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Showing posts from October, 2010

Parasitic Disease of the Intestines - Worms.

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- RUDDOCK.E.H, (Entozoa). The three most common parasites are the following - the Oxyuris Vermicularis (the small thread-worm), and the Ascaris lumbricoides (the long round worm); the Taenia solium (or pork tape-worm), and Taenia saginata (the beef-worm), the common tape- worm of this country. The tape-worm is the least frequent of the three types, and is very rare till after the third year. There are many other worms parasitic on man, but these three are the ones commonly met with. Round worms. The OXYURIS, from a quarter to nearly an inch long, is the smallest of the worms that infest the intestines; they often exist in clusters, rolled up in masses of considerable size, chiefly, but not exclusively, in the rectum. They are thread- like, white, and move very rapidly, and when touched contract to nearly one-half their usual length. The term maw worm is sometimes applied to them, from the irritation caused in the stomach by a reflex action. They do not exist in infants fed at

Diarrhoea:Frequent excessive, fluid evacuation from the bowels

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- RUDDOCK.E.H, DEFINITION- Frequent excessive, fluid evacuation from the bowels, without tormina or straining, from functional or structural change in the small intestines, of a local or constitution origin. Simple frequency of evacuation may exist while her may be no increase in the quantity of faeces, matter discharged or it may even be deficient. True diarrhoea depends upon defective absorption of the intestine, so that an excess of matter passes through them, and less is taken up for the nourishment f the body. FORMS-The following are the chief Irritative Diarrhoea from successive stimulating or Inflammation diarrhoea; Diarrhoea lienterica, or discharges of unaltered food from arrest of the digestive and simulative functions and Summer -diarrhoea Diarrhoea lienterica, or discharge of of unaltered food form arrest of he digestive and assimilative functions; and Summer Diarrhoea a(see Enteritis). SYMPTOMS-Nausea, flatulence, griping pain in the bowels; followed by loose m

Fissure of Anus.

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- RUDDOCK.E.H, DEFINITION-A longitudinal ulcer at the anal margin. It is similar to the crack which occurs in. he lower lip of the mouth, and like the later, is exquisitely painful. Fissure of the anus is usually single and situated in the middle line posteriorly. Below it there is a tag of he mucous membrane called 'sentinel pile. SYMPTOMS-Severe burning pain during and after defecation with great spasm of he anal sphincter muscle. the faeces may be streaked with blood. TREATMENT-(See P{lies and Fistula in Ano.) -the bowels must be regulated, copious hot enemata being used when necessary, and ointment of calendula, Hamamelis, or AEsculus applied. In many cases a small operation under anesthetic is necessary.

Pruritus Ani-Itching of the Anus.

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- RUDDOCK.E.H, DEFINITION-A peculiar itching of the anus, at first of a voluptuous character, but afterwards violent and almost unbearable. SYMPTOMS-Crawling, tingling, irritating sensations about the anus, often most troublesome at night, as the patient gets warm in bed, and preventing sleep. It is frequently complicated with an excoriated or fissured condition of he anus. CAUSES-Irritation of Piles; worms; Pediculi; habitual taking of opium or Chloral; lodgment of faeces; suppressed period., or any suddenly-suppressed discharge of cutaneous eruption. Frequently, itching of he anus is only a symptom of disease of the liver, of some portion of he digestive apparatus, especially the rectum, or of some apt immediate proximity thereto. The primary cause must, therefore be removed or relieved. Pruritus Ani The patient must strenuously endeavour to avoid scratching the part, as this invariably aggravates the condition. TREATMENT-Sulph., Ac.-Nit., Lyc., Ant.-C., ARs., Nat. Mur.

Prolapsus Ani-Falling of the Bowel.

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- RUDDOCK.E.H, Definition-A protrusion of the rectum though the anal orifice. If the mucous membrane is alone prolapsed the condition is called prolapsus ani; if the entire thickness of the rectal wall is involved the term 'Prolapsus recti is applied. the order is commonly associated with pile sin adults, and the latter is more common in children. CAUSES-Long-continued Constipation or diarrhoea, purgatives, straining excited by the presence of worms, enlarged prostate, Stone in the bladder, etc. General laxity of structure may predispose to the complaint, or at any rate aggravate the causes already indicated. TREATMENT-Ignatia-Is often specific, and i generally the first to be used, especially for infants and children. The indications are-frequent ineffectual urging to stool, straining, difficult passage of faeces. itching, and Prolapse of bowel. A dose thrice daily, for two or three days; afterwards, morning and night. Prolapsus Ani Nux Vomica-Prolapsus, with costivenes

Disease of the Liver Inflammation - Cirrhosis.

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- RUDDOCK.E.H, Inflammation in the substance of the live occurs either in the form of solitary abscess see Section on Tropical Disease), or as a result of general septic poisoning, with formation of small multiple abscess The fibrous capsule of the organ may become inflamed (perihepatitis). This disease is best classed with Cirrhosis. Cirrhosis-There are various varieties of Cirrhosis due to various cause. The commonest form result from chronic alcoholism, but other poisons, such as lead, occasionally cause similar changes, and it can occur from generally disease, such as gout, diabetes, rickets, and especially from malaria or syphilis. Alcoholic Cirrhosis (hob-nailed liver-This disease is characterized by the development of fibrous tissue between the liver cells, causing their destruction. The organ is usually much diminished inside, but if there is a fatty degeneration present as well it may be increased wherein there is always an enlargement of the liver., and also of the sple

Jaundice.

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- RUDDOCK.E.H, the above term is used to express conditions in which many of he tissues and fluids of the body become yellow, especially the whites of the eyes, and the connective tissues of the body,. Jaundice is a symptoms of some acute or chronic affects of the liver, not disease. SYMPTOMS-Yellow rings, first of the white of the eyes, then of the roots of the nails, and next the face and neck, and finally the trunk and extremities. The urine becomes yellow-coloured or deep-brown, and stains the linen; the faces whitish or drab- coloured; there is Constipation; LassituDe; anxiety; pain in. he stomach; bitter taste;a nd generally febrile symptoms. Sometimes, especially in children, the bowels are relaxed from the food not being properly digested and occasioning irritation. there are also, usually, depression of spirits, prostration of strength, and slowness of he pulse. The presence of yellow tint in the conjunctivae and urine is very conclusive that the patient is suffering from

Appendicitis.

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- RUDDOCK.E.H, A DEFINITION-Inflammation of the appendix vermiformis, due to bacterial infection of its lining membrane. Except in the mildest forms of catarrh of the appendix peritoneum covering it,a nd if the peritoneum fail to react or the infection be virulent, this localized peritonitis may rapidly spread until the condition of general peritonitis is set up. An important result of catarrh with stagnation of contents in. the appendix is the formation of appendicular concretions. These concretions often bear a resemblance to date stones, plum stones, or orange-pipes. but contrary to the popular belief, it is extremely rare for any recognizable foreign-body, which has been swallowed with the food, to be found in the appendix. Although appendicitis is chiefly a disease of youth, and occurs with greatest frequency between the ages of ten and thirty, it may e met with at any period of life. It is more common in the male than in the female, and usually occurs in those who are app

Myxoedema and Cretinism- (Hypo-thyroidism).

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- RUDDOCK.E.H, There are certain circumstances of unknown origin by reason of which the Thyroid gland ceases to function. The result is Myxoedema of Cretinism, the first being a disease of advanced life, the second of early years. Cretinism may be congenital, the gland being absent. More commonly it atrophies after one of the fevers. Where goitre (q.v.) is epidemic, cretinism occurs; the gland is enlarged in these cases, but not functioning. SYMPTOMS OF CRETINISM.- The child (in a congenial case) is mentally slow or deficient. The tissue is thin and the skin dry. The face is pale and the eyelids are puffy, the whole body gradually acquires a swollen appearance. The fontanelles remain open; there is great muscular weakness. Imbecility is the rule in regard to the mental condition. If Cretinism follows fever or goitre these symptoms appear in individuals who may till then have been bright and well developed. The words stunted growth and feeble mind sum up the condition. SYMPTOMS

Hyperthyroidism-Exophthalmic Goitre.

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- RUDDOCK.E.H, In this disease the thyroid is over active. Cases of all degrees may be met with. Acute infection, worry, shock, nerve strain, all seem to play a predisposing part and the tendency to this disease runs in families. Goitre. SYMPTOMS.- Acute cases are known but are rare. Usually the onset is gradual. The pulse rate rises to 120, 140 or more, with visible pulsation of vessels. The face is flushed and erythema is common. The thyroid gland enlarges as a rule; the swelling is firm and elastic. A double murmur may be heard by the stethoscope placed not he gland The eyeballs protrude, and the eyelids retract (Exophthalmus). Tremor is an early symptom affecting the hands chiefly. Anaemia, emaciation, occasionally fever, vomiting and diarrhoea, are all possible symptoms. Myxoedema may follow this disease. The body output of energy is increased. TREATMENT.- The disease may disappear spontaneously, even after lasting for months. When advanced cases have resisted medicine

Goitre.

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- RUDDOCK.E.H, This is a chronic enlargement of the Thyroid Gland, attacking women more often than men and occurring about puberty generally. The cause is obscure; it has been considered as due to excess or deficiency of some mineral constituents in the drinking water, or to a specific micro-organism as yet unidentified. Possibly the last is the essential and the other a contributory cause. Goitre is very common in certain districts, Oxfordshire, Derbyshire, parts of Switzerland, Pyrenees, etc., and in all goitrous districts water tends to the hard, rich in lime and magnesia, and poor in iodine. The enlargement of the gland in simple goitre does not mean over activity as in exophthalmic goitre. Generally, indeed, the gland secretion seems lessened and enlargement may sometimes be compensatory. There are few symptoms beyond the enlargement, and occasionally, pressure symptoms, cough and dyspnoea. Many cases spontaneously recover. Large tumours or those causing pressure can be sent

Tetany.

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- RUDDOCK.E.H, Beside the Thyroid gland are two pairs of small glands called Parathyroids. They control the dealings of the body with Calcium (lime). When this is interfered with by disease of these glands, the nerve muscular system becomes over-excitable, and spasms of muscles of the extremities occur. This condition is Tetany. The disease may be epidemic, may follow infections. In adults gastro-intestinal symptoms are common, and the fundamental cause may be an intestinal toxaemia acting specially on parathyroids. In children it is common with rickets (q.v.), and other nutritive disorders (see Laryngismus Stridulus). SYMPTOMS.- The spasms are the characteristic feature. The arms are flexed across the chest, the two last finger-joints extended and the first joints flexed. The thumb is flexed into the palm. There is planter flexion of feet and toes, and the legs are extended. Other groups of muscles may be involved in face or elsewhere; spasm of the larynx is possible; pain is ra

Muscae Volitantes (Muscae Volitantes) - Spots before the Eyes.

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- RUDDOCK.E.H, DEFINITION. - An appearance before the vision as of black motes; or of thin grey films, like the wings of a fly; or half- transparent grey threads, like spiders' webs; or if viewed against a white wall, or other clear and near object, they appear as one of a number of small circles with a central aperture. They depend probably upon minute remains of the embryonic tissue in the vitreous humour. Mouches volantes have no clinical importance. They do not interfere with the acuteness of vision. Those annoyed with them are strongly recommended not to look for them, as in that case others are very apt to become visible. Muscae Volitantes CAUSES. - The exciting causes of these ocular spectres are chiefly the following short sight (myopia), excessive use of the eyes, especially in artificial light, or in badly-ventilated rooms; insufficient sleep; certain fevers, as Typhus and Enteric; deranged digestion; Hypochondriasis; morbid sensibility of the general system from

Scarlet Fever-- Scarlatina.

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- RUDDOCK.E.H, (A popular idea exists that when the disease is severe it is termed Scarlet Fever, but when mild, Scarlatina; the terms, however, are strictly synonymous.) Like Measles, Scarlet fever is infectious and contagious, but it is much more to be dreaded. It chiefly affects children, and usually occurs but once in the same person. During the epidemic in London (1869-70), however, instances were comparatively numerous in which the disease occurred a second time in the same person. The second, third, fourth, and fifth years of life are those in which it is most prevalent; after the tenth year its frequency rapidly declines. The opinion that the disease does not attack children under two years of age is erroneous, for in 1887 the deaths from this disease in England and Wales were 7,859; and out of this number 5,111 were children under five years of age, 435 of these being under twelve months old. in 1910 the deaths were 2,370, and above 2,000 of these were in patients under si

TUPHUS TREATMENT:

- RUDDOCK.E.H, TREATMENT.-- It is a question whether Typhus can ever be cut short, or the definite course of the disease altered by the administration of remedies; some contend that it may be broken up in the first stage especially by the combination of Homoeopathic remedies and hydropathic appliances; other believes that the disease must have its course. However, our experience amply proves that in the great majority of cases the violence of the symptoms can be held in check, the patient's comfort promoted, and convalescence hastened, by judicious treatment. EPITOME OF TREATMENT.-- 1. Febrile symptoms.-- Acon., Bapt., Bry., Gels. 2. Cerebral Symptoms.-- hyos., Bell., Verat.-vir. Stram. Tereb. (from Uraemia). 3. Sleeplessness.-- Coff., Bell., Gels. 4. Stupor.--Opi., Rhus. 5. Extreme prostration.-- Ac.-Mur., Ars., Ac.-Phos. 6. Pulmonary complications.-- Phos., Bry., Acon., (Congestion). 7. Septicaemic conditio

Enteric Fever-- Typhoid Fever.

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- RUDDOCK.E.H, DEFINITION.-- Enteric Fever (so-called from its chief pathological effects being evident in the bowels ) is a continued fever, whose infective agent is contained in the motions, and is generally conveyed through contamination of the water supply,lasting about twenty-one days, often longer, with an eruption of a few rose-coloured spots on the chest, abdomen, or back , and attended with a great feebleness, abdominal pains of tenderness, ulceration of the intestine, and usually diarrhoea, which increases with the disease, the discharges being copious, liquid, of a light-ochre colour, putrid, and often containing altered blood. The word Typhoid signifies similarity to Typhus; but although the two fevers have many symptoms in common, Enteric is essentially a different disease, which render it important to be able early to identify the variety we may be called upon to treat. Thus the causes of these fevers are different, and suggest sanitary regulations of an opposite natu

Chronic Gout.

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- RUDDOCK.E.H, DEFINITION. A persistent constitutional affection, characterised by stiffness and swelling of various joints with deposits of urate of soda. SYMPTOMS. The deposits in the joints constitute the distinguishing feature; chronic stiffness and swelling of various joints, with pain, are considered as cases of Chronic Rheumatism. The original condition of the Chalk stone Deposits is that of a liquid, rendered more or less opalescent from the presence of acicular crystals; as the fluid part is absorbed, the consequently becomes creamy, and at last a solid concretion is produced. When the effusion is confined to the cartilages, unless very excessive, the injury to the mobility of the joint is comparatively slight; but when the ligaments are infiltrated, they are rigid, and the play of the parts is consequently interfered with. If a bursa has been infiltrated the resulting chalk stone is free and of uniform composition, but the distortion is considerable. The visible occurrenc

Osteo Arthritis (Arthritis Deformans).

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- RUDDOCK.E.H, DEFINITION. A chronic disease of the joints, characterized by changes in the synovial membranes and ligaments, and often by atrophic or hypertrophic changes in the bones. This disease was long called Rheumatic Gout, but is distinct from both Rheumatism and Gout. It affects women more than men, and is generally a disease of middle life. It appears often at least, if not always, to be due to poisoning from some chronic suppuration. The effect of gonorrhoea in causing joint troubles us well known, and diseases like pyorrhoea alveolaris ( a disease of the gums and teeth, with constant suppuration), or chronic pelvic inflammation, leucorrhoeas, etc., are responsible for some manifestations of osteo arthritis. Exposure to damp and cold. worry and care, overwork and under feeding are all predisposing cause. SYMPTOMS. The disease may come on acutely with fever and implication of several joints. Even cardiac complications are observed, and in children enlargement of lymph gla

TUMOURS TREATMENT:

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- RUDDOCK.E.H, TREATMENT. Except perhaps in the case of that form of malignant disease termed rodent ulcer, there is, at the present day, no means of treating a malignant tumour in the early stages of its growth, which holds out a sufficient hope of effecting a cure to justify recourse to it rather than in resorting at once to removal by operation. Unfortunately in the majority of cases of malignant disease, it is the presence of metastases which render the condition inoperable. Operation for a malignant tumor may sometimes be justified, even when a cure is not obtained, if the patient's life is prolonged in a condition of comparative comfort, or even if life is not prolonged, if the distress and suffering due to the primary growth are relieved. Tumour The treatment cannot be commenced too early. There is no single remedy which is capable of curing every given case of Cancer; but cases of even advanced Cancer have been cured by different remedies. Each case must be treated

Syphilis - Venereal Disease.

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- RUDDOCK.E.H, DEFINITION. - A chronic contagious, sometimes congenital, disease peculiar to human subjects, due to the entrance of a specific motile spiral micro-organism, the spirochaeta pallida, through abraded skin or mucous membrane. Syphilis is usually, but not always, a venereal disease, and is communicated by inoculation which occurs for the most part during sexual intercourse with an infected person. The disease may also be transmitted by infection of the tongue or lips in kissing, by smoking poisoned pipes, by drinking out of infected vessels, by vaccination with human lymph which contains the pus of a syphilitic eruption or the blood of a syphilitic person. Primary Syphilis. - About twenty-eight days after inoculation a primary sore (hard chancre) appears at the site of infection, which is characterized by a superficial ulcer with indurated base. After about two months it gradually heals and becomes absorbed. So little may the patient be incommoded by the hard chancre

Dropsy:

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-RUDDOCK.E.H, General and Local (In this Section are included most of the local forms of Dropsy, both for convenience of reference, and to present a more connected view of the subject.) (Anasarca, OEdema, etc.). DEFINITION.- A serous or watery accumulation in the aerolar tissue, more or less general throughout the body, with or without effusion into the serous cavities. Dropsy is of two different varieties, for besides it occurrence in the meshes of the loose tissue beneath the skin, it may take place as a local Dropsy in any of the natural cavities or sacs of the body, and is named according tot he parts involved. If the accumulation occur in the ventricles of the brain it is called Hydrocephalus; if in the membrane that lines the d surface of the lungs, Hydrothorax; if in the membrane of the heart, Hydropericardium if in the abdominal cavity Ascites; if in the serous sacs of the joints. Hydrops Articulorum; if in that of the testicles, Hydrocele. Dropsy is course a symptom of

Rickets :

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-RUDDOCK.E.H, DEFINITION.- A from of general malnutrition which is specially characterized by peculiar changes in the bones, by which they are increased in thickness, especially at their ends; moreover, they become softened so that they are peculiarly apt to bend. It is essentially a disease of childhood, and seldom occurs before the sixth, or after the eighteenth month. CAUSES.- Rickets is proximately induced by improper food, and especially in relation to a deficiency of the appropriate vitamine. (See Scurvy.) Anything, however, which interfered with developed and nutrition favours its occurrence. Want of sunlight, impure air, confinement, and lack of exercise, are important factors. (The Glasgow School of Pathologists attach more importance to confinement and lack of exercise than to any dietetic failure and their experiments are very convincing.) Prolonged lactation, and suckling the child during pregnancy, are accessory influences in some cases. Like scurvy, rickets may be fou