic acid has been mixed in the proportion of one to sixty. Tepid sponging adds much to a patient’s comfort; it also hastens convalescence. When the pustules have burst, powdered starch should be freely applied, to absorb the matter.
FOR GENERAL TREATMENT See pp. 73-87.
This is the process by which the disease Vaccinia is artificially introduced into the body for the purpose of protecting it against Small-pox.
The performance of this great preventive is now rendered compulsory during the first three months of infancy. In performing vaccination there are four precautions to be observed: (1) The vaccine lymph should be taken direct from the calf, or, if this is not possible, from a child free from Scrofula or any constitutional taint. (2) The lancet employed should be absolutely clean. (3) The matter should be inserted in three places in the left arm, or whichever arm comes least frequently in contact with the nurse’s body. Much care should be taken to avoid rubbing or irritating the vesicles. If the operation is successful well-marked scars will be left. (4) It should be repeated at the age of puberty, the great changes which take place at this period of life rendering its repetition necessary.
8. Chicken-pox (Varicella)
On the second day of a slight fever an eruption appears similar to that of Small-pox, for which it may be at first mistaken. But it differs from Small-pox (1) in the mildness of the fever which attends it; (2) in the appearance of the eruption on the trunk first, on the face afterwards; (3) in the rapid appearance of the spots twenty-four hours: (4) in the spots having no inflammatory ring around them in the first stage; (5) in the vesicular character of the eruption, the spots of which become filled with a watery fluid about the second or third day, which is rarely converted into yellow matter; (6) in the absence of hardness to the touch; (7) in the absence of odour; and (8) in the rapid course of the complaint. Generally in the third day the pustules dry up, forming crusts or scabs, but no pits.
TREATMENT. It generally requires little else than attention, to diet and warmth, as in Febricula, unless the fever be considerable, when a few doses of Aconitum may be given. For headache and disturbance of the brain, two or three doses of Belladonna, Rhus Tox. is also believed to accelerate complete recovery.
9. Measles (Morbilli)
Measles 1 For an account of German Measles we must refer the reader to the author’s Vade Mecum, 1898 Edition. is a disease of childhood, usually unattended with danger, unless improperly treated; but in adults it is often a severe or even dangerous malady. Like Scarlatina and Small-pox, it is highly contagious, often epidemic, and generally attacks the same patient only once.
SYMPTOMS. About eight days after the reception of the poison, the disease is ushered in with the symptoms of a common cold sneezing, running from the nose, red, swollen, and watery eyes, frontal headache, aching in back and limbs, shivering, a hoarse, harsh cough, and fever. On about the fourth day from the commencement of the illness, the eruption appears on the face and neck, and soon after on the whole body. It is in the form of minute raspberry-coloured pimples, which multiply and coalesce into blotches of a more or less crescentic form, slightly raised above the surrounding skin, so as to be felt, particularly on the face, which is often a good deal swollen. In four or five days the fever abates, and the eruption declines, a bran-like scurf being afterwards thrown off the skin.
Measles differs from Scarlatina in several respects. The eruption is rough, so that on passing the hand over the skin considerable inequalities may be detected, and it is of a darkish scarlet colour; in Scarlet-fever the roughness is absent, and, in simple cases of the disease, the rash is of a bright scarlet colour. The sneezing, lachrymation, and other catarrhal symptoms, which characterize the primary stage of Measles, are usually absent in Scarlet-fever.
TREATMENT. In mild forms, Aconite and Belladonna alternately, Pulsatilla and Sulph.; in severe and complicated, Aconite, Bryonia, Belladonna, Sulphur, Ipecac., Mercurius, Rhus., Tox., Arsen., etc.
Aconitum. Febrile symptoms, either at the outset, or during the progress of the disease. A dose every third or fourth hour as long as necessary. (See also Veratrum Vir., under Scarlet fever).
Pulsatilla. Almost specific in Measles, especially when symptoms of cold, derangement of the stomach, and much phlegm in the chest are present. It is most useful after the fever has been modified by Aconite; in the absence of fever, it may be given alone. Dose every two or three hours.
It is also useful as a preventive measure (see p. 104).
Belladonna. Considerable affection of the throat, dry, barking cough, etc.; restlessness, and tendency to delirium. A few doses, at intervals of two or three hours.
Bryonia. Imperfectly developed or suppressed eruption; stitching pains in the chest, difficult breathing, cough etc. In addition to this remedy, a sudden recession of the eruption might necessitate a hot-bath (see page 82).
Antim tart. Complicated with bad Congestive Bronchitis, Gelsemium, great restlessness. Baptisia, very bad gastric symptoms.
Sulphur. After the eruption has completed its natural course, and the other remedies are discontinued. A dose morning and night for several days.
AFTER EFFECTS (Sequelae). Measles is often succeeded by diseases of the lungs, eyes, ears, bones, or some affection of the skin. These are often far more serious than the malady itself, and generally require professional treatment. They may generally be prevented by the administration of Sulphur as just directed. Sequelae are very infrequent after homoeopathic treatment, unless constitutional evils are latent.
MEASLES AND CONSUMPTION.
Tubercular disease of the lungs, or more often, of the bowels, is by no means an infrequent sequel in delicate or strumous children. Cases of this nature are often under our care, and from long observation we have reason to believe that such a connection is far from uncommon. Whenever, therefore, a child makes but a slow or imperfect recovery after an attack of Measles, more particularly if there be a high temperature, tenderness, pain, or enlargement of the abdomen, diarrhoea or irregular action of the bowels, a grave constitutional disease may be suspected, and no time should be lost in obtaining professional homoeopathic assistance.
DIET AND REGIMEN. The general directions in the chapter on Nursing (pp. 73-82) should be carried out. Sponging thrice daily with a mixture of one pint of dilute acetic acid to six pints of hot water.1 See the Author’s “Homoeopathic Treatment of Infant and Children,” p. 47, 6th Edition, 1899. The Wet-pack (p.84) is useful at the commencement of the fever. It is especially necessary, while securing efficient ventilation, to guard the patient from cold, and, except during the very height of summer, a fire should be kept burning in his room. Exposure to strong currents of air may cause the eruption to recede, and bring on Bronchitis or Pneumonia. But a constant supply of fresh air may be secured without exposing the patient to draughts of cold air. The patient should be kept warm in bed. The room should be equally warmed, well ventilated, light, but the eyes protected from strong light. The diet should be the same as that recommended on p. 78.
PREVENTIVE MEASURES Measles is contagious, but may generally be prevented, or modified by giving children who have not had the disease a dose of Pulsatilla, morning and night, during the prevalence of the disease. 1 For much useful and interesting information on this disease, see “Measles; its complications and Fatality prevented by Homoeopathy; being Contributions from more than Twenty Medical Men,” Price ld.; and sold by this publishers of this Manual.
10. Scarlet Fever Scarlatina (Febris rubra).
This is a contagious disease, the poison of which is only second in virulence to that of Small-pox. The second, third, fourth and fifth years of life are those in which it is most prevalent; after the tenth year its frequency rapidly declines. The opinion that the disease does not attack children under two years of age is erroneous; as also is the idea that there is a difference between Scarlatina and Scarlet-fever; for the terms are synonymous.
The increasing prevalence of Scarlatina during the present century leads us to assign to it that pre-eminent rank among the causes of the mortality of childhood which was formerly occupied by Small-pox; indeed, the mortality from it often exceeds that from Measles and Small-pox combined. The mortality in towns is double that in the country. Its fatality during the epidemics of 1869-70 was again very great, and for many weeks during the latter part of 1870 the mortality averaged 108 per week in London alone. In 1886 the mortality from the disease in England was 5,986, and in 1890, 6,974. The largest number recently was 14,275 in 1881, and the smallest, 4,532 in 1895.
SYMPTOMS. Scarlatina has a latest period of about five days. The disease commences with the ordinary precursors of fever shivering, hot-skin, frequent pulse, thirst, and sore throat, headache, backache, and, often, vomiting. On the second or third day, after these symptoms, the eruption appears, first on the neck and breast, and then over the great joints and body generally, as a scarlet efflorescence, minutely point-shaped, but not raised above the surrounding skin so as to be felt; and some what resembles a boiled lobster shell. On the fourth or fifth day the eruption generally begins to decline, and gradually goes off, the outer skin desquamating in large flakes. The distinctive characters of Scarlatina are (1) The scarlet rash, just described, (2) The high temperature of the skin and blood, which becomes higher than in most other fevers, rising often to 105*, from 98*, the normal standard. (3) The papillae of the tongue are red and and prominent, and may be first seen projecting through a white fur, or, as this fur clears away, on a red ground suggesting the term “the strawberry-tongue.” (4) The sore throat. The throat is congested and swollen round the soft palate and tonsils, and the mucous membrane of the mouth and nostrils is generally involved.
For points of difference between Scarlatina and Measles, see p.97.
DEGREES OF INTENSITY. There are three recognized degrees of intensity, viz: Scarlatina simplex, in which the skin only appears to be affected; S. anginosa, in which both skin and throat are involved; and S. maligna, with extreme depression of the vital strength, super-added to the affection of the throat and skin, the fever assuming a malignant character. In this form, the tongue is brown, there is low delirium, the eruption is imperfect, darker than usual, and appearing and disappearing alternately. The throat is dark, livid, and even sloughy. Often this form of the disease terminates fatally on the third or fourth day, and is always one of such extreme danger that none but patients of very vigorous constitutions, with whom skilful treatment is commenced early, survive it.
DANGERS. (1) Exhaustion from virulence of the poison. (2) Inflammation of heart and brain. (3) Ulceration of the throat, suppuration through the ear, and consequent deafness. (4) Disease of kidneys and dropsy. (5) Rheumatic fever, consequent on exposure during convalescence. (See also After-effects). 1 For fuller particulars, see the Author’s “Infants and Children.”
Scarlatina is more prone to assume a malignant form than any other of the eruptive fevers, and sometimes prevails as an epidemic in low, ill-drained districts.
EPITOME OF TREATMENT:-
Scarlatina simplex. Belladonna alt. Aconite; Sulph. (during convalescence).
S. Anginosa. Mercurius (ulceration of the throat); Apis (excessive swelling).
S. Maligna. Ailanthus Gland, (early use, in frequent doses of 1x dil.), Baptisia, Arsenicum, Apis, Gelsemium, Murex Ac., Phosphorus, Opi., etc.; also spray of Sulphurous Acid, or of Condy’s Fluid, diluted one part of either to about ten of water.
If possible, this disease should always be under the care of a homoeopathic physician, as the mildest forms, neglected, have often led to the worst results.
LEADING INDICATIONS. Belladonna. Immediately Scarlatina is suspected, and especially when the rash begins to appear, the swallowing becoming difficult, and the throat inflamed, Belladonna should be given every first, second, or third hour, according to the severity of the symptoms, and as long as the eruption is bright-red. In the simple form of the disease. Scarlet-fever will frequently yield to its action without the aid of other medicines.
Aconitum. If the fever be severe, a few doses may precede, or be alternated with, Belladonna
Gelsemium. In simple cases when the eruption is not clear, when the symptoms are remittent, and there is much nervous restlessness.
Rhus tox. When rheumatic symptoms appear, and the patient cannot bear to be still.
Bryonia. In alternation with Belladonna, when rheumatic symptoms come on and the patient cannot bear the least motion.
Veratrum Viride is valuable when there is much head disturbance, vomiting, and very rapid pulse. It may be alternated with Belladonna
Mercurius. Inflamed, swollen, or ulcerated throat. If there is a predominance of the throat symptoms, especially malignant sore throat, Mercurius is most valuable.
Terebinthina. Disorder of kidneys; urine smoky and dark.
Arsenicum. Great prostration of strength; cold clammy sweats; frequent, weak pulse; threatened dropsy. Arsenicum is also valuable during convalescence; it expedites desquamation and tends to prevent sequelae.
Sulphur. When the disease is on the decline, to prevent secondary complaints. See also Arsenicum A dose morning and night for several days.
GENERAL MEASURES. The hints on Nursing (pp. 73-82) should, as far as possible, be strictly carried out. The surface of the body should be sponged thrice daily with the acetic acid and hot water (see also p. 100) to moderate the great heat and allay restlessness Sucking and swallowing small pieces of ice are both useful and grateful. A wet bandage to the throat, when it is affected, is a sovereign remedy, and seldom fails to relieve. It should be fastened both at the back of the neck and at the top of the head, so as to protect the glands near the angles of the jaws. Inhalation of steam from hot water is useful when the throat is sore and painful. Also the WET PACK (p. 84).
PREVENTION. During the prevalence of Scarlatina, a dose of Belladonna (1x) should be given morning and night to children who have not had the disease. Should the disease occur not with- standing this treatment, its severity will be much mitigated. Daily out-of-door exercise.