Treatment by Neuropathy and The Encyclopedia of Physical and Manipulative Therapeutics

Compiled By Thomas T. Lake, N. D., D. C.

1946


BOOK II

Chapter 2

MANIPULATIVE AND PHYSICAL THERAPEUTICS

Abortion and Miscarriage

 

DEFINITION: A concise definition of both the terms may be: Abortion is the expulsion of the fetus between the fourth and the sixth months. But here we will use them as synonymous terms. Because the above terms are usually associated with criminality, the subjects are rather offensive to most people. But while there are great numbers of forced or criminal abortions, there are many others brought about by conditions of ill health, to which the physician must give his attention. Bland states that while there is no record of the number of criminal abortions performed, he believes that more than 35 per cent of all abortions result from criminal interference.
ETIOLOGY: Three types may be included in the etiology. In the majority of cases of premature expulsion of the ovum, the death of the fetus has been the beginning. So it is necessary to study what causes the death of the fetus. Accidents, and injuries to the pelvic regions, may cause a spontaneous expulsion.
DISEASES: Infection, and inflammation of the endometrium nephritis, malpositions of the uterus. Included in this group are all forms of infectious diseases, acute or chronic, which favor degenerative changes in the placenta, in the fetus, or both. Influenza, syphilis, toxemia, chronic visceral disease, drug or chemical intoxication, conditions brought about by repeated pregnancies that weaken the walls of the uterus, or adhesions that prevent the uterus from ascending up into the pelvis, and the growing infection forcing it to empty its contents. Induced abortion is one brought on intentionally either criminally or therapeutically. The latter is termed justifiable abortion when performed to save the mother’s life.
SYMPTOMS: In threatened abortion there is distress and pain in the pelvic region, accompanied by a bloody discharge. If the above symptoms should increase, then the abortion can be said to be imminent. Usually takes from three to six days.
The material expelled may be all the contents. That is termed a complete abortion. Again only a part of the contents may be expelled, creating an incomplete abortion. In the complete abortion the symptoms soon subside, and the tissues go back to normal. But in the incomplete abortion there is always danger of infection, which, spreading may cause peritonitis. There is a bleeding that may continue indefinitely.
PROGNOSIS: Favorable in the cases of complete abortion, but in the incomplete abortion, bleeding may lead to a severe secondary anemia, then to other complications including septicemia. In the cases of induced criminal abortion, it is said that probably one hundred or more thousand take place every year, and that about 6000 die.
TREATMENT: Threatened Abortion. Absolute rest in bed. Vitamin E, and a diet rich in lettuce, germ of wheat, liver and eggs. Also progestin, thyroid extract and vitamin F if there is jaundice. Ice bag to the abdominal wall, removed every two minutes or so, or a cold, wet towel laid over the abdomen.
Complete Abortion, without any complications. The patient must be kept in bed for some time and refrain from any movements that are of a fatiguing nature.
An Incomplete Abortion with danger of complications should not only have the attention of the patient’s physician, but also in consultation, with a surgeon versed well in the techniques of gynecology or obstetrics, because some or all of the following conditions may be found, and some or all of the following techniques may be necessary.
Hemorrhage, sepsis, and lacerations of the cervix are the immediate dangers. The pathologic conditions subsequent to an abortion are uterine subinvolution, endometritis, salpingitis in one of its forms, pelvic adhesions, chronic metritis.
Because of the tendency to retention of a portion of the deciduae, etc., with a resultant hemorrhage, chronic salpingo-oophoritis or septicemia. In criminal abortions there is the added risk of traumatism from unskillful use of instruments, and also of sepsis.
Marked bleeding without dilatation demands the use of a vaginal tampon of gauze, which is allowed to remain in situ for twelve to twenty-four hours and then replaced if it is needed. In many cases the cervix will have dilated enough, after the introduction of the first tampon, to allow the aseptic evacuation of the uterine contents, which is the best treatment. When the tampon is removed, moreover, it will be found in a number of cases that the fetus and membranes are wholly or in part extruded with it. In evacuating the uterus the woman is anesthetized, and removal accomplished with the finger, the dull curet, and Emmet’s curetment forceps. In addition to the above there may be some legal aspects that are easier explained by two physicians than by one.


Acidosis


 ACIDOSIS DEFINITION: An abnormal condition caused by the accumulation in the body of an excess of acid, or the loss from the body of alkali. See also, Alkalosis.
SYMPTOMS: Loss of appetite, lassitude, listlessness, headache, weakness, nausea, occasional vomiting, dehydration, muscle aches, abdominal cramps, loss of weight, drowsiness and renal insufficiency.
The most pronounced symptoms of advanced acidosis are air hunger or hyperpnea and nausea. In diabetes mellitus, the defective oxidation of the fats results in the formation of the acetone bodies.
TYPES: Simple acidosis. Acidosis of Diabetes Mellitus of Nephritis, or Pregnancy.
The treatment of simple acidosis is of chief concern here. The others will come under the specific titles.
TREATMENT: Since the etiology is a concentration of blood bicarbonate below normal, it might be inferred that the treatment consists of merely giving the patient some sodium bicarbonate. But, it requires a good deal more than just that. The attempt must be made to restore the acid-base equilibrium to normal, which would bring the acidity to between 25 and 30 degrees.
PROGNOSIS: Is always favorable if not complicated with diabetes mellitus, nephritis, pregnancy or poisoning.
NEUROPATHIC TREATMENT: Lymphatic, with emphasis on the liver and kidneys. Stimulation or spondylotherapy of the segments of the spine to the above organs.
ENDO-NASAL THERAPY: Lake Head Recoil. Anterior and posterior nasal dilation and swabbing for relief of hyperpnea.
CHIROPRACTIC ADJUSTMENTS: Liver, kidney and atlas segments.
DIET: Foods from acid-alkaline balance chart.
DIETARY: In some cases a few days without meat is sufficient. In others a milk fast of one day. A 4-ounce glass of milk every two hours. Buttermilk fast or a lemon juice fast for one day has been found helpful. Tests made daily can determine how long the fast should be continued.
HERBOLOGY: The following has been used. One tablespoon of each to a pint of water. Calamus, Motherwort, Watercress. Bring to a boil. Let stand one hour. Strain and bottle. Tablespoonful after meals, and on retiring.


Ascites -- Dropsy


 DEFINITION: A collection of serous fluid in the abdomen, or more correctly in the peritoneal cavity, characterized by a distended abdomen, fluctuation, dullness on percussion, displacement of viscera, embarrassed respiration, plus the symptoms of its cause.
CAUSES: Ascites may form part of a general dropsy, to wit: cardiac or nephritic. The most common factor in its production is a mechanical obstruction of the portal system from cirrhosis of the liver, pressure of tumors, diseases of the heart or lungs.
SYMPTOMS: The onset is insidious, and considerable swelling of the abdomen occurs before the disease attracts attention. Constipation from pressure of the fluid on the sigmoid flexure. Scanty urine, from pressure on the renal vessels. Embarrassed respiration and cardiac action from displacement of the diaphragm upward. The umbilicus is forced outward.
PHYSICAL SIGNS: On palpation, a peculiar wave-like impulse is imparted to the hand lying on the side of the abdomen, while gently tapping the opposite side.
PERCUSSION: Patient erect, the fluid distends the lower abdominal region, with dullness over the site of the fluid and a tympanitic note above; if the patient turns on his side, the fluid changes, and dullness over the fluid, tympanitic note over the intestines.
PROGNOSIS: Depends on the Etiology.
TREATMENT: When the physician is faced with a severe type of dropsy he must ask himself, how can I reduce the hydration in the shortest possible time? Then proceed to find the cause, and remove it. Medical opinion is charply divided on many points except one: surgical tapping. The division seems to be as follows: Fischer is chief exponent of the following -- To reduce the edema -- the physician must (1) Withhold water so as not to render too easily available the material needed for the swelling. (2) Neutralize the acids accumulated in the affected tissues, and (3) further their dehydration by increasing their salt intake. He advances the theory that in edema of any nature all salts are effective in reduction of the edema, by acting on the alimentary mucosa causing a secretion of water into the bowel, or upon the structure of the kidney, and so to cause an increased secretion of urine.
Gordon, on the other hand, maintains salt should not be allowed, and water kept at a minimum. Sajous Analytic Encyclopedia of Practical Medicine, P. 197. Both agree that when the pressure of the edema is uncomfortable to a great degree, surgical tapping is the proper procedure.
The writer in a number of cases has always judged the diet and care by the urinalysis reports and strives to establish a slightly balanced acid condition and, if possible, to maintain it at the level throughout the treatment.
NEUROPATHY: Sedation treatment to the Vaso-constrictors which have lost control.
CHIROPRACTIC: D. 6 to 10 and elsewhere as indicated.
ORIFICIAL THERAPY: Rectal dilations seem to have some beneficial effects.
DIETOTHERPY: Fasting for a day or two has produced very good results. The following regime is considered par excellent.
The patient gets a glass of milk every four hours. Hot, warm or cold. Nothing more. To quench thirst, mouth rinsing with water is permitted as often as desired but none swallowed. If food is craved and patient cannot be controlled No. 1 diet can be cut so as to allow the patient around 800 calories a day.
ELECTROTHERAPY: Ultra violet ray seems to be the only electrical appliance indicated in the acute stage. Abdominal exposure for 15 to 30 minutes daily four feet from the patient. Care must be exercised not to burn the patient.
COLONOTHERAPY: Distention prevents any radical irrigations. A very low enema may be administered internally when necessary.
HYDROTHERAPY: Neutral applications of warm and cool wet towels are sometimes helpful. The Physician must judge by each case what is best for the patient.
HERBOLOGY: Make infusion of equal parts of Composition Powder, Golden Seal and Peach Leaves. Use freely every three hours.


Acne Vulgaris

DEFINITION: An inflammatory disease of the sebaceous glands characterized by papules, and pustiles that are usually situated on the face and back.
TYPES: Acne populosa where the lesion only reaches the papular stage. Acne pustulosa, when the papules develop into pustules. Acne indurata, when the inflammation is deep seated and the papules or pustules are firm. Acne atrophica, in this form the lesions are followed by scars and pits.
ETIOLOGY: It is most common between the age of fifteen and thirty. Anemia, menstrual disorders, and gastrointestinal disturbances predispose. Certain drugs, such as iodid and bromide of potassium and copaiba may induce the disease.
SYMPTOMS: There is an aggregation of small papules, pustules, and comedones about the face, chest, and shoulders. Pustules or papules predominate according as the disease is acute or cronic. New lesions develop as the old disappear, so that the disease usually runs a protracted course unless stern measures are taken.
PROGNOSIS: Recovery is the rule, but sometimes very protracted.
TREATMENT: Both systemic and local. A complete check up is necessary with an investigation of teeth and tensils and other possible foci of infection. Neuropathic lymphatic treatment. Sedation of the whole spine. Chiropractic: D-6-10 and special liver, kidney local places. Hydrotherapy. Thorough washing with plenty of soap lather and warm water. Then a douching of the part with cold water. The salt glo in some cases is helpful. In others it has no effect. The area is thoroughly cleansed and the skin is left wet, then ordinary salt is lightly rubbed in. If, after five or ten times there is no improvement the salt glo should be discontinued. Shilling recommends the filling of a bottle with equal parts of Epsom Salts and Witch Hazel, dissolve thoroughly and apply, after steaming, at night.
DIETOTHERAPY: Each case must be judged and dieted according to the findings. We have found a short fast of grapes for a few days is effective in some cses. But, fasts must be regulated by whether anemia is present or the patient does hard labor. Diet No. 1 and 2 can fit most cases. Two or three days on No. 1, followed by alternating every other day with No. 2 has been a good procedure.
White determined that the following foods were the chief offenders--chocolate, milk, oranges, tomatoes and nuts. On the other hand, Wise and Sulzberger have found that Acne Vulgaris due to food is more imaginary than real, that it is due to the hyper-sensitivity of the pilosebaceous apparatus opening to hair and sweat glands, and of a lack of nervous and emotional control.
PSYCHIATRY: The patient, if showing any signs of emotional upsets should be examined carefully and efforts at orientation to the environment made. Every effort should be made to find the responsible tensions.
ELECTROTHERAPY: The best electrotherapy treatment for this condition is ultra violet, preceded ten to fifteen minutes by the infra red or deep therapy light. For lesions of the face the water cooled quartz light is best. The lights can be applied until a second degree erythema is produced.
Where the pimples have formed in heavy hard masses, the fulguration spark may be used to great advantage every five or six or seven days, letting the effect of the first treatment disappear before the second treatment is given. The gentler sparks from the glass vacuum electrode may be used instead of the above if desired and the treatment given six to eight or nine minutes daily.
HELIOTHERAPY: Sun bathing is very beneficial if exposure is limited to not more than ten minutes on the area at a sitting, but many sittings can be taken in a day.
VITAMINOTHERAPY: A and F.
VACUUM THERAPY: Cups suitable to fit the area, light suction for 20 to 60 seconds according to tolerance of patient, followed by light application of Derman Penatrin of Zemmer.
HERBOLOGY AND PHYTOTHERAPY: One ounce each of the following: Burdock Root, Yellow Dock Root, Yarrow, Marshmallow Root has been found helpful in the following form: Simmer in two quarts of water to two and one-half pints (50 ozs.) Strain and bathe the affected parts at least twice daily.
ACID AND ALKALINE BALANCE: The urine and skin tests for acid balance can be taken every day or every other day. If this can be attained, generally the condition is relieved quickly. The simple procedure of Litmasin pH Test is probably the quickest available.


Addison’s Disease

DEFINITION: A rare disease due to a deficiency in function of the suprarenal capsule.
ETIOLOGY: An excessive constriction or degenerative changes in the sympathetic trunks or ganglia of the spinal segments leading to the suprarenal capsules. Tuberculosis elsewhere in the body or in the adrenals themselves is the most prominent etiological factor. Syphilis also is a factor. Atrophy of the glands because of vaso-constriction is a larger factor than heretofore given attention.
SYMPTOMS: The most prominent are anemia, general languor and debility. Cardiac feebleness, irritability of the stomach, marked gastro disturbances; also marked respiratory disturbances due to defects in the utilization of oxygen. Some others are, bronzing of skin, especially about the anus and surfaces subject to irritation; pigmentation of mucous membranes, extreme muscle weakness, loss of weight, low blood pressure, faintness or dizziness, nervousness and twitchings; psychic disturbances; white line on pressure of skin which lasts two or three minutes; renal insufficiency and dehydration.
PROGNOSIS: Is uncertain. Varies from a few weeks to fifteen or twenty years, marked by complications that may produce a crisis and death at any time. On the whole it can be said that the prognosis is decidedly unfavorable, because of complications that may arise.
DIAGNOSIS: This disease most frequently occurs between the ages of twenty and fifty years. Because it is rare and has many symptoms of other diseases, physicians often tell their patients they have it even when there is no bronzing of the skin. For a clear diagnosis of this disease, three tests can be made.
(1) Give a patient a pint of water to drink. Those having this disease are a long time getting rid of this excess water. In other words, in most cases of addison’s Disease the kidneys do not secret urine freely even after excess water has been taken.
(2) Patients suffering from Addison’s Disease excrete large amounts of sodium chloride and have retention of the urea.
(3) The pigmentation of parts or all of the skin. And the secondary anemia prognosis is largely unfavorable because it is not of a uniform type. It may last for a number of years with the patient improving for a time, then remissions. But, a patient who has improved, and continues his physical and manipulative treatments has possibilities of living a normal life-time.
TREATMENT: Neuropathic -- Thorough Lymphatic, dilation of kidney segments.
CHIROPRACTIC: D. 5-7-10.
DIET: There seems to be a division of opinion. Some say a fast on fruits and fruit juices for a few days, and others say: Plenty of nutritions, but easily digested, foods. We have used No. 1 Diet for three days, then No. 2 and No. 1 alternately for months, but changing daily the fruit juices, with beneficial results. Grape fruit juice diluted 20 times. A wine glass full four times a day is very helpful.
ELECTROTHERAPY: Sinnosoidal to adrenals for stimulation. Short wave for relief of pain.
VITAMINOTHERAPY: A and G.
ENDOCRINOLOGY: The adrenals on the sodium side, are said to be regulated by the anterior pituitary and especially the parathyroids. See “Technique” on Parathyroids in Endo Nasal, Aural and Allied Techniques -- Luke. Hormones for the Pituitary, Parathyroid and Adrenal glands may be considered.
ENDO-NASAL THERAPY: Lake Recoil. Breaking adhesions of Thyroid sinus, and opening and swabbing of anterior and posterior nares. This is necessary to raise the blood pressure and increase the oxidase and thyroidase.
HYDROTHERAPY: A teaspoonful of salt dissolved in an eight ounce glass of water drunk during each day will aid in overcoming the derangement of sodium metabolism and dehydration. If distasteful add fruit juices. Epsom Salts hot compresses laid over kidney areas for 20 minute periods three times daily.
PSYCHIATRY: These patients sometimes have emotional upsets. Rest, warmth, plenty of sleep and relaxation, free from worry, are necessities. See Chapter on “Suggestive Therapeutics” in “The Principles of Applied Psychiatry.” -- Page 135, Lake.
VACUUM THERAPY: Cups very lightly over the whole spine for six minutes at two minute intervals, then extremely light over the kidney area.
HERBOLOGY: Laxative. Diuretic and demulcent herbs. Botanicals are for laxative -- Senna, Cascara Sagrada, Ginger, Buckthorn, Blue Malva, Turtlebloom, Althea, Cheese Plant and Licorice, equal parts, using one teaspoonful of mixture to one cup of boiling water. Let cool, strain, drink in three installments. Proportion of ingredients to be adjusted to constitution of patient. For a mild diuretic and soothing demulcent -- Swamp Lily Root, Marshmallow Root, Bayberry leaves, Cheese Plant, Sassafras, bark or root, Buch leaves, Horsetail grass, Bluets and Corn Silk, made and taken in same manner as the laxative.
CAUTION: This is a treacherous disease and the patient should be under the observation of the physician constantly.
HABITS: The most prominent is that: The patient must be kept at rest, warm, relaxed, free from work and worry, and protected against strains of all kinds. Sufficient sleep and an adequate intake of food.
The two prime forms and purpose of treatment are:
(1) Care of dehydration by sodium chloride and glucose.
(2) Prevention of further destruction of the glands and prolonging life. But, it is stated by one authority on the subject that “up to the present time the treatments have been a thankless job.”


Adenoid Enlargement and Infection


 In common language, when adenoids are mentioned, it implies a hypertrophied lymphatic tissue in the nasal passages and in the upper lymphatic ring known as Waldeyers ring, which surrounds the orifices of the pharynx. They are situated in the pharyngeal cavity, on the back wall, just above the soft palate. They are lobulated lymphoid masses composed of lymphoid tissue similar to the tonsil, lymph nodes of spleen and in the nodules of the intestines.
ETIOLOGY: Enlargement is due to infection of excessive lymph substances. The most frequent causes are enlargement of the faucial tonsils, upper respiratory infections, or acute diseases, such as measles, mumps, scarlet fever or frequent colds. But more often the cause is more simple. Improper diet, creating an auto intoxication, improper habits of hygiene, poor ventilation will account for many, while injuries resulting in nasal stenosis early in life will account for others.
SYMPTOMS: A typical case of adenoid enlargement in the vault of the pharynx is not hard to recognize. The patient usually wears a dull listless expression. The nostrils are narrow and pinched; the bridge of the nose by contrast is widened. Usually on examination the septum is found deflected. The child has a sallow or pasty complexion, and palpation of the cervical glands reveals they are more prominent than in a normal child. Because of interference with smell, food is not enjoyed, and a tendency to hurry through the eating, with consequent gastric disturbances. The mental dullness is due to imperfect drainage and a certain degree of anoxia in the brain due to the obstruction of the denoidal enlargement. Snuffling, and noisy breathing by day and snoring at night, and also the non resonant type of voice, are among some of the distinct symptoms of adenoids. Some of the grievous sequelae of enlargement, infection of the adenoids, comes from their close proximity to the mouths of the eustachian tubes, and tonsils. Middle ear infections with severe ear ache, and tonsilitis frequently develops. Headaches, and sometimes long nose bleed may occur.
DIAGNOSIS: The above symptoms and the picture in the rhinoscopic mirror can be regarded as unmistakable.
The lobulated or fissured mass, or masses of various sizes can be seen hanging from the roof of the pharynx. They also can be felt with the finger. If they feel hot and dry to the touch, they are infected. If cool, they are merely enlarged. A test as to whether there is enough space for the passage of air, and oxygen, to avoid anoxemia, is to inject fluid into one nostril, and expect it to escape through the other nostril. If not this can be taken as an indication that very enlarged adenoids are present. Escaping by the mouth has no significance.
Adenoids may exist without enlargement of the faucial tonsils, but it is seldom that the faucial tonsils are enlarged, that the adenoids are not more or less affected.
PROGNOSIS: Is good. Many children outgrow it by a change in climate and diet.
TREATMENT: Neuropathic: A thorough lymphatic, embracing the whole lymph system. Stimulation of whole spine.
CHIROPRACTIC: Cervicals, kidney and liver place.
ENDO-NASAL THERAPY: Open all sutures of the face to enlarge the external nares. This involves seven moves in one technique. Then dilate external nares with little finger. Go into the pharyngeal cavity. Place finger over the adenoidal tissue and massage downward. See Endo-Nasal Aural and Allied Techniques on this subject.
SPONDYLOTHERAPY: Arnold states that the vaso-contrictor neural units of the mucous membrane of the nose are from 2nd, 3rd and 4th dorsal segments, and the vaso-dilator neural cells are in the nucleus of the 7th cranial. In adenoids the concussion then is on those segments, except that Neuropathic pressure is brought to bear on No. 7 on the face. (See Plate 10.)
HYDROTHERAPY: Relief has been given for a time by hot compresses over the nose. A few have been helped by ice cubes placed on bridge of the nose.
COLONTHERAPY: Enemas should be given at least twice a week while under treatment. A pint or quart of warm water is usually sufficient.
DIET: Since enlarged adenoids are practically a condition of lymph stasis, the diet must be very restricted. Excesses of starches and sugar foods must be stopped. If a fast of a few days on fruit juices is feasible, it should be instituted, but if it will injure the child’s psychi, it better not be attempted. A diet largely made up of proteins, vegetables and fruits will produce the best effects. Such a diet can be selected from Diet No. 1.
VITAMINTHERAPY: For simple hypertrophy Vitamin A and B. For infection, Vitamin C complex is recommended.
ELECTROTHERAPY: Ultra violet ray applied over the nose or in the external nasal passage by a glass applicator has been found helpful in many cases.
SURGERY: If the child’s life is endangered by constant illness from oxygen obstruction, surgery should be considered.
HERBOLOGY: Tablespoonful doses of Pineapple juice as often as necessary. Or gargle with Tincture of Myrrh in hot water. Or gargle “Ironite” (a trade preparation of herbs with active ingredients of Ferric Oxy Chloride and Thymol). Or use equal parts of Red Oak Bark, Persimmon Bark and Golden Seal made into a tea, as a gargle.


Albuminaria


 DEFINITION: The presence of Albumin in the urine, known to occur under many circumstaqnces without indicating the presence of any serious pathology.
ETIOLOGY: Over exertion of the lower extremities. Eating and faulty digestion of hearty meals. Menstruation, cold baths, emotional and physical excitement that bring about (1) Disturbance of circulation. (2) Changes in the tubular epithelial cells or walls of the blood vessels of the kidney. (3) Changes in the composition of the blood.
DIFFERENTIAL DIAGNOSIS: In simple Albuminaria the presence of albumin is intermittent and only a trace is noticed, while in nephritis, anemia, leukemia, and diabetes, it is more abundant and usually constant. It is present in more or less degree in all cases of kidney and constant in some forms of prostatitis.
PROGNOSIS: Few have any further trouble if a simple regime is carried out for a few days.
NEUROPATHY: Kidney and liver place.
Usually the following regime will clear this condition:
No. 2 Diet for two days. The grapefruit cleansing fluid. A grapefruit is chopped into small pieces, skin included. A pint of boiling water is poured over the chopped fruit. It is allowed to stand one hour, then strained and bottled. Place in refrigerator. A wine glass full is taken every three hours. If the presence of albumin still exists after the first day, the above may be repeated. If after the second treatment the albumin is still present, serious investigation must be made to determine whether morbid changes are taking place in the liver and kidneys.


Alcoholism -- Acute


 DEFINITION: Acute and Chronic. Alcoholism is a result of excessive indulgence in ethyl alcohol. Often a result of personality complexes. The alcoholics present a great many clinical pictures, especially in the acute intoxications where the persistent heavy drinker is in danger of developing coma or amnesia. Flushing of face, quickening of pulse, mental exhilaration, followed by incoherent speech, deep respiration, loss of coordination, odor of alcohol on breath, thickened speech, dilated pupils, vomiting, delirium, slow pulse, subnormal temperature, impaired judgment, emotional instability, muscular incoordination, and finally stupor.
Acute Alcoholism has three stages. First, excitation and exhilaration. The second is when the nervous tensions are aroused, when there is an increase in the heart rate, a rise in blood pressure and the skin reddens. The higher psychic forces lose control and the alcoholic shouts out his grievances against everybody or the whole world, or is the best fellow in the world. In the second state the determination can be made whether the alcoholic is that way because of personality defects or because he has a real liking for liquor and has lost control. It is important to find out what he talked about before he went into the third stage, if a long range plan or recovery is in the mind of the physician. The third stage is that of unconsciousness and coma. In the diagnosis of coma it is essential to differentiate alcoholic coma from other types. An alcoholic in a coma can be roused for a few seconds and with the odor and absence of injury the diagnosis is certain.


Alcoholism -- Chronic

SYMPTOMS: Fine tremor, mental impairment, disturbed sleep, redness of nose, anorexia, coated tongue, nausea, vomiting, constipation, alternating with diarrhea. If long continued atheroma of arteries, cirrhosis of liver and chronic interstitial nephritis are apt to develop.
Here we can only be concerned with the future of the inebriate. Tremors must be overcome as they arise, and nothing is better than concussion of the whole spine, or the warm douche spray up and down the whole spine. All other symptoms must be treated just as they would be if they arose from a different etiology. While the symptoms are being treated, the physician can plan his course of action to free the patient from the alcoholic habit.
TREATMENT: Lymphatic of whole body. Neuropathic or Chiropractic adjustments of whole spine for stimulation. Ask the patient to take a warm spray on spine only, morning and night.
Mania is a pathological action on the nervous system. There may be great excitement, loud crying or cursing on the part of the patient. In some of the manias great harm and murder has been committed. If these continue the patient will end in a state of dementia precox. If a mania is violent, the physician should call the police to protect those around him. If of a deep, depressive nature some milk, iced milk will suffice to induce sleep.
VITAMINOTHERAPY: Many of the cases of polyneuritis in alcoholics that confront the physician are due to a deficiency of Vitamin B-1. It is assumed that if the alcoholic does ingest enough food with any Vitamin B-1 that the disturbance of the gastrointestinal tract by alcohol prevents proper absorption. A higher calorie diet with supplements of B-1 has produced great improvement of polyneuritis and often a quick cure. This may be also said that some of the cardiovascular disturbances of alcoholism may be prevented by B-1. It is claimed that a continuation of Vitamin B complex will destroy the craving for alcohol and some evidence of this is at hand.
PSYCHIATRY: Please read chapter on Alcoholic Psychosis in “The Fundamentals of Applied Psychiatry.” Lake. Technique is too long to state here. But, the physician must be a sympathetic friend to a man or woman who is fighting to be free from the cravings of alcohol, and he will need to make great use of the art of suggestive therapeutics.


Alkalosis


 Alkalosis as a clinical condition has received less attention than Acidosis, yet it is not infrequent and can cause as much distress to the patient.
DEFINITION: A condition of the blood in which the bicarbonate concentration is above normal.
SYMPTOMS: It has been found in patients with peptic ulcer and others who have headaches, drowsiness, anorexia, vomiting, muscle ache, nervousness, mental depression, feeling of weakness, faintness, numbness of extremities, rapid and irregular respiration and marked irritability. Burning of urine is a common complaint. Later, convulsions, edema and coma.
ETIOLOGY: This is the opposite of acidosis and occurs usually after taking sodium bicarbonate over a long period of time, or due to an excessive use of an alkaline diet. It is especially apt to occur in those whose liver or kidney functions have been impaired.
TREATMENT: This condition usually responds nicely to simply stopping the use of all alkalies. Then the treatments can be focused on the symptoms as enumerated by the patient.
HERBOLOGY: As nearly all fruits and vegetables contain excess alkali, change diet to include more meats and cereals. If cause is from vomiting which would decrease hydrochloric acid and sodium chloride, myrrh and Golden Seal equal parts with a bit of ginger is good, taking a teaspoonful about every two hours.


Alopecia (Baldness)

DEFINITION: A loss of hair in patches of the head. Baldness--a partial or a total loss of hair.
ETIOLOGY: The etiology of alopecia is to be determined after all the factors are taken into account by examination and diagnosis. Stevens states that baldness may be congenital, in these cases it is usually partial. It may be an expression of senility, in which case it usually begins on the crown or brow, and is associated with more or less atrophy of the scalp. It very rarely occurs early in life, as an idiopthic affection arising without obvious cause. It often occurs in early adult life as a result of seborrhea. It frequently results from general diseases, such as syphilis, myxedema, typhoid fever and other acute infections.
In addition to the above etiology, the claim is made that the loss of hair is due to a deficiency of Vitamin A.
PROGNOSIS: In congenital and senile is doubtful, although many claims of cures have been made. In alopecia of general diseases, the prognosis is favorable by removing the cause. Much has been accomplished in alopecia of seborrhic origin by persistent treatment.
TREATMENT: Remove the cause if possible.
NEUROPATHIC: General Lymphatic and dilation of all cranial centers.
CHIROPRACTIC: All cervicals and Atlas.
HYDROTHERAPY: Shampooing every one to three weeks with warm water and Castile Soap is recommended. Another form of treatment is to massage the head once a day with two drops of liquid Vaseline. Cold, wet, applications with towels to the head, followed by vigorous friction has been found of value.
VITAMINOTHERAPY: Vitamins A and B in large doses are recommended.
ELECTROTHERAPY: Ultra-violet is a valuable agent in this condition if the hair follicles are not dead. If they are, it is perfectly useless to attempt any treatment. The water-cooled lamp should be used in alopecia areata, and the air-cooled in general alopecia. When using the air-cooled lamp have it about ten inches from the scalp. The face and ears should be protected. The rays from either the air-cooled or water-cooled lamp should be given until a third degree erythema is produced. It will be a rather severe treatment, but necessary in order to be effective.
In addition to the local treatment, expose the entire body to ultra-violet rays for the general tonic action. Where there is a general systemic infection as in syphilis, care for it first, otherwise no results can be expected from the ultra-violet.
COLONOTHERAPY: Colonic irrigations are of value in helping to free the system of waste matters.
HERBOLOGY: Peach Tree Leaves made into a tea is good, putting on head daily. Sage is an old remedy. Nettle Leaves steeped in vinegar for several days, filtered, with about ten per cent glycerine added is good. Teas made of any of the following herbs are good: Boxtree, Hounds tongue, Elmtree, Marshmallow. Also oil from Lily of the Valley.


Alopecia Areata


 DEFINITION: Baldness appearing here and there over the scalp.
ETIOLOGY: Most authorities state that it is of parasitic or nervous origin. While others state that it may be a sequence of sclerodema, leukodema, Graves disease and lead poisoning. While others maintain it is of mental and sexual disturbances.
SYMPTOMS: The disease is characterized by the sudden or gradual appearance of circumscribed round patches of baldness. At first there is no change in the appearance of the skin, but later it may become pale and atrophied. Although the scalp is the most frequent seat, it occasionally involves other hairy parts, as the eyebrows, beard, etc.
PROGNOSIS: Is generally unfavorable in those whose eyebrows have been affected and whose finger nails are cribbed with holes. Otherwise good results have been attained in many cases.
TREATMENT: In addition to the treatment given under Baldness, the following have been found helpful. All foci of infection must be removed. Some recommend that the part be painted with pure phenol, iodine, or turpentine to stimulate an hyperemia of the affected areas.
The above treatment for Alopecia Areata in addition to the treatment for general Alopecia have produced some fine results in many cases.


Amenorrhea


 DEFINITION: Absenvce, or suppression of menstruation. Normal before puberty. After the menopause and during pregnancy and lactation.
Some of the more common causes for its suppression at other times are change of climate and occupation, anemia, febrile diseases and chronic diseases such as nephritis, tuberculosis, and diabetes.
Primary amenorrhea is where the menses have never made their appearance.
Secondary amenorrhea is where they have appeared but subsequently cease.
Partial amenorrhea means appearing occasionally and at irregular intervals.
We are only concerned here with the secondary and partial amenorrheas.
ETIOLOGY: May be due to operations or pregnancy which the physician should make certain of. When in doubt of the latter, see tests under Pregnancy. Suppression may be due to benign or malignant tumors. Suppression of Amenorrhea produced by X-rays or radium may be temporary or permanent, it depends on dosage. Delayed or temporary Amenorrhea may be due to general diseases or disturbance of the endocrine functions.
Some authorites state that there is a direct nervous connection between the hypothalamus and the pituitary glands, and that the latter may be controlled in some way by a center in that portion of the brain. If true, then emotional states, hysteria, inhibition of the libido, suppression, etc., will cause changes in the pituitary that are reflected in the menstrual disturbances. Changes in climate from warm to a cold climate just before the period or a change in occupation may create menstrual disturbances.
TREATMENT: The treatment must be directed at the cause.
SYMPTOMS: There may be no other than the absence of menstruation unless they are symptoms of what is causing the amenorrhea. Nervous disorders may cause heat flashes, occasionally headache and vomiting and some forms of hysteria. When the Amenorrhea is due to obstruction, the patient has a continuous dull ache in the pelvis and over the sacrum aggravated at the periods when menstruation should take place and a profuse leucorrhea is manifested.
The general techniques of the treatment may be selected from the following:
CHIROPRACTIC: 1, 2 and 4.
NEUROPATHIC: Thorough lymphatic and dilation of the lower back region. Cranial adjustment of frontal lobe, and parietals.
ELECTROTHERAPY: Sine wave, Galvanism, Diathermy, or short wave, infra red.
HYDROTHERAPY: Hot fomentations. Hot towels to abdomen.
SPONDYLOTHERAPY: Arnold stated that the inhibitory cells of the Fallopian tubes and uterus which contract the cervix are chiefly in the 2-3-4th lumbar segments and that dilator units are found in the 3-4-5th sacrals. Then deep pressure on the sacrals and concussion of the lumbars is in order.
PNEUMOTHERAPY: Cups on the lumbar area, two minutes, and over the ovaries one-half minute lightly three times, one ovary at a time.
HERBOLOGY: The following herbs are applicable for infusions: Blessed Thistle, Cotton Root, Elecampane, Ginger, Ground Pine, Milfoil, Mugwort, Tausy, Shepherd’s Purse, Water Pepper.
A favorite treatment is to take a hot mustard bath every third night, retiring to bed immediately. Bowels should be thoroughly opened by a compound Senna mixture, or similar laxative, then take one dram each of Oil of Pennyroyal, Cayenne Pepper, Extract of Peppermint, Extract of Elder Flowers, Extract of Gentian, and heat into a uniform mass and divide into 60 pills. One pill to be taken three times daily under the flow commences.
DIET: No. 1 is generally sufficient with additions as the physician’s judgment deems best. Sometimes a glass of milk between meals cana be added for anemia associated with Amenorrhea. A glass of hot water with teaspoonful of honey daily befoe breakfast is beneficial.
VITAMINOTHERAPY: ENDOCHINOTHERAPY: Youman states that a deficiency of Vitamin A causes keratinization and desquamation of the normal epithelium of the uterus and other organs. Vitamin A is then important. For Anemia B-6, E plus and F. Three times daily. Ovarian Hormone, Pituitary Thyro Ovarian substances have been recommended.
PSYCHIATRY: If due to emotional upsets. See pages 117-176-191 of “The Fundamentals of Applied Psychiatry,” Lake.
ENDO-NASAL THERAPY: Dilate anterior nasal canals. Clean out the pharyngeal cavity. Lake Head Recoil, and break adhesions, if any, in thyroid sinus and raise the glands.


Amnesia


 DEFINITION: A loss of memory. This may be from recent experiences, those subsequent to the disease, and is termed anterograde. When it involves more remote memory stores it is called retrograde. Amnesia is often applied to episodes during which the patient forgets his identity though he may conduct himself properly enough and following which no memory of the period persists. Such episodes are often hysterical, sometimes epileptic, while trauma, senility, alcoholism, and other organic reaction types account for a smaller number.
ETIOLOGY: There are several types. The traumatic, toxic and psychic.
An accident, such as would fracture the skull and result in perversions of the brain, may produce an amnesia about the accident, and about all events before the accident.
The toxic type may be produced by auto intoxication caused by wrong habits of living or by excessive use of alcohol and drugs.
The psychic type is a mechanism of defense against some impossible situations in life. Shell shock on the battlefield, intolerable home or working conditions.
TREATMENT: Of the traumatic type is largely surgical if there has been a fracture. But injury without fracture may be rested for a time, then suggestive therapeutics attempted. If after a reasonable time there is no appreciable change, hypnosis could be attempted to see if under the influence the patient would remember some of the facts of his life, which during his waking hours were forgotten. If he can, it shows that his memory images have not been destroyed, but he cannot bring them to consciousness. It is thought that all cases of Amnesia are purposeful as all people wish to forget unhappy experiences, but we cannot accept that view. There is a true and a spurious Amnesia, and the physician can judge much by surrounding circumstances which is true and which is false.
A witness in a court case recently developed such strange illusions and great falsification and incoordination of facts, that the attorney could not use her. Two days afterward she was perfectly normal. The toxic cases will clear up quickly as the primary cause is eliminated. Hysterical or wandering Amnesia are psychic and need the services of a physician versed in patience, kindliness, and trained in the arts of psychoanalysis and suggeestive therapeutics to help the patient orient himself to his environment. See Amnesia and Suggestive Therapeutics in “The Principles of Applied Psychiatry,” Pages 62, 83, Lake.


Anemia


 DEFINITION: A deficiency of red blood cells, hemoglobin or both. There are several forms.
ETIOLOGY: There is always some underlying cause for Anemia to develop. It does not just happen. Usually the cause may be found in one of the following organs that fail to function normally: the Salivary Glands, or an improper habit of eating; the Stomach, Intestinal, Liver and Spleen malfunctions. Again, Thyroxin, which regulates general metabolism, may be lacking in Vitamin C. due to defects in the thyroid and parathyroids. Then, the diet may be lacking in foods containing sufficient Vitamin B and Iron.
TRAUMATIC ANEMIA: Where there has been a hemorrhage is an exception to the above etiologies, but here we will confine ourselves to the results, not the method of traumatisms.
Because we regard Anemia as a result, or due to some underlying abnormalities or habits, and more of a symptom than a disease in itself, it is unnecessary to consider such terms as simple, essential, primary and secondary types of anemia. Here we will confine ourselves to two phases of these symptoms: Secondary Anemia and Pernicious Anemia.
DEFERENTIAL DIAGNOSIS: The term Anemia properly includes all conditions in which the blood is impoverished. Pernicious Anemia is a condition characterized by oligoeythemia, or such a great deficiency of red cells that life is seriously endangered.
ETIOLOGIES OF ANEMIA: Abnormalities of the digestive and absorptive systems. Deficient diet. Nervous derangements. Lack of food of proper quality of blood-building elements. Malfunctions of the stomach, liver, spleen and intestines. Wrong sedentary habits. Imperfect lymphatic circulation, and excessive vasomotor constriction to the arterioles.
PERNICIOUS ANEMIA: All the above, but the most outstanding is megaloblastic degeneration of the bone marrow, causing either decreased or imperfectly formed red blood cells to be delivered to the peripheral circulation, or some other serious infection.
SYMPTOMS: The outstanding symptoms of anemia are: Pallor of the skin and mucous membranes, loss of strength, and in severe cases intermittent fever. Full, rapid pulse, palpitations of the heart, heavy pulsations in neck, some dropsy in the feet. There may be ecchymosis and slight bleeding of the mucous membranes. Hard breathing is an outstanding symptom. Nervousness is marked. Headache, vertigo, disturbed sleep, slight pains are sometimes complained of. All the symptoms mentioned above may be associated with Pernicious Anemia with addition of symptoms of a more severe nature. Weakness and fatigue, shortness of breath, palpitations, are greatly increassed, and when the anemia goes below the one million blood count the bleeding becomes more evident, and the spiral nervous system perversions, lesions and subluxations become of such a type that alterations in the functions of the cord and fibers are very noticeable. The skin not only has a pallor as in anemia, but is covered with a yellow tint much in the nature of a lemon.
PROGNOSIS OF Primary Anemia is favorable, but very guarded in Pernicious Anemia.
TREATMENT: In both conditions is finding and removing the cause.
NEUROPATHIC: Light lymphatic. Stimulation of the whole spine.
CHIROPRACTIC: Kidney, Liver, Spleen and Lumbar places.
SPONDYLOTHERAPY: Concussion C, 7; D, 10.
ORIFICIAL THERAPY: Rectal dilation. While this is beneficial, great care must be taken in administration not to cause bleeding.
ELECTROTHERAPY: Ultra Violet Ray, starting with ten-minute treatment first day and doubling that time at each treatment until twenty minutes are reached, having the patient on a revolving stool in order that the whole body is covered. Short Wave, Sine Wave and Diathermy are beneficial on all the viscera and long bones.
DIET: Varioius types of diets are recommended, some of them which patients abhor. There is not much sense in giving patients food they do not like. For a while a diet may consist of 50 per cent calories, 20 per cent carbohydrates, 20 per cent vegetables and fruits, and 10 per cent fats. Then after a week or two another blood test can be made to see if a rise has taken place in the red blood cells. These may be selected from food lists elsewhere in this book. Liver, in various proportions, approximately from 16 to 20 ounces a day, may be given in addition to the above diet. A glassful of water with a spoonful of honey, and a half spoonful of lemon juice three times a day is a good tonic. Vegetables and fruits containing iron are necessary.
VITAMINOTHERAPY: Vitamins B-2, G, C, D, and E are recommended.
ENDO-NASAL THERAPY: This is one of the most important parts of the treatment. The patient needs much oxygen which has an affinity for iron, and encloses the iron in the gas units of it (the oxygen) and carries the iron via the hemoglobin to all parts of the body for absorption and assimilation as a nutritive element in all the tissues.
Anoxia anywhere in the body creates serious disturbances. Anoxemia is a general condition in all anemias. Turn to your Endo-Nasal, Aural and Allied Technique Book. Lake.
EXERCISE: Because the patient is in a weakened condition, exercises must not be extreme. Walking is the best. Gradually at first. Three blocks the first day, four the next, and so on until ten blocks a day or 1 ½ miles are covered, followed by a nap for one hour.
VACUUM THERAPY: Because the blood circulation is below normal and there is also an anemia of the spinal centers, light cupping of the whole spine is of unusual benefit.
COLON THERAPY: Enemas should be given twice a week in view of the large diet required in these cases.
HERBOLOGY: Herbs containing iron are selected in anemia, such as Yellow Dock, Strawberry Leaves, Dandelion, Dock, Salep, Raisins, Mullein Leaves, Stinging Nettle, Mustard Seed, Meadow Sweet, Parsley, Burdock, Sorrel, etc.
A good general tonic is made from Rocky Mountain Grape, Gentian, Marshmallow, Sacred Bark, Turtlebloom, Yellow Root, Fennel Seed, Jamaica Ginger, Anise Seed, Thyme, Juniper Berries, Colic Root and Bearberry Leaves. This combination has proven so helpful that Herbal Supply Houses sell it ready-mixed.
The red corpuscles being born in the red marrow of the bone (iron giving it its red color) and the main work it does being the gathering of oxygen and carrying it to the body cells, herbs containing iron are mainly indicated as iron gives energy and blood pressure. It also gives action to the heart, liver and kidneys and alkalizes the system. Iron nourishes the pancreas as well as the other glands.
Goat cheese is also excellent as a tonic.


Amyloid Kidney


 DEFINITION: A starchy like degeneration of the kidney. The kidney is enlarged from infiltraton of amyloid substances. The amyloid is deposited in the glomeruli underneath the epithelium of the capillaries; the capillary loops are thickened, the lumen is obstructed and gradually the whole glomerulus is converted into an amyloid mass.
ETIOLOGY: It is due to Vaso-constriction of the kidney segments, preventing proper metabolism in the organ, or a subluxation of K.P. It also may be due to syphilis, tuberculosis, etc., or a similar degeneration in the liver and spleen. It may also be a sequence of degenerative Brights Disease, and to a deficiency of Vitamin “E”.
SYMPTOMS: Amyloid disease of the kidneys has been occasionally found without any renal symptoms having been present during life. The characteristic renal symptom is albuminuria. The amount of albumin varies considerably, from a few grams to as much as 30 to 50 grams per liter. Hyaline and granular casts are found in the seniment; waxy casts may also be found. The daily amount of urine varies considerably. When there is no edema, there may be polyuria; when edema is present, the amount of urine is diminished and the specific gravity is high.
The urine generally gives very fairly characteristic indications. Its quantity is increased, its specific gravity is somewhat, but not greatly, diminished, varying from 1015 down to 1005. It is usually singularly clear and translucent, and on standing yields very little sediment. Under the microscope may be found a few casts which are generally broad, hyaline, fatty and granular. The amyloid reaction may be obtained with the hyaline casts. In later stages, when degeneration has set in, the urine becomes reduced in quantity, is mostly turbid and then presents under the microscope the morphological signs belonging to the degenerative processes. There are associated with this condition of urine anemia, debility, but not often much dropsy with the characteristic transparent and delicate complexion. There is usually degeneration of blood; often diarrhea and vomiting. Cerebral symptoms are not at all common. The arteries are usually soft, and the heart generally shows very little change. Death comes by wasting, diarrhea, inflammation, and the kindred affections of the liver and other organs.
DIAGNOSIS: The diagnosis canot usually be made from the urinary examinations alone, or from perversions and subluxations. But, if following syphilis, tuberculosis, or chronic bone suppuration, the urine is found to be albuminous, of low specific gravity, and increased in quantity and the liver and spleen are enlarged, the diagnosis of amyloid disease may be made with comparative certainty.
PROGNOSIS: This depends to a great extent upon the disease which is the cause of the amyloid condition, but is usually very grave. In marked cases death occurs after a period varying from several weeks to several months.
TREATMENT: The treatment of amyloid disease is that of the original disease of which it is a complication. It occurs in the course of chronic suppuration somewhere in the body, chronic tuberculosis, in the course of congenital or acquired syphilis. Hodgkin’s disease, chronic dysentery chronic malaria, chronic gonorrhea, and in the course of malignant tumors. The general treatment may consist of the following:
NEUROPATHY: Thorough lymphatic of all lymph system. Dilation of spinal segments of kidney place, and other segments as necessary.
CHIROPRACTIC: Kidney Place and other zones as indicated.
ELECTROTHERAPY: Short Wave to kidneys and infra Red.
DIET: Short fast on fruit juices, then No. 2 Diet for a few days, then alternating daily with No. 1 and No. 2 for a week. Then make a complete examination to see if changes in diet are necessary.
ENDO-NASAL THERAPY: The largest element of the blood constituents lost in this disease is Oxygen. There is usually a severe anoxia in the lungs, kidneys, liver or spleen, or a general anoxemia. Therefore, all of the Endo-Nasal techniques should be performed with particular attention to the external and internal nares, and the thyroid.
HYDROTHERAPY: Is of great value. One plan has distinct value. A hot wet towel over the kidneys liver and spleen before retiring each night leaving on for five minutes. Other forms of hydrotherapy can be used as indicated by etiology.
VITAMINOTHERAPY: A, B, C, D and especially E as indicated by symptoms.

Aneurism


 DEFINITION: Dilation of an artery, forming a sac filled with coagulated blood or serum.
It can generally be said that all aneurisms are due to conditions that weaken the arterial walls, to increasing blood pressure. It is more prevalent between the ages of 30 and 50, a period in which degenerative changes are found in those who have done laborious work without proper rest.
It affects many who are engaged in violent intermittent exercise. Males are affected 10 to 1 in comparison with females. It is said that the Anglo Saxon race is most frequently affected. The English more than the American due to a greater consumption of alcohol in England, and that it is three times as prevalent in the American Negro as the white race.
ETIOLOGY OF TYPES: Idiopathic Aneurisms may be due to some injury that has left a scar that has weakened the wall of the artery or by the lodgement of an embolism.
FUSIFORM: All the walls of the blood vessel dilate more or less equally creating a circular swelling.
SACCELATED: One due to the yielding of a weak patch on one side of the vessel and which does not involve the entire circumference; usually due to an injury.
DISSECTING: One in which the blood makes its way between the layers of a blood-vessel wall, separating them.
ARTERIO-VENOUS: One in which artery and vein become connected by a saccule following trauma or infection.
LOCATIONS: They may be located in any part of the body, often being seen on the lower part of the radial artery just above the wrist. But those that havc the most serious aspects and symptoms are: Aortic, Thoracic and Arterio-Venous Aneurisms.
The Aortic Aneurism is a more or less circumscribed dilation of the Aorta. If the whole vessel is involved in the swelling it is termed fusiform. If it is localized and only involving a portion of the circumference it is termed a saccular Aneurism. Rupture of the inner wall, with a passage of blood between the other walls is known as dissecting Aneurism. The chief cause of the aortic aneurism is weakening of the walls by syphilitic and other infections, and sometimes injury.
The Arterio-venous type where the artery and vein become connected one to to the other by a saccula following trauma, or gun shot wounds. Since the blood pressure in the artery is greater, the flow of blood will be from the artery into the vein.
DIAGNOSIS OF ANEURISMS: Inspection may reveal a bulging with an abnormal area of pulsation, and the skin directly over the area slightly reddened. If inflamed, look for abscess. Palpation of the hands will reveal a heavy pulse above the seat of the aneurism, and then gradually taper off. The seat is at the point of the greatest pulsation. Percussion will reveal an area of dullness around the point. The tuning fork is of great value here to those who have practiced with it. The Roentgen Ray also is of value in detecting and determining the size and shape of the dilation.
Tracheal tugging is often found in aneurism of the arch of the aorta and is due to the transmission of the aneurismal pulsations to the left bronchus, and is detected by inclining the head and lifting the larynx and trachea by the finger and thumb caught under the hyoid bone.
SYMPTOMS: The aneurism forms a smooth round or oval enlargement in the course of an artery. It is not sensitive, unless inflamed, is not adherent to the overlying skin, but may be associated with edema and venous congestion of the parts distal to the tumor. The swelling has an expansive pulsation up to the time that a sufficiently thick layer of clot forms within the sac to abolish this sign. Aneurismal dilation may occur suddenly from traumatism or a great increase of intravascular pressure and may be characterized by sharp pain and rapid enlargement along the course of an artery. The sac, however usually forms slowly and at first without pain or any other symptom.
Subjective symptoms include pain from the stretching and compression of the aorta of nerves and the arrest of the venous or lymphatic circulation.
The pressure and erosion of bone, especially noticed in aneurisms of the aorta, cause the characteristic boring, so-called osteopathic pains which are usually more severe at night.
Aneurism in the skull is the rushing of arterial or venous circulation creating headache and pressure that often leads to vomiting and dilated pupils, with some localized palsies, which may be classified as the main symptoms.
In the neck, the physical evidences are usually seen in the pulsations. In the neck the situation of the tumor, expansile pulsation, and the effect upon the distal vessels are characteristic symptoms.
In the chest the recurrent laryngeal nerve frequently is involved with the production of rasping voice, spasm or paralysis of the vocal cord, and brassy cough. Pressure upon the sympathetic may produce unilateral sweating and unilateral contraction or dilation of the pupil as well as tachycardia. Peripheral neuralgia may result from compression of the intercostals. Compression of the phrenic may cause dyspnea and hiccough, while pressure upon the esophagus may result in dysphagia.
PRESSURE EFFECTS: These are especially marked in aneurisms involving the transverse portion of the aortic arch. Dyspnea with stridulous inspiration may result from pressure on the trachea or a bronchus. Bloody sputa may occur from the same cause. Paroxysmal croupy cough may be excited by pressure on the trachea or recurrent laryngeal nerve. Hoarseness or aphonia may also result form pressure on the recurrent laryngeal nerve. Dysphaagia may result from press ure on the esophagus. Pain of a boring or lancinating character may arise from pressure on adjacent nerve-trunks or bones. Attacks of angina pectoris may occur as a result of the underlying aortitis. Inequality of the pupils and unilateral sweating may be excited by pressure on the sypathetic. Edema, cyanosis and enlargement of the veins of one or the other arm may arise from pressure on or rupture into one of the large venous trunks.
DIAGNOSIS: Mediastinal tumor may simulate aneurism, but in the former the pulsation is not expansil, there is no diastolic shock, the tracheal tug is usually absent, and there may be cachexia, enlargement of superficial glands, and leukocytosis.
PULSATING EMPYEMA: A left-sided purulent effusion may transmit a cardiac pulsation, but there is no diastolic shock, no thrill, and no murmur. The history, moreover, will usually suggest pleurisy.
AORTIC STENOSIS: In this condition there are no evidences of a tumor, no pressure symptoms, and no inequality in the radial pulses.
PROGNOSIS: Aneurisms of the aorta and thorax are of a very grave nature. By proper rest, treatment and care, life may be prolonged for many years. If death occurs from this cause, it is from rupture.
TREATMENT: There are two schools of thought besides that of surgery. One is to slow down the circulation and bring about a clot that will fill the sac by coagulation. The other is to keep circulation normal and help nature repair the sac. For the former, drugs are used to reduce cardiac frequency, and arterial pressures. The second idea seems to the writer to be the better one. Get the circulation normal and nature will do the healing.
NEUROPATHIC: Light lymphatic and quieting of the spinal centers covering the area where the aneurism rests.
CHIROPRACTIC: Local zone.
SPONDYLOTHERAPY: Concussion. If heart and pulse are too rapid concuss 7th vertical until normal, doing so intermittently of 30 seconds each, testing after every fourth application.
A. Abrams claims that the subsidiary center of the vaso-constrictor nerves of the aorta is vertebra, and that by stimulation of the center in question by concussion the normal as well as the abnormal aorta may be brought to contraction. Ample evidence is furnished of the latter fact in his work on spondylotherapy. The method, in brief, which he suggests in the treatment of aortic aneurism consists in concussion of the spinous process of the seventh cervical vertebra.
The writer has had some very remarkable results with this method in thoracic and aortic cases, in acute attacks and chronic cases. See spondylotherapy.
ELECTRO THERAPY: Short wave for three minutes directly through the seat of the aneurism, then sine, or galvanic directly below the aneurism to attempt to draw the infiltration away from the sac, so that new blood can rebuild the weakened walls.
VACUUM THERAPY: Is of excellent service for lessening of pressures in thoracic and abdominal aneurisms. For the former the cups are put only on the back. For the latter they are used on the back first, then beneath the affected area, followed by putting cup over the area. Caution—cups should be put on mildly at the first treatment and each allowed to stay in one place only a minute.
HYDROTHERAPY: In an acute attack the physician must decide which is best to use. Hot or cold wet towels, compresses of heat or cold. Depends on what in his judgment is necessary for the time being.
EXERCISES: It is best for the patient to rest most of the time, yet some movement is imperative. A slow raising of the arms upward, and slow throwing of the head backward, then bringing them back to normal, will aid in releasing pressures.


Angina (Ludwig’s)


 DEFINITION: An acute suppurative process beginning in the submaxillary region which may spread to all the mouth and pharynx to an alarming degree.
ETIOLOGY: Careless throat and mouth hygiene. Infections, extractions of teeth, caries, trauma and ulcerations.
SYMPTOMS: The onset is sudden beginning as a hard painful swelling in the submaxillary region, which may run a mild course for days and then suddenly assume an alarming character, because the swelling of the parts interferes with respiraton and the swallowing of nourishment. The temperature and pulse are very often comparatively low.
PROGNOSIS: Grave when respiration is interfered with extensively, after twenty-four hours of the onset. Very favorable otherwise.
TREATMENT: Neuropathy and Chiropractic same as in Vincent’s Angina which follows:
HYDROTHERAPY: Hot compresses, local antiseptics or oral hygiene.
DENTAL CARE of abscessed or impacted teeth. Oxygen inhalations. Endo-Nasal Therapy if possible.


Angina (Vincent’s)
(Trench Mouth)


 DEFINITION: An acute infectious inflammation involving the mucous membranes of the throat and mouth. The disease may be associated with diphtheria, syphilis, or streptococcus or staphylococcus infection.
SYMPTOMS: The symptoms are usually those of subacute pharyngitis, unless mixed infection is present. Headache and general malaise, with a temperature up to 102 or 5, may be present. The breath is foul, the throat painful when swallowing and there is generally some swelling of the submaxillary glands.
PROGNOSIS: The prognosis, where no mixed infection is present is good, the symptoms abating in three or four days, although some redness of the pharyngeal mucous membrane may persist for many days. In cases of mixed infection the severity of the symptoms depends upon the character of the mixed infection.
TREATMENT: Two things are necessary. 1, to give relief from pain. 2, To remove the cause. Hydrotherapy is the main reliance in the painful aspects. Thorough cleansing of the mouth with antiseptics. Hydrogen Peroxide, diluted one-half with distilled water may be used. Ice pellets dissolved in the mouth help some. Hot compresses are excellent for pain and congestion.
NEUROPATHY: A thorough lymphatic for drainage purposes, with special attention to the liver and axillary segments of the lymph system. The cervical lymphatic can be mild at first, then heavier.
CHIROPRACTIC: Adjustment of condyle cervical, L. and K places.
COLONOTHERAPY: Bowels should be thoroughly cleaned out.
PSYCHIATRY: Patients are apt to become despondent and the physician will need to exercise the art of hopeful suggestive therapeutics.
ENDO-NASAL THERAPY when acute stage is passed, then all techniques can be used.
VITAMINOTHERAPY: A, B, C and D.
MEDICAL PROCEDURE: In complicated cases local treatment consists in the application of a solution of nitrate of silver (2 to 4 percent). The patient should apply to his throat, as a home treatment, the spray from an atomizer containing ½ to 1 per cent sulphate of copper. A mild quarantine had perhaps better be observed until the throat clears up. In the more severe forms of mixed infection the internal treatment is similar to that of phlegmonous pharyngitis.
When pseudomembrane or ulcerations are present, the parts should be cleansed and Loeffler’s solution applied once or twice a day by means of a cotton-tipped applicator. Neosalvarsan is useful in all diseases caused by spirilla. The remedy may be injected as in the treatment for syphilis, or a 3 per cent solution applied to the ulcers and pseudomembrane of severe Vincent’s angina.
When local treatment fails, injections of the arsenicals are indicated but not prolonged. If tonsils do not clear up, tonsillectomy is considered.


 Angina Pectoris


 DEFINITION: Paroxysms of pain associated with sclerosis of the coronary arteries and degeneration of the myocardium. Early known as stenocardia breast pang.
ETIOLOGY: It is largely due to predisposing arteriosclerosis which may be an inherited condition. Emotional upsets due to prolonged anxiety may produce predisposing causes, or any of the causes that produce arteriosclerosis.
SYMPTOMS: Pain and oppression, about the heart; a paroxysmal affection characterized by severe pain radiating from the heart to the shoulder, thence down the arm, or rarely from the heart to the abdomen; apparently dependent upon some lesion of the coronary arteries of the heart, its walls or valves. Attacks may occur in lesions of the aortic valves. Generally afflicts males of middle age. The attacks are usually excited by strong emotion, muscular effort, exposure to cold, indigestion.
When the pain is extremely severe in the region of the heart there is great anxiety, fear of approaching death, and fixation of the body, face pale, livid, brow bathed in sweat. Dyspnea often noted; pulse variable, usually tense and quick. Attack lasts from a few seconds to several minutes.
PROGNOSIS: Always of grave import. Sudden death may occur at any time. In the false type, characteristic of hysterical men and women death never occurs, and they recover quickly when they get the pity or favor they crave.
TREATMENT: Treatment should be directed largely at the constitutional cause, but also to the relief of pain. The pain is explained by James MacKenzie as a sensory reflex due to irritation of the 1st, 2nd, and 3rd dorsal nerves, and also the 8th cervical nerves, and the sense of restriction to reflex stimulation of the intercostal nerves. These reflexes often cause complete numbness after an attack of pain, and sometimes vomiting, or a sharp movement of the bowels, which brings great relief to those who have the eliminative sequels.
During an attack of severe pain, something is necessary to dilate the arterioles. The vaso-constrictors are over active, and the heart and neighboring arteries are not getting enough nourishment to carry on their functions.
Abrams recommends at this period a concussion of all the lower dorsals to induce a heart reflex of dilation. It is seldom the patient has an attack in the physician’s office and it becomes necessary that the patient be instructed what to do in emergencies. If the arterioles can be quickly dilated the pain usually eases, and the patient can continue to take his treatments in the office to eliminate toxemia and to correct the nervous system.
Several methods are suggested for the relief of pain. Heat over the back, and chest with wet towels has helped some. Raising the arms up over the head, has been known to give some relief. If the physician is called out of his office and has a portable diathermy or short wave they are of great value. The patient may be instructed to carry an emergency supply of Amyl nitrate pearls which can be crushed in a handkerchief, in cotton or placed in the bottom of a glass tumbler and inhaled. If Nitroglycerin becomes necessary, this writer has always preferred that a Medical practitioner consult with him before such a prescription is given. Routine constitutional treatments are for avoidance of future attacks of pain, and removal of the causes creating the Angina.
NEUROPATHY: Light lymphatic on the first treatment, and stimulation of the cervicals and dorsals.
CHIROPRACTIC: H. P.
ORIFICIAL THERAPY: Rectal dilations with the finger, gentle pulling upward downward and laterally for a few minutes, has been found helpful in many cases.
COLON THERAPY: If there is constipation of any degree, colonics until freedom is attained.
ELECTROTHERAPEUTICS: Short Wave or Diathermy. One electrode on spine over the dorsals, and the other along the course, if the pain is noticed on the anterior portion of the body. Blood pressure may rise at first, then fall. But, if the blood pressure continues to rise, and reaches a constant point with no fall-back to the mean at which the treatments began then the treatments must be given with a weaker current. The physician should check the blood pressure before giving the treatments, and every three minutes during the treatment. In this way he can avoid, in a large measure, attacks of pain while giving the treatment. The treatments can run from five minutes to twenty minutes. It is best to start with a short treatment, then build up gradually to the longer duration. In this manner treatments can be given three times a week.
Recently we heard an M.D. say that in cases with hypertension, the surest way to give relief was by electrical auto condensation, and that in hypotension, the circulation was increased by putting sunlight on the feet, at the same time putting short wave electrodes on spine and over the heart. We are now giving this a trial, but it is too early to make a definite report, yet, the method does seem to have produced some favorable results.
ULTRA-VIOLET RAY: Patient sitting on revolving stool, and rays directed to upper portion of the body. The first portion to be exposed is the spine, then every two minutes patient is turned so the shoulder is exposed then the chest and then the other shoulder. This rotation can be continued on an average of ten to twenty minutes per treatment. CAUTION: The patient should never be left alone for any length of time during electrical treatments of this kind.
DIET: First day or two, Diet No. 2 can be given with variations in the fruit juices. If the patient does not object, a fast of a day or two on fruit juices may be found helpful. But, if it worries the patient, not much good will be accomplished. Heavy meals at one time are out of order, because they cause flatulency and bring on attacks. The writer has found it best to outline from Diet No. 1 and Diet No. 2, a program for eating six times a day for those who worry and finds that in this way the patient can gradually train himself in better dietetic habits.
HYDROTHERAPY: Cold baths of any nature are contraindicated. Hot towels to chest and back may be applied as often as convenient. One case we remember in particular of a farmer who could not get to the doctor’s office, but whose wife applied the hot towels faithfully morning, noon and night for three months, was relieved in a short time of severe attacks, and up to this time has had no recurrence after a period of five years. He was told to stop smoking tobacco and drinking of liquor. He said he would give one up but not the two. Liquor was dropped, but continuous smoking went on throughout his life. His daily toil was lightened by agreement not to lift anything that would weigh over fifty pounds. All working together on a compromose basis found the outcome very satisfactory.
PSYCHIATRY: The best thing the writer can do here, is to refer the reader to Alvarez: “Nervousness, Indigestion and Pain.” Pages 24, 174 and 409. And to “The Principles of Applied Psychiatry.” Pages 118 to 122. Lake.
VITAMINOTHERAPY: Garlic for hypertension. High B for Hypotension and C.
HERBOLOGY: The following may be considered:
If the pain and oppression in the region of the heart is from a weak heart, Skull Cap and Golden Seal is indicated. If from an enlarged heart Bitter Candy Tuft is good, so is Bugleweed (Lycopus) as it relieves the difficult and oppressed breathing. For Palpitation Skull Cap, Valerian and Tansy is indicated. Snow Berry will increase the heart action while Sheep Laurel will act as a sedative. Mexican Fever Plant is good for organic trouble, and Motherswort is a nervine and heart tonic.
Heart trouble being a result of toxic condition of the blood stream a general blood purifier should be used, such as Sarsaparilla, Yellow Dock, Bitter Dock and Stillingia or this combination, Sarsaparilla, Quassia Chips, Senna Leaves, Licorice Root and Yellow Dock.
MISCELLANEOUS: It is probably not necessary to say that the patient should try to live a regular life, especially relative to sleeping. The patient should not be ordered to bed at a certain hour, but allowed to discover himself, just whether he can get along the next day without fatigue on six or eight hours sleep. When he finds the required number of hours, then he should have sense enough to make it a habit. Regular habits of eating, relaxing, sleeping are the best healing agencies for this condition.


 
Anorexia


 DEFINITION: Here we will define and limit its discussion to a lack of appetite for food without any organic disease or known explainable cause.
ETIOLOGY: In children it is due to tensions, hysteria, or melancholia. The writer recalls a boy actually starving himself without any apparent reason. Having gained his confidence we learned that his mother, a few years previous, had been a food crank and had told him that certain foods had no value, and they were the very foods that the boy liked, but, she insisted on his eating what he did not like, until his nerves were shocked by continuous quarreling, and a lasting rebellion was aroused in the boy.
In the older people, Anorexia may be due to either hysteria, or psychasthenia. The types of hysteria may be of the anxiety nature, and the mechanism of protection may pass into conversion hysteria. While the psychasthenia may partake of the compulsive nature due to a complication of the paranoid element of dementia precox. See chapters 3 and 4. “The Fundamentals of Applied Psychiatry.” Lake.
There are a great many other causes for this disturbance of appetite: anemia, cancer, alcoholism, drug addiction, constipation, nephritis, nicotine, or caffeine in excess, improper feeding, excessive carbohydrates, sweets. Too much milk over a long period of time. Great deficiency of vitamin B, with intestinal atony and diminished peristalsis. Ptosis of abdominal organs. But in general, the origin of Anorexia is due to a nervous condition largely of psychic origin, which may bring on a type of indigestion at the sight of food, by an over-activity of the vaso-constrictor nerves originating in the brain centers.
SYMPTOMS: The first objective symptom of anorexia nervosa is the loss of appetite. The second is the loss of weight, then listlessness and a general lack of interest. If food is forced there is belching and sometimes vomiting. It is about this time that the physician is consulted, and the patient is fully confirmed in his or her attitude regarding foods. Fatal cases have been reported, and autopsies have revealed no organic pathology.
PROGNOSIS: Generally good.
TREATMENT: When alterations in appetite are so great, that there is danger of a serious pathological condition, the physician should try to find the cause, and treat accordingly. But a general treatment may be as follows:
Another of a boy who, for some reason had taken a dislike for food. A few hours fishing trip and an explanation that good food was necessary for him; out in the open, and watching the writer eat a sandwich and some ice cream, soon made his mouth water, and he ate plenty and has since. His mother had to be cautioned not to try to force foods on him that he did not like.
Temporary Anorexia may be due to autointoxication, especially of the intestines. Colontherapy is sufficient to relieve that condition.
TREATMENT: NEUROPATHY. Light general lymphatic. Dilation of whole spine.
CHIROPRACTIC: Stomach, Atlas Places and other places as needed.
MASSAGE: Light massage of whole body may be helpful.
ENDO-NASAL THERAPY: Treat to enhance the sense of smell. See “Sense of Smell in Endo-Nasal, Aural and Allied Techniques.” Lake.
PSYCHIATRY: Psychoanalysis on the question side, rather than free association. See both methods “Principles of Applied Psychiatry” Lake. Pages 124 to 128. For the treatment of children see page 169. Suggestion is of paramount importance. The writer recalls an elderly lady who was gradually slipping away, that he took for an automobile ride one day and ascertained the reason why she would not eat was due to the idea that since her daughter-in-law was always picking at her, and son and husband about their table manners, she, the old lady, got the notion into her head that the daughter-in-law was, in a round about way, taking a back-handed slap at her. Upon questioning we also found out that this elderly lady had, as a child, been scolded continually for bad table manners which left a fixation neurosis against any rules of conduct at the table. The fresh air of the ride, and a little persuasion was enough to get her to eat a very hearty meal, with a little soda, to prevent indigestion. All was well, after a secret talk with the daughter-in-law.


 
Anxiety Neurosis


 DEFINITION: A functional disease in which fear (or the somatic evidence of fear) is the essential part of the picture. A symptomatic fear state can be differentiated by recognizing primary disease such as thyrotoxicosis. Fear may exist consciously, or present a group of somatic symptoms not recognized for what they are; in fact, even denied as representing anxiety. Ordinarily, fear as a response to an environmental threat is quite conscious, it may be equally conscious without the patient having the slightest insight as to the causation. Fear may be an emotional correlate of organic brain disease; it is outstanding in certain toxic states (notably delirium tremens), may co-exist with depression, and occur as night-waves. Anxiety neurosis is manifested when an intact personality without organic disease, during clear consciousness, complains of palpitation, heart-pain, dyspepsia, cold, sweating, tremulous extremities, constriction of the throat hand-like pressure about the head among other symptoms. Often these are interpreted as meaning regional disease. The real significance is a feeling of inadequacy in meeting some situation; e.g., a tempting situation which is so completely repressed as to be totally unacceptable to the patient as of significance. Homosexuality is such a frustrated impulse that may lead not only to an anxiety state but to the much more intense picture of panic-psychotic terror.
TREATMENT: Correction of all physical disorders. Then psychiatry. Turn to the Fundamentals of Applied Psychiatry, Lake, p. 118.


Aphasia


 DEFINITION: A loss of power of comprehending, speaking or writing words, due to cerebral perversions.
ETIOLOGY and DIAGNOSIS: Pure aphasia is due to a perversion of the foot of the third left frontal lobe. If the perversion occupies but a portion of the region the aphasia may be partial only.
Aphasia must be distinguished from aphonia. The latter condition is an inability to utter sounds, a power not lost in aphasia, moreover, aphonia is generally dependent upon some abnormality of the larynx or of the nerves leading thereto.
Perversions that may produce aphasia are manifold; the most important are: Tumor, gumma, abscess, depressed fracture, embolism, thrombus, or softening in the localities that correspond to the various forms of aphasia. In right-handed subjects the lesion is on the left side of the brain; in left-handed it may, however, be on the right side. Aphasia is not always due to organic disease; it may occur as a transient condition in congestion of the brain, in sudden fright, in convalescence of fevers, in migraine, after epileptic seizures, and in hysteria. This depends entirely on the cause. After apoplexy the prognosis should be guarded. In cerebral softening it is absolutely unfavorable. When aphasia develops in the young, the outlook is much more hopeful.
SYMPTOMS: Patient comprehends, but is unable to express himself in words. Entire loss of voice is not common.
Divided into motor and sensory types, each of these are divided into cortical and subcortical, according to whether the perversion is in the center itself or in the tracts communicating with the center.
Sensory Aphasia is further classified as visual, and Auditory Aphasia.
MOTOR APHASIA: This is an inability to express thought in words. When the perversion is in the third frontal convolution (cortical motor aphasia) the power of silent talking and reading are lost as well as that of articulate speech. When the perversion is in the adjacent tracts which transmit speech impulses to the articulatory muscles (subcortical motor aphasia), the power of articulation alone is lost. This is the most common form of aphasia.
SENSORY APHASIA: This is an inability to understand printed or written words (visual aphasia or word-blindness), or to understand spoken words (auditory aphasia or word-deafness). The lesion is in the angular gyrus, where visual word memories are stored, or in the first temporal convolution, where auditory word memories are stored, or in one of the incoming (subcortical) tracts of special sense.
In cortical visual aphasia the patient cannot read aloud or to himself, nor can he write spontaneously or from dictation. In subcortical visual aphasia the patient can write spontaneously and from dictation, but he canot read what is written by himself or others.
In cortical auditory deafness the patient cannot understand spoken words or write from dictation. Not being able to comprehend his own speech he misplaces words or talks unintelligently. In subcortical aphasia the patient though word deaf, can speak spontaneously, read aloud, and write.
TREATMENT: Since aphasia is a symptom and not a disease, it is necessary to determine its cause and to treat this. If it is due to a cerebral thrombosis, embolus, or hemorrhage the indications are to treat that condition. If due to tumor, the latter must be removed, if possible. General treatment may be as follows:
NEUROPATHY: General lymphatic and dilation treatment. Neuropathic cranial techniques for opening of the frontal lobe sutures. This is preceded by opening of the facial sutures.
ENDO-NASAL THERAPY: All techniques necessary for proper intake of air and oxygen.
See Techniques in “Endo-Nasal, Aural and Allied Techniques” — Lake.
CHIROPRACTIC: C1, 4. D 1 to 6.
SPONDYLOTHERAPY: Concuss C1 to 3 and 4 to 7.
ORIFICIAL THERAPY: Rectal dilations.
SURGERY: An X-Ray picture should be made in all these cases to avoid overlooking of possible injuries and fractures. Injury to the skull, especially when there is depression of the inner plate, tumors, cerebral hemorrhage, and other conditions capable of inducing cerebral pressure, requires appropriate surgical procedures.
DIET: If any tumors exist the possibilities of the grape cure should have attention.
COLONTHERAPY: Enemas or colonics weekly.
PSYCHIATRY: A psychophysiological method of speech re-education is necessary. To reteach the motor acts of articulation, the writer favors the method which aims to restore the memory of sounds and the association between visual and auditory (word) impressions, beginning with individual syllables—some of which the patient can still articulate—and later building up polysyllabic words. The method is useful also where the usual method is inapplicable because of weakened intellection and attention, also the method is useful where the usual method is inapplicable. The person should be taught to write with the left hand and kept at it until by practice the movements of the left hand become instinctive as those of the right hand were before the attack of aphasia. The left-handed man vice-versa.


 
Aphonia, Hoarseness


 DEFINITION: Loss of voice.
ETIOLOGY: Among the most common causes are the following: Organic disease of the larynx—inflammation, neoplasms, cicatricial stenosis. Centric paralysis of the recurrent laryngeal nerves, as in bulbar palsy. Peripheral paralysis of the recurrent laryngeal nerves caused by pressure of an aneurysm, mediastinal tumor, or pericardial effusion. Hysteria. The lodgment of foreign bodies. Prolonged use of the voice. Excessive smoking, many colds, nasal seepage from cranial catarrh, sinusitis, childhood diseases, mechanical defects, etc.
SYMPTOMS: They are too apparent to review here.
TREATMENT: The specific treatment must be on the primary cause. General treatment may be as follows:
NEUROPATHY: Thorough lymphatic of the lymph vessel of the neck and liver.
CHIROPRACTIC: C. 4, D. 2-5.
SPONDYLOTHERAPY: Concussion of the 4th to 6th Dorsal.
ELECTROTHERAPY: Short wave or diathermy, with a pad on each side of the larynx is helpful. Infra-red applications may be given as often as indicated. Quartz light, applied through a special applicator to the larynx every other day, produces a slight erythema which is of decided value.
HYDROTHERAPY: Gargle with spoonful each of lemon juice and water twice a day. Gargle with pure pineapple juice. Hot or cold compresses. Ice cubes dissolved in the mouth have helped many.
ENDO-NASAL THERAPY: This is the treatment par excellence if there is not a malignant growth. Stretch and clean out the pharyngeal cavity. Then massage the affected laryngeal spaces. The technique for the laryngeal area is as follows: After washing hands thoroughly, dip finger covered by finger cot into cold water; now slide the finger down the side of the mouth until it reaches the root or base of the tongue, then quickly slide finger over to the middle of the tongue. (Get one pressure on finger and maintain it all through the operation; if air gets under finger, patient will gag.) Now, with your finger in middle of the tongue, move the finger backward until you reach the epiglottis. Your finger is now in the valleculae, one on either side of the glossoepiglottic fold. Now massage right and left and up and down five or six times. When you are withdrawing your finger, pull the tongue upward and outward. Many abnormal conditions in the larynx are due to ptosis of the tongue.
For anemia, enervation or congestion, this operation puts the tissues in place, and creates a freer circulation of blood fluids around the area. Some authorities have suggested using two fingers to perform this operation, one on each side of the mouth. We leave this to the discretion of the individual practitioner.
VITAMINOTHERAPY: Vitamin B1 and what is necessary for the cause.


Apoplexy Cerebral


 DEFINITION: Hemorrhage into the brain or spinal cord.
ETIOLOGY: All causes that lead to diseases of the Arterial system, such as gout, syphilis, alcoholism, sclerosis, nephritis, high vascular tension and cardiac hypertrophy.
SYMPTOMS: PREMONITORY: Headache, dizziness, disturbance of vision, tinnitius aurium, insomnia, tremor, epistaxis, thickness of speech, loss of memory, and a sensation of tingling and numbness of the affected side. Vomiting is a common symptom, preceding the attack. Unconsciousness is measured by the degree of the hemorrhage, as also is the paralysis. In grave cases, the beginnings of paralysis can be detected while the patient is in the comatose state. While in some of the milder cases the paralysis and unconsciousness are absent or of short duration. If the hemorrhage is in the usual location, the internal capsule, and has not been very copious, the clot loses its color, shrinks, and is finally absorbed, and the damaged cerebral fibers are replaced by connective tissue, which contract and form a scar.
EXTENSIVE HEMORRHAGE is followed by great changes and extends in the direction in which the affected nerve transmits impulses toward the periphery. After an extensive lesion or perversion of the internal capsule, secondary degeneration of the motor tracts begins and may be traced by the fingers downward along the spinal column by the soft, lifeless condition of the muscles in the gutter of the spine.
If the attack proves fatal, the patient does not come out of the state of unconsciousness and death ensues from a few hours to within from one to three days.
PROGNOSIS: It can be said that prognosis is always uncertain. But, if the attack is not fatal, there is always a danger of recurrence as long as the original causes remain.
TREATMENT: The head should be elevated, and an ice cap applied to the carotid sinus, or on the side of the neck or head where the hemorrhage has taken place. Venesection may be called for if there are indications of regular, strongly acting heart and an especially strong pulse. The above should be done only after a consultation. Whatever measures that will have a tendency of the blood to clot are in order.
VITAMINOTHERAPY: Large doses of Vitamin K seem to be gaining favor, due to a decrease in prothrombin in the blood. Quietness is absolutely necessary.
Physical treatment, if any is required at all, may consist of downward light strokes with the hands to the cervical region, and down the back and on the limbs to prevent, if possible, any great degree of paralysis. As a catharsis, 1 to 3 drops of Croton Oil in a little glycerin or olive oil can be placed back of the tongue. Retention of the urine can be relieved by the catheter. If feeding becomes necessary after a lapse of a few days, it can be given by the rectum. The physician will recognize that not much more can be done until consciousness is restored, and the patient must be kept in bed for several weeks, then measures introduced to remove the causes can be instituted and also to prevent any further spread of the paralysis. See Hempheligia and Paralysis.


 
Appendicitis, Acute and Chronic


 DEFINITION: Inflammation of the vermiform appendix, generally occurring between the ages of five and twenty, very rarely before the fifth year or after the fiftieth. It is more common in male adults than in female adults. The disease may be acute, subacute, or chronic.
SYMPTOMS: Any or all of the following may be present:
Abdominal pain, usually severe and generally throughout the abdomen, followed by nausea and vomiting. Localization of pain in the right lower quadrant of abdomen with tenderness and rigidity over right rectus muscle or McBurney’s point. Fever usually rises within several hours, 99 degrees F. to 101 degrees F. Pulse increases with temperature. Patient lies on back with right lower extremity flexed to relieve muscle tension. Leucocytosis present shortly after onset. In mild cases symptoms begin to subside on the second day, but in more severe cases there might be a cessation of pain indicating that the appendix has ruptured. After a few hours a well-defined abscess may be felt in the right iliocecal region showing that nature has walled off the affected area.
In the subacute or chronic, which may or may not follow an acute attack, there is a constant ache in McBurney’s point, and some gastric indigestion which may simulate a gastric ulcer, duodenal ulcer or gall bladder disease.
Pain or ache in McBurney’s point, in those whose appendix has been removed, may be due to adhesions, hernia, or ulcers.
Adhesions can be detected by palpation and the tuning fork. Ulcers by the warmth or heat of the hand, and the symptoms of ulcers, and hernias by the ptosis and hardness of the lump.
ETIOLOGY: Appendicitis is more common in males than in females. It is most frequent between the fifteenth and thirtieth years. Exposure, errors in diet, intestinal catarrh, traumatism, and the lodgment in the appendix of fecal concretions or foreign bodies predispose to the disease. It may follow some infection, as typhoid fever, influenza, or tuberculosis. It may be induced by twisting of the appendix.
Excessive vaso-constriction from the lumbar segments, which are found to be constricted and tender to the touch, are among the causes of appendicitis.
In the vast majority of cases the etiology can be traced to long-standing forms of constipation.
TREATMENT: Acute Appendicitis. All foods and purgatives are prohibited during the attack. Hot or cold wet towels are applied to the abdomen according to the reactions of the patient. Low enema may be given. Thirst being quenched with ice pellets, or rinsing the mouth with cold water. Counter-irritation has been found by the writer to be of great value. Put a vacuum cup on the left inguinal region, exactly opposite to the appendix. Inflate very mildly at first, using one cup at a time, leaving on one minute, then follow the course of the descending colon, across the transverse and down the ascending colon to the appendix. If, by this time, the patient can tolerate the cups, the process can be repeated, inflating the cups a little harder.
Adjustment of the second lumbar or Neuropathic hard pressure on the 10th dorsal has been of great help in many cases.
All, or any of the above methods have been successful in nearly all cases of acute conditions.
For those who have doubts, Riley makes the following statement to which the writer concurs.
“We are sometimes asked the question of what we would do if pus has formed in the appendix. This is easily answered. Let it be noted that there is a slight opening into the cecum from the appendix. If pus forms in the colon, it will usually, at the right time under proper treatment, following the line of least resistance, pass into the colon, and on out with the discharges from the bowels.
“Should there be a refusal to obey this law of least resistance, there would be an absorption of the matter back into the system, giving the kidneys an added work to do. This may throw some poison into the system, but the kidneys, under the treatment the spinal therapist may give, will be equal to the task of elimination, and an operation will be saved.
“Should there be a discharge into the pelvic region through a bursting that way, it may be remembered that the system, under good conditions, will be able to absorb great quantities of pus, and throw it off through the kidneys and the other eliminative organs.
“Of course, after all, there may occasionally arise some case that is too far gone, where adhesions may be hard to overcome, or some other complication be such as cannot be surmounted, but it will be very rarely, indeed, that any absolute necessity will arise under careful treatment that will require an operation.”
GENERAL TREATMENT: When the acute condition has passed, any or all of the following techniques may be used.
NEUROPATHY: Complete lymphatic and dilation of the nerve segments.
CHIROPRACTIC: L. 2-4.
NOTE: If there is a sacroiliac slip and reset.
SPONDYLOTHERAPY: Concussion of the tenth dorsal.
ORIFICIAL THERAPY: Rectal dilations.
HYDROTHERAPY: Whichever gives the most relief. The majority get relief quicker from hot compresses and hot fomentations.
COLONTHERAPY: Graduated colonics from low to high, once a week for a period of six weeks.
BODY MECHANICS: If there is a ptosis, an elastic belt, about five inches high in front, and seven inches high in back, is very helpful.
VITAMINOTHERAPY AND DIET: At present no specific has been found for appendicitis per se. But B with Bile Salts is considered to be of value with a bland diet, and nicotinic acid may also be considered.
ELECTROTHERAPY: When acute stage is passed then Sine Wave or Galvanic treatments can be given along the whole outline of the intestinal tract for stimulative purposes.
VACUUM THERAPY: Follow procedure as found under Acute Appendicitis.
HERBOLOGY: If not acute, just discomfort in lower right section of abdomen, take a cup of Timothy Seed, obtainable at any feed store, and pour on a quart of boiling water; then let boil for a couple of minutes, strain, sweeten preferably with honey and drink while hot. Can be taken cold, but is not as effective.
In acute cases, use enemas of a quart of plain water every two hours, lying on back or knee-chest position; hot applications over entire abdomen (not just over appendix) to encourage better circulation of blood and assist in draining lymphatics. Add half dozen or more drops of spirits of turpentine on each hot application cloth; when cloth is cool, put on another keeping up for hours until entirely relieved, as this disperses pus that is forming.
If, after the passing of the first acute attack considerable pain and some vomiting continues, the advisability of an appendectomy should be considered. But, it is wise for the physician to always remember that appendicitis is a disease of the young and is rare after fifty. This caution will save the physician embarrassment if, during an appendectomy he should be found wrong. Neuropathic minor surgery can be considered very seriously.
J. Montgomery Deaver, M.D., states that “No form of medical treatment, dietetic, hygienic or any other mode yet devised can eradicate the disease.” He also states that “some may have one or more attacks and get over them, but in that time extension of the pathology which will have far reaching consequences.” Naturally, he states that there are contraindications to operations when senility, cardiac weakness or systemic disease are present. But, on the whole, in a true case of appendicitis, medical practice does not ask whether to operate, but when to operate; and, operation is, by the medical profession, claimed to be the surest method of eradicating the disease.


 
Arthritis Deformans


 DEFINITION: An inflammation of an entire joint, that begins in the synovial membrane and in the acute stage involves the capsule, cartilages and if not arrested, the bones.
ETIOLOGY: It may occur at any age, but is more common after middle life. One of the first signs of Atrophic Arthritis is bone atrophy which may be due to avitamosis of vitamins A, B, C and D. It may and may not have any relationship to Rheumatism or Gout.
It is not known just exactly what causes this condition, but the consensus of opinion now is that local infections of the teeth, tonsils, ears and nose may be given a large place in the etiology. In many cases the disease can be definitely associated with some local infection, such as tonsillitis, otitis media, pyorrhea alveolaris, dental abscesses, cystitis, gonorrhea, intrapelvic suppuration or an infected wound.
Enfeeblement of the general health from mental strain, over-work, unsanitary conditions, over-eating, constipation, etc., may be contributory factors.
SYMPTOMS; When the disease is in the acute form it is like rheumatism, there is pain, swelling and impaired mobility in the region affected. Then, signs of structural changes, producing rigidity, crepitation on movement and deformity with luxations of the bones.
Monarticular Form — This form occurs chiefly in old persons, and usually affects either the hip or shoulder. The symptoms are persistent pain, impaired mobility, and muscular atrophy.
Spondylitis Deformans — This term is applied to arthritis deformans of the spine; other joints may or may not be involved. The chief symptoms are pain in the back or in the limbs, especially the legs; limitation of motion, and ultimately extreme stiffness or fixation of the spine (“poker-spine”), exaggerated reflexes, gradual muscular wasting, and, in some cases, changes in the spinal curve or undue prominence of the spine. The X-Ray picture is a valuable aid to diagnosis. The disease is a common cause of sciatica and lumbago.
Heberden’s Nodes — These are small nodules at the sides of the terminal phalanges of the fingers; they are not often painful; they are sometimes the sole expression of mild arthritis deformans, but they apparently occur also in gout.
PROGNOSIS: A stubborn condition that requires long attention and treatment. Find cause and remove if possible.
NEUROPATHIC: All of these cases show a lymphatic stasis and vasoconstriction in and to the areas affected. The liver can generally be found congested. A thorough lymphatic including Hunter’s Canal is in order; along with a complete vaso-dilation.
CHIROPRACTIC: Local zones, kidney and liver places.
ELECTROTHERAPY: Fever therapy has many advocates. Short-Wave, Diathermy, Infra-Red fomentations, and Ultra-Violet are helpful. Infra-Red is excellent for pain.
EXERCISES: It is the general, accepted opinion that patients with arthritis should be at rest all the time. We sharply disagree with that opinion. We have found that the majority of those who have light employment and good sanitary surroundings should continue their employment, and all others to do some work to prevent complete rigidity of the part or parts. Certain little tricks can be devised to keep the joints flexible. A ball can be rolled in the hands for finger exercise.
DIET AND VITAMINOTHERAPY: The diet should consist of a minimum of carbohydrates, and, if possible the Salisbury Steak regime started. See under “Special Diets.” The specific Vitamin is D, but it is found that A, B, and C is also required in the majority of cases; also, viosteral and Calciferol all in large units.
STRAPPING: Strapping painful joints or replaced joints may be applied for support. Atrophic Arthritis of spine, hips and legs, may need a brace or belt to aid in the adjustment of the mechanics of those parts.
HYDROTHERAPY: The Borax and Washing Soda bath. Hot fomentations to the parts. Epsom Salts Baths Compresses to the parts will all produce a vaso-dilation.
Drinking of mineral waters, and lemon diluted, are helpful in maintaining an Acid-alkaline balance.
VACUUM CUPPING: It is possible sometimes to drain the joints by the use of the Vacuum cups, followed by Neuropathic minor surgery. The cups, in all cases, can be applied to the whole spinal column for stimulation purposes.
ENDO-NASAL THERAPY: These cases usually have a more or less anoxemia, and tests should be made to determine the degree. If below 35% the process will be long drawn out with the average patient. The external and internal nares should be thoroughly cleaned out, and the thyroid and parathyroids released from adhesions and raised up into the thyroid sinuses. A very interesting theory is expounded in relation to the parathyroids and adrenals. That blood hunger for calcium has drawn excessive amounts from the bones, and the blood hunger was so great that the parathyroids could not, in conjunction with the adrenals, control the quantity. This overflow contains only a small proportion of calcium tht is assimilable in the blood stream and the residue finds lodgment in the joints, resulting in inflammation and deformity. This theory has a large basis in fact, because Endo-Nasal Therapy seems to shorten the periods of recovery.
COLONOTHERAPY: A clean intestinal tract is essential when treatments are given for this condition.
MASSAGE: Gentle massage of the parts is always in order. When there is pain the massage can be given with the parts immersed in hot water.


Arteriosclerosis


 DEFINITION: A degeneration and a hardening of the walls of the arteries, capillaries or veins, due to chronic inflammation and resulting in fibrous tissue formation.
ETIOLOGY: See under “Neuropathy. Section—Examination of Heart and Blood Vessels.” The main cause is excessive vaso-motor constriction to the walls of the arteries. Contributory causes can be, a process of old age, syphilis, alcoholism, over-eating, over-work, lead and intestinal toxins, kidney diseases, nervous infections and disturbances of the adrenals and parathyroids. Any of the foregoing may be contributing factors.
SYMPTOMS: These vary with extent and distribution of the sclerosis. If the process is general, it may be recognized by rigidity, and tortuosity of the accessible arteries, increasing pallor, and a gradual loss of physical and mental vigor. An increase of blood-pressure, accentuation of the aortic second sound, and signs of enlargement of the heart, especially of the left ventricle, are also commonly present, but are often absent in the senile and syphilitic forms of the disease.
If the coronary arteries are especially involved, the symptoms of chronic myocardial disease appear. If the renal vessels are especially affected, there may be symptoms of chronic interstitial nephritis. Involvement of the cerebral arteries may be indicated by headache, vertigo, insomnia, mental sluggishness, and, perhaps, transient paralysis. Sclerosis of the mesenteric vessels may lead to digestive disturbances and occasionally to attacks of abdominal pain.
Sclerosis of the arteries of the limbs may be manifested by painful muscular cramps, sudden lameness or “giving way” of the legs during walking. Some other symptoms may be fatigue, enlarged prostate, chronic bronchitis, dizziness and polyrina.
PROGNOSIS: Favorable if none of the following sequels have occurred. Cerebral hemorrhage or thrombosis, chronic myocardial disease, angina pectoris, interstitial nephritis, aneurysm, and gangrene of the extremities.
In all cases of suspected arteriosclerosis a complete urinalysis should be made, and traces of fully developed nephritis should be noted. Cardiograms are useful on noting strong tympanitis of second sound of the heart; and also increase if any, of blood pressure over normal.
Normal blood pressure should be one hundred plus the age of the person up to the age of twenty years. Beyond the age of twenty, where the blood pressure would measure 120, add one point to every two years of life. A person 50 years of age would register normally 135 blood pressure.
But, if the pressure is over 190, it can be considered on the dangerous side.
TREATMENT: NEUROPATHY — A thorough lymphatic, with special attention to the liver, spleen and kidneys. Spinal dilaton of all affected segments.
CHIROPRACTIC, according to findings of subluxations, but generally, D 4.
ELECTROTHERAPY: Auto condensation, for about ten to fifteen minutes daily by chair or mattress. If kidney or other conditions are present the electro-therapy principles can be applied specially to the areas involved. Infra-red Ray may also be applied to the specific areas.
SPONDYLOTHERAPY: Concussion of the 7th cervical if heart is too burdened and rapid, three minutes in ½ minute periods. Then, generally a concussion of the splanchnic vessels for dilation purposes, any of the Dorsal vertebrae from the 3rd, downward.
DIET: Someone has said of these cases, that there are three types:
1. Cases which respond to correction of diet and change in life habits.
2. Cases which require treatment in addition to the above to effect a cure.
3. Cases in which no lasting results can be obtained.
Diet is considered the most important of all, but the hardest to enforce. Fasting is probably the best of all curative methods. If not possible, then all heart stimulants and toxic substances should be discarded. Tea, coffee, alcohol in any form, and tobacco should be forbidden. Flesh foods of every description should be reduced to a minimum, and better still, discarded altogether. Gluttony should receive a death-blow. All high life, late hours, irregular meals and business tension should be abandoned.
A good plan we have followed is to lead the patient through No. 1 and No. 2 Diet on alternate days, for two weeks, then No. 2 for two weeks. A salt-free diet is considered essential. Fruit juices can be used in abundance.
HYDROTHERAPY: If severe hypertension is present with all the symptoms of red lines in the eyes, dizziness and pain in back of head, our plan has been to order the patient home to a quiet room, then instructed as follows:
Put feet in hot water, with ice bag, or cold wet towel on head for twenty minutes, at least four times a day. One garlic capsule is taken three times in the day. The patient may have a glass of fruit juice every hour or two hours the first day. If not content, then a glass of milk every three hours. The physician visits the patient and concusses the 7th cervical at the end of the first day. If the pressure then is not satisfactory, another or even two more days of the above regime is carried out before the patient is permitted to return for office treatment.
HYDROTHERAPY AND MASSSAGE: Thorough massage is permitted when the danger point has passed. Free sweating, by Cabinet Baths, Oxygen Baths, or the Borax and Washing Soda Baths may be used with certain precautions. Also, the cold or hot sheet pack.
EXERCISES: Waalking erect in the open seems to have the most beneficial effect, but light labor is also beneficial in keeping vessels flexible.
VITAMINOTHERAPY: Three Standard Garlic Capsules daily with meals. Also, B plus.
PSYCHIATRY: Many of these cases should be psychoanalized to note what fears, phobias and tensions they are living under. See p. 115, “Principles of Applied Psychiatry”—Lake.
ENDO-NASAL THERAPY: Oxygen and thyroxin are absolutely necessary for healthy arteries. So give at least the Lake Recoil. The swabbing of the pharyngeal cavity, the opening of the nasal canal, and the thyroid techniques. Breathing exercises are also beneficial.
COLONOTHERAPY: Duodenal lavage at least once a week is in order.
HERBOLOGY: As low breathing is one of the chief causes of this ailment, deep breathing is indicated.
Excellent botanical tonics are mistletoe, Yellow Dock Root, Life Everlasting, Mormon Valley.
Valerian, Lime Flowers, Wood Betony, Motherwort equal parts, take teaspoonful of mixed herbs to pint of boiling water, simmer three minutes; let stand for half an hour, strain and bottle; take wineglass three times a day.
Garden Garlic, cooked, is excellent for Arteriosclerosis and High Blood Pressure.


Asthma


 DEFINITION: A sudden dyspnea accompanied by peculiar sounds caused by spasm of the bronchial tubes or swelling of the mucous membranes.
ETIOLOGY: No age is exempt. Males more than females. It is more frequent among those who do not take physical exercise. It can generally be said that asthma is an anoxia of a part, or an anoxemia of the whole body, due to improper ventilation and exercise.
Auto intoxication is one of the major causes. Some authorities have stated that one half of the cases are due to heredity. This writer cannot accept that theory. There is a specific cause for every case that started life with all the respiratory apparatus, and later development was due to carelessness, negligence or ignorance on the part of the parents or the affected persons.
There are many types of dyspnea:
Bronchial Asthma, due to dryness of bronchial tubes.
Cardiac, due to heart disease.
Renal, due to nephritis.
Dyspeptic, due to nervous reflex.
Thymic, due to enlargement of the thymus.
Nasal, due to obstruction in the nasal passages.
Nay Fever, due to obstructions in the nasal passages, dry membrane or rhinitus.
DRUGS; Fully 50% of the persons addicted to morphine have become victims of asthma—Sajous.
SYMPTOMS: A gasping for breath at stated intervals, with spasmodic severe attacks is enough to establish the condition of Asthma.
PROGNOSIS: The prognosis of asthma depends upon the nature of its underlying cause. Cases of reflex asthma in which the primary disorder is easily reached and properly treated—such as nasal hypertrophies, polypi, aural growths, etc.—are frequently cured and remain so, provided the causative affection does not remain. The prognosis is also good in young subjects with well-formed chests and in whom direct heredity cannot be traced. In all others, however, the chances of recovery are very limited.
Death rarely ensues from spasmodic asthma, but its complications may prove fatal.
McCoy stated the prognosis well as follows: “The patient usually wheezes along to a good age, with the misery of seeing every proposed remedy fail, until he dies from the effect of drugs taken in an attempt to relieve his symptoms. It may be truly said that at first he is afraid of dying and then afraid he will not.”
TREATMENT: The treatment of asthma consists of (1) arrest of the paroxysm; (2) prevention of the paroxysms by measures calculated to annul the effects of exciting factors and (3) removal of the pathological conditions forming the basis of the paroxysms.
The acute attack may be arrested quickly by concussion of the 7th cervical. This continued for a time will lessen the attack Then the pharyngeal cavity is opened, and cleaned out; after which the soft palate is held open, and the concussion continued. Many cases have responded for the writer with the above technique. General treatment should be concerned with preventing future attacks, and, second, to eliminate the causes.
NEUROPATHY: General thorough lymphatic, with special attention to liver, chest, arms, and neck. Thorough dilation of entire spine.
CHIROPRACTIC: D 2, 3, 4, 6.
Some writers have recommended the Epsic cigarette in acute attacks. An effective cigarette may also be made of equal parts of lobelia, stramonium, and green-tea leaves, or of stramonium leaves and ordinary tobacco. Tobacco sometimes proves useful alone where it has not been previously used.
The local application of epinephrine inhalent, which is available in small compressible tubes similar to those used for oil pigments and the tip of which can be inserted deeply into the nostrils, is often very efficient.
ELECTROTHERAPY: Johnson advocates the use of Galvanism. The positive electrode is placed under the lower cervical region, and the negative over the solar plexus, having the pneumogastric nerve in circuit. Dosage 8 to 10 Ma and time, 20 minutes—Johnson, p. 192.
ZONE THERAPY: Riley advocates for acute asthma the biting of the tongue or pinching thumb and index fingers; and also the diathermic current at 1500 milliamperes, but claims that the rapid sine wave and concussion are almost infallible. Riley, p. 118.
COLONOTHERAPY: If Autointoxication is present a complete flush of the whole colon is indicated. Otherwise low enemas are in order for some time.
SPONDYLOTHERAPY: Concuss C 4, 5, 7, alternately with D 3 to 8.
VACUUM THERAPY: Cups placed on the whole dorsal region, and followed by cups on the chest and neck, create a necessary dilation. These cups should be put on mildly at the first treatment.
DIET: The diet should follow the contents of the urinalysis, in an effort to keep an acid-alkaline balance. Selections can be made from the dietary charts in this book.
VITAMINS A, B, plus, C and D.
ENDO-NASAL THERAPY: The whole outline of endo-Nasal techniques are recommended in conditions of Asthma, with particular emphasis on the Lake Recoil, the nasal dilation, thyroid lifting and pharyngeal cavity swabbing. See technique in book: Endo-Nasal Aural and Allied Techniques, Lake, p. 101.
EXERCISES: Patient stands before open window with hands back of head. Before breathing the elbows are pulled to the front and touching. As breathing starts the arms are flexed outward and backward, slowly in rhythm with the intake of air.
The other is walking, and taking one long breath, then quickly two short breaths and a hard exhalation through the nose, which has practically the same effect as a sneeze.
HYDROTHERAPY: Cold and hot fomentations as each case requires.
BODY MECHANICS: If there is a diaphragmic ptosis a support belt can be considered. Or, the exercises as outlined in Endo-Nasal Therapy — Lake.
PSYCHOTHERAPY: This has long been practiced for the relief of asthma, which has been considered a nervous affliction almost since the time of its recognition as a disease entity. Occasionally cases are encountered wherein attacks are induced by excitement and emotional stress. Under these circumstances, the services of a competent neuropsychiatrist may be of much value, but such cases are occasional and selected ones. See “Hysteria” in Fundamentals of Applied Psychiatry—Lake.
HERBOLOGY: Such Antispasmodics and Carminatives as Wild Plum Bark, Skunk Cabbage, Wild Cherry Bark, Elder flowers, Elder Berries, Horehound, Mullein, Nettle, Elcampane, Grindelia and Celandine made into a tea are good.
Mullein Leaves, dried and crumpled, smoked in pipe or as cigarette gives relief from Asthmatic attacks.
Eating raw onions, red cabbage, raw linseed oil are common household remedies.
Steep a handful of bark of Wild Plum in a quart of water, boil down to one pint, add sugar or honey to make a syrup. Take about 3 tablespoons a day.


Autointoxication


 DEFINITION: As understood here autointoxication is a condition due to absorption of poisons from the gastrointestinal canal.
ETIOLOGY: Autointoxication can usually be attributed to three factors, (1) Dietetic errors, the use of meat to excess and gorging, etc. (2) The efficiency of the liver, (3) The efficiency of the autodefensive activity of the blood. All of the above may bring about putrefactive elements, which are absorbed by the blood and bring about the condition known as autointoxication.
SYMPTOMATOLOGY and DIAGNOSES: True autointoxication must be distinguished from other possible disorders and infections. A true case of autointoxication will present symptoms given below in all types of cases.
The high liver or individual who eats meat in excess may be ruddy or even appear congested, he will complain of symptoms similar that would occur in a pale, sallow woman. In the former, the morbid phenomena will be due to excess of proteids over and above his ability to digest them and destroy the poisons in the blood-stream, though, perhaps, both his digestive and antitoxic powers be normal. In the pale woman, on the other hand, both these functions may be deficient and even a small quantity of protein suffice to bring on the symptoms of autointoxication because of the large relative proportion of protein which undergoes putrefaction. The third patient may appear muddy, yellowish and fat, or emaciated—a type often due to hepatic torpor or incipient renal disease of toxemic origin. This shows that the general appearance of the patient is not typical of the disorder, though it affords a clue to the underlying cause.
The symptoms are:
Headache, often frontal and extending to other parts of the head, finally becomes a true hemicrania; it is sometimes migratory, i.e., moving about from one place to the other. It may be continuous both day and night or recur at fixed intervals, sometimes once or twice a week. The face is apt to be pale during these headaches; there may also be vertigo, considerable lassitude, and, perhaps, nausea. During the intervals, the patient often complains of anorexia, dyspepsia, borborygmus, flatulence, with more or less stubborn constipation or, rarely, diarrhea. There may be insomnia, or, even if the patient sleeps, fatigue on rising, and drowsiness during the day. Palpitations or arrhythmia and dyspnea on exertion and a stuborn cough are not infrequent, and the sufferer is often irritable.
TREATMENT: Neuropathic dilation of the liver and intestinal segments. Neuropathic general lymphatic with special attention to the three corner liver squeeze. Chiropractic liver and spleen also kidney places.
SPONDYLOTHERAPY: Concussion of the stomach, liver, and intestinal segments.
DIET: Dietetic measures are of primary importance a few days to a week on No. 1 diet usually is sufficient to follow with a gradual return to No. 2 diet.
A fast of one or two days without milk, or fruit juices or with them is excellent. While protein putrefaction is the main cause sometimes carbohydrate putrefaction in the stomach is a cause. This can be discovered by personal examination of the patient’s eating habits. In cases of the latter type, sweets and starches can also be prohibited for a while.
COLONOTHERAPY: Enemas and colonics are always in order twice a week until the symptoms clear up. Constipation is a serious factor in this condition.
ENDO-NASAL THERAPY: This type of treatment is essential, for many of these cases are in a state of either anoxia of the intestines and liver, or are in a general state of anoxemia. When the patient complains of an all gone feeling without any pain, it can be taken for granted that his blood is not getting sufficient, or is not utilizing oxygen properly. Oxygen is one of the autodefensive elements of the blood, and a good supply is needed in cases of autointoxication. All the endo-nasal techniques that relate to respiration should be performed.


Ataxia — Locomotor


 DEFINITION: A sclerosis affecting the posterior spinal cord.
ETIOLOGY: The disease develops most frequently between the ages of thirty and fifty, and is much more common in men than women. It has always been largely attributed to syphilis, but experience has shown that many cases have no trace of this disease. Much of it can be traced to overwork, sexual excesses, constant exposure to bad weather and alcoholic excesses. Recently, however, it has been found that there has been a long standing deficiency of nicotinic acid, and thamin bringing about a neutral degeneration.
SYMPTOMS: The symptoms of the early (pre-ataxic) stage comprise paroxysms of sharp, shooting pains, usually in the legs, and frequently regarded as “rheumatic;” various forms of paresthesia, such as numbness and tingling of the feet, and a sense of constriction about the body, girdle pain; disturbances of the urinary tract and sexual functions; loss of deep reflexes, especially of the knee jerk, and on Neuropathic examination, the lumber segments are soft and putty-like.
The most outstanding symptom of the ataxic stage is a want of certainty and precision in the movements of the legs especially in the dark. If the patient stands erect, with his eyes closed and feet in juxtaposition, he sways and tends to fall; or if the upper extremities are affected the ataxis becomes evident when he attempts to touch with his fingers the tip of his nose. In the recumbent position, with his eyes closed, he is unable to recognize the position in which his limbs are placed. In the course of time the gait becomes characteristic. The steps are awkward and jerky, the foot is raised high, projected forward and outward and brought down forcibly with a thud, the body is bent forward and the eyes are riveted to the floor.
PROGNOSIS: Doubtful of full recovery. Many are kept going the normal span of life by physical and manipulative treatments.
TREATMENT: Neuropathy. There are two stages. First, the period of sharp, shooting pain, when legs are regarded as rheumatic, or when there is a numbness. In this stage any of the following may be tried with good effect. Short Wave, Diathermy, High frequency spark, Foot adjustments, Vacuum cups on spine and all the way down the legs. For the girdle pain short wave is the best. The diagnosis is practically certain when girdle pains are associated with pains or numbness in the limbs, and there is some loss of reflex in the knee jerk.
GENERAL TREATMENT: Neuropathy. Thorough lymphatic and raising the discs of vertebrae especially of the lumber region.
CHIROPRACTIC: c. 1-7; d. 1, 2, 6, AND 10. l. All.
CONCUSSION: c. 7. d 9-10. Stretch spine.
VACUUM THERAPY: Lumber region and legs.
HYDROTHERAPY: Frequent bathing or swimming in warm water for a short period, then resting, then returning to the water, has been of great benefit to some. Hot fomentations to the spine and legs also are recommended.
ELECTROTHERAPY: Apply diathermy to the spine by means of a long narrow electrode about 3 x 18 inches. Place a similar one, only a little larger on the opposite side of the body. Continue the treatment about one-half hour using a tolerable number of milliamperes. This has a relaxing and soothing effect. Follow it by the static wave current to the spine. Much benefit is derived by giving static sparks to the legs. Sometimes in chronic cases they assist the other measures when applied to the spine. The Sine-Wave is helpful. The galvanic along the hips and legs for long periods has awakened sensation.
MASSAGE: In some cases where fatigue is easily acquired by any exercises, masssage will relax the muscles without the using up of energy. Give proper muscle training and reeducational exercises with the hope of increasing motion by strengthening other nerves and muscles which are not paralyzed.
VITAMINOTHERAPY: A, B2, E in large doses.
DIET: Nourishment must be adequate in proteins to make up for destruction of tissue.


Acute Nasal Catarrh


 DEFINITION: Acute Nasal Catarrh is an acute inflammation of the mucous membrane lining the nose and cavities. There is some loss of smell and abnormal discharge from nose.
The nasal branches of the ophthalmic division of the fifth nerve and the nasal branches of the anterior palatine descending from Meckel’s ganglion, which is in connection with the superior maxillary division of the fifth nerve, conduct the sensory impressions to the medulla. It is there reflected to the respiratory, pneumogastric and other centers; so what is termed a sneeze is the forced expiration, and the coincident spasm of the pharyngeal and laryngeal muscles.
The arteries of the nasal fossae are the anterior and posterior ethmoidal from the ophthalmic, the sphenopalatine branch of the internal maxillary, and the alveolar branch of the internal maxillary to the antrum.
The nerves of the nasal fossae are the nasal branch of the ophthalmic to the septum and outerwall, anterior branch of the superior maxillary to the inferior turbinated body, and the floor of the nose. The sphenopalatine ganglion gives off the Vidian nerve to the septum and superior turbinated body and the superior nasal branch to the same regions, the nasopalatine to the middle of the septum, and the anterior palatine to the middle and lower turbinates.
The olfactory or first cranial nerves from the olfactory bulb enter the nose through twelve or more openings in each side of the cribriform plate. They are distributed to the specialized nerve-endings in the mucous membrane of the superior turbinate nerve endings in the mucous membrane of the superior turbinate and a corresponding small region of the septum.
The lymphatics of the nose are numerous. The more anterior terminate in the submaxillary glands, the posterior communicate with the pharyngeal glands. Hence the not uncommon slight inflammation of the tonsils and cervical lymphatics after nasal operations.
PHYSIOLOGY AND PATHOLOGY OF MUCOUS MEMBRANES:
During respiration through a normal nose, the bulk of the air passes along the septum above the inferior, turbinated body, describing a semi-circle over and around each turbinate, smaller currents extend upward nearly to the roof of the nose, and then it spreads out like a fan in its passage through the nose. It is understood that the respiratory path changes with the shape of the nasal chambers. Abnormal dryness of the nasal mucous membrane, or nasal obstructions of any kind interfere with the free access of air.
The nose also serves as a resonant cavity during vocalizations, so that obstruction of the nasal chambers produces a peculiar nasal intonation during speech. Perhaps the most important function of the nose is to warm, moisten, and free from the dust inspired air. In health, exhaled air has a temperature of 98.5 degrees F., and it has been proved experimentally that most of the heat supplied to inhaled air comes from the nose, the turbinated bodies being well adapted not only to warm the inspired air, but to moisten it and free it from particles of dust which adhere to its moist, sticky surface.
The normal secretion of the nasal mucous membrane, is over 16 ounces of clear water mucus in twenty-four hours, a part of which in health passes unnoticed through the nasopharynx down into the esophagus and stomach But obstructions cause this mucus to congest and become infected and inflamed, creating anoxia and anoxemia.
To aid in elimination Endo-Nasal Aural and Allied Techniques are par excellent. The diet can be of light easily digested foods. No. 2 Diet would be helpful in the acute period if a fast of a day or two is not possible. High enemas are in order. See chronic nasal catarrh for other forms of treatment, that can be applied to the acute condition.


 
Chronic Nasal Catarrh (Rhinitis)


 DEFINITION: A chronic inflammation of the nasal mucous membrane. This has several varieties—simple, chronic rhinitis; Hypertrophic Rhinitis and Atrophic Rhinitis.
ETIOLOGY: Repeated attacks of perversions of vaso constrictions of the nasal nerves. Repeated attacks of acute colds. Lowered vitality, continual inhalation of impure air, dust or vapors.
Secondary causes may be exposure to cold and wet which may act as a predisposing factor, but the exciting cause is microorganismal. In some cases coryza is symptomatic of a general infection, such as measles or influenza, of a drug intoxication, such as iodism, or overeating and lack of exercise.
SYMPTOMS: The disease is ushered in with chilliness, muscular soreness, general malaise, fullness in the head, and sneezing. The nasal chambers are obstructed, so that the patient is obliged to breathe through his mouth. At first there is no secretion, but in twenty-four or forty-eight hours a watery discharge is established, which later becomes mucopurulent. Slight fever and its associated symptoms are commonly present. The duration is from a few days to two weeks.
Some complications that may arise are extensions of the disease to the accessory nasal sinuses, Eustachian tube, middle ear, pharynx, larynx and bronchi, which is not uncommon, but repeated attacks may lead to chronic rhinitis.
PROGNOSIS: If the patient is seen by the physician early enough, and will confine the patient to his home and give a thorough lymphatic including Hunter’s Canal and a complete dilation of the cerebro spinal system, or adjust the cervicals, kidney and liver segments, and putting the patient’s feet in a hot bath, while giving the patient hot lemonade to drink, elimination should begin almost at once and the patient can be around in a few days. But, warning must be given to the patient as to possible complications, unless great care is exercised.


Obstructions in the External Nares or in the Pharyngeal Cavity


 SYMPTOMS: In the simple type there is a constant discharge of mucoid or corpulent substance from the nose. The nose may swell, by retention of some of the pus. The other symptoms are similar to acute nasal catarrh.
In the hypertrophic type the membrane is red and the nasal passage almost blocked by engorgement of the blood vessels, causing the sense of smell to be impaired. In many of these cases Adenoid growths are found.
The atrophic type presents a different picture. Here the nasal cavities are enlarged due to the atrophy of the mucous membrane, and ulcers or scabs are frequently seen on the dry membrane. The secretion from the nose is thick and of a yellowish or greenish color and of a very offensive odor.
PROGNOSIS: The simple and hypertrophic types readily submit to treatment, but the atrophic requires a long series of treatments to eliminate.
TREATMENT: Neuropathy—A thorough lymphatic treatment and stimulation of the spine twice a week.
CHIROPRACTIC: Same as mentioned under Prognosis.
ENDO-NASAL THERAPY—Rhinitis can also be described as a filling up of the head and respiratory apparatus. It is the product of numerous colds aggravated by climate, drafts, drugs of suppressive nature, and many substances inhaled. Originally, however, it started by anoxia and anoxemia, and is perpetuated by a continued existence of those two conditions. The disease is usually in three stages. The first stage, the dryness of the mucous membrane, is so pronounced that even the head and body ache from nerve reflexes. There is sneezing, lacrimation and itching. There may be some fever. The second stage is when the healing crisis of the natural processes of the body are set in motion by fever to bring about the third state when the discharge becomes quite free and is sometimes streaked with blood. For a time there is relief, but unless the obstacles to normal respiration are removed, recurrence will take place, and since this is a condition of the mucous membrane that extends to all of the sinuses, the ears, pharyngeal space and tonsils, serious complications can result.
TREATMENT: Give the Lymphatic Drainage Technique, the Lake Head Recoil Adjustment, the Enlarging of the External Nares, and the Pharyngeal Dilation Technique.
There are two methods for nasal dilation. The suture opening method or the little finger method. The first may be accomplished by the following movements:
The first method, instructions: Have patient sit on low stool. Stand on right side. Place your left hand just above the fronto-zygomatic suture, the heel of your right thumb at the pisiform process, just below the fronto suture. Hesitate for a moment, then give a thrust downward. Beginners should start giving easy thrusts at first. Move 2. Stay on right side. Put left hand over the fronto-nasal suture. Place dorsal portion of thumb and hand on bony bridge of nose. Hesitate. Give thrust downward. Move 3. Go to left of patient and repeat technique on the right fronto-zygomatic suture, reversing hands. Move 4. Stay on left side and feel for the naso-maxillary suture on the right side. Having found it, place the two middle fingers of both hands on opposite sides of suture. Press deeply without hurting. With back of fingers of each hand touching the other, cup the hands around the face. Using the face as a brace, hesitate for a moment, then give a quick jerk in opposite direction with the fingers only. Go to the right side of the patient to adjust the left naso-maxillary suture and repeat as directed above. Stay on the right side of patient. Encircle head with right arm. Put pisiform portion or heel of thumb of left hand on the malar bone prominence. Press in deeply, hesitate, turn the hand downward slowly while pressing, then give a quick downward thrust. Go to left side of patient, reversing hands to adjust right malar bone and repeat as directed above.
The second Method: Stand on left side of patient with little finger of left hand in right nostril, right hand on malar prominence. With quick jerks on malar bone by right hand to open sutures, let the little finger slip up into the nostril. Do not push hard on the little finger or you will cause pain and bleeding which are not necessary if technique is performed correctly.
Patient should be instructed to maintain an erect posture and to breathe through the nose consciously for a time, so as to establish the habit. Most sufferers of rhinitis are mouth breathers.
ELECTROTHERAPY: Mild heat applied to head from a Short Wave set is of great value, providing there is no excessive high blood pressure. Ultra Violet Ray is helpful. Full body or just nasal radiation.
VITAMINOTHERAPY: Large units of A and D and Magnesium or Cod Liver Oil with vitamins A, D in the oil.
HYDROTHERAPY: Cleansing a nose with alkaline solutions is sometimes helpful. Or, plain salt solution.
For softening of mucous in head hot fomentations or compresses.
NASAL IRRIGATION: There are those who advocate nasal irrigations by filtering water through one side and having it come out the other side of the nose or through the mouth. There are some advantages to this method of treatment, but the disadvantages far outweigh its usefulness in therapeutics. Middle ear and sinus impairment are possibilities by irrigations and the writer has stopped using them. But, for those who wish to use them; an enema bag with a nasal bulb on the end of the hose. Have the bag hanging just high enough for the water to run slowly. The water or solution, preferably the Pink Rose Alkaline powder of Zemmer, in the water, is introduced by the bulb into one side of the nose. The mouth is held open, and then the water will come out the other side of the nose by mouth breathing. There are several devices on the market for the above purpose.
HERBOLOGY: A simple and effective remedy is Lemon Juice and Honey. Dilute with warm water at first and then gradually use less water. Snuff up nose four times a day. Mix equal parts of Yarrow, Boneset, Black Horehound, Balm and Sage. Simmer for 30 minutes in a loosely covered vessel. Add a small pinch of ginger and Capsicum. Take a wineglass three times a day.
Here is an old recipe from Bavaria where it is still called “Catarrh Tea.) It is here improved by adding some botanicals of Indian origin:


 Elder Flowers 10 parts
Rocky Mt. Grape Root 4 “
Juniper Berries 4 “
Anise Seed 2 “
Black Mallow Flowers 4 “
Fennel Seed 4 “
Mullein 10 “
Coughwort 10 “
Turtlebloom leaves 3 “
Marshmallow Root 2 “


 Mix herbs, take teaspoonful, put in cup of boiling water, let cool, strain. Drink 2 or 3 cupfuls per day. If desired the following can also be added: Sweet Gum Bark 4 parts, Coriander seed 2 parts, Water Plantian 4 parts, Licorice root 3 parts, Lungwort 4 parts.
Dried peach leaves are good as a smoke.
EXERCISE: Fresh air is essential and some outdoor exercises, with bathing and friction of the skin or massage is helpful.
TONICS: Teaspoonful of Honey and Lemon in a glass of hot water each morning is highly recommended.
VACUUM THERAPY: The cups can be applied on the whole spine, and a small bulb inserted in the nose for outward suction.
SPONDYLOTHERAPY: This can be given by tapping with the fingers in the area of the cranial nerve endings or by a vibrator or concussor on all the head and face. The blows being regulated to the resistance or comfort of the patient.


Backache


 Backache is one of the most common ailments known to mankind. It is a symptom of a disease rather than a disease itself.
ETIOLOGY: Tuberculosis, Arthritis, curvature, malignancy of spine; sacroiliac strain, or sprain, pelvic disorder, abdominal and chest disorders; Nephritis and pyelitis, sciatica, tumors of the cord; subluxations and many other conditions too numerous to mention.
DIAGNOSIS: The patient can tell the physician of accidents and employment and relation of such to the pain. Tests of various kinds can be made to ascertain if there are any of the above mentioned etiologies. The patient then can be stripped to the waist and a thorough examination made. See “Examination of the Back,” under Neuropathy.
The types of backache may be classified as follows:
The Industrial, Lame back, which is due to the occupation of the patient. If not aggravated by other conditions, it is more a soreness or tiredness in the muscles.
Back strain; makes up a large proportion of the present day disabilities of the spine.
ETIOLOGY: Curvature of the Spine. This type of backache may be caused by curvature of the spine, either in the lateral or anteroposterior position; some mechanical disability of the shoulders, either drop of one shoulder, or both, or round shoulders; some mechanical foot complication or other static disability or derangement of the lower extremities; some disability of the thorax or abdomen, or a pendulous abdomen.
Rectal and gynecological conditions may also be considered as contributory causes.
Back Sprain. Most frequently encountered in those who do heavy lifting and receiving a twist of the body.
PROGNOSIS: Depends on the Etiology.
TREATMENT: General Neuropathy. Thorough lymphatic and dilation of segments and Lake Recoil, indicated by symptoms and diagnosis.
CHIROPRACTIC: Local zones.
HYDROTHERAPY: Hot towels, compresses, baths, etc.
STRAPPING: If, after a number of other treatments, relief is not obtained, strapping can be considered.
ELECTROTHERAPY: Short Wave or Diathermy or Sine Wave, should all be helpful. Infra-red, until a slight erythemia is obtained, is excellent.
MASSSAGE: The light tapement after rubbing, is of value in some cases.
HELIOTHERAPY: Exposure to the sun rays for ten to fifteen minutes a day is helpful.
VACUUM THERAPY: By the counter irritation method first, then by the direct method.
SPONDYLOTHERAPY: Vibration of the whole spine, by concussor or vibrator, or local zones are helpful.
FOOT ADJUSTING: Careful examination of the position of the cuboid bone should be made, for displacement causes many types of backache. The Neuropathic three point foot adjustment may prove helpful.


Bell’s Palsy, Facial Paralysis, Pontine Paralysis


 DEFINITION: Paralysis of the face. The vast majority being unilateral. It has also been called Bell’s Palsy; but the latter has some other peculiar phases.
ETIOLOGY: May result from a tumor, clot or abscess involving the facial center in the cortex of the brain or the nucleus of the facial nerve; from the pressure of inflammatory exudate on the nerve trunk between the brain and the skull; from paralysis of the nerve within the petrous portion of the temporal bone, excited by a fracture or by an extension of inflammation of the middle ear; from inflammation of the peripheral filaments, excited by exposure, injury, diabetes, or one of the infectious fevers; syphilis, colds, diseases of the middle ear, otitis media, abscess, and pressure in the pelvis of instruments in obstetrical cases, sleeping with face to wind, or riding in car with window open in cold weather may be a factor.
GENERAL SYMPTOMS: Paralysis usually occurs suddenly. On examination one side of the face is found to be paralyzed and the unaffected muscles drawn toward the sound side. Expression is lost and the natural wrinkles and lines are obliterated on the affected side. The corner of the mouth is dropped and saliva dribbles from it. The eyelid on the affected side cannot be closed and the eye waters. Swallowing is seriously interfered with and the tongue is directed toward the paralyzed side. The forehead cannot be wrinkled.
There are three types of this disease, determined by the symptoms: Simple facial, Bell’s, and Pontine Palsy.
In simple facial palsy the lesion is supranuclear, between the cortex and the pontine nucleus, there is only a weakness of the face, with slight affection of the frontalis muscle.
In Bell’s Palsy the whole side of the face is affected, and the lesion is nuclear or infranuclear, the muscles of one side of the face, including those of the forehead and eye, are involved, both emotional and voluntary movements are lost, and the electric reactions are altered in character. In nuclear lesions other cranial nerves are usually involved with the facial.
In pontine lesions there is often paralysis of the limbs on the side opposite to the facial palsy (crossed paralysis). When the nerve is involved within the Fallopian canal there is frequently loss of taste in the anterior part of the tongue on the paralyzed side.
PROGNOSIS: Slight cases of facial paralysis from any causes will recover in from one to six weeks. But the severe types may take from two to ten months or remain permanent, according to the etiology.
TREATMENT:
NEUROPATHY: Thorough lymphatic. Dilation 3, 4, 5, and pressure on fifth cranial nerve location on face.
CHIROPRACTIC: Adjustment of the condyle or any four of the upper cervicals and D6.
ELECTROTHERAPY: Short wave. Sine wave. Deep therapy lamps, faradic current. Hot pads according to tolerance of the patient, are helpful.
HYDROTHERAPY: Hot towels on the face. Irrigation of the antrum and bathing of the eye with a boric acid solution are considered beneficial.
MASSSAGE: Relax all the muscles of the neck and give freedom to the venous return blood.
Extend the neck and give gentle, firm and steady rotation.
Thoroughly manipulate the muscles high up under the angles of the lower jaw. Pull these muscles in different directions.
Manipulate the parotid, submaxillary and sublingual glands.
EXERCISE: Before the mirror the patient can go through mimic exercises of attempting to use the muscles of his face and eye, by trying to wink, or blow out his cheek.
PSYCHIATRY: The sufferers of this affliction are usually depressed and fearful of future complications. The art of hopeful suggestions is in order, but not in regard to the prognosis until the physician is sure of his diagnosis. To build up hope and fail, is to leave the patient’s last mental condition worse than his first. But the physician can cite his experience with this type of cases and relate the majority do get well, who cooperate faithfully with him.
SPONDYLOTHERAPY: Concussion of the 4 D for three minutes at intervals of half a minute at each sitting.
ENDO-NASAL THERAPY: With the addition of the Neuropathic lymphatic treatment, Endo-Nasal techniques has given the writer the best results. Swabbing the pharyngeal area, and the antrum area, the Lake recoil technique, then finish the treatment with the external carotid sinus technique, viz.:
Put the thumb and middle finger on the tip of the chin, slide them all the way back to the angle of the jaw. Drop fingers down one-half inch, push them easily into the neck walls and feel the tissues underneath your fingers. Hold steady for an instant, then thrust the fingers quickly inward and upward with about a three-pound pressure, then withdraw the fingers quickly. Note: Pressure can be measured on any ordinary scale.
HERBOLOGY: Prickly ash, pepper cress seed and imperial masterwort are all good. Also worthy of mention are baytree kidneywort, German golden locks, pimpernel, sage, mistletoe and false wild flax.


Bright’s Disease and Nephritis


 Perversions of the functions of the kidneys, and the classifications of those perversions is rather complicated. The usual classification is Acute Bright’s Disease, Chronic diffuse nephritis, Chronic interstitial nephritis. The new classification covers a few additional points in the instruction of the development of kidney perversions, briefly stated below.


Bright’s Disease


 DEFINITION: Inflammation of the kidneys.
ETIOLOGY: Bacteria or their toxins, scarlet fever, diphtheria, septicemia, or toxic drugs, such as mercury, arsenic, alcohol. Malnutrition, exposure to cold and wet. Streptococcus infection of throat, etc. The glomeruli may be affected, or the tubules of the interstitial tissues. It may be either acute or chronic.


 
Bright’s Disease — Acute Diffuse


 ETIOLOGY: An inflammatory process involving more or less of the entire kidney but especially affecting the epithelium of the tubules and glomeruli.
SYMPTOMS: Acute onset, moderate fever, dull lumbar pain, marked edema and anasarca, hypertension, rapid pulse, vomiting, delirium, scanty, highly colored urine, containing large quantities of albumen and blood; bloody hyaline, and granular casts; uremic symptoms may develop any time.
PROGNOSIS: Guardedly favorable. May become chronic or death through exhaustive uremia or dropsy.


 
Acute Glomerula Nephritis


 Moderately acute onset. Pulse rapid, marked hypertension and moderate edema and urine containing albumen, granular and hyaline casts. Urea, non-protein nitrogen, creatinin, and some salt retention.
ACUTE TUBULAR: Acute onset, marked anascarca, scanty urine, much albumen and blood, many granular hyaline, and bloody casts in urine. Great salt retention and moderate retention of nitrogenous products in the blood.


 
Chronic Diffuse Nephritis


 Entire structure of kidney may be affected, or affection may be confined to the glomerular or tubular processes. One variety of nephritis may merge causing a diffuse nephritis. Symptoms depend upon the tissues involved.


 
Chronic Parenchymatous Nephritis


 Onset gradual. Progressive loss of strength and flesh.
ETIOLOGY: Infections, fevers, alcohol, septicemia, or consequence of acute nephritis.
SYMPTOMS: Marked anemia, indigestion, pallor not warranted by blood count, skin pale, edema first of lower eyelids, then general. Gastrointestinal disturbances, increased arterial tension, some hypertrophy of left ventricle, uremic symptoms — vertigo, headache, nausea, sleeplessness, stupor, convulsions, coma. Urine diminished, color and appearance often normal; highly albuminous, with sediment, hyaline, fatty and granular casts, and fatty epithelial cells. Sodium chloride retention in blood. Nitrogen retention if glomeruli are affected.


 
Chronic Interstitial Nephritis


 ETIOLOGY: May follow chronic parenchymatous nephritis. Alcohol, lead, irritating toxins, bacteria, syphilis.
SYMPTOMS: Headache, weakness, digestive disturbances, retinal hemorrhages and eye disturbances, dry skin, slight edema of ankles. Vaso-motor disturbances such as tingling in fingers with blanching. Hypertension marked. Low, fixed specific gravity of urine, the quantity of which is considerable — as much by night as by day. Traces of albumen, few narrow hyaline casts and sometimes granular casts. Retention of urea, uric acid, creatinin, and non-protein nitrogen in blood.


 
Focal Nephritis


 Due to direct infection, considered largely as emboli of green streptococci that break off from the valves of the heart and lodge in the glomeruli.
The nonembolic focal glomerulo nephrotos due to a direct infection from acute tonsillitis, pharyngitis, otitis media, erysipelas, wound infections, septicemia, acute endocarditis, rheumatic fever, scarlet fever, etc. The three main types of nephritis in the following pages give a synthesis of all the types mentioned above.


 
Nephritis, Acute


 DEFINITION: Acute inflammation of the kidneys. May be diffuse or it may involve chiefly the glomeruli or tubules. Also known as Acute Bright’s Disease.
ETIOLOGY: Excessive vaso-motor constriction of the kidney, and liver segments. Subluxation of the above segments. It may follow infections such as scarlet fever, streptococcus, septicemia, erysipelas and pneumonia. Focal infections, especially tonsillitis, or chemical poisons, mercury, cantharides and turpentine. Autointoxications that may come from liver and intestinal conditions, pregnancy, extensive burns, and generalized eczema. Laziness, or lack of exercise enough to consume the proteid ingestion is one of the principal causes.
SYMPTOMS: In many cases the only indications of acute nephritis are urinary changes, and slight edema about eyelids and ankles. In the severe cases the general symptoms are fever, dull lumbar pain, nausea, and vomiting. Increasing anemia. Increasing blood pressure and uremia and severe edema may occur at any period. (Please read again “The examination of the kidneys” in Book I.)
DIAGNOSIS: The exact diagnosis of this disease must largely rest upon the examination of the urine. The urine is scanty and sometimes suppressed. It is of high concentrated specific gravity 1.025 to 1.030. Color is smoky or milky under the Endo-albumen test. The urine contains a considerable amount of albumen, epithelial granular and erythrocytic casts and usually some blood. If there is a pronounced albumenuria and a constant amount of blood, with a constant decrease in excreted urea, then the indications are that there is a glomerulonephritis.
PROGNOSIS: Mild forms of acute tubular nephritis usually respond quick to treatments in a few weeks. But, sometimes become chronic. Mild glomerulonephritis also may respond quickly to treatments. But, sometimes the results are not lasting, and the disease passes into the chronic stage. In the severe stage of both types, complications and death may result from pulmonary edema, uremia, pneumonia and pericarditis.
TREATMENT: If severe ascites or dropsy has developed, turn to Section on that subject for the treatment of that phase of nephritis.
The general trend of the treatment is to relieve renal congestion, and to lessen the burden on the kidneys. Absolute rest in bed for several weeks is essential.
NEUROPATHY: Complete lymphatic of liver and spleen along with a general lymphatic. Dilation of the kidney, liver and spleen segments.
CHIROPRACTIC: K.P., L.P., S.P.
DIETOTHERAPY: Absolute fast for a few days to a week or several weeks as urine reports indicate. Milk slightly diluted with lime water, or Vichy is of great value. The grapefruit cleansing drink is very effective for liver congestion, which, in many cases brought on the disease. Spoonful of lemon juice to glass of water three times a day is helpful.
After the symptoms have abated and the physician decides the danger point has passed, then, cream, gruels, fruits, milk toast, can be given before placing the patient on No. 2 Diet for a few days and gradually leading him to No. 1 Diet.
VITAMINOTHERAPY: Vitamin A, Minerals, Chlorine, and Magnesium.
COLONOTHERAPY: Low enemas every day during acute period; or, purges may be given.
VACUUM THERAPY: If there is pain, cupping of the sections complained of may be of great value.
HYDROTHERAPY: Hot packs, hot air packs, hot vapor baths. If there is suppression, hot sitz baths. Hot douches on kidney region and along ureters and scrotum, in tub, if possible. Free sweating is an excellent aid in the treatment.
STRAPPING: If pain is severe it may become necessary to strap the patient. Usually just straight cross-strapping is enough. But, in some cases it is necessary to have the cross-strapping plus the up and down strapping from over one kidney then down and across to the hip on the other side. Two straps, two inches wide on each side and four across are considered sufficient. Should the strapping not ease the pain in a few hours, it should be removed.
ELECTROTHERAPY: Short Wave and Diathermy are very effective. Infra-red, and Ultra-violet seem to be of great value. Patient on side, or face down, and given a flow of from 15 to 25 minutes. Electric baths can be given to stimulate perspiration.
SPONDYLOTHERAPY: Dorsals 6 to 8 will aid in the circulation of blood, through kidneys.
HERBOLOGY: One ounce each of Fl. Extr. Poplar Bark and Juniper, ½ oz. Fl. Extra. Buchu, 2 ounces of Mucilage of Gum Acacia. Put a teaspoonful of this in a half cupful of Meadowsweet tea, and use every two hours.
Strong tea of Queen of the Meadow Roots is excellent.
Such Demulcents and Diuretics as Horsetail Grass, Marshmallow Root, Bearberry Leaves, Sassafras, Globe Flower Bark or Root, Huckleberry Leaves and Bugle Weed are good.
An ounce each of Sassafras, Cheese plant, Dwarf Elder root, Juniper Berries, Lily of the Valley root and make a tea, using at least a cupful a day, until relief.


 
Chronic Tubular Nephritis


 DEFINITION: A Chronic inflammation of the intervening connective tissue of the kidneys, bringing about a degeneration of the tubular epithelium. Edema of the interstitial tissue, and more or less obliteration of the tubules, and glomeruli and a substitution of fibrous connective tissue. This can be termed a process of sclerosis of the kidney or a hardening which is large and white in the beginning, but which late in the disease shrinks to a small size.
ETIOLOGY: Vaso-motor constriction of the kidney segments. Impingement of the kidney nerves interfering so much with the calorific function, that there is excessive heat which produces inflammation resulting in a hardening process. The disease may follow an attack of acute tubular nephritis, but generally comes on gradually, as a result of chronic infections, such as tuberculosis, malaria, or some chronic local infection.
Acoholism is a prominent factor, as well as habitual exposure to wet and cold.
Epithelium degeneration may be due to a deficiency of Vitamin E in the diet, also of nicotinic acid deficiency and also of Vitamin A.
The disease may be present for a long time with no more symptoms than a small amount of albumin, and a few hyaline casts present in the urine. But, in the more severe cases the urine is reduced in amount and of high specific gravity (1018-1025). It contains a considerable quantity of albumin and yields an abundant sediment, which consists chiefly of fatty, granular and hyaline casts, cellular detritus, and fat droplets, and in very severe cases there is weakness, pallor, digestive disturbances, edema. As the disease progresses there is a failure of vision and the conjunctiva is edematous. There are headaches, vertigo, shortness of breath and palpitations. There is no tendency to high blood pressure, and uremia is not a common occurrence, but may develop toward the end of the patient’s life. Dropsy of the chest, and pulmonary edema are rather usual in the severe type. Pneumonia, pleurisy or pericarditis often develop in the late stages.
PROGNOSIS: In the milder cases, under rigid supervision of diets and habits life may be prolonged for many years. But in the severe cases complications may terminate life quickly.
TREATMENT: The treatment follows practically the same plan as in Acute Nephritis. Except, that there are times when a higher percentage of calories, protein and mineral elements are permitted. Epstein in the American Journal of Medical Science recommends a diet high in protein and low in fat. The latter consists of lean veal, lean ham, whites of eggs, oysters, gelatin, lima beans, lentils, split peas, green peas, mushrooms, rice, oatmeal, bananas, skimmed milk, coffee, tea and cocoa, with restricted fluids and only enough salt to make the food palatable. The daily amount of calories runs from 1280 to 2500 and the daily amount of proteins from 120 to 240 grams (4 to 8 ounces); of unavoidable fats, from 20 to 40 grams (10 drams); of carbohydrates, from 150 to 300 grams (5 to 10 ounces). Other articles of food are added gradually as conditions allow.
Numbers 1 and 2 Diets in this book are practically the same in the number of calories.
The manipulative and physical therapies of Acute Nephritis can be followed out with the inclusion of the above ideas on Diet. But, in the more pronounced forms of this disease, absolute rest, both mental and physical are required. Flannel or a silk binding would be helpful. The patient must always keep warm. All foci of infection removed if possible. Alcohol should be forbidden. Very little salt allowed. The bowels kept free.


 
Chronic Diffuse Glomerulonephritis


 ETIOLOGY: The disease may develop out of acute Glomerulonephritis, or may come by gradual septic infection, from foci anywhere in the body. This disease is most common between the ages of twenty and fifty years.
SYMPTOMS: Loss of flesh and strength and increasing pallor are often the earliest indications. Digestive disturbances are very common. Cardiac symptoms, especially dypsnea on exertion and palpitation, are sometimes prominent features. Headaches, dizziness, and insomnia often result from the disturbed circulation or from uremia. Impairment of vision from albuminuric retinitis is observed more frequently than in any other form of nephritis and is of serious import. Dropsy is somewhat exceptional, although edema sometimes appears late in the disease in consequence of cardiac insufficiency. Uremia is of frequent occurrence.
The blood pressure is high, a systolic figure of 200 or 220 not being unusual. The aortic second sound is accentuated, the heart is enlarged especially to the left, and the arteries are thickened and tortuous.
The urine is abundant (2000-4000c.c.)(the polyuria being especially marked at night. The specific gravity is low and somewhat definitely fixed at from 1013 to 1010; albuminuria is slight and at times may be absent; and casts are usually few in number and for the most part hyaline or faintly granular. Hematuria is sometimes noted.
DIAGNOSIS: Based largely on past history of albuminosis, or Acute Nephritis. The appearance of an enlarged liver or spleen or both, albumin in the urine. Hypertension and polyuria, the diagnosis is established.
PROGNOSIS: In mild cases it can be said to be favorable. Cures are possible if the primary cause can be found and removed. In well developed cases the outlook is grave because of developing complications such as Cerebral hemorrhage, Dilation of the heart, Pulmonary edema, Uremia, Pleurisy, Pericarditis and Pneumonia.
TREATMENT: Is, in general, the same as found in Chronic tubular nephritis. Rest is important and certain periods of the day set aside for naps of an hour or so. But, the patient must be instructed to be moderate in diet, exercise and work, or study himself to find out what agrees with him so he can establish a well regulated life in the avoidance of mental and physical strain, overeating, use of alcohol, chilling of the body and all other factors that may increase the blood pressure or overburden the heart. And he must be instructed against sudden chilling at any time. As long as the renal insufficiency is not marked, protein intake need not be limited much.
For the treatment of symptoms, such as hypertension, see treatment under that subject. Treatment for mycardial inadequacy can be found under the title of heart conditions.
Now, turn back to treatment of acute nephritis and use practically the same techniques in combatting this condition.
Some Extra Suggestions
“A deficiency of calcium causes excess albumen to pass out by way of the kidneys, often causing Bright’s disease.”
“Varying amounts of albumin may be found in the urine without it being any indication whatsoever of Bright’s disease.”
“The presence of albumin in the urine, at one time regarded as indicative of nephritis, is now recognized as occurring under many circumstances without the existence of any serious organic change in the kidneys.”
“Albumin is simply due to a sloughing off of the skin cells which line the kidneys.” It can come from “great physical exertion,” “ingestion of food rich in protein,” “Standing in cold water a long time,” “Sometimes albumin is absent in morning and only present after hard day’s work.” “While albumin is usually found in chronic interstitial nephritis, it is also true that a certain percentage of cases die of this disorder without once having shown albumin in the urine test.” — Dr. McCoy.
“Rapid recovery may be expected of acute Bright’s disease if simple eliminative measures are used to aid the overworked kidneys in recovering their normal functions.” However, chronic, offers many difficulties: dropsy, albumin and casts in urine, enlargement of kidneys, or becoming smaller and hard; persistent high blood pressure, often reaching to 250 or 300 mm; requires prolonged treatment with diet and other hygienic measures for correcting the faulty metabolism and toxic poisoning. Diseased kidney retains that which it should throw out and throws out that which the blood should retain. In the diet of chronic Nephritis it is necessary to give patient a reasonable amount of protein to make up for the loss of albumin thrown out in the urine. Fast should be followed with non-starchy nd non-protein diet for 3-4 weeks, then protein added in form of eggs and easily digestible meats — say one egg daily and 4 oz. of meat protein. Skin elimination necessary by sponge baths daily. One enema daily as long as albumin shows. Deep breathing can help much. Large amount of water should be taken during day, even at night if patient is awake. One to two gallons of water should be taken daily. Milk diet is good, 2-3 quarts of milk daily, taken say a glass every hour, preceded by a few drops of lemon juice to help in the stimulation of gastric secretions; continue several weeks. Alcohol, condiments taboo; salt intake small. In resume, essential things to remember is to use all methods to keep eliminative channels freely open and avoid any habits which may induce a general toxemia.” — Dr. McCoy.


 
Bronchitis, Acute, Chronic and Fibrinous


 DEFINITION: An inflammation of the bronchial tubes and mucous membrane.
Three types are found. Acute and Chronic Catarrhal bronchitis and fibrinous bronchitis.
ETIOLOGY: Acute catarrhal bronchitis; excessive vaso constriction of the 10th cranial nerve. A subluxation in the first and second dorsals, 7th cervical or kidney place. Secondary causes may be cold, damp climate; changeable weather; occupations that necessitate confinement or the inhalation of irritating dusts or vapors; the gouty diathesis; and chronic heart disease are general predisposing factors.
In many cases the disease follows exposure to cold and wet, particularly when the body is overheated, or the inhalation of irritating gases or dusts. Not rarely it is one of the manifestations of a general infection such as measles, whooping-cough, typhoid fever, influenza, etc.
The exciting cause may be the Micrococcus catarrhalis, pheumococcus, influenza bacillus, streptococcus or staphylococcus.
SYMPTOMS: The chief features are: Chilliness and general malaise; a sense of soreness and constriction behind the sternum, increased by coughing; slight fever (100-102 degrees F.), with its associated symptoms; and cough, which is at first dry and painful, but later accompanied by more or less abundant mucopurulent expectoration.
DIAGNOSIS: Influenza. — High fever, severe pain in the head, back, and limbs, and great prostration will serve to distinguish influenza from bronchitis when the former is present.
CATARRHAL PNEUMONIA: Moderately high and irregular fever, prostration, pronounced dypsnea, cyanosis, and physical signs indicating consolidation will aid in the recognition of pneumonia.
PROGNOSIS: Is generally good. In the young and aged great care must be taken lest it become chronic or lead to catarrhal pneumonia.


 
Chronic Bronchitis


 ETIOLOGY: Chronic bronchitis may be the result of repeated attacks of acute bronchitis, or it may develop gradually from chronic cardiac, pulmonary, renal disease or gout.
SYMPTOMS: The chief features are: Persistent cough with more or less mucopurulent expectoration; a sense of soreness behind the sternum. Fever is usually absent, and unless the disease is very severe, the general health may be fairly well preserved. Dyspnea on exertion is sometimes a troublesome symptom; it, however, belongs more to the resulting emphysema than to the bronchitis.
There is rales, and wheezing. In chronic bronchitis there are a number of forms it will take. The dry form, in which the coughing is very severe, and from which there is no expectoration. The wet form in which the expectorate is profuse, amount to several cupsful in a day. The third form is the purulent form in which pus is expectorated in large quantities due to an ulceration in the dilated bronchi. Fever is present. The fourth form is when the expectoration is putrid. The odor is due to the growth of certain molds in the secretions in the bronchial tubes. In the sputum small balls, varying in size from a pinhead to a pea, can be seen composed of fat crystals, bacteria, and inter-twined threads formed by a mold. These are called mycotic plugs. Fever, usually of a hectic type, is present in this form of the disease. It also may finally be complicated by gangrene of the lungs.


 
Fibrinous Bronchitis


 A primary inflammatory disease of the bronchi associated with formation of false membrane.
SYMPTOMS: Acute and chronic forms are recognized. Acute is rare, manifests symptoms of acute bronchitis but sputa contains fibrinous casts and there is marked dypsnea. Chronic form characterized by severe cough, dyspnea and the expectoration of fibrinous plugs. Often lasts a few weeks then disappears to return again at definite periods.
PROGNOSIS: Guarded; in acute may have death from suffocation.
TREATMENT: In acute bronchitis the following forms of treatment have been found effective.
NEUROPATHY: A thorough lymphatic with emphasis on the liver, axillary and cervical regions. Dilation of the 10th cranial nerve.
CHIROPRACTIC: Adjustment of the 1st and 2nd dorsals, 7th cervical and K. P.
SPONDYLOTHERAPY: Concussion of the 7th cervical for five minutes on half minute periods.
VACUUM THERAPY: This form of treatment is excellent to quicken the circulation. The large cups are applied over the spine and chest, and the small cups where applicable on the neck according to the tolerance of the patient.
DIET: If not debilitated, No. 2 diet for a week or more may be tried. Plenty of hot water to drink. Elimination of all mucous forming foods. If possible a fast on fruit juices for a few days. If cough is dry, an equal amount of honey and lemon juice mixed and a teaspoonful given every hour may cause expectoration.
HYDROTHERAPY: Hot compresses to spine and chest, or poultices.
ENDO-NASAL THERAPY: The Lake recoil. Dilating the external nares. Swabbing out and dilating the pharyngeal cavity, also releasing and raising the glands of the neck are excellent for dypsnea, and a greater intake of oxygen. The greater intake of oxygen is necessary if a cure is to be effected.
ELECTROTHERAPY: Infra-red or radiant light from a 1,000-watt deep therapy lamp is a splendid treatment. Place the generator the proper distance from the patient so the treatment can be given in one-half to one hour. Ultra-violet is also a very valuable modality to use in bronchitis.
Diathermy is one of the most valuable agents in the treatment of this disease. It not only relieves pain but greatly assists in allaying the inflammation. Either long or short-wave diathermy is valuable, but owing to the ease of application the short-wave therapy is gradually replacing the older type.
The carbon arc light is of exceptional value in bronchitis since it delivers infra-red, visible and ultra-violet rays, all of which are indicated.
COLONTHERAPY: Colonic irrigations are in order, and whether they are needed more often than twice a week must be left to the discretion of the physician.
ORIFICIAL THERAPY: Rectal dilations may prove of some value.
HERBOLOGY: Mild expectorants such as Mullein, Coughwort, Horsehound, Sundew Yarrow, Linden flowers, Honey, Marshmallow, figwort and Flax Seed will augment diet, sunlight and proper nursing, not forgetting a laxative.
An easily made remedy is two large handfuls of Mullein Leaves, steep in one quart of water down to a pint and add a cup of honey.
Equal parts of Wild Cherry bark, Horehound, Spikenard, Comfrey Root and Elcampane made into a tea is excellent. Sweeten with honey.
EXERCISE: Breathing exercises with the arms uplifted will aid in the expulsion of the mucous by intermittent pressure.

TREATMENT OF CHRONIC BRONCHITIS


 The treatment used for the acute condition is applicable with a few additions of techniques. 1st: All foci of infection should be carefully searched for, particularly in the sinuses, tonsils and throat and removed by Endo-Nasal and Allied techniques.
A trip to a high altitude occasionally will aid much by the inhalation of dry air. But when due to cardiac disease or complicated by it, low altitude is best.
In cases complicated by arteriosclerosis, hypertension, autointoxication, colds, sinusitis and tonsilitis, see treatments under those titles.


TREATMENT OF THE FIBRINOUS TYPE


 The treatment for this type is the same as above with what additions the physician can find as a specific for the releasing of casts, and special attention to relieving dypsnea by Endo-Nasal therapy.


 
Bursitis — Acute, Chronic


 DEFINITION: Inflammation of a bursa, or inflammation of the sac or pouch containing fluid within the body often lined with membrane, especially found between tendons and bony prominences and other places where there is excessive friction.
There are two types: Acute and chronic and attacks can take place in many parts of the body especially the limbs.
ETIOLOGY: It can generally be said that they are practically all due to injury, over use, or irritation from some source. The chronic type may be due to a continuation of the acute etiology and disease.
There are many locations of the two types of bursitis — bursae about elbow; bursae about shoulder; bursae about hip; bursae about knee; deeper bursae, infrapatellar bursitis, gastrocnemius bursitis, medial tibial bursa, lateral tibial bursitis; bursae of foot; posterior group, posterior calcaneal bursae, anterior calcaneal bursa, anterior planter bursitis, lumbrical bursae.
SYMPTOMS: An acute inflammation of a bursa may be serous or purulent, and, as stated, is usually due to injury. When located superficially there is marked swelling, redness, and local heat. When an inflamed bursa is situated in the deeper tissues, the swelling can only be detected with difficulty, if at all, and the pain especially on motion, is severe. General febrile symptoms often appear when a deep bursa is involved, especially when there is a tendency to suppuration, this being likely to extend. The inflammatory process sometimes extends to a neighboring joint, including the synovial sac, which is easily penetrated. The diagnosis can usually be established by judging the effects of motion. Extreme abduction or adduction of the humerus, for instance, causes severe pain, if the inflamed bursa is under the deltoid; when the bursa between the quadriceps extensor and the femur or that under the ligamentum patellae, is the seat of the inflammatory process, flexion of the leg upon the thigh becomes painful, through the pressure thus exerted upon the bursa.
DIAGNOSIS: It is difficult to be misled in these cases If the patient complains of pain, and the examiner finds the pain is greater on touch over the bursae of any particular part he can feel certain of the diagnosis.
TREATMENT: In the acute type absolute rest for the bursa is necessary, removing all pressures and irritations. The part should be supported during the acute attack. If an arm or shoulder, in a splint, if in the foot a U strapping of adhesive tape under the heel. This strapping to come up one inch over the ankle on both sides. Cold applications, or cold compresses may be tried, and gives relief in some cases, but not in all cases. In many cases, hot antiseptic fomentations or compresses are necessary.
Infra-red, short wave and diathermy are of great value. Light massage may be given after the hot or cold applications. If in a few days of the above treatments, and the condition does not improve, blistering of the part, or absolute freezing of the part may be necessary.


 
Chronic Bursitis


 This is met with much more frequently than in the acute form. It develops insidiously. The pain is slight, and the condition manifests itself by marked swelling, which varies in density to the bursal wall. It may present a feeling similar to that of bone. This is spoken of as bursitis with calcification.
TREATMENT: Diathermy, galvanism and the sine wave are noted for their effects on this condition. For the pain short wave may be used.
VACUUM THERAPY: Application of the cups over the bursa is a great help in the breaking up of the mass, but the cups should be applied very gently at first.
HYDROTHERAPY: Baking. Hot applications, or sitting in a tub, or standing under a shower, and allowing the water to hit the particular part affected for long periods of time. The water should be as hot as can be endured.
EXERCISES: This should be regulated by the physician. The average patient will use jerking movements that are sometimes too violent to make tests for pain, thereby creating more irritation. And, his movements should not be more than necessary to carry on normal life.
STRAPPING: If the pain is from shoulder bursitis, the arm can be supported by a loop gauze strap from the neck. At the same time an adhesive tape can be placed from a point on the spinous process, then drawn over the shoulder to about 2 inches in front. A strip 1 ½ inches wide, is sufficient. Care must be taken not to attach the tape over the lower neck muscles, if discomfort is to be avoided. If the patient must stay employed, the shoulder strap can be of itself a great benefit.
NEUROPATHY: Inhibition of pain can be obtained by hard pressure on the opposite side to the seat of the pain.
CHIROPRACTIC: The adjustments are according to the location of the subluxations and perversion.
VITAMINOTHERAPY: Large doses of E and D and smaller doses of A and B2.


Cancer, Carcinomas


 DEFINITION: It is difficult to give a definition of cancer but since it is a disease of the epithelial cells in the majority of cases, and of some connective tissue cells, it can be said to be a malignant growth, that has a metastic effect upon other tissues, by the spreading of the epithelial and connective tissue cancer cells.
In the development of the cancer the invasion of the tissues having started, there is a slight thickening and hardening of the tissues. This is known as the precancerous stage, which may cause no distress to the afflicted person. But later on a swelling or tumor takes place, and when first noticed may assume a round or an irregular shape. Laboratory findings are of epithelial cells in compact aggregations without capillary vessels, for nourishment requiring the cells to live on such intercellular lymph as can reach them. The lymph containing waste, and only about twenty per cent oxygen, and since enough oxygen is not carried to destroy the cancer cells, they multiply rapidly, especially in soft adipose or edematous tissues, and large masses may be formed. In the firmer tissues, the lymph supply is not so great, and the cancer cells grow much slower, and smaller in size. The food, and oxygen supply becoming more inadequate with the growth of cancer cells, the tissues in the area involved become decadent and necrotic or dead and later putrefaction sets in. But before this stage is reached, invasion of all surrounding tissue may have taken place to a greater or less degree according to the resistance of the tissues, and the circulation of the blood, and the oxygen and nutritive supply. The writer is satisfied that metastasis of cancer cells to other parts of the body is largely due to the lymphatic circulation rather than the extension of the cancer cells themselves, or being carried by the arterial circulation. It seems reasonable to the writer, that the above is true because if the cancer cells were carried in the arterial circulation metastasis would be more rapid and death would be hastened a great deal. It is possible that a large proportion does get into the arterial stream, but are destroyed by the oxygen. But the lymph stream being slower they can lodge and colonize, then there is the primary and secondary cancer. However, there may be some cancers that can occur from blood metastasis. As the cancer spreads the mental and physical make up of the patient is disturbed. If they live long, no matter whether it be external or internal, there comes a time when they show signs of severe secondary anemia, wasting pallor, and slight yellowing of the skin. The skin becomes like wet moss, and it feels cold to the touch of the hand. There is usually a great shortness of breath, and weakness. The facial and eye expression is as if the patient is in a state of constant bewilderment.
ETIOLOGY:Hundreds of experiments have been carried on to explain the germination of cancer cells, and many interesting theories have been advanced, but to date none of them are totally acceptable. The traumatic theory has much support. Coley considers that there is an etiological connection between trauma, at least in its broadest sense, and cancer. Coley states that in 9 of 46 cases of sarcoma which he has previously reported the tumor developed within one week after the injury and at the exact site of the injury. Since this report he has observed 800 cases, making a total of 970 cases a definite history of trauma existed 225 times, or in 23 per cent. In 117 of the 225 cases, or in 52 per cent, the tumor developed within one month after the injury. Coley also has observed carcinoma of the breast following injury within one week’s time in 5 cases. Coley: Annals of Surgery 1911.
The irritation theory apart from trauma has many adherents, especially external cancers. Cancers of the lips were more frequent in pipe smoking days than at present, or cancers of the uterus from abortions or unrepaired traumatic parturition. Coal tar products, aluminum products and many other chemical elements such as sulfydryl compounds in the tissues themselves may upon trauma or irritation excite such productive activities of cells that may be the basis of cancerous tumor growth.
The hereditary theory has some advocates. But statistics on this phase of the question are puzzling.
Among 2389 women with cancer reported by Pierson from the Middlesex Hospital in London, 359 had family histories of cancer, while of the antecedents of 753 non-cancer cases only 120 were affected with cancer. This shows that cancer seems to be no more frequent in the families of patients with cancer than among those without it. Guillot has found a history of cancer in 11 per cent of antecedents of non-cancerous patients and in 17.4 per cent of the antecedents of cancer patients, and he estimates that the incidence of cancer in the parents of non-cancer cases is 16 per cent as against 17 per cent of the parents of cancer patients.
The question arises now: whether the cancer in those who had cancerous parents was transmitted from parents to children at birth, or whether later in life the production of cancer was not due to living the same kind of life as the parents, eating the same type of food, having the same sedentary habits, with the same environmental tendencies toward trauma and irritations.
The infective theory created great excitement some years ago by the announcement that certain microorganisms had been found in carcinomas, but later it was discovered that not a single microorganism was constantly present, and the excitement died down, and the conclusion now is that cancer is not an infectious disease.
The writer is inclined to the traumatic and irritative theory plus the existence of an anoxia or anoxemia. The functions of oxygen are too well known to recount them here. But it is well known that anoxia of any tissue of the body will create a basis for putrefactive elements to accumulate and constant irritation or trauma will increase the accumulation of putrefactive elements that will compound and destroy the surrounding tissues as long as there is anoxia or anoxemia.
In support of the above theory we quote the following from “Chemistry in Therapeutics:, page 132. Walter Bryant Gug.
“Dr. W. B. Bainbridge, of New York City, is quite convinced that injuries play a large part in the production of cancerous growths. As before explained, a lymph stasis is set up by inflammation or injury to any tissue. If an alkalosis is present the cancer occult virus may propagate in the injured tissues. The retained lymph and toxins and the deficiency of oxygen create the conditions favorable to its growth. In a lengthy paper printed in the Medical Times, May 1934, after quoting many undoubted authorities that trauma (injury) often precedes cancer growths, Dr. Bainbridge states that he ‘realizes, naturally that all blows do not result in cancer, and that all cancers at the sites of injuries may not be the result of trauma, but in a number of cases observed, where there are definite steps, from the injury to the tumor, it is his opinion that the finger of proof points directly to the trauma, as such as the cause of the subsequent malignancy.’
“If we could but visualize the pathology, for instance, of a gastric ulcer, we should see first of all a blocking of the lymph channels in the area involved. This stasis would shut off the nutrient fluids, also oxygen, from the cells. Likewise, a retention of toxic acids and other products of metabolic life would accumulate and cause an inflammatory congestion that accompanies this affection. Then would follow a coagulation necrosis with destruction of the epithelial cells. If the lymph stasis that causes the sore is relieved, healing takes place.” Now the trauma need not necessarily be a severe blow, but a constant irritation of some chemical, or food products.
TREATMENT: From the earliest time the idea was to rid the patient of the core or tumor of cancer. Caustics and hot irons were used for this purpose which meant death shortly for the patient. Then followed the present surgical procedures that, if performed early in the condition gave promise of a longer life than otherwise. Vaccines, serums and antitoxins followed, administered by those who accepted the infectious theory.
Another method was based on the theory that the tissues resent the presence of cancer cells and try to get rid of them by some kinds of immune bodies present in the blood. Attempts then were made to treat these patients by intravenous injections of exudates taken from other cancer cases and in this way aid the patient’s blood to become stronger in its immunizing qualities.
Hormonal therapy by injection of adrenal extracts injected directly into the tumor or elsewhere was tried, but the disturbances created led to its abandonment. Later, heat by electrical apparatus was tried, then the various types of lamps, especially ultra violet, sometimes giving relief from pain, but having no influence in retarding the growth.
An interesting theory is that of deficiency of Vitamin A may play a part in the conditioning of the epithelium for cancer cells, and also of Vitamin A in therapeutics, of the first Youmans is quoted as follows:
“The effect of a deficiency of Vitamin A on the epithelium is an atrophy of the cells followed by a replacement with undifferentiated epithelium through proliferation of the basal cells. This results in a stratified, cornified epithelium, similar to the epidermis and the same in all structures irrespective of their original structure or function. Disturbances in function result from this altered nature of the epithelium and the presence of masses of dead, cornified cells. Glandular structures such as the sebaceous and sweat glands diminish their secretion or cease entirely. Ducts are plugged, specialized epithelian surfaces become replaced by a flat, keratinized surface. Youman Nutritional deficiencies, page 23.
Today there are three standards of medical treatments, surgery being foremost and the best in medical procedure; second, X-ray treatment; third Radium. There are in some cases combinations such as surgery and X-rays and Radium, according to the biopsy reports or the grade of the tumor. Fulguration, electrodessication, electrocoagulation and the electroendotherm knife are also used as a part of surgery. Still the cancer toll piles up year after year. Drugless physicians are handicapped by the customs, habits and beliefs of the people influenced by the propaganda of the medical profession to such an extent that they are prevented from performing experiments of any degree with coalition among themselves. Always hanging over their heads is the danger of malpractice suits or being branded in their communities as quacks, charletans and fakirs.
The ethics of the medical profession demand that, if any improvement, method, discovery or remedy is found that gives better curative results than hitherto recorded, such information, through publication, must be made available to the entire medical world, in order that all may be aided; also, that any valuable discovery may not be lost to posterity. But here is the catch for the Drugless Physician. He would not be accepted as worthy of attention. His information would be distorted. He would be subjected to persecution by the Medical profession, and even some of his fellow drugless practitioners would join in the ridicule and denunciation.
All that could be if proper facilities were provided by some drugless organization, and funds for the equipment of a sanitarium and proper experimentation facilities, and proper reporting from time to time on the progress made. All reports put out by any physician as to so-called cures of cancer should be investigated and if accurate, and a number of cases have responded, this should be made known to the public, by a group of investigators which would save the individual physician embarrassment in his community. Surely there must be among the Drugless techniques a combination of methods that will get as good results if not better than the medical methods if agreement could be reached on the proper procedure. For the medical procedure is strictly arbitrary, the scope of the treatments being limited to surgery, X-ray, and Radium as the only orthodix method of therapeutics. At the time of this writing, there comes to my desk the following letter:
“Dear Friend: You have in the past shown your interest in the work of the Philadelphia Division, American Cancer Society by contributing to its support. We did not hear from you after our April appeal this year, but we hope that we can make you feel that your further cooperation is worth while.
The scope of the work of this group has been greatly enlarged, over 200,000 people having been reached this year. To them we have sent the word that Early Cancer is Curable, telling them of the danger signals, and urging consultation with their family physician, or another, if disturbing symptoms are present.
In addition we are supporting investigation and study of pelvic cancer, and are greatly interested in the problem of care of cases of incurable cancer.
Does this not warrant your support? We hope so.”
The above letter was signed by an M.D. Now why not signed by an N.D. or a D.C. It is the hour for all drugless Physicians to investigate and cause research by a body of responsible physicians into many of the claims made by individual physicians that they can detect the precancerous stage, and have a preventative, or some method of aborting a full attack. Iridiagnosis has never, to the knowledge of the writer, been thoroughly tested, as a detector of the precancer state, and a report made on results after a wait of a period of time to see if full cancer would develop. There are no statistics that a physician can call on for aid in diagnosis of the precancerous or the full stage.
Great claims are made for iridiagnosis in the detection of the presence of cancer and for the grape cure, certain types of plasters, diets, and other methods of therapeutics, but no responsible group of licensed physicians to prove or disprove these claims, and as a result if a physician does have a real discovery, he stands alone, and he falls alone, as soon as he tries to tell the world about it.
There are many questions an impartial paid group of physicians could spend their time in finding us the answers. Some might be as follows: To what extent does a condition of Alkalosis contribute to the precancerous state. To what extent does the loss of nerve control over the process of cell production contribute to the cancer state. To what extent does lymph stasis contribute and how, to a cancer state. It is within those three questions that the answer to the prevention and cure of cancer is to be found. Surely our dietitians, biochemists, nerve specialists and others who have developed some helpful therapeutics can get together some day, and give us a logical method in management of benign and malignant growths.
In the following pages on this subject, we will take up a few of the most serious types of cancer, and give what we could find in the management of such cases.


Cancer of the Liver


 ETIOLOGY: Cancer of the liver is largely considered as secondary. Rarely primary. Usually attacks after 45. Is more common in men than women. The primary is usually of one big lump. The secondary a combination of smaller nodules or lumps.
SYMPTOMS: (1) The liver is enlarged and painful, and often presents one or more smooth, hard nodules. The latter may show a central depression. (2) Jaundice is common, but it is rarely intense. (4) Digestive disturbances are a prominent feature, and often precede the hepatic symptoms. Ascites sometimes result from portal obstruction. Toward the end, slight fever, delirium, stupor, and coma may develop.
PROGNOSIS: Considered to be generally hopeless. Much depends upon the position and course of the primary neoplasm in the secondary type on the size of the liver growth, and on the interference with hepatic function. In the majority of cases, the patient loses strength rapidly and emaciates, and the liver steadily increases in size. Stupor from cholemia takes place; but occasionally death is due to some intercurrent disease such as pneumonia.
TREATMENT: Much of the treatment is palliative; although surgery offers extirpation of a localized malignant growth, it is doubtful if a recurrence is prevented.
The nervous system may be quieted by light pressure on the liver segments. The itching of jaundice may be relieved by lotions of various kinds, baths or high frequency bulb applied to the annoying parts.
Herbology is found under cancer of the stomach.


 
Cancer of the Kidneys


 ETIOLOGY: The primary malignant growths of the kidney comprise sarcoma, hypernephrona and carcinoma. Sarcoma seems to be the most common in children while the hypernephrona is most common in adults Carcinoma of the kidney is rare. But all types of tumors of the kidney can be regarded as malignant.
SYMPTOMS: There may be none until the tumor has reached a large size. The three outstanding symptoms are pain, bleeding and the palpation of a lump in the kidney. See methods of kidney examination in book on Neuropathy. In addition notice if area of kidney is cool, cold and moist. In addition to the above there are emaciation. Pain is inconsistent and the urine, apart from hematuria, often affords no indications. Metastasis is frequently observed, hypernephromas showing a special tendency to involve the lungs and bones and to invade the renal vein and vena cava.
PROGNOSIS: Depends largely on complications.
Medical treatment offers nothing more than surgery. Neither X-rays nor radium are considered effective because of the difficulty of applying sufficient dosage so far from the surface of the body.
A statistical study of the results of operation for renal tumor is that of Judd and Hand from The Mayo Clinic. In 367 cases they found that hematuria was the first symptom in 43; 86 per cent; pain in 37.32 per cent; and tumor in 13.62 per cent. Of the entire number of patients, 106 lived for from 3 to 22 years, or about 29 per cent. Judd and Hand. Journal of Urology, July 1929.
Drugless therapy up to now has no specific method of approach other than diets and comfort giving treatments. Some physicians have tried the grape cure of which nothing more has been heard by the writer after extensive efforts to get reports. One great difficulty of restricted diet in these cases is the great emaciation that has taken place before the disease was discovered. All cases the writer has had, the loss of blood and the depletion of the blood constituents by the disease made further depletion impractical by a restricted diet and the grape cure without sanitoria supervision. Vitamin E in large doses (wheat germ oil) has been reported as useful in all forms of carcinomas, but as yet is not fully established as a specific.
Herbology is found under cancer of the stomach.


 
Cancer of the Pancreas


 Cancer of the pancreas is more common in males than in females. Pancreatic cancer generally involves the head of the gland, and is largely of the hardening nature.
SYMPTOMS: Cancer of the head of the gland is early. These include disturbances of digestion, rapid loss of flesh and strength, anemia, deep-seated, and often pulsatile from its relation to the aorta. The pain often occurs in paroxysms, especially at night, and may be associated with the symptoms of collapse. Progressively increasing jaundice, with enlargement of the gall-bladder, is a frequent symptom, and results from the pressure of the tumor upon the common bile-duct. Pressure on the portal vein may cause ascites. Glycosuria is an occasional symptom. In some cases the stools have contained much free fat and numerous undigested muscle-fibers.
SYMPTOMS: Cancer of the body or tail of the gland are late in developing but once developed present the same symptoms as the other.
DIAGNOSIS: Relentless loss of weight, the intense jaundice, and palpation of the spleen. (See Spleen examination.) The feel of the lump or lumps make the diagnosis rather certain. The condition of the gutter of the spine being soft and ropy, also subluxations will confirm the findings. Laboratory findings of urine show bile, glucose, lipase, diastase and chyle due to obstruction of the receptaculum chyle. The blood shows a very low red cell count. The stools show signs of blood, while the X-ray may be of great value in showing the amount of pressure and obstruction on adjcent organs.
PROGNOSIS: Death may result anywhere from one month to two years after the discovery of the symptoms. Treatments may show some improvement for a time, but the symptoms later become more severe. An operation is only a temporary relief. At the present time there is no drugless literature extant that gives any hope for even prolonging life let alone a cure. We have heard much of the fasting cure and the grape cure but no statistical reports as to the effects of these methods.
Herbology is found under cancer of the stomach.
MEDICAL PROCEDURE: Surgery of the pancreas is very limited but has not so far resulted in what could be a satisfactory outcome. Cholocystectomy has eliminated the jaundice and allowed some gain in weight. This operation is performed after abundant fluids, blood transfusions, and glucose are administered. After the operation pancreatin may be substituted for the failure of the functioning of the pancrease Gastric analysis reveals whether belladonna, hydrochloric acid or alkalis are necessary.


 
Cancer of the Stomach


 ETIOLOGY: Carcinoma of the stomach occurs somewhat more frequently in males than in females. About three-fourths of the cases occur between the ages of forty and sixty-five years. It is rare before thirty. Heredity seems to be a factor of some importance. Ulcer of the stomach undoubtedly increases to a great extent the predisposition to cancer.
Cancer of the stomach is almost always primary. The pylorus is the part most frequently attacked. After the pylorus the points of attack are the lesser curvature and the cardia.
SYMPTOMS: Obstinate dyspepsia, persisting in spite of rational treatment; persistent pain in the epigastric region, not greatly influenced by eating; progressive loss of flesh and increasing anemia; vomiting, possibly of coffee-ground material, with other symptoms of dilatation of the stomach; the absence of free hydrochloric acid in the gastric contents and the presence of lactic acid and the Oppler-Boas bacillus; tumor or tenderness in the epigastric region.
DIAGNOSIS: The gutter of the spine is soft and lumpy with tenderness. It is cold to the touch in advanced cases and there is subluxation at S.P. By palpation of the lump or irregularity of the contour of outline of the surface.
Owing to stenosis of the pylorus, the stomach is dilated in two-thirds of cases. The absence of hydrochloric acid. The differentiation between ulcer and cancer can be said to be as follows: Cancer: Rare before forty. Severe anemia and cachexia. Pain dull, not much influenced by eating. Vomiting delayed. Hemorrhages small and of characteristic “coffee-ground” appearance; tarry stools rare. Hydrochloric acid diminished or absent; lactic acid, and Oppler-Boas bacillus in gastric contents.
While in Ulcer, it may occur in the young. Chlorosis often present. Pain sharp, stabbing, or burning, localized in epigastrium and back; occurs soon after eating. Vomiting occurs soon after eating. Hemorrhages profuse; blood bright red, tarry stools. Hyperacidity. Lactic acid and Oppler-Boas bacillus absent.
Further help can be had by fluoroscopic examination as to the form, size and position of the stomach.
PROGNOSIS: The prognosis is grave. There have been reported what is known as five year cures. But up to the time of writing this the writer has not been able to substantiate some claims made of absolute cures. No reliable statistics are available that can be thoroughly investigated and substantiated by Drugless therapy procedures.
TREATMENT: The chief plan of treatment is to give relief and delay the fatality as long as possible. The dietary phase then claims the largest part of the treatment.
NEUROPATHY: Holding the fingers in the gutter of the spine until the vaso-constrictors and dilators show some response. A light lymphatic of the liver.
HERBOLOGY: The stages of this terrible disease of the blood need diagnosing by a specialist and proper progressive treatment given.
However, one can improve the general health and purity of the blood by taking the following: Fluid extract each of Yellow Dock, Burdock, Barberry, Agrimony one-half ounce; Fluid Extract Blood Root 2 dr.; Tincture of Capsicum 1 dr.; Camphor water 8 oz. Teaspoonful three times daily after meals.
Poultices of Scraped Carrots or Mashed Cranberries can be recommended. Or, Fresh Common Daisy 2 oz.; Lobelia Herb ½ oz. Boil in a little water and place some of the herb between muslin and apply, keeping the poultice wet with the liquid. Renew every six hours. Bathe often with half ounce each of Tinctures of Myrrh, Blood Root and Celandine in a gill of water. This can, if desired be used in with the poultice.
This is a simple but good remedy: Take 1 oz. of Narrow Dock leaves to a pint of boiling water; simmer to half pint, add dessertspoonful of pure honey. Take half teaspoonful three or four times a day.


Cancer of Skin Epitheliomas


ETIOLOGY: Age and local irritations seem to be the main factors. They are superficial, deep seated or papillomatous.
The first type begins usually as a firm wax like red-yellow papule, in time it becomes scaly and this is followed by loss of substance, soon followed by a brown crust. In time this is converted into an ulcer, exuding a discharge of greenish substance containing pus and blood. It is not painful. It may not spread, or it may spread and involve all the tissues of the part. Usually appearing on the face and if spreading may destroy the nose, eyes or the cranial bones.
The deep seated variety is much on the order of the superficial except there is a tubercle or lump and the ultimate ulcer is deep, causing pain and causes enlargement of the neighboring glands.
The papilomatous variety may begin as a wart, or from one of the other varieties mentioned above.
It is characterized by an ulcerated surface from which springs an aggregation of large, highly vascular papillae. Between the papillae there are often deep-seated fissures from which exudes an offensive viscid discharge. The general health is impaired and the neighboring glands are enlarged.
The above differ from lupus vulgaris in that lupus begins in the y oung, and there is more than one center, which are not hard but soft, and the discharge from the ulcer is slow and scanty and bones are never involved.
PROGNOSIS: Should be guarded in the type of epitheliomatous ulcer that eats away adjacent tissues and bones, known as rodent ulcer, and also guarded in the deep seated epitheliomas. Other types the prognosis is favorable and often a complete cure is effected.
TREATMENT: The general treatment for growths of this nature is by electrodesiccation, electro coagulation, X-rays, radium or excision by surgery, ointments of various types. Poultice of mashed grapes has been reported helpful. The Cabasil products have been reported as excellent for conditions of this nature.
The general health condition of the patient must be looked into. The thyroid gland, and all phases of respiration should be carefully examined. Many of these patients are anoxemic, and anemic, and show a sharp tendency toward alkalosis a big part of the time. Appropriate treatment then can be instituted for building up the general health of the patient.


Carbuncle


 DEFINITION: A hard, circumscribed, deep seated, painful inflammation of the subcutaneous tissue, accompanied by chill, fever, and constitutional disturbances, suppuration and the formation of a slough.
ETIOLOGY: A lowered vitality from any cause predisposes to this affection. It is especially common in diabetes. Microbic infection is the exciting cause.
SYMPTOMS: It is characterized by a painful node at first covered by a tight, reddened skin which later becomes thin and perforates, discharging pus through several openings. Most commonly found on nape of neck, on back, or on buttocks. There is at first a chill, followed by a febrile movement, which is generally well marked, and very severe. The lymphatics in the surrounding area, are all involved.
DIAGNOSES: Carbuncle is especially dangerous when located on the scalp, abdomen, and upper lip; in these locations it usually runs an acute course and may be fatal from pyemia. The prognosis is grave when extensive and attacking the elderly, especially if complicated with Bright’s disease or diabetes. The prognosis should always be guarded, even in the most hopeful cases. Death is not infrequent in the old and debilitated because of the development of thrombi and emboli.
TREATMENT: This is an unusual problem. For each carbuncle is a serious problem in itself. No set rule of thumb exists by which all can be treated, and not many conditions are found that require more care and judgment as to whether the process is a local and stationary one or spreading upon, or underneath the tissues. Very little literature is extant by drugless physicians. It is skipped over generally as a problem of surgery or blunt statements are made that certain adjustments will relieve the condition or a fast will break it all up. The above are helpful but the fact still remains that no one method of treatment is sufficient for relief of all cases. Each case is a peculiar problem. The treatment must be local and constitutional and at any time may require the services of a surgeon.
NEUROPATHY: A complete treatment of the lymphatic system, and release of the vasodilators.
CHIROPRACTIC: Local, S.P. and K.P.
ELECTROTHERAPY: Infra-red directed by a small funnel at the mass and held for three minute intervals, with a three minute wait each time for five consecutive times daily has been helpful. Dry fomentations of any nature are applicable. Hot dry towels. Hot water bag, etc. Surgery of any nature should only be performed after very serious consultation and with but three objects in mind. The relief of tension when it has become unbearable; the removal of dead tissue, and the prevention of the spreading of the infection. The writer has seen some results of surgical interference that raised the question “was it necessary or even worth while?” X-rays have many advocates. Biers hyperemia is also suggested. The writer has used the small suction cup with good effect in a few cases. Short wave diathermy seems to have the endorsement of most writers on this condition.
COLONTHERAPY: Colonic irrigations twice a week or daily enemas of hot water will aid in keeping a free and clean colon. The Cabasil products have been highly recommended for this condition.
DIET: This is of great importance but no general rule can be laid down. It is according to the blood and urine test reports. Yet it can be said that all rich pastries, spices, fatty foods, fried foods, warmed over foods, should be omitted from the diet, and alcohol should be forbidden.
MEDICAL PROCEDURE: General tonics like quinine and iron. Opium or other anodynes to relieve pain. Human and animal serums. Autogenous vaccines. Ichthyol, applied pure so as to cover the entire swelling, a new application each day. Sulphur in minute doses and sulphur baths are recommended. Liver diet is suggested when there is secondary Anemia. Some suggest that it is possible to transform chronic inflammatory processes into acute forms and hasten the healing of these by feeding the patient on a meat and oatmeal diet that contains a minimum of two and a half drams of sodium chloride daily, that the acidosis produced tends to make lesions flare up and this induces healing. Surgery, cautery, etc., are included in a host of other remedies that the medical profession individually or collectively advocate for this serious ailment.
HERBOLOGY: Constant bathing of the part with hottest water bearable allays pain and is essential in assisting the carbuncle to burst. Take internally: 1 ounce of Fluid Ext. of Yellow Dock, 1 ounce Fluid Ext. of Burdock and two drams of Fluid Ext. of Mandrake. Fullers earth when sore opens. One physician reports 120 F.M. as very effective for douching the slough, 20 drops to 30 drops of water.


 
Catalepsy


 DEFINITION: Mental and motor inertia, in which the person will remain in the same position for short or long periods of time, also called sleeping sickness.
ETIOLOGY: A syndrome from impairment of the carotid sinus in which the contents of the carotid sinus collapses creating anemia and anoxia of the brain. There is also a form called “Grippal Catalepsy” understood to follow influenza and LaGrippe. It may occur from extreme hysteria, hypnosis and psychosis especially of dementia praecox.
Certain drugs like morphine, poisons, like lead and alcohol, Microorganisms, disorder of the glands, Auto intoxications, influenza and cranial tumors have been found as contributory to attacks of catalepsy. Up to the present time reports are that previous attacks of influenza account for between forty and fifty per cent of catalepsy cases.
TYPES: There is the mild and severe type. The limp and the firm type. The mild type is when the attack of catalepsy is over anywhere from one minute to half an hour. Recently a young man was in the office, and while telling the history of his headaches, suddenly became rigid, and sat stiff in the chair staring into space. The attack lasted about five minutes, then, when he came to consciousness he had no recollection whatever of what he had been talking about for some few minutes. During this spell the pulse and repiration were not in any way impaired.
In the severe types the rigidity may last from one hour into days and months. In some cases of mild and severe types the muscular system is not rigid but limp, and the body can be moved in any direction. These limp types are considered as “incomplete catalepsy.”
SYMPTOMS: In the mild type there is a sudden onset, and the person will stand or sit still for a short period of time, then, they will awaken, with sighs and a dazed expression, as if awakening from a deep, long sleep.
In the severe type which is considered as “complete’ the onset may be sudden, or may be preceded by headache. The patient may be believed dead; for not only are the limbs inert, the eyes staring or half-closed and the pupils dilated, with drooping jaw, and the skin cold and pale; but their respiratory movements cease, the pulse is impalpable, and swallowing is not effected. Only the heart can be felt to beat faintly, for even the reflexes may be entirely suppressed; although most observers find the corneal reflex; and the rectal temperature approximates normal, and the patient may stay in that condition until she dies. Some victims have slept from two weeks to many months. The attacks may be grouped close together, with long periods of freedom, or there may only be one in a lifetime.
DIAGNOSIS: A method of differentiating the hysterical, and psychotic from the true catalepsy is as follows: A heavy weight is attached to the hand horizontally, in true catalepsy the hand falls slowly to its full length, while in false, the resistance of the patient to keep the arm in the horizontal position and when fatigue of the arm takes place, spasms of the arm follow.
TREATMENT: Catalepsy is only a symptom of some underlying disease. Malnutrition, Auto-intoxication, enervation, signs of infection, meningitis, tumor and other conditions that impair health, need to be investigated and when found treated as the primary cause. Look at the neck, and toe nail and find out which side of the brain is mostly affected. The side of the neck which shows the largest expansion is the best criterion for it reveals a carotid sinus syndrome. This condition then is closely related to epilepsy, and if any symptoms of epilepsy are found, the treatment then is found under that title.
In the paroxysm it is well to unload the bowels by giving a high enema of clear, warm water. Stimulation of the gutter of the spine by friction with the fingers; hot towels to the spine, or a mustard plaster to the nape of the neck may arouse the patient.
Chiropractic treatment of all cervicals and kidney place may be given. Nasal stimulants, such as ammonia may be used to advantage. When the cause is found, then the general treatment can be given as indicated. A general health building program of diet and exercise is always in order.


 
Chlorosis
(Green Sickness)


 DEFINITION: Chlorosis is a form of anemia occurring in young girls about the time of puberty, and is characterized by a reduction of hemoglobin out of proportion to the number of red blood cells.
ETIOLOGY: The essential cause of the disease is unknown, but the evidence favors the view that the blood-making function is impaired in consequence of some disturbance in the ovaries. Chlorosis occurs exclusively in females, and develops between the fifteenth and twenty-fourth years.
It can be said to be an iron and oxygen deficiency in the blood.
SYMPTOMS: In addition to the general symptoms of anemia, the conspicuous features are a greenish hue of the skin; pallor and weakness without marked loss of flesh; dyspepsia with perversion of appetite; menstrual disorders, especially amenorrhea; and a tendency to hysteric outbreaks. The blood changes are chacteristic. The number of red cells is moderately reduced (not often below 3,500,000); the hemoglobin, on the other hand, is greatly reduced, usually below 50%. There is no leukocytosis.
DIAGNOSIS: The tests for iron deficiencies are so well known that it is unnecessary to repeat them here.
TREATMENT: The treatment follows much along the outline of Anemia (of which see).
NEUROPATHY: General lymphatic and stimulative techniques of the whole spine.
CHIROPRACTIC: C-1, D-7 and L. region.
DIET: Many of these patients have been freak eaters, refusing to eat eggs, meats and vegetables. Some getting along only on toast and tea or coffee or some kind of soda fountain drinks. A diet deficient in iron continued until it has become a habit is hard to overcome. But the physician must insist upon it. Whatever may be the fault in the diet must be overcome. The writer tries the No. 1 and 2 diet as a test before making either one a standard for some length of time. Honey added to the meal, or in water is an excellent builder.
VITAMINOTHERAPY: A, B, C, D, G may be considered and oxygen therapy.
ENDO-NASAL THERAPY: Same as under Anemia.
ELECTROTHERAPY: Ultra violet ray, starting with five minutes for the first treatment, then giving an extra two minutes at each sitting, if treatments are given twice or three times a week, until twenty minutes of exposure is reached.
The patient should be on a revolving stool so that all parts of the body can feel the exposure.
HERBOLOGY: Black Walnut Leaves made into a tea, used with meals, and between meals. A small handful of dried leaves to a pint of boiling water. As with all herbs, those over a year old are worthless.
EXERCISES: Moderate exercises are of great benefit. The writer advises his patients to join a hiking club. Those who do so generally pick up very quickly.


 
Chorea


 DEFINITION: St. Vitus’ Dance. Involuntary spasmodic muscular twitchings of a neurotic origin.
This condition is also known as Sydenham’s Chorea.
ETIOLOGY: This is essentially a disease of the young from five to fifteen years of age. The great fundamental cause is rheumatism. It is always more or less associated with it in the form of inflammatory rheumatism. The immediate attack, however, may not be preceded by rheumatism. There may be growing pains, tonsillitis, rheumatic endocarditis, but the rheumatism sooner or later manifests itself. Heredity, reflex conditions, dentition, fright and worms are said to play some part in it.
It seems to attack the high-strung, mentally alert children, while the dull, stupid and well-built child is immune.
The hyperthyroid type of child is more susceptible than the hypothyroid.
It sometimes occurs during or after pregnancy, and in the very aged.
VARIETIES: 1. Acute (St. Vitus’ Dance). This disease occurs chiefly in children, usually lasts from six to ten weeks, is prone to recur, and is frequently complicated by endocarditis. A severe form occurring chiefly in women during pregnancy and characterized by violent movements, fever and delirium, is known as chorea insapiens.
2. Huntingdon’s Chorea. This affection occurs in adult life and is hereditary. The movements in time become general involving the muscles of speech and deglutition, and are associated with a progressive mental deterioration. This disease is usually hereditary; it rarely develops before the age of thirty; it runs a chronic course; and it is characterized by slower and more incoordinate movements than occur in acute chorea, by progressive mental failure, and by a marked suicidal tendency.
3. Cerebral Diplegia and Hemiplegia. Choreiform movements are frequently observed in the cerebral paralysis of children and occasionally they occur in adults on the paralyzed side after cerebral apoplexy.
4. Senile Chorea. Occasionally aged persons with arteriosclerosis and degenerative changes in the brain become subject to chorea.
CHOREA INSAPIENS: This form occurs chiefly in adults and most frequently in pregnancy. The movements are very violent, almost constant, and in many cases associated with delirium and fever. Death sometimes results from exhaustion.
DIAGNOSIS: The recognition of chorea is rarely attended with difficulty. In habit spasm or tic the movements are coordinated, purposeful, more localized and partly or completely under the patient’s will.
SYMPTOMS: An attack usually comes on gradually with spasmodic twitching of the muscles of the hands or face. This increases in intensity until all control of the muscles of expression are lost. The eyelids close spasmodically and the facial muscles jerk. Speech is often indistinct and mumbling. Swallowing is sometimes difficult. The hands are in constant motion, and objects on being taken up by the hands are dropped. The gait is stumbling. Usually only one side is affected, later both. The person is peevish and fretful and is subject to sleeplessness and unpleasant dreams. The appetite is poor, patient is constipated and anemic, and there is a gradual loss of weight.
PROGNOSIS: This is good. Even under the worst conditions the tendency is to recover after a long period. Those who have recurrences of attacks may in time show neurotic or psychotic tendencies of a mild form in after years. Death only occurs where there is a severe exhaustion in the aged, or chorea insapiens, which also is rare, and when the jerkings are so violent as to cause mania, then death follows. The attacks may last from four weeks to one or two years, unless some method is found to abort it.
PATHOLOGY: Even today after all the years of research little is known about the morbid anatomy. Several things noticed at necropsy, are rheumatic endocarditis, brain hyperemia, and sometimes microscopic emboli, and hemorrhages scattered throughout the brain, and especially in the lenticular region.
TREATMENT: Physical and emotional quiet are imperative.
NEUROPATHIC: Sedation of the cervical segments especially. Then the dorsal segments.
CHIROPRACTIC: C 1, D 6, lumbar region.
SPONDYLOTHERAPY: Concussion at 10th dorsal for short periods each day. Some member of the family can be shown how to do it.
HYDROTHERAPY: Warm towels laid over the spine daily are of value.
VITAMINOTHERAPY: B, D, E and G with potassium, calcium and sulphur supplements may be considered.
ORIFICIAL THERAPY: Rectal dilations have been known to be helpful.
ELECTROTHERAPY: At the present time the author has found no form of practical electrotherapeutics for this condition because of the uneasiness of the patient. Short wave on spine has been recommended.
HERBOLOGY: One ounce each of Gentian, Peruvian bark, St. Johnswort, Skullcap, Valerian and Mistletoe boiled in 5 pints of water boiled down to 2 pints. Strain. Cut 3 large oranges, add to the tea, simmer again 10 minutes. Strain and add half pound sugar. Tablespoonful after each meal.
PSYCHIATRY: In view of the fact that this condition develops in the intelligent and ambitious youngster, school activities that involve contests of any description should be forbidden, and moderate study be insisted on. Dropping back a year is a small matter compared to the future welfare of the child. In fact, to take the child out of school entirely is the best thing that can happen as soon as any signs of chorea appear. A trip at the early stages to the country or seashore or to any new environment is always beneficial.
The parents must be cautioned against expressing too much sympathy for the child, lest they develop a false neurasthenia from which the child may grow up with mechanisms of self pity and the continual need of sympathy. See pages 49, 50 and 120 in “The Fundamentals of Applied Psychiatry,” Lake.
The child should be trained to spend as much time out-doors as possible under the watchful eyes especially when playing games or swimming, but should not be stopped unless the playing becomes violent and the swimming dangerous.
MASSAGE: Massage can be of a soothing nature by just rubbing the hands up and down the spine lightly, or by stretching the spine, also relaxing the muscles of the neck and shoulders and the affected muscles by heavy or light massage, judge which is of most benefit by the reacion of the patient.
DIET: In addition to a balanced diet a glass of milk in between meals is ample. For the cases that have complications of tapeworms and tonsillitis see treatments under those titles.


Coma, General


 DEFINITION: A state of prolonged abnormal deep stupor, or unconsciousness, from which the patient can be aroused. Comas as produced by many conditions, some of which are as follows:
The temporary unconsciousness due to anoxia of the brain is termed a syncope. See Endo-Nasal book, page 50. In this the names of Catalepsy and Epilepsy are found. See treatments under those subjects.
The traumatic type is due to injury of which evidence can be found by bleeding from some part of head or face, with bruises.
Those due to organic brain disorders are usually the result of apoplexy, which may be recognized by a study of the history of arteriosclerosis and hypertension and also evidences of paralysis or stiffness on one side of the body.
Drug Comas may be from alcohol, opium poisoning, atropine, chloroform, cyanides, carbon monoxide, hyosine, phenols, treional, sulphonal, veronal, ether, etc.
In alcoholic poisoning the odor with the ability of the person to hear a shout will confirm the diagnosis.
Generally in drug poisoning the pupils are small, the respirations slow, and the temperature is low. The limbs are limp and show no signs of paralysis.
DIABETIC COMA: Occurring in diabetes, due to presence of diacetic acid in system and to acidosis. Paralysis not present. Symptoms are sweet breath, coma casts; showers of short granular casts may appear in urine when diabetic coma is threatened by acidosis. Hyperglycemia present and softening of eyeballs may occur.
UREMIC COMA: The result of disturbed kidney metabolism, causing autointoxication through the retention of unknown substances in the blood and producing acidosis. Seen in nephritis as a result of lack of elimination of kidney toxins. Symptoms are in general, respiration stertorous, face livid, skin dry, hard and rapid pulse, blood pressure raised, sphincters relaxed according to cause, urinous odor on breath, urine scanty and containing many casts and albumin.
Insulin coma is due to either an overdose of insulin or netlect to follow out the instructions given by the physician.
Infectious fever comas. The history of infection will give the diagnosis. Malaria is one of the chief causes.
Hysterical coma is much in the nature of a deep sleep from which the person can be aroused by painfully pinching some part of the body, or some other external stimuli. The history of previous hysterical attacks can aid in the diagnosis. Specific care of coma cases is according to the underlying cause. The general care may be as follows. The collar should be loosened. Cold compresses to head and hot ones to the spine and abdomen may be indicated. Stomach pump in case of poisoning indicated. Insulin injection for diabetic coma may be given unless the coma is due to too much insulin. Sugar may be administered if it can be taken. Urine should be examined for albumin, and dropsy looked for in pregnant women. In uremic coma, stimulate elimination. Lumbar puncture or bleeding may be necessary. Induce sweating. In hysteric coma no treatment is needed. The patient revives if ignored.
Riley recommends adjustment of C, 1, 4, D, 4, 6. Baths and rectal dilation.


 
Cough


 ETIOLOGY: Cough may be induced by diseases of the pharynx, larynx, bronchi and lungs, catarrhal infections such as whooping cough, influenza, measles, typhoid fever, inhalations of dust, irritation of the nerves, especially those in relation with the vagus. It may be caused by an attack of hysteria.
DIAGNOSIS: Cough without expectoration is usually observed in those who have inflammatory conditions of the bronchi and lungs, in pleurisy and hysteria. Loose expectoration is especially noted in bronchitis, bronchiecstasis, pulmonary edema, pulmonary tuberculosis, also in pneumonia after the crisis; and in abscess of the lungs. A study of the expectoration will help to reveal the irritant.
TREATMENT: The specific treatment is of the underlying cause. The general treatment for severe paroxysmal coughing may be:
NEUROPATHY: Dilation treatment of the cough center in the medulla oblongata, the phrenic nerve, or the vagus nerve or all. Segments are D 3 to 8.
CHIROPRACTIC: Lower cervicals, D 5, for throat cough. Bronchial cough, D 1 and 2. Lung, D 3.
SPONDYLOTHERAPY: Concuss D 7.
Counter-irritation by a mustard plaster to breast and back is often sufficient to control cough.
If cough is from the ear, and persistent, the ear may be flushed with warm water, or if by a foreign body in the ear, it can be removed. Examination of the ear should always be made in children.
ENDO-NASAL THERAPY of the nose, throat, and pharyngeal cavity are often effective in easing the cough. See technique on raising tongue.
ELECTROTHERAPY: Short wave is of value in loosening mucous in dry coughing. Infra-red for abscess in ear. See under title of Ear in this book.
DIET AND VITAMINOTHERAPY are given according to the underlying cause.
HYDROTHERAPY: Neck and chest hot compresses are recommended. But the writer had a few cases that had to be suppressed for a time by cold compresses.
HERBOLOGY: Make a tea of Cheestnut Leaves for spasmodic coughs; Thstle tea for Winter coughs. General cough, take equal parts of Boneset, Pennyroyal, Mullein, Chestnut Leaves, Catnip, Hops, Mouse Ear, Wintergreen, Peppermint, Bloodroot and Coltsfoot, and make a tea. Some every few hours. Another good remedy is to take Wild Cherry Bark, boil down, strain, mix with honey. A tea, strong, made of only Boneset is good. Another remedy is a tablespoonful each of Mullein Leaves, Horehound, Elecampane and a teacup of cane sugar. Put in a quart of water, boil down to a pint. Tablespoonful when needed.
The writer has found a mixture of equal amounts of honey and lemon, taking a teaspoonful every half hour, to be very soothing. The treatment of habit or hysterical coughing is due to tensions. See “Hysteria” in “The Fundamentals of Applied Psychiatry,” Lake.
STRAPPING: If cough causes pain on the sides of the body semi-circular adhesive strapping is in order. If pain in the abdomen, a full circular binding for support of the muscles is of benefit.


 
Convulsions


 DEFINITION: Convulsions are involuntary muscular contractions, interrupted or long-continued; resulting from excessive irritation of the motor centers. Interrupted contractions, occurring in rapid succession are termed “clonic” and long-continued contractions are termed “tonic.”
ETIOLOGY: The etiology may be said to follow the outline of the classification of the types of convulsions. The types may be outlined as follows: Terminal convulsions, of young infants. Just before death they develop twitching of the extremities and rolling of the eyes. The cause is attributed to malnutrition. This type is tonic.
In the toxic, the convulsions are generally attributed to poisons of a chemical or bacterial nature and usually occur when the temperature is very high. Other types may also occur during high fever. This type is clonic.
The convulsions due to intracranial perversions are from injury and are tonic, such as cerebral concussion, or skull fracture. Other forms may be from meningeal irritation, meningitis and encephalitis. Intercranial hemorrhage, and tumors of the brain are causes of convulsions.
Epileptic convulsions are clonic and may be included in this classification, but is a separate identity which is treated under an individual article elsewhere in this book.
Tetany is a motor neurosis, or “spasmophile diathesis.” The spasms or convulsions, appear suddenly, are occasionally preceded by sensory, or constitutional disturbances; they may last several hours, or even days, to reappear after remissions of equal length, and are often accompanied by alterations of sensibility in the affected limbs, without loss of consciousness. It is far from common, yet not rare.
Hysterical convulsions may come at any age, and are due to tensions of some nature from which the person finds a way of escape from the tensions or some embarrassing situation. These may be tonic or clonic as it suits the hysterical person. There is often an initial scream, which differs in quality from that of epilepsy, and which usually is not given until the patient is aware that she (usually a female) has an audience. The patient then falls to the ground in a way that she will not be hurt. Engorgement of veins about the head is frequently noted, and more or less active tonic spasm is present. After this follows a condition of relaxation with wild quasi-purposeful movements of the arms; broken short sentences, explosions of passion and profanity, weeping, laughing and grinding of the teeth often follow. The larger and more sympathetic the audience, the more varied and emotional will be the manifestations.
SYMPTOMS: Each type of convulsion has some symptoms that are peculiar yet through them all certain general symptoms are recognized with a few exceptions. Paroxysms of involuntary muscular contractions and relaxations generally in children. Tonic spasms in which the contractions are maintained for a time, as in tetany, distinguished from clonic spasms as in epilepsy. Tetanus and hydrophobia are easily distinguished and for the most part involve a small portion of the voluntary musculature. On the contrary, strychnine poisoning involves the entire body usually as do convulsions. The word is accurately applied to unilateral attacks as seen in Jacksonian epilepsy and less likely, in hysteria. When a convulsion occurs it usually is accompanied by unconsciousness and may properly be called epileptiform. This is not the case in strychnine poisoning, hysteria or in Jacksonian attacks until the second side is involved.
Other types of involuntary muscular activity must be differentiated. Chills or rigors are fine or coarse, diffuse, trembling, easily distinguished because of the sense of cold. More or less generalized tremors though due to many factors have in common their rythmicity and failure to accomplish gross movement of the part. Tics are localized motor contractions of a spasmodic nature simulating a purposive movement.
TREATMENT: Usually, the attack of convulsions is over before the physician arrives. But, even if the physician is present, the course of the attack is not influenced much. For ages past, it has been the custom to dip children with convulsions into warm water first, then into cold water this brings about quicker respiration. This is harmless, but not very good when fever is present.
If the cause is undetermined, keep the patient from injuring self. Soft pad between the teeth to avoid biting tongue or cheeks. Warm bath, with cold to head; if fever is present, tepid or cold bath. After care—Rest in bed, absolute quiet, careful diagnosis without unduly disturbing the patient; then the specific treatment must be according to the diagnosis of the underlying cause. It can be said that in practically all cases of spasms or convulsions there is a severe deficiency of Vitamin D and calcium.


 
Croup


 DEFINITION AND ETIOLOGY: Spasm of the vocal cords, caused by catarrh of the larynx. Also known as catarrhal laryngitis. It is one of the most common diseases of early childhood, occurring most frequently in the changeable weather of spring and fall. It is said that ninety-three per cent of the cases occur during or before the fifth year, but the general ages are between two and eight years. Enlarged tonsils and adenoids may be contributing causes.
SYMPTOMS: In most cases the child has a slight cough and becomes hoarse during the day and perhaps has some fever. Late in the evening the cough becomes loud, dry, and hoarse, its characteristics being peculiar and distinctive. In the great majority of cases this occurs between the hours of 9 and 12. The child wakes suddenly with a barking cough and begins to struggle for breath. He frequently becomes alarmed at his inability to breathe, and his fright adds to the severity of the symptoms. In attacks of ordinary severity the respiration is loud and noisy; the voice is hoarse, but rarely lost; the dypsnea is sometimes extreme and the respiration so noisy it can be heard in an adjoining room. The temperature is usually somewhat elevated, but rarely reaches 102 degrees. The lips and nails frequently assume a purplish hue, but are rarely cyanotic. There is often a discharge from the nose, and the eyes are sometimes congested and watery. After two or three hours the symptoms usually subside. Occasionally they appear in less severe form later in the night, but, as a rule, all urgency is passed by early morning. In some instances the child is almost as well as usual during the following forenoon, but the following night there is a return of the attack, which may not be as severe as the first, and this may continue each night for some time. The night attacks are the rule, because of the horizontal position of the child, which tends to congest the membranes of the nose and respiratory tract, forcing mouth breathing, and the inspiration of dry, cold air, which produces a dry, tickling throat.
DIAGNOSIS: The common type can be recognized by the attack coming at the early hours of the night, the quick development of characteristic symptoms of loud, metallic, cough, the moist respiration, the frightened appearance of the child, and the rapidity with which the attack subsides.
In all cases the physician should examine the larynx, to make sure there is no diphtheria, or what may be termed Membranous or Pseudomembranous Croup. Hoarseness and dypsnea develop gradually, and the latter is not intermittent. False membrane may be seen in the throat or may be coughed up. The constitutional symptoms are more severe.
LARYNGISMUS STRIDULUS: This is a pure neurosis, and is often associated with rickets. The paroxysms resemble those of false croup, but are associated with a peculiar crowing inspiration, and lack catarrhal symptoms, such as hoarseness and cough.
PROGNOSIS: Ordinary types of catarrhal croup are never fatal. In very rare instances in which the catarrhal element predominates and is very severe, the prognosis may be grave. In other words, catarrhal croup is rarely or never fatal, while severe catarrhal laryngitis with spasm may be dangerous.
TREATMENT: To aid in relief of severe spasm, concussion of the cervicals 4 and 7 is very effective. Compresses of hot towels over the throat and chest will do much to relax the spasm. Hot camphorated oil is also very helpful. Hot, wet flannel is wrapped around the neck after the neck has been rubbed with one part turpentine to three parts of olive oil. General care and office treatments of the child. Exercise in the open air is vital. But, the child must be properly clothed. Wild running and loud talking and screaming are very harmful.
NEUROPATHY: A lymphatic treatment especially of the liver, axillary and cervical regions. A quieting treatment of the whole spine from cervicals to sacrum.
CHIROPRACTIC: C region and D 5 are specific.
Vacuum Therapy over the dorsals and to each side is of great benefit in aiding circulation.
ELECTROTHERAPY: Short wave on throat and chest, also Ultra Violet Ray.
DIET: Many of these cases are anemic, and need not only a good nutritious diet, but also some supplementary food such as thiamin. A balanced list of foods can be taken from Diets Nos. 1 and 2, supplemented by plenty of fruit between meals.
VITAMINS: B, D and others, according to the clinical findings.
COLONOTHERAPY: It is best not to start a child on enemas, unless absolutely necessary. Lax may be given, but not even those, unless “habit time” seems impossible. Unnecessary colon flushings in children sometimes starts a lifetime struggle with a laziness of the bowel that is difficult to overcome, and may lead to a form of neurasthenia, especially fear of poisoning from the bowel, and become a lifetime addict to colonotherapy or all kinds of physics sold in drug stores. Of course, in fevers of any degree, enemas may be necessary But, establishing “habit time” should be the physician’s aim with children, aided by the exercise a normal child usually obtains at play.
HERBOLOGY: Fresh pineapple juice is A-1 for this illness. Balsam copaiba 20 to 30 drops three times a day. Black Snake Root, made into a tea and sweetened to taste is good.


 
Cystitis
Acute — Chronic


 DEFINITION: Inflammation of the urinary bladder, involving one or more of its four coats.
ETIOLOGY: It is brought on by invasion of bacteria or microorganisms from above or below the bladder. Among them are found the Bacterium coli communis, streptococcus, Bacillus tuberculosis, gonococcus, and Bacillus typhosus. These bacteria gain entrance to the bladder in one or more of four ways, to wit: through the urethra, the blood or lymph channels, the kidneys, and the wall of the bladder. The inflammation thus produced by these germs is aggravated by the ammoniacal fermentation of the urine which the bacteria bring about. This fermentation is due to the decomposing action of microbes upon urea, with the resulting formation of ammonium carbonate. This fermentation is the result, and not the cause of cystitis.
It is also possible that many cases are produced by chemicals of various kinds, retention of urine, abnormalities of the urine, foreign bodies in the bladder, traumatism and neoplasms.
SYMPTOMS: In the acute form there is an urgency, and frequency to urinate, and the amount is small each time. There is pain over the bladder in the suprapubic regions. Temperature at the onset may be as high as 103 and the pulse is accelerated. Pyuria, or pus, is always present. The urine is of a blood or smoky color and strongly acid, or shortly turning to strongly alkaline, due to ammoniacal decomposition, and then there is burning. It contains albumin relative to the amount of blood and pus present. Sediment is abundant, consisting of blood-corpuscles, pus and various forms of epithelium.
SYMPTOMS OF CHRONIC CYSTITIS: In this type the symptoms continue the severity of the acute condition. The urine is only moderately diminished, or it may be of large quantity but never satisfactory; generally pale, but may be normal in color, or very slightly tinted with blood. The freshly passed urine is generally turbid, due to the presence of pus, epithelium, and bacteria. The reaction is frequently alkaline, but may be acid; specific gravity varies between 1012 and 1020. The sediment is abundant, consisting chiefly of pus, small round cells, epithelium, and usually a small (sometimes considerable) amount of blood. If the urine be alkaline (ammoniacal), the sediment contains also amorphous phosphates, triple phosphate crystals, and often crystals of ammonium urate.
While pain is not as great as in the acute form, there is a continuous discomfort in the suprapubic region, the bladder never seems to be satisfactorily emptied, although large amounts may be voided. A moderate rise in temperature is noticed.
DIAGNOSIS: The four factors that can establish the diagnosis, in chronic cystitis, are, (1) Low grade febrile reactions. (2) Frequency of micturition, (3) Dysuria, constant desire to urinate, burning of urine and (4) pyuria or pus and some blood. In the male, prostatitis or vesculitis can be distinguished by manual examination.
After the acute stage has passed a thorough general physical examination with detailed history of the patient can be made, including history of habits, etc., which may reveal injuries, alcoholism, nervous tensions, and abuses of various types. Bacteriological study of the urine will reveal the presence of infection. While cystoscopic examination will reveal the extent of the inflammation.
TREATMENT: Acute Cystitis. It is best for the patient to stay in bed for a few days. Plenty of water to drink, preferably hot, unless there is severe retention. Hot compresses to the suprapubic and lumbar region. Sitz bath, if there is any signs of retention. Hot colonic irrigations. If there is high acidity, alkaline liquids can be given, but as soon as the urine is alkaline, all alkaline diuretics should be stopped. If retention of urine becomes severe a catheter is used as a last resort. (See under title of “Retention”.)
Neuropathic dilation of the bladder segments can be given to release the motor constriction to the sphincters.
Chiropractic Adjustments of a mild nature may be given to D. 10 and L. 1. Mild rectal dilations, or massage are also indicated. If the physician has a portable short wave machine, it will be of great benefit at the bedside, applied directly over the bladder.
TREATMENT: Chronic Cystitis: Here the physician can make a complete examination and find the underlying cause and treat the cause and symptoms. In many cases the symptoms persist long after the original cause is removed, and the person may become accustomed to the symptoms, and bear this condition indefinitely. But, by persistent treatment, the majority of these cases can be made well again. An outline of treatment for the chronic condition may be as follows:
NEUROPATHY: A thorough lymphatic of the lymph system. Dilation of the spinal segments of the spinal cord controlling the bladder. See chart.
Chiropractic Adjustments of D. 10.
SPONDYLOTHERAPY: Light pressure on sacrals 2 to 5; or light tapping with fingers. Rectal dilations for a minute or two in every direction, with finger, not instruments, lest the tissues be irritated.
HYDROTHERAPY: Irrigations of the bladder. The writer is of the opinion, however, that catherization and irrigation of the bladder should not be used unless absolutely necessary, and if done at all it should be by an expert in that form of therapy, and the first attempt should be with a four or five per cent solution of warm, boric acid. For the female, hot vaginal douches daily are very effective. Hot sitz baths once or twice a day, or hot spray over the bladder, and lower spine from a bath tub spray are par-excellent.
DIET: A change from No. 1 to No. 2. Diets on alternate days for a few weeks will help keep the acid base balance of the urine, or the physician can select foods from the Acid-alkaline charts in this book.
VITAMINOTHERAPY: Vitamin A is the specific to be given in large doses. In addition, Cod Liver oil with vitamins B and D have been found to be of excellent benefit.
ELECTROTHERAPY: Fever therapy of various kinds have been recommended. Short Wave and Diathermy are also recommended. Infra-red for ten to twenty minutes over the bladder is very helpful.
COLONOTHERAPY: If the movement of the bowels is not normal, a few, hot, high colonic irrigations are in order, followed by low enemas until regularity is established, then all forms of colon therapy should be discontinued.
STRAPPING: If there is an abdominal ptosis a belt or some kind of a support should be worn.
GENERAL SUGGESTIONS: Patient should not use alcoholic beverages, nor eat spices or condiments, lest more irritation be set up. Patient should also be instructed to have regular hours for retiring at night.
HERBOLOGY: Mix 3 parts each of Cleavers, Uva Ursi; 2 parts each of Marshmallow, Couch Grass, Sanicle, and one part of Ginger. If there is constipation put in a little Senna. Steep a heaping teaspoonful in a cup of boiling water for 20 minutes A cupful or two during day. The pods and hulls of the common bean made into a tea and used freely is considered good.


 
Diarrhea


 DEFINITION: Morbid frequency of liquid bowel evacuation.
ETIOLOGY: Loss of vaso constrictor control, due to irritation or inflammation of the mucous membrane. The irritations may come from many sources. Excessive water drinking has been known to cause it. Faulty diets with excess of certain foods, such as fats, fruits, and certain coarse vegetables. It may also result from inflammation of the intestines, enteritis, ileocolitis, dysentery, (inflammatory diarrhea). It is a symptom of certain infectious diseases, such as typhoid fever and cholera (symptomatic diarrhea). It may be excited by cathartic drugs. It often occurs as a final symptom in cachectic states, as in cancer, diabetes, and chronic renal disease (colliquative diarrhea). It sometimes marks the crisis of acute infections, such as typhus fever and pneumonia. It may also result from certain nervous influences; emotional excitement, Graves’ disease, neurasthenia.
Infantile diarrhea is a serious matter. It is said that in the first two years of life, diarrheal conditions cause more deaths than any other classified disease or group of diseases. It is usually termed Infantile Gastroenteritis. But, in the summer time, it is designated as Summer Diarrhea. There is another term Cholera Infantum, which designated a heavy, watery type of diarrhea. Dysentery is included as a term of diarrhea when the stool contains blood. See under that title. In infants and children, improper feeding, spoiled fruit, or other food stuff, Toxic foods, such as impure milk, etc., may be the factors.
SYMPTOMS: In infants and children, there is usually a rise in temperature. Skin is dry, great thirst is evident, some pain, or great pain, according to the cause, and there may be vomiting, with increasing frequency of watery stools.
TREATMENT: Of infants or children. If possible breast feeding is the best way to raise an infant, but if not possible then the artificial feeding must be regulated by the proper amount and not overfeeding and perfect cleanliness of the methods of feeding the child, in an effort to prevent the child from becoming ill. Clothing is no small item in this respect. Some times the clothing is too heavy, preventing proper heat-radiation and also muscular activity. The actual treatment of the infant or child may begin by giving as much water by spoonful as the child will take. Vomiting does not need to stop the giving of fluids. The fluid given can be barley water, sweetened with saccharin, or some very weak tea. The fluids may be given at from two to three ounces per pound of body weight every twenty-four hours. Food should be withheld for some period of time. Low enemas may be carefully given.
Enemas are also in order when there is vomiting and temperature is high. Several may be needed to bring the temperature to normal.
NEUROPATHY: Sedation treatment of the 4th to 10th Dorsals, and inhibition treatments to the lumbar segments of the spinal cord. Heat of some nature may be applied to the abdomen for pain.
CHIROPRACTIC: Adjustments to fit the age of the patient. D 5-10, L 1, 2, 3.
VITAMINS “K” IN Bile Salts if blood is present in stools. Nicotinic Acid and Vitamin C may be considered in proper dosage, as beneficial. A small teaspoonful of table salt or sodium bicarbonate dissolved in a glass of water, and fed by teaspoonful may stop the vomiting. The above may be all that is necessary in mild cases.
An apple diet is recommended and is often helpful for the treatment of diarrheal conditions in infants and children and the treatment is as outlined: Only ripe and mellow apples are utilized. When the fruit has been peeled and cored, it is grated and the child is given from 1 to 3 pounds (500 to 1500 Gms) daily of this pulp, or from 3 1/3 to 10 ounces (100 to 400 gm) per feeding. After two days, a transitional diet containing neither milk nor vegetables is given, following which the patient may again be placed on a mixed diet.
HERBOLOGY: Half ounce each of Tormentil, Bayberry, Ginger. Boil two heaping teaspoonfuls in a cup of water for 30 minutes. Strain. Add ½ oz. tincture Catechu. Teaspoonful after each liquid movement. Diarrhea should not be checked too rapidly—rather remove the cause. After diarrhea has ceased then give a teaspoonful three times daily after meals of the tea made from half ounce each of Tincture Gentian, Tincture Columbo, quarter ounce of Tincture Ginger and 8 oz. of Cinnamon Water.
A mild astringent, carminative, having laxative and emollient properties is to make a tea of the following: Wild Alum Root, Prairie Plant, Buckthorn, Indian Sage, Fennel Seed, Flax Seed, Cheese Plant and Marshmallow Root.
A tea made only of Blackberry Root is a favorite with some.
An old German recipe is to take a handful of Pepper Grass and steep it in a pint of boiling water. Teacupful with each meal or after the meal.


 
Acute and Chronic Adult Diarrhea


 TREATMENT: Find the cause and treat specifically. Go back to Etiology again. The general treatment may be as follows:
DIETARY: All food should be eliminated for about twelve to twenty-four hours.
NEUROPATHY: Sedation of the 4th to 10th Dorsals. Inhibition of the 1st, 2nd and 3rd lumbars.
CHIROPRACTIC: It may be that adjustments are required on L. P. S. P. K. P. L. P. according to the organs mainly involved.
COLONOTHERAPY: The hot enema, or flushings are in daily order. The physician judging whether any toxic matters are retained in the colon. Saline solutions are recommended. A teaspoonful to every quart of water.
SPONDYLOTHERAPY: Concussion or hard finger pressure alternately on the 11th dorsal, and first three lumbar will aid in controlling spasms.
ELECTROTHERAPY: For pain, the short wave or diathermy or the infra-red.
DIET: This must be according to the cause. But, as a general rule constipating food is used, such as boiled milk, boiled rice and cinnamon are considered for that purpose. Rough cereals and roughage for the time being are eliminated.
HYDROTHERAPY: Hot packs or cold packs over the abdomen may be used at the discretion of the physician. One plan that has been beneficial in the writer’s experience has been to have the patient dip a towel in cold spigot water and after wringing out laid over abdomen and allowed to remain for fifteen minutes.
Plenty of liquids should be used. The old type remedy of a dose of castor oil is sometimes more effective than all other forms of treatment.


Diphtheria


 An acute infectious disease characterized by formation of false membrane on any mucous membrane or mucous surface, accompanied by great prostration.
ETIOLOGY: Predisposition by an enervation of the nerves to the neck and throat or any mucous membrane affected, or a general toxic condition of the above places where the ferments of the Klelbs-Loeffler bacillus may breed and multiply.
The vast majority of cases occur between the ages of two and ten, but older children and adults are not exempt.
There are several types. The Pharyngeal, which is the most common type, the symptoms of which are: Onset gradual. Usually slight headache; often backache. Temperature 100 to 103 degrees, and sore throat with presence of yellowish-white membrane adherent to tonsils or pharyngeal walls. Cervical adenitis may develop early in severe types.
NASAL DIPHTHERIA: Fever is much more evident. Adenitis often severe, serous discharge from nostrils which may be blood-tinged and of strong fetid odor.
LARYNGEAL DIPHTHERIA: In this type, croupy cough, aphonia, stridulous respiration due to narrowing of glottic opening, are early evidence of the disease. Restlessness, anxious expression, retractions of the supraclavicular and intercostal spaces evident on inspiration. In this type of infection, the danger from asphyxiation due to mechanical obstruction is far greater than any serious results from toxemia. Diphtheria of the conjunctiva, external auditory canal, lupus, or genitalia are sometimes seen.
SYMPTOMS: The general and specific symptoms may be as follows, before and during the full invasion.
The invasion may be mild, with rigors succeeded by moderate fever, headache, languor, loss of appetite, stiffness of the neck, tenderness about the angles of the jaw, or slight soreness of the throat.
In other cases the invasion is more abrupt and severe, with chilliness followed by great febrile reaction, 103 to 105 degrees F., pain in the ear, aching of the limbs, loss of strength, painful deglutition, and swelling of the neck, compelling the patient to take to bed from the onset.
The appetite is poor, the tongue slightly coated, sometimes more or less exudation appearing upon it, the bowels either regular or slightly relaxed. The pulse, at first full and strong, soon becomes either rapid or slow, but compressible. The urine is scanty, high colored and contains albumin.
The local symptoms in the majority of cases are associated with the throat. The patient often complains of a frequent and persistent desire to hawk, in order to clear the throat. On inspection, the fauces are seen red and swollen and more or less covered with a film of diphtheritic exudation, giving a glazed appearance, soon followed by the dirty-white membrane; sometimes the tonsils and uvula are greatly swollen and spotted with exudation. In severe cases, more or less ulceration or sloughing may be observed. Not infrequently fragments of exudation, the false membrane, are expectorated with particles of the ulcerated tissues, having an offensive odor which is transmitted to the breath. The lymphatic glands of the neck are enlarged and tender, and in severe cases the tissues of the neck are greatly tumefied.
Extension to the nasal cavities causes a sanious and offensive discharge from the nose, with attacks of epistaxis.
Extension to the larynx is indicated by hoarseness or complete loss of voice, croupy cough, and obstructive dypsnea, which often becomes urgent, the breathing being noisy and stridulous, and subject to paroxysmal exacerbations. If the inflammation extends to the bronchi, the breathing becomes still more embarrassed.
DURATION: Ranges from two to fourteen days, the average being about nine days, although complications and sequelae may prolong its course.
COMPLICATIONS: The most common complications are bronchopneumonia, heart failure, the result of myocarditis or of degeneration of the cardiac nerves, acute nephritis, hemorrhage from the ulcerated surfaces, otitis media, and suppuration of the lymph nodes. The most important sequel is paralysis, due to toxic neuritis. This occurs in about 20 per cent of the non-fatal cases and usually appears during the second or third week of convalescence. The pharynx is the most common seat, the palsy being manifested by difficulty in swallowing and the return of liquids through the nose. The external muscles of the eye are often involved, the result being ptosis or strabismus. In some instances the heart is affected and if sudden death does not ensue, the condition may be manifested by tachycardia or bradycardia. The muscles of the extremities may also be involved. The paralysis usually disappears in from a few weeks to several months. Those who recover are for weeks pale and cachetic in appearance.
DIAGNOSIS: Whenever the throat is red and swollen, having a glazed appearance accompanied by the necessary symptoms, a culture should be made from the deposit, and if the bacillus is present, the colonies can be seen under the microscope.
PROGNOSIS: This is always serious and there should be no delay in instituting measures to give relief.
TREATMENT: The laws of most states if not all make this a quarantinable disease. In the presence of such a case where such laws exist the drugless physician is required to withdraw from the case, report it to the health authorities, and have a member of the medical profession assigned to do the actual treating. Until that law is changed it is best for the drugless physician to adhere in order to avoid embarrassment, or a medical doctor may be called into consultation, and both treat together, if feasible.
There are certain things that the physician can do: When there is a suspicion of this disease, whether it be the pharyngeal, the laryngeal, nasal or black type, the case should be isolated at once, and no one allowed in the room except those that are absolutely necessary in attendance. Then a smear from the throat should be obtained, and laboratory examination made.
The manipulative treatment may be
NEUROPATHY: Complete lymphatic, paying particular attention to the liver, axillary and cervical regions.
CHIROPRACTIC: Adjustments, 3rd, 5th, and 7th cervicals, 5th, 10th, and 12th dorsals, and anywhere else necesssary.
HYDROTHERAPY: Washing or gargling the throat with warm ordinary table salt solution is helpful. Care must be taken that none is swallowed. The spraying of the throat with hydrogen peroxide solution is regarded as helpful. Swabbing with saline solution or water-soluble chlorophyll in two drops to nine drops of warm water. The latter may be used as a nasal spray also. 120 V. M. is excellent in relieving throat and nasal conditions. Only a little at a time should be put in the nose.
Hot compresses or cold compresses are helpful when there is much swelling of the cervical glands. Heat is better for infants and cold in ice bag for older children.
Croup kettle or steam inhalations may be old fashioned, but still a good procedure in the home. By making a tent of a towel thrown over the head and kettle, enough should be inhaled in ten minutes to give relief. Turpentine or eucalyptol may be added to the boiling water. The tent should not be air-tight. If fever is high, sponging may be given three times a day or a cool compress may be put around the neck.
ELECTROTHERAPY: If the physician has a portable short wave or ultra violet ray, he will find them of great service. A portable cold quartz with applicators for nose and throat are worth while.
ENDO-NASAL THERAPY: When the patient is recovering this type of therapy will be of great benefit in furthering elimination, and preventing complications, one of which may be otitis media, and also helping the child to build up a good oxygen content in the blood for rebuilding a strong vigorous body.
HERBOLOGY: Gargle every hour or two with lemon juice and water, using as little water as possible. Swallow a teaspoonful or less each time.
VACUUM THERAPY: The use of nasal and laryngeal suction has advantages if possible at all to perform.
DIET: Early in an attack, only a liquid diet should be given, plenty of water, fruit juices, and nourishing broths. Where the membrane is not extensive, a soft diet can be given including many vegetables, milk, beef tea and gruels. As the child recovers adequate feeding is necessary, and it is best to give him what he likes if it is nourishing.
SPONDYLOTHERAPY: Concussion with fingers of the 7th cervical.
COLONTHERAPY: It is essential that the bowels be kept in order. A small hand syringe is all that is required with the infant. But a larger child can be given douches of a pint a day.
Caution to the physician: After making sure or even after suspecting diphtheria, the physician should always wear a gown, mask and cap and leave them at the house he called at, or take them to his office properly sealed. They should be properly disinfected or destroyed, each time. And he himself should sit under ultra violet radiations for fifteen minutes before treating another patient or making a call. Besides the above he should spray his nose and throat with an antiseptic solution.


DISEASES OF THE MALE GENITALIA


Prostatitis


 DEFINITION: A general term used to designate any inflammation, infection or injury of any portion or all of the prostate gland.
The present tendency is either to view the whole gland when abnormal, as either in an acute state, or a chronic state and to classify the types of prostatitis according to their etiology. The causes of prostatitis can be said to be as follows:
1. Infection
2. Retentive and Congestive
3. Mechanical
4. Biochemical
5. Traumatic
The infective type of prostatitis may be acute or chronic, according to the type of the infection and its discharge of bacteria into the prostate. The position of the prostate is such that it is vulnerable to infection by drainage from above it, and by suction from below it. Thus it may be infected from gonorrhea, from tooth decay, influenza, mumps, constipation, boils, abscesses, carbuncles, amoebic dysentery, etc., the infection being carried to the gland by the blood stream or transmitted through the urinary system, or it may come directly through the intestinal tract by osmosis.
For many years all cases of prostate trouble were frowned upon as only the penalty for loose living. A result of gonorrheal infection and many cases of prostatitis were ignored while a course of treatments was instituted for the supposed lingering infection in the blood stream of the patient before anything was done for the prostate itself. Much more harm was done to the prostate than good by this manner of treatment. The manipulative physician recognizes the unity of the whole body, and while eliminating the infection at most will only be a minor factor, whereas the body’s eliminative processes, and not kill the patient while trying to kill germs. It is not wise to assume that because a man has an enlarged or senile prostate that he has been exposed to sexual diseases. It is not even wise to consider gonorrheal infection as the cause, even in those who are past sixty years of age and who admit that as young men they were victims of gonorrhea two, three or four times, if, in the intervening years they have lived a normal life. Younger men with acute prostatitis and evident discharge might be considered as gonorrheal, but not told until the clinical findings have substantiated the suspicion. In acute or chronic prostatitis of the older generation, gonorrheal infection at most will only be a minor factor, whereas the mechanical, the chemical and traumatic etiologies will loom very large. It is a peculiarity of human nature to shun from anything that the mass of people make merry about. For years, if a person were known to have been examined by a psychiatrist, henceforth that patient was regarded as always acting somewhat queer. But today people have psychiatric examinations as a matter of course.
The writer has had men patients who showed evidence of prostate symptoms refuse to have that organ examined in fear that he would be told that it was the result of loose early living or sexual excesses. But, after the seriousness of the matter was explained to them, the examinations and treatments became a matter of periodical request by those men. There are many other causes besides gonorrhea and syphilis. Now we will take up the four main causes and try to put them in their right proportions.
The first, then, is Infection. Gonorrhea can be verified by the many chemical laboratory tests. The others can be ascertained by observation, palpation and urinalysis. This can be stated now, that no permanent relief can be obtained for the prostate gland until every foci of infection is removed. A case of record is of a man who took treatments for nearly a year, whose prostate gland would enlarge, and on treatments would be reduced to normal. Yet, in a few months would be very large again. Not until two foci of infection were removed was there any permanent results. Several bad teeth which had been decaying for years, a discharge of purulent mucus from the ears, some of which no doubt reached the prostate via the blood stream. It is of note though that the enlargement of the prostate ceased by the neutralization of the above infections.
Other forms of infection are, dripping sinusitis, tonsillar infection as a result of influenza, mumps, scarlet fever, or any contagious infectious diseases. Infection from any of the tissues adjacent to the prostate. One form of infection that is frequently overlooked is that incurred by intercourse during the menstrual period and, when there is leucorrheal discharge. These types of infection to the prostate are more numerous than realized by many men and physicians.
RETENTION OF WASTE PRODUCTS is a cause of prostatitis, largely due to faulty diet and sedentary habits. Constipation of a great degree for any length of time is practically death to the functions of the prostate gland, bringing along with it a host of inflammations to the surrounding tissues which cause pressures, straining, hence hemorrhoids and sometimes hemorrhages that have a deleterious effect on the prostate. Some have given this type the name of Congestive Prostatitis, where there is a filling up of the gland to an abnormal size with blood. Here the lobes may be two or three times their normal size. There is always great danger in the acute, congestive prostatitis if there is also an infection present at the same time and an abscess forms. This may rupture into the urethra, through the skin of the perineum, or into the rectum, leaving a cavity. If small, this cavity will contract and close with scar tissue, but if large it becomes a pus pocket capable of holding sufficient pus to maintain an irritation and infection for months or even years. In some cases the entire gland is in this way destroyed.
The retentive or congestive types may be also caused by sexual excitement without gratification. It is well to remember that failure to exercise vital functions of an organ leads to congestion or atrophy of that organ. Once the sexual functions have been accustomed, and a periodicity has been establlished for the discharge of that glandular secretion, and there is a sudden cessation and the secretions are not thrown out, more continue to form, and the prostate and vesicles will swell and become distended in proportion to the amount retained. It is well for the physician to note this point carefully in men who have recently lost their wives, for in a short while they show nervous and other symptoms that point to prostate congestion.
It is a matter of record that single men do not live, on the average, as long as the married men. It is conceivable that prostatic congestion in the single man is a factor in the difference in longevity.
When a man enters an active sexual life, the cells of his prostate gland as well as those of his testicles secrete more actively. In order to provide for this increase in the production of secretion, the muscles of the prostate stretch. As long as sexual activity is periodically indulged in, the prostate will exercise its normal function of expansion and contraction. Should the normal routine of this sex life be interrupted by continence, the prostate gland and vesicles will continue to fill with secretions. Continence produces flabby muscles, and the prostate becomes boggy. Periodic emissions occur, to be sure, but the force from the muscles, the nerves which stimulate ejaculation during coitus are not functioning properly and the emission only partly empties the prostate and vesicles. Unless the patient again establishes his sexual life, or goes to a Physical and Manipulative Physician for proper massage and treatment, he is sure of a prostatitis.
As has been said before, many of these patients never consult a physician until their condition becomes unbearable. They will suffer untold agony rather than go to a physician. The fault is not entirely theirs. The trouble reverts to the earlier discussion of sin and sex — they are ashamed to go. Yet, there is nothing to be ashamed of. Prostatitis and prostatic hypertrophy are diseases of respectable people all over the world.
The Mechanical Causes of Prostatitis. Abdominal ptosis creating a ptosis of the bladder is always worthy of investigation. In good body mechanics, in which the chest is held up and the diaphragm is high, and the abdominal wall is firm and flat below the umbilicus, the abdominal viscera exert little or no pressure on the pelvic organs. In poor body mechanics, where the chest and diaphragm are both low, and the lower abdominal wall — that below the umbilicus — is relaxed and protuberant, there must be a marked backward thrust of the lower abdominal viscera directly into the pelvic cavity. Not only can this cause local pressure and possible congestion, but it must also have an effect on the pelvic organs, since their only method of drainage is through the great abdominal veins.
With such a conception of the mechanical factors influencing the circulation of the pelvic organs, is it not possible that here is an explanation for the congestion of the bladder and prostate, so often found in older men, which may lead to prostatic hypertrophy and malignancy of the prostate. Other mechanical causes are many.
In this group the sexual element seems to be the greatest offender. Mechanical prostatitis results from coitus interruptus, coitus reservatus, coitus prolongatus, masturbation, frustrated sexual excitement, continence, impotency, sexual excesses, exposure to cold and chilling of extremities, etc., may be some of the mechanical causes.
The Biochemical group of causes come from overindulgence in alcoholic beverages, irritant action of impure alcohol, impure or irritating foods, drugs and tobacco.
The Traumatic group are caused by accidents and injuries affecting the prostate, urethra, rectum or bladder.


A Suggested Examination Procedure


 Men, generally, are reluctant to submit to an examination of the genital organs, unless there is great pain. Here the physician can be of great aid in opening the way by just asking a few questions. This brings us to the question, When is a prostatic examination required? A man forty-five to seventy years, presenting himself to the physician, will reveal certain of his symptoms. If, among those symptoms are one or more of the following, then a prostatic examination is in order, and the physician can explain to the patient, why.
1. When there is lower back, or hip, or groin pain, dull or severe.
2. Chronic constipation with a feeling of a lump in the rectum the patient would like evacuated and cannot.
3. Difficulty in starting micturition, feebleness of the stream, dripping at the end of urination.
4. When there is frequency of urination which is a symptom in all types of prostatitis. But, it is well to remember that frequency is also a symptom of many other diseases. It can be taken for granted, however, that in nearly all cases of frequency of urination, the prostate has become more or less involved. Some of the other causes of frequency are—strictures in the urethra. The seminal vesicles may be enlarged and infected. There may be stones in the bladder, or the bladder may be deformed from a ptosis of the abdominal wall. The kidneys may be afflicted by nephritis, or have stones, tuberculosis or dropped and floating. Diabetes, injury to the spinal column, large intestinal and external hemorrhoids, excessive drinking, smoking and drugs may also be causes of urgent frequency. This one complaint alone is sufficient to justidy a careful examination.
5. Burning of urine.
6. Constant tiredness, and shakiness of the limbs on required exertion.
7. When there is more than one rising at night to empty the bladder.
8. When there is complaint of lack of sexual vigor and lessened sexual satisfaction.
9. When there is complaint of nervousness and insomnia.
10. When there is occipital and neck muscle pain and side headache.
11. When a man complains of peculiar sensations of slight fever at times, nausea, and haziness of mind, and an all out-of-sorts feeling which he cannot explain.
Before proceeding with the plan of a suggested method of examination, it might be well to consider the size of the normal prostate.
The size of the prostate is important, since in old age enlargement of the prostate gives rise to a train of symptoms that may end in death. The diameter of the prostate varies to some extent within normal limits in healthy adult life. As given by Merkel, they are as follows: Basic to apex, 25 to 35 mm.; average, 30 mm. The greatest transverse diameter, 35 to 45 mm.; average, 40 mm. The greatest thickness, 15 to 25 mm.; average, 20 mm.
The best method of finding specimens in normal condition and comparing them with the abnormal is to have some one about forty years of age who has no complaint whatever, and make an examination. Notice the contour and size, then follow this with some one who does complain. The author found no difficulty in getting men to submit to the examination for comparison when the purpose was explained.
After the finger, covered with a finger cot, well lubricated, has been inserted into the rectum, the following general principles can be followed.
A uniform, smooth and bending enlargement of the prostate gland can be suggestive of chronic inflammation, or a senile enlargement if the age is enough to justify that conclusion. An irregular, hard and unbending prostate can be suggestive of a malignant disease A soft and extremely tender swelling suggests abscess formation in the prostate. More types under Chapter on Classification.


Methods of Examining the Prostate


 The prostate may be examined in a variety of ways, as follows:
1. Rectal Palpation.
2. Urethral examination with a metal catheter.
3. Cystoscopy and endoscopy.
1. RECTAL PALPATION. — The manipulative physician with his training should become par excellent in a short time at this form of examination. The steps taken are usually as follows:
The bladder should contain a moderate quantity of urine, i.e., be neither distended nor empty. The patient is placed in the knee-chest position on a table or bed, or may stand leaning over the back of a chair, one knee resting on the chair and the thighs separated. With the patient on his back the examination is not so satisfactory. The right forefinger of the physician, protected by a rubber glove or a thin rubber finger-cot, is lubricated and gently introduced into the anus with a slight boring motion. After passing the sphincter the finger comes in contact with the membranous urethra in the anterior rectal wall for about one-half inch, then with the prostate. Normally the prostate is felt as a slightly prominent, heart-shaped body, an inch and a half long, of firm, elastic consistence. By palpation one determines general or one-sided enlargement, the presence of nodules, or of general or localized change in consistence, as induration, fluctuation; also the presence of tenderness. Bimanual palpation of the prostate is seldom useful except in very slender subjects.
2. URETHRAL EXAMINATION WITH A METAL CATHETER. — The last two types of examination we shall mention here can only be made by those who have been well trained in this art, and have the proper facilities at hand. We mention them here that in case the results of the palpation method is not satisfactory, then an examination can be made by the following methods:
If a silver catheter of medium curvature be introduced into the urethra, and it is found necessary to depress the shaft of the instrument nearly to the horizontal before urine flows, we may conclude that the prostatic urethra is notably increased in length and that the prostate gland is correspondingly increased in size.
A maneuver, described by Socin, for the determination of the length of the prostatic urethra is thus performed. A silk or other catheter is introduced into the bladder until urine flows. The catheter is then withdrawn until the flow ceases, i.e., the lateral eye of the catheter is inclosed within the prostate. The length of the catheter protruding from the penis is then measured. The physician then introduces his finger into the rectum while an assistant holds the penis in an unchanging position; with his left hand the physician withdraws the catheter until he feels its tip emerge from the prostate into the membranous urethra. The length of the protruding catheter is again measured. The difference between the two measurements, less the beak of the instrument beyond the eye, is approximately the length of the prostatic urethra. When the prostatic urethra is considerably increase in length, it indicates an hypertrophy of the middle lobe or the formation of a marked prostatic bar. The length of the entire urethra in healthy male adults varies a great deal, according to the length of the penis. It may be from 16 to 20 cm.; on the average about 18 cm.—a little less than seven inches. Usually the length of the catheter introduced into the urethra before urine begins to flow is from seven and one-half to eight and one-half inches. Any marked increase over this distance indicates prostatic enlargement.


FIGURE A
OUTLINE OF SEXUAL AND URINARY ORGANS


3. ENDOSCOPY AND CYSTOSCOPY. — It is possible, and not very difficult to introduce a straight endoscopic tube into the prostatic urethra, and to study the condition of its mucous membrane with more or less success. The verumontanum can be recognized, but not the sinuspocularis unless it is the seat of the disease when its orifice may gape or permit the observer to see a purulent or muco-prostatic hypertrophy. It is quite painful, but has been rather extensively used in America during recent years. This form of examination requires trianing and great skill.


 
FIGURE B
ANTERIOR VIEW OF PROSTATE


 In cases of prostatic hypertrophy, with unequal enlargement of the lobes or with a greatly increased urethral distance, the use of the cystoscope is not practicable, even under a general anesthetic, without undue violence. If the kidneys are faulty there is also risk of uremia. In elderly men, therefore, the use of the cystoscope should be preceded by an examination of the urine, with particular attention to the function of the kidneys, and by rectal palpation of the prostate. In acute inflammation of the prostate, in acute posterior urethritis, and in cases where malignant disease of the prostate is suspected, the use of the cystoscope is contraindicated. While we are here stating these methods of examination we will utter a word of caution. That instruments of solid substance should only be introduced into the urethra or rectum as a last resort for examination or for treatment. More harm than good is done by the use of those instruments when done unnecessarily.
The experience of this writer has led to the conclusion that over-much instrumental methods used on the prostate is not the proper procedure.
The chemical irrigations required in gonorrheal infection are helpful in the acute stage, but continued applications are harmful. The urethra has a sensitive membrane and the continuance of the administration of potassium permanganate solutions after the gonococcus is eliminated will cause persistence of urinary shreds and damage the urethra.
The writer is not very enthusiastic about the introduction of solid instruments of any kind, such as solid or hard electrodes. Of course, there are those who insist these are sometimes necessary for drainage. But, poor drainage is seldom if ever solely a matter of the follicular opening into the urethra, and stretching this minute aperture would not stretch the deeper portions of the follicular canal and thus cause the follicle to drain. Except in acute gonorrhea, and possibly, in what has been called descending prostatitis, the posterior urethra is a mirror to the prostate and it becomes normal because drainage of the prostate by massage reduces its activity as an infective feeder to the canal. Such chemical and instrumental treatment probably does not harm the prostate but it often harms the urethra. It is decidedly like trying to patch a ceiling harmed by a leak in the roof and doing nothing about the leak.
It takes a long practice for some to grasp the idea of finger tip examination, while others see its significance at once. A careful reading of what follows will convince the most skeptical that a little practice is all that is needed to make one proficient.


 
Classification of Prostatic Diseases


SYMPTOMATOLOGY, DIAGNOSIS AND TREATMENT


 In the beginning of this section we think it would be well to state how the general masssage treatment is given and when some special form of physical therapy is indicated. That will be given and explained under its proper heading. There is no doubt that massage is the ideal and rational therapy for the majority of prostate troubles. It empties the ducts. Improves the circulation and tends to cause absorption of inflammatory products. For this procedure the patient may lie on the back with the thighs flexed and separated, or he may lie on his side. But the best position we have found and which allows of better drainage is the knee chest position. We will designate the general massage, Light and Heavy. Before giving the massage, a cot of absorbent cotton should be affixed, or tied over the penial meatus to absorb the residual thrown out of the prostate by the massage. This should be inspected after every treatment to see the effects of the treatments. The longest finger, covered with a rubber finger cot well lubricated, is then inserted in the rectum. The gland should be rubbed from the periphery toward the urethra, that is, pressure rubbing is made, first, on one lobe toward the center and then on the other, finally on the medium lobe, to evacuate the ducts into the urethra. See Fig. B. If strong, eight pound pressure is used a few strokes on each lobe is sufficient, if but gentle force is used each lobe may be stroked for one minute. The force used may have to be gradually increased according to the effects noted on the absorbent cot over the penial meatus. Brief massage and treatment of the seminal vesicles may with advantage precede all prostatic manipulations. The procedure should seldom be carried out oftener than two or three times a week. It may be continued until the symptoms have abated and the purulency of the drained fluid largely or entirely lost. Prostatic massage is contraindicated in acute inflammation of the prostate, vesicles or urethra, but given on abatement of the acute condition.
There are many types of electrical equipment advanced as being of great value in the treatment of prostatitis. But after years of experience we have discarded all those that require electrodes or any hard substance pressed against the prostate. Once in position, these electrodes may do a great deal of good. But in placing of them in position, and the pressure of the instrument while the patient is lying down may have an injurious effect upon the prostatic tubes, ducts and urethra. Diathermy, Galvanism, sine wave and short wave we used by the indirect method rather than direct. Finger massage, with hydrotherapy, and short wave as adjuncts, we now consider to be the ideal method in the majority of cases of prostatitis.


RELAXATION OF MUSCULAR TISSUE AND PAIN CONTROL


 Before treatments are given to the prostate gland the muscular tissue of the lower abdomen may be relaxed with a great deal of benefit to the patient. It is not absolutely necessary, but, it does, in some cases hasten the recovery of the patient, especially those who have an abdominal ptosis. Many forms of tension relaxation have been taught and are practiced. After a trial of many of them, the writer has come to the conclusion that the following are of the best. However, no matter the method used, the importance of relaxation and the raising up of the lower abdomen in prostatic treatment cannot be overlooked. The first step we list in this process is to give what we call the Pneumo Tapotment Technique. A medium size vacuum cup is placed over the os pubis, inflated, according to the resistance of the patient, or until it hurts a little. Then the physician, putting his left hand on the lower side of the cup pushes it upward as far as possible without giving pain. After the position of the cup is fixed and held there, then with the fingers of the right hand the physician taps all around the abdomen not covered by the cup. These taps are very light, but the whole abdomen should be covered. It is best to do it in circle fashion. The cup is then put on right and left groin respectively and the tapotment repeated. The time spent on this at the first treatment should not be less than 15 minutes, and should be repeated at least every two weeks, if the patient is given the prostatic treatment twice a week. If a vacuum cup is not available, the relaxation treatment can be given by using just the left hand as a substitute. For the two-hand technique; start with left hand cupped above the os pubis, raise the tissue up as far as possible, then with the fingers of the right hand, tap the abdomen, going in circles and covering all the abdomen not under the left hand. The left hand is then brought to the left and right groin respectively and the circular taps are repeated. The tapping must be very light. This relaxation treatment if performed properly, need only be repeated every two weeks.
PAIN CONTROL — The theory of pain control comes under the old principle of counter irritation and inhibition. In the first theory, the circle of nerve circulation is the prime factor. That is, the body is a unit, that nerve, blood and lymph all have a complete cycle in distribution and circulation. The sensory impulses of pain starting at any part of the body travel to a nerve center or to a center in the brain and then to the opposite side center of the brain, and its circulation is completed on the opposite side in the peripheral nerve ending in the corresponding location. To test this out, the next time there is suspicion of appendical involvement with swelling or tenderness and pain try counter irritation by the cups or hand pressure or tapping on the exact location of the opposite side.
When giving the heavy pressure treatment to the prostate, if massaging the right lobe, press heavily on the opposite side of the anus. Hold all the while pressure is being used on the right lobe. When on the left lobe reverse to the other side. When on the median lobe, just above the massaging finger.
Inhibition to some extent can be created by pressure on the constrictors to the prostate. The first, second, and third lumbars. This is done by deep pressure in the gutter of the spine on the opposite side of the lobe being treated. If working on the right prostate lobe, with a finger of the right hand, the fingers of the left hand are pressed hard, at the same time, in the gutter of the spine on the left first, second and third lumbar segments.
After treatment of the prostate is completed, it is usually a good thing to stimulate the vaso Dilators to the prostate by vibration or friction of all the sacral segments.
Adjustments of the cranial sutures underneath of which are the anterior and posterior pituitaries can be adjusted once every two weeks for psychic and hormone relaxation, or stimulation as necessary.
The beginner should go easy the first two or three treatments and study the reactions of their patient, and gain by experience how much pressure to use. However, the exudate found on the penial cot can always be used as a guide to the amount of increased pressure to use.
The abdominal relaxation technique should precede all the prostate techniques, and the pain control technique whenever necessary.
There are those who advocate as strong a pressure as possible on the prostate. We heard a physician say: “Give them the works for all your worth” and then proceeded to give at least a twelve to fifteen pound pressure in spite of the screaming and howling of the patient. It must be remembered that drainage is the aim and not the crushing to pieces of the organ.
Look again at the cut showing the contents of the prostate from the superior to the inferior urethral crests, see Figures A and B, and the possibilities of causing strictures, elongations and congestions in the ejaculatory ducts and urethra, that greater chronic pain after than before the treatment can be experienced. If a patient is from far away, and cannot be treated but once or twice before leaving town, it may be justifiable to use a ten pound pressure with great care, and, also using the abdominal and pain controlling techniques.
Our classical Formula for the first treatment is as follows: First, a thorough examination. Second, no matter what the condition, give the abdominal relaxation treatment. If massage is indicated, along with the massage we give also the pain control technique. At the first treatment we sweep the fingers over the whole prostate five times with a four pound pressure ending up on the middle lobe holding for one-half minute. Then we deposit a rectal suppository of garlic composition which will have value in reducing inflammation, relieving pain and restoring normal tissue. It is better to replace the suppository in the center just at the base of the prostate, than just depositing it anywhere in the rectum. An appointment is made for the following day or not more than forty-eight hours later. The finger technique is then begun in earnest The finger is then inserted and a six pound pressure is exerted on the left and right lobes, with a sweeping motion toward the middle lobe. This motion is carried out five times on the middle lobe. This motion is carried out five times on each lobe then the middle lobe is pressed for half a minute with a four pound pressure in a rotary manner, from right to left, after which another suppository is inserted and the patient told to come back in a week. Our treatments are on the average of two a week until complete relief is obtained. After two treatments, suppositories are used once a week.
The vesicles often need to be treated for the reason that, when congested or inflamed they have a profound influence upon the virility of the patient and also on his psyche. He is the type of patient the doctor will put down as a neurasthenic, and his wife and others will say: “It is all in your head.” Let the patient think that it is a combination of Neurasthenia and physical symptoms and treat the vesicles at least once every two weeks, if necessary. The treatment for Vesiculitis is found in Chapter I. It was thought best to put the technique there to avoid confusion in this Chapter.


 
ACUTE PROSTATITIS


 Here the gland is enlarged, tender and there is deep seated pain accompanied by a sensation of heat and weight in the perineum. The desire to pass water is frequent, and micturition is painful, particularly at the conclusion of the act. Defecation is painful, and digital examination of rectum reveals a hot and tender swelling of the prostate gland. Usually a muco prostate. The perineum is also hot and tender. The patient cannot sit comfortably, and supports his weight upon one buttock to avoid pressure upon the perineum. If suppuration occurs, as is often the case, the pain becomes more marked and of a throbbing character, the perineum becomes red and edematous, retention of urine may occur, fever is present, and there may be a marked chill. The abscess may discharge through the urethra, rectum, or perineum. Generally the condition is regarded as a result of gonorrhea, but traumatism, urethritis, strictures calculi and cystitis may also be causes. Treatment same as in acute gonorrheal prostatitis.


 
ACUTE GONORRHEAL PROSTATITIS


 In these cases the symptoms of acute posterior urethritis will have preceded the prostatic involvement for days or weeks. If the prostate becomes involved in the course of a chronic posterior urethritis, there will be a history of an old uncured gonorrhea with acute excerbations. In this latter group the exciting cause may be prolonged sexual excitement, coitus, acute alcoholism, overfatigue, the passsage of a sound, or other source of local irritation. The involvement of the prostate is indicated in severe cases by a chill, a rise of temperature, and a rapid pulse, prostration, and other septic symptoms. Such an onset usually indicates that the process will end in suppuration. From my own experience in cases of prostatic abscess the original septic symptoms, including fever, often subside in a few days, though the abscess is still developing. The general symptoms of constitutional depression are usually marked. In several cases I have observed great mental depression, amounting almost to acute melancholia. Locally, the patient will complain of increased frequency of urination, of a sense of weight and fullness in the rectum and perineum and of pain in the sacral region. Defecation is painful and the sensation of a large foreign body in the rectum is present. Urination becomes more and more frequent, painful and difficult. If a large abscess forms, retention of urine is the rule. Rectal palpation reveals the prostate much enlarged, tender, hot and throbbing, and either hard or elastic. The abscess may be confined to a single lobe, or involve both sides of the gland. If the abscess ruptures, its contents may flow into the urethra, the ischiorectal fossa, or burrows along the urethra and perineum, or into the rectum, rarely into the bladder. Rupture into the urethra may occur during the straining efforts to urinate, or as the result of passing a catheter for the relief of retention This will be indicated by the discharge of considerable pus with the urine, sometimes also from the meatus independent of urination. Rupture of the abscess is followed by marked relief from the symptoms. By rectal massage, pus in quantity may sometimes be pressed out of the abscess cavity, and made to appear at the meatus. If the opening is small, it may close or drain imperfectly. In this event septic and painful symptoms may recur, sometimes with the formation of new and more serious lesions, and as long as the abscess cavity remains unhealed.
TREATMENT: Absolute rest in bed and liquid diet. The bowels should be kept loose to avoid the pressure of hardened feces upon the inflamed prostate. Hot hip-baths sometimes cause a marked diminution of the pain. If the pain is intense an ice bag can be applied to the perineum, or an alternating douche of hot and cold water from a spray in the bathtub have been found very helpful for relief of pain. Water applied in this manner has great therapeutic value. Short wave is helpful to a great degree. Massage is not indicated, neither is any hard substance projected into the rectum until all acute symptoms subside, and then light massage can be given twice a week. Should severe retention of urine occur the catheter may have to be used. See Chapter on Catheterization. In the acute condition which does not subside in from three to ten days, the physician is faced with some faulty conduct of the patient. Either he is disobeying order about diet, alcohol or sex relations, and he may be using some drugstore preparation on the side. For a urethral wash via the meatus—one drop of 120 VM in one-half ounce of water can be injected by the patient by use of a small syringe, four times a day. In starting prostatic treatments some urine should be left in the bladder. Several light strokes should be given from above downward. First on the lateral lobes, then ending with the middle lobe. This can be done several times a week if no recrudescence of symptoms occur, and if they do not occur, the full treatment after a few days can be given as outlined in the beginning of this chapter.
A fast for a day or two of milk or skim milk is of great value in favoring diuresis. A glass of milk every two hours, after which a light food diet is given until all symptoms subside. All the mild, alkaline drinks desired should be given. Sexual intercourse is entirely forbidden as well as the use of alcohols, spiced foods, etc., for some time after the acute symptoms subside.


 
CHRONIC PROSTATITIS


 Chronic prostatitis is a low-grade inflammation of the gland. It is always of long standing, may be associated with enlargement of one or both lobes of the prostate, a normal-sized gland, or a decrease in size of one or both lobes. It may be either specific or non-specific and may be due to any of the bacterial, mechanical, chemical or traumatic causes described. In this condition the ducts which lead from the prostate to the urethra become plugged with mucous pus and inflammatory products. The secretions of the prostate are held in the gland by these plugs, causing it to swell.
The patient with chronic prostatitis may have no symptoms for years, he may have the symptoms of any of the four groups mentioned above, or he may conplain of a dull pain and uncomfortable feeling in the perineum; a slight daily frequency of urination, six to seven times during his wakeful hours, and once at night; a slight burning on urination; a slight discharge, usually in the morning, during bowel movements, or when straining. This discharge is like the white of an egg in consistency and composition. There is a loss of sexual power and nocturnal pollutions may be frequent.
The feel of the prostate in this condition is varied and difficult, but as a general rule the lobes are smaller than in true hypertrophy, and larger than in atrophy. Yet one lobe may be larger than the others. If there are nodules particularly in the smaller ones, along with neurasthenic symptoms, and certain phobias, especially the fear of impotency, and with the symptoms enumerated above the diagnosis of chronic prostatitis can be considered certain.
TREATMENT: Every source of infection must be eliminated. The whole general constitution of the patient must be built up by tonics or tonic treatments. Psychiatry will play a big part in bringing about relief. (See book The Fundamentals of Applied Psychiatry, by the Author.)
The manipulative treatment will consist of three steps. (See Figures A and B). Note particularly the positions of the vas deferens as it turns over the epididymus then circles up the side and around the bladder to reach the sides of the vesicles. All of these must be treated in a case of chronic prostatitis. Light pressure can be exerted at the right and left of the penial crest, then moving up a half inch bringing pressure again. This pressure should be gradual but as deep as possible without giving pain. This is one of those conditions in which to remember that you are trying to get the prostate to function normally again. Do not squeeze out every drop of secretion from the prostate, but only enough to emulsify its contents and break up the congestion, and also to help the muscles regain their tone. In other words, massage in the same sense in which that term is used when applied to other portions of the body. Using powerful pressure on a sensitive prostate is like punching a man in the belly and calling it massage. Short Wave, Sine Wave without solid rectal Electrodes, Douches, Sprays and a liberal but easily digested diet all are helpful. But, it is the massage that emphasis must be placed on, and should be kept up for months until all symptoms are gone. Glandular substances may be considered as necessary.


 
HYPERTROPHY OF THE PROSTATE


 Patients suffering from enlarged prostate often come to their physician complaining that there is something in their rectum which will not pass. The more the catharsis and straining at stool, the worse the condition gets. This is produced by pressure of the enlarged gland upon the rectum. This may become so great that defecation is impossible at times.
A number of theories have been advanced as to the cause and nature of prostatic enlargement. A few of these only can be cited. These theoretical causes of prostatic enlargement are: A fibrous change from advancing age, sexual excess, ungratified sexual desire, perverted action of the testes, an attempt on the part of nature to counteract the pouching of the bladder accompanying its muscular degeneration, the change normal to advancing years, a chronic inflammatory process, a septic catarrhal infection, a new growth or tumor. There can be no doubt that many of these are contributing factors.
The process begins with a swelling of the smallest sac-like dilations composing the prostate gland. This is due to a retention of the secretion which, under normal conditions is periodically evacuated by ejaculations. This secretion thickens, and by infection from any part of the body pus and inflammatory products accumulate, and since none of this can escape, cysts are formed. As this cyst formation progresses the entire gland enlarges.
As the gland swells, it bulges into the rectum and into the bladder interfering with bowel movements and increasing the size of the bladder floor. This usually carries the urethral opening to or near the summit of the projection and lengthens the canal. It is therefore evident that the neck of the bladder and the prostatic urethra become deformed and retention of urine results.
Many different theories have been proposed to explain this phenomenon of retention. One interesting conception is that contractions forcing the urine toward the neck of the bladder thrust the obstructing prostate against this opening as a stopper closes a bottle. Another is that the swollen gland in raising the bladder floor forms a curve in the middle, or two pockets on each side of the bladder. Only the urine which rises above the level of these pockets is voided. That which remains causes the muscles to sag, thereby increasing the amount retained. Sooner or later this urine becomes infected and a cystitis results. The bladder muscles, in their effort to force out this excess urine past the obstructing prostate, thicken and develop a network of ridges called trabeculae. As the obstruction grows, the bladder becomes stretched and the muscles lose their tone. A point is reached where the patient is unable to void, save for a few drops, and these with great pain and burning. If there is a ptosis of the abdomen, hypertrophy symptoms re greatly aggravated. Before the symptoms of a true hypertrophy appear there is generally a preprostatic stage. It may come a number of years earlier, shortly after forty, and then either disappear or remain quiescent. At this time the patient has attacks of frequent urination, burning when passing his urine with perhaps some tenesmus and pain. As true hypertrophy approaches, the symptoms return in a more aggravated form. Urination is more frequent, the burning and tenesmus more intense, there is a sense of fullness and a feeling of pressure in the perineum and bladder, the stream is feeble and urination is difficult. There may be retention, dribbling or incontinence.
Frequency of urination is due to bladder congestion, irritability of the nervous mechanism of the bladder and urethra, over-activity of the kidneys, or to residual urine in the bladder.


SYMPTOMS

In fifty percent of the cases there is very little inconvenience, the patient merely being annoyed somewhat by nocturnal frequency of micturition. The stream is sow to start and falls feebly from the end of the penis. The last drops fall entirely without control. In fifteen percent of all cases the bladder cannot be entirely emptied, and residual urine collects. Frequently of micturition comes on, particularly at night, the patient has to get up often, the bladder never feels empty, and cystitis is apt to arise. The urine, at first acid and clear, becomes neutral and cloudy, and finally ammoniacal and turbid.
It contains bacteria, muco-pus, precipitates of phosphates and sometimes blood. Enlargement of the lateral lobes can be detected by a finger in the rectum, The patient should be examined by rectal touch at once. The amount of residual urine should be determined and the urine carefully analyzed.


DIAGNOSIS


 Night frequency is more significant as well as more distressing than that in the day time. In a man normally passing his urine four times a day and none at night, five times a day and once at night would be both a day and night frequency. If this same man urinated six times a day and three times at night, his night frequency would be relatively greater than his day, as he would only be going two more than his normal by day, but three more at night. Day implies the sixteen waking hours and night the eight hours for sleep.
As the patient is less active at night than during the day, the local circulation of the bladder and prostate becomes more sluggish. Congestion results, and the accumulation of smaller amounts of urine gives a feeling of fullness, and a desire to void. The change in posture, from a standing or sitting to lying alters the hydrostatic effect of the bladder. The intensity of these factors governs the number of times that a patient gets up. When night frequency first starts the patient awakens with a feeling of fullness and a desire to urinate an hour or so before his usual time of arising. As the trouble advances, this time will come two or three or even four hours earlier. Soon, unless he receives treatment, he may have an urgency to get up three times or every hour of the night. The constant passing of the urine leads to straining, causing congestion and irritation of the bladder and urethra. Acid urine coming in contact with the membranes creates a burning of those tissues. If excessive urea or crystals are present in the urine they make the burning much worse. The above symptoms along with the results ascertained by manual examination make the diagnosis certain. The finger feel of an enlarged prostate will be as follows:
In glandular hyperplasia the tumors or lumps in the lobes will be soft and the lobes will be warm. If muscle fibrous tissues are increased the gland will be symmetrically hard, cool and dry. In some cases one or two lobes will have muscular and fibrous enlargement while one lobe has a glandular hyperplasia.
The treatment largely consists of finger massage. We have found that after a few treatments that urination can be controlled. But here a word of warning. Patients are apt to stop coming to the doctor just as soon as he discovers he only has to get up once a night. He must be informed sharply that he must continue the treatments until there is no residual urine left in the bladder, and until the glandular hyperplasia, or the muscular and fibrous condition is reduced to normal, which may take from six months to a year, twice a week. If he does not do it his trouble will recur and recur in more severe form each time which will only result in an operation in the end.
There are many electrical apparatuses that can be used, and we have used them extensively, but apart from short wave we have not found them as effective as finger massage. For softening effect the garlic suppositories are par excellent. The physician can follow the usual course of massage as outlined in the beginning of this chapter. And lay special emphasis on what instruction for living as may be found under the chapter on instructions to the Patient. The daily use of the spray douche on the whole top of penis and underneath the testicles is of great value. The patient experimenting to find which gives the most relief, hot or cold water, or both, alternately. The hot water causes a relaxation and a dilation of the tissues. The cold and the force of the stream both causing reflex contraction of the congested blood vessels. In some cases hot hip baths for a few minutes each day are of service. Ichthyol suppositories may be prescribed. But we are sure if the finger massage is given intelligently and regularly a complete cure will be accomplished.


 
PROSTATIC CALCULI


 Stones in the prostate may be found at any age after puberty, but they are more common and larger in old age. They may be formed from prostatic secretion and become scattered throughout the substance of one or both lobes, or a number of these may become cemented together to form irregular or nodular concretion. Calculi may also form in the kidneys or bladder, and during their passage become lodged in the prostate gland. Calculi may cause enlargement, inflammation, destruction or abscess. The symptoms are frequently obscure. Pain is usually present. It may be felt only during and after urination, in which case it is sharp and pricking. It may, on the other hand, be a constant aching not connected with urination and sometimes relieved by it. In these cases it is a pain felt in the rectum, testicle, perineum, groin or thigh. Bowel movements usually aggravate the pain. Bloody urine is often present. In many cases there is a copious purulent discharge from the urethra. Frequent urination both day and night is a constant symptom. Small stones may be passed and occasionally difficult urination or retention are observed.
Prostatic stones may originate from one of two sources:
1. From concretions formed in the prostatic ducts.
2. From ordinary vesicle calculi which become impacted in the prostatic portion of the urethra. Such calculi may originally lodge in such a manner that a portion of the stone projects into the bladder. The continued growth by deposition of phosphates may cause such stones to become firmly fixed, so that a cutting operation may be necessary for their removal. Prostatic Calculi originating in the prostatic ducts are quite common in elderly men, though they rarely grow to a size larger than that of a pea, and sometimes do not give rise to any symptoms. We have detected them in the prostates of old men by means of X-ray pictures since they usually contain enough phosphates to cast a definite shadow. Yet, some of these patients made no complaint of pain but only of a heavy weight in the perineum. But, when these concretions multiply they may cause atrophy of the prostatic substance so that a considerable cavity is formed, containing numerous small stones, readily palpated per rectum, a grating sensation being imparted to the examining finger. When such calculi enter and remain in the prostatic urethra they produce the same symptoms as ordinary calculi in the same situation.
It is interesting to note the theories as to the etiology of stone in the urinary tract. Two of the most common components in urinary and prostatic stones are calcium oxalates and uric acid.
This theory was expounded for a long time, and that it was only a matter of excluding foods that contained those substances. Then it was found that uric acid was an end product of protein metabolism, and it was thought that by eliminating the proteins the cure was easy. However, people were found to have stones whose diet was free from any proteins, largely carbohydrates. Yet, diet does play a big part in the formation of stones. More because of substances lacking in the foods rather than the foods themselves. Chiefly among these was the lack of Vitamin A of animal origin.
Then, the following theory also will have to be considered as having an indirect bearing on the formation of stone:
Inflammatory bone lesions. Water drinking in which are lime deposits. Prolonged recumbency with infection. Excessive exposure to the sun’s rays. Injuries of the urinary tract. Diseases of the parathyroids. (See Chapter on Parathyroids in Endo-Nasal, Aural and Allied Techniques.) These theories are worthy of close investigation, but a discussion of all of them here would make the book too large for its purpose.
In prostataic calculi there is usually one or more of the following—blood, pus, bacteria, urinary crystals and sometimes a minute amount of gravel.
TREATMENT: Some have claimed that by Vitamin Therapy they have made it possible to dislodge the calculi and have it passed out. We have not been able to do so. Prevention of calculi by vitamins is possible, but the removal after formation and enlargement is another matter. Also, surgery is not always the answer. In most cases conservative treatment is the best. This applies particularly to small calculi. One should then proceed with the vitamins and plenty of drinking water. Light finger massage twice a week, with a careful watch being made on the different localities of the calculi. It is not wise to try to move them toward the prostatic tubes until weeks have passed and there has been time for reduction of their size. Hot baths are in order for pain, and one and one-half ounces of glycerin once a day for three day may be of benefit in emulsifying the calculi. If the glycerin causes flatulent distention an enema will give relief. Short wave will often give relief. Several cases have been reported that cod liver or olive oil taken over a period of several months, in addition to the prostatic massage, has caused the calculi to dissolve and be eliminated. But, should pain become unbearable, surgery must be considered.


CYSTS IN THE PROSTATE


 Cysts due to the blocking of the ducts of the gland gradually distend as the fluid accumulates. They give no symptoms when small, but large cysts press upon the bladder and rectum with characteristic symptoms. Retention of urine as well as radiating pains in the testicles and thighs may follow. A large cyst has been mistaken for a distended bladder. The contents of a cyst consist of thickened prostatic secretion, granular material and concretions. The treatment for this condition is the same as under Hypertrophy.


ABSCESS


 Abscess of the prostate may follow an acute prostatitis. It may follow smallpox, chicken pox, scarlet fever, measles, typhoid, or any acute infectious disease. The chief symptoms are a sudden chill, elevation of temperature, repeated attacks of retention, a constant heavy throbbing pain in the rectal region, sweating and a headache. If the abscess ruptures, the symptoms clear. It may, however, rupture and close again. In this case the symptoms will return. Such an abscess may rupture into several organs and structures, but the most common location is the urethra, then the rectum, perineum, etc. An abscess of the prostate should receive immediate treatment for unless it breaks spontaneously, or by the physical therapist, the condition will remain chronic. Treatment is the same as in acute prostatitis.


MALIGNANT GROWTHS


 Malignant growths of the prostate have many of the symptoms of hypertrophy. In the beginning, like all cancerous conditions, they are usually painless. For this reason the onset is insidious and the condition overlooked or neglected until great damage is done. Years may elapse between the first symptoms and the time when the patient goes to a physician for his first examination.
The urinary disturbances are usually the first symptoms to appear. Frequency, five or six urinations at night, exertion to empty the bladder, prolongation of the act of urination, a small, feeble stream, dribbling and finally retention. Incontinence may follow. Pain is not a part of, yet is made more severe in urination and defecation. The pain, once it starts, is a dull, constant aching which persists for months and years.
The pain will be not only in the perineum, but low down in the back, bladder, in hips and legs. The physician may be misled and treat for lumbago and sciatica. Bleeding takes place in about fifteen per cent of these cases, and for a short while after there is some relief. There is some constipation and sometimes intestinal obstruction.
In the majority of cases before the physician can realize the seriousness of the condition he has to deal with, the patient is beyond any possibility of cure either by manipulation or surgery. But in some cases there will be some physical signs that will aid in an early diagnosis. First when the finger comes in contact with the prostate it will feel knobby, and cold. If there are swollen, unequal and iliac glands, and a nodule or nodules in one of the glands, then diagnosis can be considered sure, and these cases can be referred to the surgeon.
In the majority of cases, however, the entire gland is soon involved, together with the prostatic urethra, the bladder, rectum, and seminal vesicles, yet the disease may run its course until death, including the formation of extensive secondary deposits in the pelvic and inguinal lymph nodes, together with metastatic tumors in the bones and other organs, without involving the entire gland. The original tumor may remain small, and even pass unrecognized.
Owing to the fact that cancer of the prostate occurs chiefly in elderly men, who are or might be suffering from enlarged prostate, and that the early symptoms of both conditions are similar, prostatic cancer often remains unsuspected until the disease is far advanced. Just how often cancer develops in the hypertrophied gland and what causal relation if any, exists between hypertrophy and cancer is still not definitely known.
For those who are beyond the scope of surgery, the physician will give as much relief as possible. Hydrotherapy and diathermy seem to fit in the treatment of these cases with the most effectiveness in giving relief.
If the patient can survive the ordeal, the grape diet regime may be tried which has been of great help to give relief. It is always best to have the patient where close supervision and watch can be kept over him.


ATROPHY OF THE PROSTATE


 This is a diminution in the size of the prostate. When the finger is inserted on top of it, it is flat and rather hollow in the middle, and its periphery has the feel of file-like ridges. This is particularly true of the elderly man. Arrested development of the gland is found in combination with other congenital malformations of the genital organs, especially the testicles. When one testicle has failed to develop, there may be a corresponding arrest of development in the prostatic lobe of the same side. Not infrequently, however, both lobes of the prostate are fully developed when one testicle is infantile.
Castration before puberty results in arrested development of the prostate gland. Castration after puberty is followed by diminution in size of the prostate. Castration at one time was supposed to be followed by diminution in size or atrophy of the hypertrophic prostate, and was practiced as a method of treatment for this condition. Reduction in congestion of the organ is produced, but it is no longer the belief that shrinkage of the enlarged organ takes place.
Atrophy may follow inflammatory diseases of the gland, such as acute or chronic gonorrheal prostatitis, tuberculosis, pressure from calculi or cysts. It is not infrequently present in long standing cases of stricture of the urethra.
Senile atrophy develops after the age of fifty, although cases have been reported in the fortieth year.
Frequent urination is the most constant symptom of atrophy of the prostate. The patient averages six to eight times during the day and two to six times at night. Occasionally there is great urgency and constant desire to urinate. Involuntary discharge of the urine at night is not uncommon, and in a few cases complete incontinence is reported. There is generally a loss of sexual vigor to a marked degree and sometimes complete impotency.
TREATMENT: In the aged, and those who have marked sexual weakness the prognosis to attain sexual vigor is very poor and great discretion must be used in making any promises. The aim of the treatment must be toward the most menacing symptoms. Light massage twice a week is in order. Short wave will have very beneficial effect.
Concussion of the lumbars and sacrals have been of great help. Sitz baths, or douche bathing are in order twice a week. If an abdominal ptosis is present a belt can be worn, and the posture corrected. A constant influx of blood and nerve force is the only way that atrophy of the prostate can be relieved, and nerve and blood circulation treatments can be given according to the methods practiced by the individual physician. Special attention should be given to anoxia and anemia. See Chapter on Anoxemia in book: Endo-Nasal, Aural and Allied Techniques.
Three outstanding features of this condition are immediately noticeable. First, a partial or complete impotency. Second, the constant urgency to urinate. Third, the effect on the physical appearance and mental fogginess of the patient as well as some unusual mannerisms. It would be well for the physician to read again the section on psychological impotency found in The Principles of Applied Psychiatry.


TUBERCULOSIS OF PROSTATE


 In tuberculosis of the prostate there is often a family history of this disease. An attack of gonorrhea frequently precedes tuberculous prostatitis, but it is often found in patients who give a negative history. Tuberculous prostatitis is generally due to an extension of the disease from elsewhere in the body. The predisposing cause may be anything producing congestion in the gland. Stricture, sexual irregularities or excesses, constipation and injuries are among the many possibilities. There may be complete absence of symptoms until the condition is well advanced—a strong argument favoring periodic health examinations. Frequent urination both day and night is often present. The urethral discharge which appears is not infrequently mistaken for a gonorrheal infection. Blood may appear in the urine as well as in the emissions at an early stage. In late cases the desire to urinate is constant, there is pain and burning along the urethra, great straining, and the painful discharge of a few drops of urine at each attempt. The patient is robbed of his sleep and rapidly loses flesh. All hygienic measures peculiar to tuberculosis should be observed. Plenty of sleep and fresh air and special food outlined for people afflicted with this condition. Tuberculosis of the prostate may be:
First, primary in the gland itself.
Second, secondary to tuberculosis in distant organs: namely, the lungs, the peritoneum, etc.
Third, the infection is secondary to tuberculosis of other portions of the genito-urinary tract. In the primary cases the infection may be tuberculosis from the start, or may be ingrafted upon a chronic gonorrheal prostatitis. The third group forms the most common type, the prostatic invasion being secondary to tuberculosis of the epididymis or of the kidney, the former being more common.


SYMPTOMS AND DIAGNOSIS

In the group of cases in which the tuberculous infection is ingrafted upon chronic gonorrheal posterior urethritis, the invasion with tubercle is not, as a rule, attended by any sudden change of symptoms. The patient gradually gets worse in spite of treatment, and examination of the prostate discloses a nodular enlargement, usually of one lateral lobe. In other cases bleeding from the prostatic urethra may first attract the physician’s attention to the probability of a tuberculous infection. In the cases not preceded by gonorrhea the patient usually presents himself, suffering from a chronic posterior urethritis for which there is not apparent cause. Gradually the signs and symptoms of a tuberculous lesion are developed.
In that group secondary to phthisis or tuberculosis of the peritoneum the symptoms of vesicle irritation, with pyuria sometimes hematuria, are gradually developed, usually when the patient’s general condition is already quite hopeless.
In the group of cases secondary to tuberculous epididymitis the presence of an enlarged, nodular, hard, usually painless epididymis upon one side is followed or accompanied by vesicle irritation, the appearance of pus and shreds in the urine, sometimes hematuria. Rectal examination discloses a nodular prostate.
The following are the data upon which the diaagnosis may be based. A tuberculous personal or family history. The presence of other tuberculous lesions, either distant or of other parts of the genito-urinary apparatus, notably of the epididymis. The extreme chronicity of the disease. The presence of tubercle bacilli in the urine. The utter futility of ordinary successful treatment. The fact that such treatment only aggravates the ssymptoms. The introduction of a sound or catheter and irrigation of the bladder is followed by an exacerbation of all the symptoms, but increases pain and frequency, a hemorrhage, an attack of epididymitis, etc. The irregular nodular enlargement of one or both lobes of the prostate. The formation of a tuberculous abscess or the existence of a tuberculous fistula as the result of such an abscess. The occurrence of one or more shaarp attacks of prostatic bleeding. These are the data whereby we arrive at the diagnosis of tuberculosis of the prostate.


PROGNOSIS


 The prognosis of prostatic tuberculosis is bad, though the course of the disease is very slow. Death comes from dissemination of tubercle, from exhaustion, from abscess formation with septic infection or urinary infiltration from kidney tuberculosis or from preexistent tuberculous lesions of the lungs. By hygienic measures, life out of doors in suitable climate, etc., cures are possible in a few cases. A few operative cures have been reported from incision and curettement of tuberculous prostatic abscesses. So far we have not been able to accomplish much with this condition except to give temporary relief. It is gratifying to know that not more than two per cent of all cases of prostatitis are of this nature.


Advice and Instructions That Will Help the Patient


 If there is an abdominal ptosis or the football belly, an abdominal belt is advisable. If scrotum is large a suspensory support should be worn.
Moderate exercise is essential, should be regular and never carried to the point of fatigue, sawing wood, playing golf or walking. A walk of two miles a day in the open, with periods of rest is one of the best exercises.
Clothing in winter time should always be very warm. Woolen underwear if the patient is over sixty years of age.
Sitting suddenly on cold seats is bad.
A flannel abdominal binder can be worn in place of a belt, but should not be removed until warm weather.
The diet. No man should eat any foods that, by experience he has learned disagree with him and aggravate the condition. All greasy foods, insufficiently cooked vegetables, heavy breads and pastries, raw vegetables such as radishes and cucumbers, excessive uses of salt or any condiments and highly seasoned foods have been found to aggravate prostatic conditions. A patient with a prostatic condition should never overeat. Sometimes a milk fast for one day a week has worked wonders. A four ounce glass of milk every two waking hours is sufficient.
Alcohol is a direct irritant to the bladder neck and must be forbidden. But, if a man is a daily drinker, consuming a certain portion each day, and a sudden stopping at once would shock his psyche, then he must be ordered to taper off the amount gradually until he can break off completely.
Sound, relaxing sleep for six to eight hours can be called sufficient if the daily toil is not that of a laborer.
Sexual intercourse should be a regular habit and should be at uniform periods and be preceded by love-making. If a man, whose natural ability for intercourse, is, say — once or twice a week, indulges himself two or three times that number and must use artificial methods of forcing an erection it will injure his physical life, especially his prostate and vesicles, and will also build up a mental fear of not being able to accomplish the act, thereby bringing about for the time being at least a physical or physic impotency, which, if continued, will lead to a permanent impotency.
The husband must be taught to know his natural rhythm, that is, know how regularly he can have intercourse without artificial stimulation. When he has found this out then he should never neglect to prepare his wife by caresses for the act. It takes but a little loving and mutual respect for husband and wife to come to a real harmony of sex instincts. When the act is being performed, he should come at once to its termination, fulfilling it agreeably and completely. He must be warned that in his condition any psychic suggestion may cause him to delay and become impotent for that particular act. He must also be warned that sexual excitement without gratification creates a further blocking and congestion of the prostate and vesicles doing a great deal more damage. If he wakes at night with an erection due to a full bladder, he should urinate at once and not attempt to break his regularity of intercourse. If the erection is due to a full bladder, an attempt at intercourse will result in failure, and possibly do him unrepairable damage. If a complaint is made by the wife, then the physician should ask husband and wife to come to his office where he can fully explain why such a procedure needs to be followed.
A hobby is particularly beneficial for those who have a morbid state of mind, and worry too much about their loss of vigor and stamina. The patient must be told that constant thinking about the matter only creates greater psychic inhibitions, and the more he can occupy his mind and bodyinside and outside of his business hours the less annoying will become the symptoms of the prostate gland. This hobby business is a “must”—especially for the retired man or the man out of work for any length of time. Constipation must be avoided, for it is one of the great causes of prostatitis, and direct cause of irritation to an inflamed prostate. But, the purgative or foods eaten should not be of such a nature as to cause a thin, watery evacuation, for that will cause burning and much irritation in the rectum if continued over a period of time.
For men who are overanxious in regard to sex relations, and it seems to affect their psyche unduly, Hormones or Vitamins A, B, E, E+ and F, can be suggested. We do not know whether these glandular or vitamin substances have any physiological value or not, but they do have a powerful psychological value which has been demonstsrated again and again in giving the man confidence that he can accomplish the act without undue worry or fear of hysteria.
Long automobile driving or riding must be restraicted to not more than one hundred miles, before a stop is made, and some stratching of the legs is made. Prolonged sitting, hour after hour is not conducive to a free flow of blood through the lower parts. When the patient has pain at home he should be instructed to do one of two things. Spray with hot water on the parts, or cold water, one or the other will give relief. Or, if the pain is on one side of the crest of the penis, he can press deeply on the other side, goin in deep under the penis and holding steady for one minute; then release for one minute. This should be repeated three times. If the pain is on both sides then this technique should be performed on both sides. Many of my patients have actually helped to bring about permanent relief in this way.


VESICULITIS


 DEFINITION: Any inflammation, infection or injury affecting the seminal vesicles. Diseases of these organs is rare, and even in most cases are associated with diseases of the surrounding genital organs.


SEMINAL VESICLES


 The seminal vesicles are two hollow organs lying above the base of the prostate between the bladder and the rectum. They are two inches long and one-half inch in diameter, lie transversely along the upper border of the prostate, and incline upwards, especially at the outer end. They are bound to the bladder wall by a layer of tissue of fascia, continued upwards from the back of the prostate. Each seminal vesicle consists of a coiled and folded tube which will stretch to about six inches in length. At the inner and lower end is the narrow duct which unites with the corresponding vas deferens to form the ejaculatory duct. The function of the seminal vesicle is to store spermatic fluid to which it adds a secretion of its own. The vesicle consists of a convoluted, blind tube, about four inches in length, having many lateral blind pouches and sacculi, inclosed in a thin, fibrous capsule, but loosely attached, and containing some muscular fibre. In health their lower thirds feel like two irregularly cylindrical bodies, of elastic, soft consistence, extending upward from the prostate, separated by the width of a finger.
One or both vesicles may be absent. The tests are commonly absent in the latter case. The vesicles vary much in size, not only in different persons but in the same individual on the two sides. One, usually the right, may be much larger than the other.
The secretion of the seminal vesicles consists of a viscid, opalescent fluid. It is usually seen intimately mixed with the secretion of the testes, i.e., spermatozoa. The vesicles probably act to a considerable extent as storehouses for the semen. This is shown by the fact that in a normal individual who has been continent for some time the vesicles can be more distinctly felt and their distention recognized by touch than if palpated soon after sexual intercourse.
Since the vesicles are the contiguous organs that seem to have a more profound effect upon the prostate than any other organ in a diseased condition, a little more detail will be given.


METHOD OF OBTAIING THE CONTENT OF THE SEMINAL VESICLES FOR PURPOSES OF EXAMINATION


 The patient passes his urine. The urethra is then washed clean with a mild salt solution and a few ounces are allowed to remain. The contents of the prostate are then carefully expressed by the finger in the rectum. A smear may now be taken from the meatus for miscroscopic examination. The patient now partly empties his bladder to wash out the urethra. The finger is then introduced into the rectum as far as possible, and the seminal vesicle is then repeatedly and firmly stroked from above downward on one or both sides. Some care and practice are necessary to drain the contents of the vesicles. The patient should bend his body over the back of a chair while the physician stands behind him. Since very firm pressure is needed against the perineum in order to reach the vesicles, the patient’s body should be solidly supported. The physician’s right forefinger is introduced into the rectum—he stands with his own elbow pressed against his own side, so that the weight of his body may be transmitted through the forearm and the examining hand—the same attitude, in fact, assumed in making a deep examination of the pelvic organs of women. The forearm, wrist, hand and forefinger should be held in a straight line, the third, fourth and fifth fingers sharply flexed into the palm. Palpation and treatment is made by flexion of the terminal joint of the index finger. Thus the weight of the physician’s body helps to invaginate the soft tissues of the perineum and by attention to these details one is enabled to reach a good deal higher. Some of the contents of the vesicles will usually appear at the meatus, and may be examined at once. If not, the patient empties his bladder, the liquid discharged is centrifuged, and the product examined under the microscope. As stated, spermatozoa will probably be found in moderate numbers. If, in addition, the fluid contains numerous pus cells, the seminal vesicle is inflamed. Search for gonococci should be made and if such be found, the fact will explain the obstinate persistence of chronic and relapsing gonorrhea in a certain proportion of cases. For a treatment of the vesicles, the same position is assumed as above by both physician and patient; when the vesicles are reached they are massaged downward, lightly the first time, then a little harder each week.
Some of the conditions that can afflict the seminal vesicles are: Gravel or concretions in the older men, that give rise to spermatic colic. The treatment for pain can be a hot rectal douche, or diathermy or short wave. Light massage is helpful. If pain is severe and continuous surgical interference may be necessary.
Acute and Chronic Vesiculitis may be due to result of gonorrhea, or some other organisms. The symptoms of the acute condition are: An uneasiness in the lower belly, then at the beginning of suppuration painful and frequent micturition, very painful defecation, and pains in the anus and rectum, perineum, and hips or back are likely to be complained of. Priapism and bloody ejaculations may be noted. True abscess formation is rare.
The vesicles on palpation from the rectum at the sides of, and behind the prostate are found enlarged, tense and very tender. The treatment must be then of a general nature, for removal of infection from all the genitalia.


EPIDIDYMITIS


 DEFINITION: An inflammation of the epididymis, which may be syphilitic, tuberculous or of gonorrheal origin.
The testes, two in number, are suspended in the scrotum from the groin, or inguinal region, by the spermatic cords. The left testicle hangs somewhat lower than the right in the majority of cases. Each gland consists of two portions, the testis proper and epididymis. In each testis are from five to seven hundred little tubes, or tubules. The spermatozoa after being developed in these tubules are transmitted through the epididymis to the vas deferens. Thence, at orgasm, they reach the urethra through the ejaculatory duct. This duct is formed by the conjunction of the vas deferens and a narrow duct coming from the corresponding seminal vesicle. The testicles are subject to injuries, infections, torsions, congestions and many other conditions which can have a direct influence on the prostate. Hydrotherapy measures are the best treatment here. A torsion of the epididymis can be adjusted by the fingers, by twisting it to its proper place. Then strapping it.
SYMPTOMS: These are the inflammatory type — tenderness along the cord, hard swollen vas, and pain in the back. The testicle rapidly swells, and becomes exceedingly tender, the patient walking with a stooping posture and the legs wide apart. When the inflammation is at its height general malaise, anorexia and fever of 100 degrees or over may be included in the clinical picture. On examination the tenderness and swelling will be found confined to the posterior part of scrotum.
TREATMENT
HYDROTHERAPY: Rest in bed with the scrotum elevated. Hot fomentations, if pain is not too great. In that case an ice bag can be used, but it should not be used too long, because it will devitalize and cause a hardening of the part. When pain has eased it should be removed. Hot sitz baths are helpful. Spraying with hot water is very beneficial.
ELECTROTHERAPY: If of gonorrheal origin, the diathermy fever methods of treatment can be said to be the best. Infra-red eminations are helpful. Surgery is sometimes required.


ORCHITIS


 DEFINITION: An inflammation of the testicle caused by gonorrhea, mumps, tonsilitis, tuberculosis, syphilis and traumatism.
SYMPTOMS: Dull, sickening pain, radiating towards the hips and back; the testicle rapidly swells, but retains its ovoid form. Occasionally an acute hydrocele develops, and as a result there is an increase in swelling and pain. Occasionally suppuration takes place.
DIAGNOSIS: Orchitis must be distinguished from epididymitis, which can be readily done by noting the position of the tenderness, this being posterior when the epididymis is involved.
TREATMENT: Short wave, ultra-violet ray lamp or by vacuum tube diathermy and infra-red may be used. The old time hydrotherapy procedure was to put hot applications on saturated with laudanum and lead. Rest is absolutely essential, with good nourishing food and plenty of fresh air. Cod liver oil with vitamins included of either A-B or C-D.


RETENTION AND CATHETERIZATION


 Retention of the urine may become so great that it will distend the bladder to such an extent that its upper border will reach almost to the level of the umbilicus, before the help of a physician is sought.
Instruments to overcome retention should be used only as a last resort.
The patient should first be given a hot douche bath. That is, hot water should be sprayed on the penis, testicles and bladder region, or given a hot sitz bath, to see if the tissues will relax and allow the urine to pass. A non-drug diuretic can be given. A low hot enema may enable the patient to relax the bladder sphincter while emptying the lower bowel. Some have found that by injecting warm glycerine into the peneal urethra then massaging it upward toward the bladder that relief has been obtained. After all these methods have failed then catheterization is in order.
Three important rules should always be kept in mind: First, clean hands; second, clean instruments; third, gentleness in the operation. Clean hands and clean instruments are necessary to avoid sepsis. Sepsis may also come from the patient himself. (See under Infection.)
In an emergency, after the previously mentioned methods have failed, the next best thing that can be done is to give an irrigation of the peneal urethra through the meatus by a fountain syringe or a hand syringe. A teaspoonful of boracic acid to a pint of warm water, after which a short rubber catheter is passed into the bladder and the urine is drawn off, the bladder then is irrigated with half the solution mentioned above, some of which is left in the bladder. When sepsis is very important, we are of the opinion that gentleness in introduction of the catheter is more important. We are inclined to the belief after careful observation that there is more danger from injury than from sepsis.
If it is at all possible to get some one who has had experience in this technique it is wise to do so and observe carefully the technique. But, emergencies do sometimes arise in which there is no time to delay, lest uremic poisoning set in and which may have a fatal termination. In that case the general practitioner must do his best, always aware of sepsis and gentleness.
Now, most men may be catheterized easily with a soft rubber catheter which is the safest with less risk of injury. The latex catheter is the best for this purpose. If you will recall that under hypertrophy of the prostate we mentioned that sometimes the prostatic urethra was enlarged by pressure. This enlargement may make it difficult to get the catheter into the bladder; this condition may make it necessary to use an especially long one which has a bend near the end and to use the largest size in diameter than can be introduced into the urethra. However, try the smallest size at first and sufficient urine to relieve the acute symptoms is allowed to escape. Then the catheter is withdrawn. After four or five hours if the patient feels the desire to micturate and cannot, then the catheter is reintroduced, and a larger quantity is drawn off. We are here writing of only one phase of retention of urine: The prostatic urethral.
Retention of urine may be due to an obstruction at any point of the channel of outflow:
At the neck of the bladder, as a result of an intravesicle tumor of hemorrhage filling the bladder or of pressure from without caused by pelvic tumor due to enlargement of the gland.
The result of senile change, malignant disease, calculus, or abscess formation in the membranous or penile urethra owing to the formation of a stricture (whether traumatic or inflammatory); or, from occlusion by an abscess at the external meatus at any part of the urethra, as the result of the impaction of a vesicle calculus or of a foreign body.
Retention may be due, however, to non-obstructive causes, such as tabes dorsalis, hysteria, lesions of caude equina and reflex inhibition.
The course of the more common lesions which produce obstruction to the outflow of urine are slowly progressive, senile, enlargement, or atrophy or some chronic condition. When, however, the lesion is complicated by inflammation or vascular engorgement, as may be produced by a drinking bout, or excessive exercise, or a long period of sitting on a saddle, acute retention may supervene.
It is necessary, therefore, to obtain all possible information of the previous history of the case so as to ascertain whether there has been any difficulty in passing water or any reduction of the stream, such as might be expected in the case of a stricture, or any frequency of micturation, particularly at night, which would suggest prostatic enlargement, or a discharge, if recent and profuse, due to an acute urethritis. The age of the patient, the acknowledgment of venereal infection, or history of injury must all be taken into account.
In cases of stricture, a large gum elastic catheter is used, and when the catheter is stopped the point of stricture is known. Then, smaller catheters can be used. If the stricture is finally passed by a very small catheter this is then tied in place and left there for about ten hours.


TECHNIQUE OF CATHETER INTRODUCTION


 The catheter having been well lubricated on the tip with a water-soluble jelly and made slippery, the water-soluble jellies are more easily removed from the genitals than oils of any nature. Now that the catheter has been sterilized and lubricated, stand on the right side of the patient, who is flat on his back with legs spread apart. Gently stretch the penis forward with the left hand until it has reached its limit, slightly toward the left groin, then insert the catheter with the right hand into the meatus. After this is done, the penis is brought to the center and held directly upward. Now, with little force, if any, slide the catheter down the urethra as far as it will go. If obstruction is encountered do not use force of any nature without turning the catheter from the side line to the middle, then try to slip it past the obstruction with very little force; if this is not possible, turn the catheter gently, completely, around if necessary. The bladder will be entered as the shaft of the catheter becomes horizontal. The possibility of urethral shock must always be kept in mind. It is more apt to occur in the aged than young men at the first attempt, and particularly in those who have enlarged prostates, especially if metal sounds are used. This shock is due to a rapid emptying of a chronically distended bladder, which causes a fall of blood pressure averaging 40 mm. of mercury in the first twenty-four hours, and that in 60 per cent of the cases there is a further fall averaging 17 mm. in the next twenty-four hours.
The greatest peril lies in the removal of the first few ounces of urine, there being a fall of twenty-five per cent in the travesicle pressure with the removal of one ounce, and an additional fall of twenty-five per cent with the removal of the succeeding one to three ounces.
It is possible that a continued fall in pressure cn have a fatal termination. While this outcome is always possible, it can be avoided with proper care, in not allowing the bladder to be emptied rapidly but drawing one ounce at a time. If, after the first catheterization is a success, and the bladder has been evacuated slowly and further catheterization is necessary after a wait of a day, then the catheter can be placed in a position and tied to remain for a number of hours at a time.


WHEN IS SURGERY INDICATED


 When is surgery indicated? Prostatism is a progressive condition, which, if not relieved by treatments, leads to a fatal termination. But, surgery has prolonged the life of many men for years and years, some of whom have been able to exercise the sex function occasionally, but with hardly any satisfaction. The author has always considered it wise to have the patient consult a urological surgeon immediately after the second attack of retention of the urine. From that time on the patient has the alternative of operational relief, or a catheter life. The catheter life is a short one—not more than two to five years at the most. There may be some who by great care and natural living extend the period to a year or two longer, but they are few in number.


Diseases of External and Middle Ear


TRAUMATIC PERFORATION OF THE DRUM MEMBRANE


 ETIOLOGY: Injuries to the drum membrane may be caused by blows on the ears, by attempts to remove wax, or stop itching by various instruments by the person himself, or by a physician who fails to remove the object properly and skillfully. Too forcefully blowing the nose has been known to break the tympanic membrane.
TREATMENT: The less done for this condition the better for the patient, other than wiping out what debris and putting a wad of cotton in the ear and wait for any results, often there is no impairment of hearing whatever.


DISEASES OF THE EXTERNAL AND MIDDLE EAR


 The writer suggests to the reader that in addition to what follows, he should read pages 38, 50, 75 to 85 in Endo-Nasal, Aural and Allied Techniques Book by the writer. The diseases of the Auricle are many. There may be congenital or acquired malformations. These, if treatments are needed require the services of a surgeon. There may be inflammations of various kinds, one may be frost bite. The condition can become serious, varying from hyperemia to ischemia, and in some cases gangrene and death of the tissue. The treatment may be gentle massage. Application of snow to the auricles. If heat is available it should be applied gradually. The vacuum cup is also of excellent benefit, using discretion and the proper sized cup.
Erysipelas of the ear is the same as found in other parts of the body, and the discussion of it is contained in another part of this book under that title.
ECZEMA: This may be an extension of eczema of the face. The disease may be acute or chronic, moist or dry and may have the following forms — erythema, papules, vesicles and pustules. Symptoms may be weeping, fissures, crusting and scaling, in the severe form there may be pyrexia and swelling. The chronic form has a tendency to recur.
ETIOLOGY: This is usually constitutional, such as digestive disorders and malnutrition or a deficiency of all or one or the other vitamins of B, G, A and D. Rheumatisms, gout, rickets, anemia, and a host of other constitutional causes may be mentioned Some other causes are emotional, occupational and allergic disturbances. If there is a discharging ear, it may or may not play a part in the production of eczema of the ear.
TREATMENT: The treatment is largely constitutional. Find the cause and remove it. Tonics, diets, vitamins are all in order. The local treatment — moisture and irritation should be avoided as far as possible. Ultra-Violet from a cold quartz has been found effective by producing a second degree erythema, and repeated in a few days after the erythema has subsided. Sometimes in the moist type a non-vacuum electrode connected to the Audin pole of the high frequency machine and applied with slight pressure will give the best results. It is helpful to sprinkle the part with zinc stearate powder for it is antiseptic and allows the electrode to move freely over the part.
The above treatment may also be used in shingles and variola of the Auricle. One good addition to the above therapeutics is to have the patient clean the Auricle daily with a 50-50 solution of lemon juice and water. The above is in addition to treatment of the underlying cause.
Neoplasms, Cysts, Elephantiasis and Malignant tumors in and around the auricle usually require the services of a surgeon if they are troublesome.
FOREIGN BODIES IN THE EXTERNAL CANAL: The symptoms may be mild, or severe, according to the type of obstruction and location. There may be slight impairment of hearing, a fullness in the ears. They may be tinnitis, dizziness, itching and reflex coughing from irritation of the auricular branch of the vagus nerve. A good autoscope will reveal the type of the obstruction, which may include seeds, pencil points, impacted cerumen and some decomposed material. At times insects will get into the canal and cause great annoyance. Pouring some hydrogen peroxide into the canal will get rid of the insects. If not, then the use of the ear syringe is required. For removal of impacted cerumen and objects the following methods may be tried. If there is pain, heat of any kind applied first will give relief Then, warm wter should be used in the syringe first, followed by hot water of about 105 degrees F. The water is projected up over the object to be removed. A cup of some sort is held under the lobule, and a towel is put over the shoulder. Oil solutions of various kinds, or boric acid solution may help soften the mass. A small, smoothly working piston syringe is to be best recommended, with a small tip that will enter a little way into the canal without obstructing the view. Always, and ever, there should be care not to injure any of the hearing apparatus. Please turn to your Endo-Nasal Aural and Allied Technique Book, page 80, in the Fourth Edition and page 107 in the Third Edition for complete instructions.
Furunculosis or boil in the External Auditory Canal: The ear is rather susceptible to these boils, especially in debilitated persons. It may occur in the summer time, from swimming, or at any time from scratching the ear with foreign objects to relieve itching; causing a breaking of the canal membrane which becomes infected. They also may be caused by the same constitutional conditions that cause furunculosis in other parts of the body. The main symptom is extreme pain which is pulsating in character, due to the pressure of the narrow space for the development of the boil. The pain is increased by talking or moving the jaw or while eating. The temperature may rise a few points. The diagnosis can be fully established with a good autoscope. The treatment consists of two parts. First — to control the pain, then to remove the cause. Warm, moist compresses, continuously applied. Infra-red, with ear funnel, or a hot water bag or electric pad, can furnish the necesssary heat.
STENOSIS — or too narrow external ear canal may be helped by giving the Ear Fixation treatment, or continued dilation treatment with the little finger. Sometimes, a plastic surgeon’s services are necessary. If there is pain, heat in some form can be applied.
OTALGIA, EARACHE WITHOUT ANY IMPAIRMENT OF HEARING. — The importance of quick attention to any distress in the ear cannot be emphasized too strongly. It may be the beginning of an abscess in the middle ear, which if properly examined and treated may avoid more serious complications. Unless there is a deeper constitutional cause, most of the earaches come from swimming, or picking the ears with instruments that scratch the membrane or come in contact with the drum too forcefully. Too strong currents of air may strike the ears and set up a temporary irritation; mild reflex irritations from congestions in nose, throat, and the pharyngeal cavity may cause some symptoms of pain, or muscular rheumatic diathesis may be present. Every ear distress has a possibility of serious complications. Tympoil is highly recommended for pain. Roche-Renaud Pharmaceutical Company, Fairhaven, Mass. Radiant light heat and infra-red have been found to produce splendid results. Positive galvanism, which has been successful, is given by placing an electrode in the ear or a pad electrode behind the affected ear, with the negative pad on the opposite side of the neck Heat of some nature is necessary. After all the pain has been relieved, then Endo-Nasal Techniques can be instituted to remove the causes. See “Endo-Nasal Techniques.”


OTITIS MEDIA, ACUTE AND CHRONIC:


 Otitis Media Non-Suppurative. — Otalgia of this nature is usually of catarrhal origin, created by anoxia of the middle ear. The middle ear, in health consumes great quantities of air and oxygen. This air is supplied through the eustachian tube. If the nose and the pharyngeal cavity and the cavity of Rosenmuller have obstructions by mucus, ptosis, adenoids, or adhesions the entrance of air and oxygen to the eustachian tube is shut off, and the air in the middle ear is rarified. This causes engorgement of the blood vessels and in time a serious exudate is poured out which fills the tympanic cavity, causing the tympanum to bulge, giving pain on pressure. This exudate becomes purulent and infected by bacteria because of the lack of cooling by the germ-destroying elements of air and oxygen. The amount of pressure against the drum will vary according to the amount of interference with air passing through the eustachian tube. If the interference is slight there may be a low degree of congestion, which may pass off in a day or two. When the pain is exceptionally severe, the interference by congestion of ptosis of the eustachian tube is very great. If the congestion is not released then the otitis will go on to rupture or paracentesis of the drum membrane.
The doctor has before him three tasks: First, to relieve the pain; second, to create drainage, and third, to remove all obstructions to the intake of air into the middle ear. We are convinced that if rupture and paracentesis can be avoided by establishment of the above three healing proesses, the patient will in future years be better off if afterward an occasional Endo-nasal treatment is given.
PHYSICAL SIGNS: The signs of this disease are pain and throbbing with certain degrees in loss of hearing. Some have tinnitis, redness, and a bulging outward of the drum tympani with disappearance of all signs of the malleus except the handle.
Extraneous points of examination for possible infiltration of toxemic substances and obstructions are the teeth, tonsils, nose, pharyngeal cavity, carotid sinus block, the liver and intestines through congestion and constipation.
TREATMENT: The first step as we have noted before is the relief of pain. Methods suggested for otalgia are all useful. In addition, the standard remedy for this particular condition is phenol and glycerin. Glycerin has osmotic power and attracts fluid from the membrane, while phenol has antiseptic properties that relieve pain. A blending of five per cent of phenol and ten per cent of pure glycerin is the proper proportion. The patient lies on the side opposite to the affected ear. The ear is pulled down a little and the solution poured in. The patient is told to lie in that position for at least a half hour. This can be repeated as often as necessary. This solution should not be used in purulent discharging ears.
Radiant heat light has been advocated as the ideal treatment for otitis media. It is claimed it will lessen the earache immediately, and in most cases the membrane and canal will clear up in two or three days, the exudate will be absorbed, and the bulging of the drum disappear, paracentesis avoided and infection controlled. While we can see how the pain should be lessened by the heat, yet we fail to understand how the obstructions of a static nature can be removed by the radiant heat. This, as we see it, can be done only by finger or instrumental surgery. This brings us to the second desired result; namely, removal of obstructions and drainage. After all pain has subsided, every General Technique should be given, with special emphasis on the external and posterior nares, Eustachian tube and tonsils. Treatments for at least six to eight weeks, twice each week, should follow an acute attack, with diets and vitamins to suit each particular case.
ACUTE AND CHRONIC PURULENT OTITIS MEDIA: Otitis is a discharging ear with small or large perforation or with complete obliteration of the membrane tympani. Barring accidents and paracentesis, it is otherwise a sequence of acute catarrhal otitis media with rupture. In some cases the discharge may last only a few days or weeks and then cease. In others, it will continue intermittently or almost continuously for a long time, even through life.
The symptoms are easily recognized; the discharge and odor. The odor of discharge is not as offensive in some cases as in others, but so far as we have been able to judge the odor has no special significance in evaluating the effect of treatments or of the virulence of the disease Both the non-offensive and offensive seem to respond alike in a given time. Some never respond except by surgery, and few patients care to submit to the operation because of the risk of total deafness in the affected ear. Many patients and others who have discharging ears can hear rather well without aids of any kind if the discharge does not block the ear entirely. It often happens that after the ear is blocked for a day or two, the pressure of pus forces the block out and there is an overflowing rush of fluid for a few seconds. It is known that people have lived for a half century and more with this condition, and gotten along very well except for some annoyance from the odor. Surgical interference of course, should be suggested only as the last resort.
TREATMENT: The damage having been done to the tympanum by rupture or paracentesis, and to the contents of the tympanic cavity by pus and other exudates, the effort of the Endo-nasalist must be directed toward saving as much of the hearing as possible, and to the removal of the causes of the discharge. The causes can be stated briefly as anoxia of the middle ear and imperfect drainage. There also may be anoxemia, created by the anemia or ischemia of tuberculosis, syphilis, or diabetes. These latter complications make such cases almost hopeless, but the physician should try at least to bring about some relief.
Since this condition is generally a sequence of otitis media, it follows then that after the acute attack, sufficient drainage and airifying did not take place and there was a prevention of the recession into the lymphatics or open cavities of the catarrhal substances. Draining must now be established. To overcome the blocking and anoxia, give the full General Endo-Nasal, Aural and Allied Techniques, with specific techniques on tonsils, the pharyngeal cavity, and the Eustachian tube cavity on the side of the affected ear. All sorts of remedies have been offered for discharging ears, but none of them will amount to much unless the obstructions to the intake of air and oxygen are removed.
AIDS: To keep the ear clean, a light wash of two ounces of warm water with ten drops of lemon juice has been found very suitable. The patient lies on the opposite side to that of the affected ear. The solution is put in by a dropper. After a few seconds the patient turns over and floods it out. This is repeated until the solution is used up. Ultraviolet light from a water cooled lamp is of some value, but should not be employed until obstructions have been removed in the nose, pharynx and the cavity of Rosenmuller.
Zinc ionization has been reported to bring about very favorable results, both alone and as an aid to Endo-nasal Therapy. This technique and its contraindications should be studied thoroughly before the operation is performed. Efforts should be made by diets and exercises, especially of walking, to build up the patient’s resistance.


OTOSCLEROSIS


 This is a condition that is baffling to say the least. In a class room, our professor once remarked that otosclerosis is a condition about which the doctor is in the dark, can see nothing, and the poor patient can hear almost nothing, if not absolutely deaf. For a definition of this condition, we have searched the literature available, and all definitions are practically the same with some slight deviation in the use of words. The substance of them all is that otosclerosis is a spongification of the bony capsule of the labyrinth and fixation of the stapes due to ankylosis of the oval window, the membrana tympani are normal and the Eustachian tubes are of normal patency. It is easy to accept the first part of this definition relative to spongification, ankylosis and fixation, but difficult to accept the last part, in view of our experience. Most of these patients, on close examination, show some variations in color and contour of the tympanum, and a bulging of the carotid sinus area, which denotes a ptosis of the Eustachian tube.
Again, if the patency of the Eustachian tubes were true, it is extremely doubtful if spongification could have taken place. It may be true that the ear can be inflated and the sound can be considered to be that of the air going through the tube by force.
However, if there had not been an anoxia, thereby causing a rarefication of the air in the first place, no engorgement or spongification could have taken place. It is reasonable then to suppose that preceding the otosclerosis, there were toxemic infiltrations, stasis, exudates, and hardening due to a lack of free exercise of the Eustachian tube functions, and the assumption that the Eustachian tube is not fulfilling all its functions remain even after the disease has fully developed. The assumption also remains that the origin of the cause of auditory sclerosis is the same as sclerosis or arthritis anywhere else in the body. It is our practice in all cases of this nature to study thoroughly all signs of physical disturbances in the whole body. Intoxications from the intestinal tract, rheumatoid arthritis from excess calcium, use of drugs, tobacco and alcohol are all studied carefully. Anemia, local ischemia tuberculosis, and other symptoms which can produce anoxia and anoxemia are investigated.
Those who were not afflicted by heredity usually have a rather long history of congestions and colds affecting the nose, the pharyngeal cavities in particular. Extension of the congestion through the Eustachian tube to the middle ear diminishes the amount of air that normally should pass through the tube. Because of this diminished amount of air, the congestion begins to dry, a process which eventually affects the bones producing a hyperostosis with spongification and fixation of the ossicles.
SYMPTOMS: There is a gradual loss of hearing, but sometimes this varies, the hearing being better some days than others, especially if the weather is dry and clear, but trend is toward greater deafness. The membrane tympani is usually showing its normal luster, but careful examination will reveal some signs of congestion of the inner wall. Patients say they can hear better in noisy places; others say they hear the sound of the voice but cannot quickly distinguish the words spoken. This slow apprehension is due to the weight of the congestion on the inner wall of the tensor tympani. While in a noisy place, the weight of the external vibrations forces the congestion back of the tympanum to recede enough to allow the vibrations to go through. Noise and voice vibrations are blended, but by some inherent or developed faculty they are able to differentiate the sounds and interpret them one from the other. The patient will hear his own voice at a pitch higher than others, and if of a nervous temperament, he will be afraid of it and speak very low. It disturbs him to speak loudly because of the pitch in bone conduction and also from the fear he is yelling at people. Some overcome the fear and go to the other extreme, and they really do yell in conversation. Tinnitus is present in more or less degree and is worse at night than in the day time. Tinnitus, we have found, varies much in tensity according to the general physical condition and the temperament of the patient.
TREATMENT: This is a condition that involves the whole upper respiratory and auditory apparatuses. Therefore, all General Techniques should be given at least twice a week. Emphasis should be placed on external nasal, tonsil, and post nares drainage, with a thorough clearing away of adhesions, adenoids and toxic matters from the whole pharyngeal space, and an effort to get the finger in the fossa of Rosenmuller to massage and clear the auditory orifice. (See specific techniques on breaking adhesions and raising the Eustachian tube.) In addition to the above, every effort should be made to get more freedom in all the processes of respiration. It might be well to state here that we are decidedly opposed to the use of the Eustachian catheter both from personal experience and from reports that have reached us of some of the after effects. The technique is always painful and there is always great risk of some injury and even death. Should the point of the catheter make a break in the mucous membrane to the extent that emphysema is brought about, an obstruction to respiration may be so great as to cause a fatal anoxemia. We have experienced pain and distress for weeks after these operations without any beneficial results. Diathermy has proved itself of great value from reports we have received. The idea is that since diathermy is very useful in treating any conditions of fibrous connective tissue formations, or fixations of joints, it is reasonable to assume that it should act on the same principle in the middle ear. The purpose, then, of applying diathermy is similar to that of treating a joint. Absorption of calcified deposits may be affected to such a degree that function is at least partially restored. Diathermy increases the arterial flow in the part treated and augments the return circulation; intercellar tension is then altered and cellular acticity stimulated. Furthermore, it is fairly well accepted that sedative diathermy aids in the absorption of effusions, the softening of exudates and fibrous tissues, and in relaxation of muscle spasms. By giving the general endo-nasalist’s treatments and the few specific techniques as mentioned above, we believe we have the best approach to this problem, because of attention to the constitution as a whole. No. 1 and No. 2 diets, alternated day by day, for a period of a month or so, with supplemental vitamin therapy, especially that of the endocrine type, and some clear cut instructions to the patient on their habits of life, can be of assistance. Total deafness may be delayed, or hearing gradually restored to such a degree that the patient will not need to resort to lip reading or mechanical devices. It is wise to instruct the patient in living the positive life, or forming the habit in conversation of insisting on hearing distinctly what is being said before replying. This will in time rehabituate the functional faculties of reception and interpretation of sound waves. These are like any other portions of the body; if not exercised, they atrophy.
TEMPORARY FIXATION OF MEMBRANA TYMPANI AND THE OSSICLES: Very often patients will complain of a fullness in the ear with some sound as of wind coming out or going in. They complain of being dull of apprehension and also lack of alertness. Nothing seems to be wrong. However, a careful examination of the membrana tympani may reveal some slight deformities or variations in position.
Look into the ear of a normal hearing person who has not complained of any ear troubles worthy of note for some years. You will notice that the cone or membrana tensor is pearl gray and of transparent appearance. It is like a light in a cavern. The whole drum is oblique in appearance. Notice now the short process of the malleus located in the upper portion of the drum. In health, it is yellowish white. Then look at the long process of the malleus terminating in the lower middle of the “U” of the membrane at what is known as the umbo, or the funnel-shaped area of the drum membrane. Look carefully into the ears of several people of good hearing and you will notice some slight variations in color and light reflex; however, the variations are very slight, but all variations are of significance when a patient complains of pain. However, if there is a fullness felt and a slight lack of acuteness then we can regard it as a temporary fixation of the tympani itself and possibly a temporary fixation of the ossicles.
TREATMENT: A little heat applied in any form and then The General Endo-Nasal, Aural and Allied Techniques with emphasis on No. 4 and No. 5.
TINNITIS AURIUM — is discussed under the general topic of Meniere’s disease.


Deafness — General


 There are many kinds of deafness and many causes. Deafmutism is not considered here because it largely belongs to the field of education, and is a rather too long and complicated procedure for discussion in this book. It is a congenital or acquired deafness complicated by special inabiity that requires a special education of the person to make adjustments to normal living.
Deafness, as we define it here is the inability to hear sufficiently to carry on ordinary conversation. It is assumed under that definition that the person could hear well or fairly well at one time in his life and that as time went on the ability to hear was suddenly completely lost or gradually diminished to a certain degree of acuity. Accepting the above definition, the etiology may be stated as follows:
There is a deafness due to catarrhal infection. Endocrine disturbances, occupation, such as in noisy places of employment. Adhesions in and around the fossa of Rosenmuller. Cerebral deafness due to brain lesions. Ceruminous deafness due to impacted cerumen. Middle ear suppurative deafness. Ptosis of the eustachian tube deafness. Relaxation or a falling in or out of the ear drum. Pocket handkerchief deafness, or blowing nose too hard. Hysterical or psychological deafness, due to inattention, which in many cases is deliberate, or an involuntary reaction mechanism to escape some unpleasantness that has persisted long enough to become a fixed complex. Anemic deafness is quite common. Anemia and Anoxia of the ear structures. Throat deafness, those that are due to enlarged tonsils and other conditions that cause pressure on the eustachian tubes. Many other types are recorded.
TREATMENT: The treatment is divided then into three main divisions:
First. — Anatomical. The replacing of displaced structures, or enlarging of orifices.
Second. — The functional and physiological, giving the proper impetus to the nerves and blood stream through removal of obstructions, toxemias, and supplying the necessary oxygen and nourishment.
Third. — The psychic or mental; to determine whether general emotional tensions from the effort to avoid facing the difficulties of life have enough pressure to cause a restriction of activity on the ear drum, the ossicles, and the nerves to prevent proper functioning of the hearing apparatus.
In considering the treatment, all three must be taken into consideration. For methods of examination, see your Endo-Nasal Aural and Allied Technique Book, page 35, fourth edition, page 37, third edition. Also, “The Fundamentals of Applied Psychiatry,” pages 92 to 109. Also pages 115 to 128. No one form of treatment can be arbitrarily given, because each case of deafness is different in etiology and symptoms, except in those cases of the aged. However, a general finger treatment of the following type has produced some very beneficial results.
First. — The removal of all toxemias, habits, and other contributory causes. Then, removing pressures in the carotid sinuses of the neck by adjustments of the cervicals. By the jerking of the head upward, sometimes called the Lake Recoil, and it must be a recoil adjustment or pain will be caused. The recoil must be very mild, not rough or exaggerated. So important does the writer consider this technique that it is given in full here:


INSTRUCTIONS FOR PERFORMING THE LAKE HEAD RECOIL ADJUSTMENT


 Sit the patient on a low stool. Stand on left of patient, put patient’s arm back of him. The left hand of the doctor is then placed on the forehead of the patient with the heel of the hand on the frontal ridge of the nose, while the fingers rest lightly on forehead. No pressure should be exerted The right arm encircles head all around, bringing the fingers to rest lightly on the wrist of the left hand. Now the adjustment emphasis is made just over the occipital, lamboidal and mastoidal sutures, and in order for the fatty part of the forearm to fit snugly on the skull turn the head to the right three times very slowly, then bring head to dead center. To make sure it is in dead center, bend the head forward a little, then bring it back. Now put your feet in position for a proper body balance, so you will not slip. Next bring your chest over against the patient’s head toward you. Now stretch the head of the patient upward slightly until all slack is taken out, then give a quick upward jerk, slightly raising the patient a little off the stool. Repeat on right side, reversing arms and contact.


CAUTIONS


 Do not hurry, make positive contacts first.
Do not let encircling arm slip.
Do not press hard on the forehead.
Watch that ear is not squeezed by encircling arm.
The second step is to open the external nasal canals by a number of adjustments on the sutures of the face, or by the little finger. The third step is to jerk the lobe of the ear downward, outward and upward quickly, but with mild strokes so as not to give pain. This is known as the Ear Fixation technique.
The last step is to go into the pharyngeal cavity and clean it all out, then find the slit of the eustachian tube and if there are any obstructions, remove them. If not, start a pumping process with the finger inside, and a pushing up process on the outside with the thumb of the other hand. For further instruction and illustrations see Endo-Nasal, Aural and Allied Technique Book.
Other forms of treatment that may be tried are light cupping over the ears, Ultra Violet Ray, Negative galvanism, vibration and massage which produce excellent results in some cases. Inflating of the eustachian tube by the method of Politizers Air Bag is of value in some cases. The use of the catheter in the hands of an expert may be used with great effectiveness.


Dizziness and Vertigo


 DEFINITION: A symptom complex, characterized by a loss of equilibrium of the body.
ETIOLOGY: It is not a disease of itself, but only a symptom of some other diseases or malfunctions of many types remote from the head. Some may be from disturbances of the cerebral circulation. The vertigo occurring in arteriosclerosis, arterial hypertension, chronic myocarditis, heart-block, valvular lesions of the heart and the severe anemias is included under this head.
Organic disease of the brain. Vertigo is especially common in lesions of the cerebellum, but it may also be present in lesions of the cerebrum.
Neuropathic conditions. Vertigo is not uncommon in hysteria, neurasthenia, traumatic neuroses, migraine, and epilepsy. In epilepsy it may precede, follow, or take the place of a convulsion.
Aural disturbances. Vertigo is most frequently observed in lesions of the labyrinth (Meniere’s disease), but it may make its appearance as a result of disease of the middle ear.
Ocular disturbances. Ocular vertigo is usually dependent upon paresis of the ocular muscles, and is probably due to false projection of the retinal images. It is relieved by closing the eyes.
Toxemic conditions. Vertigo is sometimes observed in indigestion, gout, uremia, diabetes, acute infections, and in poisoning by tobacco, alcohol, lead, and many other substances.
Mechanical causes. The vertigo experienced in seasickness, swinging, whirling, etc., is probably dependent upon violet excitation of the semicircular canals, produced by the rapid movements of the body.
The term “Essential Vertigo” is applied to those cases in which, after exhaustive study, no adequate cause can be found. The writer found that by adjusting the feet, relief was almost instant in a few cases of what he had decided was “Essential Vertigo.” The plan followed was that, if, after ten to twenty regular treatments had produced no appreciable results, to experiment with the case by treating the feet only. The treatment consists of the three Foot Moves found elsewhere in this book.
SYMPTOMS: The patient feels that either he, or the room, is moving around. It may assume two forms. The horizontal form when the attack comes while the patient is lying down, or, the erect form that comes while the patient is standing up. There are two other forms mentioned. One is called the objective, when the room and its contents seem to be on wheels, while in the subjective form only the patient seems to be whirling.
PROGNOSIS: Depends on the causes. In some cases it will last for years, in others only a short time.
TREATMENT: A diligent search should be made to find the cause. Read again the partial list of causes given above. In cases of vertigo of more than two weeks standing the etiology can be considered of a serious nature. Those that are of cardiovascular disease, hypertension or organic conditions of the brain or the ears, are among those regarded as serious, and require special attention. The treatment of the serious conditions mentioned are found under those titles, and under Meniere’s Disease.
For the treatment of an attack of vertigo in general, the following method may be employed:
NEUROPATHY: General lymphatic with more than passing attention to the liver and neck. Vaso-dilation of the 3rd to 5th Dorsals. Kidney and Spleen segments.
CHIROPRACTIC ADJUSTMENTS: C. 1-4. D. 5.
COLONOTHERAPY: A thorough daily cleansing of colon is important, and this may be continued until the symptoms subside.
HABITS: A change of habits should be tried; less, or eliminate entirely tobacco and alcohol. Hours of retiring should be readjusted. Overeating must be stopped. If, of a worrisome nature, then psychotherapeutics are needed to suggest some method out of his difficulties.
DIET: There are three types of blood conditions associated with vertigo. The hypertension, associated with arteriosclerosis, the hypotension and the anoxemic, associated with the anemias. If hypertension is present, see diets under the headings of those subjects.
The general diet, however, may be a fast for a day or two, with a four ounce glass of milk every hour or every two hours. Then No. 2 Diet for a day or two and a building up of articles of diet from No. 1 to its fullest complement in about a week.
At no time should the patient be allowed to overeat. Better that he eat every two hours than overeat at one meal. If acidity of skin or urine is present take diet from the Alkaline list chart in this book. If alkaline vice versa. An experiment with a salt-free diet for a week, is in order in all cases.
VITAMINOTHERAPY: Nicotinic Acid, Vitamins B-1, B-Complex, or B-6 and G may be considered.
ELECTROTHERAPY: The writer has searched diligently to find some form, of electro-therapeutics for Vertigo, but there are none that are specific. However, the writer used auto-condensation of ten minutes duration on a large number of stubborn cases, and several had very definite relief.
HERBOLOGY: This is a symptom, the cause of which may be indigestion, nervous dyspepsia, chronic constipation, tobacco, alcohol, certain drugs, ear or eye trouble. Might be from hardening of arteries with elderly people who have high blood pressure. Improved condition of the blood is remedy.
Take an ounce each of Black Horehound and Dandelion, half ounce of Sweet Flag, quarter ounce of Mountain flax; simmer in three pints of water down to 1 ½ pints. A wineglass after meals.
It is claimed that eating two cloves of garlic on whole wheat bread before going to bed for two weeks is excellent.
ENDO-NASAL THERAPY: Same as in Meniere’s disease, which see, Cranial Therapy, Lake recoil for occipital and lamboidal sutures and the coronal sutures.


Diabetes Insipidus (Polyuria)


 DEFINITION: Many different definitions have been given of Diabetes Insipidis.
Diabetes Insipidis is a syndrome comprising several altogether dissimilar states, and characterized by marked increase in the quantity of urine without any necessary qualitative changes in the elements of which it is composed.
A chronic disease characterized by the excretion of large quantities of dilute but otherwise normal urine.
ETIOLOGY: There is no doubt that polyuria is due to a lack of vaso-constrictor nerve control to the kidneys. This is the primary cause; the secondary causes are numerous. It has been demonstrated that a section of the splanchnic nerve is followed both by polyuria and lowered vascular tension.
As for the details of the mechanism through which there occurs in the kidney an increase of the excretion of urine, in cases where there is no primary dyscrasia and, in particular no excess of water in the blood-stream, they are still shrouded in obscurity. The circulation through the glomeruli is known to be increased, and the possibility that this occurs owing to relaxation of the arterioles must be admitted. A relaxation of the efferent vessel may, in particular, be supposed to occur. If this be the case, the blood-pressure must increase in the capillary network which follows the glomerulus, and the mechanical conditions for the reabsorption of water are favorable to its occurrence. The benefit conferred by vaso-constricting treatments of Neuropathy tends to support the idea that vasomotor relaxation is an important factor in the production of polyuria.
The thought is that the above takes place from a reflex of some perversion of function in some part of the brain, notably the pituitaries and principally the posterior lobe. There being no pathological lesions in the kidney, except a slight engorgement, the conclusion is that this condition is due to reflex from perversions of function, or injuries to the brain, causing perversions of function in the pituitaries. Some things that may cause the above are—fracture of the skull, tumor, syphilis, tubercle, meningitis, etc. Other causes of polyuria may be: Excessive ingestion of fluids. Administration of diuretics. Suppression of perspiration. Crises of certain febrile diseases, and certain neurotic manifestations, such as neuralgia and hysteria. Absorption of serous effusions and transudations. Removal of some temporary obstruction in the urinary passages. Diabetes mellitus. Chronic glomerulonephritis. Amyloid kidney. Polycystic disease of the kidneys.
SYMPTOMS: Diabetes insipidus is not a common disease, and occurs most frequently in young adults. The onset may be gradual or sudden. The chief symptom is the passage of large quantities (5 to 20 liters) of sugar-free urine, of low specific gravity (1005-1001), over a long period. Accompanying the polyuria there is usually insatiable thirst. The skin and mouth are dry; the bowels are usually constipated and headache, lumbar pains and nervous irritability are present. In many cases there is weakness and emaciation, while in others this does not occur.
DIAGNOSIS: The differential between diabetes mellitus may be stated as follows:

Diabetes Mellitus

Diabetes Insipidus

Specific gravity of urine nearly always high, rarely low.

Specific gravity of urine low — never exceeding 1010.

Glucose constantly present.

Glucose absent.

Abnormal hunger and thirst, itching of the skin, tendency to boils and carbuncles, characteristic ethereal odor of the breath.

 General symptoms of diabetes mellitus absent.


PROGNOSIS: The condition is chronic unless treated by one who understands the basic principles of reflex activity and knows how to apply the physical and manipulative therapies in proper places. Even as chronic the disease is seldom fatal directly, but leads to much discomfort of excessive water drinking, and excessive urination that may bring on a complete break-down and some serious complications.
TREATMENT: The chief feature is to find the contributing factors and treat them as well as giving the general treatment. Neuropathic Cranial Adjusting of the sutures adjacent to the pituitaries on each side of the head.
NEUROPATHY: The vaso-dilators and constrictors range from the 9th to the 5th lumbar. But, to bring about a constriction of the dilator nerves to the kidney, only the 10th to the 13th are given the inhibitory hard pressure. For the secondary cause, the cervical and the 3rd to the 5th dorsals, also the cranial nerves on the face (see numbers on cut of skull) are given light sedation treatment.
CHIROPRACTIC: Upper cervicals, condyle, kidney place. D. 10 and L. 1.
ELECTROTHERAPY: Irradiation over the pituitary area has been useful in some cases. The water cooled ultra violet seems to be the best for this purpose.
Concussion with one minute interruptions over the 5th lumbar, sine wave, or galvanic current, with the positive pole placed upon the spinal column at Dorsal 10 or the lumbars and the negative pole at the level of the hilum of the kidney.
DIET: Diet does not seem to have much influence on this condition, except that a large amount of fresh beef seems to give the patient some strength and slightly diminishes the amount of urine while being ingested. This leads to the conclusion there is a protein deficiency. Water drinking restriction may be tried, by having the patient sip from a glass a solution of equal parts of lime water and water; two glassfuls in every six hours being permitted. Vitamins A, B 1 and G. and Endocrines of the pituitary substances may also be used.

 
Diabetes Mellitus

 DEFINITION: A chronic disorder of carbohydrate metabolism, caused by a functional disturbance of the islands of Langerhans in the pancreas, and manifested clinically by an increase of the blood-sugar, glycosuria, polyuria, loss of weight and strength, and a pronounced tendency to an acid intoxication resulting in coma.
This form of diabetes can be said to be a nutritional and hormonal deficiency resulting in disorders accompanying a deficiency of insulin.
Insulin is understood to be a vegetable principle, or polysaccoride isomeric with starch. A hormone or activating substance secreted by the islet cells of the pancreas and is necessary for the utilization of carbohydrates in the body. It is a derivative of the ammo acids. It prepares glucose for oxidation and lowers its concentration in the blood.
ETIOLOGY: There are five or more internal physiological perversions that may bring on the illness known as diabetes mellitus. The first may be a vasomotor constriction in the organs due to shock of the cerebral centers by worry or fright. Second, an autointoxication of the liver, gallbladder (even stone in the gallbladder) intestines or a general toxemia. Third, a broken down respiratory apparatus that does not supply enough oxygen to create proper oxidation.
The above can also include infections or perversions of the thyroid and adrenals which tend to increase the amount of sugar in the blood. Both the adrenals and thyroid, when overactive, can produce diabetes by increasing, through their secretion, abnormal oxidation and metabolism in the pancreas. The latter organ is thus caused to produce an excess of amylopsin which in turn acts on the hepatic glycogen, sugar is formed beyond the needs of the tissues at large, and the surplus of sugar is eliminated with the urine. This is termed the asthenic form of diabetes mellitus. In what is termed the asthenic form, the adrenals and thyroid are insufficient and metabolism in the pancreas being correspondingly impaired, alimentary glycosuria occurs precisely as it does after removal of the pancreas or to a less degree when disease of the pancreas inhibits its functional activity.
Fourth. — Obesity, with great compression of function, and loss of proper respiration, and oxidation of a more or less degree is found in ninety per cent of all incipient cases of adults.
Fifth. — Infections of, or sepsis of infection reaching the pancreatic islands. Many colds may leave a catarrhal infectious condition in the pancreas. Syphilis is found in a number of cases.
EXTERNAL ETIOLOGY: May be from Trauma, or injury from some external source that may cause a perversion of nerve or blood control to any organ, has been associated with a large number of diabetic cases in the writer’s experience. Especially when the trauma has been of the liver, stomach, brain or pancreas. One or two reported having injured the back some time previous to the manifestations of diabetic symptoms.
SYMPTOMS: The onset is usually insidious, but in some cases is abrupt. The first things that the patient notices is a weakness, excessive thirst, and frequency of urination, and polyuria. The above is usually sufficient to bring him to the physician’s office, or he may wait until other symptoms are developed also. Some of which may be: Pruritis, especially of the genitalia, which may set in early. The appetite will change either eating a great deal more, or less. The skin becomes dry and harsh. The mouth is dry, the tongue red and glazed. The teeth may decay. In the very severe cases there is a marked emaciation. There may be headache, somnolence, air hunger, fruity odor of breath and the urine and blood may reveal the following:
THE URINE: The urine is increased in amount, the daily output varying from 3 or 4 liters to 10 liters or more; it is pale in color, of increased specific gravity (1025-1040), and contains sugar, and frequently one, two, or all three of the acetone bodies. The sugar content varies from 0.5 to 10 per cent, and the daily output from 50 to 600 grams. Albumin and casts are also present in many cases. The total nitrogen and ammonia are increased, the latter often to 8 grams or more, normally from 0.5 to 1.5 grams. The excess of alkali is required for the neutralization of the organic acids, and the amount of ammonia excreted is therefore an approximate measure of the degree of acidosis, 2 grams corresponding to about 6 grams of B-oxybutyric acid and 5 grams to about 20 grams of B-oxybutyric acid. The amount of urine, and the sugar and acid contents usually diminish markedly before the onset of coma.
THE BLOOD: Hyperglycemia is a constant feature, even when the urine is sugar-free. The amount of sugar varies from 120 to 800 mg. per 100 c.c. When the amount exceeds 160 mgm. sugar usually appears in the urine. The fat or lipoid content of the blood is also increased, especially in the severe cases. A marked increase of the blood-fat imparts to the serum a milky appearance. With the occurrence of acidosis there is a decrease in the reserve alkali of the body, and this is shown in a reduction of the carbon dioxid tension of the alveolar air from the normal of 40 to 45 mm. of mercury to 35 to 30 mm. in mild acidosis, or to 20 or less in severe acidosis.
COMPLICATIONS: Loss of resistance to infections seems to be the greatest complication, for boils, carbuncles, tuberculosis and pneumonia are common.
Neuritis, skin eruptions, defective vision, retinitis, and gangrene of the extremities are possible complications.
PROGNOSIS: This depends on the complications, the severity of the disease, and the faithfulness in treatment and dietetic regimes. In the slightly obese, middle aged persons, the outlook is better for a longer life than on the very thin. In children the prognosis is always doubtful and grave. Coma is the direct cause of a fatal issue in a very large proportion of cases. It is due to acidosis, and may result from overexertion, dietetic indiscretions, or nervous shock, or it may develop without any exciting cause.
TREATMENT: The previous outline of Diabetes Mellitus, Etiology and Symptoms, leads to the conclusion that the physician has three fundamental things to do.
First. — Put all the body mechanical organisms in proper working order for proper functioning of the processes of metabolism, thereby aiding in keeping the urine sugar free, and keeping the blood sugar normal.
Second. — To maintain proper nutrition so that there will not be an excess, or too little of any of the necessary articles of diet.
Third. — To prevent any complications from arising.
Starting from the above premise we may use the following outline of treatment:
Dietary:This is probably the most important part of the treatment. Here we must recognize tht the disorder disturbs not only carbohydrate metabolism, but all metabolisms, and that no arbitrary rule of diet can be laid down that will suit all cases. No two cases of diabetes are alike, and therefore, the diet of each patient must be planned experimentally for each individual case. However, the general principle is established that carbohydrates have the strongest and quickest effect in producing glycosuria. From that point on, experiments must be made. Give Diet No. 2 first, for a few days, then make a urinalysis examination twice each day. If there is a dropping of the sugar content, and no unusual disturbance of the patient, it is continued a few days more. When the urine is sugar free, it will stay free until the blood sugar content rises above 160 mgm, then it will appear in the urine again. But, just as soon as the urine is sugar free, the patient is put on Diet No. 1, and kept on it until or when the sugar may appear in the urine again. Should there be at any time a high acidity of the urine, the acid foods are diminished gradually, not suddenly stopped. (See list of Acid Foods.)
Fasting is proclaimed from the house-top as the great panacea. It will make the patient sugar-free quickly, but in some cases it results in such undernutrition that it takes years to restore strength to the patient, even if he does not succumb to a fatal acidosis.
It is understood that in diabetes there are no prohibited foods. It is a problem of food values and total quantities. The average food requireent of the diabetic is between 1500 and 2500 calories. The above can be said to be necessary for strength, some energy and comfort. If there is obesity, then the lower calorie diet can be used for a time, or a few days on Diet No. 2.
In addition to the diet, special attention must be given to the liver, intestines, pancreas and the pituitaries. Turn back to your Book of Neuropathy, and read again the outline of examination of those organs. All have some direct relation to the production of glycosuria, or glycocemia.
NEUROPATHY: For the above conditions, a thorough Neuropathic Lymphatic treatment is in order. Then, an easy sedation treatment of all the spinal centers. Twice a week is sufficient.
CHIROPRACTIC: Firth, in “Chiropractic Diagnosis,” pages 47-48, it is stated that adjustments are “K.P. in combination with local subluxations, which might affect the organs of digestion, especially the pancreas and liver.” Then, the writer makes the following significant statement — “Although diabetes is considered an incurable disease from the medical standpoint, fully 90 per cent completely recover under Chiropractic adjustments. The time required to bring about complete restoration is very variable, depending upon the recuperative powers of the patient, his vitality, the degree of the subluxation, etc. Cases of twenty and twenty-five years standing have completely recovered after one month’s adjustments.”
Riley — “Mastery of Disease,” page 535, contributes the following:
“Under our own rational methods of treatment the spinal therapist will bring his cure almost every time in from one to three months. The treatment is simplicity itself. Adjust cervical 1 and dorsals 5, 7 and 10, or dorsals 7, 8 and 10, according to the finding of the lesions in the spine and give good and continued concussion of the 7th cervical. This concussion has the power of contracting the liver and preventing the formation of sugar. Examinations show that the liver during this concussion contracts to very little more than three-fourths of its normal size and in this condition will not form sugar. If this concussion is continued in combination with the adjustments for a reasonable time and the analysis of the urine be made again it will be found to be free from sugar or the quantity greatly reduced. Normal conditions of the liver will soon ensue. Any physician who tries this treatment on a serious case of diabetes, will be so fully gratified with the results that he will never again criticise this form of treatment.”
HYDROTHERAPY: The diaphoretic type may be of value in reducing the strain on the renal organs. Vapor baths, or Sitz baths, at home, with Epsom Salts, may be sufficient.
STRAPPING: In many cases diabetes has a direct relationship with poor body mechanics. A binding around the abdomen, or a support belt or brace may be of great benefit until proper posture has been obtained. See “Body Mechanics”, page 151.
COLONTHERAPY: Colonic irrigations, at least once a week for four weeks, can be an established rule, in the beginning of the treatment.
SPONDYLOTHERAPY: See Riley, above. In addition, the heart action can be controlled by concussion.
ELECTROTHERAPY: It is said that sunlight and ultra violet radiations have a great influence on carbohydrate metabolism. That exposure must be uniform, of from 10 to 20 minutes each on the organs of digestion.
VITAMINOTHERAPY: The most common secondary perversions of diabetes are the various peripheral neuroses. The knee jerk is sometimes absent. Nerve pain may develop resembling neuritis, polyneuritis, and gastric pain. In addition see the regular treatments for pain, and neuritis found in separate sections. The Vitamins that are especially necessary are: For Neuritis B 2, G and E. If one Vitamin can be said to be specific it is B. A, C, D also have their place. The minerals have a prominent place in the prevention, and relief of infections that accompany this disease, i.e., boils, etc. Boils, furuncles, gangrene. In all inflammatory processes Amino Acids result from the disintegration of protein. The pH of necrotic tissues or zones of necrosis ranges from 6 to 45, depending on the degree or stage of disintegration. It is then necessary to buffer the fluids of the inflammatory process back to a normal pH 7.5 Kabnick states that “by utilizing the alkaline substances that it can be done by Calcium stabilizing the osmotic pressure necessary for cell growth, proliferaton and repair — the replacement with newly formed healthy living cells to form new tissues for those that have been damaged by external events.
“Sulfur is present in all plant and animal cells and practically all sulfur utilized by animals is in the form of protein. There can be no cell life without this element. It shares the oxidation of the protein molecule in the animal body which it leaves to return to the soil from which it was taken by plant cells. This cycle is continuously being repeated.
“Disinfection of the inflamed tissues with Cabasil is brought about with the aid of halogens. IODINE AND TRACES OF SILVER present in some of the different forms have a bacteriostatic influence in the milder concentration, but exert a bacteriocidal influence in the higher concentrated solutions, i.e., Concentrated ointment and Cabasules (Cabasil in plants sealed in a sterile glass tube). ‘Lactocin’ (a partially digested sugar) is a source of nutriment at the site of injury and is especially important in all the vessels leading into the area of pathosis have sloughed or are blocked by leucocytic emboli. These sugars also supply oxygen to the starved tissues, thus stimulating cell metabolism.
“Cabasil was planned with the idea of bringing about as nearly as possible a normal environment for the tissue cells in and contiguous to any inflammatory process.”
All the above are now properly combined, by the Cabasil Company.
ENDO-NASAL THERAPY: This form of treatment is one of the “musts”, for air hunger is one of the prominent symptoms, and air or oxygen deficiency is hard on the processes of oxidation and the danger of a severe Acidosis is always present. Acidosis is a disturbance of the acid-base balance on the acid side, while alkalosis is a disturbance on the alkaline side. One may be due to a deficiency of the other.
This is seen in characteristic form in the acidosis of diabetes. In diabetes, the primary factor is excess of abnormal fixed acids B-oxybutyric acetoacetic, resulting from incomplete oxidation of fats. These combine with the alkali of the blood and the combinations are excreted in the urine.
The treatment may consist of the Lake Recoil. The Anterior Nasal dilation and a complete swabbing out of the whole pharyngeal cavity. Thyroid and parathyroid releasing and raising techniques.
HERBOLOGY: One ounce each of nettle leaves, Cranesbill, Agrimony, Yarrow and one-half ounce of Ginger. Boil in three pints of water down to one pint. One tablespoonful three times a day after meals.
A statement has been made that a diet of Stinging Nettles will some day supersede Insulin. The diet is two days fast, then one day eating the young nettles and drinking a tea or brew made of them. This is repeated once a week until the urine is sugar free.
INSULIN: There seems to still linger among the laity the thought that insulin is a cure, and not a substitute, to supply the lacking pancreatic hormone. A drugless physician, licensed, or unlicensed, may find himself in a quandary, what to do. The writer does not believe that insulin is of any actual value for the comfort or longevity of diabetic patients, and does not accept them as patients if an insulin regime has been started. There is, or should be in some diabetic institutions, a long experience of handling insulin, and insulin diets, before even a medical physician should be allowed to dispense it. For a drug, that requires so many cautions, not only to the doctor and nurse, but the patient particularly, lest there be shock, gangrene, surgical amputations, coma and death, surely there should be a very intensive training in the food values in proportion to the insulin injected or swallowed. He should be able to calculate diets in relation to insulin dosage, or he should not treat diabetes with insulin at all.
Many drugless physicians have been threatened, or have had court hearings, because they advised a patient to quit taking the insulin. That is an unwise thing for a Drugless physician to do. Several very serious things can happen to the patient even death in a few hours. It has been our custom to refuse the case, until he has talked it over with the physician who has been giving the insulin, and if that physician was satisfied to have us work with him on the case, a consultation was arranged, and we insisted on being directed as to what our part of the treatment was to be. This has worked out very satisfactory in a number of cases. The writer does not think insulin is of the great value proclaimed for it. But, he has profound respect for the Medical man who knows its properties, dosages, and diets required and will work side by side with such a doctor.


Disorders of the Glands of the Neck, Thyroid, Parathyroid, Thymus

SIMPLE GOITER

 This is a perversion within the glandular structure of the thyroid causing it to enlarge. It may be due to an excessive accumulation of colloid within the gland acini, then the term colloid goiter is sometimes used.
There may be a marked increase in the parenchymatous elements of the gland, due to hypertrophy and hyperplasia of the secretory epithelium composing the lining walls of the acini, even with diminution of the colloid content, thus giving rise to hyperplastic thyroid enlargements. The milder forms of hyperplastic enlargement are commonly known as the puberty hyperplastic type, whereas the severe advanced types are known as Graves’ disease, Basedow’s disease or exophthalmic goiter. These hypoplastic and hyperplastic changes occur primarily in the secretory epithelium of the whole thyroid gland, and produce, as a result, hypothyroidism in the case of the underfunctioning colloid goiters and hyperthyroidism in the hyperplastic goiters of puberty, early Graves’ disease or exophthalmic goiter.
PATHOLOGY OF SIMPLE GOITER: Hyperplasia of the glandular tissue, either uniform or affecting only certain portions of the gland, with a tendency to degeneration. The amount of colloid material is usually increased — colloid goiter; the tumor may resemble adenoma — struma adenomatosa; it may be cystic; or the capsule and stroma may be increased in thickness at the expense of the glandular tissue — fibrous goiter. Calcification may occur.
SYMPTOMS: The simple goiter may in appearance be unilateral or bilateral and may be evenly or unevenly distributed. The enlargement may be sufficient to produce enough pressure on the trachea as to cause aphonia hoarseness, cough, laryngeal stridor or tracheal wheeze. There is sometimes acute respiration distress, with cyanosis which in time may reach a critical stage.
PROGNOSIS: Recovery is the general rule.

TREATMENT

 NEUROPATHY: A thorough lymphatic of all the lymph system with special emphasis on the glands of the neck. A sedation treatment of the thyroid segments of the spine.
CHIROPRACTIC: Adjustment of the 5th and 6th cervicals.
SPONDYLOTHERAPY: If tension is too high, inhibition can be effected by concussion of the 7th cervical.
ENDO-NASAL THERAPY: The thyroid gland has a vital part in the oxidation processes, and treatments to increase the intake of oxygen are always in order. The writer has found the Endo-Nasal and allied techniques to be a splendid adjunct to other treatments in quickly removing pressure, reducing the size of the gland, and establishing equilibrium. See General Endo-Nasal treatment under parathyroid disorders.
Here we might also mention the other glands and give the general technique for them.
Any deformities in or around the thyroid, parathyroid or thymus glands will, if enlarged, contracted or displaced, interfere with the intake of oxygen and air. The interference is direct by pressure and indirect by the malfunctioning of the glands themselves.

THE PARATHYROID GLANDS

 These are four small glands about the size of a pea, two on each side of the back of, and at the lower edge of, the thyroid gland. They control the calcium phosphate balance of the body with the aid of the adrenal glands. They reduce the calcium in bones while the adrenals increase the calcium in bones. The loss of calcium promotes excitability, muscular contractions, and probably is the basis of some types of epilepsy and pseudo epilepsy.
A second function of the parathyroid glands is the neutralization of certain toxic wastes generated in the gastrointestinal tract as a result of proteolytic bacteria.
The first technique to be used is the Lake Recoil, then opening the external canal and swabbing out the pharyngeal cavity. The specific technique for the glands of the neck are for two purposes, first, to release them from adhesions which are always present in any disorders. Second, to raise them up from the ptosed state.
The first step is to make sure of the location of the thyroid gland. This is accomplished by massing the muscles of the neck between the fingers until a semi-solid like substance is felt in the shape of the little finger. Take it for granted that if the thyroid glands are down and out of position, all the others are also. After finding the gland on one side, press the fingers easily but deeply in between the trachea and the gland, and feel for adhesions. They are string-like tissue. They may be single or in clusters of two to five. Now release that side and dig deep into the other side of the gland to ascertain if adhesions are binding the gland to the anterior, lateral or posterior branchial walls. We have found it best to try and count these adhesions and not to break more than two at a setting, or to give more than two operations a week unless the acute condition makes the complete operation imperative at one sitting.
INSTRUCTIONS: Patient sits on a low stool. He should be made to relax. Place the fingers of one hand between the trachea and the gland, then go deep without hurting, sliding fingers up and down. Adhesions are stringlike; sometimes they are in clusters of three to five, but more often they are individual adhesions. Having located one, slide the finger over tightly against its origin in the gland. With the finger of the other hand, cover its insertion into the tracheal tissue. Let the finger tips touch, with hands raised so back of hands almost touch. Then, holding position, bring hands around neck; after a few seconds of pause, quickly snap the fingers inward and apart. Never hurry. Take time to make sure of your diagnosis and contacts. This same process is used to break adhesions in the external lateral portion of the gland where it is embedded in the branchial walls.
Caution: Do not put hands with pressure on both sides of the neck at one time. Leave one side entirely free for free breathing.
The above technique is also used for parathyroid conditions because all parathyroid conditions have a direct relation to thyroid disorders.

THYMUS GLAND

 To find the adhesions of the thymus gland, run fingers along the clavicle bone. The adhesions here must not be mistaken for normal tissues that have pathways upward and downward. It would be well for the student to review the anatomy of this whole section before attempting diagnosis. We can be assured, however, that with the small force needed to break adhesions here, only good can come of the treatment to all the tissues. This technique is repeated on the other side if deemed necessary.
INSTRUCTION: Patient sits on stool, the doctor standing on the right side of him. Put left thumb on clavicle bone over adhesion. Bend patient’s head until it rests lightly on chest of the doctor. Put right hand cuffed just under angle of the jaw of patient. Hold firm with left thumb over adhesion, then with the right hand fitting snugly so it will not slip, give an upward recoil jerk. The first time the doctor performs this technique, his jerk should be very light, but always quickly, as in a recoil. Repeat on other side of neck. After the techniques are given for the releasing and breaking of adhesions around the glands, then the Raising technique follows:
INSTRUCTIONS: To raise all the glands of the neck have patient sit on stool. The doctor stands on right, a little behind patient, patient’s head resting on doctor’s chest. Cup one hand, with the ulnar border of the hand pressed into the neck tissue. The other hand is then cupped equally over the other hand. Hesitate a moment. Now give a jerk upward with the right hand only. Using both hands to give the adjustment will cause the left hand to slip. Three of these adjustments at one sitting is sufficient; one just above the clavicle bone, one in the middle of the neck, and the other just below the ear. It must be done on both sides of the neck, reversing the hands and position of the doctor.
ELECTROTHERAPY: The Colloid type, as a rule, responds nicely to iodine ionization. The indifferent (positive) electrode should be 6 inches square and placed at the back of the neck just above the shoulders. The active (negative) one, a sponge electrode covered with fresh gauze which has been saturated with a solution of potassium iodide, is placed over the gland. The solution can be any strength up to saturation. Sometimes it is preferable to rub an iodine preparation called Iodex over the gland and then the gauze on the sponge should be moistened with water. Have the current strength about 10 milliamperes, and move the sponge around slowly over the goiter for 10 to 15 minutes. Excellent results can be obtained by this treatment.
Ultra violet ray irradiations are par excellent in all gland conditions of the neck.
COLONOTHERAPY: In any thyroid condition there may be a toxic condition from the intestines. Toxic Goiter—in this condition a daily high enema, or colonic irrigation twice a week will be of great value.
DIET: There are those who advocate a prolonged fast, and it is very beneficial if institutional care can be obtained. The writer once being superintendent of a large sanitarium, recalls some excellent results with fasts on orange juice from two to four weeks. Then a gradual building-up diet selected from diet No. 1, recorded elsewhere; in addition to the diet, large quantities of sweet fruits were urged on the patients. Without institutional care, diet No. 2 may be used with some increase of fat for a short time, this to be followed by No. 1 then No. 2 on alternate days for at least two months.
VITAMINS AND MINERALS: The human requirement of iodine is about 20 to 75 gamma per day. This amount may be obtained in some regions from the water or from sea food, or leafy vegetables. But when a goiter exists this supply must be augmented. It may be augmented by the use of iodized salt. Or one drop of iodine in a glass of water twice daily. Vitamins B, C, D and G with iodine are reported as very beneficial.
GLAND HORMONOTHERAPY: Sajous makes the observation that the continued disturbance of the thyroid gland is due to overactivity of the suprarenal glands, although started by overactivity of the thyroid gland. It has been also stated by others that the pituitary gland also has a direct influence on the thyroid gland. For those who use this type of therapy the following is recommended.
Briney states that the thyroid hormone, made up of thyroid substances, ovarian (for female) orchic (for male), adrenal, hepatic and pituitary, has very distinct value. See Endocrine System by Briney under bibliography for all gland substances.
HERBOLOGY: For general herbology on the glands of the neck, see last part of this section.

GOITER EXOPHYTHALMIC

 DEFINITION: A general perversion of the thyroid gland resulting in a hyperthroidism, protruding eyes, and general nervousness or tremors.
ETIOLOGY: A vaso dilation of the thyroid segments and a subluxation of the 6th cervical are the primary cause. The disease most frequently develops in women more than men. The secondary causes may be consequent upon some acute disease, pregnancy, the menopause, or profound mental or emotional strain.
SYMPTOMS: The first sign that the patient may notice is an acceleration of the pulse and palpitations; the pulse rate may rise to 120. The exophthalmos, or protrusion of the eyeballs, usually bilateral, is noticed. Accompanying it there are often other ocular changes, such as lagging of the upper eyelids in downward movement of the eyeballs, a peculiar staring look, due to widening of the palpebral fissure; infrequent and incomplete reflex winking; insufficient power of convergence for near objects. As a rule, vision is not disturbed.
Enlargement of the thyroid may be the last symptom to appear. One or both lobes of the gland may be affected. Palpation often detects pulsation and a purring thrill, and auscultation, a soft systolic bruit.
Nervousness manifested in muscular tremor most pronounced in the extremities is usually an early symptom. Abnormal irritability and extreme restlessness are characteristic of the disease. Vasomotor disturbances, such as excessive flushing and sweating, urticaria, and local edema, are frequently observed As the disease progresses, weakness, emaciation, and anemia usually become pronounced. Attacks of vomiting and of serious diarrhea are common. Moderate fever is an occasional symptom. There may be glycosuria and albuminuria. The basal metabolic rate is incresed from plus 15 to plus 50 or even plus 75. This factor is responsible for the weakness and emaciation.
TREATMENT: The first step in the treatment in the opinion of the writer is to allay the nervousness of the patient. For this a general concussion of the whole spine or deep pressure all along the spine is the proper procedure. Then attention can be given to the palpitations if still existing after the inhibitory treatment. If severe, an ice bag can be put over the precordium while the patient is resting. The anemia is then attended to. See treatment for Anemia. For the circulation, if it is feeble, a general massage is indicated.
HYDROTHERAPY: A cold compress put around the neck, covered with another cloth and left on all night is of great benefit. The under wet cloth dipped in a salt solution has been reported also of value.
Applications of X-rays or surgery may be required in the most severe types. The diet should be of a high caloric and fat content, or a fast of milk for periods of a few days at a time.
HERBOLOGY: A good herbal laxative, walking, deep breathing and sunshine, vegetables rich in mineral salts, especially iodine. Herbs containing minerals are Bladder Wrack, Irish Moss, Red Clover Flowers, Spinach, Peach Tree Leaves and Walnut Leaves.
A good combination is three parts Red Cover Flowers, one part each of Buckthorn Bark, Blue Vervain Leaves and flowers, Nerve Root, Sassafras, bark or root and Anise Seed, made into tea, using a cupful or two a day.
Here is a method which has worked: A sponge laid on a hot stove until a powder can be made, turns the vegetable fibre of the sponge into charcoal ashes, which contain iodine. Never wash the sponge. Heat sponge each time so that one teaspoonful of ashes is made. Do this three times daily. It may take half a dozen sponges and a year to clear up the trouble, but it is a simple and effective remedy.
External treatment would be a tablespoonful of powdered Borax, Alum, Salt, and enough cream to make a paste. Apply every four hours. Most growers of botanicals for the trade have excellent formulas already mixed also ointments for enlarged glands.

MYXEDEMA

 DEFINITION: A condition due to loss of function of the thyroid gland, and characterized by a myxedematous condition of the subcutaneous tissues, mental failure, and atrophy or pathologic change of the thyroid gland.
ETIOLOGY: It is a thyroid deficiency that comes with or after birth and is referred to as Cretinism. It also may be produced by traumatism that destroys the function of the gland, or by surgical removal of the gland.
The disease is much more frequent in women than in men. It is occasionally hereditary or familial. It usually develops between the ages of twenty and fifty years. The basic condition is atrophy of the thyroid gland, but the cause of this morbid change is unknown.
SYMPTOMS: The first thing that may be noticed is a swelling of the subcutaneous tissues, particularly of the face, supraclavicular regions, and hands. Unlike edema, the parts do not pit on pressure, but are firm and elastic. The skin is dry and harsh. The hair becomes brittle and falls out. The thyroid gland is atrophied. A peculiar slowness in thought, speech, and movements is a characteristic symptom. The temperature of the body is subnormal and the pulse is irregular.
There is undue sensitiveness to cold and neuralgic pains. In the urine albumin and sugar are sometimes present. The basal metabolism rate is always reduced running as low in some cases as minus 40.
In Cretinism, which may be endemic or sporadic, there is arrested development, physical and mental, with changes in the skin and a characteristic deformity of the bones and soft parts. The head is large, the features are coarse and bloated, the expression is stolid or idiotic, the trunk and limbs are short and thick, the abdomen is protruberant, the sexual organs are infantile, and the skin is rough and dry.
PROGNOSIS: Myxedema progresses slowly, a case lasting, as a rule, from six to twenty years, unless the patient is carried off through some intercurrent trouble, which is often the case. Tuberculosis and pneumonia are the infections to which they seem to be especially vulnerable — owing to the enfeebled condition of their autodefensive resources. Nephritis, pericarditis, and cerebral hemorrhage seem to be next in the order of frequency. Periods of amelioration sometimes occur, but sooner or later the patient relapses into his previoius state, and gradually dies of exhaustion. But some by treatments that practically cover a life time have been kept with symptoms more or less suppressed and enjoyed life fairly well.

TREATMENT

 NEUROPATHY: A general lymphatic and sedation of the whole spine.
CHIROPRACTIC: Lower cervical, spleen and kidney place and according to symptoms.
The general treatment follows the treatment of the symptoms, while the specific follows the endocrine and mineral pattern, Thyroid extract, odized foods and Salt, or Thyroxin.
HERBOLOGY: Make a tea of the following and use a dessert spoonful every four hours. (Put herbs in cup (8 fl. oz.) of boiling water, let cool, strain.)

 Jam. Sarsae (Jamaica Sarsaparilla) 1 oz.
Calendulae off. (Garden Marigold) 1 teaspoonful
Zea Mays (Indian Corn) ½ oz.
Humulus lupulus (Hops) 1 teaspoonful
Menth. Virid. (Spearmint) 1 teaspoonful

Dysentery

 DEFINITION: Dysentery is a term to describe a number of conditions that cause abdominal pain, diarrheal discharge of mucous and blood.
ETIOLOGY: An inflammation of the mucous membrane of the colon, caused by catarrh of the colon. Infection caused by Amoebia or epidemic due to drinking water containing certain vegetable organisms and mineral elements. The catarrhal type may be due to change of weather or a cold that has spread to the intestines, or a general autointoxication. The amoebic is due to the bacillus dysenterial, and is seldom encountered outside of the tropics especially Japan and the Philippines. But in the summer time it may sometimes be encountered in the United States.
The epidemic is encountered quite frequently, when large numbers of people complain at the same time.
This form is usually due to drinking contaminated water.
SYMPTOMS; In mild cases for weeks there may be only the symptoms of indigestion, some colicky pains, and slight diarrhea. In other cases the infection is acute, and marked by fever, abdominal pain, vomiting, tenesmus, mucus and blood discharges, great weakness and emaciation. Death may result from exhaustion, or the condition may gradually become chronic. The disease shows a marked tendency to assume a chronic form. It is then characterized by continuous or intermittent diarrhea; the passage of mucus, blood, and perhaps pus in the stools; more or less abdominal discomfort; afternoon fever; and, ultimately, marked anemia and wasting.
COMPLICATIONS: It may become chronic, in which there is a wasting away of the body. Hepatic and pulmonary abscess may form. Other complications may be performation of the bowel, peritonitis from extension of the ulcerating process, intestinal hemorrhage and stenosis of the bowel.
PROGNOSIS: Recovery is the rule, unless a severe complicaton ensues.

TREATMENT

 NEUROPATHY: A sedation of all the abdominal spinal segments.
CHIROPRACTIC: C. P. KP. D. 10 L. 2, 4.
PYPHOLACTIC: Whether mild or severe it is best for the patient to stay at home, and mostly in bed for at least a few days. If not possible a flannel binder should be worn around the abdomen until the attack passes.
HYDROTHERAPY: Dry or moist hot applications to the abdomen changing frequently. Thirst is a problem, if there is vomiting, and in that case lime water or barley water should be given tablespoonsful at a time.
DIET: A fast for some time is the best procedure. Milk may be given to those who can not fast for a few days. Diet No. 2 may be used, with all roughage removed.
COLONTHERAPY: If at all possible without giving pain, the high enema or colonic are excellent. Anal irritation should be allayed before the enema is given. A salt solution of one to 2 teaspoonsful in a quart of water has good therapeutic value. Electrotherapy short wave, diathermy, and infrared ray have great value in some cases.
SPONDYLOTHERAPY: Concussion alternately of the 11th dorsal and the first three lumbar.
HERBOLOGY: Take bismuth subnitrate tablets — 2 every half hour — to form a protective coating for the bowels. When the disease has run its course a weak tea of Blackberry Root as an astringent may be taken — gradually increasing its strength. Go to bed, avoid exercise, use porridge and milk, no vegetables, no fruit, no meat or meat broths. No sugar.
Half ounce each of Tormentil, Willow Bark and Vervain; simmer half hour and add half ounce of Sage and quarter ounce of Ginger. Let stand until cool. Strain. Small wineglassful three times a day.
VITAMINOTHERAPY: A, C, D and K are indicated.

 
Dypsnea

 DEFINITION: A shortness of breath, difficulty in breathing, with or without an increase in the number of respirations or with and without pain. Those cases which require sitting up continuously are termed “orthopnea.”
ETIOLOGY: Increase of carbon dioxide and decrease of oxygen due to imperfect metabolism. The above is the main result of many contributing causes. Please read again in Endo-Nasal, Aural and Allied Techniques, Chapter II, “Oxygen and Oxidation,” for a clearer outline of this subject. Then turn to the title of “Asthma” in this book.
Its chief causes are: Obstruction in the larynx from spasm, paralysis, false membrane, edema, or a foreign body. Pressure of an aneurysm, a tumor, or large glands upon the trachea, a bronchus, or the recurrent laryngeal nerve. Asthma. Diseases of the lungs, as pneumonia, emphysema, edema, etc. Pleural effusions. Cardiac disease. Paralysis of the muscles of respiration. Abdominal distention. Anemia.
Inspiratory dypsnea is especially marked when there is obstruction in the upper air passages — larynx or trachea.
Expiratory dypsnea is noted in emphysema and occasionally in movable tumors situated below the glottis. In asthma, also, the dypsnea may be largely expiratory.
Here it would be well to read again the outline of normal respirations, and the required amount of oxygen, Chapter II, page 25, Endo-Nasal, Aural and Allied Techniques.
The Cheyne Stokes, or tidal-wave breathing, is an irregular type of rhythmic breathing occurring in certain acute diseases of the central nervous system, heart, lungs, and in intoxications. At first it is slow and shallow, then it increases in rapidity and depth until it reaches a maximum. Then it decreases gradually until it stops for ten to twenty seconds, then repeating in the same manner. It frequently occurs before death. Associated with cerebral, cardiac, renal and pulmonary affections.
TREATMENT: A general treatment can be given for relief, but for permanent relief the underlying cause must be removed.
Abrams states that if a good heart reflex can be obtained the prognosis of this condition is favorable. The reflex then is induced by concussion of the 7th cervical with the finger tapping or a concussor, or by Neuropathic pressure. The writer finds the concussor in these conditions best run at medium speed for one-half minute periods, over about three minutes, then reflex action is judged. After relief to certain extent is given, then the underlying cause is ascertained and treated. After cause has been found, look under title in this book for the specific treament.
Endo-Nasal therapy and dieting are the specific, with concussion of the 7th cervical in the acute condition.

 
Eczema

 DEFINITION: An acute or chronic non-contagious inflammatory disease of the skin, characterized by many types of lesions of redness, papules, vesicles, pustules, scales and crusts. There is itching and discharge.
TYPES: Erythematous. In this type there is redness, swelling, itching, burning and some scaling. Usually on the face. The Papulosom type is usually on the extremities and is in the form of groups of papules. There is intense itching. The Vesicular type is usually found in children on the face and adults on the extremities. They are red patches in which there are minute vesicles that rupture and leave a raw weeping surface, that in a while leaves a crust. The itching is intense. Pustular. This type consists of an aggregation of small pustules that break and leave a thick yellow crust. This type is seen on the face and scalp. Not much itching to this type. The squamous type are irregular red patches that are found on the scalp, there is some itching and considerable scaling.
ETIOLOGY: It is most common in the young and aged. And may be due to dietary indiscretions, unhygienic surroundings and habits, digestive disturbances, debility, neurosis, excessive vasoconstriction to the skin, subluxations, gout It may be due to external irritants such as cold, heat, certain plants, hard soaps, chemicals, etc.
PROGNOSIS: Recovery is the rule, under proper treatment.
TREATMENT: Specific. Find the cause and treat accordingly. The general treatment may be:
NEUROPATHY: Light dilation treatment of the whole spine, after a thorough and complete lymphatic.
CHIROPRACTIC: K. P. Sp. P. Li, P. as well as all local zones indicated.
HYDROTHERAPY: A saturated solution of boric acid may be applied after thoroughly washing the part with a good soap. When the boric acid solution has dried, cover with mild zinc oxide or magnesium talcum powder. Aristol powder sprinkled on the inflammatory area has given many patients wonderful relief.
COLONOTHERAPY: Irrigations should be given twice a week for at least three weeks. Many of these cases have a history of constipation.
DIET: Many cases require special building up diets for debility. For these see diet under the Anemias. Others may have gout, diabetes, chronic nephritis and if urine tests reveal a relationship regulation of the diet is made accordingly. See Diets under each item mentioned.
ELECTROTHERAPY: In subacute and chronic forms ultraviolet is indicated. Produce a second degree erythemia and repeat in a few days after the reaction has subsided. The more chronic the case, the greater should be the length of exposure. In acute cases, especially the moist form, ultraviolet is usually contraindicated. Use a non-vacuum electrode connected to the Oudin pole of the high frequency machine and apply with slight pressure to the lesion. Many times zinc stearate powder previously applied to the skin not only allows the electrode to be moved freely, but also aids in the healing due to the astringency of the zinc.
Riley states that the following has been successful and the writer can verify that it has been true in a number of cases.
Intense itching is driven away as soon as the blue or violet heat penetrates fully into and through the skin. We have found it useful sometimes in cases where patient had torn the skin until it would bleed under or from the scratching, to first moisten the itching parts fully with strong epsom salts solution, and then throw the strong violet or blue ray on until the surface is perfectly dry and warm, when all itching for the time will have ceased and will not return for hours. When the itching does return, patient should refrain from scratching the surface and apply the salts and heat again as before. It will soon make a perfect cure.
Either the ray or the salts will cure eczema or itching of any kind, but intense and persistent cases are more easily and more surely conquered by making the double application as directed above.
VITAMINOTHERAPY: It is now thought that one or all of the following three will make up deficiencies in this condition if given in sufficient dosage. A, D, E, F, B and G. Cod liver oil with one or more of the above vitamins has been recommended.
PSYCHIATRY: In all cases of itching it is well to look into the emotional state of the patient. There may be a neurosis of some nature present.
HERBOLOGY: An ounce each of Yellow Dock Root, Burdock Root, Figwort Herb, Sarsaparilla Root. Boil in one quart of water for twenty minutes. Strain. Wineglassful three or four times a day. This when general health is not good.
If general health is good, use equal parts of Queen’s Delight, Yellow Dock, Blue Flag and Clivers. Infuse one ounce to a pint. Wineglassful four times daily.
EXTERNAL LOTION: Tincture Bloodroot, one ounce; Witch Hazel Extract, two ounces. Fl. Extract Marigold, half ounce. Glycerine, one ounce. Lime water enough to make one pint. Apply three times a day.
The mineral compounds of Cabasil are highly recommended for this condition.

 
Embolism, Infarct and Thrombosis

 DEFINITIONS: Embolism is an obstruction of a blood vessel by a substance which is carried to the point of obstruction, by the blood stream. The substance foreign to the blood is known as an embolus. The most common types of embolus are fat, air, fragments of atheromatous plaques, vegetable parasites, animal parasites, tumor cells and pigment granules.
THROMBOSIS: A thrombosis is the formation of a blood clot or thrombus. Coronary thrombosis: Severe precordial pain extending to left arm and sometimes to right arm, or epigastrium. Dypsnea, restlessness. If patient survives attack of six to eighteen hours, collapse ensues and recovery is very gradual. Sinus thrombosis: Lateral. Associated with middle ear disease. Symptoms are sudden rise of temperature with remission, chills, prostration, sweats, headache, mental symptoms, dullness, or delirium, high leukocyte count. Sinus thrombosis, cavernous: Sinus structures involved, edema and venous statis in and about the eye. Thrombo-angiitis obliterans: Buerger’s disease. Acute disease of blood-vessels. Symptoms are Occlusion, thrombosis, excruciating pain in leg or foot; worse at night, cyanotic clammy, cold extremity, diminished sense of heat and cold, gangrene of toes or foot may set in.
INFARCT: An infarct can be said to be the complete occlusion or obstruction of the blood supply to a part, and of which the embolus, or thrombus, may have been a part.
Infarcts are caused by a blockage of the blood supply and may occur in several ways, the more common and more important being: Embolism of the nutrient artery; Thrombosis of the vein; Thrombosis of the artery; Occlusion of vessels, especially veins, from external pressure as may occur in volvulus, intussusception, strangulated hernia, and torsion of the pedicle of pedunculated tumors, especially ovarian tumors.
Infarcts may take place in any part of the body. But those that are the most serious are those that may occur in the kidneys, intestines, spleen, liver, lungs, heart or brain.
TREATMENT: Up to the present time, the author has found no specific treatment, other than rest, and applications of cool water to stem the hemorrhagic processes. Then, to treat the causes and the symptoms. If one occurs in the lungs, the following symptoms may be noted: When the infarct is large, the usual symptoms are localized pain, dypsnea, cough, and the expectoration of dark blood. These symptoms occurring in chronic heart disease or phlebitis are especially suggestive. Small infarcts occasion no physical signs; larger ones may yield a circumscribed area of dullness, with subcrepitant rales and feeble breath sounds, or, perhaps, bronchovesicular breathing.
DIAGNOSIS: Differential. Some points in diagnosis of embolus and thrombosis may be as follows: Embolism never occurs in the heart cavities and never in a vein. Antemortem thrombus is always more or less adherent, whereas a recent embolus lies loosely in the vessel. However, if some time has elapsed since the impaction, more or less subsequent thrombosis may take place, thus producing some degree of attachment to the vessel wall.
While the vessel wall at the site of thrombosis practically always shows changes due to reaction or disease, at the site of the embolism the vessel wall is healthy or practically so.
It is also of value to remember that embolism is less common than thrombosis in the coronary and cerebral arteries, while thrombosis is less common than embolism in the arteries of the intestines, lungs, kidneys, spleen and basal arteries of the brain.
A few sections of the body are mentioned below that when attacked are serious.
EMBOLISM AND THROMBOSIS OF THE MESENTERIC VESSELS: Occlusion of the mesenteric vessels occurs most frequently in the latter half of life. It may involve the arteries, the veins, or both, and is most commonly due to embolism originating in acute or chronic endocarditis, but it occasionally results from thrombosis due to sclerotic changes in the mesenteric artery or aorta, or to inflammatory changes in the mesenteric vein, occurring in association with morbid processes in the adjacent viscera. Hemorrhagic infarction of the intestine is the usual result. The chief symptoms are acute colicky abdominal pain, vomiting, profuse blood diarrhea, or constipation, abdominal distention, and shock. Peritonitis frequently occurs. Occlusion of large vessels almost always and fatally in a few days, unless operation with resection of the bowel is undertaken at an early stage.

 
Obstruction of the Cerebral Arteries
(Embolism; Thrombosis)

 ETIOLOGY: Cerebral emboli may be derived from the valves of the heart in endocarditis; from an atheromatous plate in the aorta; or from a thrombus in the heart or in the sac or an aneurysm. Obstruction from embolism may occur at any age, but it is much more frequently observed in young adults than at the extremes of life.
Cerebral thrombi are usually caused by arteriosclerosis or syphilitic endarteritis. They are most frequently observed in old persons, but those dependent upon syphilis often occur in early adult or middle life.
SYMPTOMS: An embolus lodging in the middle cerebral artery usually causes abrupt hemiplegia, and, if on the left side of the brain, motor aphasia. There are usually no cerebral prodromes, consciousness is not often lost, and marked disturbances of the temperature, respiration and pulse are uncommon.
For further treatment see under “Apoplexy.”
HERBOLOGY: For Embolism one dessertspoonful should be taken every four hours.

 Anemone pulsatilla 1 tsp.
Bryonia alba 1 tsp.
Borago off. 1 tsp.
Hydrastis ½ tsp.
Capsici ¼ tsp.
Sennae 2 oz.

 Aquam — add sufficient to make 8 oz. of finished product.

For THROMBOSIS:

 Dioscorea villosa ½ oz.
Eunonymus atropurpureus ½ oz.
Leptandra Virginica 1 oz.
Vivurnum opulus ½ oz.
Sennae 1 oz.

 Aquam — add sufficient to make 8 oz. of finished product.

 
Enuresis

 DEFINITION: An involuntary discharge of urine, which has many different causes.
SYMPTOMS: The chief one is that of bed wetting.
ETIOLOGY: Incomplete development of the sphincter muscles. Debility of the neck of the bladder. Inadequate control of the nerve centers due to subluxations or disease of the spinal centers. Lack of tone in the whole muscular system. Nutritional disturbances. Anemia, or disturbed metabolic processes. Spasmodic contractions of the bladder due to nervous disorders Masturbation or frequent handling of the parts by children may produce enuresis. Also a psychoneurosis.
PROGNOSIS: When the cause can be discovered, and removed, the prognosis is favorable.
TREATMENT: Neuropathy to bring more strength to the constrictors to the sphincters of the bladder. Inhibition by deep neuropathic pressure is made on the 2nd, 3rd and 4th lumbar sesgments.
CHIROPRACTIC: Adjustment of the 1st lumbar and also the cervicals in children in cases of abnormal respirations.
DIET: A complete vegetable diet is best until the condition has been overcome. Liquors of all kinds should be forbidden.
REEDUCATION: The child should be awakened at certain periods of the night and taken to the toilet.
PSYCHIATRY: Many of these cases are due to familial tensions.
By the end of the second year most children have matured psychologically to the point of toilet control. It sometimes happens though that in the best regulated families that a bed wetter develops. This habit is usually only one symptom of a psychoneurosis. It is most probably associated with the child’s feelings of deprivation in love relationships, especially if the enuresis begins when a new birth takes place in the family. In this case the regressive behavior of the child may have value to him. It is an effort on his part to get as much attention from the mother as she gives the baby. Punishment of the child in this period is a great error, only increasing the child’s sense of inferiority or of being no longer wanted Treatments are of no value but an expression of mother love will go a long way. Of course all neurological and genitourinary disorders must be treated, and often a dietary regime instituted with a diminution of water intake several hours before bedtime, and the mother should wake the child up at a certain hour each night, and take him to the toilet, no matter how tired and sleepy the mother is, she should speak endearing terms to the child.
SPONDYLOTHERAPY: Concussion of the sacrals, and the 7th cervical. Some member of the family can be taught how to do this.
HYDROTHERAPY: Douching of the genitoanal region with cold water has been known to cause a constriction of the sphincters and in some cases a cure.
ELECTROTHERAPY: Sine or faradic current applied to the lumbar region and the mons veneris in the female and over the perineum in the male may have some value. Putting an electrode in the rectum has been claimed as having many advantages but the writer found it of no value in any case.
Some general considerations. — The urine should be examined twice a week; and search made for the white cells, if any in it at all, to eliminate the possibility of infection of the urinary tract.
If there is an organic condition that requires surgery the physician should not hesitate to have one consulted. But, if no serious pathology is discovered, he may try the techniques given above in addition to the regime given below.
During the day and up to four o’clock in the afternoon, the child may have as much water or other fluids as he wants. A dry supper is given at six o’clock. During the night the child is awakened every three hours (7. P. M., 10 P. M., 1 A. M., 4 A. M. and 7 A. M.) This must be done by the clock regularly. If the three hour interval proves too long, then it should be reduced to two hours or one as the case requires. As the child becomes drier, the intervals are lengthened one hour at a time, until he is able to go through the entire night without wetting the bed.
General measures should not be neglected since it has been found that many of these children are undernourished and of neurotic temperament. Good food, fresh air, plenty of sunshine, and exercise with wholesome companions are all beneficial aids in the treatment of bed wetting.
Nearly a year ago the writer had a case that was terribly discouraging: The boy would stop bed-wetting for as much as ten days then start all over. After examination by a specialist, it was suggested that along with what I had been doing, that he give the child a small dose of tincture of belladona, increasing the number of drops each day until a maximum of 23 drops had been given three times a day It is now six months since the last bed-wetting and the belladona was only given for 12 days. Surely this is a condition that sometimes requires aid from any direction that it can come.

 
Epilepsy

 DEFINITION: An episodic disturbance of the brain lobees, with a loss of consciousness, with or without tonic or clonic convulsions.
ETIOLOGY: The primary causes of epilepsy is an anemia and a consequent anoxia of a certain portion of the brain. To bring about that anoxis many factors may be involved. There may be a vaso-constriction of the nerves, due to subluxations of the condyle or upper cervical vertebrae.
We cannot go into detail here on theories of the etiology of epilepsy, except to say that there is no one part of the body or brain which has not been accused of causing epileptic seizures—gastric disorders, worms, vaginal disorders, brain disorders, tumors of the brain, intestinal disorders, auto-intoxication, etc., etc., that the seizure and convulsions are of reflex origin due to irritating stimulus set up by any cause powerful enough to bring on such a reflex. It is generally agreed that whatever the underlying cause, the immediate cause is a sudden anemia, with a consequent anoxia of the brain, or portions of the brain.
The writer feels that fully 70% of epilepsies are caused by reflex stimulus, that creates a carotid sinus block or syndrome.
The carotid sinus is a dilation at the proximal end of the internal carotid artery and is situated at the angle of the jaw. It is supplied with sensory receptor nerves which are particularly rich in adventitia. This network of nerves leaves the carotid sinus and ends in a meniscus, forming what is known as the sinus nerve of Hering or the intracarotid nerve of De Castro. It is associated with the glosso-pharyngeal and the hypoglossal.
These intracarotid nerves, and the aortic depressor nerves are very important in the reflex regulation of the blood pressure. The carotid sinus nerves also influence the vagal system, the cardio inhibitory portions of it, and the adrenal glands. Normally, the carotid sinus prevents an exceptional elevaton of the blood pressure under stress.
Interference with the free flow of blood, lymph, and nerve currents here, is a serious matter. These interferences may come from diseases, from drugs and from the processes of gravity especially in old age. The meniscus may fall, creating a block from emotional states, or from subluxations of the cervical vertebrae, occipital and lamboidal suture closure, unusual deposits of calcareous matter in the neck and shoulder regions, all creating a stiffness and tenseness of the muscles of those regions. Any or all of these may cause an irritation of the bundle of nerves in the carotid sinus, creating a squeeze which causes a fall of arterial blood pressure, which in turn results in a change of normal cerebral blood supply to the ischemic state with a consequent anoxemia of the whole cranium.
Out of this fall of blood pressure and consequent anoxemia in the cranium may come such diseases as catalepsy, epilepsy, vertigo, heart irritations, palpitations, asthma, headaches, migraine, deafness and tinnitis.
In all epilepsies, the position of the carotid bodies must be given consideration. These are wheat-sized glands located slightly inward from the carotid sinus and accordingly to Heyman of the Belgian School have important functions to perform, one of which is that when there is a lack of oxygen, the rise of carbonic gas creates a stimulation on the sensory nerve end fibers of those bodies which in turn sends impulses to the respiratory center in the floor of the fourth ventricle of the medulla. This in turn is stimulated as a result of these impulses, and thus is maintained the balance of intake of oxygen and the outgo of CO2. For further reading the author recommends the student to Volume 5, pages 896 to 922 of “The Cyclopedia of Medicine, Surgery and Specialties.” F. A. Davis Co. Also Endo-Nasal, Aural and Allied Techniques book under Epilepsy.
SYMPTOMS: In the grand mal form of epilepsy, there is usually an aura or warning of the approach of a loss of consciousness. It occurs in different ways in different victims. The aura may be a peculiar sensation, arising in finger or toe, and arising upward until the head is involved, when the patient gives a shrill cry and falls unconscious, often injuring himself; he may bite his tongue, pass urine, and awake to realize something has happened because of muscular soreness. There is a tendency to sleep following the attack; indeed attacks may only occur during sleep.
The first stage of this unconsciousness is called the tonic convulsion, in which the trunk is rigid, and the extremities are extended, the hands are closed, and the jaw is clenched, the respiratory muscles are so rigid that a deep jaw works convulsively, there is frothing or foam around the mouth, tongue or lips may be bitten, the arms and legs go through actions of relaxation and contraction, and the head may be pounded on the floor, or just rolled from side to side. Then the clonic spasms begin; the cyanoses is soon noticed. The clonic spasms last for a few minutes – perhaps a half minute to a minute - after which the patient falls into deep sleep or coma, from which the patient usually awakens in a state of amnesia, but with bruises, and a severe headache, and a mental dullness that may last for a few days.
The symptoms of petit mal, are a loss of consciousness for a short time, with no attending convulsion. The patient may have an attack at any time anywhere, without any warning. He stares, his features are fixed but he does not fall, the face is pale, the pupils dilated, and there is some twitching of the muscles. The attack may last less than a minute, after which the patient will go on about his business, but with an uneasy consciousness that something has happened to him, and he cannot make it out. If these attacks continue this constant uneasiness has a very serious effect on the nervous and mental apparatus.
TREATMENT: This is considered as specific, and general. In the specific treatment, the considerations must be given to what etiology is found during a careful examination. The posture should be given special attention, and perhaps an abdominal support belt should be supplied. Cases that started with the first menstrual period and have continued at all subsequent periods should be treated a day or two before the next menstrual period; this should be accompanied by a suggestive idea of the doctor, that this period will be free of any attack.
The abnormalities, if any, of the blood, urine or intestinal contents should have specific attention. Laboratory diagnosis should be thoroughly made. Wassermann tests may reveal positive reactions. After all the specific conditions are tabulated and notations made for attention, the general treatment may be given as follows:
NEUROTHERAPY: A thorough lymphatic. Sedation of the whole spine with sedation also in the gutter of the cervical spine.
CHIROPRACTIC: Condyle, and upper cervical adjustment. Also any other segments or vertebrae indicated by examination.
SPONDYLOTHERAPY: C 7, D 2, L 2.
COLONOTHERAPY: Colonic irrigations twice a week for from four to six weeks are of special benefit.
DIET: There seems to be much confusion about the diet for these patients. They run from long fasts to short fasts. From the high fat ketogenic diet to complete vegetarianism. The effect upon the psychi of these patients is a very important item, and since epilepsy is considered a nervous syndrome, the less worry the physician gives the patient the quicker the results. The patient who is always cautioned about what he shall or shall not eat is constantly in a high psychic state. Therefore the writer has found it best to use No. 1 and No. 2 diets alternatively, with additions of plenty of fruit. The experience of the writer with fasting has been that while the patient fasted, no attacks were experienced, but as soon as the patient began to show a weakness from fasting the attacks were worse than before fasting, and when the patient got back to eating the attacks were the same as before the fast. If diet is to be of value, it must be low in carbohydrate, and high in fat content. But even making up the proper proportions for those of various ages, the question still arises whether the effect on the psychi does not overbalance the good. The writer uses No. 1 and No. 2 with changes from time to time that are pleasing to the patient.
EXERCISES: These patients should be given definite tasks to do, if not employed.
ELECTROTHERAPY: Sine wave on the liver, and intestines, and central spine, with one electrode on the 7th cervical, and the other on the lumbar, will give a soothing stimulation.
VITAMINOTHERAPY AND ENDOCRINOLOGY: The vitamin therapeutics in epilepsy is somewhat confusing, but a good cause can be made out for large dosages of B1, G and E in the absence of a definite etiology.
The endocrine aspects have been stated, that fits are increased by hypofunction of the posterior lobe of the pitutitary. Another theory maintains that body water and salt are regulated in part by the hormones, particularly the gonads, the thyroid, and the posterior lobe of the pituitary.
The above theory led to the institution of the water drinking restriction as a therapeutic agent, but which has some very serious objections, because of the danger of fatal acidosis, that the method is not generally practiced to a degree of danger. However, there have been some very good reports of the effectiveness in the use of pituitary, gonadal and thyroid hormones.
ENDO-NASAL THERAPY: The writer has explained the relationship of anoxia to epilepsy, and recommends to all physicians that in addition to whatever other form of treatment that they give, to find a place for (1) The Lake Recoil; (2) Enlarging the external nares; (3) Releasing and raising the Thyroid and Parathyroid glands; (4) Swabbing out the whole pharyngeal cavity.
PSYCHIATRY: Habit is a very important factor in epilepsy. Each attack tends toward making a cycle of attacks. A young girl may start having them at the first menstrual period and then at every monthly period. This cycle should be broken if possible and auto suggestion or treatment just before the hour of habit time with suggestions are sometimes helpful in breaking the cycle of habit time. Mental hygiene, or the proper attitude to be taken by the patient toward all around him, is a part of the physician’s orientation suggestive treatments.
A drugless physician who succeeds a medical practitioner in the care of an epileptic who has been taking regular doses of bromide or phenobarbital should use good judgment in breaking the patient off from those drugs too abruptly, without a substitute of some kind offered, lest a quick series of convulsions follow one upon the other from psychic fear of being left without some support. Vitamins may offer a good substitute.

Eye Disorders

 Note: The examination and diagnosis of eye disorders are of such an extensive nature, and the treatment of them so highly specialized, that no effort is made to be specific in treatment and only a few of the disorders are mentioned. A general outline of some drugless forms of treatment is given following a brief outline of the conditions.

AMAUROSIS — AMBLYOPIA

 DEFINITION: These two terms should be used to refer to certain kinds of blindness. Amaurosis was formerly used to designate partial or complete blindness of one or both eyes, while amblyopia is now used to indicate imperfect vision not due to errors of refraction or pathological changes.
ETIOLOGY: Amaurosis may be due to tumors or other organic changes in the brain by which the optic tract is compressed or ventricular fluid is forced into the optic nerve sheaths, preventing the optic nerves from performing their functions. Venous and arterial circulation are interfered with, and the nerve gradually or suddenly atrophies as is often the case in apoplexy.
Nephritis may cause disturbances in the field of vision. Hysteria or great psychological shocks may cause disturbances for a time, or even permanent disturbances.
Amaurosis of either one or both eyes may accompany subluxations, perversions or lesions of the spinal column creating atrophy of the Optic nerves. Amaurosis may follow an extensive loss of blood from any part of the body that has a diseased condition. Imperfection in the breathing apparatus, which obstruct the intake of oxygen will contribute toward anoxemia and a constant reflection of ischemia. Pregnancy has been known to have suspended vision for a short or a long time.

AMBLYOPIA

 DEFINITION: A condition in which the accuracy of vision is below normal.
ETIOLOGY: The causes of this condition are too many to enumerate here. The majority are of a constitutional nature or from excesses in the habits of sex, eating, lack of rest, etc.
PROGNOSIS is always good.
TREATMENT: In all cases of severe eye disorders it is always wise for the physician to have his patient consult a competent Optometrist and a basis of cooperative treatment instituted. The writer has found the above plan to be of great value to the patient, if both physician and optometrist have mutual respect for each other. The optometrist can note by examination the degree of defect, prescribe the necessary glasses, while the physician can search out and remove the constitutional causes.

DIPLOPIA, STRABISMUS

 DEFINITION: Diplopia is a condition in which the visual axes are not properly adjusted to one another, causing double vision whereby an image of an object falls on two different portions of the retina of each eye.
STRABISMUS is commonly known as cross-eye, and is the inability to bring the visual axes to bear on one point at the same time. While one eye is on the object the other is elsewhere.

ASTIGMATISM

 DEFINITION: An error of refraction which causes rays coming from a single point and passing through the refractive surfaces of the eye not to be turned toward a single point, and therefore cannot be perfectly focused on the retina.
ETIOLOGY: Some form of astigmatism is common to the majority of people. Severe astigmatism is caused by inequality of the curvature in the periphery of the dilated pupil, this being cut off when the pupil contracts, by a lack of symmetry in the curvature of the refracting surfaces of the cornea or crystalline lens, or an oblique position of such surface with reference to the visual line. It does not depend on distortion of the retina. Astigmatism caused by the cornea may be partly or wholly corrected by an opposite astigmatism caused by the crystalline lens. The above may be brought about by injuries to the eyes years before the development of the condition.
TREATMENT: There is no specific up to this time except corrective glasses. But the doctor may look under the general outline of treatment and try them.

CONJUNCTIVITIS

 DEFINITION: An acute or chronic inflammation of the conjunctiva, characterized by a slight swelling of the lids and a pussy secretion. There are several types: The simple acute defined above, the chronic which is a continuation of the simple type, the granular in which there is a formation of numerous oval granulations upon the palpebral conjunctiva. The gonorrheal type in which the conjunctival vessels are engorged early, and the superficial layers of the conjunctiva are infiltrated with serum and leucocytes. Later there is a purulent discharge from the free surface.
TREATMENT: Find the cause. A general treatment is given at the end of this section.

CATARACT

 DEFINITION: A general term embracing any opacity of the crystalline lens or its capsule or both.
ETIOLOGY: General diseases, such as diabetes, etc., occupation, concussion, foreign bodies, electric shock, ocular diseases cause complicated or secondary cataracts such as iridocyclitis, high myopia, and glaucoma.
TREATMENT: See general treatment at the end of this section.

GLAUCOMA

 A disease of the eye characterized by intraocular pressure with results in atrophy of the optic nerve and more or less blindness. It has been referred to as a diseased eye in a diseased body.
ETIOLOGY: The maintenance of intraocular tension depends on the preservation of a balance between the intake and outflow of the intraocular fluids. Many ill factors contribute to an unbalance such as obstructions of the veins, sclerosis of the fibers, causing a narrowing of the drainage spaces. It may be caused by the quality of the blood supply, and especially in the amount of oxygenated blood supplied. Autointoxication may also be a factor.
TREATMENT: All treatments given at the end of this section with the exception of the hydrotherapy. Instead of using cold water, hot fomentations are used. In Glaucoma however there are usually some foci of infection, autointoxications and congestions which need to be sought out and removed.

SUGGESTED GENERAL TRETMENT

 TREATMENT: It is first necessary to have a thorough examination by an expert optometrist who can give the proper correcting glasses, and make known to the physician his findings. Then the physician can introduce any measures necessary for any constitutional treatments that are necessary.
NEUROPATHY: A cervical lymphatic.
Deep or light massage of the eyes and light pressure on No. 1. See facial drawing of cranial nerves.
CHIROPRACTIC: For diplopia adjustment of upper cervical place.
For strabismus middle cervical place.
HYDROTHERAPY: If eye work is straining, it should be stopped for awhile, otherwise cold water should be dashed in the eyes three times a day.
EXERCISES: There are many forms of exercises, such as looking up, down then to the sides without moving the head. One the physician can use after ascertaining which eye is out of focus, is by the finger manipulative method. Promiscuous exercises without a knowledge of just what correction is necessary is sometimes harmful, and because one patient has responded to a certain type of exercise it does not follow that any more cases will respond to the same exercise. Each case is individual and as such the treatment is individual.
The prism converging exercises are of value in some cases.
ENDO-NASAL THERAPY: In some eye conditions these techniques have been found of value: The Lake recoil, opening zygomatic sutures, heating of eye direct and manipulation. It has been the theory that the eye duct is to only carry away the tears, but it also has an oxygen and air conveying function. After heat has been applied, then one finger is put in the mouth over the teeth, and approximating the outlet, and one finger is put under the eye approximating the inlet and a vibratory movement to the side and up and down is started This is followed up by the external nasal dilation technique, and a complete swabbing of the pharyngeal cavity.
VITAMINOTHERAPY: The vitamins that are considered specific are A for diminished vision, corneal ulcer, and tear duct infections. B and G for conjunctivitis, C, for cataracts, and G, for soreness of the eyes.
HERBOLOGY: Tea made from any of the following herbs is excellent for bathing the eyes: Fennel Seed, Eye Bright, Chamomile, Cheese Plant, Yarrow.
CATARACT: Fresh juice from cocoanut put freely into eye with dropper; apply hot wet cloths on reclining patient’s eyes; keep cloths hot for 10 minutes.
ELECTROTHERAPY: It is well established that no medicinal treatment is effectual against cataract, but the electrical currents hold out some hope in selected cases. Negative galvanism merits a thorough trial. Daily operations over a long period are necessary, and persistency in this regard will often be rewarded by results. The high frequency currents, too, should be given a trial. Use may be made of the improved eye electrodes for this purpose. With diathermy also persistency is necessary. No claim is made that cataracts can be cured by electrical currents, nevertheless, eye physicians have recognized that some of the electrical currents prove successful in some incipient cases.
GLAUCOMA: This does not respond uniformly to electrotherapy. But relief from pain is sure by the use of galvanism, and diathermy. Glaucoma has often been ameliorated by negative galvanism and diathermy given over the closed eyelids.

 
Fever

 DEFINITION: A condition in which the body temperature rises above 99.5 degrees.
ETIOLOGY: It is always symptomatic of some underlying cause. The treatment must be of the cause, but to keep the fever within proper limits until cause is found, a cool compress around the throat, changed often. Concussion of the 7th cervical, or even of the whole spine if the concussion is kept up long enough to get the reaction. Adjustment of cervical place, and kidney place.
Enemas or colonic irrigations are in order.
All foods should be restricted for the time being, and liquid intake increased.

 
Fununculosis (Boils)

 DEFINITION: An acute circumscribed inflammation of the subcutaneous layers of the skin, gland, or hair follicle. The deeper tissue inflammation is so severe that blood clots in the vessels and the center dies. This is the cause of the acuteness of the pain; the dead core is ultimately thrown off.
ETIOLOGY: Single boils are usually due to local irritation or uncleanliness of the part. Multiple boils or crops of them, are usually due to constitutional impaired health. Either way it is caused, the entrance of pus cocci into the skin is essential for its development. In general the etiology can be said to be as follows: Improper diet and hygiene, nervous depression, overwork, too free indulgence in greasy foods and gravies and irregular action of the bowels, local irritation, friction and prolonged poulticing predispose to this affection. The entrance of pus-cocci into the skin is the essential or exciting cause of this disorder.
TREATMENT: There are two schools of thought. One school insists that if possible to abort every boil and advocates the use of ice. That cold applications contract the peripheral vessels, decreasing the amount of blood in the region, reducing the pain and driving the pus back into the deeper tissues for reabsorption and elimination. A returned physician from service at the war front said he found it better never to abort them, but bring them to a point of discharge as quickly as possible and with that purpose in mind, he made a strong concentrated hot solution of epsom salts, put it over the boil and tied it on tight. He said overnight this solution usually brought it to the bursting point. Treatment of crops of boils the cause must be found and removed by appropriate treatments.
ELECTROTHERAPY: If seen early, boils many times can be aborted by dessicating the apex. Upon suspicion of carbuncle the dessication should be carried to a greater extent. Follow this by a second degree erythema dose of water-cooled quartz light using a compression lens. If seen too late to be aborted, the point should be incised. After the pus is drained the wound should be swabbed with a 2 per cent solution of gentian violet and then irradiated with the water-cooled quartz light through a rod applicator inserted into the opening. The hand type of the cold quartz can also be used with gratifying results. When many boils are present the air-cooled general radiations are indicated for protective action upon the system. Concentrated ultra short wave has a sterilizing effect on the pus.
DIET: A fast of a day or two on the citrus fruits is usually sufficient for relief.
VITAMINOTHERAPY: Large doses of A, B, G and F are in order. In children cod liver oil with supplements of vitamins A, B, C and D are a very good approach to the problem of depleted blood content.
HERBOLOGY: Make tea of equal parts of Yellow dock, Burdock, Yellow Parilla, Cheese Plant and Sacred Bark. Drink cupful in one day.
Take equal parts of Wild Cherry Bark, Poplar Bark, Burdock root, and Sassafras; boil and make a syrup. Tablespoonful three times a day.
POULTICES: Ripe figs; Hot catnip leaves; Leaf lard and Fullers earth; then when open, Fullers earth only. Botanic Gardens make up various salves from fresh herbs which are excellent to bring boil to head and then to keep clean and heal.

 
Gall-Bladder Disorders

 The most outstanding are: Acute and Chronic Cholecystitis, Cholelithiasis and Cancer.
DEFINITION: Acute Cholecystitis is an acute inflammation of the gall-bladder.
ETIOLOGY: Before giving the etiology we would advise the reader to go back in the Book of Neuropathy, and read again the examination of the liver and gall-bladder. Cholecystitis is largely attributed to invasion by infections and organisms such as colon bacillus, typhoid bacillus, pneumococcus, staphylococcus and streptococcus. Auto-intoxication is one of the principle causes apart from infection. While no age is exempt, it is found more often in women than men. And, it is most common in those who do not take any exercise. The main cause is excessive vasoconstriction of the gall-bladder segments of the spinal nerves. Gall stones, stenosis and adhesions are other causes.
SYMPTOMS: The most common is pain, but, in catarrhal cases the symptoms are slight fever, pain in the hepatic region, tenderness and enlargement of the gall-bladder, and occasionally jaundice. In the suppurative form there are severe paroxysmal pain, vomiting, a septic type of fever, leukocytosis, enlargement and tenderness of the gall-bladder, and in some cases jaundice. There is also pain, tightness and tenderness in the spinal segments.
PROGNOSIS: Catarrhal Cholecystitis usually subsides without treatment, in a few weeks, if dietary precautions are taken. But, those complicated by gall stones, stenosis or adhesions take considerable time.
TREATMENT: Of Acute Cholecystitis. There is no sure plan of treatment for all cases. But, the majority will respond to some or all of the following methods. Naturally, the first thing to do when the patient has an acute attack is to put him to bed until it is over. The nausea, vomiting and pain may simulate appendicitis, and the physician needs to use caution in diagnosis. It may be hours before the large area of pain may be localized to the gall-bladder area. All food is prohibited Anodynes are used on the liver in the form of short wave or hot wet towels. Plenty of water or natural fruit juices are permitted. Sometimes, it is found tht the ice pack or bag gives more comfort than the hot applications.
Neuropathic sedation treatment of the spinal nerves can be given by the physician in the most comfortabls position to the patient. If lying on back, fingers can be pressed in the gutter of the spine by going underneath the patient. Generally speaking, the above is sufficient for the patient to get relief. Then, the same treatment can be used as under “Chronic Cholecystitis” following this Section.

 
Chronic Cholecystitis

 Chronic Cholecystitis may be due to repeated attacks of the Acute form, or it may be a mild case from the beginning, that is continued for a long period of time, with intermittent periods of severe pain. There is chronic indigestion, discomfort in the epigastrium, flatulence and belching. Sometimes nausea and vomiting. Severe pain radiating to the back and right shoulder with pronounced jaundice are always suggestive of gall stone complications. The touch or palpation of the hand is against a thickened wall that is very warm in chronic catarrhal inflammation and the spinal segments are tender and warm.
TREATMENT — GENERAL: The diet should be bland and readily digestible. Saccharine matters, fat meats, and highly seasoned dishes should be avoided. Water-drinking between meals should be encouraged. Regular exercise in the open air, provided there are no acute symptoms, is beneficial. Freedom from worry and mental strain rarely fails to afford some relief. If the patient’s circumstances will permit, a course of treatments in a sanitarium would be the best procedure.
NEUROPATHY: Light lymphatic and vasodilation to the spinal segments. After the first treatment, the lymphatic can be thorough.
CHIROPRACTIC: Gall-bladder, Liver place, and Kidney place.
DIET: The food allowed should be soft. All sorts of liquids are allowed, except those of alcoholic content. Soups, gruels, milk and fruit juices. Bread stuffs should be toasted; meats, such as beef, mutton, chicken (not fried), should be tender. Pork, or any salted meat is forbidden. Non-dressing salads of fresh vegetables are permitted Hot water can be taken before meals. If the patient will take it, the quickest way to obtain relief is prompt fasting of a day or two each week, either with or without milk or fruit juices.
VITAMINS: B and K in adequate units, with Bile Salts.
COLONOTHERAPY: Daily enemas by the patient, or colonic irrigations once a week should help.
EXERCISES: This is important. There are many forms, but a brisk walk out of doors will be sufficient. It is a matter of record that few athletes are affected by this condition.
SPONDYLOTHERAPY: Concussion when there is distress is always in order. It can be used in the usual way from the 7th cervical down to the 8th dorsal.
VACUUM THERAPY: Over the spinal column, especially the dorsals, then underneath the gall-bladder very mildly, then directly over it. Use according to the tolerance of the patient.
HYDROTHERAPY: The anodynes and eliminatives. Heat, applied by hot water bag, wet towels, are the best anodynes for pain, but in some cases ice packs give more relief. The colonic eliminants have been mentioned. The following method suggested by Fleet has been recommended:
“Take two tablespoonfuls of Phospho-Soda (Fleet) in a glass of cold water before breakfast.
“Then lie on the right side with the knees flexed and apply heat over the area as directed. Maintain this position for thirty minutes.
“Then turn on the left side for fifteen minutes in the same position. At the end of this period drink a glass of cold water.” The physician can aid by massaging the liver and gall-bladder.
ELECTROTHERAPY: Diathermy, Short Wave, followed by the Sine Wave are rated as good procedures. Diathermy should be applied anteroposteriorly to the gall-bladder, followed by sinusoidal, (one pad placed over the 6th and 7th dorsal vertebrae and the other pad placed over the gall-bladder). The slow surging sinusoidal should be used with 10 to 18 contractons a minute and allowed to flow 15 minutes. Short Wave diathermy treatment seems to liquefy the inspissated bile and the sinusoidal, giving powerful contractions, assists in emptying the gall-bladder. Infrared, applied for ten to twenty minutes is helpful.
PSYCHIATRY: These patients usually have a worried expression and the physician while telling them the truth must give as much encouragement as possible, and suggest methods for removing tensions that may be present.
HERBOLOGY: Give Olive Oil freely; or better, 2 oz. each of unsweetened grapefruit juice shaken well with same amount of olive oil, taken on retiring, lying on right side. Indian sage and Mullein leaves is a good combination. Sweet weed, Sacred Bark, Blessed thistle, bitter root and parsley are all good. Celandine, Calamint Herb, Flax Seed, Boldo Leaves and Radishes are all good demulcents for Biliary colic. Boneset tea is good. Another remedy is finely powdered Goose Grass, Elm Bark, Sassafras Bark, Boldo Leaves, Russian Licorice and Capsicum Berries for improving and increasing the gall fluid.
BODY MECHANICS: If a ptosis is present, Neuropathic uplifting technique and abdominal support belt can be applied.


Cholelithiasis

 DEFINITION: Stones or accretions in the gall-bladder.
ETIOLOGY: The etiology lies largely in the substances that compose the stones, and how the environment causes them to amalgamate into solid concretions. Chemically the stones are of different types, but a large part of all types are composed of cholesterol in combination with other substances. There are three common types of stones. First, the large ones, composed of cholesterol and bilirubin calcium. This type of stone is of various sizes and colors. The second common type is that which is composed of cholesterol, bilirubin, calcium, calcium carbonate, bile pigments and fatty acids. They are yellow, running to white in color. The third type are the small stones composed largely of bilirubin calcium with but traces of cholesterol.
The etiology, then, can be said to be; chemical and environmental. It may be said that (1) the chemical properties are too abundant or there is an excess of cholesterol bilirubin, fatty acids and calcium. (2) The environment of the gall-bladder may be one filled with infection. Wells and Janse state that “the gall-bladder is a favorable site for the accumulations of micro-organisms of various kinds.” (3) That congestion and stenosis may delay the utilization of the chemical elements too long, and consolidation takes place. A synthesis of the whole three is probably nearer to the truth than any particular one.
Cholesterol excess can be from eating too much food containing that substance; some of which are egg yolk, liver, lard, sweetbreads, butter, roe fish and kidneys. There are also certain body upsets that produce an excess such as continual nervousness, diabetes, nephritis and hypothyroidism.
Bilirubin is a product largely of the hemoglobin of the blood red cells, and upon catabolism, the residue is thrown in the blood stream. The calcium is excreted from the blood stream through the membranous lining of the gall-bladder.
If there is an infection or a stenosis, or congestion preventing the bile salts, glycocholate, and taurocholate from acting as solvents, the cholesterol, bilirubin and calcium will form a hard combination.
Congestion, stasis or stenosis of the liver and gall-bladder are then, predisposing causes. It is interesting to note here that in thirty years of practice, that we cannot recall one patient who has taken the Neuropathic three-cornered liver and gall-bladder treatment, ever being diagnosed as having gall stones.
SYMPTOMS: There may not be many. Gall stones may exist for a long time, dormant, and not give any trouble, and their presence be not known until discovered by accident when X-ray pictures are made for something else, or autopsies reveal them.
But, when they begin to migrate, many complications may arise. Obstruction to the bile flow and distention of the organ; then will follow the characteristic symptoms of digestive disturbances; heaviness in right hypochondrium, tenderness on pressure over gall-bladder. Gall-stone colic when passing through bile duct if obstructed. Pain may radiate to back and right shoulder. Colic usually manifests when stomach is empty. Jaundice is produced when flow of bile is obstructed. Pain may be associated with vomiting, acidity and sweating.
PROGNOSIS: Depends on complications.
TREATMENT: Neuropathy. During acute attack, dilation of the gall-bladder segments of the spine that are found tight and ropy in contour. They must be relaxed.
CHIROPRACTIC: 8th, 9th, and 10th dorsals, but an adjustment is difficult in an acute attach. Treatments may be given from the 6th to 11th dorsal to dislodge the stone or stones.
DIET: During the acute attack all food should be withheld. Later on, all foods rich in fat, or foods that create gas, should be avoided. Alcohol of every kind is to be avoided. The drinking of hot water in great quantities during the attack is recommended.
HYDROTHERAPY: Hot water bag or hot fomentations or hot compresses over the liver area, or ice bag if that gives the most relief.
COLONTHERAPY: For detoxication purposes colonic irrigations, given by an expert two or three times a week for one month are excellent. In the acute attack only low enemas as a rule are feasible.
SPECIAL TREATMENT: Accidental discovery of gall stones, with no apparent symptoms, presents a problem to the physician, in view of the fact that many live to a good old age with stones lying dormant.
Whether methods should be instituted at once to remove them without waiting for serious disturbances or delay until they develop, has long been a controversial question. Both sides have valid reason for being opposed, one to the other. This we must leave to the physician to decide, to judge each case individualy. However, when there is pain, the physician must decide on one of two courses To try and dissolve the stone or stones, or have surgery performed.
Medicine claims there is no other way but surgery. William Fitch Cheney, M. D., speaking for surgery, remarks:
“About one matter physicians and surgeons will agree, i.e., that there is no drug or combination of drugs having the power to dissolve gall-stones or to expel them. Patients frequently ask about this and there are some dishonest irregular practitioners that make claims to possess such a remedy; there is no proof, however, of results to justify any such promises.” Encyclopedia of Medicine & Surgery, Vol. 9, p. 218.
While John C. Hemmeter, in Sajous’ Analytic Cyclopedia of Medicine, states the case for immediate operation as follows:
“The 4 chief dangers that may threaten the life of the carrier of gall-stones are: 1, acute suppurative or gangrenous
cholecystitis; 2, cholangitis; 3, malignant disease of the gall-bladder; 4, operation in delayed cases. In the severer types of
acute suppurative or gangrenous cholecystitis operation should not be delayed.
On the other hand McCoy relates in his book, “The Fast Way to Health,” that he has seen hundreds of stones that had been partially dissolved passed from the bodies of patients by the following regime. He stated: “I have seen many gall-stones removed through this treatment, but usually they are only from ¼” to ½” in diameter, being dissolved to that size before they can pass through the gall ducts. This large stone, however, was brought away without any cramps or colic, and with only symptoms of nausea until it passed through.”
This first method of treatment to be used for any disorder of the liver or gall-bladder is the olive oil and fruit juice regime. Just before retiring the patient usually takes four ounces of olive oil, together with four ounces of lemon, orange or grapefruit juice. The oil and fruit juice are beaten up well together into as much of an emulsion as possible, and the mixture, if taken just before retiring, is less liable to cause nausea while the patient is asleep. This may be taken on one night only, or on several nights in succession, and should be followed by a fast with grapefruit juice, lemon juice, or orange juice. This fast should be continued as long as necessary, and the olive oil treatment may be taken as many times as seems advisable to accomplish a thorough cleansing of the gall-bladder and liver.
You will find it a great aid to the cure if neuropathic or massage manipulations of the gall-bladder are used. Heat treatment over the liver and gall-bladder may be expected to increase the rapidity of the cure. This heat is best administered through the radiations from a powerful therapeutic light or short wave apparatus.

 
Glossitis

DEFINITION: Glossitis is an inflammatory condition of the tongue characterized by excessive heat, swelling, redness and hyperemia.
SYMPTOMS: There are two types, the acute parenchymatous and the chronic. The symptoms of the parenchymatous type are: Swelling of the organ, sometimes causing it to protrude from the mouth, usually the first symptom. Severe pain follows and deglutition is impeded. When the swelling involves the lymphatic elements in the posterior portion of the tongue, dypsnea may appear, owing to pressure on the epiglottis. Stomatitis and ptyalism are more or less marked. The breath is usually fetid, owing to a thick, yellowish coating on the lingual surface, which may also present striae of ulceration. There may be considerable fever. The symptoms become aggravated up to the third or fourth day, when there is a lull, followed by gradual improvement. Occasionally an abscess forms deep in the organ, as a rule, close to the periphery. Gangrene sometimes occurs; rarely, but one side is affected.

 
Chronic Glossitis

 This condition, also known as glossitis desiccans, is, in many cases, attributed to syphilis, when in truth it is but the result of tobacco irritation, or, as shown by Brocq, due to gastric affectons in rheumatic subjects. Strong alcoholic drinks are occasionally the cause.
SYMPTOMS: The tongue is red and sensitive, especially near the edges, and oval grayish patches resembling those of syphilis replace papillae or epithelial cells which have yielded to the superficial ulcerative process. The resemblance to syphilis is accentuated by deep furrows, which tend to separate the tongue into island-like, lobulated surfaces. A foul breath is often present, especially in drunkards. The history and the results of treatment alone facilitate diagnosis.
TREATMENT: Neuropathy. A thorough lymphatic of the whole body with special emphasis on the liver.
CHIROPRACTIC: Adjustment of the cervicals and stomach place.
HYDROTHERAPY: Cold applications to the tongue, or ice pellets to sup on. Cold lemon water held in the mouth is very helpful.
DIET: A fast is not difficult at this time and food should be withheld until symptoms disappear. Liquor and tobacco only aggravate the condition.
COLONOTHERAPY: Colonic irrigations, or high enemas daily or twice a week would be beneficial.
VITAMINOTHERAPY: B2 and G. A mouth wash made of five drops of 120 V.M. to twenty drops of water three times a day is excellent.

 
Gonorrhea — Gonococcal Urethritis

 DEFINITION: A contagious specific inflammation of the mucous membrane of the urethra or vagina, accompanied by a mucopurulent discharge, due to infection with gonococcus. Because of the involvement of the urethral canal the condition is also termed Conococcal Urethritis.
ETIOLOGY: Practically all cases of the adult are due to sexual intercourse contact. Accidental infections are claimed but if so, they are rare. The period of incubation in the male is from three to seven days.
SYMPTOMS IN THE MALE: Yellow mucopurulent discharge from the penis. Inception in the urethra. May become deep-seated and affect the prostate. Slow, difficult and painful urination, and sometimes rigidity of the penis with great pain. The commonest example of gonorrhea is that of the urethra of the male. The disease usually manifests itself within three to five days after the interourse. The first symptom is an irritation of the meatus, which becomes swollen and of a deeper red color than normal, and shows a slight, thin, whitish discharge. Urination usually causes considerable local smarting. The inflammation then extends backward and rapidly becomes more intense, so that in twenty-four to forty-eight hours the discharge has become profuse, thick, yellowish, and, in the severer cases, tinged with blood. Pain in urinating is very intense. The patient has obstinate erections, especially at night, accompanied by severe pain. The characteristic phenomena known as chordee consists in a downward bending of the organ during erection due to loss of elasticity of the inflamed urethra, the corpora cavernosa meanwhile distending and elongating as usual; when this occurs the pain is especially severe.
COMPLICATIONS: In the female there is danger of involving the organs of generation, and sterility with a variety of inflammatory conditions, with local peritonitis and resulting adhesions, with a possibility of crippling the patient to invalidism. In the male there is a possibility of stricture, prostatitis, cystitis, epididymitis, lymphagitis orchitis and bubo, Gonorrheal arthritis and Rheumatism.
PROGNOSIS: It may clear up without any complications. Its effects differ in individuals. Or it may become chronic producing some of the complications mentioned above.
DIAGNOSIS: A male presenting himself to the physician with a red swollen penis and a creamy discharge, it can be assumed he has gonorrheal infection, and a smear should be taken for microscopic examination at a laboratory. A female presenting herself with painful and diffcult urination and profuse vaginal discharge, with the vulva red and inflamed and covered with a white creamy pussy discharge, an assumption of gonorrheal infection may be taken and a smear made for microscopic examination.
TREATMENT: The physician and nurse should use every precaution for self-protection. Always wash hands after tending patient. Rubber gloves and a gown should be worn. The latter should not be worn in caring for another patient and gloves should be sterilized after treatment. All linens should be sterilized after using and dressings immediately disposed of. The danger of an infected eye on the part of the nurse is very considerable.
There are two schools of thought in regard to treatment. One school thinks that in the early stage no treatment is to be given until one week after the infection has begun in order that the body be allowed to develop a natural immunity to the organism. During this period fluids are to be taken in great amounts, the diet should be free from condiments, alcohol and coffee, rest in bed if possible, particularly at the time of a menstrual period, and excessive exercise and all sexual contacts are to be avoided. After this period, active treatment is begun. The other school thinks that treatments should be begun at once to abort and eliminate the infection.
If reports in newspapers are accurate, that the medical profession have found penicillin is a direct specific, and that the condition is all cleaned up from forty-eight hours to a week without any after effects, then gonorrhea has ceased to be a serious problem to the drugless physician. However, we give the old standard form of treatment here first for the male.
DIET: Gonococcus does not fare very well in an alkaline medium. For the cure of this disease an alkalosis must be developed for the time being. The writer has known of several cases that were relieved by the patients going on a complete fast of skim milk, buttermilk or clabber. About four glasses full a day were consumed. These fasts varied from one to two weeks. But it is difficult to get patients to go on such fasts, and the next best thing to do is put them on a restricted diet. All meats, coffee, tea, beer, liquors, wine, spices and condiments are aggravating. Usually this is sufficient to allay the irritation along the urinary passages. The patient should drink all the water that is possible for him to do so, even to forcing it.
HYDROTHERAPY: A douche spray over all the genitalia with alternate hot and cold water, ending with the hot, is very beneficial for any difficulty in urination. Sitz baths, with water as hot as possible to be borne, twice a day, for a half hour is of great help; an ice bag may be applied to top of head.
CLEANLINESS: The patient should be required to bathe three or four times a day. The best bath is in warm water with three or four pounds of epsom salts dissolved in the water. Remain in the water twenty minutes, or longer, each time. Clear hot water is good also for this bath. Along here consider also the necessity for more than ordinary cleanliness of the penis itself. Pull the foreskin well back and wash gently but completely all around the end and fully under the foreskin. Use stronger epsom solution for this or a good antiseptic soap. After the washing of the organ use a little vaseline around the end and within the end of the passage to keep it open, so the discharge will pass out freely. The patient should be instructed not to allow the foreskin of the penis to glue together, but to wash as often as necessary to keep the opening free.
STRAPPING: The testicles should be supported by a suspensory or some suitable device and a very soft cloth put over the penis to catch the discharge, which should be changed frequently Sexual intercourse should be absolutely forbidden and a violation of this restricton should be reported to the authorities.
VITAMINOTHERAPY: The danger of sterility and impotency can be met with Vitamin E in large doses, but Vitamin A, B6 and K are also useful in this condition.
ELECTROTHERAPY: Great claims are made for the heat treatment of diathermy. That if a temperature of 106 degrees is maintained for five hours that gonorrhea can be cured in one or two treatments. There are about five different methods, but the one generally used is to give the patient the general hyper-pyrexia at the same time using local diathermy over the part infected. This permits the area to be heated much hotter than is recorded by the body temperature. If possible these treatments should be given in a hospital or an institution equipped for emergencies that may arise unless there are to be many treatments when the hyper-pyrexia on each visit does not exceed 102 or 103 degrees. Infrared has some value in alleviating pain.
COLONOTHERAPY: Daily irrigations or enemas may be given of hot water, but care must be taken not to injure the prostate.
HERBOLOGY: Equal parts of Yellow Dock, Red Clover Tops, Burdock, Elm Root, Myrrh. A teaspoonful of mixed herbs in a cup of boiling water, let stand till cool, strain, use cupful three times a day.
Tincture of Buchu 2 oz., Tincture of Uva Ursi 2 oz., Sweet spirits of Nitre 2 oz., Alcohol 2 oz., Tincture Juniper Berries 2 oz., Oil of Eucalyptus 20 drops. Cut the oil in the 2 oz of alcohol first. Then mix and shake before using. Use a teaspoonful three to four times a day. Take less if too strong.
The above forms of treatment are also applicable to the female in addition to the following vaginal douches of hot water three times a day Ten drops of 120 V. M. may be added to each pint of water used.
The writer for several years has refrained from taking cases of this nature or syphilis, referring them to hospitals or dispensaries where better control of the patient’s habits can be maintained and since they are reportable as communicable diseases, the responsibility of the final report is placed on the treating agency.

 
Gout — Acute, Chronic

 DEFINITION: A disturbance of metabolism, involving the disposition of purine substances in the blood, resulting in excessive uric acid in the blood and deposits of sodium urates in and around the joints, accompanied by inflammation.
ETIOLOGY: Claimed to be often hereditary. More common in males than females, and is usually seen after the 40th year. The excessive use of wines, malt liquors, over-eating, bad sedentary habits, nervous strain and chronic lead and aluminum poisoning all can be predisposing causes.
SYMPTOMS: Usually before an attack there is restlessness, insomnia, moroseness, irritability, dyspepsia, and changes in the urine, the urine becoming scanty, high colored, and deficient in urates. The arthritic signs usually appear suddenly in the early morning hours and are characterized by pain and swelling in the ball of the great toe. The affected joint is so tender that the slightest pressure causes agony. It is of a reddish-purple color; and the overlying veins are full and distinct. During the paroxysm the temperature is moderately elevated (101-102 degrees F.) and the pulse quickened. Toward daylight the pain subsides to a great extent and the patient falls asleep. During the day he is comparatively comfortable, but there are severe returns for several or many nights. At first the attacks may be a year apart, but as they multiply the intervals grow less, until finally the patient is seldom entirely free from suffering, for it may pass into the chronic stage when the ankles, wrists and elbows become involved and become enlarged, stiff and painful. Chalk-like deposits sometimes ulcerate their way through the skin, and are discharged in a pus formation.
PROGNOSIS: Acute gout is quickly relieved by physical therapy and dietary methods, but in the severe chronic form the tendency to renal and arterial complications makes the prognosis very guarded.

TREATMENT

 HYDROTHERAPY: For relief of pain, the leg should be elevated and wrapped in cotton or wool, and then cloths soaked in a magnesium sulphate solution, continually applied. If the above should not give relief, then a new wrapping of cotton is applied, and an ice pack put over the cotton. A glycerin pack has many advantages, soaking the cotton-wrapped part with glycerin, then covering with another layer of cotton.
HEUROPATHY: A thorough lymphatic of the whole lymph system with a sedation of the whole spine.
CHIROPRACTIC: Local, kidney, spleen and liver place.
DIET: A fast of a few days with or without milk is probably the best procedure. The majority of sufferers are usually overfed and obese. After the fast, vegetable soups for a day or two, then No. 2 diet as long as no weakness is shown, then a gradual working back to No. 1 diet. If the patient can tolerate them, citrus fruits and juices are helpful. But some patients do not tolerate them even with meals, and if this is found true, then the juices even in the diets will need changing. Drinking large quantities of water should be encouraged for a few weeks.
COLONTHERAPY: The bowels may be irrigated thoroughly once or twice a week for three weeks.
HYDROTHERAPY: In addition to what was mentioned above, sulphur baths, Turkish baths, sweating are all helpful.
EXERCISE: A general vitality building exercise, and swimming and bathing are of importance in eradicating this disease The exercises, however, should be mild and in the open air.
ENDO-NASAL THERAPY: Since this is a disease of the metabolic processes and oxygen is a prime element in the oxidative process, it will be generally found that these patients have very serious obstructions to the ingestion and utilization of oxygen in the open and closed cavities. The nasal cavities, external and internal, should be put in order and obstructons removed, by the Lake Recoil, by the opening of the facial sutures, and dilating the nasal canal with the little finger, and by swabbing and enlarging the pharyngeal cavity.
ELECTROTHERAPY: Diathermy, sine wave, short wave, infra-red, ultra violet, all can be used very effectively.
FOOT ADJUSTING: When pain is aborted, thorough massage and kneading is helpful in breaking up the deposits, then can follow the three-point foot technique as outlined elsewhere, to put the bones in true conformity.
VITAMINOTHERAPY: High B2 and G1 or A and D.

 
Hay Fever

 DEFINITION: Sometimes called an allergic disease of the mucous passages of the nose and upper air passasges. It is characterized by a thin, watery discharge from the nose, and burning of the membrane with sneezing.
ETIOLOGY: A long standing rhinitis, auto-intoxication, nasal catarrh which may become activated by certain odors or seasons of the year.
PROGNOSIS: Recovery is the rule where the causes can be removed. The disease is never fatal and as age advances the attacks may become less severe.

TREATMENT

 NEUROPATHY: A thorough lymphatic twice a week with a strong stimulation treatment by friction in the gutter of the spine.
CHIROPRACTIC: Cervical 4, 7 and Dorsal 1.
ENDO-NASAL THERAPY: See treatment for Rhinitis and Asthma, this book, or in the book “Endo-Nasal, Aural and Allied Techniques.”
DIET: Treatments for hay fever should begin at least two months before the season of the particular type. Rose cold generally begins the latter part of May and early part of June and lasts through August. Autumnal catarrhal hay fever begins in the latter part of August and ends at the first frost. In both these types there is usually an auto-intoxication. The procedure is to start months before with eliminating that condition. See Auto-intoxication in this book. The diets used by the writer are No. 2 for a week, then alternate 1 and 2 up to and through the summer.
Give the Neuropathy, Chiropractic and Endo-Nasal treatment twice weekly.
COLONTHERAPY: High colonics are in order twice a week for three weeks or daily enemas by the patient.
PSYCHIATRY: The physician will need to use many suggestive therapeutic ideas, because the average patient with this condition is skeptical because of a mental fixation that it is sure to appear on time and generally the time is kept in mind, giving to the patient a feeling of almost helplessness and of martyrdom.
ELECTROTHERAPY: Ultra violet applied to the membrane by means of a cold quartz orificial unit or the light from a water-cooled lamp applied through a nasal applicator is helpful. Zinc ionization has been advised. The nasal cavity is packed with a narrow strip of gauze saturated with a 2 per cent solution of zinc sulphate. Sometimes it is necessary to spray the nasal membrane with a 2 per cent solution of butyn to allay the irritation. When the gauze is used, connect with the positive pole of a good galvanic machine. The negative pole should be an electrode, 4 by 5 inches, placed at the back of the neck. Use four to twelve milliamperes of current for five to fifteen minutes, depending upon the tolerance of the patient. About sixty milliampere minutes is the average dose. Repeat the treatment several times if necesssary. This is not a specific treatment but it gives results in some cases. A combination of zinc ionization with the ultra-violet is advised for some patients.
VITAMINOTHERAPY: Vitamins A and C in large doses are recommended.
HERBOLOGY: Make a tea of Life Everlasting, take a cupful night and morning; also make a pillow of it and sleep on it.
Yellow Dock Root, pulverized and snuffed up nostrils is helpful.

 
Headache

 DEFINITION: A pain or distress in the head.
ETIOLOGY: May come from any of the sources mentioned below: Subluxations of any of the vertebrae which may cause a reflex to the head. Perversion of the blood flow by over-activity of the vaso-constrictors to the head or of the vaso-dilators.
Headaches may be classified as Hysterical headache due to some type of neurosis; Organic headache, from meningitis, intracranial syphilis, cerebral tumor, abscess and softening of the brain. This is suspected when the headache is persistent and there is vertigo and vomiting. Hyperemic and Anemic headaches; too much blood or too little blood to the brain; from mental strain or a general anemia or hypertension. Congestive headaches; catarrhal congestion gives a characteristic cold fulness of the head. Reflex headache may be due to eye strain, bad posture, ovarian or uterine disorders, sometimes spoken of as menstrual headache. Sinus headache, due to inflammation of the frontal ethmoidal and sphenoidal sinus. Gastric headache, from gastric upsets, usually relieved by vomiting. Toxemic headache is usually uremic in origin. A high arterial tension is usually present with albumin and casts in the urine.
Among toxic headaches may be those caused by alcoholism, monoxide poisoning from gasoline fumes in congested cities. Tea, coffee, and other condiments with a host of other substances and habits, may be contributing factors.
DIAGNOSIS: Headache must be distinguished from migraine. In the latter the attacks are usually more distinctly periodic; the pain is often unilateral, and is frequently accompanied by vomiting, vasomotor disturbances, and subjective visual phenomena.
Headache in the region of the orbit may be mistaken for acute glaucoma, but in the latter condition the eye is inflamed; the cornea is hazy; the pupil is sluggish; vision is impaired; and on palpation the affected eyeball is found to be harder than its fellow.
TREATMENT: Relief of the acute condition may be given at once by hydrotherapy measures, using hot or cold compresses to the back of the neck and over the pain area. The Lake Recoil if skillfully performed will usually give relief at once.
CRANIAL THERAPY: Please turn to that section and read the methods to treat headache, but in the interval between headaches, that come at regular periods, and continue, diligent search should be made for the underlying cause. By personal and clinical examination the cause is not usually hard to find.


Hernia

 DEFINITION: A protrusion of one or more of the abdominal viscera, and is sometimes referred to as a rupture.
VARIETIES: If the protrusion is noticed at birth it is known as congenital hernia. If the protrusion takes place after birth it is known as acquired hernia. Hernias take their names from the locations in which they occur. A few are as follows: Cerebral hernia, of the brain; femoral hernia, descending of intestines beside femoral vessels; inguinal hernia, passing of intestines through inguinal canal occurs in 80 per cent of cases of hernia; lumbar hernia, in lumbar regions or loins; phrenic hernia, projecting through the diaphragm into one of the pleural cavities; strangulated hernia, compressed in some part of opening through which it protrudes, interfering with circulation of part exposed.
ETIOLOGY: It is thought that about 20 per cent of hernias are of congenital or hereditary origin; 40 per cent are rupture before the age of 35; 60 per cent of ruptures occur after that age; 80 per cent of ruptures are of the inguinal type. The chief existing cause of acquired hernia is sudden strain, but anything that tends to weaken the abdominal wall, or any wall; for example, too much strain or an injury may cause a break. Obesity. Strain in excessive sexual activity, or heavy lifting, may be contributing factors.
TREATMENT of the various hernias may be as follows. Umbilical hernias are usually found in babies and children. One method of treating is to wrap a large overcoat button in a piece of sterile gauze. A coin the size of a half dollar or dollar will also do. Press this button or coin over the navel and strap it in place with adhesive tape. The straps should be placed crosswise so that the abdominal muscles are brought close together in the mid-line over the rupture. This should be kept up for six to eight months, when it will be found that the rupture has healed. Large hernia may have to be operated upon, but this is only rarely necessary.
Inguinal hernia is the one that demands the attention of the physician more than any other. Inguinal hernias may be classified as soft, hard, and strangulated. The old classification was reducible, irreducible, and strangulated. But it has been found that with the passing of the years, some so-called irreducible hernias have been reduced.
DIAGNOSIS: The soft hernia is a soft tumor like swelling that is found in one of the hernial openings. This swelling disappears to a large extent on lying down, or even on moderate pressure. It may increase in size on coughing, straining, especially straining at stool. There are sensations of discomfort noted particularly when walking. The character of the swelling varies according to contents of the sac. If it contains the bowel alone, it feels smooth and elastic. If the sac contains the omentum the tumor is more uneven, is lobulated and is without elasticity.
Both bowel and omentum may fill the sac, then there is a combination of the above symptoms.
The hard or irreducible hernia is any form that may become hard because of pressure. The irreducible hernia is not much different from reducible hernia except that the irreducible is more difficult or impossible to replace in the abdominal cavity. The symptoms, besides the evidence of the sac, are distress, colic, constipation, and inflammation, and strangulation is a possible complication.
A strangulated hernia is one in which the loop of the bowel is so constricted as to prevent the passage of fecal matter, and to interfere with circulation.
This may be caused by engorgement of the sac, and by adhesions.
TREATMENT: The effort is to return the contents forming the sac back up into the abdomen, and give the orifice a chance to close and heal. In an infant or child, the child can be put on a table with the head much lower than the legs. Then the sac can be gradually worked upward into the abdomen. When this is done, a pad or a roller bandage can be firmly fixed over the inguinal canal by adhesive strapping. For a day at least no solid food should be permitted to prevent straining at stool. An enema should be given before the above operation, and absolute rest for at least four hours afterward.
In the adult cases of all hernias: The following attempt may be made to put the tissues back in place. The patient is placed on a table with the head lowered a little. The contents of the abdomen are kneeded upward spreading them out into their natural anatomical position, while the kneeding is going on. After the above technique has been done for five minutes then a large size vacuum cup is placed five inches above the hernia. This cup is inflated just enough to grip. The left hand of the physician is used to push up lightly on the cup while the right hand manipulates in such a manner as to restore the omentum or bowel back into place. If success is achieved, then a truss or belt is put on. An enema should precede the above operation, and the patient should rest for several hours, abstaining from eating solid food for a day or two, and also from hard labor, or even light labor if possible. This operation can be repeated weekly if necessary but the truss or belt is worn continuously.
In the strangulated form of hernia, a flexing of the legs upward, and at the same time an effort to release the strangulated portion may be made. But usually this type requires surgery, and a surgeon should be consulted before it becomes too late.

Herpes Zoster - Shingles

 DEFINITION: Herpes Zoster is an acute inflammatory disease of the skin, appearing over definite nerve areas preceded by warning symptoms accompanied by more or less severe pain, with usually a unilateral eruption, characterized by the occurrence of groups of firm, tense, globoid vesicles rising from an edematous, base, sometimes followed by ulceration and scarring.
The other forms of herpes such as facialis, progenitalis and labialis are all related more or less in definition and etiology in that all the nerve areas affected seem to be affected by perversions of the nervous systems in the particular area, which does not have the power at the time to carry away the toxins that are deposited in that peculiar locality.
ETIOLOGY: Perversions of the posterior nervous ganglia or subluxations of local zones to the area afflicted. Certain medicines like the arsenical compounds may produce shingles. There is a thought that a specific virus is present which is as yet unnamed but closely associated with chicken pox. The blisters look the same in both diseases, but in chickenpox the blisters occur in crops which appear at irregular intervals and which affect the entire body, more or less, on both sides of the body, whereas shingles is usually confined to a single area on one side of the body.
There is a type known as symptomatic zoster, which affects the cells of the posterior root ganglion. From affections of the posterior root ganglia in tabes, or irritation of those ganglia from neoplasms, or injuries, or from the exudations from chronic syphilis.
SYMPTOMS: This disease starts with pain in the region where the blisters will ultimately appear. The pain lasts for several days. Then the skin gets red along the nerve which is affected. Clusters of blisters form on this reddened area. Herpes zoster occurs at any age, and in both sexes. The disease is more common in adults. After the disappearance of the eruption, the nerves continue to show signs of irritation for a long time afterward.
PROGNOSIS: The prognosis is always good in the young and healthy adults but very grave in the aged people, for it is now regarded in the aged as a warning of the approach of death. Zoster may clear up of itself in a few days or it may last for weeks. The old fiction that if shingles meet in the middle that death will immediately follow is now regarded as a myth. But it does mean a double dose of the irritation and is exceedingly painful.
TREATMENT: This disease has two aspects that require special attention: First, it is a disease of the nerves. Second, the nerves may be impaired because of an inadequate blood supply in quantity or quality or both.
NEUROPATHY: Light sedation along the spine, with special emphasis on the area involved. A lymphatic of all the body is in order if it can be done without giving pain to the area involved.
CHIROPRCTIC: Adjustment. Local and kidney place.
ELECTROTHERAPY: For pain infrared is indicated. For healing purposes, general body irradiation with the body type ultra-violet is always indicated and should be given daily. Apply short wave ultra-violet from a water cooled quartz lamp directly to the affected areas, producing a second or third degree erythema along the course of the nerve and repeat if necessary as soon as conditions will permit. The application of galvanic current over the area of one to three MA once or twice a day for 10 to 15 minutes or less. This is accomplished by moving the negative pole over the diseased area and placing the positive pole over the main artery which supplies the area. Short wave over the area has also been found to be beneficial in some cases. X-rays are sometimes necessary for intense neuralgia.
HERBOLOGY: Equal parts of Prickly Ash, Burdock, Black Cohosh and Poke Root. Place heaping teaspoonful in a teacupful of boiling water and allow to stand until cold. Strain and drink mouthful of tea several times a day.
HYDROTHERAPY: Alternate hot and cold compresses for twenty minutes or a hot and cold water bag may give relief. Lime water, black wash and carron oil may be applied freely to the affected area.
DIET: A partial fasting routine with milk may be the best thing that can be done. A fast of fresh fruit juices for a few days is sometimes helpful. If anemia is present, diet No. 1 is in order and supplements of large doses of Vitamins A, B1, C and D.
VACUUM THERAPY: For a renewed circulation vacuum therapy along the spine until a real hyperemia has been obtained is a wonderful method of treatment.

 
Heart Disorders

PERICARDITIS

 DEFINITION: An inflammation of the pericardium.
ETIOLOGY: It generally results from infections, such as rheumatism, chorea and pleurisy. It may take three forms, the acute fibrinous pericarditis in which there is a hyperemic stage marked by congestion of the visceral layer. There is an exudation from its surface of fibrin, a sticky whitish elastic substance, which causes an enlargement of the pericardium and forms adhesions.
The sero fibrinous type in which there is an effusion of serum. The effusion of serum varies in each case, but in some it may go from a few ounces to several pints.
PURULENT PERICARDITIS: In this form there is in addition to the sero-fibrinous an exudation of pus. This type is also known as empyema of the pericardium.
HEMORRHAGIC PERICARDITIS: In this type there is a hemorrhage or extravasation of blood into the sac during the course of the previously mentioned inflammation. It may occur as a result of rupture or aneurism during the attack of pericarditis.
Adhesive pericarditis in which the layers of the pericardium adhere to each other or to the pleura.
SYMPTOMS: Precordial pain or discomfort, palpitation, dypsnea, moderate fever, and weakness are the usual symptoms, but in many cases the disease is latent and only discovered on routine examination. The face may be unduly pale or distinctly cyanosed, the veins of the neck may be turgid, and occasionally, if the effusion is large, there may be hoarseness from pressure upon the recurrent laryngeal nerve or difficulty in swallowing from pressure on the esophagus.
PHYSICAL SIGNS: In the early stage of serofibrinous pericarditis and throughout the fibrinous pericarditis the only characteristic sign is the friction sound. This is a superficial rubbing or creaking sound, usually double (to and fro) and of cardiac rhythm, but not absolutely synchronous with the normal cardiac sounds. It is best heard, as a rule, in the fourth left intercostal space, and not transmitted beyond the precordium. On palpation, the apex beat is hardly noticed or is lost entirely.
INSPECTION: The precordium may be abnormally prominent, especially in children.
PALPATION: The apex beat is feeble or lost. A pulsation is sometimes apparent in the fourth interspace.
PERCUSSION: The area of cardiac dullness is increased and irregularly pear-shaped with the base directed downward and the stem upward. It often extends above the third costal. In the purulent pericarditis there are some symptoms common to infections such as irregular fever, chills, sweats and pallor.
In the adherent type the following symptoms and signs may be noticed. Enlargement of the heart with (1) systolic retraction in the region of the apex and also posteriorly in the region of the eleventh and twelfth ribs; inspiratory swelling of the cervical veins; diastolic collapse of the cervical veins; absence of shifting of the apex-beat with change of the patient’s posture and during full inspiration; deficiency in the respiratory movements of the diaphragm. With these physical signs there are often symptoms of cardiac failure — dypsnea, edema of the legs.
PROGNOSIS: Seldom fatal. On the other hand, it may in addition to some other disease that may attack the person, so weaken the respiratory process and recuperative powers that a fatal termination may come suddenly.
NEUROPATHY: A thorough and complete lymphatic with sedation of the pericardial segments.
CHIROPRACTIC: H.P., C.P. and K.P. D 2-4.
HYDROTHERAPY: For pain dry cold or heat may be used. An ice bag wrapped in flannel is a good procedure and this is put over the heart. But in some cases heat gives relief quicker.
VACUUM THERAPY: Cupping all over the upper back is usually of great benefit. The cups should be placed along the spinal column first , then to the sides covering the whole area. It is also wise in the beginning to put the cups over the area and around the pericardium. It is probably unnecessary to say that at first the cups should be applied mildly.
ELECTROTHERAPY: In each case it may be well to give a number of diathermy or short wave treatments for a large number of cases respond well to those therapies. The pads are put on the back and front.
Concussion of the 7th cervical by the hand, machine or sine wave has great value for inhibitory purposes.
DIET: During the acute stage a fast of a few days, with or without milk will sometimes correct the trouble. When the acute stage has passed then Diet No. 2 may be given for a few days followed by No. 1 with modifications as the physician deems justified.
VITAMINOTHERAPY: B2, G and C D.
COLONOTHERAPY: The alimentary canal should be thoroughly cleaned out once, then daily enemas for some time. The temperature of the water. If the fever is high the temperature can be between 85 and 95 degrees F. If the patient has chills, then the water can go as high as 110 degrees F.
HERBOLOGY: Heart tonics are Hawthorne Berries, Mistletoe, Sweet Balm, Cleavers, Corn Silk, Valerian, Lavender Flowers. A good combination tea is made from Lily of the Valley, Black Cohosh, Valerian, Wild Cherry, Gentian, Wild Strawberry and Mistletoe.
A botanical laxative is usually indicated in any heart ailment; an excellent one is Senna Alexandria, Senna Tin, Turtlebloom leaves, German Cheese Plant, Fennel Seed, May Apple, Jamaica Ginger, Bluets, Sweet Weed, Buckthorn Bark, Licorice Root, Sacred Bark. It is well to remember that heart trouble is always the result of a toxic condition of the blood stream.
Asparagus is good for the heart and so is chlorophyll.

 FOR PERICARDITIS:
Crataegus Oxycantha (Barberry) 1 teaspoonful
Leonurus cardiaca (Motherwort) 1 oz.
Hydrastis (Golden Seal) ½ teaspoonful
Althaea (Marshmallow) 2 oz.

 Place in cup of boiling water, let cool, strain, and take one dessertspoonful every three hours.

 PALPITATION: Valerian ½ oz., Skullcap 1 oz., Tansy ½ oz. Boil in a quart of water 20 minutes. Wineglassful three times a day.
HEART WEAKNESS: Roman Motherwort ½ oz., Lily of the Valley 1 oz. Infuse in quart of boiling water. Half a teacupful three times a day.
ENDO-NASAL THERAPY: When the acute attack has passed, then the Endo-Nasal techniques; with breathing exercises of fresh air are very important for permanent elimination of the condition.

ENDOCARDITIS

 DEFINITION: An acute or chronic inflammation of the lining membrane of the heart. Usually confined to the external lining of the valve, sometimes to the lining of its chambers.
TYPES: Simple, Benign, Malignant, Ulcerative, Sclerotic, Rheumatic.
ETIOLOGY: Primary causes, excessive vaso-constriction of the heart segment s of the spinal nerves or a subluxation of the second dorsal. The secondary causes of acute endocarditis may be caused by acute rheumatism or acute chorea (St. Vitus’ dance).
Much less frequently it results from acute tonsillitis, one of the acute specific infections, or focal septic infection. Malignant endocarditis is, as a rule, secondary to septicemia from open wounds, erysipelas, gonorrhea or pneumonia, and usually attacks valves that are already the seat of sclerotic changes. The Streptococcus hemolyticus is the most common causative agent, but the gonococcus, pneumococcus, or staphylococcus may be the organism concerned. Subacute infective endocarditis, which is more common than the malignant form, nearly always attacks valves that are already damaged. It is usually secondary to some focus of infection in the tonsils, gums, roots of the teeth or elsewhere that has caused little or no local disturbance. The exciting agent is almost invariably the Streptococcus viridans.
Chronic endocarditis may be congenital, may follow an acute attack, or may develop insidiously as a sequence of syphilis, gout, alcoholism, plumbism, or chronic nephritis.
All the above types may be caused by a general anoxemia.
SYMPTOMS: The onset of acute endocarditis is insidious. There may be no symptoms which call especial attention to the organ affected. There may be a slight rise of temperature and some quickening, and possibly some irregularity, of the pulse. In the benign form there may be no evidence of the disease until two or three months after it has run its course, when impairment of the valves is detected. In some cases there is precordial pain, or, if the patient is a child, they may be epigastric distress, with vomiting. The pulse is of low tension, and the patient may be restless and anxious, and may prefer a somewhat recumbent to a horizontal position. Examination of the heart will disclose in most cases a murmur, usually of a blowing character, and usually systolic in time. It may accompany or replace the normal sound. Before there is an actual murmur, it may be possible to detect an impurity and prolongation of the first sound of the heart, indicating involvement of the mitral valve. Even in the malignant form the symptoms may be masked by those of the original disease. In the severer cases sometimes there is a true chill or a succession of chills, and the fever may be either typhoidal or intermittent or remittent in its character. The patient gives evidence of great prostration. The pulse is rapid and irregular; the body bathed in profuse perspiration; the spleen enlarged and tender. There may be a rose-colored eruption upon the body; more often petechiae are seen. The number of white corpuscles in the blood is greatly increased.
A general summation of symptoms may be as follows: High fever, chills, profuse sweats, great prostration, often delirium and stupor, hurried breathing, rapid irregular pulse, brown fissured tongue, jaundice and diarrhea frequently present.
PROGNOSIS: Guarded. While an attack may not prove fatal, it rarely leaves the heart undamaged. If a compensatory enlargement of the heart takes place, life may go on for a long time.
TREATMENT: In the acute stage the patient should be confined to bed, with an ice bag over the heart to allay its excitement or this may be done by concussion of the 7th cervical.
After the acute stage has passed, then a prolonged series of treatments may be necessary.
NEUROPATHY: Mild lymphatic treatment with sedation of the whole spine.
CHIROPRACTIC: Adjustment of D-2, and any other places indicated. Concussion of the 7th cervical with indications to stop when pulse is even.
HYDROTHERAPY: If the patient is up and around during the day, an ice bag can be put over the heart during the night for twenty minutes while resting. And these patients should be at rest as much as possible. It may be possible they may have to abstain from working from four to eight weeks.
ENDO-NASAL THERAPY: Nasal dilation, external and Internal will aid in overcoming any anoxemia present.
ELECTROTHERAPY: Short wave, diathermy, and infrared have been recommended with sittings of ten minutes on each visit.
HERBOLOGY: See under Pericarditis.

 
MYOCARDITIS — ACUTE, CHRONIC

 DEFINITION: An acute inflammation of the heart muscle, which if continued results in degeneration of the heart muscle.
ETIOLOGY: Myocarditis is always the result of some previous morbid condition elsewhere in the body, either through a perforating trauma or by means of the blood or by continuity of tissue. It complicates typhoid fever, scarlet fever, diphtheria, variola, cerebrospinal meningitis, pneumonia, influenza, malaria, rheumatism and, in rare instances, tonsillitis.
It may be caused by sepsis, as in malignant endocarditis, puerperal fever, osteomyelitis, erysipelas, and gonorrhea. In some instances the specific germs of these various infections are carried to the heart with the blood; this has been demonstrated in the case of typhoid fever, septic diseases and gonorrhea.
SYMPTOMS: May be along the following lines: Dypsnea, precordial discomfort, palpitation, pallor and weakness of the pulse out of proportion to the severity of the general infection are important manifestations. The pulse is usually rapid and irregular, but there may be bradycardia from vagal disturbance or depressed conductivity of the auriculoventricular bundle (heart-block). The first sound at the apex is weak and indistinct or replaced by a soft systolic murmur, and the blood pressure is, as a rule, low. The heart may or may not be dilated.
A general listing of etiology symptoms and signs may be as follows: Marked by primary disease, great weakness, cardiac palpitation with irregularity, small feeble pulse, and dypsnea; praecordial pain and distress. Acute septic myocarditis: Localized suppurative inflammation of the heart muscle.
ETIOLOGY: Distant infection; suppurating pericardium or endocardium. Physical signs in myocarditis; Apex beat extremely weak and rapid; pulse irregular and weak; tenderness over precordium, percussion negative, auscultation reveals first sound of heart resembling second heart sound, high pitched and wanting in muscular quality.
CHRONIC MYOCARDITIS: Characterized by round-cell infiltration of interstitial tissue, followed by parenchymatous changes of muscle fibers.
TREATMENT: The same as under Endocarditis in the acute stage, then a diligent search is made for the cause. But while this search is going on the patient should avoid as far as possible muscular overexertion, mental strain and excitement. The diet should be very simple. It might be well to try No. 2 diet for a long time, liquor and tobacco are strictly forbidden. Constipation should be relieved by enemas or colonics. Exercises might consist of walking at regular intervals during the day. For nocturnal attacks, the ice bag, or hot applications will give relief.
When the cause is found, then treatment for it can be instituted.

 
FATTY HEART

 DEFINITION: An infiltration of fat tissue into the heart muscle. When the muscle begins to degenerate, it is known as fatty degeneration of the heart.
ETIOLOGY: Fatty infiltration results from the causes which lead to general obesity.
SYMPTOMS: The presence of dypsnea and palpitations may be the only sign that the condition is present. In the degenerative form the symptoms are the same as in myocarditis and the treatment is the same, but with the exception that the fat or general obesity must be reduced. See treatment for Obesity.
Additional Herbology to what is found under pericarditis.
Snow berry will increase the heart action.
Sheep Laurel will act as a sedative.
Motherwort is a nervine and heart tonic.
Bitter Candy Tuft is good for an enlarged heart and so is Lycopus (Bugleweed) as they relieve the difficult and oppressed breathing.

 
CARDIAC NEUROSIS

 DEFINITION: A functional disturbance of the heart without any evidence of pathology.
ETIOLOGY: There are four types of this neurosis. Bradycardia, Tachycardia, Palpitations and Arrhythmia.
SYMPTOMS: Bradycardia — The heart action is periodically or permanently slowed down. Bradycardia is said to begin when the heart action is reduced to forty beats per minute.
ETIOLOGY: Total bradycardia is also known as sinus bradycardia because it is probably always of nervous origin. It is occasionally observed as an individual peculiarity in healthy persons. It may occur in convalescence from acute febrile disease; myxedema (reduced metabolism); lesions irritating the vagus centrally or peripherally, such as meningitis, mediastinal tumor, or adenopathy; certain painful affections, such as lead colic, biliary colic, etc.; and cachectic states.
PALPITATION: A rapid and noisy action of the heart perceptible to the patient.
ETIOLOGY: It may result from reflex irritation as from flatulent distention of the stomach; excitement, mental or physical; organic heart disease; exophthalmic goiter; over-work; anemia, neurasthenia or hysteria; paroxysmal tachycardia.
SYMPTOMS: In the mild cases the physical signs are hardly noticed unless there is valvular disease. There may be some precordial distress and oppression such as dypsnea. But in the more severe cases when there are violent paroxysms these manifestations are increased in proportion, and the heart beats may become tumultuous; the beat against the chest is violent; the patient can only speak with the greatest difficulty; his face is pale and covered with cold sweat, and he may suddenly lapse into unconsciousness. While the arteries throb violently, the throbbing may not correspond with the cardiac pulsations. The radial pulse may seem quite normal and violent cardiac action exist. Again, the heart may simply beat with greatly increased force without necessarily involving the rapidity of its pulsations.
TACHYCARDIA: A periodical or constant fast beating of the heart. When the beats reach 150 the condition is termed Tachycardia.
ETIOLOGY: Habitual frequency is sometimes noted in health. The frequency may be temporarily increased by erect posture, excitement, eating and the use of stimulants.
Abnormal frequency may be due to Pyrexia. The pulse usually bears a definite relation to the temperature as in Hyperthyroidism, Organic heart disease, severe anemias, emotional stress, Essential paroxysmal tachycardia, action of certain drugs — belladonna, nitrites, thyroid extract, etc. Pressure palsy of the vagus from aneurysm, and thoracic tumors.
SYMPTOMS: occasionally, at the inception of the disturbance, there is a sensation of a premature cardiac pain. The patient may not be conscious of the rapid rate as palpitation if the disturbance is regular, but again the overactivity may be quite disturbing and may be the patient’s chief complaint. Occasionally giddiness, faintness, vertigo, weakness, exhaustion, depression, smothering and epigastric fullness, nausea, and vomiting may be present.
Patients during an attack may exhibit much anxiety, pallor, then grayness and cyanosis, coldness and clamminess. The neck vessels and the precordium throb rapidly and more or less violently. There is a rapid tic-tac embryocardia, but usually no murmurs or adventitious sounds are heard. The pulse is small, rapid and regular. The heart beat remains regular and rapid between 180 and 220 per minute usually; occasionally it drops as low as 140 and rises as high as 240 at the extremes.
Arrhythmia is an irregular heart action causing absence of rhythm. Two or more beats may occur in quick succession, a long pause ensuing, or other irregularities.
ETIOLOGY: The primary cause is changes in the rhythmical tone of the vagus nerve. Nervous irritability in childhood, adolescence and senility. Treatment of the above types of cardiac neurosis may consist of the following:
FOR THE BRADYCARDIA: Hot applications over the heart. A sedation of the 7th 1st and 2nd dorsals.
CHIROPRACTIC: Adjustment at the heart segments. Light pressure may be made on the tenth cranial nerve just below the carotid sinus. See drawing on page 160 of Cranial nerves and joints of contact.
SPONDYLOTHERAPY: To quicken the heart beat concussion of the atlas, and middle cervical should be used.
Palpitations or fast heart may be reduced instantly by concussion of the 7th cervical which can also be used in tachycardia.
In all the conditions mentioned under Cardia Neurosis there are three outstanding forms of treatment. First: See that circulation is kept in order. The vacuum cups over the whole spine will aid in this effort.
Second: Psychiatry. Most of these patients have some tensions or elemental fears that need to be brought to light and the patient properly oriented to his environment. Many of these have had slight attacks before and are fearful of sudden death. They need to be given assurance.
Third: Endo-Nasal Therapy, especially the Lake Recoil; opening the external and internal nares.
Fourth: Diet should be light but highly nutritious, supplemented by B, G and a low salt intake.
Fifth: Proper rest periods and breathing exercises before an open window, if not too cold; while inhaling the arms should be very slowly raised, then on exhaling the arms are slowly allowed to descend.


Hiccup

 DEFINITION: A clonic spasm of the diaphragm, which may cause a distress and sometimes ends in death.
ETIOLOGY: May be due to fast eating or drinking, this may be but temporary. Long continued hiccups may follow serious acute or chronic illness and extreme exhaustion. It may follow irritation of the phrenic nerve by subluxation, and perversions, or by pressure of a thoracic aneurism. It may be reflex from stomachic, hepatic, intestinal, or peritoneal disease. It may be due to hysteria. It is occasionally epidemic and apparently in relation with influenza or epidemic encephalitis.
TREATMENT: Hiccups should be stopped immediately lest the spasms become habitual or intermittent and last for a long time. The treatments are largely experimental, for what will succeed in one case may not in another case. Holding the breath as long as possible will check it in many mild cases.
Zone therapy has many suggestions to offer, such as compression of the ball of the thumbs with the little fingers, pressure on each side of the neck with one index finger on each side. Pressure is held firmly for a short time. Pulling out the tongue and making pressure on its surface in the middle.
HYDROTHERAPY: Cold compresses to the neck. Sipping of a glass of cold water a little at a time with or without pinching the nose.
NEUROPATHIC MINOR SURGERY: Flex legs up as far as possible, then raise the contents of the abdomen, especially the diaphragm, and hold for a few minutes; repeat at least five times.
EXERCISES: Hanging by both arms to a cross-bar or a door has stopped the spasms in some cases. Lifting of a heavy weight may be tried.
SPONDYLOTHERAPY: Concussion of the 7th cervical has been one of the most effective methods in mild cases.
ENDO-NASAL THERAPY: One case the writer had was that of a man who was utterly exhausted from the spasms. Every known method had been tried. Sometimes by some methods he would get relief, then the spasms would start again. The technique in this case was to hold the soft palate wide open and then to concuss the 7th cervical, while holding the palate open. After four daily treatments, each treatment lasting a minute, the spasms stopped entirely.
CHIROPRACTIC: Adjustments C 4, D 4-8.
After the spasm has been stopped in persistent cases, diligent search should be made for the causes.

 
Hydrocele

 This is a collection of fluid in the tunica vaginalis. It may be acute, as the result of extension of inflammation from either the epididymis or testicle; congenital, -- the result of anatomical deficiency in the vaginal and funicular processes; or it may be encysted. In many cases, however, the cause is not appreciable, although it is probable that traumatism and strains may favor its development.
In the acute variety of hydrocele, owing to the prominence of the symptoms of the primary condition, the characteristic symptoms are not pronounced. Pain is agonizing and is due to pressure. In the encysted form, swelling, of slow formation, beginning at base of the scrotum and which is pyriform in shape, smooth, tense, fluctuating, and elastic on pressure, is noticeable; this does not, however, alter the size of the organ, which is dull on percussion, stands away from the body, and cannot be reduced. In the congenital variety the swelling is also of slow formation, dull on percussion, filling from below; it disappears when the patient assumes the recumbent posture, but returns slowly when he is in the erect posture. Such hydrocelees are frequently complicated by hernia.
TREATMENT: In the acute form, rest in bed, with the scrotum elevated. Ice bag may be applied for a short time for very severe pain. Short wave may be tried, also infrared. If pain continues, tapping may become necessary, and a surgeon should be consulted.
Vacuum therapy above the point of swelling has been known to give some relief.

 
Hysteria

 DEFINITION: A lack of self-control, manifested by a train of symptoms of a varied character.
ETIOLOGY: Females are more disposed than males, and is most common in early adult life. Heredity may be a factor. Faulty home-training and education also do much to foster its development. Traumatism, prolonged emotional excitement, such as worriment, anxiety, disappointment, grief, and all causes that reduce vitality serve to excite it in susceptible individuals.
Freud ascribes hysteria to a mental conflict, suppression of memories, which has arisen as a result of painful experiences, often sexual events, in early childhood, and would make the vivid recollection of these experiences, under insistent questioning, and a complete verbal confession of them to the physician, an essential element of treatment.
There are three types, Simple, Conversion, and Anxiety hysteria. The reader is now directed to turn to the “Fundamentals of Applied Psychiatry,” Lake, Page 53. Also “Modern Psychiatry,” by Sadler, and read to the full the prime elements of this disease.
TREATMENT: The physician must make a careful search and eliminate any organic or functional ailment that may be contributory factors. If there are no organic factors, then the treatment must be directed to the mind, but at the same time body manipulations and physical treatments are not neglected.
The body treatments may be as follows:
NEUROPATHY: A general lymphatic treatment, with deep pressure in the gutter of the whole spine.
CHIROPRACTIC: Adjustment of cervical 1 and dorsal 6.
SPONDYLOTHERAPY: Concussion of the whole spine is par excellent.
ELECTROTHERAPY: Riley contributes the following in his “Mastery of Disease,” page 125:
“In hysterical conditions of women and men, we have found in electric therapy that high frequency in the form of auto-condensation as explained in this treatise, is very powerful and let the amperage be 250 to 350 milliamperes and continue for a good, long time. This is particularly indicated if there is a high blood pressure. On the other hand, if the blood pressure is low, usually effluve sparks along the spine and cervical region for ten to fifteen minutes.”
MASSAGE: This can be in the form of soothing strokes around the neck and down the back.
DIET: Diet No. 1 and No. 2 or equivalent for the obese or the very thin, the physician can select as his discretion may direct.
VITAMINOTHERAPY: A, High B, C, D, either or all may be indicated. In some cases E alone is indicated.
HYDROTHERAPY: The douche bath, shower or spray before retiring is excellent. See under Insomnia.
Oxygen baths are also recommended in this condition.
THE MIND TREATMENT: It will be well for the physician to remember that there is a hidden and a present cause for this condition. The first may be a suppression or any inhibition in the subconscious. The second may be an inhibition in the consciousness or ego from present environmental tensions. To be successful, the physician must be able to inspire absolute confidence and faith in the mind of the patient. She must be impressed repeatedly with the fact that her condition is a curable one, and that with her thorough cooperation restoration to health will certainly follow. To intimate that her symptoms are feigned or are wholly within her control is a grave error. In many cases no method of treatment proves successful until the patient has been removed from her customary surroundings and separated from her sympathetic relatives and friends.
Suggestion is employed consciously or unconsciously in the treatment of hysteria by every successful physician. Without it many of the treatments recognized as efficacious become wholly impotent. While the physician is giving bodily treatments, he can skillfully psycho-analyze the patient by the question methods, which see in the “Fundamentals of Applied Psychiatry,” Lake, Page 122. And then after discovering the past and present frustrations and tensions, the physician can give suggestion while giving further manipulations. See the above book by the writer, Pages 135, 147 to 149.

Hypotension, Hypertension — High and Low Blood Pressure

 DEFINITION: Hypotension can be said to exist when there is a decrease of systolic and diastolic blood pressure. Below 90 systolic, and 50 diastolic is pathologic. If hypotension follows hypertension the condition is serious. If the diastolic blood-pressure drops in proportion to the systolic pressure and the systolic pressure does not go below 80 points, the patient will respond to the administration of treatments. Patients with a systolic pressure of 180 points or over should be kept in bed under observation and for treatment. A patient with a systolic pressure of 90 points or less should also remain in bed for treatment. It occurs in shock and collapse, in hemorrhages, infections, fevers, cancer, anemia, neurasthenia; Addison’s disease and in other debilitating or wasting diseases, and approaching death. Hypotension causes an accumulation of blood in the veins and slows down the arterial current. Capillary circulation is interfered with as are other functional processes of the body.
Hypertension can be said to be a systolic pressure of over 170 points. It is found in arteriosclerosis and chronic nephritis. 160 mm. systolic pressure constitutes the beginning of high blood pressure which may run well above 200 or even as high as 280. Persistent high blood pressure may eventuate in apoplexy or heart-failure.
TREATMENT FOR HYPOTENSION: Not only must the primary cause be sought out and removed if possible, but the patient must be stimulated to keep going until that good result is obtained. Rest of the body and mind for a time are fundamental in the severe type of hypotension.
NEUROPATHY: A general lymphatic to stimulate circulation and a friction-like movement up and down in the gutter of the spine.
CHIROPRACTIC: Adjust Dorsal 2-4. Kidney, liver or heart place according to the cause.
BODY MECHANICS: Posture has much to do with low blood pressure. It is for the physician to note any defects and correct them, especially those who show spinal malformations and a bulge in the lower abdomen.
ENDO-NASAL THERAPY: All of these patients show signs of Anoxemia due to some obstruction somewhere in the respiratory apparatus. A hemoglobin test as outlined elsewhere will verify the statement. Use the same techniques as found under Anemia.
ELECTROTHERAPY: Short wave, diathermy, infra-red, and ultra violet all may be used.
HYDROTHERAPY: Hot compresses over the heart, or a hot-water bag will do. Swimming in warm water is excellent, if not too long at a time.
EXERCISES: If patient has a mild case, walking will cause great circulation and create the necessary appetite.
DIET: No. 1 diet is usually sufficient with some additions the physician wishes to make.
A supplemental drink that is of value. Eliminate the juices before each meal and have the patient take a spoonful of honey, and a spoonful of lemon juice in a glass of hot water before each meal.
VITAMINOTHERAPY: It is according to the findings in each case. A, B, C, D, G, and F, are all concerned more or less with the heart and blood vessels.
TREATMENT OF HYPERTENSION: This is a dangerous disease and the physician need be always on his guard lest a hemorrhage take place.
ELECTROTHERAPY: Auto condensation has long been the specific preferable in a chair rather than lying down in arteriosclerosis which see.
The bed is best when there is organic involvement such as the kidneys, when one pad is put over the kidney or the organ involved.
SPONDYLOTHERAPY: Concussion or pressure on the 7th cervical. Some physicians advocated concussion of the 3rd and 4th dorsals. But the writer gets best results from the 7th. For a complete treatment of hypertension the reader is referred to the section on Hypertension of Arteriosclerosis.

 
Influenza

 DEFINITION: Influenza has been described as La Grippe, Catarrhal Fever, Epidemic Fever or as an acute infectious and contagious disease, characterized by fever, marked prostration, severe muscular pains and catarrhal inflammation of the respiratory and gastro-intestinal tracts.
The prostration is all out of proportion to the temperature.
ETIOLOGY: At the present time the absolute factor is a matter of doubt and dispute. The primary cause is a complete enervation of the whole cerebrospinal nerve mechanisms.
There are many theories for the secondary causes and all have some bases of fact. There are those who claim it is of bacteriological origin, because of the presence of certain bacilli. Pfeiffers bacillus was thought to cause the disease from 1892 to 1918. But this bacillus is found in other diseases as well as in healthy people.
But in Influenza this organism was found to increase numerically with the height of the disease, and decrease with recovery, but the same can be said of the streptococcus, pneumococcus and catarrhal micrococcus. Today those who hold to the germ theory insist that a specific virus is the cause of human epidemic influenza. It is still to be shown that this unknown virus is responsible for the sporadic, endemic and pandemic forms. The latter types may be due to the symbiotic action with other agents or to changes in the nature of the virus itself.
Another theory is that influenza is due to retention of morbid waste matters, that weakens the resisting powers of the body, and thereby bringing on an acute attack of general inflammation, an effort of the body to throw off its load of poisonous material. This theory has some basis in fact when the gastro-intestinal respiratory irritations and fever are taken into consideration.
The theory of epidemic, endemic and pandemic episodes is stated as follows:
In the case of infection by acute diseases, the latter pass from one person to another by the transmission of fermenting matter, usually through the medium of the air. But infection is impossible without the presence of foreign matter (predisposition) in the system of the other person, as disease arises only from the fermentation of such matter.
The third theory is that of enervation. A failure of nerve energy to stimulate the flow of blood on its way through the body. This theory is supported by the premise that the spine is tender and stiff all along, that there are lesions in the atlas, middle or fifth or sixth cervicals, the fifth, seventh and tenth dorsals, and the second to fourth lumbar.
The fourth theory is a general lack of oxygen to aerate the body, particularly in the lymphatic system and especially the liver, which may and may not be the factor in creating the retentive and enervative factors. For the present it probably is best for the physician to weigh carefully all the etiological factors and to take all precautions of every theory.
SYMPTOMS: Begins abruptly with lassitude, malaise, chilliness, severe pain in head and back, fever from 101 to 103. Prostration out of proportion to the fever. Eyes injected, sneezing, hoarseness and hard paroxysmal cough. In most cases, catarrh of respiratory tract is unusually marked. Less frequently, gastrointestinal symptoms predominate. With latter, there may be diarrhea and abdominal pain. The course ordinarily runs from four to five days, and may terminate by crisis or speedy lysis. Pulse rate usually not increased in proportion to fever; may be 90 to 100. Blood pressure low, nosebleed not uncommon. Examination of blood demonstrates a leukopenia, or great lack of white cells. Urinalysis generally demonstrates presence of albumen and casts. In some epidemics, a striking symptom is a peculiar cyanosis, especially of the spine, which is, in all likelihood, of toxic origin. In addition to the respiratory and gastro-intestinal forms referred to, a nervous and fulminating type are sometimes described.
COMPLICATIONS: If any, complications are Pneumonia, pleurisy, empyema, chronic bronchitis, abscess of lung, sinusitis, otitis media, pericarditis, myocarditis, and very rarely endocarditis; peripheral neuritis, meningitis and encephalitis are still more possible complications.
PROGNOSIS: The prognosis is good in mild uncomplicated cases. In influenza with pneumonia the mortality rate is high.
DIAGNOSIS: The prostration and weakness all out of proportion to the temperature, and the pains in the head and back can make the physician suspicious of the affection being present. White finger nails, straight purple lines down middle of toe nails. All white when dying.
TREATMENT: The patient should be kept in bed during the acute attack and he must take plenty of time to recover, or in a little while he may be in bed again, with severe ear, lung, nerve or heart trouble.
It can be truly said: The patient is severely ill for three to five days, and then for four or five weeks is in misery with weakness, loss of appetite and ambition, dizziness, low blood pressure and perhaps some heart symptoms.
One thing the writer has noticed is that in those who had a background of some psychoneurotic tensions that after influenza the psychopathology became very pronounced and many adopted the sick mechanism to get pity and not work all their lives.
In the convalescent stage the physician must insist on seeing the patient in his office, as often as he deems it necessary to avoid any permanent injury.
The treatment may consist of any of the following methods while the patient is in bed and during convalescence..
NEUROPATHY: A general light lymphatic of the whole lymph system. Light stimulation in the gutter of the whole spine that is stiff and painful.
For headache, massage the jugular vein and at the same time have fingers of the other hand make deep circles around 7th cervical.
CHIROPRACTIC: Adjustment atlas or axis. C. P. , K. P., S. P. and lumbar region according to indications.
DIET: While there is fever food is strictly limited or eliminated till fever subsides, but when fever is lower plenty of good nourishing food.
Large amounts of water are indicated. A large glass of water with five drops of lemon juice, in each glass, every hour, can be given while the patient is awake.
When the fever has moderated, milk broths, gruels and custards are suitable at first; later soft foods, as eggs, milk toast, cereals, oysters, can be added, followed by an ordinary simple solid diet, or No. 1 diet.
Coughing can be controlled by giving a teaspoonful of honey and lemon every hour until cough subsides. The sleeplessness of influenza is largely due to the tickling in the throat and the desire to cough, with constant effort at suppression.
Prostration is treated by rest, fresh air and nourishment.
VITAMINOTHERAPY: A, C and D will aid in overcoming the loss of resistance in the respiratory tract. And B+ will aid in the development of nerve energy.
PSYCHOLOGY: The art of hopeful suggestions will aid in giving the patient some things to do or a change of environment with new associations will help build up a vigorous mentality.
COLONOTHERAPY: If constipation is present, a low enema of one pint of water with a teaspoonful of sodium bicarbonate mixed thoroughly in it.
HYDROTHERAPY: Hot mustard foot bath. A large bowl of boneset tea, then cover the patient with blankets, may induce immediate sweating. If a portable short wave or diathermy is handy, they may be used for the same purpose.
VACUUM THERAPY: Nothing better to restore the power of the vasomotor nerves and send the blood in good circulation. Apply cups lightly up and down the spine.
If the headache is severe, cold compresses, or an ice bag may be applied to the head.
ENDO-NASAL THERAPY: One symptom of this disease is a severe anoxia of the head, nose and throat. The Endo-Nasal Techniques then are very essential, especially the Lake recoil, the nose, pharyngeal and larynx techniques.
EXERCISE: When the patient has recovered sufficiently, he should be asked to walk a block or two, if weather permits, then take a nap of short duration. The walk can be extended gradually to longer distances according to his reactions. But the nap afterwards is essential.
ELECTROTHERAPY: Short wave; sine wave, are beneficial along the spine and chest. Infrared is of pronounced value.
If bronchitis results, see treatment under that title.
HERBOLOGY: Put the patient to bed and keep him warm. Give whiskey and lemon juice. Watch for pneumonia. After effects of this disease are frequently more to be dreaded than disease itself. Keep bowels open. Light foods.
This is excellent: make a strong brew of Boneset Tea, mix with lemon juice and sugar; drink as hot as possible while wrapped in a blanket. Drink half a dozen cupfuls a day.
Here is a good infusion: one-half ounce each of Yarrow and Boneset, quarter ounce each of Pleurisy Root and Lobelia Herb; two or three Cayenne Pods. Boil in a quart of water for half-hour. Strain into vessel containing two tablespoonfuls of Black Treacle.
Here is an old Indian remedy: two ounces Boneset Leaves, one ounce Juniper Berries, two ounces Elder Flowers, one ounce Wild Ginger, two ounces Sweet Flag Root. Put a teaspoon of the mixed herbs into a cup of boiling water. Of course tea should be made fresh every day. Also remember herbs over a year old are quite worthless if you want results.
SPONDYLOTHERAPY: Concussion with the fingers of the 7th cervical for several minutes at half-minute periods may stop headache and reduce the fever.

 
Insomnia

 DEFINITION: Sleeplessness, or sleep broken intermittently by wakefulness.
ETIOLOGY: Sleeplessness is seldom a problem for the person who does hard physical work. It is often a problem among such persons as writers, professional men, women and artists.
Sleeplessness may be due to many causes, among them being mental or emotional conflicts, worry, fear and anxiety. Often the sleepless person is not even aware of exactly what it is that is troubling him, and it may require the services of a specialist in diseases of the nervous system to ferret out the cause.
There are a number of diseases, such as toxic goitre, high blood pressure, indigestion and many infections which contribute to sleeplessness. Too much mental stimulation also may lead to sleeplessness. After a busy day requiring a great deal of mental activity, many persons find that they just cannot slow down enough by bedtime to fall asleep promptly.
Of course, other things, such as noise, light and improper sleeping surroundings, may interfere with sleep. The excessive use of stimulating beverages may be another cause.
TREATMENT: Drugs are useless and even dangerous. Many drug addicts and many deaths are ascribed to the use of them. It is important to find the cause and remove it. But in the interval of finding the cause the following treatment may be given.
NEUROPATHY: Deep pressure on all the gutter of the spine, including the cervicals and around the face.
CHIROPRACTIC: Adjustment of the atlas and middle cervical.
HYDROTHERAPY: The shower or spray douche with warm water up and down the spine, then allowing the water on the body to dry by itself, without a towel, has given relief to a large number of the writer’s patients. A warm tub bath for twenty minutes may be helpful. A change of beds may be necessary, the mattress may be too hard or too soft. If snoring is a cause, then two things may be at fault, eating before retiring or obstruction in the nasal cavity, for which Endo-Nasal Techniques are par excellent. Perhaps the techniques should be given whether there are obstructions or not to stimulate respirations and the intake of oxygen.
PSYCHIATRY: If the insomnia is severe a psychoanalysis may be necessary. Otherwise suggestions for certain relaxations before retiring will be sufficient. A pattern of suggestions may be found in the writer’s book “The Fundamentals of Applied Psychiatry,” pages 135 to 150.
EXERCISES: This is important. The patient should take exercises in the room, just before retiring, or to take a walk in the open air and the walk should be long enough to thoroughly tire out the patient.
ELECTROTHERAPY: Ultra-violet radiations has some value in many cases. The writer has used auto condensation therapy with some success in a number of cases.
SPONDYLOTHERAPY: Concussion applied to the neck from the third to the seventh cervical may relieve cerebral congestion and induce sleep. Light abdominal tapotement has also been known to relieve cerebral congestion and induce sleep.
DIET: This will have to be judged by the condition of the patient. If he is obese, if he has hypertension or is he anemic with hypertension. If any of the above conditions are present see diets under each.
If any vitamins are helpful at all they are B1, to overcome a deficiency of thiamin and G to overcome brain edema.
HERBOLOGY: Make a tea of the following combination of herbs and drink a cupful in the evening:

 Equal parts of Valerian, Peppermint, Bogbean, or
Equal parts of Valerian, Vervain, Scullcap and Wood Betony or
Equal parts of Peppermint, Catnip and Blue Scullcap.

 FINALLY: How much sleep should a person have? The answer is a very difficult one. We might say until one is refreshed and reinvigorated. But many persons have notions that they do not give vent to the invigoration that sleep has produced. This is a form of mental laziness unless there is some serious illness. If sleep requirements can be measured by hours at all, perhaps the following scale would be of some use as a suggestion to the patient.

 Age 6. From 10 to 12 hours.
Age 10. From 9 to 10 hours.
Age 15. 9 hours.
Age 20. 8 hours.
Age 25. From 7 to 8 hours.
Age 30 to 50. From 5 to 7-8 hours.
Age 60, if sleeping during the day, or taking a nap, not more than seven hours during the night.
A hard laboring man or woman may sleep longer. But sleeplessness is not one of their problems unless ill.

 
Erysipelas

 DEFINITION: Erysipelas is an acute infectious inflammatory disease of the skin and subcutaneous tissue, characterized by the presence of congestion and edema, with distention of the cutaneous lymph channels.
ETIOLOGY: Wounded persons are very susceptible, the infection getting in the blood stream through the abrasions. The many skin lesions such as eczema may act as a starting point. A mere scratch, though healed, may have allowed the streptococcus to enter; having travelled up the lymphatics, the organism starts the erysipelatous process at a distance from the seat of entrance.
SYMPTOMS: Erysipelas is most frequently found about the face and head, probably because of the excessive number of superficial lymphatic vessels.
It may occur in or extend to the fauces and tongue and, extending painlessly up the Eustachian tube, involve one or both eyes and may cause blindness.
True cutaneous erysipelas is characterized by severe elevation of temperature, attended by a disseminated inflammation of the skin. This is sometimes preceded by a chill. The elevation of temperature continues until the erysipelatous process reaches its end. There may be a wound from which the redness starts, or there may be no cutaneous evidence of the seat of infection.
Gastric symptoms may likewise occur, with less of appetite, nausea, vomiting, excessive thirst, and a highly coated tongue. The urine is generally dark colored, and may contain albumin, blood, bile-pigment, and micrococci. The spleen is sometimes swelled, and there may be pain in the region of the kidneys. An infective pneumonia due to extension of the disease from the oral cavity or pharynx may likewise occur. The heart is also involved in a large proportion of cases.
PROGNOSIS: If the process be not arrested, death may result from the extension of the local infection to some vital organ, as the brain or peritoneum.
TREATMENT: The treatment is difficult because there is no specific treatment that will fit all cases. However, we will give a general outline of local and constitutional treatment.
HYDROTHERAPY: Cold wet compresses, a cloth saturated with alcohol. Hot compresses of physiological salt solution. Boric acid solutions as compresses may also like the others be laid over the affected area. Loam poultices, buttermilk poultices kept constantly wet have been known to be effective in some cases. Ichthyol and vaseline, equal parts to make a good facial application, placing over this absorbent cotton. Applications of magnesium sulphate solution have been highly recommended.
ELECTROTHERAPY: Ultra violet radiation directly on the affected part have brought wonderful results in many cases. The patient should sit three feet from the lamp for 10 to 15 minutes at a sitting. But many sittings can be taken in the course of a day.
DIET: During the attack a light nutritious easily digested diet is best. Milk, beef tea, and eggs may be used, or selections made from No. 2 diet.
VITAMINOTHERAPY: Large doses of A, E, F and G may be also considered.
NEUROPATHY: Massage of the whole neck downward. Thorough lymphatic of the axillary and liver place. Stimulation treatment of all the spinal segments.
CHIROPRACTIC: Adjustment of cervical 4 and kidney segments.
HERBOLOGY: Mix thoroughly Fluid Extract of Rose 1 part and Honey 7 parts; use externally also give some internally.
Make bags of thin cotton cloth, put enough baking soda therein so layer is 1/8th inch thick; moisten with water, lay on part affected.
Make tea of ½ oz. each of Elderberries, Wild Marjoram, and Shavegrass, and ¼ oz of Peppermint and thyme. Use one-half wineglassful every two hours.
Golden seal (Hydrastis Canadensis) mixed with glycerine makes a good dressing.
COLONOTHERAPY: Daily enemas, or colonics twice a week.

 
Gastritis

 DEFINITION: The term gastritis is used to comprehend a large number of inflammations of the stomach which are of a non-malignant type, such as dyspepsia, indigestion, nervous indigestion, etc.
Two types are considered here: the acute catarrhal and the chronic gastritis.
ETIOLOGY: Gastritis may be due to nervousness while eating. Mental tensions may cause the person to fail to eat properly or bolt the food. An atony of the stomach produced by vaso motor insufficiency which causes gastric distress, flatulency and a fullness after meals.
Hyperclorhydria is an abnormal secretory condition of the stomach in which there is produced an excess of hydrochloric acid. This may be due to an over activity of the dilators of the stomach segments, and a failure of the vasoconstrictors to function normally. There is distress, belching and expulsion of hot liquid from the stomach in severe cases. Many of these cases can be classified as neurotic and neurasthenic. If there is no evidence of organic or infectious diseases the above types can be said to be of functional and mental origin or bad habits in eating or living, sleeping, etc.
The acute catarrhal gastritis however is generally due to the above etiologies and also an autointoxication.

SYMPTOMS OF ACUTE AND CHRONIC GASTRITIC CATARRH

 The symptoms run into a great variety of forms. But generally it can be said they are as follows: There is anorexia, with a feeling of discomfort and fullness, eruptions, nausea and sometimes vomiting. In some cases the nausea and vomiting are severe. There may be also a rise in temperature to 102 or 103. Thirst, distention of the epigastrium, local tenderness and considerable prostration. The vomitus is composed at first of sour, fermented food; later, of mucus and bile. Jaundice may follow from the extension of the catarrh to the duodenum and bile-ducts, and diarrhea from its extension to the intestines.
In the chronic form, the above acute symptoms may be present in addition to the following: Furring of the tongue, bad breath, great and noisy belching, heartburn, constipation, headache, vertigo and palpitations and some pain.
PROGNOSIS: Good, if there are no complications of a more severe nature.
HYDROTHERAPY: In the acute form when vomiting has taken place, and there is still distress, several glasses of hot water, or enough to create a gastric lavage can be given. A high enema may also be given. If there is fever ice cubes may be put in the mouth and a cold compress laid over the abdomen. If no fever is present, then hot compresses are the best If the attack is severe, hot or cold compresses can be applied to the spinal column continuously. Applications are also made over the stomach.
DIET: No food should be allowed for a few hours after the attack, then for the next two days the milk diet can be used. A glass of milk, sipped slowly every two hours. Then when the patient is able to come to the office or one comes with the chronic form of gastritis a diligent search should be made for the cause and treated. But a general treatment may run as follows:
NEUROPATHY: A lymphatic of the whole body, with a thorough three-cornered squeeze of the liver at least three times, unless there is jaundice present, when the elimination treatment is instituted. A sedation treatment of the spinal segments is given even if jaundice is present.
HYDROTHERAPY: Same as under Acute condition, when there are recurrent acute attacks. Otherwise a cool wet compress laid over the stomach every night, and allowed to remain until dry will allay many of the symptoms. Hyperacidity needs to be watched carefully and when present, lime-water with ice may be given by sipping teaspoonful at a time.
CHIROPRACTIC: Adjustment Stomach, Kidney and Intestinal places.
SPONDYLOTHERAPY: Concussion or deep pressure on dorsal 5 for three minutes is usually sufficient.
EXERCISE: Most patients suffering with this condition are a lazy lot, they have been in the habit of consuming great quantities of food without adequate physical exercise for elimination. So even when endurance is low some exercise must be taken to help build up vitality. Walking and deep breathing are good exercises. Quoit pitching is one of the best Care should be taken that it is not overdone. Bending down exercises can be used in cold weather.
ELECTROTHERAPY: Here an experiment will have to be made. In some cases of gastritis diathermy or short wave are excellent, while in others they aggravate the condition. Sine or faradic current will help the others; infrared is always good for pain.
DIET: Here also an experiment must be made. Foods that will not stir up the symptoms of each individual must be found. The best program is small meals, and from six to eight in one day. If this is not of benefit to the patient, then a milk fast can be instituted every other day for a while. If acidity keeps high, then the milk diet is of special benefit. Also Cabasil tablets may be chewed on.
VITAMINOTHERAPY: B2 and G and A and D are recommended.
STRAPPING: If an abdominal ptosis is present, a belt should be worn, or a binding of some kind. Flannel is preferable.
COLONOTHERAPY: An alkaline enema or colonic should be given daily for a week or two, then twice a week.
HERBOLOGY: One teaspoonful each of Hops, Golden Seal, Spearmint, four teaspoonsful of Marshmallow and eight teaspoonsful of Jamaica Sarsaparilla. Mix. Pour over them a cup and a half of boiling water. Cover. Let cool. Strain. Two teaspoonsful every three hours.

 
Leukorrhea

 DEFINITION: A liquid vaginal discharge more or less sticky and purulent, milk like in appearance. It may occur at any age.
ETIOLOGY: Leukorrhea is a symptom of underlying irritation causing an excess of secretion from the vaginal epithelium, and probably transudation of serum and corpuscles from the vaginal blood vessels, at least in some cases. The discharge is the more profuse as the tension in the blood-current is increased; therefore just before and after menstruation.
It also may be from conditions in which the freedom of the pelvic circulation is impaired; pregnancy; new growths, and inflammatory conditions within the pelvis. A relaxed and catarrhal condition of the mucous membranes in general. Anemia, fatigue, and the catarrhal diathesis. Frequent coitus, abortions, contraceptives, adhesions, uterine conditions, etc.
SYMPTOMS: Pain, weight, and dragging sensation in back and bearing down pains. Discharge at first serous and bloody, soon becomes thick yellowish or greenish, ropy fluid or purulent. After drying leaves yellow or greenish stain on linen and stiffens it. Afterward discharge becomes whiter, milky. May become chronic — discharge is alkaline in reaction. Examined through speculum cervix is found swollen, edematous and red and from the os pours forth a clear albuminous looking fluid, muco-pus. Usually indications of acute inflammation, pain, heat, redness of parts involved, which may subside as discharge increases. Pain in groins, hypogastrium, sacral region and small of back. Urethra often implicated causing painful micturition. Symptoms which may occur in connection with chronic leukorrhea are innumerable—reaction of discharge is acid—may be any consistency, thin and watery or viscid and tenacious.
TREATMENT: Find the cause of irritation and remove if possible.
NEUROPATHY: Deep pressure on the vaginal segments.
CHIROPRACTIC: Adjustment lumbar 2 and 4.
DIET: Is given according to the cause.
SPONDYLOTHERAPY: Concussion of the 1st and 2nd lumbars.
HYDROTHERAPY: This is probably the most important of all the therapeutics for this condition. There must be cleanliness of the parts at all times internally and externally. The externals should be washed with a good soap and plenty of water at least twice a day. Internally the douche is used. The writer has found that nearly all cases respond well to 20 drops of 120 V.M. to a quart of warm water. This douche is used once every day for four days, then a rest of three days is taken, after which the number of drops are increased to 30, or reduced to 10 drops. If the number of drops is increased to 30, a trial of four more days of douching is given. If results show that in the first four days the discharge was slowed up, then a douche of 10 drops to a quart of water twice a week for a month or more is suggested. If there is no inflammatory conditions present a teaspoonful of table salt thoroughly dissolved in a quart of warm water has been recommended as beneficial. There are many other forms of douching, in some cases plain hot water is sufficient; the whirlpool douche is the best if obtainable.
VITAMINOTHERAPY: If any vitamins are suitable or needed they are usually A, B and G. Mineral mostly needed is Calcium.
ORIFICIAL THERAPY: In young girls rectal dilations have often been helpful.
ELECTROTHERAPY: The rapid sine wave with one electrode on the pubic section and the other underneath the patient, with the current on for about 15 minutes is considered very beneficial. One electrode may be put inside the vagina if deemed necessary.
HERBOLOGY: One ounce of Wild Raspberry Leaves, add a pint of boiling water, simmer for 20 minutes. Strain. Drink half cupful every four hours. For a douche use one ounce of the leaves to a quart of boiling water, simmer for 20 minutes. Strain. Douche evening and morning.
One teaspoonful of Golden Seal, Two teaspoonsful Cranesbill. Steep in a pint of water. A small piece of alum may be added. Use douche quite warm.
Another good douche is made from a pint of distilled witch hazel extract, 2 ounces of Golden Seal, half ounce of borax. Use an ounce to a pint of warm water.
CONCLUSION: Each case presents a variable clinical history and must be studied and treated as such.

 
Leukemia

 DEFINITION: A condition of the blood in which there is an abnormal increase in the number of white corpuscles, with hyperplasia of the spleen or of the lymphatics or changes in the bone marrow, leukocythemia.
ETIOLOGY: Exposure to X-rays or radium may be a cause. Infections and traumatisms are thought to have some influence in predisposing the person to the disease, but up to now nothing has been proven. The writer is firmly convinced that this disease is due to a lack of oxygen in the tissues. No matter where blood is drawn, he has found an anoxia, leading to the conclusion there is a complete anoxemia. There is also an overactivity of the thyroid gland, and an increased basal metabolic rate way over normal.
VARIETIES: (1) Splenic, in which the spleen is enlarged from congestion. (2) The lymphatic which in the lymphatic glands are the seat of hyperplasia with a marked increase in lymphocytes in blood; acute form occurs in children and young adults; spleen is slightly enlarged. (3) Myelogenic, in which the medulla, especially of the ribs, sternum and vertebrae, is converted into a pulpy material.
SYMPTOMS: The acute form is much rarer than the chronic form, and is most often found in children or infants. Pain in various parts of the body and weakness are the first symptoms. Weakness increases rapidly and in a short time the patient is prostrated Hemorrhage is extremely common and occurs from the nose, gums, tonsils, gastrointestinal mucous membranes and into the skin. Cerebral and retinal hemorrhages may occur. In some cases severe bleeding has been the first symptom. Frequently ulceration occurs at the site of hemorrhage, especially in the mouth.
Fever is usually present and may be high, 103 to 104 degrees, F. and the curve may be irregular, but if death ensues, preceding it, the temperature becomes subnormal and the skin takes on a waxlike yellowish or grayish pallor.
PROGNOSIS: Heretofore acute leukemia has always been fatal. But in the last few years, there are many reports of recovery through a new method of injection. The writer has no information on the subject, except that one writer stated the principal elements were iron and oxygen. While many reports of cures are made, it is impossible to know how these patients got along afterward. We shall hear much of this treatment in the future and time will give us the knowledge of its real value. There is still to be settled the question, when does an acute condition become chronic and the disease go into that safer zone. A given case of what appears to be acute leukemia may be found on closer examination to be a subacute or chronic type. If after three months of treatment and the condition of the patient remains the same or nearly the same, the patient in the opinion of the writer is now a chronic case Medicine offers no hope for the acute patient, except what has been said of the new injections and blood transfusions, the latter admitted as a failure.
Most drugless therapy literature passes leukemia by without even mentioning it. But at this writing the National Chiropractic Journal, January 1946 issue, is before me, with a report on leukemia by the directors of “The Research Foundation.” This is a splendid report, and no doubt more will come as time goes on. What is said is of interest to all Drugless physicians, and the writer commends it to the profession. Here we can only give the outline of Case No. 1.
Case History No. 1. In 1943 a child of one of us (H.M.B.) was stricken with a febrile disease of an obscure nature. There was marked prostration, temperature 102-103, which continued over a few days without any definite change. Two diagnosticians were called, one of whom suggested sulfonamide therapy, which was refused. A blood count was taken on the fourth day of the illness and was as follows: W. B. cells, 1500, neutrophils 24%. A general adjustment was then given consisting of bimanual thrusts from 1 D to sacrum with rotary moves on the cervicals. Two hours later a repeat count showed W. B. cells 3.200 and neutrophils 36%. Next day the total count was found to be 4,500 with neutrophils 45%. After three other adjustments the child had completely recovered. Working on the hypothesis that adjustments in some manner influenced white cell production work was begun by both of us and the following may also be used in the acute form:
DIET: Foods containing iron and oxygen.
VITAMINS: A, B, G are needed in this condition.
Cod liver oil, orange juice and liver or liver extract might be beneficial. Good nursing care and cleanliness of all the patient’s body and orifices are necessary, especially the mouth.

SYMPTOMS OF CHRONIC LEUKEMIA

 The onset is insidious and usually by the time a physician is consulted the myeloid, or the lymphatic type are fully developed. Then the patient may complain of pain in the upper left quadrant and on examination it is noticed that the spleen is enlarged, and the liver is more or less also enlarged, causing the whole abdomen to increase in size, while there is a progressive loss of flesh and weight. A history of the case will reveal that for a long time there was a loss of appetite, fatigue and a sense of ill health, also a history of shortness of breath, and a dimness of vision. Hemorrhages from the mucus membrane may have already taken place. The blood changes to the extent of increase in the number of leucocytes from 100,000 to 500,000 and the number of red cells and the percentage of hemoglobin may be greatly decreased.
In the lymphatic type, the general symptoms are the same as in myeloid leukemia, except that the lymphatic glands of the cervical, axillary, inguinal and sometimes other glands are greatly enlarged.
PROGNOSIS: According to medical records, the average duration of life is four years. But this varies in individual cases from one to ten years. Death comes by exhaustion, infection, hemorrhage, thrombosis or cardiac failure.

TREATMENT OF CHRONIC LEUKEMIA

 NEUROPATHY: A light lymphatic to increase the circulation of the lymph stream. Stimulative treatment to the whole spine.
CHIROPRACTIC: Same as under acute leukemia with the addition of any local zone.
X-RAY: It is said that X-ray treatment is able to prevent exogenous purine accumulation in the body and thereby improving the renal function. If this is true, then liver which is rich in purines must be excluded from the diet. The claim is also made that the X-rays stimulate primitive myeloblasts and lymphoblasts to rapid reproduction. Also that uric acid content is diminished. All these results are beneficial for a time but it is admitted they are not curative. Ultimately, the relapses fail to respond to irradiation. Indeed in many of the terminal “acute” relapses this form of therapy hastens a fatal outcome.
ELECTROTHERAPY: Ultra-violet ray seems to have a very fine effect on circulation. The writer by the use of the sine wave, one pad just beneath the lymphatic enlargement and the other directly over the enlargement, has been able to drain some of them. But sad to relate, other enlargements appeared in other sections of the lymphatic system, because the lymph circulation could not be kept free. Of three cases that the writer has had experience with, all had previous hospitalization, and eventually returned to the hospital for operation and died soon afterward.


Liver Disorders

ABSCESS OF THE LIVER

 DEFINITION: A circumscribed inflammation of the liver in which there is suppuration and pus formation. It may be single or multiple. See examination of liver in first book.
ETIOLOGY: May be caused by traumatism and injuries of various kinds. Bacteria may invade the liver from the portal vein or the gall-bladder, or from any part of the digestive tract. Persons living in hot climates are more liable in the course of typhoid fever or secondary to tropical dysentery symptoms. The onset is always insidious. The principal symptoms when developed are fever, pain of a burning and boring nature. The liver is much enlarged. There is loss of appetite, more or less rapid emaciation and increasing weakness and anemia. There is a sense of weight and distress in the epigastric and right hypochondriac regions, with sometimes hiccough, nausea, and even vomiting. An icteroid hue develops; rarely, marked jaundice. The temperature is elevated from the first and is of a septic character. It is irregular, being normal at times, then rising to 103 degrees F. or more, with a more or less marked chill, to defervescence again with profuse sweating. These variations may be so regular as to clearly simulate malarial fever.
COMPLICATIONS: May rupture into the lung which would cause severe cough, dypsnea and expectoration of large amount of pus, mixed with blood.
PROGNOSIS: Generally favorable. Death can result from septic poisoning, perforation into the lungs, peritoneum, stomach, pleura, pericardium or the vena cava.
TREATMENT: Here is a difficult disease to handle. But we recall one physician who said he had been diagnosed as having an abscess on the liver and an immediate operation ordered. The surgeon that he preferred was out of town and would not be back for a week and this doctor said he decided to wait. But in the meantime he fasted, did not touch food of any kind and insisted that an ice bag and a hot water bottle be kept at his bedside so he could use one or the other as he felt like. His liquids were citrus fruit juices, particularly lemon juice. And he also had a colonic irrigation every day. By the time the surgeon returned he said he felt so much better that an operation was postponed to see how things would turn out. After 10 days of fasting he went on a milk diet for two days. Then on vegetable broths and gradually worked his way back to a normal diet. He lived to the ripe age of 78, having learned how to regulate his diet according to the feel of his liver. The medical profession up to the present time offers nothing more than relieving symptoms and maintaining the patient’s strength until the abscess discharged spontaneously, or is accessible to the surgeon for operation and aspiration. The drugless profession offers the fasting regime and hydrotherapy for aborting the abscess or hastening the discharge. Fortunate for both professions that abscesses of the liver are not more common.

ACUTE ATROPHY OF THE LIVER

 DEFINITION: A grave disease characterized by a rapid destruction of the liver tissue, with atrophy of the liver and manifestations of jaundice and constitutional toxemia and disturbances.
ETIOLOGY: This is a rare disease which may attack at any age but occurs more frequently in women because of the toxemias due to pregnancy. Alcoholic excesses, syphilis and emotional excitements are thought to be predisposing factors. Catarrhal jaundice, cirrhosis and other degenerative changes in the liver may be contributing factors. Poisons, such as lead, phosphorus and choloform may be also contributing factors.
SYMPTOMS: The first manifestation of the disease is jaundice followed by extreme nervousness, severe headache, followed sometimes quickly by delirium and coma. There may be hemorrhages from the mucous membranes and skin very early after the onset of the disease Vomiting is a very severe symptom in which there is bile and blood.
PROGNOSIS: Death usually results in from two to 40 days.
TREATMENT: Up to now the only treatment available is of the symptoms.

JAUNDICE — ICTERUS

 DEFINITION: An excess of bile pigment in the fluids and tissues of the body.
VARIETIES: (1) Obstructive jaundice, in which the bilirubin is formed normally and is excreted normally by the hepatic cells into the bile capillaries, but owing to some mechanical block in the bile-ducts is reabsorbed into the blood. (2) Toxic or infectious jaundice, in which the pigment is formed normally, but owing to damage to the hepatic cells from toxemia or infection it cannot be excreted into the bile capillaries, and so passes directly into the blood. (3) Hemolytic jaundice, in which there is excessive destruction of blood cells with the production of so much bilirubin that the cells of the liver are unable to excrete all of it and some is absorbed directly into the blood. Not rarely more than one type of jaundice is present in the same case.
ETIOLOGY: Obstructive jaundice, the most common type, may be caused by catarrh of the bile-ducts; gall-stones in the ducts; or compression of the ducts by tumors of the liver or adjacent organs, from compression of the ducts by adhesions, fibroid thickening of the pancreas, enlarged lymphnodes, from parasites in the ducts; from stricture of the larger ducts, or the consequence of visceroptosis, abdominal tumors, etc.
Toxic or infectious jaundice occurs in poisoning by phosphorus, chloroform, arsenic and in certain infections, such as syphilis, malaria, acute infectious jaundice.
Hemolytic jaundice is observed in pernicious anemia and hemoglobinuria.
SYMPTOMS: The symptoms of obstructive jaundice are first changes in the color of the skin which at first is deep yellow in color, when the jaundice has existed for some time, then the skin color changes to a greenish hue, which gradually passes into a dark olive color. There is itching and sweating with the sweat tinged with the color present at the time. Constipation is generally present, and the stools are clay color. The urine contains more of the biliary coloring matter than any other secretion. Pruritis is often a distressing symptom. Mental symptoms may be marked, including irritability, great despondency, and even melancholia. There are often headache, vertigo, and dullness; there may be sleeplessness. The vision may be affected in various ways; there may be nyctalopia, or improved vision in obscurity; objects may appear yellow or there may be hemeralopia, or very difficult vision.
Usually there is slight fever, rapid pulse, emaciation and mental depression or extreme nervousness.
The symptoms of toxic jaundice are the same as in obstructive jaundice but much milder in character. Two differences are noted. The bile reaches the intestines and the fever is higher in toxic jaundice. It can also be said that the symptoms of hemolytic jaundice are practically the same, with the exception that there is a discharge of considerable amounts of hemoglobin into the plasma, and as a result, the liver cannot remove it from the blood.
PROGNOSIS: The mild attacks may only last for a few days while the severe or chronic may last for many months.
TREATMENT: The specific treatment is of the causative factors. The general treatment may be as follows, and often the general treatment gets rid of the causative factors.
NEUROPATHY: A general lymphatic and massage. Stimulative treatment of the spinal segments. The three-cornered liver squeeze is very valuable, done lightly the first time.
CHIROPRACTIC: Adjustment 5th to 9th dorsals.
DIET: A fast of a few days is the best procedure. Alkaline juices may be given in abundance. If food is insisted on by the patient, then foods such as skimmed milk, animal broths, egg albumin for a time, then No. 1 diet can be used for a week, followed by alternating No. 1 with No. 2 for another week or two; when good improvement has been shown then a balanced diet can be made for the patient.
HYDROTHERAPY: Hot towels or hot fomentations over the liver area may be applied with benefit. The full hot blanket pack until free perspiration is established is also recommended.
ELECTROTHERAPY: Diathermy and the galvanic current directly through the liver are highly recommended. Infrared and short wave also are recommended as stimulators to the liver.
NEUROPATHIC HAND FINGER SURGERY: Make Lyons tests for adhesions then release them. If a ptosis is found it can be raised upward by the compression method.
COLONOTHERAPY: Warm saline colonic irrigations are said to be the best method, but if not feasible, daily enemas will do.
ENDO-NASAL THERAPY: All obstructions to the intake of Oxygen should be removed if the patient is able to stand the treatments. And the treatments can be given if the physician uses discretion, and applies the techniques mildly at first.
HERBOLOGY: The Root of the Rocky Mountain Grape made into a tea is par excellence as a liver tonic. Can be taken at night or morning; in the morning it acts as a laxative if taken before breakfast.
A good combination is equal parts of Mayapple, Sacred Bark, Culvers Root, Spanish Licorice Root and Rocky Mountain Grape; use ½ to a teaspoonful of the powder upon retiring, either dry or in water, milk, tea, coffee, etc.
Another good combination is a handful each of Liver Leaf, Licorice Root, Horehound; an ounce each of Mayapple root, Sacred Bark, Cheese Plant. Put teaspoonful of mixed herbs in a cup of boiling water, let cool, strain; 1 or 2 cupfuls a day.
CONGESTION OF THE LIVER

 DEFINITION: An overfullness with some distention of the liver.
ETIOLOGY: It may be of active or passive hyperemia due to disorders of circulation. It may be due to a torpidity of the liver itself. It may be due to a condition of auto-intoxication or all of them. Congestion is not a disease, but is a symptom of disease elsewhere.
SYMPTOMS: The symptoms of acute active congestion of the liver are those of gastrointestinal catarrh, such as headache, malaise, foul taste, coated tongue, constipation, weight, or even pain in the region of the liver, which may also be tender on pressure. The liver may be felt below the coastal margin. There may be slight jaundice; in the severe tonic cases the jaundice may be intense.
Symptoms of passive congestion are chiefly those of the condition of the heart and lungs causing the hepatic congestion. There may be a sense of weight and fullness in the right hypochondrium, aggravated by external pressure, deep inspiration, and by lying on the left side.
Enlargement of the liver is one of the chief signs and is usually best demonstrated by palpation. When large, the liver can often be delimited by inspection. Percussion is usually unreliable on account of distention of the intestines.
Treatment of Active Congestion is in two parts: First to correct the habits of living that caused the condition. Second, to relieve the gastrointestinal condition and the hyperemia of the liver.
The treatment of passive congestion is to correct the condition of the heart and lungs and nerve that causes the passive congestion and at the same time relieve the portal congestion.
NEUROPATHY: Deep lymphatic of the abdomen, inhibition of the liver segments for active congestion and stimulation for passive congestion.
CHIROPRACTIC: Adjustments of the 5th to 11th dorsals for active type, and for the passive type the above adjustments plus adjustment of the lumbars.
DIET: These conditions are usually brought about by overeating and drinking of alcohol stimulants. An old professor in school used to say: “When I eat like a pig my liver hits me like a club.” This condition of the liver should be named “Hogs disease.” A fast of a day or two, drinking many glasses of water diluted with a little lemon juice usually clears up both active and passive conditions. But if there is any serious disease such as heart lesions or diabetes, etc., the relief will not be great until the original cause is removed.
COLONOTHERAPY: Constipation is one of the most annoying items of the symptoms, and should be relieved quickly by enemas or colonics. Just plain hot water will do.

FATTY LIVER

 Fatty liver is a part of general obesity and the heavier weight, because of the increased size of the liver, produces a tired and dragging feeling. There is no danger to life unless there is such pressure as to interfere with the normal functions of the liver. The treatment is the same as in Obesity which please see.

CHIRRHOSIS OF THE LIVER

DEFINITION: A condition in which the liver undergoes chronic inflammatory and degenerative changes, whereby the liver becomes hard, and small, due to the ingrowth or overgrowth of connective tissue.
ETIOLOGY: Cirrhosis of the liver may be caused by chronic auto-intoxication or infection particularly from the intestines. By the abuse of alcoholic stimulants. By certain drugs containing chloroform and lead. Syphilis is regarded as a contributing factor. It may be a sequel of malaria, gout and tuberculosis.
VARIETIES: There are two types of this condition. Hypertrophic, and Biliary Cirrhosis, in which alcohol does not seem to be a factor. The liver in this condition is enlarged throughout the course of the disease. The chief features distinguishing it from atrophic or portal cirrhosis are the intralobular distribution of the fibrosis, the inflammatory changes in the biliary capillaries and the inconspicuous damage to the liver cells.
SYMPTOMS OF HYPERTROPHIC CIRRHOSIS: The liver is uniformly enlarged, usually to a marked degree, throughout the course of the disease. Not rarely it is slightly tender. The spleen is also enlarged. Jaundice, varying in degree from time to time, is a feature. Periodic attacks of pain in the hepatic region, attended by fever, increase of jaundice and perhaps, vomiting, are of common occurrent. Toward the end of the disease hemorrhages into the skin and from the mucous membranes and symptoms of hepatic intoxication, such as delirium and stupor, often develop.
SYMPTOMS OF ATROPHIC CIRRHOSIS: The size of the liver varies, it may increase in size or diminish from time to time. It does not stay large but the tendency is to grow smaller. The distinguishing features of this type are first obstruction to the portal circulation causing an upset in the digestive system then there are anorexia, fetor of the breath, fullness and distress after eating, eructations, nausea, vomiting of mucus flatulence, and constipation. For months and even years this trouble may continue but eventually as the pressure in the portal system increases, the collateral vessels enlarge and as a result the superficial abdominal veins become prominent and hemorrhoids develop. Engorgement of the portal system also leads to ascites and swelling of the feet, to enlargement of the spleen, and to hemorrhage from the stomach or bowel.
Prognosis of both types is bad because of the complications that usually develop, such as cardiac failure, pneumonia and fatal infection. After ascites has developed it can prove fatal anywhere between one and two years. However, if this disease can be recognized early and treated by Drugless methods the complications can be avoided and the life of the patient go its normal course.
NEUROPATHY: A deep lymphatic of the lymph system and also of the portal system. Three-cornered manipulative movements of the liver to soften it. Stimulative treatment of the whole spine.
CHIROPRACTIC: Adjustments from the 4th to the 11th dorsals. The liver and the gastric symptoms are influenced by those adjustments also intestinal symptoms.
DIET: At the outset of treatment a fast of from 5 to 10 days on either citrus fruit juices, grapes or milk is the best thing that can be done. One form of taking citrus fruit juice for liver conditions that has been of great value is as follows:
Take one grape fruit cut in small pieces, skin included. Pour one pint of boiling water over it, let stand one hour. Strain and bottle. Keep in a cool place. Take a wineglassful every two hours or this drink may be taken indefinitely as follows: four ounces daily, two in the morning and two at night.
After the fast the diet should be high in carbohydrates and very low in fats for a short time, then the diet should be a simple, nonirritating one and should contain easily digestible meat, chicken, or fresh fish. Cereals, vegetables, especially the green variety, should be put through a colander or given as purees. Milk should form the basis of the diet, which may be supplemented by fruit juices and cooked fruits.
VITAMINOTHERAPY: Large doses of vitamins C and K are needed to prevent hemorrhages and bleeding. Vitamin B can be given to assist in metabolism and possibly prevent ascites. Vitamins A and D may be given to assist absorption and storage. Bile salts also may be given to stimulate choleresis.
HYDROTHERAPY: A hot pack over the spinal segments and alternate hot and cold packs over the liver area are very effective, although in some cases the hot pack alone on the liver seems to be best. Sweat baths are excellent in many of these cases, given by the electric cabinet apparatus.
ELECTROTHERAPY: The writer has found the sine wave with one electrode on the back and the other over the liver area to be the most effective of all electric apparatus. A ten to twenty minute treatment twice a week is given. Diathermy, short wave, infrared can all be used to great advantage.
COLONOTHERAPY: The bowels need to be kept free, and for a time at least a daily enema or colonics twice a week can be given.
EXERCISES; If the condition of the patient is such that any exercise can be taken, walking in the open air is the best. Another one indoors would be to scatter about ten small articles over the floor of the room and pick them up, but before stooping to do so to raise the arms up over the head, then bring them down to the article, without bending the knees. If the patient cannot do so, let him bend the knees; better that way than no exercise at all.
ENDO-NASAL THERAPY: Next to the heart the liver is the greatest consumer of oxygen, and if the patient’s breathing apparatus is free of obstructions, the quicker relief can be given. The Lake Recoil, and the nose external and internal should be opened and massaged.
HERBOLOGY: One part Golden Seal, two parts Star Grass, four parts Virginia Snake Root and 8 parts Senna. Mix. Put teaspoonful in cup of boiling water. Let cool. Strain. Half cupful to cupful three times a day.
A teaspoon of Dandelion to a cup of boiling water makes a good remedy; use tablespoon every four hours.
The liver is subject to cancers and non-malignant tumors which see under those subjects.

 
Lumbago

 DEFINITION: Pain in the muscles of the lower back. See Backache.
ETIOLOGY: Lumbago may be result of disease of the spine or sacroiliac joints; defective muscular balance; bad posture; spinal curvature; flat foot; shortening of one leg; traumatism; abnormal abdominal or pelvic conditions; visceroptosis; renal calculus; retroversion or prolapse of uterus; ovarian disease; prostatic lesions; chronic focal infection in the tonsils; teeth or elsewhere, chronic intoxications (lead, diabetes gout); neurasthenia or hysteria.
SYMPTOMS: Pain is the most prominent. And while the pain may be a dull ache, movement always increases it. The pain may radiate over the buttocks and down the thighs or groin.
PROGNOSIS: May last only a few days but may persist for some time unless the underlying cause is removed.
TREATMENT: Today while writing this article a man came to the office assisted by another man and a cane. He was bent way over and on his face was a look of anguish. For acute cases of that nature the writer never asks the patient to lie down. He has them sit on a stool, then he applies the short wave, one pad tied to the back and one on the front. After the part has been well heated, the pads are removed and the large vacuum cups, three of them are placed on the lumbar section and buttocks and allowed to remain five minutes. Then a test is made to see if the pain has been removed. The patient’s arms are folded across his chest with a hand on each bicep muscle. The physician locks the legs of the patient between his own, then he places a hand on each shoulder of the patient and starts to turn the patient around. He continues to turn the patient around as far as possible but if the patient complains of pain he holds the patient in the twisted position until the location of the pain is marked out, then the cups are applied over the painful area. This is tested again and again until the pain is gone. After the pain is gone from one side the turning of the body opposite to the first twist is used and if there is pain the cups again are applied. When all pain is gone adhesive tape strapping of two pieces, 3 inches wide and 12 inches long drawn tight diagonally across the back; this is then covered with five pieces of adhesive. This technique has never failed to relieve the pain in one treatment. On the next visit a thorough examination is made to find the cause. It is a sad commentary on the intelligence of a great many people that as soon as the pain is gone the physician does not see them again until there is a recurrence. The writer has a man patient who for five years has had one or two severe attacks a year, but in spite of warnings to come to the office a sufficient number of times, so that the cause can be removed, will still go on his merry way when relieved of the pain.
It is necessary to differentiate lumbago pain from any other origin. The patient is placed on his back and his extended leg is lifted, thus lowering the corresponding half of the body and the sacrolumbar muscles. This lowering stretches the muscles and in lumbago produces sharp lumbar pain which prevents raising the leg high enough to form an angle of 15 or 20 degrees with the table or bed on which the patient rests. The pain is caused not by stretching the nerve but the muscles at the posterior aspect of the pelvis. This is done by fixing with one hand the upper anterior tuberosity of the ilium, while with the other hand, raising the leg of the same side painlessly to 90 degrees. In the coexistence of sciatica and lumbago on opposite sides, this sign is negative on the side of the sciatica, but when the opposite leg is raised, there is pain before fixation and none during fixation. When the cause is found the treatment is accordingly. Some suggestions might be in order at this point.
Thorough examination of the feet and correction. Thorough examination of the prostate or internal organs of the female. If there is a visceroptosis, drugless surgery may be necessary to raise the organs and a belt, strapping or binder applied. Infections should be sought out and removed. Postural defects can be detected by this test: Lumbago is relieved by lying down and made worse by standing and walking, while postural defect pains are the same while lying down or walking. X-rays and the plumbline will be useful in detecting bad posture. For those who seem to be neurasthenic or hysteric, turn to pages 35 and 49 of the writer’s book “The Fundamentals of Applied Psychiatry.”

 
Peptic Ulcer

 DEFINITION: A local, circumscribed destruction of tissue, involving the mucous membrane and usually one or more layers of the subjacent wall of the stomach, characterized by a clearly outlined ulcer, or multiple in number, of the stomach and accompanied by epigastric pain and disordered digestion.
ETIOLOGY: Erosion of the tissue of the stomach that may be caused by irritating substances to the lining of the stomach. Failure of the nerve supply is always a factor. Chronic gastritis may be a contributing factor. The disease may occur at any age, but the majority of cases are between 25 and 50 years. Indiscretions in diet, focal infection in the mouth, throat or any other place may be predisposing factors. Worry and fear may have a powerful effect in the production of gastric ulcer.
The peptic ulcer may be acute or chronic. The acute ulcer is usually small, rounded, with a soft clean cut margin and a smooth floor. It is more commonly gastric than duodenal, and while it may be situated in any part of the stomach it is most frequent near the pyloric end of the organ. The chronic type is larger than the acute form, and in 75% of the cases is situated near the pylorus.
SYMPTOMS: Pain in gastric ulcer is a prominent symptom. It may be burning, boring, cutting, tearing, or a constant dull ache. Its character changes from taking food or drink and even with posture. Its paroxysmal occurrence is, however, constant in the history of a typical acute ulcer case. It is due to irritation of the ulcer and to consequent (or normal) contractions. It occurs either immediately after the taking of food or after its saturation with hydrochloric acid. Often in pyloric or duodenal ulcer, it begins two to four hours after food. It is usually localized in a small area in the pit of the stomach near the median line. In duodenal ulcer especially it may be referred to the right side.
Vomiting occurs in about 70 per cent of cases, usually with gastric pain or distress. It may come on whenever foods or drinks are taken, or only at intervals of several days or more. It is usually intensified by the ingestion of much food, though perhaps relieved by small amounts. When pyloric stenosis, organic or spasmodic, exists, the contents may display evidences of retention.
Blood is present in the vomitus in probably one-third of all cases, and when in visible amounts is strongly significant of ulcer. It is usually arterial, and may be copious or more of an oozing. After a frank hemorrhage the feces are reddish, dark brown, or black; if the quantity of blood be moderate or small, blood tests are required to detect it.
Among the general symptoms may be noted weakness and emaciation, anemia, regurgitation of acid and gas, certain nervous phenomena, thirst, constipation, nausea, and faintness.
PROGNOSIS: A peptic ulcer may run its course without attracting much attention, and undergo healing, and not be discovered at all, unless discovered at a necropsy. And many have been discovered that way. It may be possible that those people had a natural method of taking care of themselves, by regulating their diets and habits to such an extent that healing took place.
In other cases the fatality is about ten per cent due to the ulcers running a rapid course to end fatally through hemorrhage or perforation. Others go on for years even without or with treatment.
NEUROPATHY: A sedative treatment of the stomach segments.
CHIROPRACTIC: Adjustment of dorsals 5 to 10.
DIET: If at all possible the best thing that can be done is to put the patient on a plain water or milk fast for one week at a time or longer. A 4 oz. glassful every hour. If not possible, then all coarse vegetables and cereals, highly seasoned foods, made-up dishes, hashes, salted and preserved meats and fish, and meat soups should be excluded. Preserved fruits, pickles, fresh berries, or vegetables with seeds, and also nuts, are dangerous. Alcoholic beverages, as well as tea and coffee, should be interdicted.
A fairly good outline of a diet after there has been some improvement was given by McCoy, which the writer has made use of with good results. Frank McCoy “The Fast Way to Health” page 90.
BREAKFAST - French omelet. 3 slices of thin brown toast, moistened with hot water, and seasoned with butter or cream. Prune whip, made by mincing stewed prunes and beating them up with the white of an egg, no other sugar being added.
LUNCH - A quart of raw milk taken 8 ounces at a time very 15 minutes.
DINNER - Whites of 3 eggs prepared by mixing with three tablespoonsful of water, and beating in a dry pan over a slow fire until cooked to a jelly-like consistency. Dish of one cooked non-starchy vegetable prepared by grinding in a food grinder before ooking, to ensure that it is well minced. Choice of one of the following raw salad vegetables, ground through a food chopper: Spinach, celery or lettuce. Dish of jello.
The patient stays in bed as much as possible while on the fast.
Great claims have been made for the Sippy routine of diet as reported in “The Safous’s Analytic Cyclopedia of Practical Medicine.” Vol. 8, page 387. The plan consists or attempts to protect the ulcer from the gastric juice until healing takes place. Neutralization of the acid is accomplished by frequent feedings and by alkalies in regulated quantities. The patient remains in bed for from three to four weeks. Three ounces of equal parts milk and cream are given every hour from 7 A. M. until 7 P. M. After two or three days soft eggs and well-cooked cereals are gradually added, until after 10 days the following is given: 3 ounces of milk and cream every hour; 3 soft eggs, 1 at a time, and 9 ounces of a cereal, 3 ounces at a feeding. Cream soups, vegetable purees and other soft foods may be substituted now and then, as desired The total bulk at one feeding should not exceed 6 ounces. Jellies, marmalades, custards, creams, etc., are permissible.
SPONDYLOTHERAPY: If pain is severe, concussion or deep pressure of the 5th dorsal will ease it. The pressure in the gutter of the spine is on the right side of the 5th dorsal.
COLONOTHERAPY: Rectal feeding is sometimes necessary. When this has been needed by patients of the writer, sanitarium care is recommended. Otherwise the colon should be kept clear by enemas of plain warm water.
HYDROTHERAPY: If hyperacidity persists mineral alkalies can be given or Cabasil tablets can be given to the patient to chew finely, then a glass of water is given. Hot water bag, or hot fomentations are good relief for pain, but when hemorrhages are present, cold applications are best. When the condition of the patient improves, a simple cold wet cloth laid over stomach at night, and to remain there until it is warm, then removed, is very helpful.
ELECTROTHERAPY: The writer has heard and read that Diathermy, short wave and infrared have some good effects on the course of peptic ulcers. But after using them, this writer cannot see that any good effects have been produced at all. In the non-hemorrhagic type, the use of ultra-violet ray has shown some effects on circulation which were beneficial.
HERBOLOGY: One ounce each of Cranesbill, Raspberry leaves and Centaury; one-half ounce each of Cleavers and Agrimony. Mix herbs and boil in three pints of water down to two pints, and take a wineglassful four times a day.
Mix equal parts of Horehound, Hops, Sage, Water Mint, Masterwort and Marigold. Put a heaping teaspoonful in a cup of boiling water, let cool, use half cupful after each meal.
Other botanicals are the following Demulcents and Emollients; Golden Seal, Marshmallow Root, Strawberry Leaves, Elm Bark, Linden Flowers, German Cheese Plant.
Golden Seal and Boneset tea is excellent.
SURGERY: If hemorrhages, and perforation cannot be prevented after a sincere effort by the physician, then consultation with a surgeon becomes necessary.
Here the physician needs to exercise great discretion. He must not rush his patient for an operation, neither must he wait until it is too late.


Pyelitis


Inflammation of the pelvis of the kidney. May be catarrhal, suppurative or ulcerative. Acute or Chronic. When the latter condition exists it is called pyelonephritis.
ETIOLOGY: It is the result of excessive vaso-constriction of the kidney, renal or intestinal of the particular spinal segments creating a perversion of functions in the kidney.
It may be said of the secondary causes that pyelitis is the result of infection reaching the kidney or its pelvis from the lower urinary tract, or from the blood stream, or directly by contiguity from some adjacent structure, colon, appendix, etc., or by means of a wound. The bacteria most frequently concerned in the process are the colon bacillus, the pus cocci, the typhoid bacillus, and the Bacillus proteus vulgaris. Among the predisposing causes of infection may be mentioned general infections, trauma, exposure to cold, gastro-intestinal diseases, excretion of irritating drugs, calculi in the bladder or renal pelvis, cystitis and especially obstruction of the urinary passages with stasis of urine (urethral stricture, prostatic hypertrophy, pelvic tumors, pregnancy, etc.) Also, a deficiency of vitamins A, E and Nicotinic Acid.
SYMPTOMS: The very nature of this affection makes it difficult to exclude other affections of the urinary tract. But, it is important to do so. It may occur at any age, but more common between the ages of 20 and 60. Females are affected more than males. In the acute form of pyelitis, the onset is sudden, with chills, and fever. The temperature may rise as high as 105 degrees. Following the peak of the fever, there is profuse sweating which leaves the patient very weak. There is pain and tenderness in the kidney regions. The patient is drowsy, the tongue is dry and thirst is usually extreme.
URINARY SYMPTOMS: Are urgency to be constantly urinating, frequency and burning of urine with frequent desire to empty the bowel. The urine is cloudy and often there is blood in it. Hematuria may be present as the result of a complication of cystitis at the same time. If suppuration occurs there will be pus in the urine. Gastro-intestinal symptoms may appear in the form of anorexia, nausea and vomiting and diarrhea. Sometimes the vomiting is persistent, to such an extent that appendicitis is suspected.

 
Chronic Pyelitis

 The acute form may go into the chronic state, with all the acute symptoms of pain, frequency of urine and discharge of pus continuously and the patient becomes more weak and emaciated.
DIAGNOSIS: Pyelitis usually offers no particular difficulty. The urine contains many pus cells, singly or in clumps, often leukocytic casts, but no hyaline or granular casts, often red blood-cells and albumin.
PROGNOSIS: Renal complications always make the pyelitis a serious affection. Catarrhal cases recover. Calculous pyelitis tends toward chronicity. Pyelonephritis and pyonephroses are likely to end fatally from exhaustion or uremia. Perforation and the discharge of pus into the peritoneal cavity, pleural sac, intestine, and bronchi, even, may precede death. The gravity in all cases of pyelitis depends upon the causes and upon the tendency to consecutive suppuration.
In the pyelitis of infancy and childhood there is practically no danger to life. Under appropriate treatment recovery in a few weeks is usual, though the condition may return at intervals for many months.
In both acute and chronic cases of adults, there is always danger of uremia and coma.
TREATMENT: General measures may consist of the following: Rest in bed for a period of time, on a fast for a day or two, with plenty of liquids. See “Diet.”
HYDROTHERAPY: Hydrotherapy in the form of hot water bags, compresses, fomentation are excellent as sedations. Plenty of water to drink, even to forcing to the limit of tolerance.
DIET: In the acute form a fast of a day or two, longer, if indications warrant it. Milk, every two hours will suffice for strength. Citrus fruit juices may be freely used. To break the fast, No. 2 Diet can be used gradually leading up to a modified form of No. 1.
VITAMINOTHERAPY: Foods rich in Vitamins A, and B, with Cod liver oil or Cod liver oil rich in those vitamins as a supplement. Alcohol must be forbidden.
COLONOTHERAPY: The importance of maintaining bowel elimination cannot be overlooked. Enemas, colonics or laxatives are in order.
VACUUM THERAPY: Complete cupping from the 7th Dorsal to the sacrum is par excellent and with care can be used over the intestines and groin for stimulation of the circulation.
HERBOLOGY: Alkaline mineral water, Moss tea, Flaxseed tea, Barley water, Lemonade, skimmed milk and Buttermilk are all excellent.
ELECTROTHERAPY: The short wave seems to be the best electrical treatment.
ORIFICIAL THERAPY: Finger rectal dilation and massage of the prostate in the male. In the female massage of the ureter may be in order. Also, replacement of the uterus, if necessary.
SPONDYLOTHERAPY: 6th to 10th dorsals. Very light at the first treatment.
NEUROPATHY: When condition permits a thorough lymphatic of the whole lymph system with special attention to the groin and Hunter’s Canal. Sedation or dilation treatment as indicated by cause of the pyelitis, on the kidney, bladder and renal segments.
CHIROPRACTIC: Kidney Place and all renal subluxations.

 
Nephrolithiasis

 DEFINITION: This condition is also known as stone in the kidney. Renal calculus; renal colic, gravel or pyelitis calculosa. A condition in which fine or coarse concretions are formed in the kidney substance or in the pelvis of the kidney by the precipitation of solid substances from the urine.
ETIOLOGY: Heredity seems to play some part. The writer knows of several families in which members for a few generations have been afflicted.
The disease can abe classified as one of deficiency of certain food elements, and an excess of other food elements. The deficiency may be said to be of Vitamin A and phosphorus, while the excess can be said to be of calcium in too great amounts to be balanced by Vitamin A and phosphorus. Read “Formation of Calculi” under “Cholelithiases.”
Existence of parathyroid conditions, with formation of calculi is often noticed and it may be a cause. This can be easily accepted, considering the fact that the parathyroids play a part in the distribution of calcium.
Pus inflammation ascending from the organs and tissues from below the kidney, or descending from some other foci of infection may be considered as large factors.
Bone lesions in which there is an avitaminosis of Vitamin D, with such diseases as rickets, deformans, or any bone condition that has begun by a disturbance of the calcium, phosphorous metabolism.
SYMPTOMS: Pain and hemorrhage are the most important symptoms, in case the stone is small and the kidney healthy; indeed these may be the only symptoms present. The pain is usually felt in the loin over the affected organ; it is of a dull, heavy, dragging character. Hematuria is generally remittent; the amount of blood passed is not great; it is thoroughly mixed with the urine, and the blood cells are altered. A larger calculus, producing suppuration, is suggested by pus in the urine with pain on pressure and perhaps increased resistance in the loin. A calculus blocking the ureter and producing hydronephrosis is suggested by feeling a soft, elastic tumor of variable size through the abdominal walls or in the lumbar region; but this is apt to disappear simultaneously with the passage of a large amount of urine.
The attacks usually recur and the urine becomes alkaline or putrid. Vesical irritation, pain, retraction of the testes, and gastric disturbances are other symptoms frequently met with in all forms of renal calculus. In case of renal colic there is acute suffering, the pain shooting down the ureter to the testicle or labium majus and often radiating to the thigh. There may be nausea and ineffectual vomiting, vesical tenesmus, faintness, cold sweating, and even collapse. Oftentimes the pain ceases as suddenly as it began; but relief is not permanent unless the stone has receded into the pelvis of the kidney or has passed into the bladder. The paroxysms of pain recur at intervals of from a few minutes to several hours or days.
All of the above can be summed up as follows:
Pain and tenderness in the kidney region are common symptoms. The pain is aggravated by rough motion, and tends to radiate along the ureter. Irritability of the bladder is sometimes a prominent feature. The urine frequently contains blood, pus, epithelium, and crystals indicating the nature of the stone.
SYMPTOMS OF SEPSIS: Irregular fever, chills, sweats, leukocytosis, and pallor often mark the occurrence of suppurative pyelitis. Renal colic is excited by the entrance of the stone into the ureter. It is characterized by intense pain radiating from the kidney downward into the groin, thigh, and testicle. The testicle is often retracted. There are often nausea, vomiting, and collapse. After such an attack the urine may contain blood or particles of stone. Anuria is one of the most serious complications.
TREATMENT: The treatments can be said to be of four divisions. (1) Relief of pain. (2) An effort to dissolve the calculi. (3) Surgical procedure. (4) Prevention of future attacks, also, prevention of calculi forming in those who are now free of any symptoms.
For the relief of pain, the following may be used:
HYDROTHERAPY: A hot tub bath will sometimes give immediate relief. Hot compresses are also of great benefit. Hot sitz baths. Poultices of various kinds may be helpful. In a few cases, where heat is not beneficial the ice packs or bag may be effective. Hot drinks of lemonade, or hot water will help. Large amounts of water, preferably mineral, such as Poland or Vichy, are to be taken daily. If not obtainable hot and cool water will do.
DIET: A fast during the attack is the best regime. Since the patient is in bed, the fast and rest should help to prevent hemorrhage. The urine must be kept faintly acid, and as soon as it becomes alkaline, changes in the diet must be made.
Between attacks of acute renal colic, the patient should see his physician every day for a urine check-up. The urine can be made faintly acid by the use of saccharin, or any of the foods in the acid column found in the “Acid, Alkaline Outline” in this book.
CATHETER: may be used to dislodge a stone that is giving recurrent distress. If a hemorrhage persists, or the stone is too large to pass, surgery must be seriously considered before irreparable damage is done.
The second phase of the treatment is dissolution and removal of the calculi and must be preceded by a thorough X-ray study. It is claimed that large doses of glycerin will dissolve the stones and envelope them to make the passage easy. The amount used is 1 2/3 ounces of glycerin at equal periods, three times a day for three days. This procedure produces a good deal of abdominal distention and gas, and daily enemas are necessary. Another method is the following:
To aid in expulsion of calculus from the kidney, Spirit of turpentine in 10 minim (0.6 c.c.) doses in gelatin capsule three times daily. Diet of milk, each tumbler diluted ¼ part with water, milk to be slightly warmed and drunk slowly. Fish and dry toast may be taken once daily. The patient is to rest recumbent during the regimen and to take occasional hot sitz baths. The treatment to last six days consecutively, then after a two-day interval it is repeated once or twice if necessary.
A third method that has produced results has been a balanced diet rich in Vitamin A. Also two Cod Liver Oil capsules six times a day rich in Vitamins A and D. But, the content of Vitamin A must be greater than D.
For prevention of future attacks, or the prevention of the formation of stone, the above regime can be reduced by one-half and continued for at least a year. A balanced diet can be selected from Forms No. 1 and 2, in this book.
HERBOLOGY: For the anuria that may develop a mild diuretic and tonic, with emolient and soothing properties to the urinary passsages can be made from Palmetto Berries, Bearberry Leaves, Licorice, Cubeb Berries, Juniper Berries, Althea Root, Sweet Fern, Pipsissewa, Fennel Seed and Bluets.
A simple yet effective tea can be made from the Bearberry and Goose Grass.

Urticaria, Hives, Nettlerash

 DEFINITION: An inflammatory affection of the skin, characterized by the eruption of whitish or pale red evanescent wheals that cause great itching and distress. Sometimes called Nettlerash or Hives.
ETIOLOGY: Acute urticaria is usually produced through some alimentary disorder, the result of mechanical irritation of the stomach or bowel, or a toxemia. Intestinal parasites and undigested food act as mechanical irritants; substances capable of producing toxemia may be primarily toxic or may become so through putrefactive changes within the intestines. Idiosyncrasy to certain foods and drugs is an active cause. Among the foods most apt to cause urticaria are: crabs, lobsters, mussels, caviar, shrimps, salted fish, clams, oysters, cheese, buttermilk, sausage scrapple, pork, veal, strawberries, raspberries, cucumbers, mushrooms, grape skins, etc.
Urticaria may also be produced by certain drugs, such as coal tar derivatives and quinine.
Urticaria may occur in connection with malaria, rheumatism, Bright’s disease, the eruptive fevers, pertussis, asthma, and various nervous and gastrointestinal disorders. It is a frequent complication of scabies and pityriasis and has been observed as a sequel of arsenical poisoning. Finally, direct local irritation—sting of nettle, bite of jelly-fish, mosquito, bee, wasp, etc., may produce the disease.
SYMPTOMS: The eruption appears suddenly and may be localized or more or less general. The lesions are firm, rounded, pinkish or whitish elevations, surrounded by red wheals. They last a few hours and are succeeded by new ones in other places. The main symptom is itching.
TREATMENT: Since this condition is due to a lymph stasis of peripheral circulation it follows that a thorough lymphatic is in order, and a sedation of the whole spinal area.
CHIROPRACTIC: D 5-7-10 and local zone.
HYDROTHERAPY: Hot baths with a handful of washing soda in tub on retiring. Lime water applied to the part with a cloth or cotton. Cold compresses will give relief in many cases. Epsom salts baths, two cups full to a tub of water is helpful.
COLONOTHERAPY: Daily enemas or colonics are in order as long as the condition is acute. Sodium bicarbonate, tablespoonful to each quart of water.
ELECTROTHERAPY: Ultra violet ray seems to be the electrotherapeutic agent. The high frequency bulb has also considerable value over the local area.
DIET: Usually a fast of a day or two will aid greatly. However, if not feasible, eliminating all acid foods for a few days at least is the rule. The diet should be of an alkaline nature.
HERBOLOGY: Use an herbal laxative. Catnip tea is excellent for Hives, especially suitable for small babies.
One dessertspoonful after meals of the following tea is good: (Put herbs in cup (8 oz.) of boiling water, cool, strain.)

Jam, Sarsa (Jamaica Sarsaparilla) 1 oz.
Urtica dioica (Stinging Nettle) 1 oz.
Hydrastis (Golden Seal) ½ teaspoonful
Sennae (Senna) 1 oz.

Laryngitis

 DEFINITION: An acute inflammatory condition of the mucous membrane lining of the larynx, characterized by slight fever, hoarseness and a catarrhal exudate.
ETIOLOGY: Improper use of voice, exposure to dampness. Extension of infections from the nose and throat, measles, whooping cough and some other conditions of nearby organs. Smoking or drinking to excess.
There are many types. The simple, in which there may be no more than hoarseness and aphonia, with slight pain on deglutition. The chronic type in which the above symptoms are prolonged and may be exaggerated. There also is a type known as membranous, which is from infection with swollen larynx and considerable pain.
Then there is the tuberculosis type with pain in swallowing and a hollow cough. And the Syphilitic type. Secondary stage in form of mucous patches or tertiary in form of gumma. Secondary syphilis is a diffuse infection and one sees luetic patches spread over large areas. In tertiary syphilis the gammatous lesion can occur in any part of larynx. There is marked redness over the infiltrated area as well as in the surrounding mucous membrane. When there is breaking down, the resultant ulceration is deep with sharp edges. Pain is usually absent and fixation of the cord is late. Cicatrization and deformity follow healing of gumma.
In all the types there is present to a more or less degree the following symptoms: Cough, hoarseness, aphonia, pain and dypsnea.
TREATMENT: Find the cause and remove it. A general treatment may be as follows:
NEUROPATHY: A good lymphatic of the throat and axillary glands.
CHIROPRACTIC: Adjustment 4th to 6th cervicals and D 2 and 5.
HYDROTHERAPY: Cold compresses around the throat or douches of cold water on the throat. Gargle with half water and half lemon juice is excellent. Alum water has been used for a long time as a gargle, but now 120 V.M. has displaced it. One drop to 10 drops of water is sufficient. A greater quantity can be made in proportion. For infections the strength of 120 may be greatly increased. Spraying of the throat with an atomizer with the above solution is also helpful. Ice cubes may be put in the mouth to allay the irritation.
ELECTROTHERAPY: Direct diathermy or short wave over the neck. Ultra-violet quartz ray directly on the diseased parts is highly recommended.
COLONOTHERAPY: In this condition the bowels must be kept free by enemas or colonics.
ZONE THERAPY: A pulling out of the tongue, twisting it from side to side gently, then exerting slight pressure underneath on the floor of the tongue, has helped some. The patient can be instructed to do the above.
ENDO-NASAL THERAPY: If at all possible, the physician should put his finger down to the larynx and massage the whole area. The finger can be wrapped in gauze that has a bit of 15 V.M. or vaseline on the end. For full instructions see book “Endo-Nasal, Aural and Allied Techniques.” Lake, page 64.
SPONDYLOTHERAPY: Concussion of the 7th cervical if heart is fast. Otherwise concussion of the other cervicals, avoiding the 7th cervical, unless the heart is too fast.
VACUUM THERAPY: Cups applied to the dorsal and cervical regions and directly over the afflicted area are an excellent form of treatment.
DIET: A fast during the acute condition, then Diet No. 2 for a day or two, followed by No. 1, has been found the best procedure by the writer. Milk may be given to those who complain of the fast.
HERBOLOGY: Smoking Mullein Leaves like tobacco is good.
The following taken before meals, one dessertspoonful is recommended.

 Hieracium Pilosella (Mouse Ear) ½ oz.
Lycopus Virginicus (Bugle Weed) 1 teaspoonful
Hydrdastis (Golden Seal) 1 teaspoonful
Glycyrr (Licorice) 2 oz.
Cinnamomi (Cinnamon) ½ teaspoonful

 Put the above in 8 oz. of boiling water (a cupful), let cool, Strain. Shake well before use.

 VITAMINOTHERAPY: A in large doses and D in smaller doses three times a day.
In malignant growths of the throat it is best to consult a specialist.

 
Malaria

 DEFINITION: The term Malaria is so broad that it comprehends a group of infections, and has many synonyms, such as ague; intermittent and remittent fevers; chills and fever; quotidian, tertian, and quartan fevers; autumnal fever; paludal fever, marsh fever; climatic fever; jungle fever; swamp fever; coast fever; mountain fever; hill fever; gnat fever; Roman fever; Chagres fever; Cameroon fever; chill fever; cold fever; hemamebiasis; paludism autointoxication.
ETIOLOGY: Whenever there are the following three symptoms recurrently present, chill, fever and sweating, there is always some infection present.
AUTOINTOXICATION: The blood stream is polluted and the insects which bite and penetrate deposit their parasites in the polluted blood of man in which the oxygen content is very low and a breeding place is found, there cultivating until the whole blood stream is poisoned. This poison or the parasite starts a destruction of red cells, which is followed by anemia and weakness. Man becomes infected through the bite of certain mosquitoes, namely, those belonging to the genus Anopheles. However, symptoms simulating malarial fever may be produced by the bite of any insect.
TYPES: Some types follow with a few of their symptoms:
The Intermittent type of Fever, enlargement of spleen, haematozoa in the blood and the occurrence at regular intervals of paroxysms divided into three states, cold, hot, and sweating. When paroxysms occur every day it is termed quotidian intermittent; every other day, tertian intermittent; every fourth day, quartan intermittent.
PROGNOSIS: Aloways favorable. Even without treatment paroxysms gradually subside. Each case should be treated according to individual manifestations.
THE REMITTENT: Malaise with moderate chilliness, followed by a continuous fever which daily remits. Maximum temperature ranges from 103 to 106 degrees. While this lasts the skin is hot, face flushed, eyes injected, pulse full and rapid, urine scanty, and patient complains of pain in limbs and head. Delirium sometimes noted, vomiting often occurs, jaundice may develop from destruction of the red blood corpuscles and liberation of their pigment. Spleen is enlarged and haematozoa present.
PROGNOSIS: Favorable. Duration, one to two weeks.
CHRONIC MALARIAL CACHEXIA: A chronic manifestation of malaria characterized by anemia, by a sallow appearance of skin and splenic enlargement.
SYMPTOMS: Patient is thin and pale. Complexion dirty yellow or muddy hue; fever often absent; if present, slight and irregular; spleen considerably enlarged; great weakness from the attending anemia. Headache and neuralgia. Hematuria sometimes present.
PROGNOSIS: Guarded.
TREATMENT OF MALARIAL DISEASES: Prophylactics. Patients living in malarial districts should avoid the night and early morning air; should sleep in upstairs room. Treatment covering the special conditions of each case should be given.
REMITTENT FEVER: Absolute rest. Light diet.
In Pernicious Malarial Fever and Chronic Malarial Cachexia, as well as in the Remittent and Intermittent forms the treatment is found under the Acute Malaria.
MALARIAL HEMATURIA: A malignant form of malaria generally appearing about the first of February or latter part of October, among those living in a malarial country most of the year, and who have had malaria.
SYMPTOMS: The principal symptom is blood in the urine with a pernicious form of malaria.
DIAGNOSIS: The following three stages of any type would lead the physician to suspect Malaria in some form:
THE COLD STAGE: This stage is characterized by lassitude, aching in the limbs, and great chilliness. The features are pinched, the lips blue, and the surface is cold and rough. The rectal temperature, however, is high (105-106 degrees F.). Vomiting may occur. The chill may last from a few minutes to an hour or more.
THE HOT STAGE: The surface temperature gradually rises, the skin becomes hot, the face flushed, the eyes injected, and the pulse full and rapid. The temperature in the axilla may reach 106-107 degrees F. The patient complains of severe pain in the head, back and limbs, and of intense thirst The urine is scanty and dark colored. This stage usually lasts from one to five hours.
SWEATING STAGE: The fever gradually subsides, the pains grow less, free perspiration follows, and the urine becomes plentiful. Within an hour or two the attack is over and the patient falls into a refreshing sleep.
TREATMENT: In every case in which acute Malaria is suspected, the patient should be put to bed at once. The bowels should be thoroughly irrigated with a warm saline solution. No nourishment should be given for at least twelve hours. The best procedure then to follow is to give the general outline of treatment, combating the symptoms as they arise.
NEUROPATHY: A good lymphatic and stimulation of the whole spine.
CHIROPRACTIC: For the decrease of temperature Dorsal 5-7. For increase of temperature Kidney segments. Cervical 5 will sometimes control the fever.
HYDROTHERAPY: Hot packs over the kidney, in the hot stage sponging. Much relief is given by cool sponging. During the cool stage the patient should be well covered with blankets, and given hot drinks. If there is vomiting, ice pellets to sip on, or ice pills to swallow.
VACUUM THERAPY: Cupping over the whole spine in the intermittent type of fever has always been of great value.
DIET: As stated above, in the fever stage all food should be withheld for some hours after the fever has subsided. When the patient seems normal after an attack, the milk diet can be given for a few days, glassful every two hours. Then if satisfactory results are obtained, No. 2 diet for a few days, gradually working the patient up to No. 1 diet.
EXERCISES: When well enough, sun baths, hot and cold showers and daily walks in the country for fresh air.
ENDO-NASAL THERAPY: Oxygen destroys germs. Oxygen attracts iron from the food into the blood stream. Then the whole respiratory system must be put in order. The nose must be dilated fore and aft. The diaphragm should be exercised by raising and falling.
HERBOLOGY: Equal parts of any of two or three of the following can be made into a good tea for Malaria. Take teaspoonful of the mixed herbs to a cup of boiling water. Large swallow at a time — one or two cupfuls a day. Boneset, Sweet Flag, Elecampane, Elderberries, Sweet Marjoram, Cloves, Wild Ginger, Cinchona, Agrimony, Five Finger Grass, Sage, Blue Vervain, Wood Sorrel, Yarrow, Hops, Juniper Berries, Lovage, Blessed Thistle, Jamaica Ginger.
A nice combination is equal parts of Wild Cherry Bark, Black Haw, Burdock and Dogwood Bark. Take about 7 tablespoonsful of the mixed herbs to a quart of boiling water; let cool, strain. Tablespoonful three times a day.
Anemia exists after manifestations of any type of Malaria, then a part of the treatment is of Anemia, which see.
VITAMINOTHERAPY: A.D to provide resistance against further attacks. B2 and G for building up blood reserve. 120 V.M. 1 drop to a glass of water two times a day.

 
Mastoiditis

 DEFINITION: Inflammation of the lining of the mastoid cells, beginning in hyperemia, followed by edema and exudation.
ETIOLOGY: It is doubtful if primary inflammation of the mastoid ever occurs except as the result of syphilis or tuberculosis, the disease being in almost every instance, the result of an extension, by continuity of structure, of inflammation from the tympanum. Politzer states that in every post-mortem that he made of chronic suppuration of the middle ear the mastoid cells were diseased. Mastoiditis, then, is generally the sequency of acute inflammation of the tympanum or of chronic suppuration of the middle ear. In rare instances suppurative inflammation of the deeper portion of the auditory canal may extend under the periosteum until pus appears upon the external surface of the mastoid beneath the periosteum; or infection may be transmitted by means of the veins which traverse canals passing from the meatus into the mastoid cells.
The chief symptom at the beginning of brain complications is usually headache, which, at first intermittent, soon becomes constant and increases in severity. Accompanying the headache there are restlessness, insomnia, occasional vomiting, and dullness of the intellect. If the eye be examined with the ophthalmoscope, commencing optic neuritis will be discovered. In children coma frequently occurs. Dilation of the pupil, paralysis of the accommodation, strabismus, ptosis or paralysis of other muscles of the body, may sometimes be present as the result of brain-abscess. This is an inflammation with pus filling up the porous portion of the mastoid bone. This bone actually is a sinus acting as a sounding board for the ear. It must be remembered that the middle ear consists of a series of communicating pneumatic spaces, beginning with the pharyngeal end of the eustachian tube in the lateral wall of the naso-pharynx and terminating in the pneumatic spaces of the mastoid processes that in health are filled with air.

TREATMENT

 ENDO-NASAL, AURAL AND ALLIED TECHNIQUES: Two things must be borne in mind: (1) the future of the patient relative to prevention of poor hearing and tinnitus arium, and (2) the safety of the patient, if conservative treatment is instituted; then general supportive measures and establishing free drainage are recommended. There has been much discussion as to whether hot or cold applications are best. Both sides have a fair argument. We usually see which gives the most comfort to the patient for a while, and then apply the cold packs if temperature remains high. The pus is thus slowly taken up by the blood stream for elimination. Infra-red light has been found useful, applied for five-minute periods at intervals of every hour. Diet: Fast on fruit juices while acute condition lasts. With all this, remember that the quicker air gets in the better. Then, as soon as possible, without giving too much pain, open the pharyngeal and Rosenmuller cavities. After inflammation has subsided, give all General Techniques for a few weeks, testing to see if eustachian tube is patent. After the pain has eased, a lymphatic of the cervical region may be given, and if not too painful, adjustments of the cervical vertebrae can be given. This is a self-limited inflammation, and if the patient will remain quiet and use hydrotherapy of heat and cold, as best suited to his needs, and will fast as much as possible, no serious complications will arise. The writer has experienced this disease three times in his life, and fasting and hydrotherapy were all that was necessary. But the average patient wants relief at once, and all sorts of things are done and all sorts of stuff are poured into the ears. This writer has had many cases of this condition, and in addition to heat and cold applications, psychiatry has been helpful in aiding the patient to wait until the discharge or the resolution of the pus. Only two went on to paracentesis or mastoid operation. This is not to say that operations and paracentesis are not sometimes necessary. But if the Drugless Physician could get the case before all kinds of things were tried at home, the above simple method would be effective.
ELECTROTHERAPY: Infrared has been useful in aborting an attack in several cases. Hollander reports that radiant light heat, a 1,000 watt, affords the patient some relief. He believes that radiant energy is effective by conversion into long obscure heat waves, which are absorbed and carried by contiguity of structure and conversion through the blood. This heat, he contends, has a local effect upon cellular metabolism of the cells themselves by reason of the heating of the cellular contents and the increased supply of invigorating blood. The increased blood supply is due to the well-known vasomotor response to heat.
VITAMINOTHERAPY: Large doses of Vitamin A, smaller doses of Vitamin D. A may be given as high as 25,000 units a day.

 
Measles

RUBEOLA AND RUBELLA

 DEFINITION: Measles, Morbilli or Rubeola is an acute, infectioius, contagious disease, generally of children.
Rubella is an acute contagious disease resembling both scarlet fever and measles, but differing from these in its short course, slight fever and freedom from complications. Sometimes referred to as German measles or Epidemic Roseola.
These two conditions are claimed to be highly contagious diseases. Yet the Department of Health of Pennsylvania has removed them from the quarantinable list of diseases.
ETIOLOGY: It is supposed to be from a virus of some nature. But before the onset there is noticed a nasal catarrhal condition and also a lack of vitality and interest in the child or patient.
SYMPTOMS: Onset gradual; coryza, rhinitis, drowsiness, loss of appetite, gradual elevation of temperature for first two days, when fever may rise from 101 to 103. Photophobia and cough soon develop, although some recession in the temperature may occur. About fourth day, fever usually reaches a higher elevation than previously, at times as high as 104 to 106, and with this recurrence the rash appears. Erupton first appears on face, being seen early as small maculopapular lesions which rapidly increase in size and coalesce in places, often causing a swollen, mottled appearance. The rash extends to the body and extremities, and in some areas may assume a deviousness suggestive of scarlet fever. A cough, present at this time, is due to the bronchitis produced by the inflammatory condition of the mucous membranes that undoubtedly corresponds to the rash seen on the skin. Ordinarily, the rash lasts from four to five days and then subsides, the temperature declines. Consequently, by the end of five days from appearance of rash, temperature should be normal, or approximately normal in uncomplicated cases. Prior to appearance of the eruption, a leukocytosis may be noted. Following presence of rash, a leukopenia may always be expected.
COMPLICATIONS: Bronchopneumonia, otitis media, mastoiditis, cervical adenitis and perhaps some encephalitis, eye disturbances or laryngeal stenosis are possible complications.

TREATMENT

 NEUROPATHY: Complete lymphatic to drain the catarrhal mucus, and stimulation of the whole spine.
CHIROPRACTIC: Adjustments C1, D 6, Lumbar 3 and wherever else indicated.
HYDROTHERAPY: A daily warm bath will aid in desquamation. But if there is high temperature, cool sponging should be used. The eyes should be washed and cleaned with warm water.
GENERAL HOME CARE: Patient should be isolated in a well-ventilated room, since when a respiratory infection is being dealt with, good ventilation is of utmost importance. Though a room is frequently darkened, this is not a necessary requirement, if strong light does not shine in patient’s face. The average measles patient does not care to eat during first few days of illness. Aside from providing plenty of fluids, no unusual effort should be made to force food upon him. Plenty of water, fruit juices and milk, however, are desirable. With fading of rash and reduction of temperature, patient will soon regain his appetite under normal circumstances. The eyes should receive careful attention, being cleansed with a saturated solution of boric acid.
The cough can be controlled by concussion of the 7th cervical or a spoonful of equal parts of honey and lemon juice thoroughly mixed.
HERBOLOGY: Alternately giving hot Catnip Tea and a Tea made from Elderberry Flowers (also berries can be used) will bring out the measles and check the fever.
Some find Hot Lemonade excellent to bring them out.
A pleasant drink to bring out the measles and which the children will like as it tastes like Lemonade is to make a tea of Saffron Blossoms, add lemon juice and sugar to taste.
When child is about (or) up and around (or) out of bed, a thorough examination of the whole respiratory system, and treatments by Endo-Nasal techniques is indicated.

 
Meniere’s Disease

TINNITUS ARIUM

 DEFINITION: Nerve racking noises in the ears or head, with vertigo as a common symptom.
ETIOLOGY: Please read the essay the writer has under “Tinnitis” in his book, “Endo-Nasal, Aural and Allied Techniques”, page 86. It is too long to put here. The general symptoms briefly stated are: Deafness, tinnitus arium, and paroxysms of intense vertigo. The paroxysms, which may occur daily or at intervals of weeks, may culminate in vomiting or even in syncope. The condition usually continues through life unless the proper treatment is given early in the disease, or the loss of hearing becomes total, on the affected side.
Noises in the head may come from other causes such as low blood pressure, high blood pressure. Tumors of cerebello-pontine angle may excite similar symptoms. But the majority of cases are from lesions in the labyrinth and there may be a degeneration of the nerve ends. In some cases the condition follows diseases of the middle ear.

TREATMENT

 The Treatment must be of the cause. See treatment for low and high blood pressure and vertigo.
PROGNOSIS: Many have but a single attack of tinnitus which may be reflexed from some abdominal organ or organs, particularly the liver, and may recover completely in a short time. Others may have it for years, or a life-time, unless the cause is found and removed.
TREATMENT: While giving the general treatments, diligent search should be made for the cause; urinalysis, and hemoglobin and blood count tests should be made in every case. High acidosis, sugar, albumen and chlorides to an appreciable amount may be evidence of anoxemia, diabetes and nephritis. These present serious implications in connection with tinnitus and vertigo. The color and blood count test will help establish the presence of anemia or leukemia. These diseases mentioned with uremia, gout, arteriosclerosis and migraine are sometimes accompanied by tinnitus. Look at the toe nail, denoting an anemia of the spinal nerves. For treatment of specific causes see under titles in the index.
AIDS: Fasts of one or two days, with a following through of Diet No. 1 and No. 2 alternately for a month, have been of great benefit to those who show toxemic tendencies. Negative galvanism is recommended and diathermy, through the finger tips of the doctor held in the patient’s ear, also endocrine therapy of the adrenal and thyroid types. Thorough elimination should be established and we have known of cases where colonic irrigations accomplished splendid results. Zone therapy has its merits if the patient will persist in its performace. Pressure on the internal and external carotid artery on one side for about five minutes, when the tinnitus is extremely annoying, has produced temporary relief; also pressure on the roof of the mouth underneath the noise area. Concussion of the seventh cervical has helped some, also vibration on the whole head area. If all of these fail, and the patient is in a state of nervous exhaustion, plugging for five minute periods about five times a day will help. A small rubber tube completely incased in absorbent cotton, so made that it will slip easily into the ear, is inserted in the ear as far as possible without force. If there is a perforation in the drums, it can be placed just over it. If the cotton tube is placed in the appropriate place, there is nearly always an immediate diminishing of the sounds in all patients. The location is not uniform. The patient, after being shown, can be instructed to do this at home. For the first few days it should be removed after five minutes. After this treatment, dry heat of some nature is very soothing. Vacuum therapy, with a small ear bulb was used by the writer on himself and it stopped every attack he had.
In addition to the above all the general Endo Nasal and Aural techniques need to be used. Air must be gotten into the eustachian tube or there will not be any relief from tinnitus arium.
CHIROPRACTIC: Adjustment of Cervicals 1 and 3.
NEUROPATHY: Deep lymphatic of the cervicals.
ELECTROTHERAPY: There are physicians who claim to have some good results from diathermy and galvanism, but the experience of the writer with these modalities has been practically negative. But Collander gives the following report of a case: R. L., age 45, male, druggist, suffered from tinnitus for twelve years. He attributed his trouble to a pneumonia, as he had never noticed the symptoms before this illness. Inflations, operative procedures on the nose and throat, and X-rays produced no relief. Thyroid extract, as well as other medication on a systematic basis, proved of no benefit. He always noticed that local heat in some form was palliative. There was no definite impairment of hearing. Diathermy was applied to both ears, one ear being treated at a time, for a period of four weeks, four treatments weeky. At the end of this course the tinnitus was almost negligible, but returned later when no treatments had been taken for about two months. The diathermy was resumed, and after a few applications, relief was again obtained. In this case, it is especially interesting to note that of all the measures utilized, diathermy was the only one which gave some promise of being beneficial.
HERBOLOGY: One tablespoonful each of Chicory Root and Pimpinella Root to a pint of water; boil moderately for thirty minutes; let cool, strain, add hot water to make up a full pint. Take three cupfuls daily, between meals. Syringe ears with warm decoction of Shavegrass or Shepherd’s Purse, three or four times daily.
COLONOTHERAPY: The bowels need to be kept free at all times.

Meningitis

 BRIEF ANATOMY: The meninges are the three membranes investing the spinal cord and brain; the dura mater, external, and the arachnoid, middle and pia mater, internal.
DEFINITION: Inflammation of the membranes, the spinal cord or brain.
VARIETIES AND SYMPTOMS, AND TREATMENT: Simple or Acute Leptomeningitis — An acute inflammation of the pia mater and arachnoid considered as one, and Pachymeningitis or inflammation of the dura mater. Really these can not be distinguished from each other. Moreover, inflammation of the brain and of the pia, dura, and arachnoid is sure to extend to either or both of the others, and the consequence will in any form be suppuration, abscess, effusion into the ventricles and softening of cerebral tissue if brain is involved. Meningitis may be either acute or chronic. Acute form: Symptoms are moderate, irregular fever, loss of appetite, constipaton, intense headache, intolerance to light and sound, contracted pupils, delirium, retraction of head, convulsions and coma.
PROGNOSIS: Unfavorable, though recovery is not impossible.
TREATMENT: Patient should be placed in a darkened, well-ventilated room. Ice bag to head. When patient is robust, vacuum cups may be applied to neck. Diet: Liquid; small quantities frequently. Constipation relieved by enemas. Treatment is for each individual case. Chronic form: Same careful treatment should be carried out; generally results from injury, syphilis, sunstroke or caries of the bone. Additional therapeutics suggested at the end of this section.
Hemorrhagic pachymeningitis may be secondary to chronic cardiac disease renal disease, one of the infectious fevers, chronic alcoholism or especially insanity.
SYMPTOMS: Often not clear. Where marked there is headache, failure of memory, impairment of intellect, stupor, contracted pupils, local convulsions or palsies.
PROGNOSIS: Unfavorable.
TREATMENT: Grave cases should be treated as apoplexy.
TUBERCULOUS MENINGITIS: An acute inflammation of the cerebral meninges excited by the tubercle bacillus.
SYMPTOMS: Loss of flesh, gradual wasting of strength, rise of temperature in evening, restlessness, irritability and sleeplessness may exist for some time before acute symptoms come on; these are severe headache, occasional convulsions, delirium, vomiting, fever, optic neuritis.
SYMPTOMS: Of compression of brain. Child passes into comatose state and dies.
EPIDEMIC CEREBRO-SPINAL MENINGITIS: A specific infectious disease caused by invasion of meningococci, characterized anatomically in inflammation of the cerebro-spinal meninges, and clinically by intense pain in head, back and limbs, convulsions, irregular fever, and frequently by a red, round, small eruption.
In the cerebro-spinal meningitis, there are three types recognized: the Mild, where there is slight fever, general malaise, and some vomiting; the Abortive type, seen in strong children who by reason of good health are able to withstand a severe infection, and the symptoms are even less than in the mild cases, and the recovery is very rapid. In the Severe cases, the duration of symptoms may last from three to seven weeks. In those that recover, in many there is left some form of physical distress. These may include defective vision from inflammation of the cornea or retina or from atrophy of the optic nerve; defective hearing from inflammation of the auditory nerve or from suppurative inflammation of the internal or middle ear; pneumonia; arthritis; aphasia; peripheral palsies; imbecility; chronic hydrocephalus; and persistent headache.
GENERAL TREATMENT: Upon an early diagnosis largely depends the outcome of any form of Meningitis. The patient should be kept in a quiet room, with the window shades well lowered. To prevent stasis of circulation by lying in one position too long, he should be turned from one side to the other about every two hours. The head and neck should be elevated to prevent cerebral congestion.
HYDROTHERAPY: When the temperature has passed 102 degrees, an ice pack around the neck may be applied, or an ice bag to the head, or cool sponging may be used on the whole body. A warm sulphur bath twice a day is recommended by some.
VACUUM THERAPY: Cupping of the whole spine and the neck has been a very good adjunct to other forms of treatment.
DIET: Feeding must be kept up to some extent or the patient may die of exhaustion. But if the stomach will not hold food then rectal feeding must be resorted to. The diet may consist of peptonized milk, broths, gruel, and soft boiled eggs. Until there are signs of convalescence then more can be added very gradually.
COLONOTHERAPY: An enema every day is sometimes necessary. When the patient is strong enough, Chiropractic adjustments, Neuropathy, Endo-Nasal therapy, all should be used in accordance to the symptoms remaining.
(General blood purifiers is all that Herbology can offer at the present time.)

 
Menopausal Disturbances

 DEFINITION: The critical period in a woman’s existence is when there is a gradual or sudden cessation of the menstrual periods. The average age is between 40 and 50 years, but there is always some variation. Some may be delayed, and others hastened by diseases of various kinds. The duration also varies from one to two and a half years. The following approximate age of the menopause is taken from the Sajou’s Analytic Cyclopedia of Practical Medicine. F. A. Davis Co., Publisher.

APPROXIMATE AGE OF MENOPAUSE

 Menses begun at 10th; should cease between 50th-52nd
“ “ “ 11th; “ “ “ 48th-50th
“ “ “ 12th; “ “ “ 46th-48th
“ “ “ 13th: “ “ “ 44th-46th
“ “ “ 14th: “ “ “ 42nd-44th
“ “ “ 15th: “ “ “ 40th-42nd
“ “ “ 16th: “ “ “ 38th-40th
“ “ “ 17th: “ “ “ 36th-38th
“ “ “ 18th: “ “ “ 34th-36th
“ “ “ 19th: “ “ “ 32nd-34th
“ “ “ 20th: “ “ “ 30th-32nd

 The above table was worked out, giving the approximate ages, as a practical working schedule upon which to estimate the probable date of the menopause, as the age limit beyond which no woman should be allowed to go on menstruating without a thorough examination.
SYMPTOMS: There is an increased flow each month, until there is a final absence, or the interval between periods may be lengthened until complete cessation is accomplished.
The menopause is usually accompanied by elevation of blood-pressure, hot and cold flashes, feeling of weakness, and in some cases marked mental derangements. In women of plethoric type symptoms are those of congestion — flushes of heat, rush of blood to face and head, uterine and other hemorrhages, leucorrhea, and even diarrhea. In chlorotic subjects, sallow complexion, semi-chlorotic skin, weak pulse, and various other indications of debility. In nervous subjects, the over-anxious look, the terror-stricken expression as if apprehensive of seeing some frightful object; the face bedewed with perspiration; and remarkable tendency to hysteria are often met with. The unusual development in some of hair on chin and lip generally coincide with final cessation of menses; so does an unusual power of generating heat, indicated by throwing off clothing and opening doors and windows. There is often rheumatism of shoulder or thigh, or swelling of joints. Maybe ulcers and polypi of uterus and carcinoma of this organ and of the breasts. Anatomically there is marked atrophy of the external pudendi, and atrophy of the uterus, tubes and ovaries, the vagina becomes conical in shape, and the mucous membrane becomes smooth and atrophic.
TREATMENT: The treatment of menopause is needed only when the symptoms become unbearable. But the physician must make sure there is no malignancy.
NEUROPATHY: A sedation of the whole spine.
CHIROPRACTIC: Cervical 1, Dorsal 6, and Lumbar 3.
PSYCHIATRY: Many women go into a state of mild or severe involutional psychosis and need very careful handling lest an outburst occur at any particular time. It would be well now if the reader would turn to The Fundamentals of Applied Psychiatry, page 73, and read what the writer has to say on involutional psychosis. Many women come to the physician not because they have pain, but because of the nervous and psychic changes that take place during the involutional changes and it is always to be remembered that there is an endocrine imbalance as well as a nervous and mental unbalance.
Three steps in these cases need to be taken: (1) Suggestion. The patient is often quieted down by assurance from the doctor. (2) Endocrine products. Thyroid, Ovarian Theelin, and Stilbestrol or Estrin. (3) Quiet the nerves by inhibition or concussion.
VITAMINOTHERAPY: Vitamin E seems to be the most favored. But C and D should also be considered. Patients who are obese should also be treated for reducing. See under Obesity.
COLONOTHERAPY: Constipation is one of the disorders that make the climacteric period more difficult and if a lymphatic of the abdomen does not create a regularity, the enema or colonic must be resorted to. But the lymphatic treatment should be kept up until the bowels will function normally without aids of any kind. Lax or Lax Special in lieu of enemas or colonics may be tried.
HERBOLOGY: One ounce each of Black Haw, Crow Corn Root and Beth Root and two ounces of Squaw Vine. Put a teaspoonful of the mixed herbs in a cup of boiling water. A cupful a day, a large swallow at a time.
An excellent assistant at this period of life is an ounce each of Scullcap, Wood Betony, Valerian and Hops. Boil in two and a half pints down to two pints. Strain. When cool take a wineglassful three times daily.
An infusion of Chickweed makes a good douche for regular use.


Menorrhagia, Metrorrhagia

 DEFINITION: Menorrhagia is an excessive bleeding at the time of menstruation, either in the number of days or the amount of blood or both, while metrorrhagia is a bleeding from the uterus at any time other than during the menstrual period. This is most often caused by lesions of the cervix uteri, and its occurrence should always lead one to suspect and search for a malignancy in the genital tract.
ETIOLOGY: Endocrine disturbances; Pituitary gland, thyroid and overy. General systemic diseases: Hypertension, Diabetes mellitus, Blood dyscrasias, Chronic nephritis. Malpositions of the uterus: Particularly fibroid of the intramural and submucous types, Adenomyosis of the uterus. Conditions of the cervix uteri: Erosions, Polypi, Inflammations in the pelvis: Acute salpingitis, Acute metritis, Acute endometritis, Chronic metritis, and endometritis. Fibrosis of the uterus.
The general or constitutional diseases causing uterine hemorrhage or anemia in exceptional cases, gout, scurvy, phthisis in the early stages, the acute infectious fevers, malaria, influenza, cardiac diseases causing vascular stasis, and hepatic diseases with portal stasis. In fact, any general disorder that will impede the return flow of blood from the pelvic viscera will cause an unusual vascular pressure that may result in hemorrhage from the uterus. In obscure cases the possibility of syphilis must be borne in mind and the Wassermann reaction utilized.
TREATMENT: The specific treatment depends on the cause. In acute cases the patient should be put to bed. A hard mattress is preferable. The room should be cool. The hips are elevated, an ice bag is applied to the pubic region. If this does not check it, ice can be applied directly to the mouth of the uterus. All liquids and food eaten during the attack should be cold.
When the acute attack is over, then a diligent search for the cause should be made. A suggested general treatment may be as follows:
HYDROTHERAPY: V. M. 120 2 to 10 drops to a quart of tepid water used as a vaginal douche twice a day for ten days.
Have the patient keep the hands in hot water as much as possible. Rest in bed as much as possible.
There is a possibility that endocrine substances may have some effect on regulating the blood flow. See “The Endocrine System” in Bibliography.
VITAMINOTHERAPY: Vitamin K is the specific. But under the causes presented as etiological factors, all the other vitamins may be also necessary.
If after one month of treatment there is no improvement, the physician if not fully acquainted with vaginal examinations should consult a specialist to try and determine the cause; it may be possible an immediate operation is necessary.
HERBOLOGY: Three parts each of Shepherds purse and Knotgrass and four parts of Mistletoe made into a tea; using two or three cupfuls daily. Use the tea cold. Or, the same proportion of the above and add two parts each of Shavegrass and Oak Bark, and three parts each of Five Finger grass and Red Saunders wood, taking a teaspoonful of the mixed herbs and putting in a cup of boiling water. Let cool. Strain. Add boiling water to fill the cup. Let cool. Tablespoonful every waking hour.

 
Mumps — Parotitis

 DEFINITION: An acute contagious disease characterized by inflammation and swelling of the parotid and salivary glands.
ETIOLOGY: The disease is rare under four years of age. Very few instances have been recorded under that age. It is also rare in adult life and more rare in old age. It is most common between the ages of 5 and 14.
There is no known specific cause of this disease. It is thought to be brought about by a filterable virus.
SYMPTOMS: Onset gradual. There may be chilliness malaise, moderate fever (101 to 102); sometimes higher, followed by swelling of parotid glands, the enlargement of one usually becoming evident a day or two before the other. Swelling is below and in front of the ear. It is pyriform in shape and has a doughy feeling. The lobe of the ear is sometimes pushed forward, surrounding tissues are edematous, the features may be greatly distorted. Movements of the jaw are painful and restricted. Saliva may be increased or diminished. Sometimes only one parotid is involved. Occasionally, the parotid glands seem to escape and swelling is confined to submaxillary. Swelling usually lasts for from five to seven days. Complications: When the swelling in the parotids subsides. The most common complication in the adult male is orchitis; in the female ovaritis or mastitis. It is rarely that permanent dullness of hearing follows an attack of mumps.
PROGNOSIS: Favorable. Although the possibility of Orchitis and Ovaritis should never be overlooked with a possible sequence of sterility.

TREATMENT

 HYDROTHERAPY: Cool applications to control swelling. Ice pack or ice bag when there is great tension from throbbing. Sometimes warm packs give more relief. Antiseptic mouth washes and gargle.
DIET: Should be of soft or liquid nature for at least three days. Not much else need be done, except to keep the patient quiet at rest in bed.
NEUROPATHY: Drain the glands by a lymphatic of the shoulders and axillaries. The liver should have special attention.
CHIROPRACTIC: If not too painful, adjustment of cervical 1 to 6, D 5. Concussion of Cervical 7.
HERBOLOGY: Upon putting patient to bed, an Herbal laxative tea may be used, a Camphor-Menthol-Oil Eucalyptus-Oil Peppermint Oil. Citronella ointment or a goose grease ointment can be used. Patient may drink all the lemon juice he wishes.
Teas made from Sweet Balm, Chamomile Flowers or Elder Flowers are good if lemon juice is added and the tea is taken cold. One to two cupfuls a day. Catnip Tea is recommended, using some of it hot and some of it cold.

Neuralgies

 DEFINITION: Severe inflammation and paroxysmal pain along the peripheral ramifications of a nerve trunk. The terminology of which takes its name by the location of the pain. Some locations may be as follows:
INTERCOSTAL NEURALGIA: In this variety the pain follows the course of the intercostal nerves. It is frequently associated with an eruption of herpes zoster. Spots of tenderness may be detected near the vertebral column, in the mid-axilla, and near the sternum. The possible dependence of intercostal neuralgia upon spinal caries or thoracic aneurysm must not be forgotten.
Occipital neuralgia involves the upper cervical nerves. A spot of tenderness may be discovered midway between the mastoid process and the upper cervical vertebrae. This form of neuralgia may also be an expression of spinal caries.
SCIATICA: The pain is usually referred to the nerve, the lesion itself being in some closely related structure, most frequently the lumbosacral spine, or the sacroiliac or hip joint and consisting of infective arthritis, or more rarely tuberculosis or carcinoma. In other cases the cause is inflammation or carcinoma of the prostate. In many cases it is due to a subluxation of the lumber segments. Positions of the bones in the lower back causing pressure.
NEURITIS: Is in the same category as neuralgia, with this exception that the pain of neuritis is fairly constant during the attack while in the neuralgias the pain is paryxysmal and limited to a certain point. The tenderness is also limited to certain points. Neuritis may be acute, chronic, migratory or multiple. In the acute form there may be three types of disturbances:
1. Sensory symptoms — There is severe pain following the course of the affected nerve, which is tender to the touch. The pain is often associated with various paresthesis, such as burning, numbness, tingling, etc. The part is at first very painful, but later it is more or less painful at various times.
2. Motor symptoms — Muscular power is impaired; there may be fibrillary tremors; the reflexes are diminished or lost.
3. Trophic symptoms — An eruption of herpes sometimes follows the affected nerves. The skin may become glossy and the nails lusterless and brittle. In advanced cases the muscles undergo atrophy and yield the reactions of degeneration.
In the chronic form there is atrophy and contracture of the muscle with constant pain or dull aching.
The multiple form is where two or more places have been attacked at the same time.
The migratory form is referred to as a pain that ascends along the nerve trunk or descends, causing pain in one place than another.

GENERAL ETIOLOGY OF NEURALGIAS

 Inflammation of a nerve may arise from trauma, as blows, stretching, compression, or wounds; exposure to cold; the extension of inflammation from adjacent structures; infectious diseases; poisons, such as alcohol or lead. Subluxations, perversions, and lesions in the spinal cord.
Specific infections, such as diphtheria, influenza, measles, septicemia, rheumatism, etc.; certain poisons derived from without such as alcohol, lead, arsenic, carbon monoxide, sulphonal, etc.; certain auto-intoxications, such as occur in gout and diabetes.
The disease is sometimes an expression of anemia. It may result from the action of some tonic agent in the blood; thus it is common in malaria, diabetes, gout and chronic lead-poisoning. It may be caused by reflex irritation; thus a trifacial neuralgia may depend on caries of the teeth or eye-strain. In some cases it is a hysteric or psychogenic symptom (psychalgia). In other cases it is the first indication of organic disease, such as tumor of the brain herpes zoster, and aneurysm.
Exposure to cold and wet frequently acts as an exciting cause in susceptible persons.

PROGNOSIS OF NEURALGIAS

 Is favorable. The greatest complication to be looked for is atrophy of the tissues of a part or their distortion.

TREATMENT

 The treatment, no matter where located, is of two parts. First to relieve the pain, then to remove the cause, if possible to discover.

GENERAL THERAPEUTICS

 HYDROTHERAPY: It is best to try hot packs or heat before using cold applications. The writer recalls several cases where all methods of treatment by heat and manipulation had failed, and an ice pack had removed the pain. These were cases of brachial neuritis. The plan is to crush ice in a cloth bag, lay it over the part affected, and cover with a turkish towel. It is kept on until the finger begins to get numb, then removed, and a hot pack put on until the numbness disappeared. This may be repeated many times if necessary. In obstinate cases this form of hydrotherapy has been useful in other locations of neuralgia with good effect. The freezing process is used by the writer as a last resort.
ELECTROTHERAPY: Diathermy is considered, with short wave, to be the best electro modality. But sine wave and galvanism are also considered helpful. The high frequency bulb run over the affected part is helpful. Ultra-violet and infra-red are also of great help.
COUNTER IRRITATION: Riley states — if of the arm, place the clothespins on the finger for ten minutes, or use the elastic rubber bands for the same length of time. The clothespins usually give the best results in this trouble. If of a sciatic nature, clamp or press the toes.
Pressure on the spinal segments opposite to the affected side will often create an inhibition and give temporary relief, and sometimes permanent relief.
VACUUM THERAPY: Cups over the spinal segments leading to the affected area, then cup directly over the pain area, applied mildly at first.
NEUROPATHY: General lymphatic and pressure in the gutter of the spine on segment affected. The Lake Recoil for neuritis in the upper portion of the body.
CHIROPRACTIC: Adjustment of the local zone and for the causative factors. Sciatica requires some forms of treatment that do not apply to Neuritis in general.
(1) The form in which there is no pain while at rest but which is worse for a while after assuming an upright position. In this form the inflammation has subsided and adhesions have formed, and they drag on the nerve and create pain.
(2) In this form there is a certain amount of pain always present but which becomes intense on lying down. Here the inflammation is still present, complicated by adhesions and inflammation in the nerve itself.
(3) When the pain is off and on for hours at a time, there are no adhesions, especially by walking the patient seems to improve. When adhesions are present, manipulations for their removal must be made or the patient will continue to have pain for a long time with a growing deformity on the affected side. See “Adhesions, and technique of detecting,” elsewhere. Besides adhesions there may be a misplaced innominate bone, which replaced before relief can be given.
VITAMINOTHERAPY: In all forms of Neuralgia and Neuritis large doses of A, B, D, and G.
HERBOLOGY: Take equal parts of Jamaica Dogwood, Scullcap, Valerian, Black Cohosh, Prickley Ash and Cinchona Bark. To each ounce of the mixed herbs use one and a half pints of water and boil down to a pint. Use covered vessel. Let cool, strain. Three times a day take a wineglassful.
Celery tea has long been known to be excellent. Use a teaspoonful of the herb to a cup of boiling water, let cool, strain and use freely.
Most Herb Companies sell a good salve for external application.
Dried Thistle Leaves made into a tea is good. A 25 cent box of the leaves will make a quart of the tea. A wineglass should be taken twice a day.
Add 5 drops of Oil of Wintergreen (the real stuff, not synthetic) to a half cup of hot water, add teaspoonful of baking soda. Stir well. Take one a day for three days, discontinue three days, etc.
Any of the following made into a tea are good. Fragrant Valerian, Chamomile Flowers, Mormon Valley Herbs and Black Snake Root. As usual, a teaspoonful of herb to a cup of boiling water; let cool, strain, drink in three installments.
The cause of neuritis may determine a variation of the above general suggestions — is it from exposure, injury, strain, aftermath of severe illness, etc.

Neurasthenia

 DEFINITION: A neurosis affecting the various organs and functions, characterized by a persistent exhaustion and nervous inability, and constant fear.
ETIOLOGY: Some cases have an organic background but the majority have some hidden tension carried over from early life, or present daily employment or home surroundings.
SYMPTOMS: Pains, palpitations, nervousness, discomfort in different parts of the body, until the physician is at his wits end, unless he understands present day psychiatry.
TREATMENT: If any organic condition is present it should be treated. But if not, then treatment of a soothing nature such as massage or diathermy, particularly over the parts complained of, while at the same time seeking out in the background, and present surroundings, the cause for the mental attitude. The question method of psychoanalysis can be made even without the patient knowing it. The reader is now referred to the writer’s book “The Fundamentals of Applied Psychiatry.” Read the subjects of Neurasthenia, Beginnings of Nervousness, Psychoanalysis, Discovery of the Tensions, Suggestion and Orientation. All listed in the index. One thing a physician should never do is to laugh at a patient and say “It is all in your head” because it is just there in the subconscious mind, but the patient will resent being told any such thing. Even if the doctor knows what the tension is, he must try to get the patient to discover it for herself, then the cooperation in adjustment to the environment will be whole hearted.
During the time of searching for the tensions, adjustments and manipulations can go on, and diets, certain exercises and books to read can be suggested. Vitamins B, G, or C. D. may be given. If a male with impotency E may be also given.
HERBOLOGY: A good combination: Half ounce each of Scullcap, Motherwort, Betony and Horehound, half that amount each of Valerian, Ginger, Licorice, Hops and Mistletoe. Mix herbs well. Take two heaping teaspoonsful to two cups of boiling water. Simmer for about 20 minutes before letting cool and straining. Wineglass two or three times a day.

 
Obesity

 DEFINITION: Abnormal amount of fat on the body, or an abnormal process of fat storage.
ETIOLOGY: Heredity, Hearty eating with deficiency of exercise, deficiency of glandular secretions, diminished oxidation, lack of sunshine, over-use of fat producing foods, hypothyroidism, low basal metabolism, constitutional predisposition. Over-development of any one part of the body should be noted and causes ascertained.
TYPES: (1) Those with slender framework and small bones. (2) Those with medium framework. (3) Those with heavy framework and large framework.
CLASSIFICATION: EXOGENOUS OBESITY — Those cases in which the caloric intake is greatly in excess of the requirements of the individual, of which excess a certain amount is stored as fat. Not only the amount but the kind of food must be taken into account.
ENDOGENOUS: - Those that result from endocrinopathology of either Thyroid, Pituitary, Adrenal or Gonads. The thyroid seems to be the one most responsible with the pituitaries next.
NERVOUSNESS: Nearly all obese patients have a history of nervous complex symptoms. Headache, vertigo, tinnitis, insomnia, etc.
Defect in salt and water metabolism. Many cases of obesity there is retained in the tissues large amounts of salt and fluids.
COMPLICATIONS: Circulatory disorders, especially myocarditis, diabetes, disorders of the biliary passages, digestive disturbances, orthopedic disorders, nearly all obese people have leg or foot pains, hypertension or hypotension.
PROGNOSIS: Depends on the etiological factors, and on the cooperation of the patient. It also depends a lot on the physician, whether he knows the psychopathology of the obese. Most women are afraid to reduce lest lines might appear in the face, especially those over forty. But the physician can massage the face and keep its true conformity.
TREATMENT: Go back now to the types. It can be generally accepted that the first two types must be helped by endocrines, that the third type can be only helped by restricted dieting and exercise.
DIET: Below maintenance requirements so far as energy units are concerned must be provided with all other essential nutrients. 1000-1200 calories per day is a slow-reduction regimen; 600-800 is more rapid, but examination should be made in the 600-800 calorie diet for the presence of acetone, and all essential nutrients must be included. Maintenance requirements are based on what the average weight should be. Acidosis may result, as body-fat may overbalance necessary glucose for the oxidation of fat. Indicated also are: (1) Vegetables and fruits low in carbohydrates (2) Skimmed milk, buttermilk, or cottage cheese every day to appear the appetite.
But the writer has found it best to put the patient on No. 1 diet, found elsewhere in this book, and keep them on it for two weeks, and let the patient understand in that time they will lose from one to three pounds. Gradual reducing is the best for the patient. If the patient gets tired of No. 1, let her have No. 2 for a while. The patient must be made to understand that if more than thirty pounds is to be taken off safely without shrunken features they must cooperate for at least three to six months.
It is thought best that no water be ingested with meals but all the patient desires after digestion has been established. But that the water should be sipped and not poured down.
ENDOCRINOLOGY: These are to be given according to the etiology.
VITAMINOTHERAPY: All vitamin companies have special formulas for this trouble, but none of them are of any value unless restriction of diet, and exercises are taken. They could not be reducing of themselves or they would interfere with the processes of digestion, assimilation and absorption to such an extent they wold probably destroy those functions. So the physician need be on his guard not to give the patient any type of reducing material which process of reducing can not be stopped when the required weight is reached, because of destruction of the digestive processes themselves. It has always been our policy to beware of those types of advertising which tell the people they can eat all they want, any kind of food they want, and grow thin. It is not Nature’s way.
SPONDYLOTHERAPY: For the nervous type, concussion of the whole spine is of great benefit.
NEUROPATHY: Lymphatic of the whole body with emphasis on the liver.
ENDO-NASAL THERAPY: The whole respiratory apparatus must have serious atatention. The air we breathe contains twenty units of combustible oxygen gas per pint; this, coming in contact with the carbonic gases gives off heat and creates what is known as the process of oxidation, which produces the rate of metabolism. In obesity, the rate of metabolism is always below normal. The rate of metabolism is calculated from the rate of oxygen consumption. It is obvious, then, that by removing all obstructions to the intake and utilization of oxygen, a remedying effect is produced.
The writer found that reduction of weight was much faster after he started giving the Lake recoil, opening the exterior and posterior nares, and breaking adhesions around the Thyroid, ending with the raising techniques.
HERBOLOGY: One ounce each of Gentian and Columbo, two ounces of Bladderwrack and a half ounce of Mandrake. Put in a quart and a quarter of water and boil down to a pint. Let cool. Strain. Add two drachms of Potassium iodide also same quantity of Spearmint. Use tablespoonful three times daily after meals.
Also Indian Chickweed made into a tea is beneficial and harmless.
Another good combination is a tea of Sassafras Root, Elder Flowers, Rosemary Leaves, Rocky Mountain Grape Root, Chickweed, Poke Root and Horsetail Grass, producing a harmless mild carminative, tonic and astringent. Make according to the standard formulae for making teas — a teaspoonful of the mixed herbs to a cup of boiling water, let cool, strain, take a mouthful a half hour apart; a cupful a day.
COLONOTHERAPY: During the time of the reducing diets enemas daily, or a colonic two times a week.

 
Ovaritis

 DEFINITION: The term Ovaritis as used here is any inflammation or growth that may attack the ovaries. It may be follicular or parenchymatous. Acute ovaritis is sometimes termed Acute Oophoritis. When the surrounding peritoneum is involved it is termed Peroophoritis.
SYMPTOMS AND ETIOLOGY: Intense lancinating pain, and tenderness generally in the left inguinal region. The temperature is elevated, pulse rapid and frequent chills. Acute inflammation is generally caused by injury, septic poisoning after parturition or abortion, gonorrhea, arsenic or phosphorus poisoning, acute rheumatism, mumps, and long-continued endometritis. The most frequent cause is sepsis, next gonorrhea. Sepsis is prone to result in abscess. Gonorrhea produces perioophoritis, with fixation of the ovary.
Chronic ovaritis is usually a continuation of the acute condition in a less active form. The pain, while less, is persistent, and made intense by sudden jars such as a misstep. And the pain becomes worse with the approach of the menstrual period. The pain extends down the thighs, and in some cases in the mammary glands.
PROGNOSIS: Generally favorable in both acute and chronic stages. The acute inflammation terminates in resolution and disappearance of abnormal symptoms, or in the development of an abscess, its rupture, the occurrence of rapidly fatal infective peritonitis; or the disease may become chronic; most frequently it is associated with disease of the tube.

TREATMENT IN THE ACUTE CONDITION

 The patient should be confined to bed. An enema is given of warm water to relieve all pressure. An ice bag or heat is put over the painful area. Sometimes heat is preferable, but the ice bag is generally used. But on the subsidence of the acute symptoms, hot applications need to be used to promote absorption. A few hours after there is ease from pain, the vagina should be thoroughly cleaned out with two quarts of hot water. 20 drops of 120 V. M. may be added to the water.
In the Chronic form of Ovaritis the causes must be found and treated if permanent relief is to be given. Sepsis, Adhesions, Nerve and other pressure, Prolapsis and other contributing factors can be sought after.

GENERAL TREATMENT

NEUROPATHY: A light lymphatic of the whole body and sedation of the whole pelvic segments.
CHIROPRACTIC: Lumbar 3 and wherever else indicated.
Douches every three days as under acute condition.
HYDROTHERAPY: The patient can cover the lower abdomen on retiring with a cool wet cloth, covered by a piece of wool or cotton and allow to remain in that position at least a half hour. Hot water spray on the abdomen while sitting in tub or hot sitz baths are also helpful.
ELECTROTHERAPY: Infrared over the area affected twice a week, followed by a whole body ultra-violet irradiation is excellent.
DIET: If obese, the patient may be put on No. 1 diet for a while, then alternate every other day with No. 1 and 2.
The Vitamins that seem to be needed in most of these cases are A, B2, G and E.
HERBOLOGY: For Cysts one ounce each of Yellow Dock, Dandelion, Yarrow and Comfrey and two ounces of Licorice boiled in a pint of water for an hour, using a covered vessel; cool, strain. Tablespoonful three times a day.
For tension use one ounce each of Horehound, Sunflower Seed, Motherwort, Yellow Dock, and one-half ounce of Wormwood. Boil in two and a half quarts of water for half hour. Wineglass three or four times daily.
A good douche is made from one ounce each of Raspberry Leaves, Powdered Myrrh, Witch Hazel and Black Currant Leaves, boiled in a quart of water for about five or six minutes, then kept hot for half an hour, strain with very fine sieve or cloth. Use with syringe at night, taking four ounces of the medicine and mixing it with a pint of cool water, which has been thoroughly sterilized by boiling.

Ovarian Adhesions, Cysts, Tumors, Carcinoma

 In addition to the above, there may be prolapse of the ovaries, and adhesions may be causing the inflammation. The tuning fork will determine to what other part the adherence of tissue is. The treatment is to break the adhesions, raise the ovaries and put a strap or belt to hold in place. Also to see that the uterus is placed in its normal position.
The ovaries are also subject to cysts, various kinds of tumors and carcinomas. There are tubo-ovarian cysts. These arise from the extended ovary into the fallopian tube. Proliferating cysts are in the majority of ovarian inflammations, and vary in size from an egg to as much as one weighing a hundred pounds.
Tumors known as Fibromyoma are hard tumors. They do not get very large.
PALPATION FOR OVARIAN TUMORS: When small, have an arm elastic feel;when large, are soft and fluctuating. In some cases detected by passing hand lightly over abdomen, in others, deep pressure required.
Percussion of Ovaries. Ovarian tumors: Sound is flat over that portion of the abdomen where abdomen comes in contact with inner surface of abdominal wall, while at sides and above where intestines have been pushed aside and upward by the tumor, percussion sound will be tympanitic; by this change in percussion sound we are enabled to make out boundaries of tumor.
DIFFERENTIAL DIAGNOSIS: Ovarian tumor may be confounded with uterine enlargements, also pregnancy, fibroid tumors of uterus, etc.; ascites, hydatids of the omentum, fecal accumulations in intestines, and enlargements of liver, spleen and kidneys. They are distinguished from uterine tumors by consistence, outline, difference in connection and relative position to uterus, and that by the fact that in uterine tumors the cavity of uterus as determined by uterine sound is always elongated. Diagnosis between ovarian and abdominal dropsy is made. First by observing the shape of abdomen when patient lies on back. Ovarian tumors project forward in the center while in ascites the abdominal enlargement is uniform; second, in ovarian tumors the percussion sound is dull as high as tumor extends, while at same time there will be tympanitic resonance in most dependent portion of abdominal cavity; in ascites the descending portion of abdomen is always flat, the percussion resonance being confined to the epigastric and umbilical regions. Third, in ovarian dropsy, the relative line of flatness and resonance is not altered by change in posture of patient as it is in ascites. Hydatids of omentum cannot be distinguished from ovarian tumors by physical signs, but the fact that omentum enlargements are first noticed above the umbilicus and gradually enlarge downward. To make the above diagnoses, a good tuning fork and stethoscope are necessary.

TREATMENT

 If the cysts and tumors are small, an attempt can be made to break them up by removing the adhesions as under Neuropathic minor surgery. Sine wave or galvanic current will aid a great deal in the attempt, putting one pad over the front of the body directly over the cyst or tumor and the other directly posterior.
Carcinoma of the ovaries requires surgical treatment. But there are patients who refuse to submit to operation. With that type the grape cure should be tried. See Grape Cure.

 
Pain

 DEFINITION: A distressed feeling that may be caused by over stimulation of any sensory nerve. It is especially present in diseases such as neuritis, neuralgia and diseases of the central nervous system or disorders causing pressure on the central nervous system.
While the following outline of locations of pain may have variations, it is probably as good an approximation as it is possible to make.
Pain in the trunk may be designated as Cardialgia. Those that are located in the Epigastric, intestinal, pleural and cardiac regions include the nature of pain and its character.
Absence of pain in troubles in which pain should be expected indicate pressure on the brain. The sudden abatement of pain when other symptoms continue to be bad is not a good omen.
CARDIALGIA: This is severe pain occurring in paroxysms in gastric disorders. If to the left of the spine, with epigastric tenderness occurring soon after a meal, gastric ulcer is indicated.
If it occurs several hours after eating and then relieved by food, duodenal ulcer is indicated. If pain is constant and not relieved by food or by alkalies, carcinoma may be suspected. Heart burn indicates acute gastritis. Epigastric pain and tenderness occurring in paroxysms, with pain in the right shoulder, indicates gall bladder disease Epigastric pain with slow pulse, occurring in paroxysms, acute and sharp, with tenderness over the umbilicus, indicates pancreatic disease. In general, epigastric pain may accompany any gastric or intestinal disorder, as well as pleural and some cardiac affections.
CAUSALGIA: This is spontaneous pain, especially when burning in character is associated with anesthesia or hyperesthesia in a given nerve.
CONTINUOUS PAIN: This may indicate persistent obstruction; also a tendency to suppuration.
CRAMPS: These are muscular spasms, such as epigastric pain.
A sharp pain in the region of the lungs indicates that the pleura is involved. There is no pain when the substance of the lungs is affected.
Location of direct, reflex, epigastric or cephalic pain: Pain in the ear may indicate inflammation of the external canal except in young children. It also may indicate a furuncle in the meatus, or middle-ear disease.
PARESTHESIA: This is a stinging, tingling sensation found in central and peripheral lesions.
PNEUDOMYELIA PARESTHETICA: This is a false sensation of movement in a moving limb.
REFERRED OR REFLEX PAIN: Synalgia, or pain that seems apparent in an area or at a point other than its origin, such as the region supplied from the spinal segment from which sensory fibers supply the organ or part in question. An example is pain from appendicitis which often seems to occur in another area other than that of the appendix.
If pain is around the eyes and nose it indicates trouble with the eyes, nose or stomach. If in the center of the forehead above the nose, it may denote constipation, decayed teeth, or errors of refraction. Ache in the center of the forehead may result from nasal or intestinal trouble. Ache over each eye indicates stomach trouble. A tight, band-like sensation all around the head above the eyes, indicates an anemia or bloodless condition. Ache in the upper center of the forehead denotes nasal trouble. Ache over the entire top of head may result from uterine trouble, debility, anemia, stomach or bladder disorders. Side of the head over the ear denotes anemia or bad blood conditions. If the pain is near the center of the back head level with the top of the ear, it indicates eye trouble. An ache just below the center of the back head indicates constipation from colon difficulties.
REMITTENT PAIN: This is characteristic of neuralgia and colic.
SHIFTING PAIN: This is present in rheumatism, hysteria and locomotor ataxia.
REGIONAL PAIN: This refers to pain and its significance in a specific area of the body.
THORAX (and abdomen): A sharp pain over the sternum, often running down one elbow is indicative of angina pectoris, although it must not be confused with pain from gastric pressure in the region of the heart, caused by an accumulation of gas. It is increased with respiration, experienced in broken ribs, intercostal neuralgia, wounds, herpes zoster, pleurisy, pleurodynia, myalgia, periostitis, acute peritonitis, colic, hepatic, gastric or renal ulcer, gall-bladder disorders, carcinoma in late stages, and rumma of this region.
TONGUE: Ligual pain may be due to local lesions of the tongue, to glossitis, fissures, pernicious anemia, and malignancies.
URETHRAL PAIN: Pain at the end of the urethra may denote (without soreness) gravel or stone in the bladder.
The treatment is according to the cause. But for relief hydrotherapy and especially counter irritation by vacuum cups or pressure (which see) are of great value.
HERBOLOGY: There are over 35 herbs in the Anodyne category, a few being Catnip, Valerian, Hops, Hounds tongue, Mullein, Black Sanicle, Primrose, etc. Their use alone or in combination with other herbs is according to the cause of the pain and its location.

 
Pancreatic Disorders

ACUTE PANCREATITIS

 DEFINITION: An acute inflammation of the pancreas affecting the parenchyma and interstitial tissue. It is of three varieties: Hemorrhagic, Suppurative, and Gangrenous. The reader should now turn back to the examination of the Pancreas to get the lay of the hand and finger symptoms of the various types of pancreatic disorders See under “Examination of the Pancreas” in the index.
ETIOLOGY: Acute pancreatitis may result from cholelithiasis, due to the extension of an infectious inflammation from the biliary tract into the pancreatic duct or to the entrance of bile into the pancreas, as when a gallstone is so lodged in the diverticulum of Vater that the common bile-duct and the pancreatic duct become a continuous closed channel; from inflammatory affect in adjacent parts — gastro-duodenal catarrh, gastric ulcer, or cancer, from general infections — specific fevers and pyemia; from traumatism. Many of the patients are fat and have used alcohol in excess.
In the hemorrhagic form the organ is irregularly enlarged and the seat of hemorrhagic extravasation. Opaque, white spots of a tallowy consistence are frequently found in the interlobular tissue, omentum, and surrounding parts, and represent areas of fat necrosis.
Suppurative pancreatitis may occur as a primary condition or as a sequel of the hemorrhagic form. There may be multiple abscesses or one large collection of pus. More or less extensive areas of necrosis re found. Thrombosis of the portal or splenic veins is frequently encountered. Pancreatic abscesses may become encapsulated or they may rupture into the peritoneum, stomach, or duodenum.
Gangrenous pancreatitis is usually secondary to one of the other varieties when the pancreas rots away.
SYMPTOMS: The onset is sudden, especially hemorrhagic pancreatitis, which produces intense pain in the upper part of the abdomen, often radiating to the back; distention of the epigastrium, with localized tenderness and rigidity; vomiting of bile-stained mucus, or occasionally, of bloody material, and symptoms of profound collapse. Constipation is the rule, but diarrhea is not uncommon. Slight jaundice is often observed. Fatty stools and glycosuria are very rarely present. Death usually occurs in from one to three days, but sometimes the severity of the symptoms diminishes and the disease enters upon a stage of necrosis (gangrene) or of suppuration extending over several weeks or months. This transition is indicated by a tumor mass in the epigastrium, irregular fever, leukocytosis, and progressive weaknesses and emaciation. Jaundice and chills may also occur.
Occasionally in primary suppurative pancreatitis the onset is gradual, and for many months the only symptoms are abdominal pain and digestive disturbances. In other cases, however, jaundice, fever, chills diarrhea, emaciation, and a tumor mass in the epigastrium are also present.
PROGNOSIS: Unfavorable. The duration is from a week to several weeks unless there is a rupture into the bowel, or the disease is aborted by treatments, or surgery for drainage purposes.
TREATMENT: Before any treatment is started, the patient should be looked at. See Facial and Physical sign diagnoses, this book. The general appearance of the patient is that of shock, pallor, an anxious drawn facial expression, cold and clammy perspiration will be observed. Tenderness is felt in palpation in the upper abdomen.
LABORATORY FINDINGS: The urine would show acetone and diacetic acid; the blood would show a high leucocytosis; sometimes the stools undigested protein, starch and fat foods. X-rays are of value in suggesting pancreatic disease associated biliary tract disease, and eliminating confusing pathologic conditions elsewhere in the abdomen. This is a rare disease, but 60% of those who are affected have a history of liver, gall duct or stomach disorders of long standing.
DIET: Should be antidiabetic. A fast of a few days and if the patient can do it, a stomach lavage with about six glasses of hot water. After the fast, a suggested diet would be as follows, subject to changes as the condition warrants.
Breakfast — White of 3 eggs. Three pieces brown, thin toast. Choice of stewed fruits.
Lunch — Choice of one of the following fruits: Apples, pears, grapes, ripe figs, peaches, apricots, plums, or a glass of orange juice. Glass of water added.
Dinner — Three-fourths pound Salisbury steak. Two non-starchy vegetables. Choice of several salad vegetables. No dessert.
ELECTROTHERAPY: Sine wave up and down the spine. Short wave or diathermy also on the spinal segments.
HYDROTHERAPY: Warm or hot packs to the whole spine. If pain is intense, ice bags may be applied over the pancreas, followed by warm pack. The ice bag may be applied also if hemorrhage is taking place.
SPONDYLOTHERAPY: Concussion or deep pressure on the right side of the 8th to 12th dorsals in the gutter of the spine will relieve pain sometimes. Concussion of the7th cervical may also be given if there is hypertension or cardiac rapidity.
NEUROPATHY: A mild lymphatic of the liver and intestines may be given for drainage purposes.
CHIROPRACTIC: If adjustments can be made, they may be made on the 4th to the 8th dorsals.
COLONOTHERAPY: Cathartics are contraindicated. If fecal impaction takes place, a low enema is indicated of one pint of water. If impactions are too hard to remove by enema they can be removed by fingers or a scoop.
VITAMINOTHERAPY: Vitamin A and B1 seem to be the specifics. But if hemorrhage is present, Vitamin F is also indicated.
HERBOLOGY: If there is no specific for this ailment, presume the remedies applying for liver congestion would be advisable for Pancreatitis. Here is a good one for “Liver Congestion”:
Equal parts of Figwort, Nettle, Horehound and Meadowsweet made into a tea, using wineglassful four times a day between meals.
(Nettle (sometimes referred to as Stinging Nettles) here shown in this recipe, is claimed by some to supersede Insulin in the cure of Sugar Diabetes. HWK.)

CHRONIC PANCREATITIS

 SYMPTOMS: The symptoms of chronic pancreatitis are not clearly defined, but, its presence should be suspected when, in addition to chronic indigestion, there is more or less jaundice, emaciation, and a disposition to diarrhea with large stools. These develop insidiously the dyspepsia, with anorexia, nausea, vomiting, epigastric distention and flatulence. Pain radiating in the back and deep-seated tenderness and resistance in the pancreatic area. Profuse salivation is occasionally witnessed. Ascites may be caused by obstruction to the portal circulation. Glycosuria develops if the islands of Langerhans are involved.
The possible diagnosis of this condition may be made from the following: Large stools which contain undigetted fibers, is evidence of some malfunction of the pancreas. The urine may show glycosuria to a marked extent showing the islands of Langerhans are affected.
Other factors which may aid in the diagnosis are: Severe indigestion, tumor, pain, tenderness, vomiting, cyanosis, and the signs of pressure upon neighboring structures; failure of the external secretion of the pancreas and failure of the internal secretion of the pancreas. A mass, which is usually movable, may or may not be present in the upper abdomen in pancreatic disease. The pain is often very severe and may be continuous or paroxysmal.
All adjacent organs and tissues should be examined as under the acute condition.
TREATMENT: Neuropathy and Chiropractic same as in the Acute condition.
DIET: This is essentially the most important part of the treatment. A fast of a few days is the best procedure. Skimmed milk may be given. If not possible to fast, all starches and fats should be eliminated from the diet, and the feeding should be in very small amounts, not more than six times a day. A small teaspoonful of sodium bicarbonate can be given twenty minutes after meals if necessary in a glass of water, which must be sipped. All the fruit juices the patient wishes may be given providing it is also sipped.
As the patient improves, the diet may be slowly worked back to balance, but the patient will have to have weekly if not daily personal and urine examinations for at least three to six months.
Other treatment may be the same as in the Acute condition.

PANCREATIC CYST

 DEFINITION: A sac contaiing an abnormal fluid or substance in the pancreatic tissue.
VARIETIES: Retention cysts from impaction of a calculus, stricture, or tumor, traumatic cysts from hemorrhagic extravasation, proliferation cysts, carcinomatous or adenomatous. Pancreatic cysts as a rule grow forward and upward and project between the stomach and colon. The contents, which are commonly viscid, maybe clear or bloody. Pancreatic ferments are often present.
ETIOLOGY: The largest group of cases results from inflammation of the gland or duct, symptoms of indigestion may be in evidence long before the cyst develops or it may develop suddenly. The next largest group are those that develop from blows and injuries to the abdomen, causing some occlusion.
SYMPTOMS AND DIAGNOSIS: The following symptoms are of value in establishing a diagnosis of cysts of the pancreas: Gastric symptoms, pain, tenderness, vomiting, signs of dilation, emaciation; development of a tumor in the epigastrium, generally somewhat to the left side; their situation near the posterior abdominal wall, upon the aorta, so that its pulsation is seen and felt; their immobility.
A persistent discharging sinus is in favor of a pancreatic cyst. Hydronephrosis, especially of the left kidney, and dropsy of the gall-bladder have to be excluded, as has also a large ovarian cyst. Distention of the lesser peritoneal cavity is often indistinguishable from pancreatic cyst.
As a rule the content of the cyst consists of serous fluid, does not contain the digestive ferments, and does not reaccumulate after evacuation.
PROGNOSIS: The writer has treated only one case of this disease in all the years of his practice. The patient lived ten years after being discharged when there was a recurrence of some abdominal trouble for which an operation was performed, and he died. The writer could never ascertain whether it was a recurrence of pancreatic disturbance or not. If no intercurrent infection, or severe hemorrhage, or carcinoma develops, then there is some hope of recovery, but it will take a long, long time of strict diet.
TREATMENT is practically the same as in Acute and Chronic pancreatitis.
Surgery may be required at any time in any pancreatic condition if drainage cannot be established.

CARCINOMA OF PANCREAS

 Carcinoma of the Pancreas is the same as carcinoma any other place in the body. See “Carcinoma” in the index.
Calculi in the Pancreas are very rare, due to the same process as calculi in any other organ. See discussion and treatment under Calculi of the kidney and gall bladder.


Paralyses

 DEFINITION: A loss of motion or sensation in a living part or member of the body, such as the loss of muscular power. Any voluntary movement depends on the integrity of two neurones—one arising in the motor-cortex, coursing across in the brain-stem and ending in the anterior gray horn of the spinal cord; and the lower neurones arising in the anterior horn-cell and passing to the muscle. If the latter are destroyed, the muscle loses tone, atrophies, withers away, and shows reaction of degeneration. The falccidity and absent muscular reflexes reveal the loss of tonus. If the upper neurone is paralyzed, the patient is equally unable to move the affected part, but the intact lower neurone may permit other motor-centers to act on the muscle as in athetosis when there is slow, repeated, involuntary, purposeless, vermicular, muscular distortion involving part of a limb, toes, and fingers or almost the entire body.
So-called pathological reflexes may appear in addition to the increase of normal deep reflexes. The best known is Babinski’s sign, elicited by scratching sole of affected foot. When positive, the great toe extends (turns up rather than down). Above this neurone lie motor formula areas, but lesions here produce apraxin (not paralysis). Psychic inhibition of motor function occurs most charteristically in hysteria, but the evidence of organic disease is always lacking in these hysterical paralyses.

BULBAR PARALYSIS

 Bulbar Paralysis is a paralysis of the lips, tongue, pharynx, and larynx from degeneration of the motor nuclei of the medulla oblongata.
ETIOLOGY: An acute form is observed that results either from hemorrhage or thrombosis with softening, or from an acute poliomyelitis of the medulla. The chronic form, progressive bulbar paralysis, is essentially a chronic poliomyelitis of the bulb, or progressive muscular atrophy.
SYMPTOMS: These include impairment of speech, inability to protrude the tongue, dribbling of saliva, difficult swallowing, choking spells from the entrance of food or mucus into the larynx, partial suppression of the voice with measured speaking, and a lack of facial expression.
Infantile Paralysis is discussed under Poliomyelitis.
Acute Ascending Paralysis is a rapidly progressive motor paralysis of flaccid type, beginning in the extremities, usually the legs, extending thence upward through the trunk to the arms, and frequently to the nerves which have their origin in the lower pons-medulla region. In some instances the disease may begin above and progressively descend. It is also known as Landry’s Paralysis.
SYMPTOMS OF ACUTE ASCENDING PARALYSIS: The first thing that is noticed is a numbness and weakness in the feet and legs, which may spread slowly or rapidly up the legs. There is general prostration and perhaps some fever. As the paralysis spreads upwards affecting both extremities, paralyzing every tissue as it spreads, making mastication and swallowing impossible. When respiration is paralyzed death follows: The duration may be from four to thirty days, terminating in death. The rapidity of onset, and paralysis, makes preventative or curative measures impossible.
ETIOLOGY: It is a diseaseof early or middle adult life affecting males chiefly. It is not very common. The etiology is not clearly understood, but there is a growing unanimity of opinion to the effect that the disease is due to a toxic infection. It may follow the infectious fevers. In at least one case seen by the writer, which terminated fatally on the eleventh day, gross alcoholism was the cause. Neither climate, season, nor heredity is an etiological factor.
SYMPTOMS: The disease begins with a feeling of extreme weakness, occasionally associated with paresthesia, especially numbness, in the legs. This is progressive, and in a few days or even hours there is complete motor paralysis of the lower limbs. Quite often the onset is attended with slight or, it may be in rare instances, decided elevation of temperature. Paralysis of the trunk muscles follows, the sphincters escaping, and finally the muscles of respiration and deglutition are involved, such involvement usually terminating the disease fatally. This order of invasion and progress is, in rare instances, reversed.
PROGNOSIS: If the disease does not result fatally within a month the patient will recover, and if proper measures are resorted to, the functions of the nerves are sometimes restored.
GENERAL TREATMENT OF PARALYSIS: For those patients who recover from an attack that causes paralysis, an effort must be made to find the cause, and treat if possible. For the paralyzed parts massage, hydrotherapy of heat, electrotherapy, sine and galvanic current. But above all, there must be re-education exercises of the part.
For good circulation a lymphatic of the whole body with special emphasis on the axillary and Hunter’s canal if the limbs are affected.
CHIROPRACTIC: Monoplegia: Cervical 1. Dorsal 6 and local zone. Hemoplegia: Cervical 1, concussion of dorsal 9 to 12.
EXERCISES: If at all possible, swimming is one of the best exercises for re-education of the muscles.
HERBOLOGY: Two teaspoonsful every four hours of following tea:
Hydrastis (Golden Seal) ½ teaspoonful
Capsici (Cayenne Pepper) ¼ “
Valeriannae (Valerian) 1 “
Cypripedium (Ladyslipper) ½ oz.
Jamaica Sarsae (Jamaica Sarsaparilla) 1 “
Teaspoonful of mixed herbs in cup of boiling water, put saucer on top, let cool, strain; restore cupful by adding hot water.

PARALYSIS AGITANS

 DEFINITION: A chronic disease of the nervous system characterized by tremor or alternate contraction and relaxation of the muscles of the part involved. Rigidity is also a part of the disease.
ETIOLOGY: Paralysis agitans usually occurs in subjects above the age of 40 years, and most frequently between 50 and 60. It is oftener observed in men than in women. Emotional factors — grief, worry, shock — appear as the main exciting cause, after which come traumatism, infectious diseases, alcoholism, exposure, overwork, and sexual excesses.
Among the diseases predisposing to Agitans are: Arteriosclerosis with degeneration in the corpus striatum. Sometimes it is syphilitic in origin.
SYMPTOMS: As a rule it appears insidiously after perhaps neuralgic pains, paresthesias and vertigo, though it may appear suddenly after a fright, a violent emotion, or a traumatism. It affects first the hand, beginning with a finger and extending upward, until the forearm is affected, thence to the foot, but it is so slight that the patient hardly perceives it. It may cross the body, as it were, passing from right arm to left leg, thence to the right leg, or may affect one limb only. It may disappear for days, or even weeks, then reappear with more or less increase in the area involved. The shaking is continuous except during sleep. It is increased by excitement and diminished during physical work. The muscles become weak, there is hesitancy in motion, and finally rigidity or spasm occurs. The gait is characteristic of this disease. The trunk is bent in walking, and in order to maintain equilibrium he walks faster and faster, until he either falls or grasps something for support. The face becomes fixed and expressionless, saliva dribbles from the mouth, the voice is slow and sometimes stuttering, and the knee-jerk may be exaggerated. Flushing and heat are sometimes complained of. The mind is seldom affected. The index finger moves against the trembling thumb, giving the appearance or the movement used in rolling pills.
Intelligence is usually good. There is no anesthesia, but there are various manifestations of paresthesia, such as numbness and tingling and a sensation of heat. Salivation is frequently a distressing symptom, and occasionally there is free perspiration.
Another paroxysmal condition encountered is respiratory difficulties. In these attacks the patient may have an intense dypsnea and have the feeling as if he is smothering. There may also be attacks of diaphragmatic spasm.
PROGNOSIS: Unfavorable in the great majority of cases Yet some have recovered. The course of the disease is slow often for twenty to thirty years before the final stage is reached, which may end in utter helplessness by exhaustion and death.
TREATMENT: Psychiatry comes first. The patient usually is very impatient, and somehow without discouraging the patient he must be told the scriptural injunction: “In quietness and peace shall be thy strength.” He must be told that the quickest way to regain control is by living a quiet life, with at least minimum of excitement. Read “Suggestive Therapeutics” in “The Fundamentals of Applied Psychiatry.” Somehow it must be put over to the patient, without making him feel hopeless, that any help for him will come only by his cooperation for a long time.
In addition to a quiet living, abundant sleep is necessary, since the shaking stops while sleeping and recuperative powers are built up by it. Food must be highly nourishing and tonics of various kinds may be necessary. Then the following methods of treatment may be used.
CHIROPRACTIC: Adjustment of Dorsals 6 to 10. Elsewhere as needed. If face is involved, Cervicals 2 and 4. Also the atlas, axis and condyle may be considered.
NEUROPATHY: Give a general lymphatic treatment with emphasis on the following: Thoroughly manipulate the neck, spine, ribs, and clavicles. Remove all lesions. Relax the spinal tissues. Give special attention to kidneys, liver and bowels by proper measures. Treat the whole length of the spine by sedative or by inhibition according to results.
COLONOTHERAPY: Due to the large diet necessary for these patients, if the bowels do not move regularly, enemas or colonics become necessary. The physician must use his discretion here. No rule can be laid down.
ENDO-NASAL THERAPY: The Lake Recoil and the external carotid adjustment. If both are given gently, they have been of great value in the few cases the writer has seen in the last few years For the dypsnea, the external nasal canal needs to be widened; they are always pinched. In addition, the pharyngeal cavity should be cleaned and lightly massaged.
The thyroid gland should have attention also, if there is an increase or decrease in the metabolic rate from near normal.
VACUUM THERAPY: Cups all along the spine and neck will crete a hyperemia in the spinal column and because of that, are of great value.
ELECTROTHERAPY: The writer once heard a great specialist say that electricity was harmful in these cases because it created a useless excitation. Perhaps as a very aged doctor he was thinking of the old type battery treatment where the current could not be controlled. But now the sine wave can be controlled, and treatments of a slow nature can be given in the very beginning of the disease, and increased to medium force and full force as improvement takes place. Early in the disease the treatments the time may be about two minutes. Pads or hand electrodes are put on the most vulnerable places. For instance, one on the neck or back of the ear, the other in the hand. Ultra-violet ray is of excellent service applied to the whole body, or just the affected area, also short wave are excellent methods of therapeutics in this condition.
EXERCISES AND MASSAGE: Gentle stroking and kneading movements seem best for this condition. Exercises can be taken by the patient under the physician’s guidance. For the hand, opening and closing it on a ball is useful. For the face, standing before a mirror and a short time of exercise in control is taken every day.
VITAMINOTHERAPY: Large doses of A, B2 and G.
FREEZING: In one case that the writer saw within the year was a man 61 who had shaken for twenty years. He was shrunken and exhausted. Treatments of every description from all types of doctors were given, but no relief. The writer applied an ice pack over neck and down the arm to the elbow. After a half hour of freezing the tremors almost stopped. The pack was then taken off and a little while later the tremors were a little more intense. He was instructed to use the ice pack daily when the tremors were exhausting. Weeks after the writer saw him and he seemed to be getting on fairly well. An effort was made to see him before this was written but neighbors reported he had moved, and did not know where he had gone.

 
Peritonitis

 DEFINITION: An acute circumscribed or chronic diffuse inflammation of the peritoneum.
ETIOLOGY: The disease is probably always caused by bacteria, which enter the peritoneum from the adjacent viscera, especially the alimentary canal, from the Fallopian tubes, from external wounds, or directly from the blood. The organisms most frequently found are the Streptococcus pyogenes, Staphylococcus pyogenes, Bacillus coli, pneumococcus, Bacillus pyocyaneus, and gonococcus.
Peritonitis may follow — Perforation of the peritoneum by an external wound, by rupture of a gastric or intestinal ulcer, by rupture of a suppurating appendix, gall-bladder, or Fallopian tube, or by rupture of a visceral abscess; extension of a septic process in adjacent structures — stomach, bowel, gall-bladder, pancreas, uterus, etc.’ traumatism; general infections — septicemia, pneumonia, etc.
Chronic diffuse peritonitis is usually tuberculous or carcinomatous. In some instances, however it develops as a simple process in the course of chronic alcoholism, chronic nephritis, or atrophic cirrhosis of the liver. In some cases of obscure origin the peritoneum is affected with other serous membranes (pleurae and pericardium), producing the condition known as multiple serositis or Pick’s disease.
SYMPTOMS OF ACUTE PERITONITIS: In an ordinary case of rapidly spreading perforative peritonitis the onset is sudden, with intense pain at the site of the infected focus, rapidly becoming general. The abdomen, at first is rigid and retracted, becomes distended, tender, and painful; the pulse and temperature curves rise together; the character of the pulse is small, hard and “thready”, while the blood pressure may be high. The degree of pyrexia is variable. There is a characteristic expression on the patient’s countenance; the pinched and drawn features, the skin covered with cold sweat, and the look of anxiety in the hollow eyes make up the well-known picture of the Hippocratic facies. The breathing is shallow, of the costal type, due to pain inhibition; the tongue is dry, and there is constant thirst. The bowels are constipated, as peristaltic paralysis is a marked and early feature; the urine scanty, high-colored, albuminous. To ease the severity of the pain, which is greatly increased by movement, the legs are flexed at the knees and drawn up on the belly. As the abdominal distention increases, vomiting sets in, fluid begins to collect in the peritoneal cavity, and the general signs of severe toxemia appear in face and attitude; the pulse weakens and becomes more rapid, sometimes attaining 160 to 170 beats in the minute; the skin is cold and clammy, although the temperature continues to rise; cyanosis develops, and the extremities become cold. There is only small quantities of vomiting at first, but later becomes larger and bilious or slightly fecal in character.
SYMPTOMS OF CHRONIC DIFFUSE PERITONITIS: Fever is slight and may be absent. Pain is not severe, and frequently there is none at all. There is usually more or less diffuse tenderness. Anemia and emaciation are often pronounced. The abdomen is usually distended, often irregularly, from sacculated effusions, inflated intestinal coils, or the projecting matted omentum. Palpation often detects a friction fremitus and resistant masses or nodules. Percussion yields dulness, varying in extent with the amount of effusion.
PROGNOSIS: The prognosis of Acute Circumscribed Peritonitis is usually rather favorable. But in the Acute or Chronic Diffuse Peritonitis it is always grave. Where the etiological factors are from tuberculosis, or carcinoma, the outlook is practically hopeless. Death results from heart failure, pulmonary edema, or aspiration of fluid into the lungs. The mind usually remains clear until near the end.

TREATMENT

 The treatment consists of two parts. First, easing the pain, which may be done with hydrotherapy by either hot or cold applications. If there is high fever the cold is best. All food is forbidden. Fruit juices are allowed. Infra-red on the abdomen and ultra-violet radiation on the whole body have value.
The second part of the treatment is to drain the fluid of ascites, so please turn to that subject, back in the beginning of this book.

Pleurisy Acute and Chronic

 DEFINITION: An inflammation of the pleura with exudation into its cavity and upon its surface. It may be acute or chronic.
ETIOLOGY: Pleurisy may result from Anoxia, or Anoxemia due to obstructions in the respiratory tract: frequent colds, and from exposure. Males are more subject to it than females.
Pleurisy may be secondary to inflammatory diseases of adjacent structures, such as pneumonia, pulmonary tuberculosis, etc.; secondary to general morbid processes that lessen tissue resistance, such as the specific fevers, chronic nephritis, cancer, etc.; traumatic; tuberculosis. The bacteria most commonly found in the exudate are the tubercle bacillus, pneumococcus, and streptococcus.
SYMPTOMS: In most instances, an attack of pleurisy sets in with slight shivering followed by fever and pain in the side. Headache, malaise, and anorexia are usually complained of. In some cases there is an abrupt chill, especially in pneumococcal pleurisy, which may closely simulate pneumonia. In children the chill is usually replaced by vomiting, sometimes by a convulsion.
Severe, stabbing pain is the most distressing and constant symptom; it usually occurs in the neighborhood of the nipple or in the axillary region.
The pain may, however, be referred to the back or to any part of the abdomen. The pain ordinarily is sharp and excruciating, aggravated by respiratory movements and cough.

DRY PLEURISY

 TYPES: Three types are thought of here. The Dry in which the membrane is red, sticky and covered with a thin film of fibrin. If the disease process stops there it is called Dry Pleurisy.

SEROFIBRINOUS PLEURISY

 The Serofibrinous, and Purulent stages are reached if the dry pleurisy continues and goes into the exudate stage, when the exudate is composed of a straw colored serum, which may be a large or small amount. In the mild cases this is gradually absorbed, but if several pints of exudation occur, the nearby organs are displaced and the lungs are compressed.

PURULENT PLEURISY

 Purulent pleurisy commonly results from the extension of infection from a contiguous structure, especially the lung. It may cause general sepsis; It may rupture spontaneously into the lung, through the chest wall, or, very rarely, into the esophagus, pericardium, stomach, or peritoneum. The pus at times may be slowly absorbed, or become inspissated and calcified. Gradual recovery is not infrequent after perforation of the lung. In favorable cases, after the discharge of the pus, the pleural surfaces eventually become united by firm adhesions.
A general course of the acute condition may be as follows: The pleura first become reddened, and a soft, gray lymph exudes. This is the dry stage. The disease may stop here, or may progress to the second stage, in which a copious exudation of serum occurs (stage of liquid effusion). The inflamed surfaces of the pleura tend to become united by adhesions, which are usually permanent. The symptoms are a stitch in the side, a chill, followed by fever and a dry cough. As effusion occurs there is an onset of dypsnea and a diminution of pain.
PHYSICAL SIGNS: A sudden stitch in the side and fever suggests acute pleurisy, but a diagnosis is not easy without a study of the physical signs. These depend chiefly on the nature and amount of the exudation. The first stage is impaired chest movement, feeble respiration, and friction sound; second stage, dulness on percussion over the fluid, the area of dulness changing with change of position; effacement of intercostal depressions. No sounds pass through the fluid to the ear when the patient coughs or speaks. Above the liquid increased percussion resonance and a friction-sound are noticed. This disease is differentiated from pneumonia by the less marked dulness, the crepitant rale, the blowing respiration, the thoracic voice, and increased vocal fremitus of the latter disease.
TREATMENT: In all severe cases the patient should be kept in bed, until pain at least has been stopped. The room should be warm, but with plenty of fresh air.
NEUROPATHY: A thorough lymphatic of all the lymph system below the affected area for drainage purposes, and a stimulative treatment of the whole spinal segments leading to the whole thoracic cavity.
CHIROPRACTIC: Dorsal 3 and Kidney place.
VACUUM THERAPY: Carefully applying the cups over the spinal segments first, then to the affected area is probably one of the best methods of relieving the congestion and pain. Only enough suction is given to make the part red, and the receding hyperemia will carry the pus away and ease the pain.
COLONOTHERAPY: The bowel movements should be noticed, and if not normal an enema should be given daily if necessary.
HYDROTHERAPY: In dry pleurisy, hot compresses are the best, although there are some who get relief quicker by cold compresses, or the ice bag. Poultices of various types may be used. The fever can be controlled by a cool or cold compress around the neck.
STRAPPING: Fixation of the chest is often very helpful. With the patient lying on the side free from pain, straps of adhesive tape two inches wide are started in the back just over the spinal column. Then the strap is brought over the axillary region to the front of the chest, to the mid-sternal line. About three pieces of this strapping are sufficient.
ENDO-NASAL THERAPY: The Lake Recoil and opening of the external and internal nares are necessary for the proper intake of oxygen.
ELECTROTHERAPY: Diathermy or short-wave directly through the affected area is suggested as a procedure producing good results. Infra-red over the affected area, followed by a whole body ultra violet irradiation is also recommended.
DIET: The diet should be of an easily digested character, but not too much should be eaten at a meal. It is better to feed as often as six times a day than to completely fill up at one meal. Vitamins A, B2, G, C, D.
HERBOLOGY: In addition to hot wet cloths to the affected side and a hot footbath and great care to avoid exposure, a good combination of expectorants and Diaphoretics is as follows, most of which are of Indian origin. Make a tea of Pleurisy Root, Coughwort, German Cheese Plant, Wahoo Bark, Wild Cherry Bark, and Bluets.
Chronic Pleurisy is a continuation of the Acute symptoms, which may be milder or more severe by the continuation. Any type of pleurisy that persists over two weeks under treatment can be considered chronic pleurisy, and is due to some long-standing infection, which in all probability is of tuberculous origin, and may be considered as tubercular empyema, or of pneumococcus origin.
Among the etiological factors in the chronic cases may be chest wounds, infective disease of the thoracic bony cage, mediastinum, or abdominal viscera, septicopyemia, rupture of tuberculous lung cavities or bone abscesses, ribs or vertebrae, into the pleura, and general infections such as scarlet fever, typhoid fever, and measles.
The treatment is the same as under the acute condition except that whatever is causing the continuance of the symptoms must be also treated.

 
Poliomyelitis

 DEFINITION: An infectious disease due to a minute micro-organism characterized by a purely motor paralysis of flaccid type, occurring usually in young children, the paralysis being followed by rapidly developing atrophy, with degenerative electrical reactions in the affected muscles. Sometimes referred to as Infantile Spinal Paralysis; Myelitis of the anterior horns; Acute atrophic paralysis; Essential paralysis of children; West’s morning paralysis.
ETIOLOGY: The disease is usually one of childhood, children below the age of six are mostly susceptible, but adults may be attacked. It is much more prevalent in the summer than in the winter time. There are several theories about the etiology. First, that it is a contagious infection caused by a minute anaerobic organism, and that its breeding place is in the nasal mucosa, and that the infection reaches the nervous system through the lymph channels rather than the blood stream. Another theory is that it is often a sequel to the febrile infections of childhood, especially scarlet fever, measles, and diphtheria. In this respect, as well as others, its etiology is quite similar to that of epidemic and sporadic cerebrospinal meningitis. Poliomyelitis may also occur as epidemic.
The third theory is that trauma may be the exciting cause, exposure to extreme cold or to excessive or violent exercise may superinduce the disease. The season has its influence, many more cases occurring in summer than in winter. This is especially noticeable in seasons of prolonged excessive heat. Among adults, violent exercise, exposure, trauma, debilitating excesses, and syphilis are recognized as potent factors. Heredity is not a factor.
SYMPTOMS: The onset is usually abrupt and accompanied by a variable degree of fever, sometimes stupor, less frequently restlessness, loss of appetite, and occasionally headache. The last symptom, in older patients, may be severe and is frequently complained of as frontal. In a small percentage of patients there are convulsions at the onset. Some complain of marked pain, the latter especially along the spine.
Muscular twitchings and jerkings are frequently noticed, especially while the patient is asleep. Probably the most important and diagnostic single sign is that of paralysis, which may be recognized easily if it involves a group of muscles; or it may be very difficult to detect if it affects only a single muscle or only temporarily involves a group. With the appearance of paralysis, which occurs usually from two to four days after the onset, the systemic disturbances usually subside. There follows a variable period of days and often weeks, during which time various degrees of atrophy of the involved muscles take place with no increase in paralysis. At the same time there is a decrease, and in some cases a complete loss, of muscular reaction to the faradic current. The involved nerves also have a variable degree of reaction of degeneration to the galvanic current. Following this, for a period of several months there may be gradual improvement, or, on the other hand, various degrees of deformities may develop, such as talipes, spinal curvature, or arrest in the development of one limb.
PROGNOSIS: Unless the initial symptoms are very severe or the muscles of respiration are affected, the prognosis as regards life is good. The death-rate has ranged between 5 and 30 per cent. In all cases much of the paralysis disappears, and sometimes the improvement is so marked that the usefulness of the members is not seriously impaired while others are left hopelessly crippled unless adequate treatment is given before the paralysis becomes fixed beyond relaxation.
TREATMENT in the Acute stage while patient is in bed.
ENDO-NASAL THERAPY: Since all available evidence indicates that the upper respiratory tract is the venue for entrance of the specific etiologic agent, it may be assumed that precautionary measures, such as those employed in handling acute upper respiratory infections, would be proper. If the techniques are not possible to perform, then some method should be found to keep the nasal tract and throat clean and antiseptic. The alkaline Pink Rose solution of Zemmer is ideal for this condition.
VITAMINOTHERAPY: Vitamin C in as large doses as possible.
MASSAGE: The neck and the whole spine and limbs may be massaged lightly after applications of warm towels; emphasis need be placed on “massage lightly.”
CHIROPRACTIC: Firth in Chiropractic Diagnosis, page 429, states: “There is no nerve tracing in a case of poliomyelitis, as the pathological condition lies within the neural canal of the spine.” Then on page 431 we read: “Restoration under Chiropractic adjustments is astonishingly rapid when given in the acute or early states. Cases of longstanding yield more slowly as would be expected.”
NEUROPATHY: A mild lymphatic of the whole body, and a stimulative treatment of the spine.
COLONOTHERAPY: Bowels should be kept free by enemas if necessary.
VACUUM THERAPY: The writer had a case of a boy seven years of age. In the acute stage he used the vacuum cups, daily up and down the spine. Suction was by hand pump, and it was done for five minutes each day no matter what the condition of stupor or weakness was. When the boy got around and regained his strength, the only sign of paralysis was in the right ankle. It was difficult to get him to exercise; but a football, light in weight, provided him with the proper interest. That boy became a good football player on his school team and also made a good soldier.
To the writer, light cupping and hydrotherapy are the two best methods to use in the acute condition; this of course is not to say other methods are not necessary or vital.

CONVALESCENT CARE OF POLIOMYELITIS

 The early use of heat is advisable in order to dilate peripheral vessels, drawing the blood away from the congested areas in the cerebrospinal area. Attention should be given to vasomotor imbalance during the very time that affected muscles are having their nutrition impaired. Special research should be done to ascertain the status of the vasomotor mechanism and its importance in relation to muscles. The tendency for the extremities to become cold indicates this upset in vasomotor action. The use of the continuous light bath or electric bed pad may be found advantageous in the quarantine period. Too little consideration is usually given to the dysfunction of the sympathetic nervous mechanism.
ELECTROTHERAPY: Short wave at low voltage for some time each day, especially on the points that are cold and numb. Baking has great merit in some cases.
HYDROTHERAPY: Exercises and massage, in the bathtub or a pool of warm water.
EXERCISES: Each muscle should be exercised about three to five times but not more if the exercises give pain to the patient. In other words, great fatigue must be avoided. Muscle training is very fatiguing in the first four weeks. When only the legs are attacked, after about eight weeks, walking in water up to the waist can be tried. If crutches or braces are needed for support in the early stages, these can be provided. Or a rail can be provided for the patient to hold on while walking.
If the physician wishes information regarding “Sister Kenny’s” method of treatment, it will be furnished on request by The National Foundation for Infantile Paralysis, 120 Broadway, New York 5, N. Y.

 
Phlebitis

ACUTE PHLEBITIS

 DEFINITION: Inflammation of a vein, with the formation of a clot within the lumen of a vein. Also known as Thrombophlebitis.
ETIOLOGY: It usually results from some injury accompanied by infection. It is sometimes very grave, leading to pyemia. The subacute form, less grave, is usually caused by some disease of the vessel accompanied by thickening and narrowing of the lumen.
A slowing or stagnation of the blood stream is the first essential to the development of a thrombophlebitis. The second is a change in the blood constituents, and the third is an injury, traumatic, infectious or chemical, to the vein wall.
Associated with the thrombophlebitis there may develop an obstruction to the lymphatic system of the leg or thigh. This gives rise to the swollen, white, and edematous leg so commonly seen after parturition and formerly called milk-leg.
It may be due to the introduction of a chemical solution into the vein, as in the injection treatment of varicose veins, or it may be due to the presence of an infection in the blood stream and thus give rise to the inflammatory condition known as “acute infectious thrombophlebitis.”
The latter condition may affect either the superficial or deep group of veins. The deep veins are more commonly affected associated with pneumonia, typhoid fever, general infections, and operations, while the superficial group often becomes inflamed from no apparent cause. The infection in these cases may be from hematogenous or local sources.
SYMPTOMS: The symptoms of phlebitis are inflammation, great swelling and hardness of the veins, with much pain and throbbing. Rapid pulse, rigors and elevation of temperature. The tongue is dry, brown and red. The inflammation may lead to coagulation of the blood in the affected area which may be followed by rupture. Pus may form in the area of inflammation and infect the stagnant blood, which circulation may carry away and infect the whole body causing further inflammation and suppuration or general pyemia.
PROGNOSIS: Generally favorable, but infectious thrombophlebitis is always a potential source of pulmonary emboli with fatal termination. It is for this reason that the examination of these cases should be done carefully and with but little manipulation and no massage. (See Embolisms.)
TREATMENT: In the acute stage, bed rest at once with limb elevated and ice packs for at least six hours followed by warm wet packs for one hour It must be understood that the packs are to be warm not hot in the last application. In some acute stages surgery becomes imperative.

GENERAL TREATMENT

 COLONOTHERAPY: Enemas need be taken daily, no matter whether the patient is constipated or not.
DIET: In the acute state when fever is present absolute fast until fever is gone. Liquid intake must be judged by the edema. If great, some water may be taken by sips. If no edema is present considerable quantities may be consumed. When the acute stage has passed and the patient is up and around diet No. 2 can be used for a few days, followed by No. 1 until all symptoms are gone.
The enemas and the cold wet applications should be continued for some time after abatement of the acute symptoms. The cold pack may be applied at night before retiring, covered by a piece of flannel and left to remain all night.
NEUROPATHY: A thorough lymphatic of the abdomen, with stimulation of all the spinal centers.
CHIROPRACTIC: Adjustment of the lumbars, and kidney place and wherever else indicated.
HERBOLOGY: A strong tea of Mullein Leaves and bathe the legs with the tea is helpful.
“Emollient Ointment” suggested for Varicose Veins can be used for Phlebitis by spreading it thickly over affected area and using a cover of flannel. Do not massage.

 
Pneumonias

I. BRONCHOPNEUMONIA

 DEFINITION: An inflammation of the bronchioles and air vesicles of the lungs.
ETIOLOGY: Bronchopneumonia is a disease of childhood and the aged. It may arise from a chronic cold, a tubercular condition, which is quite common among those afflicted, and difficult to overcome. It may be precipitated by irritation by smoke and noxious vapors and gases, and, in case of such origin, it may likewise be associated with, or arise by extension from, inflammatory processes in the upper air passages. It may be caused by chloroform, and less often by ether, administered for surgical anesthesia in the presence of artificial light by combustion.
It may arise from purely local infection by agents recognized and not recognized, and probably not specific. It may occur in extension from bronchitis of any origin.
It is, however, usually met with as a complication or sequela of one of the infectious diseases, and especially of those of childhood. Even when it is the only or most prominent manifestation of the existence of infection, -- as, for example, in influenza or tuberculosis, -- it is to be regarded as secondary.
It may be associated with, or follow, measles, scarlet fever, small-pox, whooping-cough, influenza, tuberculosis, or infectious materials in cases of anesthesia or paralysis of the larynx, in coma of any origin, in malignant disease of the larynx and esophagus, following hemoptysis, following operations about the mouth and upper air passages, and in some cases through the inspiration of matters from a vomica or from a bronchiectatic cavity, or, in exceptional instances, from the rupture into the lung of a purulent collection in the pleura, liver, or elsewhere.
The immediate cause is said to be possibly the bacillus of Friedlander, the typhoid, influenza, colon or diphtheria bacillus.
SYMPTOMS: The onset is usually gradual, and is characterized by prostration, cough, and fever. The last is moderately high and very irregular (102 – 104 degrees F.). The dypsnea is marked, and the respirations are rapid, in children often 40 to 50 a minute, the pulse is also accelerated—110 to 150 a minute; cough is painful and accompanied by a mucopurulent expectoration that is occasionally blood-streaked. The face is usually pale and anxious, and the lips may be blue.
PROGNOSIS: In previous healthy children the prognosis is good. In cachectic children the outlook is very grave. Aspiration pneumonia is usually fatal. The duration varies from about ten days to about three weeks. In cases delayed beyond this the suspicion of tuberculosis or localized empyema becomes strong. Some cases, however which are not clearly tuberculous, run a remittent or subacute course, and others gradually take on a chronic type.
TREATMENT: While to some extent dependent upon the exciting cause of the pathological process in the individual case, and subject to modification acording to age, sex, personal characteristics, environment, and so forth, the general lines of treatment in cases of bronchopneumonia are very much alike in cases of every type.
Much can be done by careful management in preventing bronchitis from gaining access to the smaller bronchi.
On the outset of bronchopneumonia the patient should be confined to bed, in a well-ventilated room, which should be kept preferably at a temperature of about 65 degrees F. Plenty of air must be furished. The low mortality of the roof ward in sanitariums give this requirement proof.
HYDROTHERAPY: Hot flaxseed poultices applied over the affected area. The poultice is put over the entire chest and back. It should keep warm for at least four hours when another can be applied. There are many other valuable packs that can be used Chickweed ointment is highly recommended. Steam inhalations with creosote, 10 drops to 960 cc. of water under a croup tent helps release the exudation.
ELECTROTHERAPY: Diathermy, short wave, applied to chest and back, and given according to tolerance are very valuable.
COLONOTHERAPY: Bowel movement at least once a day is highly important. Abdominal distention should be avoided by all means. Enemas of warm water may be necessary more than once a day. The fever condition can be controlled with a cool cloth around the throat when the enema is given, if meningitis has intervened An ice cap to the head may be applied. Rapid or slow heart can be regulated by heat or cold over the heart or by concussion or pressure.
ENDO-NASAL THERAPY: All of these patients have an anoxia or anoxemia. It may not be possible to give them the Endo-nasal treatments in the acute condition, but if dypsnea is dangerous it is then necessary to administer artificial oxygen. A nasal catheter or oxygen tent, may be necessary or any other method possible, see your Endo-Nasal book on Artificial Oxygen, page [no page number given].
DIET: While the fever lasts only cold drinks, and fruit juices can be given, otherwise feedings can be of small quantities every two or three hours of easily assimilable foods. Gruels, broths of beef juice, egg albumin, soft boiled eggs, etc. In the most severe cases alcohol in the form of brandy and whiskey are recommended but the writer so far has not had to resort to it.
HERBOLOGY: One ounce each of Skunk Cabbage, Comfrey, Elecampane, Spikenard, Horehound, Wild Cherry. Put in a gallon of boiling water, let steep for 6 hours. Strain. Add pint of honey. Wineglass every 3 hours.
Another excellent recipe for clearing the lungs is to infuse one-half ounce of Boneset and one ounce of Mallow leaves in a pint and a half of boiling water. Then infuse one ounce of Pleurisy Root in the same quantity of boiling water. Now mix both infusions and take a wineglassful, warm, about every 15 to 20 minutes.
After lungs seem clear a tea of equal parts of Agrimony, Meadowsweet, Betony, Raspberry Leaves and Great Burnet. Teaspoon of mixed herbs in cup of boiling water, let cool, large swallow frequently is suggested.
Or infusion of Black Horehound, Wild Cherry Bark sweetened with honey is good to tone and nourish system.
VACUUM THERAPY: This method of treatment is par excellent if applied lightly and continuously for at least one hour. No hurting, just a mild hyperemia. The cups are put on the back first, covering the dorsal vertebrae then gradually working toward the chest. If the physician is called early, this hyperemia will usually break up the attack.
CHIROPRACTIC: Adjustment D 3-10 and other zones as indicated.
NEUROPATHY: Lymphatic of the whole body, emphasis on Hunter’s canal, liver and axillary places. Mild stimulation of the whole spine.
The patient should be looked after by the physician for many weeks when up and around.

II. LOBAR PNEUMONIA

 DEFINITION: Lobar pneumonia is an acute specific infectious disease caused by Pneumococcus, characterized by a sudden onset with chill, pleuritic pain, rapid respiration, cough with rusty tenacious sputum, and high fever which often terminates by crisis. Pathologically, it is characterized by a diffuse exudate inflammation involving one or more lobes of the lung, which passes through the stages of congestion, red hepatization, gray hepatization, and resolution. In the above definition may be included Croupous pneumonia, fibrinous pneumonia, pleuropneumonia, pneumococcus lobar pneumonia.
ETIOLOGY: The disease may occur at all ages. Males are afflicted more than females. Lowered vitality in the winter or spring months produces the greatest number of victims, when colds are rampant. Preexisting diseass such as influenza, nephritis, arteriosclerosis and diabetes may be precipitating causes. Alcoholism is also a precipitating cause.
The exciting cause is said to be the pneumococcus of Frankel, or Diplococcus pneumoniae. There are usually three states.
SYMPTOMS: In children it may begin suddenly with vomiting or convulsions after a cold of some time. In adults there may be a day or two of ill health, with headache or cold, sore throat and some pains in the extremities. On the first day of pneumonia a sudden chill, and pain or pronounced thoracic oppression may be the initial complaints. After the chill the temperature rises quickly, often attaining 104 degrees F. The face becomes flushed. Then pain is complained of on the affected side, especially on inspiration. A dry cough increases the pain.
Headache and muscular pains are also likely to be complained of. Complete anorexia is usually noted, and often there is vomiting. Marked thirst appears, the skin is dry, the pulse rapid, the urine scanty, and the bowels generally inactive, though occasionally diarrhea occurs. Usually the patient lies on the affected side until the pain has largely disappeared.
On the second day the cough generally becomes more productive, a characteristically viscid, airless tenacious, and rusty or blood-stained sputum being expectorated. At the same time the physical signs of lung consolidation usually appear, though in some instances — in central pneumonia especially — they may be delayed until the third day. The effects of general toxemia are also manifeest in sleeplessness and delirium. On the second or third day, an eruption of herpetic vesicles about the lips and alae nasi develops. The respiration becomes rapid and shallow owing to reduction of functionating lung tissue by the pathological process. The resulting dypsnea may even be accompanied by cyanosis and suffusion of the conjunctivae.
In from five to nine or ten days the febrile movement generally terminates by crisis, -- sometimes accompanied by abundant sweating or diarrhea, -- after which convalescence, as a rule, becomes rapidly established.
But the various types of pneumonia may present some serious complexities.
PNEUMONIA IN CHILDREN: It is often ushered in with vomiting or convulsions. Headache, delirium, and stupor are prominent symptoms, so that the disease may simulate meningitis. The temperature is very high; expectoration is often absent. The disease frequently begins at the apex of the lung. The duration is usually short.
TYPHOID PNEUMONIA: In this form there are pronounced typhoid symptoms (See Typhoid)—headache, muttering delirium, stupor, a dry, brown tongue, a rapid, weak pulse, and high fever. The expectoration may resemble prune juice.
PNEUMONIA OF ALCOHOLICS: The onset is often gradual; the dypsnea is marked; the temperature is not high; maniacal delirium commonly develops; and death from exhaustion is not unusual.
FIBRINOUS PNEUMONIA: In this form the bronchioles, as well as the air vesicles, are filled with fibrinous exudate. The physical signs resemble those of pleural effusion.
CENTRAL PNEUMONIA: In this form the inflammatory process commences in the center of a lobe, and in consequence the characteristic physical signs may not manifest themselves for two or three days.
SPREADING PNEUMONIA: In this type the specific inflammation shows a tendency to spread and to involve successively fresh areas of lung tissue.
COMPLICATIONS: Pleurisy is the most common complication. It may be either serous or purulent. Pericarditis and endocarditis are sometimes a sequel. Among less frequent complications may be mentioned inflammation of the middle ear, meningitis, arthritis, parotitis, nephritis, catarrhal jaundice, acute dilatation of the stomach, and delayed resolution. Consolidation may last for five or six weeks and then gradually disappear. Abscess, gangrene, and chronic interstitial pneumonia are rare sequels.
PROGNOSIS: Favorable in the young and generally healthy persons. After the age of sixty it is very guarded. In the alcoholic the prognosis is always grave. The coexistence of heart, liver or kidney disease makes pneumonia very dangerous.
TREATMENT: The windows of the room should be open so that the temperature of the room can be below 65 degrees F. with a lot of fresh air. No matter what the temperature or atmospheric condition outside the windows should be open. The treatment must follow much along the line of the symptoms. The symptoms as they arise must be combatted, lest any one of them contribute to a fatal outcome. These serious symptoms can be: Pain, Cough, Fever, smothering or dypsnea, delirium, cardiac pressure, insomnia and gaseous distention of the abdomen.
For the general treatment of pneumonia see the last section on the subject of Pneumonia.
But in lobar pneumonia some of the symptoms need specific mention. The cough, hard and dry needs to be released as quickly as possible. Hot applications to the throat, with equal amounts of honey and lemon juice, given every few minutes.
Fever must not be completely broken, only kept in control. This can be done best by hydrotherapy. Dypsnea or smothering; usually Endo-Nasal treatments are impossible in the little child, but pumping of the chest may help. Oxygen inhalations in croup. Delirium, an ice cap to the head is serviceable. Gaseous distention of the abdomen may be relieved by enema, or just the passage of a rectal tube. Pain may be relieved by the vacuum cups.
Insomnia is a serious matter and methods need to be found to induce sleep, so that there may be a conservation of energy and vitality.
Cardiac symptoms can be controlled by spondylotherapy or pressure on the cardiac segments.
Now turn to the general treatments of Pneumonia, under Bronchopneumonia.

III.CHRONIC INTERSTITIAL PNEUMONIA

 DEFINITION: A chronic inflammation of the connective tissue of the lungs, characterized by hardening and thickening. It is also known as Cirrhosis of the lung and Pulmonary induration.
ETIOLOGY: It may be a sequel of other forms of pneumonia but in most cases it may be excited by the constant inhalation of irritating dusts, as stone-dust (chalicosis), coal dust (anthracosis), or metal-dust (siderosis). It may result from syphilis. It is occasionally secondary to chronic pleurisy. It is an invariable accompaniment of chronic tuberculosis.
PATHOLOGY: When the thorax is opened, the lung is found retracted and the heart displaced. The organ is tough, firm and more or less airless. Section shows an overgrowth of fibrous tissue, and usually inflammation and considerable dilatation of the bronchi.
SYMPTOMS: The chief symptoms are dypsnea on exertion and cough. The latter may be dry, but it is usually associated with more or less mucopurulent sputum. There is rarely fever, and the general health may be well preserved for many years.
PROGNOSIS: Unfavorable, but by treatment life can be preserved for many years. The treatment must be along the symptomatic line. Asthma, Bronchitis or Tubercular symptoms are prominent at various times. See treatment for each.


Rectal Diseases

 DEFINITIONS: Rectum — lower part of large intestine, about five inches long (12 cm.), ending at anus. The centers of the anorectal mechanism are in the 3rd and 4th sacral segments. The Anus is the outlet lying in the fold between the nates.
This subject would require a large book in itself. Here we will take only the common complaints and give a brief outline and state the treatment.

PAINFUL AND DIFFICULT DEFECATION AND TENESMUS

 The greatest cause is constipation. The second is disturbances of the nervous system by voluntary reflex inhibition. Not convenient to go when nature calls and inhibition becomes a fixed habit of the nerves.

TREATMENT

 NEUROPATHY: Lymphatic of the groin. Flex legs, then stretch to the side three times.
CHIROPRACTIC: Dorsal 7, 10. Lumbar 2-4.
ORIFICIALTHERAPY: Dilations of the rectum by the finger or the Ross instrument.
DIET: Less roughage. More liquids.
HERBOLOGY: See page 629.

HEMORRHOIDS

 Hemorrhoids or piles are varicose tumors of one or more of the inferior hemorrhoidal veins. They are of two types: the external which originate in the inferior hemorrhoidal veins are external to mucocutaneous line and are covered with skin. Internal hemorrhoids are an involvement of the superior veins and are above the mucocutaneous line and are covered with mucous membrane.
ETIOLOGY OF INTERNAL HEMORRHOID: Pressure at stool causing distention of the veins. Constipation by pressure of the hard fecal mass. Any infection such as cellulitis in action, or abrasions in the perianal and perirectal tissues which may produce a periphlebitis and a phlebitis of the veins weakening the walls, producing a dilation, which straining may rupture and cause bleeding piles.
There are three stages of internal hemorrhoids, the first is where the pile is a mass of varicose veins covered by a normal mucous membrane. All that is noticed is a little pain, and a slight coloring of blood. The second, is when these piles have become larger, and the tumor has become elongated and protrudes with defecation. It retracts into the rectum after defecation. There is some bleeding, but stops on completion of defecation. In the third stage, there is a loss of elasticity and the sphincter muscles have lost their tone. There is marked protrusion with each bowel movement which must be replaced by the fingers or it will stay down. The mass will often fall out of the rectum just by standing up or walking. In addition there may be a great deal of bleeding or massive hemorrhages.
In the second stage, the patient should be instructed to replace it immediately, and to rest a while after replacing the tissue. Astringent ointments, applied by the finger or a collapsible tube with perforated nozzle are useful. The stools are to be kept soft and easy. Specialists in this line also treat by injection and operation and the drugless physician, after a fair trial, should consider such a procedure.
In the third stage of internal hemorrhoids, and the writer has seen many of them, is frank to admit that operation by electrosurgery or injection of some sclerosing substance or operation by the knife is probably the best thing that can be done in the last stage of protruding bleeding piles. The loss of blood being so continuous that the future good health of the patient is always endangered.

TREATMENT OF INTERNAL HEMORRHOIDS

 A careful examination should be made with a sigmoidscope. If a patient is in the first stage, orificial therapy is usually sufficient. The patient is put in the knee-chest position, and with the forefinger the mass is massaged so that circulation of the veins are established. The sphincters are relaxed Ross or Young dilators are recommended also for this purpose. Constipation if present must also be overcome. See Treatment for Painful Defecation.
TREATMENT: If the hemorrhoid is small and causing no distress it is best to leave it alone. But if distress is felt, then the following outline of treatment may be followed. The cause is found first and corrected if possible, then the softening and shrinking process is undertaken. The writer in some cases has applied first heat to the thrombus and then stretched the tissue as far as possible, then applied an ice cube right in the middle of the thrombus. This method has been useful in a number of cases. Another was to have the patient take a sitz bath, first of hot water, then in cold tea. Three tablespoonsful of tea to three quarts of water. This is boiled until black, then it is allowed to cool and the patient immerses his anus in this for ten minutes each day. Hot compresses of magnesium sulfate is recommended. Suppositories of various kinds are also recommended. A cold sitz bath taken on arising or retiring is helpful in some cases, but a full body warm bath should be taken afterward.
Oil or water enemas can be taken until the feces are softened.

FISSURE IN ANO

 DEFINITION: A tear or ulceration of the membrane of the anus. One of the most painful conditions that afflicts the anus, which is worse on evacuation.
DIAGNOSIS: The signs are so characteristic of the lesion that it is almost impossible for a diagnostic error to be made. The peculiar nature of the pain, the time of its occurrence (either during or some time after an evacuation of the bowels), its continued increase until it becomes unbearable, and its gradual decline and entire subsidence until the next evacuation clearly point to irritable ulcer of the anus and in most instances should be sufficient to establish a diagnosis.
TREATMENT: The first step is to see there is no constipation or diarrhea. Both are aggravating. Enemas of flaxseed tea from a half pint to a pint is soothing to be taken just before retiring. A swab of cotton soaked in one drop of 120 V. M. to ten drops of water has a healing effect. After the second treatment the number of drops of C. M. can be increased up as high as one-half the water. The above can be done twice a day. The part must be kept perfectly clean, and especially after evacuation. A soft moistened wet cloth either hot or cold can be used, or soft moist toilet paper.
ELECTROTHERAPY: Ultra-violet cold quartz may be applied with the applicator for a very short time at the first visit, then increasing the time with each visit. Diathermy and electro coagulation are also recommended. In some cases the only relief is by surgical interference.

FISTULA IN ANO

 DEFINITION: An unnatural channel leading from a cutaneous or mucous surface to another free surface or terminating blindly in the substance of an organ or part.
There are a number of varieties of this condition. We think of the complete here in which there are two openings, one in the rectum and one on the skin more or less remote from the anus.
ETIOLOGY: Fistula is usually due to the pus of previous abscesses within the rectum, or due in some instances to injuries which extend from the exterior to the interior.
TREATMENT: If health is broken down, or the patient is an alcoholic, tubercular, or diabetic, the treatment is attended with great difficulty.
The second opening can be washed out thoroughly by the V. M. solution as found under Fissure of the Ano, or any other antiseptic solution. Then the treatment may be the same as under Fissure of the Ano. Surgery is sometimes necessary.

PRURUTIS ANO

 DEFINITION: A functional affection of the anus, characterized by severe itching.
ETIOLOGY: Pruritis, or paresthesia, is usually a functional disorder of the sensory nerves of the skin; it may be caused by functional or organic nervous disease, or by nutritive or metabolic disorders, through their action on the sensory nerves, a hyperesthesia being induced. Among the acknowledged causes of pruritis are the various psychic neuroses, neurasthenia, the uric acid diathesis, diabetes, Bright’s disease, utero-ovarian disorders, pregnancy, indigestion, constipation, and hepatic disorders. Tobacco, coffee, tea, opium, alcohol, etc., if excessively used, may be etiological factors.
TREATMENT: The cause of the itching must be found as well as giving relief. Many of these patients are psychoneurotic, and the tensions under which they live should be looked for, and the patient aided in overcoming those tensions. See Neurasthenia in “The Fundamentals of Applied Psychiatry.”
Urine examination in all cases for sugar, for Diabetes is a frequent cause.
Local treatment may be alkaline sponging of the anus. Sodium carbonate lotion. Cold applications of water are sometimes useful.
DIET: A strict vegetarian diet for a few days.
The solution or powder of Kabnick products is par excellent for this condition anywhere in the body. Dermal Penatrin Zemmer is very effective.
ELECTROTHERAPY: Air-cooled quartz ultra-violet ray with a local applicator for at least half a minute to a full minute twice a week is helpful.

PROCTITIS

 DEFINITION: Proctitis is an inflammation of the mucous membrane of the rectum with or without conjunction with other diseases. There are two types: Where the rectum is involved in an inflammatory lesion along with other portions of the colon, such as ulcerative colitis, or gonorrheal proctitis. The other can be considered a local simple proctitis.
SYMPTOMS: No matter what the type, the symptoms of proctitis are practically the same.
Inflammation of the rectum may be caused by a variety of factors in which hemorrhoids, tumors, parasites, dysentery, and gonorrhea are the most common. The symptoms are those of inflammation in other regions: heat, fullness and pain, besides more or less marked tenesmus. The latter may be accompanied by frequent defecation of small quantities of feces containing mucus, pus, or blood. The inflamed mucosa of the rectum may prolapse. When there is ulceration, stricture of the rectum may follow. Ulcerative proctitis with stricture is generally of syphilitic origin, but may also be due to local tuberculosis or dysentery.

TREATMENT IN THE INFECTIOUS TYPE

 The treatment is the same as for the type of infection found under that title.
For simple Proctitis a local treatment may be all that is necessary. Rest in bed. A liquid diet to avoid rectal irritation; soothing lotions, such as are found under Prurutis. Enemas. Relief of pain by heat or cold applications. If possible, establish habit time for bowel movements.
In all rectal disease conditions, Vitamins A, B, C and G can be considered.
In all the above, Neuropathic general treatment may be given, also Chiropractic where indicated.

HERBOLOGY FOR RECTAL DISORDERS.

 The following makes a very mild laxative, yet effective, with diuretic properties: Senna Alexandria, Senna Tin, Turtlebloom leaves, German Cheese Plant, Fennel Seed, May Apple, Jamaica Ginger, Sweet Weed, Buckthorn Bark, Licorice Root, Sacred Bark.
Psylla Seeds are laxative and lubricate internally.
Red Clover Blossoms made into strong tea; use as table tea.
Bran and Mineral Oil is good.
Authorities seem divided over saline solutions.
Intestinal stasis is generally due to deficiency of sodium, potassium, magnesium, and chlorine in the food; spinach has high content of first three; eat it raw or slightly steamed in its own juices for about three minutes.
Brazil nuts are highly esteemed as a preventative of constipation and bowel disorders.
It is claimed most obstinate cases of constipation can be absolutely cured, usually in five days. Soak a handful of wheat as it comes from the farm, in water, to cover it by an inch. Do this in evening and it is ready for morning’s breakfast two days after (36 hours approximately). When breakfast is ready, drink off the water, put milk and fruit in the pan and eat as is, not cooked. Use brown sugar, if desired, to sweeten, not white sugar. Honey, however, is best.
Old-fashioned fruit laxative: 1 pound prunes, ½ pound figs, ½ pound dates, ounce Senna leaves. Remove pits, chop, mold into balls size of hickory nut. Take one as needed. This will keep all winter, when most laxatives are needed.

OTHER DISEASES OF RECTUM

 Abscesses, tumors and carcinoma are some of the other diseases of the rectum. Treatment is mainly surgical.

RHEUMATIC FEVER

 DEFINITION: A rheumatism that is characterized by fever, pain and swelling of the joints. It is sometimes called Acute Articular Rheumatism or Inflammatory Rheumatism.
ETIOLOGY: Rheumatic fever tends mostly to attack the young, and young adults between the ages of 10 and 35 years of age. Males are more often attacked than females. Much exposure to damp weather may procede an attack. Autointoxication is a big factor. Infection by sepsis from previous attacks or tonsillitis, scarlet fever, gonorrhea or diphtheria, infected teeth, sinus drainage of pus from infection, all have been thought of as contributing factors. The exciting cause is thought to be the Streptococcus rheumaticus.
The disease may follow an attack of acute tonsillitis, or it may set in at once with chilliness, fever, and inflammation of the joints. The joints involved are, as a rule, the larger ones, as the knees, ankles, elbows, and wrists. They are swollen, hot, painful, and tender, but only slightly reddened. The inflammation shows a marked tendency to flit from joint to joint, and to subside in one while attacking another. In severe cases the muscles also are painful and tender. Small subcutaneous nodules are sometimes found along the tendons and over the bony prominences. The fever in ordinary cases ranges between 102 and 103 degrees F., and is very irregular. The perspiration is often copious and has an acid reaction and a peculiar sour odor. The appetite is lost, the tongue is coated, the bowels are constipated and the urine is scanty and highly colored. Moderate leukocytosis is usually present, and as the disease progresses marked secondary anemia develops. Many sub-acute cases occur in which fewer joints are involved and the symptoms are of a mild type, but the course is often protracted.
The disease usually lasts from two to four weeks, but it may persist with alternate exacerbations and remissions for several months.
PROGNOSIS: In regard to life the prognosis is favorable. Complications involving the heart are frequent and often lead to serious consequences. One attack of rheumatic fever predisposes to another with more serious consequences after each recurrence.
TREATMENT: A patient with this disease should be confined to bed in a well-ventilated room, even those who have a mild case of it.
NEUROPATHY: A mild lymphatic with sedation of the whole spine.
CHIROPRACTIC: Adjustment D 5 to 7. Also kidney place.
COLONOTHERAPY: Daily enemas or colonics twice a week of warm water.
HYDROTHERAPY: Hot wet packs with a solution of epsom salts over the affected joints.
The fever can be controlled by tepid sponge baths, or a cool compress on the throat. Skin irritation is relieved by frequent sponge bathing and witch hazel daubing, not rubbing. The local use of wintergreen oil, one dram to an ounce of lanolin, may give relief to the joints.
DIET: When there is high fever, all food should be withheld for some time. If food is given, it should be of the protein type. It should include milk or milk products, cereals and broths. See the Salisbury Steak diet under Arthritis.
Should the complications of Articular Rheumatism arise after the fever subsides, treat as found in the next section.
Hyperpyrexia and cerebral rheumatism may necessitate the application of tepid and even cold baths; the cold baths or cold pack should be begun as soon as the temperature starts to rise quickly above 105 degrees F. (40.5 degrees C.), otherwise considerable danger to life may be entailed. Upon the advent of endocarditis the use of the ice-bag over the heart may be necessary.
A persistently high pulse rate in acute articular rheumatism is always to be regarded as indicative of myocardial involvement, and as long as it continues absolute rest is essential.
SPONDYLOTHERAPY: Concussion of the 7th Cervical may be sufficient or an ice bag may be put over the heart.
Where a case persists over many weeks, there surely is an infection some place. Sinus and tonsils should be thoroughly inspected, and ENDO-NASAL treatments given if a gonorrheal infection has been present before the attack of rheumatic fever a process of elimination will need to be instituted to free the system of the poison. A good process, if the fever is gone, is the following: One cupful of washing soda, one cupful of borax in a quarter filled tub of hot water. The patient sits in it for twenty minutes with cold cloth or ice bag on head, after which the patient should retire. Two sittings a week are enough.
HERBOLOGY: Use 1 drop of true Oil of Wintergreen in a teaspoonful of sugar three times a day, increasing the dose to 2 drops the second day, until on the ninth day 9 drops are taken with sugar; then on tenth day take 8 drops and decrease a drop each day back to 1 drop again.
One-quarter ounce each of Ginger Root, Celery Seeds, Prickly Ash Berries, Sassafras Bark, one-half ounce each of Bittersweet, Broom Corn Seed, Cleavers, three-quarters ounce each of Meadowsweet and Yarrow. Mix herbs. Pour on a quart of boiling water; keep covered; simmer for fifteen minutes, let cool; strain through fine cloth. Small wineglass three times a day.
Various herb companies have excellent prepared combinations. Also ointments for external use, but washing part with soap and hot water, drying, and applying Methyl Salicylate Ointment gently three times a day is excellent. Cover parts with flannel after putting on ointment.

Rickets — Rachitis

 DEFINITION: A disease of metabolism affecting children and often resulting in deformities.
ETIOLOGY: The old etiology was given as poor nutrition of the mother, faulty hygiene and, above all, defective feeding, and lack of sunlight, ultra-violet radiations are important etiological factors, hence the disease is observed most frequently in large cities and among the children of the poor.
But, later this condition became known as an avitaminosis of Vitamin D. The reader is advised to read the scientific article on Vitamin D, its several forms, compositions and activations in “Nutritional Deficiencies,” by Youmans, page 144. Lippincott Co. Also be sure to read on page 153 “The calcium and phosphorus balances necessary for the utilization of each other in the body.”
SYMPTOMS: Restlessness and slight fever at night 101-102 degrees F., free perspiration about head, diffuse soreness and tenderness of body, pallor, slight diarrhea; enlargement of liver and spleen; delayed dentition and eruption of badly formed teeth, head large and more or less square in outline; craniotabes or skull bones often so thin they crackle like parchment. Sides of thorax flattened; sternum prominent; nodules can be felt at sternal ends of ribs. There may be kyphosis, lordosis or scoliosis. Liver and spleen may be considerably enlarged, long bones are curved and prominent at their extremities. Bowels constipated, abdomen distended.
PROGNOSIS: Usually favorable. Deformities disappear in a large majority of cases when proper nutrition is given over a long time.
TREATMENT: Careful regulation of diet, fresh milk, properly diluted for infants; meat juice or raw beef for older children. Fresh air and sunshine. Vitamin D and an abundance of calcium and phosphorus in the food. Sunlight or ultra-violet rays. Fresh air and sunshine. Sea-bathing, irradiated cod liver oil, liver, egg-yolks, lacto-phosphate of lime, good hygiene. Lime or lemon water is excellent. Cod liver oil or halibut oil or any fish oils fortified by viosterol can be also utilized as well as Vitamin D in any other form.
ELECTROTHERAPY: Whole body ultra-violet irradiations for long periods turning the body around so that the whole may be irradiated.
CHIROPRACTIC: Adjustments of Atlas-Axis. Spleen and Kidney segments.
NEUROPATHY: Lymphatic of the neck and abdomen lightly. Emphasis on liver and spleen. Sedation of whole spine. Vacuum therapy very light on the spine of the young is beneficial. A little harder on the older people.
HYDROTHERAPY: Ocean or salt water bathing is the best method. Residence at seashore is of great help.
STRAPPING: The use of an elastic belt for abdominal massage and support is also of help.
HERBOLOGY: Phosphorus bearing botanicals are Dandelion, Meadow Sweet, Marigold Flowers, Licorice Root, Chickweed, Caraway Seed and Calamus.

 
Scarlet Fever

 DEFINITION: An acute contagious disease characterized by sore throat, fever, punctiform scarlet rash, and rapid pulse.
SYMPTOMS: Incubation — Probably never less than twenty-four hours. May be from one to ten days, with average time of from two to four days.
Onset sudden, rarely with a chill, but sometimes with a convulsion in very young children. As a rule, begins with sore throat, temperature from 103 to 104, frequent vomiting, followed within twelve to thirty-six hours by a rash, first on neck and chest, rapidly extends over body, lastly, involving the extremities. Face flushed and may be characterized by the well-known pallor. The punctiform rash on the remainder of the body, seldom seen on face. With first eruption, throat is almost closed, tonsils are swollen, tongue heavily coated, and the papillae are enlarged, projecting through it. The tongue is properly described as a “strawberry” tongue. In mild or average case duration of rash is from two to three days. By the end of third day, the coating has disappeared from tongue, though the papillae are still enlarged, the remainder of tongue presenting a deep red appearance. In this stage, the tongue may be referred to as the “raspberry” tongue. With disappearance of rash in an uncomplicated case, the temperature closely approaches normal and recovery is uneventful. Extremely mild cases occur in which the rash is very faint and of very short duration, possibly not exceeding twenty-four hours. Scarlet fever may actually occur without any rash whatsoever. In any form of scarlet fever a leukocytosis is to be expected in the average case. This may range from 14,000 to 16,000.
ETIOLOGY: The inciting agent of scarlet fever is a specific strain of streptococcus — Streptococcus scarlatinae. Infection usually occurs by direct contact, but may occur through the medium of clothing, books, toys, etc., a third party, or milk that has become infected by handling. The chief source of the virus is the nasopharyngeal secretion. Contagiousness is most active during the eruptive period of the disease, but it may last as long as otitis media or other open lesions persist.
COMPLICATIONS: The most common complications are suppuration of the cervical lymph-nodes, suppurative otitis media, inflammation of the accessory nasal sinuses, and arthritis endocarditis, and pericarditis are less frequently nephritis. Retropharyngeal abscess, bronchopneumonia, observed. Nephritis occurs in about 10 per cent of the cases and usually develops in the second or third week of the disease.
TREATMENT: This is a quarantinable disease, in nearly all, if not all of the states. And the physician better obey the law, and make report as soon as possible. However, if in any state that permits treatment of this disease by the drugless physician, the following regime may be carried out.
First, the patient should be isolated for six weeks, longer if there is discharge from nose or ears. Every prophylactic measure should be taken for his own and the protection of others. The urine should be taken every other day, to watch that nephritis does not develop. It should be examined weekly for two months after recovery. Massage of the body with some ointment should be done daily to allay itching. Irrigations of the throat with a mild salt solution or with 120 V. M. Plenty of water, or diluted fruit juices to drink should be given. The diet if any, should be of milk, ice cream, junket, kumiss, milk soaked toasted bread, or gruels. The bowels need to be kept open and enemas may be needed. Adenitis is best treated by a cold pack around the throat. But if suppuration is close to the breaking point, hot packs.
Endo-Nasal Therapy and Aural instruments should always be on hand to look in the nose, ears and down the throat. If there is any soreness in the ears, dry heat is always available. Bulging of the drum in this disease with great pain calls for paracentesis or incision. Cardiac symptoms must be carefully watched, if too fast, a concussion of the 7th cervical or an ice bag over the heart, if too slow, a warm or hot bag over the heart.
If nephritis develops, cups should be applied over the kidney and renal setments at once, or very hot packs, but at the same time holding the fever in check by cold compresses on the neck. Short wave, to the throat and sinus, and ultra-violet radiations to nose and mouth are all helpful.
During the period of desquamation, some oil, cocoa butter or the lotion of Kabnick can be applied to the skin to relieve the itching. For some time after all symptoms have passed, the physician should supervise the activity and diet of the patient.
HERBOLOGY: The following herbs mixed, made into a tea with one dessertspoonful every four hours is helpful.
Jam. Sarsae (Jamaica Sarsaparilla) 1 oz.
Geum urbanum (Common Avens) ½ oz.
Achillae millefolium (Common Yarrow) ½ oz.
Calendulae off. (Garden Marigold) 1 teaspoonful
Humulus lupulus (Hops) 1 teaspoonful
Menth. virid. (Spearmint) 1 teaspoonful
One teaspoonful of the mixed herbs in a cup of boiling water, let cool, strain. Add hot water to fill up cup. Of course, as in making all herb teas, always put a cover on the cup while strength is being drawn from herbs.

 
Torticolis - Wryneck

 DEFINITION: Torticolis is the name applied to an abnormal position of the head due to tonic contraction of the sterno-cleido-mastoid muscle, and sometimes of the upper part of the trapezious muscle. There is also a type known as spasmodic or clonus type of Torticolis.
ETIOLOGY: Torticolis is congenital or acquired. Torticolis usually occurs in childhood and is sometimes congenital. In the congenital form it has been ascribed to intrauterine disease or injury, such as pressure, but it is undoubtedly, sometimes the result of injury to the muscle of the neck, particularly the sterno-mastoid at the time of birth.
In acquired torticolis cold or rheumatism acts at times as a cause; also affections of the throat, inflammation of the glands, and constrictions from burns. Paralysis of the muscles of one side and even bad eyesight, as extreme myopia causing monocular vision, may result in holding the head in a more or less permanently incorrect position.
Subluxations, perversions and lesions in the segments of the spinal column are the primary factors.
In the form known as spasmodic torticolis, spasms twist the head to one side in jerking movements that are distressing. The cause of this form lies in a considerable proportion of cases in some disease of the central nervous system. The sternomastoid muscle is not apt to be the only muscle involved, the trapezius, splenius, and others being also affected at times.
TREATMENT: The physician should not overestimate, neither should he underestimate the seriousness of this condition. The writer had a case of a young woman who had repeated attacks. Her work as an accountant required the turning of the head constantly to the left toward an accounting machine, and the jerking went on as a habit. Only by getting another position and many days of controlling the muscles was she able to free herself from the habit.
In another case that was stubborn a final diagnosis was of lethargic encephalitis. There is no doubt that some cases of torticolis are due to organic diseases, and a number due to neurasthenia, worry and overwork. A thorough examination is required of these cases just as in any other abnormal condition.
While giving the relief treatments which may be curative in themselves, the cause can be sought after. The question in the mind of the physician can be: Is it congenital? If acquired, is it occupational, or a result, of organic disease, or due to hysteria. For the last condition only psychiatry with manipulative treatments can help. For the occupational type, a change of methods of working or occupation and treatments can help. Each organic condition found need be treated as well as the torticolis.
NEUROPATHY: Thorough lymphatic of the abdomen and especially of the axillary and neck region. Sedation of the spinal segments of the muscles involved, after which the Lake Recoil may be lightly performed.
CHIROPRACTIC: Adjustment of the cervicals, and elsewhere as indicated.
HYDROTHERAPY: Hot moist packs or poulticing are serviceable.
ELECTROTHERAPY: Diathermy, short wave or sine wave are all of service. The infra-red is excellent for pain, followed by the ultra-violet irradiations for circulation.
VACUUM THERAPY: Cupping the dorsal region and over the trapezius muscle, also lightly on the sterno-cleido-mastoid muscle is excellent for pain and good circulation. An adhesive strapping over the shoulder gives the patient a sense of relief.
HERBOLOGY: “Geranium” linament, medium or triple strength is highly recommended for external application and can be secured from Botanic Gardens where fresh herbs are used in its manufacture.
Another good remedy is to take four ounces of Comfrey to a quart and a half of water, boil down to a quart, and bathe the neck.
Prepared salves of Camphor, Menthol, Oil Eucalyptus, Oil Peppermint, Oil Citronella as their main ingredients can be secured from Herbal Companies.

Tuberculoses

TUBERCULOSIS — PULMONARY

 DEFINITION: A specific inflammatory disease of the lungs, caused by the tubercle bacillus, characterized anatomically by a cellular infiltration, which subsequently caseates, softens and leads to ulceration of lung tissues. Manifested clinically by wasting, exhaustion, fever and cough.
ETIOLOGY: The disease most commonly develops between the ages of fifteen and forty. Although tuberculosis is very rarely transmitted from parent to offspring, an inherited susceptibility to the disease seems to exist in some families. Overcrowding, lack of sunlight, and poor food; occupations that necessitate the breathing of impure air and irritating dusts, especially flint and silicious dusts; and certain other diseases, such as catarrh of the respiratory tract, whooping-cough, measles, diabetes, and cirrhosis of the liver, favor infection.
Infection may take place by the inhalation of air laden with moist particles of infected sputum, expelled in coughing and sneezing or with the dust of dried tuberculous sputum, by the ingestion of food contaminated directly or indirectly with infected sputum, as the milk, or rarely the meat, of tuberculous cattle, or of bacilli-infected material that has been conveyed to the mouth by the fingers, drinking-cups, toys, etc., or by the direct inoculation of wounds (rare).
The bacilli may reach the lungs directly through the air passages, or they may be brought to these organs from the intestines, tonsil, or some other portal of entry by the lymphatics or blood-vessels.
SYMPTOMS: Acute phthisis resembles pneumonia and is marked by chill, high fever, rapid pulse, dypsnea, sputum at first rusty, then purulent, flushed face, profuse sweats, and the signs of consolidation. Instead of ending ninth day by crisis, as in ordinary pneumonia, the symptoms grow rapidly worse, signs of softening appear, the sputum shows bacilli and elastic fibers, and death results in a few weeks to months.
Chronic Fibroid Tuberculosis is a disease of long duration. Gradual loss of strength and abundant muco-purulent expectoration, which is at times fetid from being retained in dilated bronchi. Dypsnea, sweating and fever are slight. There is marked retraction on affected side from shrinking of the fibrous tissue; with this exception, physical signs are similar to those of
Ulcerative Pneumonia.
Chronic Ulcerative tuberuclosis symptoms are usually insidious and marked at the outset, by pallor, gastric disturbance, loss of flesh and strength, by a dry hacking cough, especially noted in the morning. From some undue exposure the cough is aggravated. In some cases symptoms appear abruptly with hemorrhage or an acute pleurisy. Slight fever and acceleration of pulse are early symptoms of great diagnostic import. Temperature marked by evening exacerbation, during which face is flushed, eyes bright, mind animated. Later, cough becomes troublesome, expectoration more abundant. In well developed cases expectoration is greenish in color, is in coin-shaped plugs, is heavy and sinks in water, is often blood streaked and contains bacilli and fibers of elastic tissue. Phthisis in itself is not a painful disease, but the associated dry pleurisy causes much suffering. Hemoptysis occurs at all stages but profuse hemorrhages occur late. Blood is bright red, frothy and mixed with mucus. Profuse sweating troublesome in advanced cases. Final state characterized by extreme emaciation, weakness, pallor, high remittent or intermittent fever and edema of feet.
COMPLICATION: The chief complications of pulmonary tuberculosis are hemoptysis, bronchopneumonia, pleurisy, pneumothorax, gastro-intestinal catarrh, rectal fistula, amyloid degeneration of the viscera tuberculosis of other structures, such as mentioned under general miliary tuberculosis.

TUBERCULOSIS — ACUTE, MILIARY, GENERAL

 DEFINITION: An acute infectious disease excited by the tubercle bacillus, and characterized and anatomically by the presence of miliary tubercles in many parts of the body.
We have discussed pulmonary tuberculosis. The miliary is of other parts of the body; it is the spreading of the tubercles not only throughout the tissues of the lungs, but to any tissues or bones in the body.
SYMPTOMS: A loss of flesh and strength; fever, 102 to 104 degrees irregular, marked by evening exacerbations and morning remissions, cough; hurried respirations; a brown fissured tongue; weak, rapid pulse; enlargement of spleen; delirium; stupor. Tubercle bacilli rarely found in expectoration or in the blood. Duration from two to four weeks. When lungs are chiefly affected, there are dypsnea, marked cough, mucopurulent and bloody expectorations, cyanosis, sibilant and subcrepitant rales and perhaps areas over which bronchial breathing is heard. When meninges are chiefly affected there are intense headache convulsive seizures, photophobia, delirium, facial palsies, stupor, coma, and Cheyne-Stokes breathing. Tubercles may be detected on the retina. When intestines and peritoneum are affected there are pain, tenderness, abdominal distension and diarrhea.
Tuberculosis of bones and joints is essentially a disease of childhood. More than seven-eighths of all patients with this condition start before the age of 14 and nearly one-half occur between 3 and 5. The infection is rare before the age of 2 years.
Tuberculosis involvement of bones and joints is usually secondary to a primary focus elsewhere which is probably in the lungs or along the alimentary tract. The tubercle bacillus enters the blood stream and is carried to the bone