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be very light, if any, for a day or so.

RUPTURE (Hernia).—Hernia means a protrusion of an organ from its natural cavity, through normal or artificial openings in the surrounding structures. But by the term hernia, used alone, we mean the protrusion of a portion of the abdominal contents through the walls, and that is known by the popular term of "rupture."

[DIGESTIVE ORGANS 123]

The most common forms of rupture protrude through one of the natural openings or weak spots in the abdominal walls, as for instance, the inguinal (groin) and femoral canals. The femoral canal is located at the upper and inner part of the thigh, and this place is a seat of rupture, especially in women. Rupture may also occur at the navel, when it is called umbilical hernia or rupture. The contents of a hernia are bowel and omentum (a covering of the bowel) separately or together. The bowel involved in a rupture is usually the lower portion of the small bowel, but the large bowel is sometimes affected. A sac covers the bowel or omentum in a rupture. This sac consists of the protruded portion of peritoneum, which has been gradually pushed through one of the canals (inguinal or femoral) or of the process of peritoneum, which has been carried down by the testicle in its descent, and the connection of which with the peritoneum of the abdomen still continues, not having been obliterated, as it usually is before birth. The former is called an acquired rupture sac; the latter is a congenital rupture sac, and it is found only in groin (inguinal rupture).

Causes.—Rupture is more common in men than in women. It may occur at any time of life. The majority of cases occur before middle age, and the largest number during the first ten years of life, owing to the want of closure of the peritoneum which is carried down by the testicles before birth. Rupture is most frequently strangulated between the ages of forty and fifty.

Location.—The great majority of cases of rupture are groin or inguinal rupture.

Symptoms.—A fullness or a swelling is first noticed in the groin, which is made worse in standing, coughing and lifting. This disappears on lying down and reappears on rising in many cases, even at first; coughing makes the lump or swelling harder. It may come on both sides, when it is called double rupture or hernia.

MOTHERS' REMEDIES.—Rupture, Poultice for.—"Take equal parts of lobelia and stramonium leaves; make a poultice and apply to the parts. Renew as often as necessary. This combination makes a very effective poultice and is sure to give relief."

PHYSICIANS' TREATMENT.—A person should wear a truss (support) that fits perfectly, and this should not cause any pain or discomfort. The truss should be worn all day, taken off at night after going to bed and put on before rising, when still lying down. If it is put on after rising a little of the gut may be in the canal and pressed down by the support. There are many kinds of supports.

Operations now performed for rupture are very successful if the patient takes good care for months afterwards until the parts are thoroughly healed. The operation simply closes a too large opening. The testicles descending through the groin canal from the abdominal cavity before birth and in congenital rupture, left too big an opening. In acquired rupture, these natural openings were enlarged by lifting, falls, etc. The round ligament of the womb goes down through this canal and sometimes there is too large an opening left or acquired by accident.

Irreducible Rupture.—This is when the rupture cannot be returned into the abdominal cavity, and it is without any symptoms of strangulation. They are of long standing and of a large size. This condition is often due to carelessness of a patient in not keeping in a reducible rupture with a proper support. Adhesions form, holding the rupture. Even if it is small, it gives rise to much discomfort and the patient is always in danger of strangulation of the rupture.

Operation for radical cure is generally a success.

[124 MOTHERS' REMEDIES]

Strangulation Hernia or Rupture.—This means the rupture is so tightly constricted that it cannot be returned into the abdominal cavity, and its circulation is interfered with; then there is not only obstruction to the passage of the feces, but also an arrest of circulation in the protruded portion of bowel which, if not relieved, results in gangrene and death. This occurs more often in old than in recent ruptures and more often in congenital than in acquired rupture.

Symptoms.—Sudden and complete constipation with persistent vomiting. The lump may be tense, hard and irreducible. Then there is faintness, collapse; severe abdominal pain, complete constipation, with no gas passing, then vomiting, at first of food, then of the bile-stained fluid and finally of fluid with a bowel odor. All these symptoms increase and the patient gradually sinks from exhaustion in eight or nine days, though in very acute cases the patient may die within forty-eight hours.

MOTHERS' REMEDIES.—Strangulated Hernia, Hop Poultice for.—"A large warm poultice of hops over the abdomen will be found one of the best known means of relieving strangulated hernia."

PHYSICIANS' TREATMENT.—It must be reduced or an operation must be performed and soon.

To reduce.—The patient is put under an anesthetic and placed on his back with the hips (pelvis) raised and the thigh of the affected side flexed, bent up and rotated inward if the rupture be inguinal or femoral. This motion relaxes the parts. The neck of the sac is then seized with the thumb and fingers of one hand, and thus fixed, while with the other hand, the operator endeavors to return the strangulated gut by gentle pressure in the proper direction. In femoral rupture, this is at first downward, to bring the gut opposite the opening then backward and then upward. In groin (inguinal) rupture it is usually slightly upward and outward. It must be coaxed, kneaded and squeezed carefully. Care must be taken. If it cannot be returned in from five to ten minutes no further time should be wasted, but an operation should be performed immediately. This consists in cutting down to the constriction and through it, thus allowing the rupture to be reduced.

The patient should be kept in bed and treated the same way as for other abdominal operations.

Caution.—Persons with rupture must be very careful not to lift or fall.
If a support is worn it must fit perfectly and be worn with comfort.

[DIGESTIVE ORGANS 125]

INTESTINAL COLIC. (Enteralgia).—Causes.—Predisposing; poor general condition, worry, over-work, nervous disposition. Exciting causes; exposure, gas in the bowels, mass of feces, undigested or irritating food, cold drinks, green fruit, ice cream when a person is very warm.

Symptoms.—Intermittent pain usually in the umbilical (navel) region, moving from place to place, dull or sharp pain, relieved by pressure or bending forward. Abdomen is distended or drawn back. It lasts a few minutes or many hours, ending gradually or suddenly, after a passage of gas or movement of the bowels.

PHYSICIANS' TREATMENT.—1. Remove cause first if possible. Mild cases; put heat to the abdomen by hot water bag, wring cloths out of hot water and put in them ten drops of turpentine and place over the bowels hot. Give dose of peppermint water or ginger tea.

2. Severe case.—Morphine hypodermically, if necessary, in a severe case; mustard poultice is good, also a spice poultice.

3. Tincture of Colocynth (bitter cucumber) is an excellent remedy for this trouble. I have often used it with great success. Put five drops of it in a glass half full of water and give two teaspoonfuls every fifteen minutes until relieved. A few doses generally relieve the patient.

THE LIVER.—The liver is the largest gland in the body, and is situated in the upper and right part of the abdominal cavity. The lower border of the liver corresponds to the lower border of the ribs in front and to the right side. It weighs fifty to sixty ounces in the male; in the female, forty to fifty ounces. It is about eight to nine inches in its transverse measurement; vertically near its right surface it is six to seven inches, while it is four to five inches thick at its thickest part. Opposite the backbone from behind forward it measures about three inches. The left lobe, the smallest and thinnest, extends to the left, over what is called the pit of the stomach.

BILIOUSNESS.—This condition presents different symptoms in different cases, but it always includes languor, headache or dizziness, perhaps some yellow color of the skin and conjunctiva, and a general sense of want of tone, depression of spirits and discomfort.

Causes.—The liver does not perform its function well, or there is a retention of bile in the bile ducts. Most of the symptoms do not depend directly upon the changes in the bile, but upon failure of proper digestion in the stomach and intestines. Certain poorly prepared foods or improper food for stomach digestion, quickly cause the development of active fermentation and its results irritate the stomach mucous membrane bringing about a faulty stomach secretion of mucus, which causes further trouble. It may end in a sick headache.

TREATMENT. Prevention.—Normal, easily digested food, open bowels. Active exercise, horseback riding, massage of the liver region. Stooping over and bending from side to side and bending back with feet close together are good aids.

[126 MOTHERS' REMEDIES]

Diet.—Do not over-eat. Avoid alcohol in any form. Stimulating foods such as spices, mustard salads, concentrated meat extracts and meat broths, pepper, horseradish are not to be used. Do not use too much salt; strong coffee and tea are harmful. In severe cases milk either diluted with water or lime water or peptonized should alone be used.

Gruels, albumen water, kumiss, buttermilk and oyster broth may be allowed. Orange juice as well as lemonade may generally be given. Fasting is good in biliousness. No one will starve in a few days of fasting.

MOTHERS' REMEDIES.—1. Biliousness, Lemons for.—"One lemon squeezed in a glass of water with a very little sugar, repeat for several days." Lemon is a very good medicine, and it is surprising to know how few people realize what medical properties the lemon contains. This is a good, simple, but very effective remedy.

2. Biliousness, Salt and Water for.—"Take a teaspoonful of salt to a cup of water and drink before breakfast for a few mornings." It is a well-known fact that a little salt in warm water before breakfast is laxative and also cleanses the system and bowels on account of its purifying action.

3. Biliousness, (chronic) Dandelion Tea for.—"Dandelion root is highly recommended for this." The root should be collected in July, August or September. Dose:—A strong tea may be taken freely two or three times a day, or the fluid extract may be purchased at any drug store.

4. Biliousness, a cheap and very safe plan.—"Drink plenty of cold water and exercise freely in the open air." Following the above advice is often better than medicines and spring tonics, also unless doing hard physical labor, cut down on the meat eating. In fact, eat less generally for a time.

5. Biliousness, Salt Lemonade for.—"Hot salt lemonade night and morning. Juice of one lemon and teaspoonful salt to as much hot water as you can drink."

6. Biliousness, Boneset Tea for.—"Pour hot water on boneset and let stand until it is cold. Take a swallow occasionally." This is very good.

PHYSICIANS' TREATMENT. Medicines.—1. Nitro-hydrochloric acid three drops three times a day in half a tumblerful of water is valuable.

2. Twenty drops of fluid extract of Queen's root three times a day.

[DIGESTIVE ORGANS 127]

3. The following combination forms a good pill to be taken every night:

    Extract of Chirata 40 grains
    Podophyllin 4 grains
    Wahoo 8 grains
    Culver's root 8 grains
    Creosote 10 grains

Mix and make into twenty pills. Take one every night.

4. For the Attack.—Take calomel one-sixth grain tablets; one every fifteen minutes until six are taken, and then follow with two to four teaspoonfuls of epsom salts.

JAUNDICE (Icterus).—A symptom consisting in discoloration by bile pigment of the skin, whites of the eyes, other mucous membranes and secretions.

Causes.—Obstruction of the gall ducts, from gall stones, inflammation, tumor, strictures, from pressure by tumors, and other enlarged abdominal organs.

Symptoms.—The skin and the conjunctiva (red membrane of the eyes) are colored from a pale

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