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severe cases they may become atrophied and an eruption often appears along the course of the nerve. Sometimes the hair and nails are not properly nourished, causing falling out or grayness of the hair and loss of the nails. This neuritis may extend from the peripheral (external) nerves and involve the larger nerve trunks or even reach the spinal cord. This rarely occurs in neuritis from cold, or in that which follows fevers; but it occurs most frequently in neuritis caused by blows, wounds, etc., (traumatic).

Duration.—This varies from a few days to weeks or months. If the primary cause can be remedied it usually ends in full recovery. Sometimes it is followed by the chronic form.

PHYSICIANS' TREATMENT for Neuritis.—The first thing to do is to try to remove the cause. Then absolute and continued rest of the affected part. If one has a sore hand it will be rested, if possible; so it must be with the sore and inflamed nerve.

For the Attack.—After having placed the part in absolute rest, moist heat applied to it frequently brings great relief. Sometimes a mustard plaster applied along the sore part does good. This produces a counter irritation and thus draws some of the congestion from the congested, inflamed nerve. Ice is more effective in some cases than heat. The bowels should be kept open daily with salts. Build up the general health with tonics; no alcohol can be used. If it shows a tendency to become chronic, use massage, electricity or change of climate. Atrophy (shrinking) of the muscles is likely to follow if the disease continues long and for this massage and electricity must be given.

[278 MOTHERS' REMEDIES]

Treatment. Preventive.—A person who has once had neuritis must exercise all care to keep from taking cold or exposing themselves to severe cold winds and storms. Wet clothing will be apt to cause its return. Damp houses are bad. The climate should be dry and not changeable. There should be enough and proper kind of clothing to keep the body heat at the normal point. Plenty of rest and sleep are required. These cautions also apply to rheumatism and neuralgias.

Multiple Neuritis.—Other names: Polyneuritis, Disseminated Neuritis, Peripheral Neuritis. Meaning—Multiple neuritis is an inflammatory disease of the peripheral (toward the end of the nerves or external nerves) nervous system. It varies much in extent and intensity and affects symmetrical parts of the body.

Varieties.—These arise from differences in the nature, causes, severity and location of the disease process.

Causes.—They are many. (1.) The poison that comes from infectious diseases such as typhoid fever, diphtheria, smallpox, leprosy, la grippe, etc. (2) From poisons such as alcohol, lead, arsenic; phosphorus, mercury, coal gas, etc. (3) From anemia, cancer, tuberculosis, syphilis, septicemia, diabetes. (4) From cold, over-exertion, etc.

Symptoms.—Acute febrile multiple neuritis. A typical case: This comes on from exposure to cold, over-exertion, or in some cases spontaneously. There are chills, headaches, pains in the back, limbs and joints, and the case may be called rheumatism. Loss of appetite, coated tongue, constipation, and other symptoms of stomach and bowel trouble. The temperature rises rapidly, and may go to 103 to 104 degrees. The limbs and back ache, but intense pain in the nerves are not always constant. The pain is usually sharp, severe, and located in the limbs, and is worse from moving and pressure. There are tingling feelings in the hands, feet and body, and a feeling as if ants or insects were crawling over them, and there is also increased sensitiveness of the nerve trunks or entire limb. There is loss of muscular power, first marked, perhaps, in the legs, and it extends upwards and reaches the arms. Sometimes it first begins in the arms. In typical cases the extending muscles of the wrist and ankles drop. (Wristdrop and foot-drop). In severe cases there is a general loss of muscular power, producing a flabby paralysis. This may extend to the muscles that control speaking, swallowing and hearing resulting in impairment of these functions. The muscles soften and waste away rapidly. Disorders of nutrition are frequent, like watery swelling (oedema), glossy looking skin, sweating, hives, etc.

[NERVOUS SYSTEM 279]

Recovery.—The course of the disease varies considerably. In mild cases the symptoms disappear very soon. In the worst form the patient may die in a week or ten days. As a rule, in moderately severe cases after persisting for five or six weeks, the condition remains about the same for a few months, and then improvement slowly begins and recovery takes place in six to twelve months. In neuritis from alcohol drinking there is a rapid onset as a rule, with delirium and delusions. The result is usually favorable and after persisting for weeks or months improvement gradually begins, the muscles regain their power, and even in the most desperate cases recovery may follow. The mental symptoms are very severe in alcoholic cases. Delirium is common. It takes much longer for such cases to regain what they call their normal condition.

Neuritis following diphtheria and other infectious diseases. The outlook in cases from these diseases is usually favorable, and except in diphtheria, fatal cases are uncommon. It is most common from diphtheria. Recovery, in neuritis from diphtheria, takes place in about three months, but some cases are fatal.

Neuritis from lead.—The first symptoms are those of intestinal colic, lead line on the gums, "dropped-wrist." The recovery is quite gradual and the poison may be cast out in three to four months.

In Neuritis from Arsenic.—We have disturbance of the stomach and bowels first, then the legs and arms are about equally affected, weakened; may recover in two to six months.

Treatment for acute kind.—The first thing to do is to rest in bed and control the pain and acute symptoms. Hot applications help to relieve the suffering. Patient must be kept comfortably and constantly warm and quiet. Hot applications of lead water and laudanum.

Medicines.—It may be necessary to use morphine to control the pain. Remedies such as antipyrine or aspirin are often used. A physician must be called. When the disease is caused by arsenic and lead and alcohol, of course you must remove the cause before you can hope for any improvement.

Caution.—Any one can readily understand from reading this description that the thing to do is to be careful not to needlessly expose yourself to taking cold. One subject to rheumatism or neuritis, even in small degree, should take care not only not to take cold but not to overdo in laboring; cold, wet and over-exertion cause the majority of the acute attacks. But some are caused by diseases, such as diphtheria, typhoid fever, etc., and a great many cases of neuritis following these and other infectious diseases can be avoided if proper care is taken during and after these diseases. Such care can easily be taken. Keep your rooms warm and comfortable, and the patient in bed or in a comfortable room until all danger is past. How often I have heard a doctor blamed for such results when in most cases it is the patient's or nurse's fault. Certain results will follow certain diseases and only proper care can keep such results from following. Dropsy frequently follows even a light case of scarlet fever. Why? Simply because, on account of being a light case, the child is left to roam at will about the rooms and catches cold, takes la grippe. If people would only take care of themselves this disease would not leave so many lifelong victims. I have seen men and women who have just recovered from this disease stand on the street corners on a cold, damp day, and talk an hour, and the next day they wondered how they could possibly have taken cold. We cannot disobey the laws of nature safely. Persons who are subject to neuritis or rheumatism should be especially careful on cold, damp, wet days and of over-exertion.

[280 MOTHERS' REMEDIES] GENERAL AND FUNCTIONAL BRAIN DISEASES. NERVOUS PROSTRATION. NERVOUS EXHAUSTION. NEURASTHENIA.

NERVOUS PROSTRATION.—Is a condition of weakness or exhaustion of the nervous system, giving rise to various forms of mental and bodily inefficiency.

Causes. 1. Hereditary causes.—Some children are born of parents who are weak themselves, and who have led fast lives through business or pleasure and these parents have given their offspring a weakened body, and the children are handicapped with a nervous predisposition and furnish a considerable proportion of "nervous" patients.

2. Acquired.—It is acquired by continual worry and overwork, sexual indiscretion, excesses, irregular living and indiscretion in diet. A great many business men, teachers and journalists become "neurasthenics." It may follow infectious diseases, particularly influenza, typhoid fever and syphilis. It also follows operations sometimes. Alcohol, tobacco, morphine may produce a high grade of the disease, if their use is abused.

Symptoms.—These are varied. The most prominent symptom is fatigue. The patient feels so tired and complains of being unable to do any mental labor. It is almost impossible to put the mind on one subject for any length of time. There are headache, dizziness, want of sleep, and there is great depression of spirits; patient is gloomy, irritable in temper with manifestations of hysteria. Sometimes there are marked symptoms of spinal trouble. Pain along the spine with spots or areas of tenderness. Pains simulating rheumatism are present. There is frequently great muscular weakness, great prostration after the least exertion, and a feeling of numbness, tingling, and neuralgic pains. In spinal symptoms, there is an aching pain in the back, or in the back of the neck, which is a quite constant complaint. Then there are the anxiety symptoms in many cases. There may be only a fear of impending insanity or of approaching death, or of apoplexy, in simple cases. More frequently the anxious feeling is localized somewhere in the body, in the heart region, in the head, in the abdomen, in the thorax (chest, etc.). In some cases the anxiety becomes intense. They are so restless they do not know what to do with themselves. They throw themselves on the bed, complain, and cry, etc. Sometimes the patients become so desperate they commit suicide. Some patients do not wish to see anyone. Some patients cannot read, reading wearies them so much, or they get confused and dizzy and must stop. Some are very irritable. They complain of everything. Remember they cannot help it, usually. Some are easily insulted and claim they are misunderstood. The circulation may be disturbed in some cases. Then there is palpitation of the heart, irregular and very rapid pulse, pains, and feeling of oppression around the heart, cold hands, and feet. The heart's action may be increased by the least excitement and with the fast pulse and palpitation there are feelings of dizziness and anxiety and such patients are sure they have organic disease of the heart. No wonder. Flashes of heat, especially in the head, and transient congestion of the skin are distressing symptoms. Profuse sweating may occur. In women, especially, and sometimes in men, the hands and feet are cold, the nose is red or blue, and the face feels "pinched." Nervous dyspepsia is present in many cases. The digestion is poor and slow and constipation accompanies it. Sometimes there is neuralgia of the stomach. The sexual organs are seemingly affected, many men are "almost scared to death" and they use all sorts of quack remedies to restore their sexual vigor. Spermatorrhea is their bugbear. They usually get well if they stop worrying. In women there is the tender ovary and the menstruation may be painful or irregular. The condition of the urine in these patients is important. Many cases are complicated with lithaemia (sand-stone in the urine). It is sometimes also increased in quantity.

[NERVOUS SYSTEM 281]

PHYSICIANS' TREATMENT for Nervous Prostration.—The patient must be assured and made to believe that the disease is curable, but that it will take time and earnest help on the part of the patient. Much medicine is not needed, only enough to keep the system working well. Encouragement is what is needed from attendants. Remove the patient from the causes that produce the trouble, whether it be business, worry, over-study, too much social duties, or excesses of any kind. The patient must have confidence in the physician, and he must be attentive to the complaints of the patient. It is the height of foolishness and absurdity for a physician to tell such a patient before he has thoroughly examined him or her that the troubles are imaginary. I believe that is not prudent in the majority of cases. I have heard physicians talk that way to such patients. I thought, what fools! The patient needs proper sympathy and sensible encouragement. You must make them believe they are going to get well. If you do not wish to do this, refuse such cases, or you will fail with them. If there are any patients that need encouragement and kindly, sympathetic, judicious "cheering up,"

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