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Simple hot water applied to inflamed eyes for hours together, allowing short intervals between the applications, will often cure most painful cases.
_Never apply cold_ to inflamed eyes. It always aggravates. When the inflammation is in a scrofulous person, especially in infants, it a.s.sumes a purulent character, and may leave the cornea in clouded (nebulous) condition, and the sight more or less obliterated. For this condition use _Conium_ first, and apply it _in tinct._, half water, to the eyes every four hours.
Wounds and Bruises.
On this subject, I must necessarily be very brief. When a wound is inflicted, the first and most important thing to be done is to _arrest the flow of blood_. Every one should know how to do this. The bleeding is to be stopped, and the wounded vessels to be secured, so that no further flow can take place.
First, then, to stop the bleeding, _pressure_ is to be made upon the artery leading to the wound. If the wound is in the leg or foot, pressure is to be made, either on the vessel above and near the wound, or, where that cannot be easily found and compressed, make firm pressure with the thumb or some hard substance, in the groin, about two and a half inches at one side of the center of the pelvis, (wounded side) just below the lower margin of the belly, towards the inner side of the thigh, where the great artery (Femoral artery) can be felt pulsating. By pressing firmly upon this artery, the blood is arrested in its flow into the limb, and of course the bleeding from the wound soon ceases. If the wound is in the arm or hand, _pressure_ is to be made, either just above the wound, or on the inside of the arm, about one-third of the way from the shoulder to the elbow, where the artery (Brachial) can be felt. To secure the parts from further bleeding, the wounded artery must be taken up and tied. Let it be seized by forceps, or the point of a needle may be thrust into it, and the vessel stretched out a little, a thread put round it and tied; cut off one end of the tie, and let the other hang out of the wound, until it comes out by the vessel sloughing off. Bring the lips of the wound together, and if it is large, put in st.i.tches enough to hold them, and put on an adhesive plaster, compress of cloths, and bandages to keep it from straining the st.i.tches, and protect it from the air. The _Arnica_ plaster, made by JOHN HALL, of Cleveland, is the best adhesive plaster of which I have any knowledge. Give the patient _Aconite_ once in two hours, for a day after the accident.
_Slight Cuts_ about the joints, especially the knee, are dangerous, from their liability to affect the ligaments, inflame, and produce _Lockjaw_.
Therefore, such wounds, ever so slight, are of great importance. They should be at once closed up, whether they bleed or not, and covered with an adhesive plaster, (Arnica plaster is the best) a bandage, and the knee should not be bent, even when walking or sitting, until the wound is healed. It is best to apply a splint from the hip to the heel, and bandage the limb to it, so as to prevent bending of the joint.
_Bruises_ are to be treated with _Arnica_, applied to the part affected, by putting twenty drops of the tincture into a gill of water, if the skin is _not_ ruptured, or three drops into the same if it is, and bathing freely. The _Arnica_ is to be taken internally at a higher dilution. Keep the parts covered with cloths and wet in _Arnica_ water.
If a blow is received upon the head, by a fall, or in any other way, producing a "stunning" effect, (concussion of the brain) so that the patient appears lifeless for a time, and delirious when he begins to come to, there is great danger of inflammation of the brain, and death from the re-action, or in some cases, the shock is so great that the patient will never revive unless he has the proper aid.
_Arnica_ is the great remedy to bring on reaction, arouse the patient, and prevent _dangerous_ inflammation or congestion of the brain.
When a patient is "stunned" by a blow or fall, he should be conveyed soon as possible, to some _quiet_ place, and as little noise as practicable made about him, and the room kept darkened. _Arnica_ 3d should be given immediately, and the nostrils wet with strongly arnicated water.
If fever arise after he comes to, _Aconite_ should be given with _Arnica_, and if the head aches, or becomes hot, _Bell._ is to be used.
This will prevent or arrest all symptoms of inflammation.
_Torn and Mangled_ wounds should not be handled much. If they bleed, the blood must be stopped as in any other case. If they are dirty, warm water may be gently applied to cleanse them. The wound should be covered with some soft cloths, and kept constantly wet in Arnicated water of the strength of four drops of the _tincture_ to a pint of water.
Piles--Hemorrhoids.
One important matter in all cases of habitual piles, is, to keep the bowels regular. Much can be done for this purpose by diet and regimen.
On rising from bed in the morning drink freely, from a gill to half a pint of cold water, at least half an hour before breakfast; use such diet as is easily digested, and drink no alcoholic beverages. To relieve the bowels when costive, take a dose of _Nux Vomica_ at night, and _Podophyllin_ in the morning. This may be repeated from day to day until the proper effect is produced.
To relieve from a severe attack of Piles, use _Bell._ and _Podophyllin_ in alternation every four hours, and apply to the tumors when inflamed, cloths wrung out of hot water, or sit in hot water for a time.
A poultice made of fine-cut _Tobacco_ wet in hot water and crowded firmly up against the pile-tumors, secured by a T bandage, will relieve the most desperate cases for the time, and is attended with no danger or disagreeable symptoms except in rare cases, when it produces sickness at the stomach, which soon subsides on the poultice being removed. _Oil of Arnica_ is an excellent application for inflamed Piles.
A most important point in the management of Piles, and one often neglected, is to replace the prolapsed tumors. The tumors will be protruded from within the a.n.u.s by the act of evacuating, and if left in that condition, will be pressed upon by the external parts, chafed and inflamed. In all such cases, the patient should take particular pains to return the tumors into the r.e.c.t.u.m; and to aid in that process a little oil may be applied when they will be easily pushed back, and the sphincter of the bowel will close below them, preventing any chafing, and the consequent inflammation.
For _Bleeding Piles_, _Ipecac_ and _Bell_. are very efficient remedies.
They may be alternated every half hour, or oftener if the bleeding is severe, or at longer intervals when it is only slight.
_Hamamelis V._, (Witch Hazel,) will in nearly all cases arrest the bleeding at once. It should be applied to the parts and taken internally at the same time. Drop doses to be put on the tongue once in fifteen or twenty minutes.
An infusion of the _Hamamelis_ may be taken internally in doses of half a teaspoonful, and the same injected into the bowel with excellent effect.
The most effectual way, and the best for obtaining permanent relief from Piles when the tumors have become hard, and remain all the time so as to pa.s.s out of the a.n.u.s at every evacuation, being constantly more or less tender and painful, and often becoming inflamed, is to have them taken off. But never let that be done with a knife. The bleeding would, in such a case, be very excessive, and most likely fatal. The history of knife operations for the excision of Pile tumors is written in blood, and the tombstone stands as a monument of condemnation of the practice.
No trustworthy surgeon will at this day attempt it.
But however dangerous may be the knife operation, there is no danger at all to be apprehended from removing the tumors by a _ligature_. To accomplish this, take a soft cork about three-fourths of an inch in diameter, and one inch long--make a hole through the center from end to end, about one-eighth of an inch in diameter--cut crucial grooves in the top of the cork about an eighth of an inch deep, bevel down the lower end nearly to an edge, make a cord of saddler's silk, three fold twisted together and waxed, about eight or ten inches long, double this in the middle and pa.s.s the loop down through the cork out at the sharp end, the two loose ends of the string being out at the grooved end. Make a strong hickory stick about three-sixteenths of an inch in diameter, and just long enough to pa.s.s across the square end of the cork. Now have the patient protrude the Pile tumors as far out as possible, being placed on his knees with the head bent to the floor, pressing out firmly as if to evacuate the bowels. Let the tumors be dried as much as possible by gently pressing a soft, dry cloth to them; then let the loop of the string projecting from the flattened end of the cork, be pushed on over the largest tumor, and held down at its base, while an a.s.sistant places the stick in one of the grooves, ties the two ends of the cord firmly down over the stick, or _toggle_, by a square bow knot; then turn the stick round once, twice, or more, until the pressure upon the tumor is sufficient to strangulate it perfectly, and prevent the string from slipping off. Care should be taken to keep the cord down to the base of the tumor while it is being tied and tightened, as in many cases the base is much the larger part of the tumor, and the cord tends to slip up. After the ligature is applied and tightened, apply arnicated water to the parts, and a large, warm poultice of superfine slippery elm bark, wet so as not to be too soft and slippery, on the face of which Arnica may be put. Keep it on with a T bandage. The patient must be put to bed and kept quiet until the ligature and tumor come off, which will be in about six or seven days, sometimes sooner. Once a day the "toggle" must be turned part, or the whole of a circle or more, to tighten the cord as the patient can bear. This will be very painful from beginning to end of the ligating, but any, even the most sensitive, patient can bear it. The patient must have quite warm hip baths two, three, or more, times a day, or as often as the pain is severe, the poultice being replaced after each bath, and kept constantly on.
If there are several tumors protruding, apply ligatures to two of the largest, when these are removed, the others will disappear.
Injections of mucillage of slippery elm should be carefully used to move the bowels daily, or at least once in two days. Let the diet be of corn or oat meal mush, or rice. As the tumor gradually sloughs off, the surface heals, so that, though the base where the ligature was applied, may have been an inch or more across it, there will not be a raw surface of over an eighth of an inch in diameter, to which _Calendula Cerate_ should be applied. The patient must keep quiet for a few days longer.
Though this is a painful operation, it is not in the slightest degree dangerous. I have effected complete and permanent cures by this mode in numerous instances.
Sea-Sickness.
_Nux Vomica_ should be used once in about four hours, for twelve hours before sailing, as a preventive to sea-sickness.
If, however, symptoms, such as dizziness or blur before the eyes, and headache, begin to come on, a dose of _Nux_ should be taken, followed in an hour with _Pulsatilla_.
If the nausea comes on, _Ipecac_ and _a.r.s.enic.u.m_ should be taken alternately between the paroxysms of vomiting, should that symptom appear.
If practicable, the patient should lay still upon the back until the sickness pa.s.ses off. I have removed sea-sickness immediately in several instances with _Pulsatilla_ alone, and the last time I had an opportunity to prescribe for this affection I gave _Podophyllin_. It removed all the symptoms in a few minutes. That is the only time I ever tried it, but from the provings I am satisfied it is one of the best remedies.
Asiatic Cholera.
I was practicing in Cincinnati during the prevalence of Cholera in the years 1849, and 1850, and in Northern Ohio in 1854, and had abundant opportunity to observe and treat it. The disease generally begins with a diarrhoea, which may continue for several days, or only a few hours before other symptoms set in, such as vomiting, then cramping in the stomach and muscles of the legs, arms, hands and feet, followed by cold sweats, great prostration, restlessness, excessive and burning thirst, drinks being immediately rejected. These symptoms continue, the patient sinking rapidly into _collapse_, when the skin looks blue and shriveled, the eyes sunken, the surface covered with a cold, clammy sweat, the extremities, nose, ears, tongue and breath cold, the voice hollow and unnatural. This condition continues from two to eight or ten hours, the patient regularly failing, sometimes becoming delirious before he dies.
In some cases the vomiting and diarrhoea set in simultaneously, and the other symptoms follow, as above described, in rapid succession. In others the cramping may be the first symptom, the others following it.
In a large proportion of cases, the disease takes the course first described above, the diarrhoea, called the _premonitory symptoms_, or sometimes _cholerine_, coming on several hours, if not a day or more, before any other symptoms.
The diarrhoea is not usually painful, hence the patient may not be alarmed so as to attend to it until the more dangerous symptoms appear.
It begins in some cases with pain and some griping, the discharges rather consistent, having a bilious appearance, so that the patient supposes it to be an ordinary bilious diarrhoea, which is not dangerous, his fears being thus quieted. But however the diarrhoea begins, it becomes sooner or later, copious, watery, and light colored, (rice water) painless but rapidly prostrating.
TREATMENT.
In the early stages of the diarrhoea, _Veratrum_, taken about twice as often as the evacuations occur, will frequently arrest it in a few hours, especially if the patient lies down and keeps quiet. But if not, and it increases in frequency, or becomes more copious, or any sickness is felt at the stomach, the patient should, at once, be laid upon a bed and _strong tincture of Camphor_ should be given in drop doses, once in five minutes, for one hour or more, and as the symptoms abate, once in ten, fifteen or twenty minutes, for six or eight hours.
A teaspoonful of the _Camphor tincture_ may be put into a tumbler of cold water, ice water if at hand, and the water agitated until it becomes clear, giving a teaspoonful of this camphorated _cold_ water as a dose, stirring the water each time. I think this is better than to give the pure tincture. After the patient becomes quiet and easy, _Veratrum_ should be given in alternation with Camphor, a dose in four to six hours for several days, or oftener if he feels any symptoms like a threatened return of the disease. These two medicines serve as _prophylactics_ (preventives) of Cholera.
If, however, the disease continues in spite of the Camphor and Veratrum, in the first instance, or later, (as the Camphor may be given in many cases with success in the advance stage,) you must resort to other remedies.
If vomiting comes on with burning in the stomach give _Ipecac_ and _a.r.s.enic.u.m_ in alternation as often as the vomiting occurs, and if the diarrhoea continues give _Veratrum_ between the doses of the other two, in a violent case, as often as every ten to fifteen minutes, and at longer intervals when the disease is slow in its progress. If the vomiting and diarrhoea, or either, occur with a kind of explosion, the vomiting ceasing suddenly for the time, after the first _gush_, or the discharges from the bowels are involuntary, _Secale_ is the specific remedy.
For the cramping, _Cuprum_ and _Veratrum_ are the remedies to be given alternately.
If, however, the _cramping_ comes on as the first symptom, which is sometimes the case, the patient being suddenly seized with it before any other alarming symptoms occur, _Camphor_ is _the great remedy_, and in this case it may be given in doses of double or treble the quant.i.ty before directed.
If he sinks into the _collapse_ and lies quiet, indifferent to everything, the pulse sinking, or he is pulseless, _Carbo Veg._ will sometimes arouse and restore him, hopeless as the case appears. It should be given once in half an hour until the pulse begins to rise. If, however, instead of being quiet he is restless and thirsty, give _a.r.s.enic.u.m_ in alternation with _Carbo Veg._, repeating the dose as above directed. In some cases, after all the active symptoms cease, the patient will become quiet and drop to sleep, and instead of the pulse rising, as it will if he is recovering, it sinks, or does not appear if he has been pulseless, and the breathing becomes irregular and feeble--he is sinking. If aroused, he sinks back into the stupor in a few moments as before. _Laurocerasus_ is a specific for this condition.
It should be given once an hour until he is aroused.
If, however, besides the stupor, the head is hot, the face red, the breathing oppressed, the pulse slow and sluggish, _Opium_ is to be used, and may be given in alternation with _Laurocerasus_.