Medical adviser : a full and plain treatise on the theory and practice of medicine suited to planters and families

Front matter

a

MEDICAL ADYISER:

A FULL AND PLAIN TREATISE

Preface

The author, after carefully reviewing the pages of this work, is obliged to acknowledge that it partakes of the character of all human productions, viz., that it is imperfect. It however contains as few errors of execution as perhaps any other work of its size ; but some subjects are treated of rather too much at length — not that any thing has been said which is not useful, but that it was the occasion of crowding out matter which would otherwise have been inserted. The fact is, the material which was prepared made more pages, when set in this large, beautiful type, than was anticipated, and by the time the work was half stereotyped it was discovered that a much greater amount of material was still on hand than had been used ; and though from that time the copy was condensed as much as possible consistent with clearness, yet a hundred and fifty pages more than was originally intended barely brought in that which was essential, still leaving out much that would have been interesting. But the purchaser need not object to the increased size of the work, as he will obtain it at the same price, the loss failing upon the author and publisher.

Another matter for which the author feels that he owes

the reader an apology is, that he has, in many instances,

used words which are unfamiliar to common readers, and

which could have been substituted by others more common ;

but these words, when understood, add much to the force

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IV PREFACE.

and clearness of the style, and may all be found explained in the Glossary, which has not been limited to technicalities, but is really a compendious dictionary.

So far as treatment is concerned, the work will be found sufficiently plain ; and the descriptions of disease have been also made as full and precise as possible. It is only in the philosophical part of the work that many words will be found that are not entirely common, except the mere names of diseases, and parts of the body, which have all been explained, and generally at the place where they occur.

In the prosecution of the work the author has drawn principally upon his own knowledge and experience, but has also availed himself largely of the experience of others; and, when the matter referred to has been of much importance, he has given his authority. In the description of diseases the author has principally followed Wood ; but the treatment is all his own, or presented upon his authority, except where expressly credited to others.

Chapter II. Specific Inflammations

Pulmonary Consumption 406

Gout 457

FUNCTIONAL DERANGEMENTS.

CHAPTER I.

^FUNCTIONAL DERANGEMENTS CONNECTED WITH THE DIGESTIVE

ORGANS.

General Remarks .... 458

Heartburn .... 481

Neuralgia of tfte Stomaon 481

CONTENTS. Vll

PAOK

Waterbrash 484

Cramp of the Stomach 486

Nausea and Vomiting 489

Sick-Headache 494

Depraved Appetite 496

Diarrhoea 499

Spasm of the (Esophagus 523

Cholera Morbus 525

Cholera 529

CHAPTER II.

FUNCTIONAL DERANGEMENTS CONNECTED WITH RESPIRATION.

Cold or Catarrh 561

Influenza 562

Spasm of the Glottis in Infants 576

Adults 579

Loss of Voice 579

Coryza 581

Ozaena 583

Inflammation of the Larynx 585

Croup 588

Chapter III. Functional Derangements Connected With The Circulatory

SYSTEM.

Palpitation of the Heart 593

Fainting or Syncope : 595

Angina Pectoris 598

Arterial Palpitation 603

Vlll CONTENTS.

PAGE

Anaemia 608

Chlorosis 609

Scurvy 613

Purpura 613 from the Nose 621

Mouth 624

Lungs 625

Stomach 630

Bowels 633

Rectum 639

Kidneys 642

Womb 645

Skin 651

Serous Membrane 653

Cellular Tissue 654

CHAPTER IY.

FUNCTIONAL DERANGEMENTS CONNECTED WITH THE ORGANS OP

SECRETION.

Anasarca 674

Dropsy of the Brain 676

Chest 678

Heart 680

Lungs 681

Abdomen 682

CHAPTER Y.

FUNCTIONAL DERANGEMENTS CONNECTED WITH THE URINARY ORGANS.

Nervous Affections 687

Nephritic Colic 688

Spasm of the Bladder 690

Irritable Bladder 690

Debility of the Bladder 691

Strangury 693

CONTENTS. ix

PAGE

Diseases of Secretion and Excretion of Urine 694

Diuresis 696

Suppression of Urine 702

Gravel 705

Retention of Urine 721

Incontinence of Urine 726

CHAPTER VI.

FUNCTIONAL DERANGEMENTS CONNECTED WITH THE NERVOUS

SYSTEM.

Nervous Irritation of the Brain -. 730

Vascular Irritation 731

Depression 733

Passive Congestion 735

Headache 735

Stupor and Wakefulness 740

Ecstasy 742

Somnambulism 743

Catalepsy 750

Idiocy 758

Moral Insanity 760

Monomania 760

Hypochondria 762

Insane Impulse 763

Delirium Tremens 774

Hysteria 786

CHAPTER VII.

FUNCTIONAL DISEASES OF THE SPINAL MARROW.

Chorea, or St. Vitus's Dance 788

Spinal Irritation 790

Contents

PAGE

Tetanus or Locked-jaw 792

Hydrophobia 798

Introduction

The author having been many years engaged in observing and treating disease, and ever watchful for any developments which might throw new light upon its nature, or lead to a better or safer treatment, had come to the conclusion that he had made some progress ; and, from time to time, made known to the profession his views upon various subjects through the medium of the press, medical societies, and occasional lectures to the students of Nashville Medical College. Finally he published a little book, entitled " Thompson on Fever, Dysentery, etc.," in which he gave whatever he esteemed new and valuable upon the subjects treated of in the work. The work was kindly received by the profession, and the treatment recommended has been generally found to be much more successful than any other previously adopted; in fact, the success of most of those who have reported appears to be unprecedented. As the first edition was soon exhausted, a second was imperatively called for ; the author accordingly prepared an enlarged edition, which is now rapidly being disposed of. Quite a number of planters and others, not of the profession, obtained the work, and have been enabled to manage their own cases of fever, pneumonia, dysentery, etc., very successfully. But as it was written expressly for physicians, though not abounding in technicalities, yet it is not quite plain enough to suit the common reader ; and then only a few diseases having been treated on, many such have importuned the author to write

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XIV INTRODUCTION.

a general practice, suited to families, so that they might have something to guide them in the absence of a physician. But he felt rather a dislike for family medical books, being perhaps prejudiced against them by the fact that the most he had examined had been written by very incompetent persons, abounding in bad treatment and worse language, the writers not knowing how to be plain without descending to vulgarisms. Others, on the contrary, are written in a style above the comprehension of ordinary readers, and all are behind the teachings of the age.

That a work written in good, plain style, and so worded that common decency would not be outraged by having it read aloud in the family, and containing such information as would enable the reader to guard against the encroachment of many diseases, or arrest them in the forming stage, would be eminently useful, and prevent much suffering, no one can deny ; and as many partial friends have impressed it upon the author that he possesses the peculiar qualifications necessary to write such a work as it should be done, and as he finally came to the conclusion that he could in this way do some good for his fellows, he obtained his own consent to undertake the task.

But being fully aware that it was no light task — a much harder one than preparing a general work for the profession would be, because it musl be more minute, and more carefully worded, and greater pains taken to say just enough to be understood, and not so much as to weary or produce confusion — all this, and more, being perceived and appreciated, occasioned a shrinking from the task; and would perhaps have occasioned an indefinite postponement of the work, but that my friend, I. W. Bliss, of this State, who has devoted much of his life to disseminating family medical works among the people, had come to the conclusion

INTRODUCTION. XV

that no work of the kind could now be obtained that was up to the teachings of the age, and approached me with the purpose of obtaining my aid in making such a revision as would remedy this serious defect. I accordingly looked over the works which he had been circulating, to see if such a thing could be easily done, and finally informed him that the works were so exceedingly imperfect in style, and embraced so little really valuable information, being taken up principally with very poor dissertations upon morals, family government, etc., and then were so very far behind the present improvements in medicine, that I could not undertake the task of a revision, as it would be a more onerous duty than writing a new work — which he importuned me to undertake, as he had made arrangements for going into the business extensively, and was obliged to have a work published.

After mature deliberation I came to the conclusion that perhaps duty enjoined upon me the task, and consented to undertake it. How well I shall succeed in meeting the expectations of friends the event must determine. The greatest difficulty which I anticipate is the lack of words which are familiar to the common reader to express medical ideas ; and rather than fail in communicating the idea, I suppose it will be better to put the reader to the trouble of learning the word which represents it. Very few words, however, will be used but what will be explained by the connection in which they stand ; but, in addition, they will all be found in a glossary at the end of the work.

As the author has for a third of a century been a member of the regular medical profession, and has labored hard, if not successfully, in advancing its usefulness and guarding its honor, he of course feels himself identified with its interests, and would be slow to undertake any enterprise that would in any way be in opposition to the one or the other.

XVI INTRODUCTION.

But he is very certain that to furnish the people with correct medical information is the only successful means of securing proper respect for honorable, scientific medicine, in contradistinction to the isms, humbuggery, and quackery of the day.

The fact is, that the profession has been sadly lacking in its duties to itself, and to the people, in this respect. No adequate efforts have ever been made for furnishing the masses with a pure and correct medical literature, and of course the people receive their medical ideas principally from quack advertisements, almanacs, and puffs of charlatans, whose trade it is to decry and caricature the regular profession. Even the very best writers of family medical books have not thought it worth while to reason with the people, or teach them " the why and the wherefore" of their prescriptions ; taking it for granted, I suppose, that the people-would not comprehend the science of diseased action. But I am very confident that this is a mistake, and that if the truth is presented in a plain and clear style, it will be attractive, and will be studied, and understood sufficiently at least to enable the reader to perceive the distinction between science and pretence. But I do not entertain the idea that this or any other work will ever make the people their own physicians, so as to supersede the services of the men who make medicine the business of their lives. Nothing short of entire devotedness to the subject can qualify a man for the important business of taking charge of the lives of his fellows ; and unceasing attention to the subject is essential for keeping posted as to the progress of the science, and the varying types of disease.

If this be true, says one, why should I purchase your work, and waste time in reading it, if I have to call on a doctor at last when sickness comes ?

INTRODUCTION. XYli

There are sufficient reasons, my good friend, why you should. First, as a purely literary work it will well pay for y our most careful perusal and study in the enlargement of your ideas and improvement of your style, if that is not already good, and the work be written as it should be. Secondly, it will pay by enabling you to know the approach of disease, and, by the timely use of means, prevent its full development. -Thirdly, it will enable you to manage many cases without medical advice, and by being familiar with the signs of amendment, or of a dangerous turn of the disease, will prevent you from sending for your physician unnecessarily, or of deferring it too late. And, fourthly, it will pay by qualifying you for better judging of the qualifications of those who hold themselves as physicians ; for to be guarded against pretence and imposture, or even stupidity assuming the garb of wisdom, is no small matter — your all of life may depend on it. So I insist that you procure correct medical information ; and if this work should fail in presenting it in the most attractive form, or in the simplest language, recollect it deals in grave truths, and not in pleasing fancies, and that unknown facts often require the use of words also previously unknown; but, at any rate, seek medical information, and if you can find it purer or better dressed elsewhere, seek it there.

But, although the author claims to be of the regular medical profession, and will in this work give its teachings as set forth by the best and latest authors, yet in some things he differs from many of his brethren, and will give the reader the benefit, as he thinks, of this difference, but will also give the treatment by others in such cases. It is, however, only in reference to fever that he holds peculiar views ; and since he made these views known, or within the last five years, many of the most prominent 2

XVU1 INTRODUCTION.

physicians, both in Europe and the United States, have advanced very similar doctrines, so that at present the author's peculiar treatment of fevers is in harmony with the tendency of the age ; but its unusual success would entitle it to acceptance unsupported by authority.

It is with reference to febrile diseases that the author will feel himself called on more particularly "to give a reason for the faith that is in him," and he hopes to be heard patiently, for his object is the good of the reader, and not his own advantage ; for he has sacrificed much for "the defence of the truth," and is now too old to be elated by success, however brilliant.

Before entering upon the main body of this work, it will be well to take a hasty view of parts of the human body usually referred to in reference to diseases, and of the classes of remedies commonly prescribed, so that the reader may better understand what is meant when terms are used significant of these things.

DIVISIONS OF THE HUMAN BODY.

As there are certain divisions of the body which are often referred to in connection with the descriptions of diseases, it will be well at the outset to point them out, and give the names by which they are designated. The grand divisions are, the head, trunk, and extremities. The head is divided into the head proper ; or all that part usually covered with hair, and the face, including the forehead, eyes, ears, nose, and the upper and lower jaws, or maxilla. The trunk is divided into the neck, chest or thorax, the abdomen, pelvis or basin, and the back-bone or spinal column j which is again divided into its cervical portion, forming the neck ; dorsal, to which the ribs are joined ; the lumbar, forming the small of the back ; and the sacrum and

INTRODUCTION. XIX

coccyx, which terminate the column. The chest, or thorax, comprises all that part of the trunk included within the ribs and breast-bone, or sternum, and contains the heart and lungs, or lights. The abdomen is the space between the ribs and the bones of the pelvis, and contains principally the stomach, bowels, liver, pancreas, spleen, and urinary bladder ; its divisions are — the epigastrium, or pit of the stomach; the right and left hypochondria, which are the spaces on each side of the epigastrium, or pit of the stomach ; the umbilical region, or the middle portion, of which the navel forms the centre ; on each side of which the space is called the hypogastrium. Below the right and left hypogastrium, and above the groin, the space is called the iliac region, and between those in front, and situated between the umbilical region and the pubes, or share bone, is the pubic region.

In order to fix these divisions of the abdomen in the memory of the reader, we will again refer to them in connection Avith the organs which are principally found in each. The stomach is found in the epigastric region, and hence its complaints are referred to this part. The end of the breast-bone forms about the centre of the* epigastrium, for the diaphragm or midriff which divides the chest from the abdomen rises upward in the middle, and allows a part of the stomach and liver to lie above the line of the ribs. The liver is principally found in the right liypochondrium, but its thinner edge extends across the epigastrium, and frequently reaches the left liypochondrium. The great bowel, or colon, crosses from the right hypogastrium between the navel and the end of the breast-bone, and reaches the left hypogastrium, and then descends; this is 'called the arch of the colon. Hence, in wind colic the pain is commonly felt to commence in the right side, and extend across

XX INTRODUCTION.

the belly to the left, where it descends, and, if the wind be expelled, for a time ceases ; but it may return by a reverse motion in the bowel, and then the misery will be felt crossing from the left to the right side. The small intestines are mostly contained in the middle or umbilical region — the umbilicus, or navel, being the centre ; hence, when they are the seat of suffering, it is felt mostly near this point. The spleen lies obliquely across the left side of the belly, extending from a little to the left of the end of the breast-bone, or centre of the epigastrium, downward, and toward the left groin ; so that it principally is found in the left hypogastrium, and when much enlarged, as in the ague cakes in old cases of fever and ague, it often is felt extending from the breast-bone to the hip. The kidneys are seated one on each side of the lumbar vertebra, or bones of the small of the back, and are said to lie in the lumbar region.

The ovaries of the female lie in each iliac region, and hence, when the seat of irritation from cold or deranged menstruation, the uneasiness is felt a little above the groin. The bladder lies behind, and, when full, above the centre of the pubes or front bone, and is said to be in the pubic region. The basin, or pelvis, contains principally the womb in the unimpregnated state, the vagina, the bladder when empty, and the rectum, or lower gut.

The upper extremities are divided into the shoulder, the arm, extending from the shoulder to the elbow, the forearm, the wrist, and the hand. The lower extremities are divided into the hip, the thigh, the leg, the ankle, and the foot.

CLASSIFICATION OF MEDICINES.

Medicines are divided into external and internal. External remedies may either be general, as the hot and cold

INTRODUCTION. XXI

bath ; or topical, when only applied to a particular part, as blisters, poultices, etc.

Topical remedies have received names which designate or point out the particular effect which is produced, as —

Rubefacients, or means which excite the skin, as the various stimulating liniments.

Epispastics, those which cause blistering.

Emollients, or applications which soften the skin and allay irritation, as mild poultices.

Discutients, or such as tend to discuss or drive away swellings or risings.

Refrigerants, or those which allay heat, etc.

Internal remedies have also been divided into classes, which have received names denoting the principal effect produced, or the particular organ on which they mostly act, as,

Emetics, or medicines which occasion vomiting.

Nauseants, such as produce a less degree of sickness than will produce vomiting.

Cathartics, or medicines which purge the bowels ; and these are said to be active or drastic when they occasion very copious or profuse discharges ; and aperient or laxative when the effect is mild and gentle.

Diuretics are such medicines as increase the flow of urine.

Emmenagogues are remedies which excite the menses or courses.

Diaphoretics, such means as promote increased secretion from the skin, as in sweating; and these are also called sudorific s when the action is very powerful.

Expectorants are such medicines as excite a discharge from the lungs and throat, by increasing the natural secretions of these parts.

Sialogogues are medicines which increase the flow of saliva or spittle.

XX11 INTRODUCTION.

Sternutatories, such as excite the secretions of the nose or nares.

Hydragogues are medicines which occasion an increased discharge of water or serum, as from the bowels or kidneys.

Cholagogues are medicines which produce a flow of bile, as the mercurials.

Anthelmintics are such means as expel worms.

Antacids are such as neutralize or destroy acids in the stomach or bowels.

Absorbents are such medicines as combine with and render inert acrid matters in the stomach and bowels, as chalk, charcoal, etc.

All these are more or less local in their effects upon certain organs or parts. There are other remedies which produce a general effect upon the whole system, as,

Astringents, or such medicines as cause an increased contraction of the tissues or fibres.

Tonics, or those which give strength or tone to the system.

Corroborants, which mean nearly the same thing as tonic, viz., strengthening, invigorating.

Antiseptics, or medicines which resist putrescency, or a tendency to gangrene or decomposition, as the acids, and most of the essential oils.

Stimulants, or such means as increase the activity or force of the circulation of the blood.

Nervous Stimulants are remedies which excite a more vigorous condition of the brain and nerves.

Narcotics are means which depress nervous influence, and destroy consciousness and sensibility, as opium, henbane, etc.

Sedatives or Anodynes are such remedies as relieve pain

INTRODUCTION. XX111

and allay nervous irritation without producing unconsciousness, such as assafoetida and hops.

• Antispasmodics are nearly the same as sedatives, but the term is particularly applicable to such means as prevent spasm and soothe nervous irritation without occasioning stupor or any disposition to sleep, as musk, castor, etc.

Ancesthetics, or such means as destroy sensation, as chloroform, ether, etc.

Alteratives, or such remedies as produce a gradual change in the condition of the system, as iodide of potassium.

Attenuants, such as occasion a thinness of the blood.

Disobstruents or detergents, such medicines as cleanse the system from impurities ; and, lastly,

Alimentives or dietetics, or such means as nourish or build up the system, as food and drink.

MEDICAL ADYISER.

FEVER.

Chapter I

fever: its nature and phenomena.

Febrile diseases have, in every age and country, formed the principal outlet of human life. Sydenham estimated that in his day two-thirds of the human family died of fevers. At this time, I suppose the mortality from this cause is not so great ; perhaps not more than one-half now die of fevers. But this is sufficient to give the subject paramount importance ; and any plan which would materially lessen the mortality, we would reasonably suppose, would be seized on by every one who had a spark of philanthropy in his composition.

Suppose a plan were adopted which would stop this outlet to human existence : it would save in one year, in these United States alone, at least half a million of lives ; a number greater than that which composed the entire belligerent forces in the late European war. But a plan which would save half of this amount would in all fairness entitle the discoverer to be classed among the prominent benefactors of mankind. And this, yes, more than this, I profess to have discovered, and propose to explain. I will not only speak of the means used, and present the evidence of their success, but trust that I shall be able to prove, by sound philosophical reasoning, that there is a fitness between the means and the end ; and that the remedies ought to do exactly what I have proved by experience that they will perforin. But whether this important discovery will be duly appreciated, is yet to be ascertained.

I am aware that we are all slow, .to acknowledge any thing to be great which is the work of a contemporary, and especially of a fellow-citizen and an equal : it requires the charm of distance, of time or space, to throw around any great, discovery that prestige which commends it to our acceptance.

In order to a correct understanding of any derangement in complicated machinery, it is essentially necessary to possess a thorough knowledge of its construction, and the philosophy of its operations. With regard to the mechanism of the human system, and the manner of its natural movements, I must refer the reader to systematic works on anatomy and physiology ; I can only here give a general summing up of a few of the most important points.

For example, we have the osseous [bony] system, forming the framework ; the fibro-cartilaginous system, to invest the bones and tie them together; the muscular, whose office it is to act upon the bones and other parts, and put them in motion ; the glandular system, to prepare material for ingress and excretion ; the circulatory, by which material for reparation is carried to every part, and the worn-out particles conveyed from every part ; the cerebrum, [upper brain,] where thoughts are manufactured and sensations recognized ; the organs of sense, which serve to put this thinking apparatus into connection with the world; the cerebellum [lower brain] and its spinal prolongation, where motive and other powers are generated for propelling all this complicated machinery; the nerves, which serve as electric wires to transmit intelligence or influence to the great mental or sentient emporiums, and return the proper responses ; then we have the cuticular [skinny] system, which forms a covering for the whole, and a lining for all the hollow viscera which have an external opening; and, lastly, we have the cellular system, which serves the important purpose of connecting all the other parts together, of filling up irregularities and unoccupied spaces, and giving to the whole the proper form and pleasing contour which is presented by a well-developed human body.

Now, in order that we may have a perfect manifestation of the phenomena of life, all these parts must be fully developed, and in a healthy condition, and each perform its function well. It is evident that if any part be preternaturally developed, or act with unwonted power, a loss of harmony must be the consequence, and the whole machinery be caused to work imperfectly or unnaturally. If all should work with increased power, we would certainly have a high development of the phenomena of life ; and if all should act with diminished energy, we would have a weaker development of life ; but so long as there remained harmony of action between the various parts, in neither case would we have disease. I wish to impress this particularly upon your attention, for some important inferences will be drawn from it. I therefore reiterate, that neither increased nor diminished action constitutes disease, so long as there is harmony maintained between the various organs. Example : take a young man whose system is fully developed ; place him under the influence of the various excitants addressed to each organ and sense ; let his stomach be stimulated by the most savory food and exhilarating viands ; his hearing enraptured by exciting music ; his smell regaled by the most delicious odors ; his eyes wander over a galaxy of captivating beauty ; his touch vibrate to the magic influence of contact with the embodiment of female loveliness ; his muscles strung to their highest tone by the whirling dance ; his sexual orgasm thrilled by the uncovered developments of feminine charms ; his intellect excited to its highest capacity by sallies of wit, sentiment and humor from his bewitching partner.

Look at him! His eye flashes light ; intelligence and zest of enjoyment beam from every feature ; his whole form is full from centripetal action ; his step is as elastic as the steel bow ; his heart beats vigorously, and sends the red current coursing through the minutest vessels. Is he sick? He never could feel better. But will not disease ensue from this state of excitement as a consequence ? It may, or it may not. If his stamina is good, if his organs are well balanced, this state of high excitement may be indulged in a thousand times with impunity; but if there should be some weak point, some imperfectly developed organ, it may suffer under the pressure, become exhausted by the excessive tension, and afterward be incapable of performing well its part ; disturbance in the play of the machinery of life be the consequence, and disease be set up, more or less dangerous in proportion to the importance of the suffering organ to the continuance of life. By this disturbance in the play of the vital forces, resulting from the broken harmony among the organs, some are thrown into increased action, but others are debilitated. There is never general increased action ; for then would there be harmony in the. working of the machinery, and a high state of life would follow, and not disease. But it is philosophically certain that no one organ can act with unusual power for a considerable length of time without exhausting its energies, and occasioning subsequent debility in itself; and also, by breaking up the harmony, and calling upon the general supply for more blood and more vital influence than are allotted to it, either the whole system must feel the shock, or, what is more common, some other organ, from accidental or constitutional weakness, wijl suffer in particular.