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When the attack commences with much fever.

Aconite.

When the attack commences with shivering and creep ing chills. Pulsatilla.

When the pains are principally in the great toe.

Puls. Arnica.

When the attack commences in the heel, affecting the large tendon (tendo achillis.) Cannabis.

When the attack commences in the foot, knee and calf of the leg. Bryonia.

When the entire foot is equally painful. Rhus-tox,

For the retrocedent, or wandering gout.

Pulsatilla, Arnica, Nux Vomica.

For the gouty nodes and lumps. Antimony-Crude, Calcarea, Carbonica, Graphites, Lycopedium, Phosphorus, and Sepia.

For gout in fishermen, and those exposed to the water.

Dulcamara.

When it affects the stomach. Antim. Nux Vomica.

When it affects the heart. Aconite, Pulsatilla.

When it affects the lungs. Aconite, Bryonia.

When it affects the liver.

Aconite, Nux Vom., Pulsatilla.

When it affects the kidneys.

Aconite, Arsen., Bell., Cantharides.

When it affects the bladder.

Aconite, Cannabis, Cantharides.

Nitric - acid, Phosphorus, Ledum, Lycopodium, Manganum, and Ferrum, have all been recommended in gout, but I have generally succeeded well with those specificallynamed; there may be cases requiring one or more of the other drugs, which should be selected, by carefully consulting the Materia Medica, and adapting the drug to the peculiarity of the symptom.

Administration.—The same as in Rheumatism.
Diet.—The same.

CHAPTER V.

CHOLERA.

The term Cholera is derived by Gelsus, from the Greek, literally meaning a flow of bile; by Trallian as an intestinal flux, and by Dr. Cullen, in his Nosology, as a genus of disease in the class Neurosis and order Spasmi. Hooper defines it as a "purging and vomiting of bile, with anxiety ; painful gripings; spasms of the abdominal muscles, and those of the calves of the legs," and particularizes two species :—" 1. Cholera spontanea, which happens in hot seasons, without any manifest cause. 2. Cholera accidentalTM, which occurs after the use of food that digests slowly and irritates;" both of these species, or either of them constitutes the disease usually denominated

I . CHOLEBA-MORBUS.

This disease occurs generally during the summer months in almost every section of the country, and differs widely from that fatal scourge "Asiatic Cholera," but with which it has not unfrequently been confounded. Its attacks are generally sudden, commencing with sickness of the stomach and vomiting; severe griping and cutting pains in the stomach and bowels, accompanied with purging, and sometimes violent cramps. At the commencement, the pulse is somewhat accelerated, and skin rather above the natural temperature; the substances discharged from the stomach appear to be nothing more than its ordinary contents mixed with bile; and the discharge from the bowels at first are feces much resembling an ordinary diarrhoeic stool; but as the disease advances, the pulse becomes small, the skin cool, face pale and covered with perspiration. The matter thrown from the stomach much diminished in quantity and is changed to a thin watery or slimy liquid, with violent retchings; the stools become less copious and changed to a thin bilious or watery substance, and sometimes to a slimy mucus, particularly if there is much tenesmus, (a straining and bearing down sensation.)

Causes.—The heat of summer, more particularly when the nights are cool, chilly or humid; errors in diet, such as eating indigestible and irritating articles of food, unripe and acrid fruits; or drinking largely of acidulated liquids, beer, etc., and the too free use of iced water when heated; suppressed habitual discharges, or repelled cutaneous eruptions.

Treatment.—The principal remedies in this disease are Aconite, Ipecac., Antimony, Arsenic, Colocynth, Veratrum, Dulcamara.

At the commencement, if there is any fever, give Aconite, which will frequently arrest the disease at once.

But should the disease progress, with vomiting and purging of a bilious character, give Ipecac.

If the discharge from the stomach and bowels is tnin and watery; the face pale, and covered with perspiration in large drops, give Antimony.

When the vomiting is very violent; and diarrhoea of a watery, bilious, dark brown, green or black appearance, with severe pains in the abdomen, sudden prostration, coldness of the extremities, clammy sweat, and burning thirst. Arsenicum.

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If, in addition to the above symptoms, the pains in the abdomen are very sharp and cutting, particularly around the navel; cramps of the muscles of the legs, and great prostration. Veratrum.

Or Veratrum may be given in alternation with Arsenicum, when the pains are more of a colic character, with vomiting and purging of a green bilious matter.

And as the disease advances, and the discharges become rather colorless and watery. Cohcynth.

When caused by cold drinks, or sudden changes of temperature, and the disease attended with bilious stools and vomiting. Dulcamara.

Administration.—As the disease is an acute one, and requires prompt efforts to arrest its progress, the appropriate drug should be given every ten, fifteen, or twenty minutes, according to the urgency of the symptoms, and persisted in until another is indicated by a change of symptom; when the disease begins to yield, and the symptoms become less formidable, the remedies must be given at longer intervals.

External applications, dry heat, in the form of heated bricks, or bottles filled with hot water, may be applied to the feet; or the limbs may be wrapped in hot flannel, and hot flannel cloths applied over the stomach and bowels, or if the skin is hot and dry, with severe abdominal pains, hot fomentations to the bowels are not only admissible, but in many instances will prove a valuable auxiliary.

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