HEMOPHILIA 413 



roast with peas, French beans, potatoes and preserved cranberries, 4. Mulber- 

 ries with cream, 5. Cake with marchpane. 



The general treatment of scurvy is entirely analogous with the prophylactic 

 diet. Warm baths often have a favorable action. 



Special treatment: In the drug treatment of scurvy, cochlearije has long 

 been prominent. A formula greatly employed is : 



^l^ Herb, cochl. rec. cone 50.0 



Sem. sinap. cont 12.5 



Vin. gall, alb 300.0 



Macera per biduum, colat. adde spir. seth. chlor 6.0 



M., D., S. : Half a wine-glassful three times daily. 



• 



There are further employed : Astringents, such as tonica amara, and aro- 

 matics, such as tannic acid, quinin, cascarilla, myrrh, ratanhia, calamus, and 

 gentian. 



The employment of beer yeast, pure or with the addition of water and 

 sugar, aa 200 to 300 grams, daily, is very popular. 



Disease of the gums is best prevented by the early removal of all carious 

 teeth and deposits of tartar; later this is not so feasible, and the affection of 

 the gums must then be treated locally with astringent solutions. Tincture 

 of myrrh, potassium chlorate and potassium permanganate in weakened solu- 

 tion are especially employed. 



In scorbutic cutaneous ulcers, poultices containing potassium permanganate 

 in solutions of 1 to 300 and bandages are serviceable. 



Hemorrhages are treated by styptics and tampons, as well as by ergot. 

 Surgical interference may be very dangerous ; even simple bandages that cause 

 pressure may bring about deep tissue hemorrhages and deep ulcerations. 



In case of constipation all purgatives which have a decided action are. to be 

 avoided unless absolutely necessary. The bowels must be opened by the cau- 

 tious administration of enemata, or by the employment of the mildest laxatives, 

 such as tamarinds, for by the too active stimulation of peristalsis fatal intes- 

 tinal hemorrhages may be produced. In the treatment of such bleeding little 

 or nothing is gained with styptics such as ergot and sesquiehlorid of iron ; ice 

 externally or internally serves the purpose best. 



HEMOPHILIA (BLEEDER'S DISEASE) 



By the term hemophilia we mean a peculiar hereditary anomaly of con- 

 stitution, characterized on the one hand by traumatic hemorrhages of extraordi- 

 nary stubbornness, and on the other hand by a conspicuous tendency to spon- 

 taneous and repeatedly recurring hemorrhages, for which, up to the present 

 time, no plausible anatomical substratum has been determined. Combined 

 with this is a marked predisposition to "rheumatic" affections which is mani- 

 fested by painful arthritic swellings. In the recognition of the disease, the 

 congenital and hereditary factors must be considered as well as the habitual 

 tendency to bleeding, and in the present conception of the disease these two 

 peculiarities dominate the clinical picture. They form a basis, too, for the dit- 



