-16 THE TREATMENT OF DISEASES. 



mercury (obtainable from any chemist), and rub up in a mortar until no red grains 

 are visible, and keep it in pots protected from the light. The ointment is applied 

 to the swelling at sun-rise, and is well rubbed in for at least ten minutes. The 

 patient then sits in the sun as long as he can endure it. In some six or eight hours 

 there will probably be more or less pain from the blistering action of the application. 

 About two in the afternoon the ointment is again well rubbed in with the hand. 

 Some ointment is then left in contact with the swelling, and this becomes absorbed 

 by about the third day. In ordinary cases one such course is usually found to 

 effect a cure ; but in bad cases it may be necessary to repeat the treatment after an 

 interval of from six to twelve months. In England, the kitchen fire will probably 

 have to be substituted for the rays of the sun. Very good results have been 

 obtained by rubbing in the ointment night and morning, and afterwards covering it 

 with oil-silk. 



For many years spongia, or roasted sponge, has been used in the treatment of 

 goitre. It contains both iodine and bromine, and it is probably to the presence of 

 one or both of these bodies that its curative properties are due. It has, however, 

 sometimes proved successful where iodine has failed. To be of service it must 

 be given in small doses and frequently. 



For exophthalmic goitre, tincture of belladonna is the best remedy. Its effects 

 are often very striking. In one case, five tea-spoonfuls of the belladonna mixture 

 (Pr. 39), taken hourly, afforded great relief in four or five days, although the disease 

 had lasted more than a year, and in two months a cure was all but effected. Of 

 course, in this, as in the other form, iron should be given when ansemia is a marked 

 symptom. 



Such, then, is the medical treatment of bronchocele. Should these remedies fail, 

 it may, under certain circumstances, be necessary to resort to surgical interference. 

 It may, however, be laid down as a rule that so long as the disease is merely a 

 deformity so long as it does not interfere with any of the important functions of the 

 body, nor produce serious discomfort does not distress the breathing by pressing 

 upon the windpipe, nor interfere with swallowing by pressing upon the gullet, nor 

 impede to any great extent the flow of blood to or from the head by pressing upon 

 the great blood-vessels of the neck, nor grievously encumber the patient by its 

 weight, a surgical operation is neither advisable nor justifiable. 



We must now say a word or two on what is known as cretinism. By cretinism we 

 mean a strange, melancholy disease, which has a curious and as yet but little under- 

 stood connection with goitre. It is a kind of idiocy, accompanied by some deformity 

 or affection of the bodily organs. The mental affection varies in degree from mere 

 obtuseness of thought and purpose to complete obliteration of intelligence. Many 

 cretins are incapable of articulate speech ; some are blind, some deaf, and others 

 labour under all these privations. They are usually dwarfish in stature, with large 

 heads, wide vacant features, goggle eyes,* short crooked limbs, flabby muscles, and 

 retracted bellies. This disease occurs most commonly in goitreous districts. It is met 

 with in the Pyrenees, in the Alps, in the mountains of Syria, in the hilly parts of 

 China, and in the Himalaya regions. With few exceptions, cretins have bronchocele; 

 but of course bronchocele is not always accompanied by cretinism. What is the 



