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center, accompanying the pressure by kneading the parts thoroughly with the fingers. Repeat this several times for about ten to twelve minutes. At first this should be practised every day; later twice a week. Special treatment should be given the small intestines and liver when the bile and intestinal secretion are lessened. In children gentle rubbing of the abdomen with circular movements from right to left with a little oil for ten minutes daily will help to increase the action of the bowels and often bring on a normal movement.

Copious Warm Water Injections.—This is good at the beginning of the treatment when the feces become packed. They soften the mass and aid its discharge. The water must go above the rectum into the colon. To do this a colon tube from eighteen to twenty-four inches long, a good syringe (the Davidson bulb) hard rubber piston or a fountain syringe, the nozzle of which can be inserted into the tube, are required. The patient is placed in the lying down position on the left side with knees drawn up, with the hips elevated. Oil the tube and pass it gently and slowly up the bowel for a few inches until it meets with a slight obstruction. A few ounces of water are then forced through the tube and at the same time pressure is made upward with the tube; by these means the obstruction will be lifted out of the way each time the tube meets with resistance; the procedure must be repeated until the tube is well within the colon. Attach the syringe to the tube and allow the water to run until the colon is distended. A quart to a gallon of warm water can be used depending upon the age and amount of feces present. The water should be retained as long as possible.

The injections should be continued daily until all the feces has been removed. They should not be used for weeks as has been recommended. If soap suds are used in the enema, green or soft soap should be used, not the hard soap.

Electricity.—One pole may be placed over the spinal column and the other moved about over the course of the colon, or one over the spine and the other over the rectum.

Again constipation is caused by the womb lying upon the rectum. Change this condition. (See diseases of women).

[142 MOTHERS' REMEDIES]

Rules.—Patients should go to stool daily at the same hour, usually after the morning meal. You can educate the bowel to act daily at the same hour or after breakfast; or on the other hand not more than once in two or three days in those who are careless in their habits. Some patients need to have two or three movements daily in order to feel well. It may take time to educate the bowels to do this, but it can be done in many cases and many persons become constipated because they put off attending to the educated bowel's call, and often produce constipation by carelessness. It is surprising how many educated people put off this duty; Nature neglected, soon ceases to call. If constipated persons will persevere in going to the closet at or near the same time every day and devote their entire time while there to the expulsion of the fecal contents, and not make it a reading room, they will bring about the desired result. Patients are apt to become discouraged at first; they should be informed that the final result of the treatment is not influenced by the failure of the bowel to act regularly during the first few days. Do not strain to expel the stool.

Corrections of Errors in Diet.—This is one of the necessary features in the treatment. All kinds of foods known to disagree should be discarded. The foods should be easily digested. In children the diet should be rich in fats, albuminoids and sugar, but poor in starches. A reasonable amount of fruits such as apples, oranges, and figs should be allowed. Meals should be at regular hours. Foods that can be used:

May Take—

Soups.—Meat broths, oyster soup.

Fish.—Boiled fish of all kinds, raw oysters.

Meats.—Almost any fresh tender meat, poultry, game, not fried.

Farinaceous.—Oatmeal, wheaten grits, mush, hominy, whole wheat bread, corn bread, graham bread, rye bread.

Vegetables.—Boiled onions, brussels sprouts, spinach, cauliflower, potatoes, asparagus, green corn, green peas, string beans, salads with oil.

Desserts.—Stewed prunes, figs, baked apples with cream, ripe peaches, pears, oranges, apples, melons, grapes, cherries, raisins, honey, plain puddings, fig puddings, apple charlotte.

Drinks.—Plenty of pure water, cold or hot, new cider, buttermilk, orange juice, unfermented grape juice.

Must Not Take—

Salt, smoked, potted or preserved fish or meats, pork, liver, eggs, new bread, puddings of rice or sago, pastry, milk, sweets, tea, nuts, cheese, pineapple, spirituous liquors.

Foods classed as laxatives are honey, cider, molasses, and acid fruits, such as apples, pears, peaches, cherries, and oranges. Berries are effective laxatives on account of the acids and seeds they contain. (Huckleberries are constipating). Prunes, dates and figs are good and effective, also fruit juices.

[DIGESTIVE ORGANS 143]

Drinks.—There are few laxatives better than a glass of cold water or preferably hot water, taken upon an empty stomach before breakfast; water prevents the feces from becoming dry and massed, and stimulates the intestinal movements. A pinch of salt added to the water increases its effectiveness.

Out-door Exercise.—This should be taken regularly and freely.

Bathing.—The best time is before breakfast, and in as cold water as possible. The bath should be followed by a thorough rubbing of the skin with a Turkish towel.

Clothing.—Warm clothing in winter; cool clothing in summer. Cold weather induces constipation, and warm weather diarrhea. Moderate manner of living is everything.

PHYSICIANS' TREATMENT for Constipation. 1. One year to three years.—For infants one teaspoonful or less of black molasses or store syrup, or of olive oil; and Mellin's food eaten dry, is good for babies a year and older.

2. Small Children.—Increase cream in the milk, give oatmeal or barley water. Castile soap suppository, enema, massage, castor oil, or citrate of magnesia if drugs are needed.

3. Older Children.—In older children, fruit, oatmeal, etc. Black molasses is good for children, one to two teaspoonfuls.

4. Fluid Extract of Cascara Sagrada.—Dose: ten to sixty drops at night. This is good for a great many cases and sometimes it cures the trouble, but on the other hand it seems to injure some people.

5. The Aromatic Cascara is also good; doses are larger and pleasant to take. This is more agreeable for children.

6. The Compound Licorice Powder is a mild, simple laxative and effective. It is composed of senna eighteen parts, licorice root powder sixteen parts, fennel eight parts, washed sulphur eight parts, sugar fifty parts. Dose:—One to two teaspoonfuls.

7. For one dose, or one capsule, the proportions would be:

                                ONE AMOUNT FOR
                              CAPSULE ONE DOZEN
    Aloin 1/4 grain 3 grains
    Extract of Belladonna 1/8 grain 10 grains
    Extract Nux Vomica 1/4 grain 3 grains
    Powdered Gentian 3 grains 36 grains

Mix and put up in twelve capsules and take one at night.

There are many tablets and pills made that can be bought at any drug store. No doubt some of them are first class, though perhaps not attaining to that high degree of virtue claimed in their advertising columns.

[144 MOTHERS' REMEDIES]

ITCHING OF THE ANUS. (Itching Piles) (Pruritus ani).Causes.—An inherited or an acquired nervous constitution. Disease of the colon, rectum or anus. Improper diet. Skin affections in that region. Operations about the rectum and anus with resulting discharge sometimes. Diseases in the neighboring organs. Disease of the general system. Diarrhea, discharge of mucus and pus, fissure, etc. Irregular habits and dissipation. Over-seasoned foods such as lobster, salmon, shell-fish and foods containing much grease or starch are especially conducive to it; the same is true of tea, coffee, cocoa, strong alcoholic drinks. Skin diseases, lice, pin worms often cause it.

After Operations.—Some part has not healed, and there is left an irritating discharge.

Symptoms.—There is intense itching at the anus, increased by warmth, and contact of the buttocks. The itching grows worse after the patient becomes warm in bed. It may spread and extend to the scrotum, down the limbs and sometimes over the lower back.

PHYSICIANS' TREATMENT FOR ITCHING OF ANUS. Preventive and Palliative.

DIET.—May Take.—Strong drink must be prohibited; tea, coffee, cocoa, if used at all should be sparingly used. A light diet such as bread, milk, eggs, nourishing soups, kumiss and a little fresh fish, broiled steak, etc., may be used.

May Not Take—Hot cakes, pastry, parsnips, cheese, pickles, beans, cucumbers, cabbage, oatmeal, pork, shell-fish, salmon, lobster, salt fish, confectionery and starchy or highly seasoned foods are to be prohibited. Regular meals, no lunches between meals, and the patient must not over-eat at any time. Long course dinners and over-indulgence in highly seasoned foods and wines aggravate it.

Remedies for Bath.—The bowels should move daily and the parts should be kept clean. The parts should be bathed with hot water or weak solutions of carbolic acid, alcohol or listerine, the heat being especially soothing. Bathing the parts with bran, oatmeal, flaxseed, salt, rice, slippery elm teas, or tar water adds much comfort to these parts. Do not wash much with soapy water.

1. Separate the Buttocks with Gauze, a thin layer of cotton or a piece of soft cloth. This eases the soreness, pain and itching by absorbing the secretions and preventing irritations while walking. The patient should not scratch the parts. Direct pressure over the itching parts with a soft cloth, or by drawing a well oiled cloth across the sore parts several times gives relief.

2. Dr. Allingham Recommends the introduction of a bony or ivory nipple-shaped plug into the anus before going to bed. It is self retaining, about two inches in length, and as thick as the end of the index finger. He claims it prevents the night itching by pressing upon the many veins and terminal nerve fibres of the parts. When the rawness is extensive and the parts are highly inflamed, the patient should be kept to bed and kept on his back with the limbs separated until the irritation is allayed.

3. Local Applications.—Soothing remedies: These can be used when the parts are inflamed and raw. Lead and opium wash, or boric acid, or linseed oil, or starch, or cocaine, and zinc stearate with boric acid. This form of zinc adheres to the parts when rubbed on, and is thus more valuable.

[DIGESTIVE ORGANS 145]

4. The following is good to dust in the parts:—

    Boric Acid 2 drams
    Stearate of Zinc 2 drams
    Talcum 1 dram

Apply as a dusting powder.

5. The following is good for the raw parts:—

      Carbolic Acid 1 scruple
      Menthol 10 grains
      Camphor 10 grains
      Suet enough to make 1 ounce

Mix. Apply freely two or three times daily after cleansing the parts.
Melt the suet and when partially cold, add the other ingredients.

6. The following is good for the itching and to heal the raw surfaces:—

      Carbolic acid 1 dram
      Zinc oxide 1 dram
      Glycerin 3 drams
      Lime water 8 ounces

Mix and apply once or twice daily to relieve the itching.

 7. Carbolic acid 1 dram
      Calamin prep 2 drams
      Zinc oxide 4 drams
      Glycerin 6 drams
      Lime water

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