MEDICINE. 



caused by eating unripe fruit, indigestible food 

 such as duck, or veal, or salmon by drinking 

 impure water, by mental excitement, or by cold or 

 damp. The symptoms are well known. If caused 

 by any irritating food or fruit, a dose of castor-oil, 

 along with 8 or 10 drops of laudanum, should 

 be given. If due to other causes, astringents, 

 such as chalk mixture (No. 4), are serviceable. 

 The irritation of having a constant desire to go 

 to stool, with pain, called tenesmus, may be re- 

 lieved by a warm hip-bath. The diet should be 

 nutritious and non-stimulating such as arrow- 

 root, or rice and milk, or white fish. Where there 

 is severe pain, the individual may take with bene- 

 fit a little cold brandy and water. Pain in the 

 bowels, or colic, is usually due to flatulence. It 

 may be distinguished from inflammatory pain by 

 the fact of being relieved by pressure, while there 

 is no fever or quickness of the pulse. As a rule, 

 the pain is quickly removed by hot brandy and 

 water, followed soon after by a dose of castor-oil 

 Constipation is more a symptom than a disease, 

 and as it may be caused in many different ways, 

 it is difficult to treat. Medical advice is neces- 

 sary ; but it may be laid down as a general rule, 

 that the habit of taking purgatives daily is in- 

 jurious. The patient should try various kinds of 

 diet, indulge in outdoor exercise, and take as little 

 medicine as possible. Occasionally, the bowels 

 become obstructed, so as to prevent the passage 

 of faecal matter. This is a disorder often fatal. 

 It requires the best advice ; and all we can do 

 here is to indicate the earlier symptoms. These 

 are vomiting, swelling of the abdomen, consti- 

 pation, hiccup, and great mental depression. All 

 that can be done in the absence of a doctor is to 

 apply hot fomentations, give a dose of castor-oil, 

 and support the patient with nourishing food, 

 given in small quantities at a time. 



6. Intestinal Worms. Various worms infest the 

 intestinal canal of man. We will describe the 

 more common species : (a) Trichocephalus dispar, 

 or long thread-worm, about 2 inches in length, 

 like a bit of yellowish-white thread, (b) Ascaris 

 lumbricoides, a large round white worm, like an 

 earth-worm, except in colour, found chiefly in 

 children, (c) Oxyuris -vermicularis, the common 

 little white worm, about \ inch in length, found in 

 great numbers in the lower bowel of children, 

 causing itching and irritation about the anus, 

 picking of the nose, foul breath, and grinding of 

 the teeth during sleep. All these worms may be 

 removed by small doses of jalap or scammony pow- 

 der (No. 5), or by the administration of from i to 

 5 grains of santonine, according to the age of the 

 child, and followed by a purge of castor-oil. This 

 dose may be repeated, (d) Tcenia, the tape- 

 worms, of which there are various species. The 

 symptoms produced by the presence of these large 

 parasites are indefinite, and the only reliable 

 evidence of their existence is the presence in the 

 stools of fragments of the worm, like bits of seg- 

 mented tape. The remedy of most service is 

 an oil obtained from the male fern. A tea-spoonful 

 of this oil, beat up in mucilage, taken at bedtime, 

 and followed in the morning by a dose of castor- 

 oil, rarely fails in bringing away the intruder. 



7. Diseases of the lower bowel or rectum give rise 

 to much suffering, and always cause depression 

 of spirits and anxiety. Children suffer occasion- 

 ally from a protrusion of the lower part of the 



bowel, even to the extent of 5 or 6 inches. This 

 usually happens in badly nourished children, and 

 therefore it is of the first importance to improve 

 the general health by nourishing food and tonics, 

 such as small doses of iron (No. 6). When the 

 bowel protrudes, it should be carefully replaced by 

 pushing it upwards with a wet towel or handker- 

 chief ; the anus is then to be sponged with cold 

 water, and pressure made on it by a pad of lint or 

 cotton, fixed by a bandage. If these means prove 

 insufficient, consult a surgeon. Adults suffer from 

 various diseases of the anus. An abscess may 

 form in the loose tissue round the rectum, which 

 may open internally into the bowel, and externally 

 by the side of the anus. This is then called a 

 fistula, and as the irritation caused by it weakens 

 the general health, surgical advice is necessary. 

 A common malady among all classes, but more 

 especially among sedentary people, is known as 

 haemorrhoids or piles. Haemorrhoids are either 

 swollen and congested veins, or they may be 

 simply excrescences of the skin. Occasionally 

 they bleed freely at each stool. They cannot be 

 cured by home treatment, but the symptoms may 

 be palliated. When very painful, bathing with 

 warm water gives great relief. If they are not 

 inflamed, but bleed, bathing with cold water is 

 useful. As they are usually connected with a 

 constipated condition of the bowels, small doses 

 of purgatives, such as magnesia or sulphur mixed 

 with treacle, should be used. No substances 

 which act on the lower bowel (such as aloes) 

 can be given, because they cause much irritation. 

 Plain nourishing food and walking exercise are 

 important. Stimulants are forbidden. 



II. DISEASES OF THE ORGANS OF THE 

 CIRCULATION. 



The chief organs of the circulation (see PHYSI- 

 OLOGY) are the Heart, the Arteries, and the Veins. 



I. The Heart. This organ is surrounded by a 

 covering termed the pericardium, composed exter- 

 nally of fibrous tissue, and lined by a delicate 

 membrane which is reflected from the pericardium 

 over the surface of the heart. The two surfaces, 

 in health, glide smoothly on each other. It is 

 often the seat of inflammation (pericarditis). 

 The effect of inflammation is to render the mem- 

 brane (which, in health, is smooth and glistening) 

 dry and rough ; and usually there is an effusion 

 between the layers of the membrane of a watery 

 fluid from the blood, called serum. This accum- 

 ulation of fluid interferes with the action of the 

 heart, and causes great distress. Afterwards, the 

 fluid may be absorbed, and the roughened sur- 

 faces of the membrane may again touch, and 

 ultimately firmly adhere together. The heart is 

 then bound to the pericardium, and its free action 

 is interfered with, a result which may lead to other 

 diseases of the organ. Pericarditis may occur 

 suddenly during the course of acute rheumatism, 

 or of disease of the kidneys, attended by dropsy. 

 There is usually pain in the region of the heart, 

 an intense feeling of uneasiness, and high fever. 

 In these circumstances, apply hot fomentations 

 over the heart, and send at once for medical 

 advice. 



What is commonly known as heart disease 

 is disease of those valves which guard the 

 various apertures in the interior of the heart, and 



