Part 8 (1/2)

This affection, though it somewhat resembles a common boil, and is by some writers considered only such, in an overgrown state, is, nevertheless, far from being identical with it.

While a _boil_ is only a sanitive effort of nature to eliminate the cause of a morbid process, and tends to a spontaneous, healthy termination, the _carbuncle_, on the contrary, is the very essence of disease; its constant tendency being towards the dissemination of diseased action, causing destruction of the parts affected. It, in fact, appears like a parasite, living by the destruction of surrounding tissues, literally absorbing them and ”thriving on death.” It begins with a red, livid color, slight aching and burning pains, the part swells and is elevated some like a boil, except that it does not ”point,” but has a broad base rising like a cone and flattened at the top. It feels soft and spongy, and will appear to fluctuate, but if punctured, blood only flows. The pain and burning increases rapidly, and sooner or later several openings appear upon the top, varying from three or four to half a dozen or more, looking like the holes in a sponge, out of which issues a fluid like thin gruel. Instead of becoming easier after the suppuration begins, as is the case with a boil, the burning increases to an alarming and unbearable extent; cold chills, loss of appet.i.te, great depression of spirits, general nervous and muscular debility come on. The tumor continues to discharge, turns purple; gangrene beginning in the carbuncle extends to other parts and death follows.

The disease is nearly always confined to quite feeble persons and those past the meridian of life; but I have seen it on younger though feeble patients. It is generally located on the back, occasionally on the head, where it is very dangerous from its liability to affect the brain.

TREATMENT.

If treated very early, _strong tincture of Arnica_ applied to the surface of the carbuncle, by cloths wet and laid over the tumor, will often arrest it so that the swelling will not be developed to the suppurative stage. However, to reap any benefit from _Arnica_, it must be applied while the pain is not severe, and the parts only feel bruised and tender to pressure, like a common bruise.

After the ulceration occurs, _a.r.s.enic.u.m_ is the great remedy to be relied on. It should be given at the second or third attenuation as often as every three hours, when the pain is severe, and applied to the surface of the carbuncle freely by cloths laid over it, wet in the first dilution, or by sprinkling the first trituration of the oxyde (1-10) freely upon the open surfaces, so that it may penetrate into the open mouths or orifices. Over this powder apply an emolient poultice, or soft cloths wet in water hot as can be endured. This will soon allay or greatly lessen the pain. It should be repeated as often as any of the burning pain peculiar to the carbuncle returns, until the tumor suppurates in a tolerably healthy manner; then lessen the strength of the _Ars._ applications, and continue them until it has the appearance of a healthy abscess, when only simple dressings are necessary. Some may suppose such strong applications injurious, but I can a.s.sure them from abundant experience, that there is not the slightest danger. The carbuncle should _never be punctured_ or _cut into_. Such operations always make them worse, and induce a more rapid approach to gangrene.

The patient should have nouris.h.i.+ng food, and good native wine may be taken in moderate quant.i.ties, by a very feeble person, with decided advantage.

Though the knife operations for the removal of carbuncle are always injurious, the chemical effect of _Potash_ is frequently most beneficial. I have, in repeated instances, applied to the ulcerated surface, _caustic potash_ freely, allowing the dissolved caustic to penetrate to the very ”core” by running into the orifices. At first it would produce some smarting, but the pain is different from that of the carbuncle, and the change is agreeable rather than otherwise. Soon after the application all pain ceases, and the tumor, under the use of a poultice, begins to slough off in a few days, leaving a raw surface, disposed to heal kindly. Occasionally, however, the healing process is tardy, when _a.r.s.enic.u.m_, at the third, applied and taken internally, will soon effect a cure.

I have occasionally used _Hepar Sul._ with good effect in the latter stage.

Felon--Whitlow.

For this disease, in the early stage, when the sensation is that of sharp, sticking pain, feeling as though a brier or thistle was in the finger, immerse the part in water as hot as possible, into which put common salt as long as it will dissolve; hold it in this _hot_ salt bath for an hour or more at a time, and when removed, apply finely pulverized salt, wet in _Spirits of Turpentine_; bind on the salt with several thicknesses, and keep it constantly wet with the sp'ts turpt. for twenty-four hours, when, if all symptoms of felon are gone, no further treatment is necessary. As a general rule, the hot bath should be repeated three times a day, especially if the symptoms have existed for several days and there is much pain or swelling, and the dressings should be kept on as above directed for several days, more or less, until all symptoms disappear.

I am quite confident that a large majority, if not all, of the cases if thus treated at any time before pus is formed, will be discussed and cured. If pus has begun to form before the treatment is commenced, this will not _cure_ the felon, but it is good treatment, especially the hot bath, as it will greatly lessen the pain.

By holding it in hot water for an hour or two each day, the suppurative process will be hastened, and as soon as the pus can be felt at any point, fluctuating, puncture and let it out; then continue the hot bath, with _Calendula_ (_Marygold_) flowers in the water, keeping the part all the time warm and moist.

For the restless and nervous irritability that frequently occurs, especially in females, _Aconite is the best remedy_. It should be given, one drop of the tincture to a gill of water, in teaspoonful doses, once in one or two hours, and the same applied to the sore.

DISEASES OF FEMALES

Suppression of the Menses, (Amenorrhoea.)

For sudden suppression from taking cold, as by wetting the feet, there being headache, more or less fever, the pulse frequent and variable, pains in the small of the back and cramp like pains in the pelvic region, give, in alternation, _Aconite_ and _Pulsatilla_, as often as every fifteen or twenty minutes in a violent case, and at longer intervals as the patient begins to get easy. Putting the feet into hot water, or taking a hot Sitz bath is very useful. If the patient is sick at the stomach, as is often the case, give lukewarm water freely and let her vomit; after which let her drink freely of water as hot as it can be safely swallowed, adding milk and sugar to make it palatable. The good effects that are often attributed to and experienced from the use of various hot teas in this affection, are, in my opinion, attributable more to the hot fluid alone than to any specific medicinal virtue in the substance of which tea is made. At all events, very _hot_ drink with nothing but water, milk and sugar, is equally efficacious, and my medicine (a few grains of sugar of milk) put into the hot water, seasoned as above, has often obtained great credit, when the _hot water_ was alone worthy. Rubbing the loins and abdomen briskly downwards with the hands of a healthy and vigorous nurse, will often excite the menstrual flow after a sudden suppression. If the head is hot, the face full and red, and the arteries of the neck and temples beat violently, give _Bell._ with _Pulsatilla_, and if the lungs are oppressed, use also _Bryonia_, giving the three in rotation. If, after the menstrual flow begins, there is still much pain in the pelvic region, give _Caulophyllin_, which will immediately afford relief.

_Apis mel._ is very servicable in suppressed menses of several days, or even weeks duration, where there is fever, redness of the face, and pain in the head, and pains in the hips extending to the limbs, especially if there is any tendency to bloating of the abdomen and swelling of the limbs or feet. It acts _promptly_ and _efficiently_.

If the suppression has been caused by sudden fright or any strong mental emotion, _Veratrum_ should be given in connection with the two former medicines. Should there be great fullness of the vessels of the head, or bleeding at the nose, _Bryonia_ with _Pulsatilla_ are to be used.

_Bell._ is also useful in this case if the pain in the head is throbbing, especially if any delirium is present.

For suppression in young females, of several months duration, I have used, with much success, _Podophyllin_ and _Macrotin_, one at night, the other in the morning, giving them for two or three weeks before the proper time for a return, and a day or two prior to the time, give also _Pulsatilla_, and give the three in rotation, a dose every six hours.

This practice has been successful with me in cases of long standing and apparently obstinate character. Where there is other disease, as an affection of the liver, lungs or stomach, this must be treated and cured, or the menses will not probably return. Great care should be exercised to keep the patient's feet and limbs warm, as upon this may depend her future health.

Dysmenorrhoea.--Painful Menstruation.