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the neck, headaches, stupor, muscular spasms, a slow pulse, often purple bleeding, eruption, coma and death within hours, rather than days. This is a terrible disease, and a physician is needed from the first. The death rate varies from twenty to seventy-live per cent. Treatment must be given by a physician. Spinal meningitis is inflammation of the membrane of the spinal cord along with the accompanying back and extremity symptoms, while the head remains clear and free from complications.

MENINGITIS.—This is an inflammation of the membranes covering the brain alone, and generally commences with fever and severe headaches, with avoidance of light and noise as these are painful. In some cases we have delirium, stupor and coma.

Treatment.—Treatment must be given by a physician, but cold applications to the head and back are generally good. The bowels also must be kept open.

MENINGITIS. Tubercular, (Basilar Meningitis).—This affection which is also known as acute hydrocephalus (meaning water on the brain), is essentially an acute tuberculosis in which the membranes of the brain, sometimes of the cord bear the brunt of the attack. It is more common in children than in adults. It is more frequent between the second and fifth years, than in the first year. It is caused by the tubercular infection, and follows the usual course of this disease. Ordinary meningitis is rapid and well defined in its course, with "high fever," severe pains in the head, intense nervousness, avoidance of light and sound, loss of appetite and constipation. These symptoms are easily understood and are generally clearly read by those around the patient. Unfortunately in tubercular meningitis the clearly defined symptoms are absent in the beginning, and when the physician is called the condition is dangerous. Usually the patient complains but little. There is a slight headache, low fever, no heat in the head, patient is pale most of the time, has little appetite, vomits occasionally and desires to sleep. He is nervous, stupid and lies on his side curled up with eyes away from the light. This disease appears mostly in delicate children, who are poor eaters and fond of books; usually in those inheriting poor constitutions. The mortality is very high. Parents who have thin, pale sallow children with dainty appetites, who frequently complain of headaches and are fond of books, should be afraid of infection from tuberculosis and make the little ones live in the open air and keep away from school. But earlier in the lives of these children care must be taken. A child with that pale, thin, sallow, delicate face and poor body should be fed with the best of food and live in the open air. I once had a family who lost their only two babies through this disease. After the first one died I instructed them carefully how to treat the second child. However, they loved their child foolishly and not wisely and fed it everything it wanted, and you know the children take an advantage of their parents. Give plenty of good, wholesome digestible food. Dress them comfortably and warm and keep them out in the open air. No cakes, candy, peanuts or any food that is not nourishing and easy to digest.

[INFECTIOUS DISEASES 211]

TUBERCULOSIS. (CONSUMPTION).—Tuberculosis is an infectious disease caused by the bacillus, tuberculosis, and characterized by the formation of nodules or diffuse masses of new tissue. Man, fowls and cows are chiefly affected.

Indians, negroes and Irish are very susceptible. The disease is less common at great altitudes. Dark, poorly ventilated rooms, such as tenements and factories and the crowding of cities favors infection, as do in-door life and occupations in which dust must be inhaled. Certain infections such as measles, whooping-cough, chronic heart, kidney and liver diseases and inflammation of the air tract are predisposing factors. Inhalation is the chief mode of transmission. Hereditary transmission is rare.

Forms. The Lungs.—Consumption. This is caused by a germ. Some have the form called galloping consumption. This person is attacked suddenly, wastes away and dies, in a very short time. There is rapid loss of strength and weight, high fever, night sweats, fast breathing, pains in the chest, cough and profuse expectoration, and rapid loss of strength.

Ordinary Consumption.—Begins slowly and the patient is not aware of the danger. He may have loss of appetite, dyspepsia, diarrhea and distress after meals. He looks pale, is weak and loses flesh. Soon he has a hacking cough, worse in the morning, with a scanty, glairy sputum. His weight continues to decrease, his heart is weak and beats faster. He has pain in his chest below the shoulder blades. He may have a slight bleeding from the lungs. His cough becomes worse, the expectoration gets thicker and more profuse, with night sweats, high fever, and shortness of breath. The eyes are bright; the cheeks are pale or flushed. Chronic looseness of the bowels may be present. Bleeding from the lungs may occur at any time, but it is most frequent and profuse during the last stages. The patient becomes very weak, thin and pale, emaciated. The brain action remains good, and he remains hopeful almost until the last. Tuberculosis may exist in almost every part of the body and we have many forms. It is not necessary to discuss all. It would tend to confusion. I will name the most of them:

  1. Acute Miliary Tuberculosis.
    (A.) Acute General Miliary Tuberculosis.
    (B.) Pulmonary (lung) type.
    (C.) Tubercular Meningitis.

  2. Tuberculosis of the lymph nodes (glands). This was formerly called
  Scrofula. This is more curable and will be treated more fully elsewhere.

3. Tuberculous Pleurisy.

4. Tuberculous Pericarditis.

5. Tuberculous Peritonitis. (Of this there are a good many cases.)

6. Tuberculosis of the Larynx.

7. Acute Pneumonia (Pulmonary Tuberculosis) or "Galloping Consumption."

8. Chronic Ulcerative Pulmonary Tuberculosis.

9. Chronic Miliary Tuberculosis.

10. Tuberculosis of the Alimentary Canal.

11. Tuberculosis of the Brain.

12. Tuberculosis of the liver, kidneys, bladder, etc.

13. Tuberculosis of joints, this will be treated more fully elsewhere.

[212 MOTHERS' REMEDIES]

CERVICAL, TUBERCULOSIS (Scrofula).—This is common in children that are not well nourished, living in badly ventilated and crowded houses, and in the negroes. Chronic catarrh of the nose and throat and tonsilitis predispose to it. The glands under the lower jaw are usually the first involved. They are enlarged, smooth, firm and often become matted together. Later the skin may adhere to them and suppuration occurs, that is, pus forms. An abscess results that breaks through the skin and leaves a nasty looking sore or scar. The glands in the back of the neck may enlarge also; or in the arm pit or under the collar bone and also the bronchial glands. There is usually secondary anemia. A long course and spontaneous recovery are common. Lung or general miliary tuberculosis may occur.

Mesenteric Kind.—Symptoms are loss of flesh and strength, anemia, distended abdomen (pot-belly) and bloated, with offensive diarrhea.

MOTHERS' REMEDIES.—1. Consumption, Simple Home Method to Break up.—"A cloth saturated with kerosene oil, bound around the chest at night and frequently repeated, will remove lung soreness, and it may be taken inwardly with advantages, eight to ten drops three or four times a day in sarsaparilla. It has been tried efficaciously as a cure for consumption."

2. Consumption, Physicians' Remedy for.—

      Arsenic Acid 1 part
      Carbonate of Potash 2 parts
      Cinnamyllic Acid 3 parts

Heat this until a perfect solution is obtained, then add twenty-five parts cognac and three parts of watery extract of opium which has been dissolved in twenty-five parts of water filtered. Dose:—At first take six drops after dinner and supper, gradually increasing to twenty-two drops. Mild cases are cured in two months, but the severe cases may require a year or two. This treatment should be given under the care of a physician, as it is poisonous and needs close watching.

[INFECTIOUS DISEASES 213]

PHYSICIANS' TREATMENT for Consumption.—Tuberculous peritonitis is often present. General better hygienic measures; fresh air, nourishing food; cod-liver oil. The glands are now often cut.

Sanitary Care. Prevention of Tuberculosis.—The sputum of consumptives should be carefully collected and destroyed. Patients should be urged not to spit about carelessly, but always use a spit cup and never swallow the sputum. The destruction of the sputum of consumptives should be a routine measure in both hospitals and private practice. Thorough boiling or putting in the fire is sufficient. It should be explained to the patient that the only risk, practically is from this source.

The chances of infection are greatest in young children. The nursing and care of consumptives involves very slight risks indeed, if proper precautions are taken.

Second.—A second important measure, relates to the inspection of dairies and slaughter houses. The possibility of the transmission of tuberculosis by infected milk has been fully demonstrated, and in the interest of health, the state should take measures to stamp out tuberculosis in cattle.

Individual Prevention.—A mother with pulmonary tuberculosis should not nurse her child. An infant born of tuberculosis parents or of a family in which consumption prevails, should be brought up with the greatest care and guarded most particularly against catarrhal affections of all kinds. Special attention should be given to the throat and nose, and on the first indication of mouth breathing or any affection of the nose, a careful examination should be made for adenoids. The child should be clothed in flannel, and live in the open air as much as possible, avoiding close rooms. It is a good practice to sponge the throat and chest night and morning with cold water. Special attention should be paid to the diet and to the mode of feeding. The meals should be given at regular hours, and the food plain and substantial. From the onset the child should be encouraged to drink freely of milk. Unfortunately in these cases there seems to be an uncontrollable aversion to fats of all kinds. As the child grows older, systematically regulated exercise or a course of pulmonary (lung) gymnastics may be taken. In the choice of an occupation, preference should be given to an out of door life. Families with a predisposition to tuberculosis should, if possible, reside in an equable climate. It would be best for a young person belonging to such a family to remove to Colorado or Southern California, or to some other suitable climate before trouble begins. The trifling ailments of children should be carefully watched. In convalescence from fevers, which so frequently prove dangerous, the greatest care should be exercised to prevent from catching cold. Cod-liver oil, the syrup of iodide of iron and arsenic may be given. Enlarged tonsils should be removed. "The spontaneous healing of local tuberculosis is an every-day affair. Many cases of adenitis (inflammation of the glands) and disease of the bone or joints terminate favorably. The healing of pulmonary (lung) tuberculosis is shown clinically by the recovery of patients in whose sputa elastic tissue and bacilli have been found."

[214 MOTHERS' REMEDIES]

General Measures.—The cure of tuberculosis is a question of nutrition; digestion and assimilation control the situation; make a patient grow fat, and the local disease may be left to take care of itself. There are three indications:

First, to place the patient in surroundings most favorable for the greatest degree of nutrition; second, to take such measures as in a local and general way influence the tuberculosis process; third, to alleviate the symptoms. This is effected by the open air treatment with the necessary feeding and nursing.

At Home.—In the majority of cases patients must be treated at home. In the city it has many disadvantages. The patient's bed should be in a room where he can have plenty of sunshine and air. Two things are essential—plenty of fresh air and sunshine. While there is fever he should be at rest in bed. For the greater part of each day, unless the weather is blustering and raining, the windows should be open. On the bright days he can sit out-doors on a balcony or porch, in a reclining chair. He must be in the open air all that is possible to be. A great many patients spend most of the time out in the open air now. In the country places this can be easily carried out. In the summer he should be out of doors from eleven to twelve hours; in the winter six to eight at least. At night the room should be cool and thoroughly ventilated. "In the early stages of the disease with much fever, it may require several months of this rest treatment to the open air before the temperature falls to normal." The sputum is dangerous when it becomes dry. As long as sputum is moist the germs

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