[146 MOTHERS' REMEDIES]

PILES. (Hemorrhoids).—Hemorrhoid is derived from two Greek words, meaning blood and flowing with blood. "Pile" is from a Greek word meaning a ball or globe. Hemorrhoids, or piles, are varicose tumors involving the veins, capillaries of the mucous membranes and tissue directly underneath the mucous membrane of the lower rectum, characterized by a tendency to bleed and protrude. They were known in the time of Moses.

Varieties.—There are the external (covered by the skin) and the internal (covered by mucous membrane).

Causes.—Heredity. More frequent in males. Women sometimes suffer from them during pregnancy. Usually occurs between the ages of twenty-five and fifty. Sedentary life, irregular habits, high-grade wines and liquors, hot and highly seasoned and stimulating foods. Heavy lifting. Those who must remain on their feet long or sit on hard unventilated seats for several hours at a time. Railway employees, because they take their meals any time and cannot go to stool when Nature calls, causing constipation. Purgatives and enemata used often and for a long time. Constipation is perhaps the most frequent cause: when a movement of the bowels is put off for a considerable time the feces accumulate and become hard and lumpy and difficult to expel. If this hard mass is retained in the rectum, it presses upon the blood vessels interfering with their circulation and by bruising the vessels may induce an inflammation of the veins when the hardened feces are expelled; straining is intense, the mass closes the vessels above by pressure and forces the blood downward into the veins, producing dilatation when the force is sufficient. One or more of the small veins near the anus may rupture and cause a bloody (vascular) tumor beneath the mucous membrane or skin.

External Piles.—Two kinds, venous piles and skin or simple enlarged tags of skin. Venous piles usually occur in robust persons. They come on suddenly and are caused by the rupture of one or more small veins during the expulsion of hardened feces. There may be one or more, and may be located just at the union of the mucous membrane and the skin. Their size is from a millet-seed to a cherry, livid or dark blue in color, and appear like bullets or small shots under the skin. At first they cause a feeling of swelling at the margin of the anus; but as the clot becomes larger and harder, there is a feeling of the presence of a foreign body in the lower part of the anal canal (or canal of the anus). The sphincter muscle resents this and occasionally contracts, spasmodically at first, producing a drawing feeling; later these contractions become longer and more frequent, and there is intense suffering caused by the pile being squeezed, and this suffering may be so great that sleep is impossible without an opiate. Because of the straining, irritation of the rectum and pain in the sphincter, the piles soon become highly inflamed and very sensitive. The clot may be absorbed without any treatment. Occasionally it becomes ulcerated from the irritation, infection takes place and an abscess forms around the margin of the anus terminating in a fistula.

[DIGESTIVE ORGANS 147]

Skin Piles. (Cutaneous).—These are enlarged tags of the skin. They frequently follow the absorption of the clot in the venous piles where the skin is bruised and stretched. There may be one or many and usually have the skin color. These cause less suffering than the venous variety, and sometimes they exist for years, without any trouble, providing care is taken; but when bruised from any cause, such as a kick or fall, sitting on a hard seat, stretching of the parts during stool, or when they become irritated by discharges from the rectum or vagina, they become inflamed and cause much annoyance and pain. When they are acutely inflamed they swell greatly, are highly colored, swollen, painful, and extremely sensitive to the touch and cause frequent spasmodic contractions of the sphincter muscle and may finally result in an abscess. The pain is usually confined to the region of the anus, but may go up the back, down the limbs or to the privates.

MOTHERS' REMEDIES FOR PILES. Sulphur and Glycerin for.—"Equal parts of sulphur and pure glycerin. Grease parts." This preparation is very healing, and will often give relief even in severe cases.

2. Piles, Strongly Recommended Remedy for.—

Extract Belladonna 15 grains Acetate lead 1/2 dram Chloretone 1 dram Gallic acid 15 grains Sulphur 20 grains Vaseline 1 ounce

Mix.

In protruding, itching and blind piles, this ointment will give you almost instant relief. If kept up several days it will promote a cure."

3. Piles, Good Salve for.—"Red precipitate two and one-half drams, oxide of zinc one dram, best cosmoline three ounces, white wax one ounce, camphor gum one dram." It is much better to have this salve made by a druggist, as it is difficult to mix at home. This it a splendid salve and very good for inflammation.

4. Piles, Smartweed Salve for.—"Boil together two ounces of fresh lard and half an ounce smartweed root. Apply this to the piles three or four times a day." This is very healing, and has been known to cure in many cases when taken in the early stages.

5. Piles, the Cold Water Cure for.—"Take about a half pint of cold water and use as an injection every morning before trying to have a movement of the bowels." This simple treatment has cured many cases where the stronger medicines did not help.

6. Piles, Simple Application and Relief from.—"Mix together one tablespoonful plain vaselin and one dram flower of sulphur. Apply three times daily and you will get relief."

7. Piles, Steaming with Chamomile Tea for.—"A tea made of chamomile blossoms and used as a sitz bath is excellent; after using the sitz bath use vaselin or cold cream and press rectum back gently."

[148 MOTHERS' REMEDIES]

PHYSICIANS' TREATMENT for Piles.—What to do first.—The palliative treatment of both varieties of external piles is the same. In all cases the patient should lie flat on his back in bed and remain there for a few days. Highly seasoned foods and stimulants, tea, coffee, whisky, wine, etc., must be discarded. Secure a daily half liquid stool by the use of small doses of salts, Hunyadi or Abilena water. Cleansing the parts with weak castile soap water is essential to allay the pain, reduce the inflammation and soothe the sphincter muscle; cold, or if it is more agreeable, hot applications may be kept constantly on the parts. Hot fomentations of hops, smartweed, wormwood, or poultice of flaxseed, or slippery elm, or bread and milk give almost instant relief in many cases; while in others soothing lotions, and ointments or suppositories are needed.

The lead and laudanum wash is always reliable.

Lead and Laudanum Wash.—

Solution of Subacetate of Lead 4 drams Laudanum 20 drams Distilled water enough to make 4 ounces

Mix thoroughly and apply constantly ice cold on cotton to the sore parts.

The following ointments, lotions, and suppositories to be used freely within the bowels and to the piles, are effective in relieving the pain, reducing inflammation and diminishing pain and spasm in the sphincter.

1. Ointment of Stramomium 1-1/2 drams Ointment of Belladonna 2-1/2 drams Ointment of Tannic Acid 1/2 ounce

Mix thoroughly and apply inside and outside the anus.

2. Camphor Gum 1 dram Calomel 12 grains Vaselin 1 ounce

This must be thoroughly mixed. Apply freely within the anus and to the piles. Good for the pain.

3. For External Piles cleanse them well with a sponge dipped in cold water, and then bathe them with distilled extract of witch hazel.

4. If there is much itching with the piles use the following salve:—

Menthol 20 grains Calomel 30 grains Vaselin 1 ounce

Mix and apply to the piles.

5. I use quite frequently the following for sore external piles:

Chloroform and Sweet oil in equal parts

Apply freely with cotton or on to the piles. Ten cents will buy enough to use.

[DIGESTIVE ORGANS 149]

Operation for Piles.—When these measures do not relieve the pains or the piles become inflamed from slight causes and often, it is best to operate. This can be done in a few minutes with a local anesthetic and the patient frequently goes to sleep afterward, almost free from pain. Inject a three per cent solution of eucaine, or six per cent solution of cocaine. Thoroughly cleanse the part and hold the buttocks apart, pierce the pile at its base with a thin sharp-pointed curved knife, laying it open from side to side. Remove the clot with a curette, cauterize the vessel and pack the cavity with gauze to prevent bleeding and to secure drainage.

Cutaneous (skin) piles are operated upon as follows.—Each one is grasped in turn with a pair of strong forceps and snipped off with the scissors, or removed with a knife. Close the wound with sutures, if necessary, and dress it with gauze. Small ones need no sutures. Be careful not to remove too much tissue. Much after-pain can be prevented by placing in the rectum a suppository containing one-half grain of opium or cocaine before either of the above operations are performed. The after treatment is quite simple. Keep the patient quiet, cleanse the parts frequently, and secure a soft daily stool. Cleanse with tepid boiled water with clean sterilized gauze and give salts in small doses, one to two drams to produce a stool.

INTERNAL PILES. Symptoms.—The two prominent symptoms are bleeding and pain. The bleeding is usually dark. It may be slight and appear as streaks upon the feces or toilet paper; it may be moderate and ooze from the anus for some time after a stool, or it may be so profuse as to cause the patient to faint from loss of blood while the "bowels are moving." Death may follow in such a case unless the bleeding is stopped. The blood may look fresh and fluid or if retained for some time, it looks like coffee grounds, sometimes mixed with mucus and pus. Patients who bleed profusely become pale and bloodless, and are very nervous and gloomy and they believe they are suffering from cancer or some other incurable trouble. The first the patient notices he has internal piles is when a small lump appears at the end of the bowel during a stool and returns spontaneously; afterwards the lump again protrudes after the stool and others may appear. They become larger and larger, come down oftener and no longer return spontaneously, but must be replaced after each stool. As a result of this handling, they grow sensitive, swollen, inflamed and ulcerated, and the sphincter muscle becomes irritable. Later on one or more of the piles are caught in the grasp of the sphincter muscle and rapidly increases in size. It is then hard to relieve them, and when returned they act as foreign bodies, excite irritation and they are almost constantly expelled and the same procedure goes on at each stool. The sphincter muscle contracts so tightly around them as to cause strangulation and unless properly treated they become gangrenous and slough off.

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Recovery, Pain, etc.—The pain is not great in the early stages, but when the muscle grasps and contracts the pile or piles it becomes terrible and constant. Piles rarely end fatally. Palliative treatment does not afford a permanent cure. They frequently return, but by care and diet many can be kept from returning so frequently. They should be treated upon their first appearance when the chances of a permanent cure without an operation are much better.

PHYSICIANS' TREATMENT for Internal Piles.—What to do first. The cause should be removed. Restore a displaced womb. Regulate the bowels, liver, diet, and habits. Much can be accomplished by these measures if properly used, in allaying inflammation diminishing pain and reducing the size of the piles. These measures will not cure them if they are large, overgrown and protruding. When the piles are inflamed, strangulated or ulcerated, the patient should remain in bed in a recumbent position and hot fomentations of hops, etc., and hot poultices, of flaxseed, slippery elm, bread and milk, the ice bag, or soothing applications and astringent remedies, should be applied to the parts. In some cases cold applications are the best. The cold or astringent applications give the best results where the piles are simply inflamed and the sphincter muscle does not act spasmodically, jerkily. But when the piles are strangulated, "choked tight" by the sphincter muscle, hot fomentations, poultices and soothing remedies give the most relief, because they reduce spasmodic contractions of the muscle and allay the pain. Instead of the poultices and fomentations, the "sitz" bath can be used. Put in the steaming water, hops, catnip, tansy, pennyroyal, etc., and the steam arising will frequently give great relief. This can be given frequently; ten to twenty drops of laudanum can be added to the poultices when the piles are very painful.

1. For inflamed piles, the following combinations may be used:—

Gum Camphor 1 dram Calomel 12 grains Vaselin 1 ounce

Mix thoroughly and apply freely around the anus and in the rectum on the piles.

The external parts should always be bathed with hot water, thoroughly, before using.

2. Gum Camphor 2 drams Chloretone 1 dram Menthol 20 grains Ointment of Zinc Oxide 1 ounce

Mix and apply directly to the piles.

3. When there is a slight bleeding, water of witch-hazel extract, one to two ounces to be injected into the rectum. This witch-hazel water freely used is good for external piles also. This is good and well recommended.

[DIGESTIVE ORGANS 151]

4. If the protruded pile is inflamed and hard to push back, the following is good and recommended highly:—

Chloretone 1 dram Iodoform 1 dram Gum Camphor 1 dram Petrolatum 1 ounce

Mix and use as a salve.

5. An ointment composed of equal parts of fine-cut tobacco and raisins, seedless, chopped fine and mixed with enough lard, makes a good ointment to apply on both external and internal piles.

6. Tea of white oak bark, boiled down so as to be strong, and mixed with lard and applied frequently, is good as an astringent, but not for the very painful kind. It will take down the swelling.

7. Take a rectal injection of cold water before the regular daily stool. This will soften the feces and decrease the congestion.

Preventive Treatment.—This is very important and includes habits and diet and other diseases. If the patient is thin and pale give tonics. Correct any disease of any neighboring organ. Attend to any disease that may be present.

For Constipation.—Take a small dose of salts or hunyadi water so as to have one semi-solid stool daily. If necessary remove any feces that may even then be retained, by injections of soap suds or warm water containing oil. Discontinue injections as soon as a daily full stool can be had without it.

Habits.—Full-blooded people should not use upholstered chairs as the heat of the body relaxes the tissues of the rectum. A cane seated chair is best or an air cushion with a hollow center. It is best to rest in bed, if possible, after stool for the rest relieves the congestion and soreness. An abundance of out-door exercise, when the piles are not present, or bad, consisting of walking or simple gymnastics may usually be indulged in; violent gymnastics and horseback riding must be avoided. A daily stool must be secured.

Diet.—Such patients should avoid alcoholic beverages, spiced foods, strong coffee, and tea, cheese, cabbage, and old beans.

Foods Allowed.—Potatoes, carrots, spinach, asparagus, and even salads, since they stimulate intestinal action and thus aid in keeping the stool soft. Stewed fruits, including grapes, oranges, pears, and apples. Water is the best to drink. Meats: tender broiled, boiled or baked beef—do not eat the inside part to any great amount. Other meats, but no pork or ham, fresh fish, chicken. The foods should not be too highly seasoned; vinegar is not to be used to any extent and this excludes pickles, etc.

PERIPROCTITIS. Abscess Around the Anus and Rectum. (Ano-rectal) (Ischio- rectal Abscess).—This is an inflammation of the tissues around the rectum which usually terminates in the above named abscess. It occurs mostly in middle-aged people. Men are affected more often than women.

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Causes.—Sitting in cold, damp hard seats; horseback riding, foreign bodies in the rectum such as pins, fish-hooks, etc., blows on the part, kicks, tubercular constitution, etc.

Symptoms.—Inflammation of the skin, like that of a big boil, some fever, throbbing pain, swelling of the part, heat and fullness in the rectum, these symptoms increase until the pus finds an outlet into the rectum.

PHYSICIANS' TREATMENT for Periproctitis.—Little can be done in a palliative way. It generally terminates in an abscess. Make the patient as comfortable as possible, by applying cold or hot things to the part, rest in bed, mild laxatives to keep the bowels open. Cut it open as soon as possible, and it should be laid wide open, so that every part is broken up. Then it should be thoroughly washed and scraped out. Sometimes it is necessary to use pure carbolic acid to burn out the interior. The dressing should be as usual for such wounds and removed when soiled and the wound washed out with boiled water and then gauze loosely placed in the bottom and in every corner of the wound. The dressing should be continued until all has been healed from inside out. Be sure to leave no cotton in to heal over it. Such patients should be built up with nourishing foods, and should remain quietly in bed. Cod liver oil is good for some patients. Iron, etc., for others. Keep the bowels regular. Outdoor life and exercise. If treated right it should not return.

FISTULA IN ANUS.—This usually follows the abscess. It has two openings, one upon the surface of the body near the anus, and the other in the rectum. There are a great many varieties of fistula, but it is unnecessary to name them. What can be done for them?

PHYSICIANS' TREATMENT.—If the general health is good an operation is the best thing to do, but patients in the last stage of consumption, nephritis, diabetes, or organic heart disease, are not apt to receive much benefit from an operation. The patient in poor condition should be given the treatment suitable to his condition, according to the advice of a trusted physician.

[KIDNEY AND BLADDER 153]

DISEASES OF THE KIDNEYS AND BLADDER.

KIDNEYS.—The kidneys are deeply placed and cannot be felt or distinctly identified when normal. They are most accessible to pressure just below the last rib, behind. The right kidney usually lies lower than does the left, but even then, the lower part of this kidney is an inch above the upper part of the hip bone, or an inch above a line drawn around the body parallel with the navel. The kidney is about four inches long. The long axis of the kidneys corresponds to that of the twelfth rib; on an average the left kidney lies one-half inch higher than the right.

[Illustration: Kidneys, Ureters and Bladder.]

As stated before, each kidney is four inches long, two to two and one-half in breadth, and more than one inch thick. The left is somewhat longer, though narrower, than the right. The kidney is covered with what is called a capsule. This can be easily stripped off. The structure of the kidney is quite intricate. At the inner border of each kidney there is an opening called the pelvis of the kidney, and leading from this, small tubes penetrate the structure of the kidney in all directions. These tubes are lined with special cells. Through these tubes go the excretions (urine) from the body of the kidneys, to the pelvis, and from the pelvis through the ureters, sixteen inches long, to the bladder.

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KIDNEY TROUBLE. MOTHERS' REMEDIES.—1. Kidney Trouble and Inflammation of the Bladder, Cornsilk for.—"Get cornsilk and make a good strong tea of it by steeping slowly, and take one ounce three or four times a day. This acts well on the kidneys, and is a harmless remedy to use."

2. Kidney Trouble, Flaxseed and Lemons for.—"Make a tea by placing the flaxseed in a muslin or linen bag, and suspend it in a dish of water, in the proportion of about four teaspoonfuls for each quart of water. After allowing the seeds to soak for several hours remove the same and tea will be ready for use. The addition of a little lemon juice will improve the flavor. Give in quantities as may be found necessary."

3. Kidney Trouble, Temporary Relief for.—"Rub witchhazel on stomach and back; use freely." This is an old-time remedy, and can be relied upon to at least give temporary relief. The witch hazel has a very soothing effect upon the parts affected.

4. Kidney and Bladder Trouble, Buchu Leaves for.—"Get five cents' worth of buchu leaves at any drug store, and make a good strong tea of it by steeping. This acts nicely on the kidneys. This remedy is easily prepared, and is not expensive."

5. Kidney Trouble, Common Rush Root for.—"Take a handful of the root of common rush in one and one-half pints of water, boil down to one pint. Dose:—One tablespoonful every two or three hours. For a child ten years, give one teaspoonful four times a day. For a child of four to six years, one-half teaspoonful four times a day."

6. Kidney Trouble, Effective and Easy Cure for.—

"Fluid Extract of Cascara Sagrada 1 ounce Fluid Extract of Buchu 2 ounces Fluid Extract of Uva Ursi 2 ounces Tincture Gentian Comp 1 ounce Simple Syrup 1 pint

Mix the above ingredients and give a teaspoonful four times a day. This is a very good remedy, as the cascara sagrada acts on the bowels and the buchu and uva ursi acts on the kidneys, carrying off all the impurities that would otherwise be retained in the system and cause trouble."

7. Kidney Trouble, Sheep-Sorrel Excellent for.—"Make a decoction of sheep sorrel, one ounce to pint of water; boil, strain and cool. Give wineglassful, three or four times a day. If necessary apply the spinal ice bag to kidneys." The sheep sorrel is a good kidney remedy, and the ice bag by continuous application will relieve the congestion.

[KIDNEY AND BLADDER 155]

MOVABLE KIDNEY. (Floating Kidney. Nephroptosis).—Causes.—This condition is usually acquired. It is more common in women than in men, possibly due to lacing and the relaxations of the muscles of the abdomen from pregnancy. It may come from wounds, lifting too heavy articles, emaciation.

Symptoms.—They are often absent. There may be pain or dragging sensation in the loins, or intercostal neuralgia; hysteria, nervousness, nervous dyspepsia and constipation are common. The kidney can be felt. A dull pain is caused by firm pressure. Sometimes there are attacks of severe abdominal pain, with chill, fever, nausea, vomiting and collapse. The kidney becomes large and tender. The urine shows a reddish deposit and sometimes there is blood and pus in the urine.

Treatment.—If the symptoms are not present, it is best for the patient not to know the true condition, as nervous troubles frequently follow a knowledge of its presence. If the symptoms are present, replace the kidney while the patient is lying down and retain it by a suitable belt. Also treat the nervous condition. If the symptoms are of the severe kind an operation may be needed to fasten the kidney in its proper condition. This is quite generally successful, and does away with much suffering and pain. The pain may be so severe at times as to require morphine. Sometimes the pain is due to uric acid or oxalates in the urine. For this regulate the diet.

Diet for Movable Kidney.—The diet should be such as to produce fat. Milk is excellent where it is well borne; if not well borne give easily digested meats, such as chicken, roast beef, broiled steak and lamb chop; fish of various kinds and vegetables, such as spinach, carrots, asparagus and cauliflower; of fats, butter, cream, and chocolate; for constipation, cider, buttermilk, grape-juice, fruits and honey.

ACUTE CONGESTION OR HYPEREMIA OF THE KIDNEYS.—This occurs at the beginning of acute nephritis; in acute infectious diseases, after taking turpentine, chlorate of potash, cantharides, carbolic acid, alcohol, etc.; after one kidney has been removed.

Kidney.—The kidney is enlarged, dark red, while the covering is very tight (tense). The urine is scanty, and there is increased specific gravity (normal is 1015 to 1020) and contains albumin and a few casts.

Treatment.—The cause should always be removed if possible. Rest in bed, and as a diet use only milk; if the congestion is bad, use dry cupping over the kidneys and inject large quantities of hot normal salt solution in the bowels. Hot fomentations of wormwood or smartweed are of benefit. If you can get the patient into a sweat the congestion will be somewhat relieved by it.

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CHRONIC CONGESTION OF THE KIDNEYS. Causes.—Diseases of other organs and obstruction to the return of the circulation in the veins. Cirrhosis of the liver causes it. The kidney is enlarged dark red, the urine is diminished, with albumin and casts and sometimes blood.

Treatment.—Remove the cause if possible. Fluid diet, like milk, broths, etc. Dry cupping or sweating materials can be used. Rest in bed if possible. The bowels should be kept open, and the kidneys should rest.

BLOOD IN THE URINE. (Haematuria). Causes.—The congestion of the kidneys, pernicious malaria, etc., nephritis, tuberculosis, kidney stones. The urine looks smoky and dark, or bright red.

Treatment.—This depends upon the cause. The patient must rest in bed and the kidneys should not be stimulated. Cold applications to the loins. Hot applications would injure.

URAEMIC TOXAEMIA.—This means poison in the blood occurring in acute and chronic nephritis (inflammation of the kidneys). The cause is unknown. The disease is acute and chronic.

ACUTE URAEMIA. Symptoms.—The onset may be sudden or gradual. The headache is severe, usually on the back top of head (occipital) and extending to the neck; there is persistent vomiting with nausea and diarrhea attending it. This may be due to inflammation of the colon. Difficulty in breathing, which may be constant or comes in spells. This is worse at night, when it may resemble asthma; fever if persistent, is usually slight until just before death. General convulsions may occur. There may be some twitching of the muscles of the face and of other muscles. The convulsions may occur frequently. The patient becomes abnormally sleepy, before the attack, and remains so. One-sided paralysis may occur. Sudden temporary blindness occurs sometimes. There may be noisy delirium or suicidal mania. Coma (deep sleep) may develop either with or without convulsions or delirium, and is usually soon followed by them; sometimes by chronic uraemia or recovery.

CHRONIC URAEMIA.—This develops most often in cases of Arterio-sclerosis or chronic interstitial nephritis, (one kind of Bright's disease). The symptoms are less severe than those of acute uraemia, but similar, and of gradual onset, sometimes with symptoms of the acute attack. There is often constant headache and difficult breathing; the tongue is brown and dry, sometimes there is nausea, vomiting, diarrhea, sleeplessness, cramps of the legs and much itching may be present. It may last for years. Death may occur when the patient is in coma (deep sleep). There may have been mania, muscular twitchings or convulsions before death.

Treatment.—Found under "Chronic Interstitial Nephritis."

[KIDNEY AND BLADDER 157]

ACUTE BRIGHT'S DISEASE. (Acute Inflammation of the Kidneys. Acute Nephritis).—This occurs chiefly in young people and among grown men. Exciting causes are exposure to cold, wet, burns, extensive skin tears (lesions), scarlet fever, diphtheria, typhoid fever, measles and acute tuberculosis, poisons; and pregnancy is one cause when it occurs in women.

Symptoms.—After exposure or scarlet fever the onset may be sudden, sometimes with chills or chilliness, variable fever, pain in the loins, watery swelling of the face and extremities, then of other portions of the body like the abdomen, then general dropsy. Sometimes there is nausea, vomiting, headache, delirium, or very deep sleep. The urine is scanty, dark colored, of increased "specific gravity" and contains albumin, cells and casts. Anemia is marked. After some fever disease, the onset is gradual with anemia, swelling of the eyelids, face and extremities; scanty thickish urine containing casts, then headache, nausea, vomiting, little or no fever, dry skin. In these cases there may be gradual recovery, attack of uraemia, or they may end in chronic nephritis.

Diagnosis.—Examine the urine often in pregnancy, scarlet fever, etc., and especially when watery swelling is noticed.

Recovery.—The result in your children when it comes with scarlet fever is not so good. It may run into chronic nephritis. In adults when it is due to exposure the rule is recovery.

Treatment.—The patient must be kept in bed until there is complete recovery. He should be clothed in flannel.

Diet and Nursing.—This must be of milk, water or mineral water in large quantities; milk or buttermilk should be the main article of food. You can give gruels made of arrowroot or oatmeal, barley water, beef tea and chicken broth. But it is better to stick strictly to milk. As the patient gets better, bread and butter, lettuce, watercress, grapes, oranges, and other fruits may be given. The return to a meat diet should be gradual. The patient should drink freely of mineral waters, ordinary water or lemonade, these keep the kidneys flushed and wash out the "debris" from the tubes. One dram of cream of tartar in a pint of boiling water, add the juice of half a lemon and a little sugar; this when taken cold is a pleasant satisfactory diluting drink. Cream of tartar one dram, juice of lemon, sugar sufficient, water one pint, may be given whenever desired. There should be hot water baths daily or oftener; or you can produce sweating by placing hot water jars around the patient, and watch to see whether it is too weakening. It can also be done by introducing steam underneath the bedding, that is then lifted a little, so that the steam vapor can circulate about the patient. Be careful not to burn the patient with the hot steam. This, of course, is done through a hose attached to a steaming kettle. Also see treatment of dropsy under "scarlet fever."

Bowels, Attention to.—They should be moved every morning by a saline (salt) cathartic, if necessary, especially if the dropsy continues. This produces watery stool. Cream of tartar and epsom salts, equal parts, is good remedy; one-half teaspoonful every three hours for a child one year old until the bowels move freely; one-half to one ounce can be given to an adult.

[158 MOTHERS' REMEDIES]

CHRONIC BRIGHT'S DISEASE. (Chronic Parenchymatous Nephritis. Chronic Diffuse Desquamative or Tubal Nephritis. Chronic Diffuse Nephritis with Exudation). Causes.—Young adult life and most common in males. It may come from acute inflammation of the kidneys that was due to exposure, pregnancy, or scarlet fever, or follow excessive use of alcohol, etc. In children it usually follows acute inflammation of the kidneys or scarlet fever.

Condition.—The kidneys may be enlarged, with thin capsule, white surface, cortex thickened and yellowish, or whitish (large white kidney). The epithelium of the tubules is granular, or fatty or the tubules are distended and contain casts. Cells of the "Glomeruli" and their capsules are swollen. There is moderate increase of interstitial tissue. In other cases, the "small white kidney," the kidney is small and pale either at first or as a later stage of the large white kidney. The surface is pale, rough and granular; the capsule is thickened and partially adherent; the surface is thin with white and yellowish areas of fatty degenerations. The interstitial tissue is much increased; epithelial degeneration in the tubules extensive. There is also the large red kidney, and with any of these types the left heart may be enlarged and the arteries thickened.

Symptoms.—If it occurs after acute nephritis the symptoms of acute nephritis subside, but anemia and the changes in the urine persist. Usually there is a gradual onset with paleness and puffiness of the eyelids, ankles or hands in the morning. Later there is difficult breathing, increased watery swelling of the face, extremities and dependent portions of the body; worse in the morning. There is a pasty yellowish pallor, afterwards dropsy of the abdominal and chest cavities. The urine is diminished, high colored, specific gravity usually 1020 to 1025 with much albumin. Many casts which are named hyaline, granular, epithelial and fatty. The action of the heart is bad. There may be trouble with the stomach and bowels, constipated, etc. The digestion is poor and the patient frequently suffers with much gas. Recovery is rare after it has lasted one year.

Treatment. Diet.—Milk or buttermilk should be the main article of food. You can give gruels made of arrowroot or oatmeal, barley water, beef tea, and chicken broth, but it is better to keep strictly to milk. As the patient gets better, bread and butter, lettuce, watercress, grapes, oranges and other fruits may be given. The return to the meat diet should be gradual. The patient should drink freely of mineral water, ordinary water, or lemonade. These keep the kidneys flushed and wash out the "debris" from the tubes. One dram (teaspoonful) of cream of tartar in a pint of boiling water, add the juice of a half a lemon and a little sugar. This when taken cold is a pleasant, satisfactory drink. Medical treatment is not satisfactory. The only thing to do is to give medicines to meet the indications; fifteen to twenty grain doses of lactate of strontium. Diuretin also is used. Basham's mixture for anemia is of help in some cases. It can be bought at any drug store.

[KIDNEY AND BLADDER 159]

CHRONIC INTERSTITIAL NEPHRITIS. (Sclerosis or Cirrhosis of the Kidneys. Granular, Contracted or Gouty Kidney).—This is met with, (a) as a sequence of the large white kidneys forming the so-called pale granular or secondary contracted kidney; (b) as an independent primary affection; as a sequence of arterio-sclerosis.

Causes.—The primary form is chronic from the onset, and is a slow creeping degeneration of the kidney substance, and in many respects an anticipation of the gradual changes which take place in the organ in extreme old age. Families in which the arteries tend to degenerate early are more prone to this disease. Doctor Osler says: "Among the better classes in this country Bright's disease is very common and is caused more frequently by over-eating than by excesses in alcohol."

Arterio-Sclerotic Form.—This is the most common form in this country, and is secondary to arterio-sclerosis. The kidneys are not much, if at all, contracted; very hard, red and show patches of surface atrophy. It is seen in men over forty who have worked hard, eaten freely, and taken alcohol to excess. They are conspicuous victims of the "strenuous life," the incessant tension of which is felt first in the arteries. After forty, in men of this class, nothing is more salutary than to experience the shock brought on by the knowledge of albumin and cast tubes in the urine.

Symptoms.—Perhaps a majority of the cases are latent (hidden) and are not recognized until the occurrence of one of the serious and fatal complications. There may have been no symptoms to suggest to the patient the existence of a dangerous malady. In other cases the general health is disturbed. The patient is tired, sleepless; he must get up two or three times at night to pass urine; the digestion is disordered, the tongue is coated; the patient complains of a headache, failing sight, and gets out of breath by exercising. There may be vomiting, headache, neuralgia, and increase of the quantity of urine is common. This is light in color, of low specific gravity, 1005 to 1012; frequently there is a trace of albumin and a few casts of the hyaline and granular kind. In the late stages the albumin may be increased with high specific gravity and a less quantity of urine. The disease often lasts for a year.

In the arterio-sclerotic variety the urine may be normal or diminished in quantity, specific gravity normal or increased, the casts are more numerous, and the albumin is usually more abundant. There is an enlargement of the heart; the pulse is increased in tension; the wall of the artery is thickened. The skin is usually dry, with eczema common, but dropsy is rare, except when it is due to heart failure. There may be bronchial and lung troubles; attacks of uraemia, or hard breathing caused by the heart, frequently occurs. There may be hemorrhage of the brain or hemorrhage of the membranes, and these are often fatal.

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Recovery.—Chances are unfavorable, but life may be prolonged for years, especially with care and especially if it is discovered early.

Treatment.—A quiet life without mental worry, with gentle but not excessive exercise, and residence in a climate that is not changeable should be recommended. A business man must give up his worry; his rush; his hurried eating, and rest. The bowels should be kept regular; there should be a tepid water bath daily, and the kidneys should be kept acting freely by drinking daily a definite amount of either distilled water or some pleasant mineral water. Alcohol, tobacco, excessive eating and improper food must not be allowed. Weak tea and coffee may be allowed. The diet should be light and nourishing. Meat should not be taken more than once a day. If it is possible, the patient should be urged to move to a warm equable climate during the winter months, from November to April, like that of southern California. Medicines must be given to meet the indications. No special directions can be given. The heart, stomach, and bowels must be watched.

DIET as Allowed by a Prominent Hospital.—

May Take:—

Soups.—Broths with rice or barley, vegetable or fish soup.

Fish.—Boiled or broiled fresh fish, raw oysters, raw clams.

Meats.—Chicken, game, fat bacon, fat ham (sparingly).

Farinaceous.—Hominy, oatmeal, wheaten grits, rice, stale bread, whole wheat bread, toast, milk toast, biscuits, maccaroni.

Vegetables.—Cabbage, spinach, celery, water-cresses, lettuce, mushrooms, mashed potatoes, cauliflower, onions.

Desserts.—Rice and milk puddings, stewed fruits, raw ripe fruits.

Must Not Take:—

Fried fish, pork, corned beef, veal, heavy bread, hashes, stews, battercakes, lamb, beef, mutton, gravies, peas, beans, pastry, ice cream, cakes, coffee, tobacco, malt or spirituous liquors.

[KIDNEY AND BLADDER 161]

PYELITIS.—This is an inflammation of the pelvis of the kidney and may be caused by bacteria from the blood, or by ascending pus, infection or tuberculous infection from the lower tracts like the ureter, bladder and urethra.

Symptoms.—There is pain in the back, with tenderness and pressure, cloudy-looking urine, either acid or alkaline, containing pus, mucus, and sometimes red blood cells; chills, high fever, and sweating occur. This may become chronic and then it becomes quite serious. Anemia and emaciation are then marked. Mild cases usually recover; pus cases may end in other diseases or death from exhaustion.

Treatment. Diet.—In mild cases fluids should be taken freely, particularly the alkaline mineral water to which citrate of potash can be added. Tonics should be given when called for, and milk diet and buttermilk may be taken freely. When a tumor has formed, and even before, it is perceptible, if the symptoms are serious and severe, an operation may be necessary.

KIDNEY STONE. (Renal Calculus. Nephro-Leithiasis).—Forming of a stone or gravel in the kidney or its pelvis may occur in intra uterine, (before the child is born), in the womb, or at any age. A family tendency, sedentary life, excesses in eating and drinking and very acid urine predispose. They vary in size from that of fine sand to that of a bean.

Symptoms.—Patients may pass gravel for years without having an attack of renal (kidney) colic, and a stone may never lodge in the ureter. A person may pass an enormous number of calculi. Dr. Osler speaks of having had a patient who had passed several hundred kidney stones (calculi) with repeated attacks of kidney colic. His collection filled an ounce bottle. A patient may pass a single stone and may never be troubled again. A stone remaining in the kidney may cause dull aching pain in the affected kidney, or the pain may be referred to the other side and sometimes there may be blood or pus in the urine, with chill and fever due to pyelitis. Kidney (renal) colic comes on when a stone enters the ureter, if it is at all large. At attack may set in abruptly, without any apparent reason, or it may follow a strain in lifting. The pain may be agonizing in character, which starts in the flank of the affected side, passes down along the course of the ureter and is felt in the testicle and along the inner side of the thighs. The testicle is drawn back. The pain may also go through the abdomen and chest, and be very severe in the back. In severe attacks nausea and vomiting are present and the patient is collapsed; sweating breaks out in his face and the pulse is feeble and weak. The pain lasts from an hour to several days, until the stone reaches the bladder, partial suppression of the urine during the attack occurs, but a large quantity of urine is usually passed after it and a feeling of soreness may, be present for several days. The stone may again cause pain in passing through the urethra, or it may remain in the bladder as a nucleus for a bladder calculus (stone). Dr. Osler gives Montaigne's description as follows; "Thou art seen to sweat with pain, to look pale and red, to tremble, to vomit well nigh to blood, to suffer strange contortions and convulsions, by starts to let tears drop from thine eyes, to urine thick, black and frightful water, or to have it suppressed by some sharp and craggy stone that cruelly pricks and tears thee."

[162 MOTHERS' REMEDIES]

Treatment.—Great relief is experienced in the attacks by the hot baths or fomentations which sometimes are able to cause the spasm to relax. If the pain is very severe morphine should be given by the hypodermic method and inhalations of chloroform given until morphine has had time to act. Local applications are sometimes grateful,—hot poultices or cloths wrung out of hot water may be helpful. Cloths wrung out of steaming hop, wormwood, or smartweed teas, are of benefit sometimes. Change of position often gives relief; when the stone is large an operation may be needed. The patient should drink freely of hot lemonade, soda water, barley water. When the patient is free from the attack, he should live a quiet life and avoid sudden exertion of all kinds. There should be a free passage of urine always. The patient should drink daily a large but definite quantity of mineral, or distilled water which is just as satisfactory. You may take the citrate or bicarbonate of potash. Mineral springs are good to visit, such as Saratoga, Hot Springs, Arkansas, etc. Abstain from alcohol and eat moderately. Live an open-air life with plenty of exercise and regular hours. The skin should be kept active; a cold friction bath in the morning is good, if one is strong; but if he is weak and debilitated the evening warm bath should be substituted. The patient should dress warmly, avoid rapid alterations in temperature, and be careful not to allow the skin to become suddenly chilled.

Diet.—Most persons over forty eat too much. One should take plenty of time to eat, and not too much meat should be eaten.

"Queen of the Meadow."—The Indians used this medicine quite frequently in the treatment of kidney and bladder troubles. A lady, whom I know well, told me that she had a cousin who was affected with the kidney stone colic. At one time, when he was suffering from an attack, an Indian happened in their home and saw him suffering. He went into the meadow and dug some of this remedy and made a tea of it. It seemed to do the work, for while he gave it, the pain was eased and he never had any more attacks. I give this for what it is worth. The remedy will certainly do no harm for it is a good diuretic.

INFLAMMATION OF THE BLADDER. (Cystitis). Causes.—It may occur from injury from passing a catheter, etc., from the use of drugs like cantharides, from the presence of a stone, from stricture of the urethra and from gonorrhea or cold.

Symptoms.—The urine is passed more frequently, sometimes the desire to pass the urine is almost constant. The distress is relieved for only a few minutes by passing the urine; sometimes only a few drops are passed, and it gives no relief from the desire for passing urine. The straining is extremely severe. Sometimes the patient will lean over the vessel quivering with the muscular effort to pass urine. The bowels often move at the same time from the straining. The urine becomes thick with much mucus, then scanty, and then tinged with blood.

[KIDNEY AND BLADDER 163]

BLADDER TROUBLE. Mothers' Remedies. 1. English Oil of Sandal Wood for.—"Get one ounce of the pure English oil of sandal wood, take four drops three times a day in a little water. As you urinate more freely reduce the dose. This is a splendid remedy."

2. Bladder Trouble, Effective Herb Teas for.—"Make a tea of half ounce of buchu leaves, half ounce of uva ursi leaves (barberry leaves), one pint of boiling water. Dose: Two or three tablespoonfuls three times a day, or may drink quite freely." A tea made of cornsilk is a common and standard remedy.

Treatment.—Remove cause if possible. Fomentations of hops, smartweed, wormwood are good, even hot water over the bladder. Hot hip bath is good, and also the warm foot bath. The bowels should be kept open with saline laxatives. Buchu tea is very good. Use about one-half ounce of the leaves to a pint of warm water and let it steep, not boil. Drink freely of this. Pumpkin seed tea or watermelon seed tea is good, also flaxseed tea. Dr. Hare recommends the following at the beginning if there is fever:

Tincture of Aconite 3 drams Sweet Spirits of Nitre 1 ounce Solution of Citrate of Potash enough to make 6 ounces

Mix.

Give a dessertspoonful every four hours until all fever ceases and the pulse is quiet. The patient should be kept quiet.

Diet.—Should be milk only.

CHRONIC INFLAMMATION OF THE BLADDER.—Causes.—It follows repeated attacks; partial retention of urine in the bladder, decomposing there; Bright's disease, inflammation of the urethra, injury, etc.

Treatment.—Wash out the bladder with pure warm water or water containing about one to two teaspoonfuls of boric acid to the pint of warm water. This should be given once or twice a day; or enough permanganate of potash can be put into the water to give the water a tinge of the color. An injection of golden seal, one teaspoonful to the pint of warm water, is good if there is much mucus. The best way to give the irrigation is to attach a small funnel to a soft rubber catheter and fill the bladder by raising the funnel when full of water above the patient's belly; or you can attach the rubber tube of a fountain syringe to a catheter at one end and to a funnel at the other and raise the funnel to the desired height; or you can attach a catheter to the rubber tube of a fountain syringe (clean one) and raise syringe high enough to allow the water to run into the bladder gently. The patient will stand just about so much water. The rubber can then be detached from the catheter and the water allowed to run out.

[164 MOTHERS' REMEDIES]

DISEASE OF THE PROSTATE GLAND. The prostate, which both in structure and in function is rather a muscle than a gland, is situated at the neck of the bladder and around the first inch of the urethra. It is divided into two lateral (side) lobes (parts) by a deep notch behind and a furrow at the upper and lower surfaces. The so-called middle or third lobe is the portion which is between the two side lobes at the under and posterior part of the gland, just beneath the neck of the bladder. The urethra (the channel for the urine to pass through from the bladder out through the penis) usually passes through the gland at about the junction of its upper and middle third.

HYPERTROPHY OF THE PROSTATE.—This is a general enlargement of the gland in all directions. All the three lobes may enlarge and in about one-third of the men who have passed middle life some enlargement takes place, and in about one-tenth of all men over fifty-five this enlargement becomes of importance in regard to the size. The middle lobe may enlarge so much that it may extend up into the bladder and block the opening into the urethra; the side lobes may compress the urethra into a mere slit, or may lengthen it so that the prostatic portion measures three or four inches, or may twist and distort it so that the most flexible instrument can only be made to pass through it with difficulty.

Symptoms.—The earliest symptom may be increased frequency in passing urine, especially at night. Soon some urine is retained in the bladder, and this may increase so much that only an ounce or two can be passed spontaneously, although the bladder contains one pint or more. The stream of urine is feeble, and will drop perpendicularly towards the feet of the patient. In some cases an inflammation of the prostate and bladder is set up, and then the symptoms felt are very distressing. There is an almost constant desire to pass urine; there is much pain and straining with it; a slight bleeding may follow and night rest is broken; the general strength fails from the continual suffering; the urine becomes foul, smells like ammonia, and is reduced in quantity; inflammation of the kidneys develops also; general poisoning occurs; and the patient dies of uraemia and in a "coma" condition.

Treatment. Preventive.—The patient should avoid taking cold in this disease. Light and easily digested diet is necessary. The bowels must be kept regular. Alcohol of any kind should not be used. The bladder should be emptied at regular intervals. Some patients keep a catheter and "draw" their own urine. Unless the patient takes great care, the bladder and urethra will be irritated and perhaps infected through neglect of cleanliness. Medicines are not very useful in severe cases. Operation is the only reliable cure especially when some urine is always retained.

URINARY PASSAGE. Mother's Remedy.—1. Dandelion Root Will Clean.—"A decoction made of the sliced root of dandelion in white wine is very effectual for cleansing and healing inward ulcers in the urinary passage. If the fresh root cannot be obtained, buy extract of dandelion and give two teaspoonfuls in water once in two or three hours as the case requires. It also acts on the liver, gall and spleen."

[KIDNEY AND BLADDER 165]

DROPSY.—Dropsy should be regarded as a symptom, which may arise from many causes, such as heart disease, lung disease or kidney disease, or it may depend upon obstruction to the normal flow of blood and lymph through the vessels and tissues.

From Heart Disease.—In heart disease dropsy is due to a weak heart. The heart is unable to supply the arteries with enough blood to maintain the normal pressure, or to damming up of blood in the venous system as the result of imperfect emptying of the heart cavities. In kidney trouble the dropsy depends more on the lack of proper nourishing processes in the capillary walls and upon changes in the blood and blood pressure. If the kidneys are diseased, they may not be able to eliminate the proper amount of liquids which accumulate and finally escape into the tissues. Liver troubles cause dropsy by producing pressure upon the large blood-vessels going to the liver, and consequently the fluid is generally confined to the lower limbs and abdomen.

MOTHERS' REMEDIES. Dropsy, 1. Juniper Berries Fresh or Dry for.—"The berries of the juniper tree are regarded as excellent home remedies in dropsy. They may be eaten fresh or dry, or make a decoction and drink. Two teaspoonfuls of the berries two or three times a day is considered a dose. It is well to bruise them thoroughly by breaking the seeds with a hammer before taking." The decoction is more effective. This helps the dropsy by acting on the kidneys.

2. Dropsy, Wild Milkweed for.—"Steep the root of the wild milkweek and drink the tea in doses of a wineglass three times a day. This is a sure cure if taken in early stages."

3. Dropsy, White Bay Buds for.—"White bay buds steeped in water." The white bay buds can be secured at any drug store, and are easily prepared. Make a tea of these the same as you would make green tea for the table, only stronger. Take several times a day. This is an excellent remedy.

4. Dropsy, Canada Thistle for.—"Steep dwarf elder root, or Canada thistle root, and drink the tea." This is an old tried remedy that our grandmothers used to use, and can be depended upon. We all know that in olden times mothers had to use these herb remedies, as doctors could not be secured as easily as they can in these days.

5. Dropsy, Very Effective Remedy for.—"Make a decoction of fresh dandelion root slices, one ounce to one pint of water boiled down to one-half pint, strain, adding two drams of cream of tartar. Dose: A wine glassful two or three times a day."

6. Dropsy, Common Herb Remedy for.—"One gallon white beech bark, after the rough bark is removed, good big handful of blackberry root, cut fine, and also of sassafras root. Cover with cold water and steep to get the strength; then strain. When cool, not cold, add one pint bakers' yeast and one cup of sugar. Let it stand twenty-four hours in a warm place. Then strain and set in a cool place. Take a wineglassful three times a day before meals. This has been highly recommended to me by a friend in Kalkaska, Michigan."

[166 MOTHERS' REMEDIES]

7. Dropsy, "Queen of the Meadow" for.—"Is a symptom of morbid conditions existing in the system, therefore nutritious diet, alkaline baths and a general hygienic regulation of the daily habits are of the greatest importance. Take one teaspoonful of powder of "Queen of the Meadow" in a cupful of water three or four times a day as the case may require. Either use tea or powder."

PHYSICIANS' TREATMENT for Dropsy.—Treat the disease that causes it. Remedies should be given that will cause an outpouring of the liquids. Salines, such as epsom salts in large doses. Cream of tartar and epsom salts (equal parts) taken freely is effective. If the kidneys are inactive owing to heart trouble, the following may be used: An infusion of digitalis in one to four teaspoonful doses every three to four hours. This pill is good.

Powdered Digitalis 20 grains Powdered Squills 20 grains

Mix into twenty pills and take one every five hours.