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Title: Remarks on the Uses of some of the Bazaar Medicines and Common Medical Plants of India

Author: Edward John Waring

Release date: December 23, 2018 [eBook #58525]

Language: English

Credits: Produced by Deaurider, Chris Pinfield and the Online
        Distributed Proofreading Team at http://www.pgdp.net (This
        file was produced from images generously made available
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Transcriber's note:

Apparent typographical errors have been corrected. Variations in the use
of hyphens and of accents have been retained.

The symbol for "minim" (an obselete measure of capacity) is used once.
It may not display properly in all applications

Italics are indicated by _underscores_ and bold font by
+plus signs+. Small capitals have been replaced by full capitals.




 REMARKS ON THE USES
 OF SOME OF THE
 BAZAAR MEDICINES
 AND
 COMMON MEDICAL PLANTS OF INDIA

 WITH A FULL INDEX OF DISEASES, INDICATING THEIR
 TREATMENT BY THESE AND OTHER AGENTS
 PROCURABLE THROUGHOUT INDIA

 TO WHICH ARE ADDED

 DIRECTIONS FOR TREATMENT IN CASES OF
 DROWNING, SNAKE-BITES, &c.

BY

EDWARD JOHN WARING, C.I.E., M.D.

 FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS OF LONDON
 SURGEON-MAJOR (RETIRED) HER MAJESTY'S INDIAN ARMY
 EDITOR OF THE PHARMACOPŒIA OF INDIA, ETC.

_FIFTH EDITION_

 LONDON
 J. & A. CHURCHILL
 7 GREAT MARLBOROUGH STREET
 1897




PREFACE TO THE FIFTH EDITION.


Owing to the favour in which this work is still being held by the public
in India, as proved by the entire sale of the Fourth Edition, I have
taken upon myself to issue this, the FIFTH EDITION, with the generous
assistance of my late father's friend, J. E. T. Aitchison, M.D., C.I.E.,
to whom I owe a great debt of gratitude for the time and trouble and
valuable special knowledge he has so liberally bestowed on the work.

The only important changes that occur in this Edition are the
introduction of a couple of diagrams of a clinical thermometer, with a
few notes to guide the non-professional in its use; some alterations in
the text, where subjects that had been issued in the Fourth Edition as
notes to the text are now incorporated in the text itself; and lastly,
Dr. Aitchison has more fully entered upon his treatment of small-pox
with carbolised oil.

 C. WARING.




PREFACE TO THE FOURTH EDITION.


That this little work should have reached a FOURTH EDITION may be taken
as pretty clear indication that it has met a recognised want amongst our
Indian fellow-subjects, for whose instruction and guidance it was
originally issued. To render it worthy of continued favour, and to make
it additionally useful, has been my anxious endeavour.

Of any merit which this edition may be found to possess over the
preceding one, a very large portion is due to Dr. J. E. T. Aitchison,
C.I.E., Surgeon-Major in H.M. Indian (Bengal) Medical Service, who, with
a liberality that demands my warmest thanks, placed at my disposal an
elaborate MS. commentary on the Third Edition, embodying his own
professional experience in India (extending over many years), and
supplying the vernacular names of the various drugs in the Punjábí,
Kashmírí, and Leh languages. Of this document it need hardly be said I
have availed myself largely, my only regret being that I could not
insert it _in extenso_, but to have done this would greatly have
exceeded the prescribed limits of the work. As it is, Dr. Aitchison has
laid me under a vast obligation, which I am only too happy to have this
opportunity of acknowledging.

Five new articles have been added to the List of Drugs: two at the
suggestion of Dr. Aitchison; namely, (1) Sugar, and (2) Kerosene Oil,
which latter, owing to its extensive use for lighting purposes during
the past few years, is now obtainable in nearly every bazaar in the
country; the other three being the (3) Cinchona Febrifuge (Quinetum),
(4) Petroleum, and (5) Rock Salt. The various ways in which these
articles may be utilised in the treatment of disease will be found under
their respective headings in the "Addenda," p. 171, _et seq._

In addition to these there have been introduced notices of Indian Hemp
(Gunjah) smoking in the treatment of Tetanus, of the antiscorbutic
properties of Ámchur (dried Mangoes), the lactifuge powers of Sambac
flowers (_Jasminum Sambac_), the emmenagogue virtues of Til or Jinjili
Seeds (_Sesamum Indicum_), and other points unnoticed in previous
editions. The therapeutic applications of Water are enlarged upon; as
also are those of Carbolic Acid, especially in the treatment of Leprosy.
The Sick Dietary has likewise been extended. Amongst the new matter has
been introduced a section (pp. 268-272) detailing the "Precautions to be
taken by persons residing in snake-infested localities."

By these and other additions (occupying upwards of thirty pages of new
matter), and by the revision and modification of other passages, it is
confidently hoped that the practical value of the work will be found to
be materially increased. Indeed, it has been my earnest endeavour
throughout to render this little volume as useful as possible, and if
through its instrumentality suffering humanity be in any degree
benefited my highest aspiration will be attained.

 E. J. WARING.




PREFACE TO THE SECOND EDITION.


Fourteen years have elapsed since this work, in an elementary form, was
first issued for the use of the District Vaccinators of Travancore,
whose sphere of action was far removed from regular medical aid. It was
originally published in English and Tamil on opposite pages;
subsequently it was reprinted in Tamil alone by the London Missionary
Society's Press at Nagercoil, for the use of the catechists and others
connected with that Mission. In 1868, a Malyalim translation, by Dresser
Ramswammy Rajoo, was issued by the Travancore Government. From reports
received from various quarters, there is reason to believe that the work
has enjoyed a wide circulation amongst the people of Travancore and
Tinnevelly, and that it has exercised a considerable influence on the
practice of the native doctors of those districts.

Were I wise, I ought, perhaps, to rest satisfied with these results,
which far exceed what were originally contemplated; but recent
observation has convinced me that there are other classes scattered
through our great Indian possessions to whom a work of the kind would
prove most acceptable, by pointing out to them the agents—either
purchasable in the bazaars at an almost nominal price, or procurable at
the cost of collection, from the road-sides, waste places, or gardens in
the immediate neighbourhood of almost every out-station—by means of
which, with the exercise of ordinary intelligence, they may often be
enabled to relieve the sufferings of those amongst whom their lot has
been cast.

And at the head of these classes stand the Missionaries, whose stations,
for the most part, are too far removed from the busy haunts of men to
allow of their calling in regular medical aid in cases of sickness, and
who are consequently thrown, at such times, very much on their own
resources. Many of the missionaries have under their charge large
establishments of catechists, pupils, &c.; and it cannot be otherwise
than highly desirable that they should be put in possession of any
information regarding the available means of relieving the sufferings,
and treating the diseases, of those placed under their care. This is not
the place to enter into a disquisition on missionary work, but I cannot
refrain from expressing my firm conviction that the more the principle
of Medical Missions—making Religion and Medicine go hand in hand—is
carried out, the greater, humanly speaking, will be the success of
missionary efforts. How many a door for the admission of Gospel truth,
which would otherwise be shut, would be opened, and that readily, to one
who, with "the glad tidings of great joy" in the one hand, would bring
in the other the means of relieving physical suffering and curing bodily
disease! The highest distinction that I would claim for this little work
is, that it may constitute, as far as India is concerned, a
Missionaries' Medical Vade Mecum.

Next on the _rôle_ comes a large army of European and Anglo-Indian
officials, whether within the magic circle of "the Service" or beyond
its pale, who are attached to the Public Works, Forests, Railway,
Telegraph, or other Departments, or employed in Tea, Coffee, or Cotton
plantations, in commercial pursuits, &c., many of them married men, with
families and a large number of dependants, the majority at distant
"up-country stations," miles away from medical aid; how important for
persons under such circumstances to possess a knowledge of the means
lying (literally so in many instances) at their very feet, by which pain
and suffering may be alleviated, and, perhaps, a valuable life saved.

Lastly, but by no means least, either in point of numbers or importance,
comes the daily increasing array of educated Natives, who, as a class,
readily avail themselves of every scrap of knowledge drawn from
trustworthy European sources, which tends to throw light on the products
and resources of their native land. Whilst, on the one hand, I am
perfectly prepared to admit that much of the knowledge I possess of the
properties and uses of Indian drugs has been derived from Native
sources, I think I may, on the other hand, without presumption, claim
the credit of repaying the debt with interest, furnishing in return a
considerable amount of information on the uses of even the same drugs,
of which the Natives themselves had previously no idea. It is to this
class that I venture to think this little work will prove most useful
and acceptable.

In addition to the above, I venture to hope that to even duly qualified
Medical Officers, especially at up-country stations, a work like the
present may prove serviceable on emergencies, _e.g._, a failure of the
supply of European drugs, &c., by showing them what resources they have
at command in the bazaars or in their immediate neighbourhood, by means
of which many a gap may be stopped till more efficient remedies are
available.

In undertaking a Second Edition of this work, I have been further
influenced by a desire to render its scope and contents more complete.
With more extended knowledge on my part, drawn partly from subsequent
personal experience in the use of Indian drugs, and partly from the
Reports received from Medical Officers during the preparation of the
Pharmacopœia of India, I realised how imperfect the original work was;
and feeling myself in a position to add much information which would
tend to increase its usefulness, I determined upon issuing another
edition. The whole work has accordingly been rewritten and greatly
enlarged.

It was evidently quite out of the question, in a small work like the
present, to include the host of medicines included under the general
headings of "Bazaar Medicines" and "Common Medical Plants of India," but
from them I have made a selection of about 80, comprising—1 Antacid, 8
Astringents, 3 Antispasmodics, 2 Antiscorbutics, 6 Antiperiodics, 5
Demulcents and Emollients, 4 Diaphoretics or Sudorifics, 4 Diuretics, 3
Expectorants, 2 Emmenagogues, 4 Emetics, 6 Purgatives, 3 Narcotics or
Sedatives, 5 Refrigerants, 9 Stomachics or Carminatives, 7 Bitter
Tonics, 5 Alterative Tonics or Alteratives, 2 Metallic Tonics, 7 Local
and 4 General Stimulants, 2 Vesicants, or Blistering Agents, 6
Vermifuges, and 17 Miscellaneous Articles, not included in the above
classes.

In making this selection I have been guided by the following
principles:—1. By the safety of the drug; hence Arsenic, Aconite Root
(Bish), Nux Vomica, Indian Hemp, and some other powerful medicines have
been omitted, as it was felt to be inadvisable, in a work like the
present, to introduce agents which, in the hands of unprofessional
persons, might do more harm than good if employed in unsuitable cases.
Where, however, a powerful drug, _e.g._, Opium, has been admitted,
minute directions as to its employment have been given. 2. By the
acknowledged utility or efficacy of the drug as proved by European
experience. 3. By the drug possessing a generally well-known, recognised
native name. 4. By its wide distribution and easy procurability in all
parts, and in all the bazaars of India generally. It is hoped that by
the addition of the native names and descriptions of the drugs (which
were omitted in the First Edition), even a new-comer will have little
difficulty in obtaining and recognising any particular article he may
require.

With this native "Apparatus Medicaminum" very much may be accomplished
under ordinary circumstances, in the way of relieving suffering and
curing disease; but it must be admitted that there are certain articles
included under the class "European Medicines" for which the Indian
bazaars supply no adequate substitutes. I have therefore (in Appendix E)
added a list of nine drugs which it appears desirable should be kept in
store. They are—1. Sulphate of Quinine; 2. Ipecacuanha; 3. Smyrna or
Turkey Opium; 4. Calomel; 5. Acetate of Lead; 6. Santonin; 7. Liquor
Ammoniæ; 8. Blistering Fluid; and 9. Carbolic Acid.[1] No attempt has
been made in the body of the work to enter into a description of the
properties and uses of these drugs generally (with the exception of
Opium), but in the Synopsis or Index of Diseases (Part II.) it has been
pointed out how these valuable agents may be utilised in the most
efficient manner. It is believed that, by adopting this course, the
practical utility of the work will be greatly enhanced.

Attention is particularly directed to the Synopsis or Index of Diseases
in Part II.; it is not pretended that the modes of treatment therein
detailed are the best which could be adopted; the object has rather been
to show how much good may be effected by the simple means at command at
almost every "upcountry station" throughout India; and those who follow
the directions may feel assured, that with the exercise of ordinary
prudence, if they fail to do good they will at any rate do no harm.

 LONDON, 1874.

[Footnote 1] To these Bromide of Potassium and Biniodide of Mercury
have since been added.




INTRODUCTION.


This work, it is presumed, will fall into the hands of many who are
wholly ignorant of, or very partially acquainted with, matters
pharmaceutical; hence some few introductory remarks are indispensable to
enable such persons to understand fully, and follow out correctly, the
directions given.

1. _Weights and Measures._—In Appendix C, a small set of Apothecaries'
scales and weights is included, but in the absence of the former it is
well to remember that a small set of scales, such as is used by native
jewellers, can be procured for a few annas in every bazaar; care,
however, is necessary to see that the balance is strictly correct and
even.

_Weights._—The Apothecary weights supplied from England have the
following marks or signs impressed upon them:

 ℈fs  = half a scruple        =  10 grains.
 ℈j   = one scruple           =  20  "
 Ʒfs  = half a drachm         =  30  "
 Ʒj   = one drachm            =  60  "
 Ʒjfs = one drachm and a half =  90  "
 Ʒij  = two drachms           = 120  "

The small circular indentations on the grain weights indicate the number
of grains each weight represents.

In the absence of these, the following hints may be useful:

A new rupee of the present currency weighs 180 grains or three drachms.

A half rupee of the present currency weighs 90 grains or a drachm and a
half.

A quarter rupee of the present currency weighs 45 grains or three
quarters of a drachm.

To obtain smaller weights beat a new quarter rupee into a long, thin,
narrow plate, and divide it carefully into three equal parts. You have
thus three 15 grain weights. One of these divided again into three equal
parts, furnishes three 5 grain weights. One of these subdivided into
five equal parts furnishes five 1 grain weights. Care should be taken to
see that the parts are of equal weight, and each part should be marked
with a figure to denote its weight. A native jeweller, at a very small
cost, will readily carry out the above subdivision.

With these, you may obtain any small weights you require; thus, if you
require nine grains, you use a 5 grain weight and four single grain
weights. If you want a drachm weight (60 grains), you use a quarter
rupee (45 grains) and a 15 grain weight, which makes exactly the 60
grains or one drachm. To get a scruple (20 grains) weight, you use one
of the 15 grain and one of the 5 grain weights = 20 grains or one
scruple.

Two rupees and a half rupee together weigh 450 grains or slightly over
one ounce, which weight they may be taken to represent, in the absence
of regular weights in making up any of the prescriptions given in the
following pages.

_Measures of Capacity._—For these, the English Graduated Measures,
glasses included, in Appendix C, should be employed. The marks on them
signify as follows:

 ♏                    =  1 minim.
 fƷj one fluid-drachm = 60 minims.
 f℥j one fluid-ounce  =  8 fluid-drachms.
 O   one pint         = 20 fluid-ounces.

In default of a graduated measure glass, it may be useful to know that a
small cup of silver or other metal, exactly the circumference of a
quarter rupee and 3¾ inches deep, will hold exactly one ounce, and
twenty of these full of liquid make one pint. Each ounce contains eight
fluid-drachms, so with the aid of this ounce measure you can calculate
the quantity required pretty accurately. The measure should be made of
silver, as some medicines, especially the acids, act on the other metals.

Any native jeweller would manufacture one of these measures in a short
time, and at a very small cost.

In the following pages other domestic measures, as they may be termed,
are mentioned; they represent approximately the following quantities:


 A wine-glassful (ordinary size) = one fluid-oz. and a half.
 Two table-spoonfuls             = one oz.
 One table-spoonful              = half oz.
 One dessert-spoonful            = two drachms.
 One tea-spoonful                = one drachm.

"A drop" may be taken generally to represent a minim, though in many
instances they differ considerably in capacity.

It must be borne in mind that these measurements apply solely to
fluids—never to solids. A tablespoonful of some solids, as powders,
would _weigh_ two or three ounces, whilst of others it might only be as
many drachms.

_Preparations._—A few hints on these may be useful to the uninitiated.
_Infusions._—In preparing these, the following points require attention:
_a_, the solid ingredients should be cut into small pieces or slices, or
bruised in a mortar, so that the water shall readily penetrate into the
substance; _b_, the water should be _boiling_; _c_, the vessel or
_chattie_ containing the ingredients on which the boiling water has been
poured, should be covered over to prevent evaporation, and set aside
till the liquid is cold, when it should be strained through a muslin or
thin rag. In hot climates infusions soon spoil, hence they should be
freshly prepared every other day at the furthest. _Decoctions._—These
differ from Infusions so far that the ingredients are subject to the
process of boiling. The requisite quantity of water having been heated
to boiling-point, the solid ingredients, prepared as for infusions, are
to be introduced, and the whole boiled in a covered vessel for the
specified period. The liquid whilst hot should be strained and set aside
in a covered vessel till cold. Like infusions, they rapidly become
spoiled in hot climates. _Tinctures._—These are formed by macerating the
solid ingredients, prepared as directed for Infusions, in a bottle with
the specified quantity of spirit, for seven days or more, occasionally
shaking the same to ensure the spirit acting thoroughly on the
ingredients. At the end of the specified period it should be strained,
and the clear liquid set aside in a cool place in well-stoppered
bottles, for use. Great care is necessary to prevent evaporation; hence
if a glass-stoppered bottle is used, softened wax should be carefully
placed round the stopper, which should be further secured by a cap of
thin leather or wax-cloth tied tightly over it. It is thought by many
that evaporation of spirit takes place less rapidly in a closely fitting
_corked_ bottle than in one provided with a glass stopper. Very
serviceable corks, especially for temporary use, may be made out of
Sola, the material used for hats, &c. In either case layers of wax and
the leather are advisable. Under the most favourable circumstances
evaporation to a greater or lesser extent will take place in hot
climates; hence by long keeping, the tincture acquires increased
strength, and in regulating the dose of the more active tinctures, as of
Opium or Datura, the fact ought to be borne in mind, or serious
consequences may ensue. _Powders._—When an article is ordered to be
taken in the form of powder, it should be pulverised as finely as
possible. There is little difficulty in this when a large quantity of
the article is required to be kept in store, as is generally advisable,
as the natives, by the aid of the simple machinery which they employ in
making "Curry powder," will reduce the hardest woody ingredients to the
requisite state of fineness. When only a few grains or a small quantity
is required, it may be obtained by means of a nutmeg-grater (included in
List in Appendix C), and subsequently triturating the rough powder thus
obtained in a mortar till it is reduced to the state of a fine powder.
In the preparation of a _Compound Powder_, _i.e._, a powder containing
two or more ingredients, it is of the greatest importance that they
should be uniformly and thoroughly incorporated, else it is evident that
a small portion of it, such as is usually prescribed as a dose, may
contain an excess of one ingredient—it may be an active or dangerous
one, and operate powerfully—whilst the next dose may be comparatively
inert. Powders, when prepared in large quantities, should be kept in
well-stoppered or corked bottles; if left in open vessels exposed to the
action of the air, they soon become deteriorated. _Pills._—For the
reasons just stated, it is necessary, when two or more ingredients enter
into the composition of a pill mass, to be careful that they are
thoroughly incorporated. When powders, &c., enter into their
composition, a little honey or _jaggery_ is the best thing to give them
cohesion and consistence. They should be moderately hard; if too soft,
they are apt to lose the globular form which they ought to possess, and
become a shapeless mass. When several pills are made, a little Arrowroot
or Rice Flour should be added to the box which contains them, to keep
them from adhering to one another. No pill should ordinarily exceed 5
grains in weight, otherwise there will be a difficulty in swallowing it;
two 3 grain pills are more easily taken than one of 6 grains. Pills,
when prepared in any quantity, should, like powders, be kept in
well-stoppered or corked bottles.

_Ointments._—Animal fats, _e.g._, Lard, which is so generally used in
English pharmacy, are apt to become rancid and irritating in hot
climates; hence they should be discarded in tropical practice. In India
there is another _cogent_ reason for _abandoning them_, viz., _the
religious prejudices of the natives_, especially of the Mussulman, to
whom hog's fat is _an abomination_. The only allowable animal fat in
India is freshly prepared Ghee, or clarified butter; but this in the
hotter part of India is of too thin consistence for ordinary ointments.
Fortunately India supplies at least two vegetable substitutes, Kokum
Butter and Piney Tallow (the expressed Oil of Vateria Indica). In
addition to these, I have introduced a third article, Ceromel (a mixture
of wax and honey). With these three agents it is believed that animal
fats may be altogether dispensed with in Indian pharmacy.

_Native Names._—These have been mainly derived from Mr. Moodeen
Sheriff's valuable Catalogue, which forms the Supplement to the
Pharmacopœia of India. Some have been drawn from Ainslie's _Materia
Indica_, a work of sterling merit. For the Malay names I am indebted to
the Hon. Major F. M‘Nair, C.M.G., Surveyor-General, Straits Settlements,
and for the Punjábí and Kashmirí names to Dr. J. E. T. Aitchison,
formerly British Commissioner, Ladakh.

It is only necessary, in this place, to indicate the pronunciation of
the vowels met with in this work.

 a (short) as in _a_bout, or the final _a_ in Calcutt_a_.
 á (long) as in _a_ll, c_a_ll.
 e (short) as in _e_lbow, or the first _e_ in n_e_ver.
 é (long) as _a_ in _a_ble or _ai_ in f_ai_r.
 i (short) as _i_ in _i_nk, b_i_d.
 í (long) as _ee_ in f_ee_d and fr_ee_.
 o (short) as in fr_o_m.
 ó (long) as in _o_pium, h_o_me.
 u (short) as in f_u_ll, or as in w_o_lf.
 ú (long) as in f_oo_l, t_oo_.

Explanation of the Abbreviations employed in the lists of the native
names of the drugs:

 _Hind._ Hindústaní.
 _Duk._ Dukhní.
 _Beng._ Bengálí.
 _Punj._ Punjábí.
 _Kash._ Kashmirí.
 _Tam._ Tamil.
 _Tel._ Telugu.
 _Mal._ Malyalim.
 _Can._ Canarese.
 _Mah._ Máhrattí.
 _Guz._ Guzrattí.
 _Cing._ Cingalese.
 _Burm._ Burmese.
 _Malay_ Malay.




 REMARKS ON THE USES
 OF SOME OF THE
 BAZAAR MEDICINES OF INDIA.




 PART I.

 ALPHABETICAL LIST OF THE BAZAAR MEDICINES AND
 INDIAN MEDICAL PLANTS INCLUDED IN THIS WORK.


1. +Abelmoschus, or Edible Hibiscus. Okra.+ The fresh unripe capsules or
fruit of Abelmoschus (Hibiscus) esculentus, _Linn._

 Bhindí, Rám-turáí (_Hind._), Bhéndí (_Duk._, _Punj._), Dhéras or
 Dhénras, Rám-Toráí (_Beng._), Vendaik-káy (_Tam._), Benda-káya
 (_Tel._), Ventak-káya (_Mal._), Bendé-káyi (_Can._), Bhéndá (_Mah._),
 Bhíndu (_Guz._), Banda-ká (_Cing._). Youn-padi-sí (_Burm._),
 Kachang-lindir (_Malay_).

2. This well-known vegetable, cultivated throughout India, abounds in a
copious, bland, viscid mucilage, which possesses valuable emollient and
demulcent properties, rendering the practitioner in India independent of
mallow and other European articles of that class. The dried fruit may be
employed where it is not procurable in a fresh state. It is best given
in decoction, prepared by boiling three ounces of the fresh capsules,
cut transversely, in a pint and a half of water for twenty minutes,
straining and sweetening to taste. This, taken as an ordinary drink,
proves alike agreeable and serviceable in _Fevers_, _Catarrhal attacks_,
_Irritable states of the Bladder and Kidneys_, in _Gonorrhœa_, and in
_all cases attended with scalding pain_, _and difficulty in passing
Urine_. Under its use the urine is said to become much increased in
quantity. _In Dysentery_, especially in the chronic form of the disease,
the bland, viscid mucilage is often most beneficial. It is a good plan
to give it in soup.

3. _In Hoarseness, and in dry and irritable states of the Throat, giving
rise, as is often the case, to a troublesome Cough, as in Consumption,
&c._, the free inhalation of the vapour of the hot decoction (_ante_)
has in many instances been found serviceable.

4. The fresh capsules bruised are stated to form an efficient emollient
poultice.


5. +Abrus, or Country Liquorice Root.+ The root of Abrus precatorius,
_Linn._

 Mulatthí-hindi, Gunj-ka-jar (_Hind._, _Duk._), Jaishtomodhu-bengala,
 Kunch-ka-jar (_Beng._), Múlathí (_Punj._), Shangir (_Kash._),
 Gundumani-vér (_Tam._), Guru-venda-véru (_Tel._), Kunnikuru-véra
 (_Mal._), Gul-ganji-béru (_Can._), Olindamúl (_Cing._), Yu-e-si-anú
 (_Burm._), Akar-sagamerah (_Malay_).

6. This root, obtained from a twining shrub common throughout India,
whose bright scarlet seeds with a black spot at one end are universally
known, possesses many of the sensible properties and medical qualities
of the true liquorice-root (which is also to be met with in some of the
large bazaars), hence its common name. Country Liquorice. Properly
prepared, and according to directions in Indian Pharmacopœia, it yields
an extract similar to officinal liquorice, but less sweet and more
bitter. According to Moodeen Sheriff (_Suppl. to Ind. Ph._ p. 18), an
extract prepared from the dried leaves of Abrus precatorius is much
superior both in taste and as a medicine to that prepared from the root.
He gives the following directions for its preparation: Pour boiling
distilled water on the dried leaves till they are sufficiently covered;
keep the vessel on a slow fire for six hours; then strain the liquor
while hot through flannel and evaporate on a water bath to a proper
consistence. The extract prepared from the juice of the fresh leaves, he
adds, is also sweet, but very inferior to the latter for medicinal
purposes. The following syrup has been found useful in the _Coughs of
Childhood_. Take of fresh Abrus roots, the larger sized the better, well
bruised, two ounces; and Abelmoschus capsules sliced, one ounce; boil in
a pint of water for half an hour, and strain; to the liquor add eight
ounces of sugar-candy or honey, and boil down to the consistence of a
syrup. From a tea to a table-spoonful may be freely given several times
a day when the cough is troublesome, whether fever is present or not. It
forms also a good adjunct to other more active cough mixtures. The great
objection to this, in common with all syrups in India, is the readiness
with which it undergoes fermentation; hence only small quantities should
be prepared when cases occur requiring its use.


7. +Acacia, or Babúl Bark.+ The bark of Acacia Arabica, _Willd._

 Babúl-ka-chál, Kíkar-ka-chál (_Hind._), Kali-kíkar-kí chilká (_Duk._),
 Babúl-sál (_Beng._), Sák (_Punj._, _Kash._), Karu-vélam-pattai
 (_Tam._), Kulit-pokoh-bunga (_Malay_).

8. Babúl bark occurs in large thick pieces, coarsely fibrous, of a deep
mahogany colour, and astringent, bitterish taste. It is an excellent
astringent, and though less powerful than some others of the same class,
it possesses the advantage of being obtainable, either in the fresh or
dried state, throughout India, the tree yielding it being common
everywhere in dry, sandy localities.

9. The best form for medical purposes is a decoction prepared by boiling
one ounce and a half of the bruised bark in a pint of water for ten
minutes, and straining. Of this the dose is from one and a half to two
ounces twice daily, or oftener in _Chronic Diarrhœa_, &c.; it is,
however, chiefly employed as an external or local application—as an
injection in _Leucorrhœa and other Vaginal Discharges_; as an enema in
_Piles_ and _Prolapsus (descent) of the Anus_, and as a gargle in _Sore
Throat, and in Sponginess and Ulceration of the Gums_. In all these
cases, however, it is generally used conjoined with alum and other
agents.


10. +Acorus, or Sweet Flag Root.+ The root stock or Acorus Calamus,
_Linn._

 Bach or Vach (_Hind._, _Duk._), Bach, Saféd Bach (_Beng._), Warch
 (_Punj._), Vá'í (_Kash._), Vashambú (_Tam._), Vasa, Vadaja (_Tel._),
 Vash-anpa (_Mal._), Bajé (_Can._), Vékhanda (_Mah._), Vaj, Vach
 (_Guz._), Lene or Linhe (_Burm._), Jaringowe (_Malay_).

11. This is one of the commonest of bazaar medicines, and generally
procurable everywhere, of good quality, at a very small cost. It occurs
in pieces of various lengths, about the thickness of the thumb, rather
flattened, spongy, provided with numerous sheath-like, ringed
appendages; odour peculiar and aromatic; taste, bitterish, warm and
somewhat acrid. Till very recently it was included in the British
Pharmacopœia. It well deserves a place in every Indian domestic medicine
chest.

12. It is a tonic and stomachic of no small value, and is best given in
the form of infusion: one ounce of the bruised root to half a pint of
boiling water, in doses of a wine-glassful twice or thrice daily.
Combined with Chiretta, it has been reported to cure _Intermittent
Fevers in natives_, but though its power in this respect is doubtful,
except, perhaps, in cases of the mildest description, yet in
_Convalescence after this and other forms of Fever_, a mixture of equal
parts of the infusion of Acorus and Chiretta (98) is as good a formula
as can be employed. The same combination proves also most serviceable in
_Dyspepsia, especially when attended with much flatulence, in Loss of
Appetite and Constitutional Debility_.

13. _In the Dysentery of Natives, and in that especially of Native
Children_, Dr. Evers (_Indian Medical Gazette_, Feb. 1, 1875) speaks
very highly of Acorus given in decoction as follows: Take of the bruised
root-stock two ounces, Coriander seed one drachm, Black Pepper half a
drachm, Water one pint; boil down to about twelve ounces (or for about a
quarter of an hour), and set aside to cool. The dose for an adult is a
wine-glassful three times daily; for a child from one to three
tea-spoonfuls, sweetened with sugar, two or three times a day.
Astringents or Quinine (the latter when the disease is apparently of
malarious origin) may be added if necessary. Dr. Evers found this
decoction not only useful in _Dysentery and Diarrhœa_, but also in the
_Bronchitic Affections of Children_. He considers it worthy of a more
extended trial.

14. This root, especially when freshly collected, and retaining its full
aroma, is reported, on good authority, to _drive away fleas and other
insects_, a fact well to bear in mind in a sick room, as well as
elsewhere.


15. +Aloes.+ The inspissated juice of Aloe Socotrina, _Linn._, and other
species of Aloes.

 Musabbar, Ilvá, Yalvá (_Hind._), Musanbar (_Duk._), Móshabbar
 (_Beng._), Elwá (_Punj._), Mússbar, Sibar (_Kash._), Kariya-pólam,
 Irakta-pólam (_Tam._), Múshámbaram (_Tel._), Chenna-náyakam (_Mal._),
 Musam-bara-bóla (_Mah._), Yéliyo (_Guz._), Kalu-bólam, Kari-bolam
 (_Cing._), Mo (_Burm._), Jadam (_Malay_).

16. Aloes, as met with in the bazaars, are generally imported, and of a
very inferior description, but they may be rendered fit for medical use
by the following process: Take of bazaar Aloes, in small fragments, one
pound; boiling water, one gallon; stir them well together until they are
thoroughly mixed, and set aside for twelve hours; then pour off the
clear liquor, strain the remainder, mix the liquors, and place in open
vessels in the sun, or over a gentle fire, till it is evaporated to
dryness. Aloes of very good quality may also be prepared from two
indigenous species of Aloe, A. Indica, _Royle_, and A. litoralis,
_König_; the former inhabiting dry sandy plains in the Northwestern
Provinces, and the latter similar localities on the sea-coasts of the
Madras peninsula. The viscid juice with which the thick leaves abound
should be collected and evaporated to dryness by exposure in open pans
in the sun or over a gentle fire.

17. The principal use of Aloes is as a purgative, in doses of from three
to six grains. If administered alone, it is apt to cause griping,
nausea, &c.; hence, it is generally given in combination with aromatics,
&c. _It is ill adapted for children, for persons subject to Piles, or
for Pregnant Females._

18. Few medicines are more generally useful for women when suffering
from _an Irregular or Suspended_ _state of the Menstrual Discharge_; but
it _should not_ be given during pregnancy, _nor whilst_ the menstrual
discharge is present. In these cases, especially when the patient is
pale, thin, and weak, it is best given as follows: Take purified Aloes
and Sulphate of Iron, of each, finely powdered, 24 grains; Cinnamon in
powder, 60 grains; Honey, sufficient to make a mass; be careful that all
the ingredients are well mixed; and divide into 24 pills, of which two
are to be taken twice daily.

19. The following is another very good combination: Take Aloes and
Asafœtida, of each 20 grains; beat into a mass with honey, and divide
into 12 pills, of which one may be taken twice daily. These pills often
prove of great service to women subject to _Hysterical fits_, and
_Flatulent distension of the Abdomen_, especially when at the same time
there is _Constipation of the Bowels_. _In Headaches arising from the
sudden stoppage either of menstrual discharge or of long-standing
bleeding from piles_, these pills often prove useful. Aloes should not
ordinarily be given to persons subject to piles, as they are apt to
aggravate the disease.

20. _In cases of Habitual Constipation of the Bowels_ great benefit has
been found from the persevering use of the following pills: Take of
purified Aloes, 18 grains; Sulphate of Iron, 30 grains; beat into a mass
with a little honey, and divide into 24 pills. Of these, one may be
taken three times a day, immediately after the principal meals, till
they begin to act upon the bowels gently and then the number may be
reduced to two daily. At the end of a week or two another pill may be
omitted, and within a month a single pill once or twice a week will
suffice. If at any time they should act powerfully on the bowels as a
purgative, they should be discontinued for a time.


21. +Alum.+

 Phitkarí (_Hind._), Phitkarí (_Beng._), Fatkarí (_Punj._), Fatkar,
 Phatkar (_Kash._), Pati-káram (_Tam._, _Tel._), Chinik-káram (_Mal._),
 Pati-kárá (_Can._), Patikár, Turatí (_Mah._), Sina-karam (_Cing._),
 Keo-khin (_Burm._), Twas (_Malay_).

22. Alum of good quality is generally procurable in all bazaars. It
should be in colourless, transparent, crystalline masses, or pieces of
various sizes, with an acid, sweetish, astringent taste. When mixed with
impurities, as it often is, it may be rendered fit for medicinal
purposes by dissolving it in boiling water, straining the solution, and
evaporating it so as to obtain crystals, which should be preserved for
use. Alum, whether applied externally or given internally, is a valuable
astringent. Dose, from 10 to 20 grains for adults.

23. In that form of _Ophthalmia_ commonly known in India by the name of
_Country Sore Eyes_, especially when it attacks children, a solution of
Alum is often of great service. For children the strength of three
grains to an ounce of water is sufficient; but for adults, a solution of
double this strength may be used: the eyes should be freely washed with
it four or five times a day, or a cloth wet with it may be kept
constantly applied. If the eyelids are much swollen, especially in the
morning, they should be well bathed with warm milk, the eyelids should
then be carefully separated, and the Alum lotion dropped in. There is a
native plan of treatment of these cases which proves in many instances
effectual, but it has the disadvantage of being very painful for a short
time. It is as follows: Place some finely powdered alum on a heated
plate of iron, and whilst it is in a state of fusion add a small portion
of lemon or lime-juice, until it forms a black, soft mass. This, whilst
hot, is applied entirely round the orbit, care being taken that none of
it gets beneath the eyelids, as it causes under such circumstances
intense agony. One or two applications, each being allowed to remain on
for twelve hours, suffice ordinarily to effect a cure.

24. _After severe Blows on the Eye_, when the pain and heat have
subsided, and much discoloration and swelling remain, an ALUM POULTICE
is an effectual application. It is made by rubbing up 30 grains of
powdered alum with the white of an egg till it forms a coagulum. This
placed between two pieces of thin rag or muslin, should be kept applied
to the eye for some hours.

25. _In Hæmorrhage from the Lungs, Stomach, Kidneys, Uterus, and other
Internal Organs_, Alum, in doses of 10 to 12 grains, thrice daily, with
or without opium, may often be given with advantage. It is, however,
inadmissible if much fever is present, and should at once be
discontinued if after the first few doses the symptoms are at all
aggravated. The following, called ALUM WHEY, is a good form of
administration: Boil for ten minutes two drachms of powdered Alum in a
pint of milk, and strain; of this, the dose is one and a half to two
ounces thrice daily. This may also be given with the view of checking
_Excessive Menstrual Discharges_ (_Menorrhagia_) and _Bleeding from
Piles_. In this last case, clothes saturated with a solution of Alum in
decoction of Galls (145) or Babúl bark (9), in the proportion of two
drachms to eight ounces, should be kept constantly applied externally.
This application also proves useful in _Prolapsus (descent) of the
Anus_, especially in children. _In Profuse Bleeding from the Nose_
injections of a solution of Alum (20 grains to one ounce of water) into
the nostril is sometimes effectual; care, however, is required in its
use. Powdered Alum, or a very strong saturated solution, applied locally
on a compress, occasionally suffices to arrest _Bleeding from
Leech-bites, Cuts, &c._

26. _In the Chronic Diarrhœa of Natives_, the following mixture has been
found useful: Take of Alum ten grains, infusion of Acorus root (12), one
and a half ounce, Laudanum, five drops; repeat three or four times
daily. _In the Diarrhœa which precedes Cholera, and in the early stages
of Cholera_, the following powders are worthy of a trial. Take Alum,
Catechu, and Cinnamon, of each, powdered, ten grains, mix with honey,
and give at a dose. It may be repeated every one or two hours, according
to circumstances. It proves useful also in controlling the _Diarrhœa of
Phthisis_.

27. As a palliative in _Diabetes_, "Alum Whey," prepared as directed in
paragraph 25, may be tried; under its use the quantity of urine voided
is, in some instances, diminished. _In Albuminuria_, also, it has been
useful in some instances in reducing the proportion of albumen in the
urine.

28. _In Hooping Cough_, when the first or acute stage has passed, no
remedy is more generally efficacious than Alum, in doses of three or
four grains, every four or six hours for a child from two to three years
old. It may be given in the form of powder or in solution (Alum 25
grains, Omum Water three ounces) in doses of a dessert-spoonful every
four or six hours for a child from two to four years old.

29. _For Relaxed or Ulcerated Sore Throat, for Ulceration and Sponginess
of the Gums, in Salivation, and in Fissures of the Tongue in
Consumption_, a very useful gargle or mouth wash is made by dissolving
two drachms of Alum in a pint of the decoction of Galls (145) or Babúl
Bark (9), and sweetening with honey. _For the small white Ulcers_
(_Aphthæ, or Thrush_) _in the mouths of infants and young children_, a
better application is 20 grains of finely powdered Alum, incorporated
with one ounce of honey. This may be applied twice daily, with the tip
of the finger. _In the severer Ulcerative forms of the disease_
(_Ulcerative Stomatitis_) Alum in fine powder, or in strong solution,
proves a more effectual application.

30. There is a disease often confounded with _Gonorrhœa_, where the
discharge does not come, as it does in true gonorrhœa, from the urethra,
but from a sore or excoriated surface between the prepuce and the head
of the penis. For this there is no better application than a solution of
Alum, 20 grains in one ounce of water. It may be used twice or thrice
daily. The strictest cleanliness should be enforced at the same time.
_In Gleet_, a solution of Alum (three grains), in water (one ounce),
used as an injection twice daily, is often productive of benefit. _In
Leucorrhœa and other Vaginal Discharges_, injections of Alum in
decoction of Galls or Babúl bark, as advised in the last paragraph,
often prove very useful.

31. _In old Chronic spreading and gangrenous Ulcers_ so common amongst
natives, the following forms an excellent application: Finely powdered
Alum, four drachms; finely powdered Catechu, one drachm; Opium, half a
drachm; Ceromel (167), or Kokum butter, or Ghee, one ounce. First, rub
down the opium with the ceromel till thoroughly mixed, and then
incorporate the other ingredients. A portion of this, spread on soft
rag, should be applied to the ulcer night and morning. If it occasion
much pain, the proportion of ceromel should be increased. _For Bed-Sores
or where these are likely to occur_, Dr. Aitchison describes as an
excellent remedy—a mixture of 30 grains of burnt alum and the white of
an egg. It should be well painted over the part.

32. _For Enlargement of the Joints, especially that of the Knee, and for
other Swellings resulting from Blows, Bruises, or Sprains_, the
following lotion has been found useful; Alum, four drachms, Vinegar and
_Arrack_, of each a pint; dissolve, and keep cloths wet with this lotion
constantly to the affected part. _In Scorpion Bites_, Alum moistened
with water and locally applied often affords instantaneous relief (Dr.
Saunders).


33. +Asafœtida.+

 Hing (_Hind._, _Duk._, _Beng._, _Pung._, _Mah._, _Guz._), Yang
 (_Kash._), Káyam, Perun-gáyam (_Tam._), Inguva (_Tel._), Perun-gáyam,
 Káyam (_Mal._), Perun-káyam (_Cing._), Shinkhu or Shingu (_Burm._),
 Hingu (_Malay_).

34. Asafœtida of good quality may be obtained in most bazaars. The
moister and most strongly smelling kinds should be chosen for medical
purposes. It may be given in the form of pill, in doses of from five to
ten grains; or in that of mixture, prepared by rubbing down in a mortar
five drachms of Asafœtida in a pint of hot water, and straining and
setting aside to cool. Of this solution, which is thick and milky, the
dose is from one to two table-spoonfuls. Its nauseous taste is a great
objection to its use.

35. _In Hysterical Fits_ and in _Fainting, Nervous Palpitations, and
other affections connected with Hysteria_, Asafœtida proves most useful.
When the symptoms are urgent, as in fits, &c., it is best given in the
liquid form (_ante_), but where the object is rather to combat the
tendency to this state, and to make an impression on the system, the
solid form should be preferred. For this purpose it may be
advantageously combined with Aloes, as advised in Sect. 19.

36. _In Flatulence, Flatulent Colic, and Spasmodic_ _Affections of the
Bowels_, especially when connected with hysteria, it is best given in
the form of enema (30 grains in four ounces of water); but if this is
not practicable, it may be given by mouth in the liquid form advised
above. A teaspoonful of the mixture, with a little Omum water, is often
very effectual in relieving the _Flatulent Colic of Children_. It may
also be tried in the _Convulsions of pale, weakly children_. An
Asafœtida enema is an effectual means of removing _Thread worms_ from
the rectum and lower bowel.

37. _In the obstinate Coughs of Childhood_, remaining after attacks of
inflammation, and also _the advanced stages of Hooping Cough_, the
mixture has also occasionally been found of great service in doses of a
teaspoonful four or five times daily. It has also been recommended in
the _Chronic Bronchitis and Asthma of Adults_; its disagreeable smell
and taste is a great bar to its use, but this may, in a great measure,
be obviated by giving it in the form of pill.


38. +Asteracantha (Barleria) longifolia+, _Nees_.

 Talmakháné, Gokshura (_Hind._), Kolsí (_Duk._), Kánta-koliká (_Beng._),
 Tálmakhánáh (_Punj._, _Kash._), Nir-mulli (_Tam._), Niru-gobbi
 (_Tel._), Vayal-chulli (_Mal._), Kolava-like (_Can._), Tál-makháná
 (_Mah._), Ikkiri (_Cing._), Súpadán (_Burm._).

39. The whole of this plant, common in moist sites throughout India, but
especially the root, which in the dried state is sold in the bazaars,
enjoys a high repute amongst the natives as a diuretic in _Dropsical_
_cases_, which European experience has, in a great measure, tended to
confirm. It may be given in the form of decoction, prepared by boiling
one ounce of the root in a pint of water for ten minutes, straining, and
taking the whole in divided doses during the day. The following is
advised by Baboo Kanny Lall Dey: Take of freshly dried Asteracantha
leaves, two ounces; Distilled Vinegar, 16 ounces; macerate for three
days; press and strain. Of this, the dose is from one to three
tablespoonfuls in water thrice daily.


40. +Atis, or Atees.+ The root of Aconitum heterophyllum, _Wallich_.

 Atís (_Hind._), Atviká (_Duk._), Atis, Batis, Patis (_Punj._),
 Mohand-i-guj-saféd, Hong-i-saféd (_Kash._), Ati-vadayam (_Tam._),
 Ati-vasa (_Tel._).

41. Atís, as met with in the bazaars, occurs in the form of small
tuberous roots, tapering towards a point, from one to one and a half
inches or more in length, and from three-eighths to a quarter of an inch
in thickness; grey externally, slightly wrinkled longitudinally, and
marked here and there with rootlet scars, easily friable; internally
white, farinaceous, inodorous, and of a pure bitter taste, devoid of
acidity or astringency. This last character serves to distinguish it
from all other roots sold under the same name. _Every root should be
broken across, and all which are not pure white, with a short, starchy
fracture and pure bitter taste, should be discarded._ Further, if on
placing a small piece on the tongue it cause _a_ _feeling of tingling or
peculiar sensibility_, followed by even the smallest degree of numbness
or altered sensibility, it should _on no account_ be used. Mr. Boughton
discovered in it an alkaloid to which he gave the name of _Atisine_.

42. The chief use of Atís is in the treatment of _Intermittent Fever and
other periodical fevers_, and in these it often proves most valuable. It
should be given in doses of half a drachm (30 grains), mixed with a
little water, every four or six hours during the intermissions,
commencing its use during or towards the close of the sweating stage.
For children the dose may be reduced one-half, or three-fourths,
according to age. For combating the _Debility after Fevers and other
diseases_, Atís is an excellent tonic, in doses of five to ten grains
thrice daily.


43. +Bael Fruit.+ The fruit of Ægle Marmelos, _Corr._

 Bél, Si-phal (_Hind._, _Beng._, _Punj._), Bél-phal (_Duk._), Vilva or
 Bilva-pazham (_Tam._), Bilva-pandu, Márédu-pandu (_Tel._),
 Kúvalap-pazham (_Mal._) Bilapatri-hannu (_Can._) Bél-phal (_Guz._),
 Bélá-chaphala, Bela (_Mah._) Bélli, Bélli-ka (_Cing._), Ushi-si,
 Ushi-ti (_Burm._), Buah Bail (_Malay_), Bil-kath (the entire fruit),
 Shífal-gúj, the pulp and seeds with the rind removed (_Kash._).

44. The half-ripe fruit is best suited for medical use, and that freshly
gathered is preferable to that which has been kept a long time, as is
generally the case with the bazaar article. In bazaar specimens, the
Wood-apple (fruit of Feronia Elephantum) is often substituted for Bael.
Though they bear a close resemblance externally, they can easily be
distinguished by opening them. In the true Bael there are, in the centre
of the pulp, a number of cells, from five to eighteen, each containing
one or more seeds and glutinous mucus, whilst in the Wood-apple there
are no cells, and the seeds are embedded in the pulp. European
experience has confirmed the native opinion that it is a remedy of much
value in cases of _obstinate Diarrhœa and Dysentery_ when unattended by
fever, and the patient is weak and dyspeptic. It proves especially
serviceable when any signs of _Scurvy_ are present. It is best given as
follows: Take of the soft gummy fluid from the interior of the fruit two
ounces, mix this with three or four ounces of water, sweeten to taste,
and, if procurable, add a lump of ice. This draught should be repeated
twice or thrice daily. _In the obstinate Diarrhœa and Dysentery of
Children_ it may safely be given in doses of from one quarter to one
half the above quantity, according to age. The Fluid Extract of the
_dried_ Bael is regarded by many as superior to any other preparations
of this fruit. The dose is from half a drachm to a drachm, twice or
thrice daily for an adult. Dietetic Bael is also a valuable preparation.
Dr. Aitchison suggests that a supply of Dietetic Bael (prepared by
Messrs. Bathgate & Co., of Calcutta) should be kept in store. "It
consists," he remarks, "of the pulp of dried Bael fruit carefully
pulverised and mixed with a certain proportion of arrowroot. It is an
excellent preparation to be used in those cases when Bael is prescribed,
and where the fresh fruit cannot be got of good quality, _e.g._, the
Bael fruit grown in the Punjaub is not to be compared with that of the
more moist and tropical regions. Besides using this in actual disease it
makes a good substitute in a patient's diet owing to its pleasant
aromatic flavour."

45. _In Irregularity of the Bowels, presenting alternations of Diarrhœa
and Constipation_, one draught, as described in the last section, taken
in the early morning, often exercises a most beneficial effect in
regulating the bowels. Where much debility exists, and the stomach is
weak and irritable, it is apt to disagree, occasioning eructations, &c.,
in which case it may be tried in smaller doses, or be given at bedtime
in place of early morning.


46. +Betel or Betle Leaves.+ The fresh leaves of Chavica (Piper) Betle,
_Retz._

 Pán (_Hind._, _Duk._, _Beng._, _Punj._, and _Guz._), Vettilai (_Tam._),
 Tamala-páku, Nága-valli (_Tel._), Vetrila (_Mal._), Viledele (_Can._),
 Videchapána (_Mah._), Balát (_Cing._), Kún-yoe (_Burm._), Seereh
 (_Malay_).

47. These leaves are in almost universal use amongst the natives of
India as a masticatory, in conjunction with lime and areca-nut; and can
now be purchased, almost fresh, in any of the larger bazaars of the
Punjaub, as they are forwarded by rail and post. There are two ways in
which they may be usefully employed medicinally:

48. _In Coughs, especially those of Infancy and Childhood, where there
is difficulty of breathing_, the application of betel leaves, warmed,
smeared with oil, and applied in layers over the chest, often affords
speedy and marked relief. It is a native practice, the utility of which
has been confirmed by European experience. It can do no harm, may do
much good, and is therefore worthy of a trial in all cases. The same
application has been recommended in _Congestion and other affections of
the Liver_.

49. For the purpose of _Arresting the Secretion of Milk_, when from any
cause this may be desirable, betel leaves, warmed by the fire, and
placed in layers over the breast, are stated to be very effectual. Thus
employed they are also said to be useful in reducing _Glandular
Swellings_.


50. +Bonduc Nut.+ The fruit of Cæsalpinia (Guilandina) Bonducella,
_Linn._

 Kat-kalijá, Kat-karanj (_Hind._), Gajgá (_Duk._), Nátá, Nátú-koranjá
 (_Beng._), Kanjúá (_Punj._), Kazhar-shik-káy (_Tam._), Gech-chak-káyá
 (_Tel._), Kalan-chik-kuru (_Mal._), Gajaga-káyi (_Can._), Gajaga
 (_Mah._), Gájgá (_Guz._) Kumbura-atta (_Cing._), Kalén-zi (_Burm._),
 Buah gorah (_Malay_).

51. These nuts, common in all the bazaars of India, are roundish or
ovoid in shape, about half an inch, or more, in diameter, smooth, hard,
of a grey or leaden colour externally, and contain a white starchy
kernel of a pure, bitter taste. Their efficacy appears to reside in a
bitter oil. Mr. Broughton failed to detect in them any special
crystalline principle.

52. _In Intermittent Fevers_, especially in those of the natives, this
remedy has been found very useful. It is adapted only for mild,
uncomplicated cases, and is best given in the following form: Take of
Bonduc seeds, deprived of their shells and powdered, one ounce; Black
Pepper, powdered, one ounce; mix thoroughly, and keep in a
well-stoppered bottle. Of this the dose is from 15 to 30 grains three
times a day for adults. In smaller doses it is a good tonic in _Debility
after Fevers and other diseases_. The bark of the root of the Bonduc
shrub in 10 grain doses is reported to be even more effectual in the
above cases than the seeds themselves.


53. +Borax.+ Biborate of Soda.

 Sohágá, Tinkál (_Hind._), Sohágá (_Beng._, _Duk._, _Punj._), Vávut,
 Váwuth (_Kash._), Venkáram (_Tam._), Elegáram (_Tel._), Ponkáram,
 Vellakaram (_Mal._), Biligára (_Can._), Vengáram, Puskara (_Cing._),
 Lakhiya, Let-khya (_Burm._), Pijar (_Malay_).

54. Borax of good quality is met with in most bazaars; if good it should
be in transparent, colourless, crystalline masses or pieces of various
sizes, inodorous, with a cool, saltish taste. After having been exposed
to the air for some time, as that found in the bazaars has generally
been, it becomes covered with a whitish powder or efflorescence, which
being removed shows the transparent crystal beneath. If brown or dirty,
or otherwise impure, it may be rendered fit for medical use by
dissolving one pound of it with one drachm of quicklime in three pints
of water, straining through cloth and evaporating by exposure to the sun
in an open vessel or over a gentle fire. Dose from 20 to 40 grains for
an adult.

55. _In Aphthæ or Thrush_ (small white spots and ulcerations in the
mouths of infants and young children) a mixture of powdered Borax (1
drachm) and Honey (1 ounce) is one of the best applications which can be
used; it should be applied by means of the finger to the spot twice or
thrice daily. _In Fissures or Cracks in the Tongue in adults, which
occur in the advanced stages of Consumption, Fever, &c._, an
application, twice the strength of the above, proves highly serviceable.
_In Mercurial Salivation_, a solution of Borax (half an ounce), in water
(eight ounces) forms an excellent gargle.

56. _To Sore Nipples_ a solution of Borax, one drachm to one ounce of
water, should be applied before and after suckling the infant, or it may
be employed in the form of ointment (a drachm of Borax to an ounce of
Ghee). These applications are also serviceable when applied to _inflamed
and painful Piles_.

57. _As a means of allaying the distressing Irritation of the Genital
Organs, both of males and females_, the latter especially, a solution of
Borax (half an ounce) in eight ounces of water or Camphor julep (67)
sometimes affords more relief than anything else. Cloths saturated with
it should be kept to the parts, and in the case of women it should also
be used in the form of vaginal injection. It also proves very useful in
allaying the _Irritation of Nettlerash, Prickly Heat, and other Skin
Diseases_.

58. _In prolonged and tedious Labours_ dependent apparently on want of
action or power in the uterus to expel the fœtus, and in _Abortion_
under the same circumstances, 30 grains of Borax with 10 grains of
powdered Cinnamon in a little warm _conjee_, may be given every one or
two hours to the extent of three or four doses. This may also be given
in _Convulsions attendant on Labours_. In doses of 10 grains, with 10
grains of Cinnamon, thrice daily, it also occasionally proves useful in
_Suspension or Irregularity of the Menstrual Discharge_ and in some
_Chronic Uterine Affections_.

59. _To Ulcerated Buboes, and Sloughing Ulcers_, a solution of Borax
(two drachms in a pint of water or Camphor julep) often proves very
useful by cleansing the surface and hastening the healing process. It
should be applied on rags well over the whole sore, and renewed
frequently by night and day. For dressing _Delhi Sores_, and stimulating
them to healthy action, a favourite application is composed of Borax,
Sulphur, and Catechu, of each, finely powdered, one drachm, and Ghee one
ounce. This may be advantageously used in other forms of _Ulceration_.

60. _For Ringworm_, a solution of Borax (one drachm) in distilled
vinegar (two ounces) is stated to be an effectual application.


61. +Butea Gum. Bengal Kino.+ The inspissated juice obtained from the
stems of Butea frondosa, _Roxb._ Pterocarpus Marsupium, _D.C._, which
yields the officinal Kino, inhabits the forests of Ceylon and the Indian
Peninsula as far north as Behar; but almost all, if not the whole, of
the Kino met with in bazaars is the produce of Butea frondosa or B.
superba; but this is a matter of little moment, as it appears to be
equally effectual as an astringent.

 Palás-kí-gond (_Hind._, _Duk._), Pálásh-gun (_Beng._), Dhák-kí-gond
 (_Punj._,), Kamar-kash (_Kash._), Muruk-kan-pishin, Palásha-pishin
 (_Tam._), Palásha-banka, Móduga-banka (_Tel._) Plách-cha-pasha
 (_Mal._), Muttaga-góndu (_Can._), Phalása-cha-gónda (_Mah._),
 Khákar-nu-gún (_Guz._), Káliya-melliyam (_Cing._), Páv-si (_Burm._).

62. Butea Gum occurs in the form of irregular shining fragments, seldom
as large as a pea, more or less mixed with adherent pieces of greyish
bark, of an intense ruby colour and astringent taste. Its astringency is
due to the presence of tannic and gallic acids. It is an excellent
astringent, similar to Catechu, but, being milder in operation, it is
better adapted for children and delicate females. The dose of the
powdered gum is 10 to 30 grains, with a few grains of powdered Cinnamon.
It may be used with advantage in _Chronic Diarrhœa_, _Pyrosis_
(_Water-brash_), _and in those forms of Dyspepsia attended with
increased secretion_. In these cases the addition of a small portion of
opium increases its efficacy.


63. +Butea Seeds.+ The seeds of Butea frondosa, _Roxb._

 Palás-ké-bínj (_Hind._), Palás-Páprá (_Duk._, _Beng._), Dhák-papri,
 Palás-páprí (_Punj._), Khálás-pápúr (_Kash._), Porasum-virai,
 Murukkam-virai (_Tam._), Palásha-vittulu, Moduga-vittulu (_Tel._),
 Pláshu, Murukka-vitta (_Mal._), Muttaga-bíjá (_Can._), Phalásá-cha-bí
 (_Mah._), Palás-páparo (_Guz._), Kaliya-atta (_Cing._), Páv-si
 (_Burm._).

64. Butea seeds are thin, flat, oval or kidney-shaped, of a mahogany
brown colour, 1¼ to 1¾ inches in length, almost devoid of taste and
smell. European experience has confirmed the high opinion held by the
Mohammedan doctors as to their power in _expelling Lumbrici, or Round
Worm_, so common amongst the natives of India. The seeds should be first
soaked in water, and the testa, or shell, carefully removed; the kernel
should then be dried and reduced to powder. Of this the dose is 20
grains thrice daily for three successive days, followed on the fourth
day by a dose of Castor Oil. Under the use of this remedy, thus
administered in the practice of Dr. Oswald, 125 lumbrici in one
instance, and between 70 and 80 in another, were expelled. It has the
disadvantage of occasionally purging when its vermifuge properties are
not apparent; in some instances also it has been found to excite
vomiting and to irritate the kidneys; and though these ill effects do
not ordinarily follow, yet they indicate caution in its employment.

65. _For destroying Maggots in Unhealthy Ulcers_, so commonly met with
amongst the natives, Raghupatie Mohun Rao (_Indian Medical Gazette_,
Dec. 2, 1879, p. 346) directs the powder of these seeds to be sprinkled
over the surface to kill them.


66. +Camphor.+

 Káfúr (_Hind._, _Punj._), Káphúr (_Beng._), Karruppúram _or_ Karppúram
 (_Tam._), Karpúram (_Tel._, _Mal._), Karpúra (_Can._), Kapúra (_Mah._),
 Kapúr, Karpúr (_Guz._), Kapuru (_Cing._), Payo, Piyo (_Burm._), Kapor
 baroos (_Malay_).

Several varieties of Camphor are met with in the bazaars. That best
suited for medicinal use should be in masses or lumps, white,
translucent, of a crystalline structure, of a powerful penetrating
odour, and pungent taste. Much of the camphor sold in the bazaars is
worthless. Dose, from two to five grains or more for an adult.

67. CAMPHOR WATER, OR JULEP, as it is commonly called, may always be
advantageously kept ready prepared for domestic use; it is made by
adding two drachms of Camphor to a quart bottle of water, and setting
aside for a few days. Of this the dose for an adult is about a
wine-glassful. It is a good vehicle for other medicines.

68. CAMPHOR LINIMENT is formed by dissolving one ounce of Camphor in
four ounces of Cocoa-nut, Sesamum, or other bland oil. It is an
excellent application in _Chronic Rheumatism_, _Lumbago_, _Enlargement_
_of the Joints_, _Glandular Swellings_, _Bruises_, _Sprains_, _Muscular
Pain, especially that of the loins, to which women are subject during
Pregnancy and the Menstrual periods_, and other cases attended with
local pain. It should be well rubbed in night and morning for 10 or 15
minutes; friction in these cases playing an important part.

69. _In Chronic Rheumatism_, in addition to its use externally, as
advised in the last paragraph, it may be given internally in a dose of
five grains with one grain of Opium at bedtime; it affords relief by
causing copious perspiration, which should be promoted by a draught of
infusion of Ginger (154) and by additional bedclothes. An excellent
vapour bath for these cases may be made by substituting half an ounce of
Camphor placed on a heated plate for the _chattie_ of hot water
described in Section 397. Thus employed, it causes speedy and copious
perspiration. Care, however, is necessary to prevent the patient
inhaling the vapour, which is of comparatively little consequence when
simple water is being employed.

70. _In Asthma_, Camphor in four-grain doses, with an equal quantity of
Asafœtida, in the form of pill, repeated every second or third hour
during a paroxysm, affords in some instances great relief. Turpentine
stupes (362) to the chest should be used at the same time. Many cases of
_Difficulty of Breathing_ are relieved by the same means. These pills
also sometimes relieve violent _Palpitation of the Heart_. _In the
Coughs of Childhood_, Camphor Liniment (68), previously warmed, well
rubbed in over the chest at nights, often exercises a beneficial effect.
For young children, the strength of the liniment should be reduced one
half or more by the addition of some bland oil.

71. _In Rheumatic and Nervous Headaches_, a very useful application is
one ounce of Camphor dissolved in a pint of Vinegar, and then diluted
with one or two parts of water. Cloths saturated with it should be kept
constantly to the part.

72. _In Spermatorrhœa, and in all involuntary Seminal discharges_, few
medicines are more generally useful than Camphor in doses of four grains
with half a grain of Opium, taken each night at bedtime. _In Gonorrhœa_,
to relieve that painful symptom, _Chordee_, the same prescription is
generally very effectual; but it may be necessary to increase the
quantity of Opium to one grain, and it is advisable to apply the Camphor
Liniment (68) along the under surface of the penis as far back as the
anus. _To relieve that distressing Irritation of the Generative Organs
which some women suffer from so severely_, it will be found that five or
six grains of Camphor taken in the form of pill twice or three times
daily, according to the severity of the symptoms, will sometimes afford
great relief. In each of these cases it is important to keep the bowels
freely open.

73. _In Painful Affections of the Uterus_ Camphor in six or eight grain
doses often affords much relief. The Liniment (68) should at the same
time be well rubbed into the loins. _In the Convulsions attendant on
Childbirth_, the following pills may be tried: Camphor and Calomel, of
each five grains. Beat into a mass with a little honey, and divide into
two pills; to be followed an hour subsequently by a full dose of castor
oil or other purgative.

74. _In the advanced stages of Fever_, _Small Pox_, and _Measles_, when
the patient is low, weak, and exhausted, and when there are at the same
time delirium, muttering, and sleeplessness, three grains of Camphor
with an equal quantity of Asafœtida, may be given even every third hour;
Turpentine stupes (362) or Mustard poultices (247) being applied at the
same time to the feet or over the region of the heart. It should be
discontinued if it causes headache or increased heat of the scalp. Its
use requires much discrimination and caution.

75. _To Prevent Bed Sores_, it is advisable to make a strong solution of
Camphor in _arrack_ or brandy, and with this night and morning to bathe,
for a few minutes, the parts which from continued pressure are likely to
become affected. _Gangrenous or Sloughing Ulcerations_ often sensibly
improve, and heal under the local application of powdered Camphor.


76. +Capsicum.+ The ripe dried fruit of Capsicum fastigiatum, _Blume_.

 Lál-mirch, Gách-mirch (_Hind._), Mirchí, Lál-mirchí (_Duk._),
 Lal-morich, Lanká-morich (_Beng._), Lal-mirch (_Punj._), Mirch-wángun
 (_Kash._), Mulagáy, Milagáy (_Tam._), Mirapa-káya (_Tel._),
 Kappal-melaka (_Mal._), Ménashiná-káyi (_Can._), Mir-singá (_Mah._),
 Lál-mirich, Marchu (_Guz._), Miris (_Cing._), Náyu-si (_Burm._),
 Chalie, Loda-cheena (_Malay_).

77. A powerful stimulant; the bruised fruit applied locally in the form
of poultice acts energetically as a rubefacient, and, added to Mustard
poultices, greatly increases their activity. In the absence of mustard,
Capsicum poultices may be substituted, but, being more energetic in
operation, require more care; if left on too long they will cause
blisters.

78. _In Scarlatina_, the following mixture has attained much repute in
the West Indies. Take two table-spoonfuls of bruised Capsicum and two
teaspoonfuls of Salt; beat them into a paste, and add half a pint of
boiling Water; when cold, strain, and add half a pint of Vinegar. Dose
for an adult, one table-spoonful every four hours; to be diminished for
children according to age, or the severity of the attack. The same
formula forms an excellent gargle in the _Sore Throat which accompanies
this disease_, as well as in ordinary _Relaxed Sore Throat_,
_Hoarseness_, &c.

79. Capsicum is a very useful adjunct to Aloes and other remedies for
_Dyspepsia, Loss of Appetite, &c._ _In Diarrhœa, arising from the use of
putrid food, especially fish_, Capsicum in five-grain doses in the form
of pill has been found most useful.


80. +Cassia alata+, _Linn._ Ringworm Shrub.

 Dádmurdan, Dád-ká-pát (_Hind._), Dádmurdan, Dádmari (_Beng._),
 Dát-ká-pattá, Viláyatí-agtí (_Duk._), Shimai-agatti, Vandu-kolli
 (_Tam._), Shíma-avishi-chettu (_Tel._), Shima-akatti (_Mal._),
 Shíme-agase (_Can._), Attóra (_Cing._), Timbó-mezali, Mezali-gi
 (_Burm._).

81. This handsome shrub, with its large conspicuous spike of yellow
flowers, is common in gardens and waste places throughout India. Its
leaves have attained a well-earned repute as a local remedy in _Skin
Diseases_, especially in _Ringworm_; hence one of its common English
names of _Ringworm Bush or Shrub_. The ordinary form of application is a
sort of ointment made by bruising the fresh leaves with Sesamum,
Cocoa-nut, or other bland oil; but a far better preparation is made by
bruising the fresh leaves, with lemon or lime juice, into a thick paste.
Whichever preparation is employed, it should be thoroughly well rubbed
in over the affected part twice daily till a cure is effected. The more
recent the case the greater will be the prospect of a speedy cure.
Long-standing chronic cases often resist its influence.


82. +Castor Oil.+—The expressed oil of the seeds of Ricinus communis,
_Linn._

 Arandí-ká-tél (_Hind._, _Punj._), Yarandí-ká-tél (_Duk._),
 Bhérandá-tail (_Beng._), A'manak-kenney (_Tam._), A'mudam (_Tel._),
 Kottenná (_Mal._), Haralenne (_Can._), Eran-déla (_Mah._), Dívás,
 Yerandi-nu-tél (_Guz._), Endaru-tel (_Cing._), Kesú-si (_Burm._),
 Miniak jarak (_Malay_).

83. Castor Oil, of various degrees of purity, is met with in most
bazaars. The dark brown viscid oil (obtained by boiling, and subsequent
expression of the seeds) should be avoided, on account of its acridity.
The best kind is clear, of a pale straw colour, and with a slightly
nauseous taste. The "cold-drawn expressed oil" should always be used
when procurable, as it generally is in most large bazaars. It is an
excellent purgative when the object is simply to clear out the bowels.
It is especially adapted for children and for women after confinements.
The ordinary dose for a child is about a teaspoonful but it may be
gradually raised according to the age of the patient, to two
table-spoonfuls (one ounce), which is the full dose for an adult. It is
best given floating on milk, strong coffee, or Omum water. _In Painful
Affections of the Rectum_ Castor Oil in small doses is often of great
service, softening the fæces and lubricating the passages without
weakening the patient. (_Mr. Curling_.) The same remark applies to
_Piles_, or when it is desirable to prevent the patient straining at
stool, but, as a general rule, it is inferior to Sulphur, _q. v._

84. _For Sore Nipples_ nothing, according to Dr. Conant Foster
(_Practitioner_, April 1872), is so beneficial as Castor Oil. The nipple
should be smeared freely with it each time the child is removed from the
breast. Rags or lint are unnecessary and injurious.

85. +The leaves of the Castor Oil plant+ deserve notice _as a means of
increasing the secretion of Milk_. For this purpose a decoction is made
by boiling a large handful of the plant in six or eight pints of water.
With this the breasts are bathed for a quarter of an hour, and then the
boiled leaves, in the form of a poultice, spread over them. In a few
hours the effects of the application are manifest. A simpler mode of
application, said to be equally effectual, consists in applying layers
of the fresh leaves, simply warmed before a fire, over the breasts.


86. +Catechu.+ An extract from the heart-wood of Acacia, Catechu,
_Willd._

 Kát, Kath (_Hind._, _Punj._), Kát (_Beng._), Kathah (_Duk._), Khairah,
 Kuth (_Kash._), Káshu, Kátta-kámbu (_Tam._), Kánchu (_Tel._), Kátta
 (_Mal._), Káchu (_Can._), Kath-tho (_Guz._), Kaipu (_Cing._), Sházi
 (_Burm._), Gambir or Kachu (_Malay_).

87. Several varieties of Catechu are met with in the bazaars. That best
adapted for medical use occurs in the form of masses consisting of
layers, occasionally enveloped in rough leaves of a blackish-brown
colour, easily fractured, of a very astringent taste.

88. _In Diarrhœa unattended by Fever_ Catechu is of much value; ten or
fifteen grains in powder, with an equal quantity of powdered Cinnamon,
may be given in honey or _jaggery_ three or four times a day if
necessary; or it may be given in infusion prepared by macerating three
drachms of bruised Catechu, and one drachm of bruised Cinnamon in half a
pint of boiling water for two hours, and straining. Dose from one and a
half to two ounces thrice daily. From five to ten drops of Laudanum to
each dose add to its efficacy, or one grain of Opium may be given at
bedtime. These doses are suited only for adults; for _the Diarrhœa of
Children_, three or four grains of finely powdered Catechu, with an
equal quantity of powdered Cinnamon, generally answer well.

89. _In Mercurial Salivation_, in _Ulceration and Sponginess of the
Gums_, a small piece of Catechu allowed slowly to dissolve in the mouth
is often of great service. The same measure is often useful in _Relaxed
Sore Throat, Hoarseness, Loss of Voice, &c._ _In Toothache_, where there
is a decayed tooth, with a piece of loose flesh growing within, great
relief sometimes results from inserting into the hollow a small piece of
Catechu, and retaining it there till it is dissolved.

90. _Chronic Ulcerations_, _attended by much or Fœtid Discharge_, often
speedily improve under the use of an ointment composed of a drachm of
finely powdered Catechu and an ounce of Ceromel (167). In obstinate
cases the addition of sixteen grains of finely powdered Sulphate of
Copper to the above greatly increases its efficacy. Another mode of
treating these old ulcers is bathing them twice or thrice daily with an
infusion of Catechu (six drachms to a pint of water), and dressing in
the intervals with Ceromel. The above infusion proves effectual in some
instances as a preventive of _Sore Nipples_, for which purpose the
breasts should be bathed with it daily, for some six weeks prior to the
confinement, and thus the tissues become so hardened that when the
infant begins to suck any ill-effects are obviated.


90 _bis_. +Charcoal Wood, Charcoal.+

 Lakrí ka-kóyelah (_Hind._), Lákri-ká-kólsá (_Duk._), Kásh-tha-kóyalá
 (_Beng._), Aduppu-kari (_Tam._), Katta-boggu (_Tel._), Atuppa-kari,
 Muttí-kari (_Mal._), Kattige-iddallu (_Can._), Láka-dácha-kólasé
 (_Mah._), Lákdu-kóelo (_Guz._), Thén-misu-e (_Burm._), Anguru
 (_Cing._), Ahrang (_Malay_), Kóiláh (_Punj._), Tsuíng (_Kash._).

91. Charcoal is an article of great importance in a sanatory and medical
as well as in an economical point of view. It possesses no mean power as
a deodoriser, and in close sick rooms the smell of the air is deprived
of much of its unpleasantness by hanging about the apartment thin muslin
bags loosely filled with roughly powdered charcoal. The charcoal
requires to be renewed occasionally. For purifying water an effectual
plan is to boil it with a good-sized piece of freshly prepared charcoal;
it also forms an excellent filter, placed in alternate layers with river
sand, as is in use by the natives of Southern India. Charcoal,
especially that of the Areca or Betel nut, forms an excellent
tooth-powder; but it is essential that it should be _very_ finely
powdered, or it may scratch the enamel of the teeth. Lastly, it is of
great value in forming the CHARCOAL POULTICE, which is made by adding
finely powdered charcoal to a common Rice poultice (322 _c._) in the
proportion of one part of the former to three of the latter. A little of
the Charcoal should also be sprinkled over the surface of the poultice
previous to applying it. This is a valuable application to _Ulcers_ _and
Wounds attended by a fœtid discharge_; it proves useful in correcting
the bad odour and stimulating to healthy action.


92. +Chaulmugra.+ (The seeds of Gynocardia odorata, _R. Brown_). In
Southern India, where Chaulmúgra is rarely obtainable, the oil of the
seeds of a tree of the same family, Hydnocarpus inebrians, _Vahl._
(Néradi-muttu, _Tam._, Niradi-vittulu, _Tel._), seems well worthy of a
trial. This oil has a great repute amongst the natives of Malabar as a
remedy in leprosy.

 Chaulmúgra or Chál-mogré-ké, bínj (_Hind._).

93. Chaulmúgra seeds are about an inch in length, of an ovoid form,
rendered more or less irregular by mutual compression. The shell,
greyish brown, smooth and fragile, contains a large kernel, which by
expression yields a fixed oil which has a peculiar and slightly
unpleasant smell and taste. The oil procured from the bazaars is usually
impure, and hence objectionable for internal administration.

94. _In Leprosy_ Chaulmúgra has been used with excellent effect; it has
also been advantageously administered in _Scrofula_, _Skin Diseases_,
_and Chronic Rheumatism_. The dose of the seeds coarsely powdered is
about six grains, thrice daily, in the form of pill, gradually increased
to three or four times that amount, or until it causes nausea, when the
dose should be diminished, or the use of the remedy suspended for a
time. This is the best form of administration. The dose of the oil is
from five to six drops, gradually increased as in the case of the seeds.
During the use of this remedy it is advisable to avoid all salt meats,
acids, spices, and sweetmeats; on the other hand, its operation is aided
by butter, ghee, and oily articles of diet. It might, perhaps, be
advantageously combined with a course of fish-liver oil.

95. An ointment, prepared by beating the seeds, deprived of their
shells, into a paste of the requisite consistence, with a little ghee,
or simple ointment, has been found of great service as a local
application in some _obstinate Skin Diseases_.


96. +Chiretta.+ The dried plant Ophelia Chirata, _D.C._

 Charáyatah (_Hind._, _Duk._), Shirat-kuch-chi, Nilavémbu (_Tam._),
 Nelá-vému (_Tel._), Cherota (_Beng._), Chiraita, Kiraita (_Punj._),
 Chiraiet (_Kash._), Chiráyitá (_Mah._), Chírayata (_Guz._), Bincohamba
 (_Cing._), Sekhági (_Burm._), Chrita (_Malay_).

97. Stems about three feet long, of the thickness of a goose-quill,
round, smooth, pale-brown, branched, branches opposite; flowers small,
numerous, panicled; the whole plant intensely bitter. These characters
belong to the officinal Chiretta, but there are met with, in almost
every part of India, numerous varieties which differ more or less from
it in many respects, except in bitterness, which pervades them all. They
also partake, for the most part, in the same medicinal properties.

98. Chiretta is a good bitter tonic, and renders the practitioner in
India independent of imported articles of the same class. It is best
given as follows: take Chiretta, bruised one ounce, Hot Water a pint;
infuse for six hours or more and strain. Dose from two to three ounces
three times daily. A drachm of bruised Cloves, or Cinnamon, or Cardamom
seeds, increases its efficacy and improves its flavour. It may be given
in all cases of _Debility, especially after Fevers_, _in Indigestion_,
_Loss of Appetite_, &c. It may also be given in mild cases of _Ague or
Intermittent Fever_; but this is spoken of in Art. Galls, _q. v._

99. A good form of employing Chiretta as a tonic is to add two ounces of
the bruised stems to a bottle of Sherry and let it stand for a week. Of
this a wineglassful should be taken once or twice daily, one hour before
meals, in _Indigestion_, _Loss of Appetite_, and other cases mentioned
in the last section.


100. +Cinnamon.+ The dried bark of Cinnamomum Zeylanicum, _Nees_.

 Dár-chīnī (_Hind._, _Punj._), Dál-chíní (_Duk._, _Beng._, _Kash._,
 _Guz._), Lavanga-pattai, Karuvá-pattai, (_Tam._), Lavanga patta
 (_Mal._, _Tel._), Dála-chini (_Can._, _Mah._), Kurundo (_Cing._),
 Timbo-tik-yobo (_Burm._), Kulit-manis (_Malay_).

101. The above names belong only to the true Cinnamon, which is
procurable in most bazaars; it requires to be distinguished from the
country Cinnamon, the bark of Cinnamomum iners (Jangli-dal-chiní,
_Hind._, Kattu-karuvá-pattai, _Tam._), which is very inferior. The
former occurs in small closely rolled quills, containing several smaller
quills within them of a light yellowish-brown colour, fragrant odour,
and warm, sweet, aromatic taste; the latter is a much larger and thicker
bark, generally curved, but seldom completely quilled, the taste less
sweet, with some degree of astringency, and the smell less fragrant.

102. Cinnamon is a pleasant aromatic stimulant and carminative, closely
allied in medical properties and uses to Cloves (105), for which it may
be substituted when the latter are not available. It is an agreeable
adjunct to many other medicines.


103. +Cloves.+ The dried unexpanded flower-buds of Caryophyllus
aromaticus, _Linn._

 Lóng (_Hind._, _Beng._), Lavang (_Duk._), Kirámbu, Ilavangap-pú
 (_Tam._), Lavango-pú, Lavangálu (_Tel._), Karámpu (_Mal._), Lavanga
 (_Can._, _Mah._), Lavang (_Guz._), Krábu-nati (_Cing._), Láúng
 (_Punj._), Raung (_Kash._), Leniah-poén, Lenang-poén (_Burm._), Bunga
 Chingkeh (_Malay_).

104. The Cloves met with in the bazaars are often old and worthless.
Those suited for medical use should have a strong, fragrant odour, a
bitter, spicy, pungent taste, and should emit a trace of oil when
indented with the nail.

105. Cloves are a good useful stimulant and carminative, stronger than
Cinnamon, which, however, may be advantageously substituted when the
former are either of inferior quality or not procurable. A pleasant and
serviceable mixture is made by infusing three drachms of bruised Cloves
in a pint of boiling water, and straining when cold. Of this the dose is
from one or two ounces in _Indigestion_, _Flatulence_, _Colic and
Spasmodic Affections of the Bowels_. It sometimes succeeds in checking
_Vomiting, especially that attendant on Pregnancy_. A mixture of equal
parts of the infusions of Cloves and Chiretta (98) has often excellent
effect in _Debility_, _Loss of Appetite_, and in _Convalescence after
Fevers_.


106. +Cocculus Indicus.+ The fruits of Anamirta Cocculus, _W. et A._

 Kákmárí-ke-bínj (_Hind._, _Duk._), Káká-mári (_Beng._),
 Kákkáy-kolli-varai, Pén-kottai (_Tam._), Káka-mári, Káki-champa
 (_Tel._), Karanta-kattin-káya, Pollak-káya (_Mal._), Kaka-mári-bíjá
 (_Can._), Tit-taval (_Cing._).

107. The dried fruit, sold in most bazaars, is rather larger than a
full-sized pea, somewhat kidney-shaped, blackish-brown, wrinkled,
containing a yellowish, oily, bitter, kidney-shaped kernel enclosed in a
two-valved shell. It is _powerfully poisonous_ and is _never
administered internally_; its sole use, and in this respect it is very
effectual, is as an insecticide, _i.e._, as an agent, _for destroying
pediculi, or lice_, which infest the body. For this purpose 80 grains of
the seeds, divested of shell, should be beaten up into a paste in a
mortar, and then thoroughly incorporated with an ounce of kokum butter,
or ghee. In applying this ointment, care should be taken to avoid all
abraded or ulcerated surfaces, on account of the danger of absorption of
the poisonous principle of the seeds.


108. +Sulphate of Copper. Blue Stone.+

 Nílá-tútá (_Hind._, _Punj._), Mór-tuttá, Mhor-tuttah (_Duk._), Tutiyá
 (_Beng._), Nila-toth (_Kash._), Mayil-tuttam, Turichu, Tuttam-turichi
 (_Tam._), Mayilu-tuttam (_Tel._), Turisha, Mayil-tutta (_Mal._)
 Mail-tutyá (_Can._), Mórtúta (_Guz._), Palmánikam (_Cing._), Douthá
 (_Burm._), Toorsi (_Malay_).

109. Sulphate of Copper, of fair quality, is procurable in most bazaars;
it should be in crystalline masses, of various sizes, of a dark-blue
colour, without any light green or whitish powder adherent on the
surface; if these exist they should be thoroughly removed previous to
the salt being employed medicinally. Or it may be further purified by
dissolving in boiling water, filtering, and setting the solution aside
to crystallise. In doses of from a quarter grain to two grains it acts
as an astringent and tonic; in larger doses (5 to 10 grains) it is a
powerful emetic.

110. _In Chronic Diarrhœa and Dysentery_ the following pills are often
productive of great benefit. Take finely powdered Sulphate of Copper and
Opium, of each 6 grains; thoroughly mix them with a small portion of
honey, and divide into twelve pills, of which one should be taken thrice
daily. These pills have been found very useful in controlling _Diarrhœa
in the advanced stages of Consumption_ (_Phthisis_). _In the Chronic
Diarrhœa and Dysentery of Children_, a better form is 2 grains of the
Sulphate dissolved in 12 drachms of Omum water; of this the dose is a
teaspoonful thrice daily. In all these cases, should benefit not be
manifest in a few days, the remedy should be discontinued.

111. _In Diphtheria_ the Sulphate of Copper has been highly spoken of.
Of a solution of 5 grains in one ounce of water, a teaspoonful may be
given to young children, and repeated every half-hour till it produces
vomiting. The same treatment has also been advised in cases of _Croup_.
After the occurrence of free vomiting its use should be discontinued.

112. _In Ulcerations of the Mouth_, whether occurring in children or
adults, 3 to 5 grains of finely powdered Sulphate, incorporated with
half an ounce of honey, is a very useful application. It may be easily
applied to the ulcers by the finger.

113. _In the Ophthalmia of Children attended with copious discharge_, a
solution of one grain in one ounce of water, applied several times in
the day, will often be found serviceable. In obstinate cases the
strength may be doubled, but it should never be so strong as to cause
pain.

114. _Obstinate Indolent Ulcers_ will often yield, when other measures
have failed, to the persevering application of solutions of the
Sulphate, of graduated strengths, from 2 grains to 10 grains in the
ounce of water. At the commencement the weakest solution is applied
morning and evening, water dressing (394) being applied in the
intervals. When the first solution ceases to occasion a feeling of heat
in the ulcerated surface, the strength should be gradually increased by
single grains till the 10-grain solution is borne, by which time the
ulcer is generally almost healed. When the edges of the ulcer are hard
and unyielding, they may be touched every second or third day with the
Sulphate in substance; and it may also be thus used to check _Exuberant
Granulations_.

115. _In Ringworm and Scalled head_ the following ointment has been
found useful: Sulphate of Copper in powder, 20 grains; powdered Galls, 1
drachm; Ceromel, 1 ounce. Mix them thoroughly, and rub well into the
diseased spot. _In Prickly Heat_, a lotion of the Sulphate of Copper (10
grains to one ounce of water, or Rose water) often affords more relief
than any other application.

116. _Excessive Bleeding from Leechbites_ may often be speedily arrested
by the application of a little powdered Sulphate of Copper. _In Bleeding
from the Nose_, a solution of 4 grains of the Sulphate in one ounce of
water introduced into the nostril, is sometimes effectual when Alum
fails.

117. _In Poisoning by Opium_, _Datura_, _Nux Vomica_, _Cocculus
Indicus_, _Bish_ (_Aconite_), _Arsenic_, _&c._, where the poison has
been swallowed, an emetic should at once be given to evacuate the
contents of the stomach. For this purpose, Sulphate of Copper may be
advantageously employed—5 grains in a pint of tepid water, taken at a
draught. If this does not operate in half an hour it may be repeated;
and a third dose, even, may be given if necessary, but this quantity
should not be exceeded; as, unless it is vomited up, it remains in the
stomach, and in large quantities is itself capable of acting as a
poison. Its operation should be promoted by copious draughts of warm
water. Its use as an emetic should be _limited to cases of poisoning
when it is of the greatest importance to empty the stomach as rapidly as
possible_. In other cases it _is not a safe or manageable emetic_. White
of egg is the best remedy if the Sulphate causes any unpleasant effects.


118. +Croton Seeds.+ The seeds of Croton Tiglium, _Linn._

 Jépál, Jamál-gótá (_Hind._), Jamál-guttah (_Duk._), Jépál, Jamál-gotá
 (_Beng._, _Punj._), Nérválam kottai (_Tam._), Népála-vittulu (_Tel._),
 Nirválam (_Mal._) Jápálada-bíjá (_Can._), Népálácha-bi (_Mah._),
 Jamlá-gota (_Guz._), Jápála, Jaipála (_Cing._), Kanakho-si, Sa-díva,
 Ta-díva (_Burm._), Buah doomkian (_Malay_).

119. The Croton seeds met with in Indian bazaars are often spoilt by
long keeping, &c.; they should, when practicable, be collected fresh
when required for use. They are about the size of a grain of coffee,
oval, rounded, of an imperfectly quadrangular form, with a thin brittle
light-coloured shell, containing a yellowish albuminous kernel,
enclosing a large leafy embryo; inodorous; taste at first mild,
subsequently acrid and pungent. In their natural state they are
violently purgative, and even in small quantity poisonous.

120. The following Croton pill is said to be an effectual purgative:
take any quantity of the seeds, deprived of their outer shell, boil them
three times in milk, and after boiling, carefully remove the outer skin
and the little leaf-like body (embryo) which will be found between the
two halves of the kernel; if the latter be allowed to remain, it will
cause violent griping and vomiting. To 30 grains of the seeds thus
prepared add 60 grains of finely powdered Catechu, and with the aid of a
little honey or gum beat them into an even mass. Mix the ingredients
thoroughly, and divide into pills, each weighing two grains. One of
these is a sufficient dose for an adult, and should be given only when a
strong purgative is required, as in _Apoplexy_, _Convulsions_,
_Insanity_, _Ardent Fevers_, &c. Should it cause much griping, vomiting,
or too violent purging, a good large draught of lime juice is the best
remedy; and it may be safely repeated in half an hour if the vomiting,
&c., continue.

121. The oil expressed from these seeds, CROTON OIL, is a powerful
purgative, in doses of one drop, or even less, made into a pill with
bread-crumb. It is applicable for all the cases mentioned in the last
section; and where one drop does not operate the dose may be increased
to two or even three drops. In _Apoplexy_, _Fits_, _&c._, where the
patient is unable to swallow, it is sufficient to place the oil at the
base of the tongue. Its use, as a general rule, should be confined to
adults.

122. A useful stimulant liniment is made by mixing half an ounce of
Croton Oil with three and a half ounces of Sesamum, Cocoa-nut, or other
bland oil. It causes a vesicular eruption, and proves serviceable in
_Chronic Rheumatism_, _Paralysis_, _Diseases of the Joints_, _Phthisis_,
and _Chronic Bronchitis_.


123. +Cubebs.+ The dried unripe fruit of Cubeba officinalis, _Miquel_.

 Kabáb-chíní (_Hind._, _Duk._, _Punj._), Liút-marz (_Kash._), Vál-milagu
 (_Tam._), Tóka-miriyálu, Chalava-miriyálu (_Tel._), Vál-mulaka
 (_Mal._), Bála-menasu (_Can._), Kabábachini, Himsí-míre (_Mah._),
 Kabáb-chíní, Tadamirí (_Guz._), Vál-molagu, Vát molavú (_Cing._),
 Lada-bereker (_Malay_).

124. Cubebs of very fair quality is often obtainable in the bazaars. [In
Southern India and elsewhere _Sítal-Chíní_ is the name in use for
Cubebs, and _Kabáb-chíní_ for Allspice (fruit of Eugenia Pimenta),
whereas in Calcutta the reverse holds good, the former (_Sítal-Chíní_)
is applied to Allspice, and the latter (_Kabáb-chíní_) to Cubebs. In the
Madras bazaars the name Kabáb-chíní is also often applied to the buds of
_Mesua ferrea_: this is incorrect, the proper name of the latter being
_Nágésar_ (Moodeen Sheriff). According to Dr. Aitchison the fruit of
Zanthoxylum alatum, _Roxb._ (Zanthoxylon hostile, _Wall_) is often sold
as Cubebs (Kabáb-chíní) in the Punjaub bazaars.] It is usually about the
size of black pepper, globular, wrinkled, blackish, supported on a short
stalk, has an acrid camphoraceous taste, and a peculiar aromatic odour.
Within the shell is a hard, spherical, whitish, oily kernel.

125. The chief use of Cubebs is as a remedy in _Gonorrhœa_, but it is
only admissible in the more advanced stages, when the acute symptoms
have subsided; in the earlier stages it may do harm. The following is a
good form: Take of powdered Cubebs, two ounces; powdered Alum, half an
ounce. Mix thoroughly, and divide into nine equal parts, one to be taken
thrice daily in water. These powders may also be used with benefit in
_Gleet_, _Leucorrhœa_, _and other Vaginal Discharges of Women_.

126. _The Coughs of Old Age_, attended with much expectoration, are
sometimes greatly benefited by Cubebs in doses of eight or ten grains
thrice daily.


127. +Datura.+ The dried leaves and stems of Datura alba, _Linn._, and
Datura fastuosa, _Linn._

 Dhatúrá (_Hind._, _Duk._, _Beng._, _Punj._, _Guz._), Umattai (_Tam._),
 Dáthir (_Kash._), Ummetta, Duttúramu (_Tel._), Ummatta (_Mal._),
 Ummatte (_Can._), Attana (_Cing._), Padáyin (_Burm._), Kachubung
 (_Malay_). These are the native generic names of the Datura plant, the
 different species being distinguished by affixes denoting the colour of
 the flowers, white, purple, &c.

128. The white and purple varieties of Datura are common on waste places
throughout India; they possess the same medicinal properties, and
although the purple variety is generally regarded as the more powerful,
there is no evidence of its being so. Although a valuable medicine,
_much caution is necessary in its employment; as in over-doses it acts
as a powerful narcotic poison_. A very useful preparation is a tincture
made by macerating two and a half ounces of bruised Datura seeds in one
pint of proof spirit (356) for seven days in a closed vessel,
occasionally shaking; it should then be pressed, and filtered, and
measured, and sufficient proof spirit added to make one pint. This
tincture generally produces all the sedative and narcotic effects which
could be expected from opium, besides effecting a great saving, opium
being very expensive, whilst this tincture can be prepared at a
comparatively small cost. The dose requires to be regulated in each
individual case; it is better, therefore, to commence with small doses
of ten or twelve drops in a little water, and increase them to twenty or
thirty drops, according to circumstances. As a general rule, twenty
drops will be found to be equal in effect to one grain of opium. One of
the effects of Datura is to produce dilatation of the pupil; the eye
should therefore be occasionally examined whilst this remedy is being
administered, and should the pupil be found very large and dilated, it
may be regarded as a sign that the medicine has been carried as far as
it can be _with safety, whether it has produced its other intended
effects or not_.

128β. In Datura we have an excellent, if not perfect, indigenous
substitute for Belladonna [Atropa Belladonna, _Linn._, is an indigenous
shrub, in the Western Temperate Himalaya, alt. six to eleven thousand
feet; from Kashmir to Simla (Flora British India), and the Kuram Valley,
_Aitchison_]—in the treatment of _Cataract and other Diseases of the
Eye_. Its mydriatic (pupil-dilating) powers have been examined by
Sub-Assistant Surgeon Tarra Prosonno Roy (_Indian Med. Gaz._, Sept.
1870). He first applied a portion of a watery extract of the leaves of
D. alba around the eyes; the pupils became widely dilated, and continued
so for two days. He next tried an alcoholic extract of the seeds of the
same species prepared by macerating half an ounce of the seeds in four
ounces of country spirit, evaporating the tincture to dryness on a water
bath, and dissolving the residue in one ounce of water. Experiments made
with this solution prove beyond a doubt its power of causing dilatation
of the pupil when locally applied; the strength of this watery solution
being, at a rough estimate about equal in power to a four-grain (to the
ounce) solution of Atropine.

129. _In Asthma_, the dried leaves and stem cut small and smoked, like
tobacco, in a pipe, afford in many cases great relief. In some the
benefit is immediate and striking, in others it has little effect, and
in a few it acts injuriously; its value in any case can only be
ascertained by personal experiment, but it is worth a trial in all
cases. When the leaves fail, the dried seeds, which are thought to be
more powerful, may be tried. The earlier in the attack it is employed
the greater are the chances of success; it has little effect when the
attack has lasted for some hours. For a person subject to asthma, a good
plan is to adopt the habit of smoking a pipe of it the last thing at
night, whether an attack is threatening or not; at any rate, he should
keep a pipe of it already filled, with the means of lighting it, by his
bedside, so that, immediately on an attack commencing, he may use it.
From ten to twenty grains of the dried plant is sufficient to commence
with; it may subsequently be increased to thirty grains, but in all
cases it should be immediately discontinued if it produces giddiness, a
feeling of sickness, or any other unpleasant symptom. Serious, and even
fatal, consequences have followed its incautious use, hence too much
care cannot be exercised in its employment. In _Chronic Coughs_, where
the cough comes on in violent paroxysms, and is hard and dry, with
scanty expectoration, smoking Datura (_ante_) proves beneficial.

130. _For Rheumatic Swellings of the Joints_, _Lumbago_, _Painful
Tumours_, _Nodes_, _&c._, Datura, locally applied, often proves most
serviceable in relieving pain. There are four modes, in either of which
it may be advantageously employed: 1. POULTICE, made by bruising the
fresh leaves into a pulp, and mixing them, with the aid of a little
water, with an equal weight of rice flour, to the consistence of a
poultice. 2. EPITHEM; which consists of steeping a few entire leaves in
arrack or other spirit, and placing them, whilst wet, over the seat of
pain, and securing them in that position by a bandage. 3. FOMENTATION;
made by infusing the leaves in boiling water, in the proportion of one
ounce to each pint of fluid, and applying as directed in paragraph 393.
4. LINIMENT; prepared by macerating, for seven days, one ounce of the
bruised seeds in a pint of Sesamum or other bland oil, and straining. In
addition to the above-named affections, these preparations, applied to
the loins, are useful in relieving _the pain attendant on painful or
difficult Menstruation_, and in some _painful affections of the Uterus_;
in the latter, they may more advantageously be placed over the lower
part of the abdomen. They also prove beneficial in relieving _Neuralgic
pains, especially of the Face_; for this the liniment is best adapted,
well rubbed in over the seat of pain, and along the space immediately in
front of the ear, or rather, in the narrow space between the ear and the
jaw.

131. _In Tetanus or Lock-jaw, consequent on a wound_, Datura is worthy
of a trial in the absence of more effective agents. Poultices of the
leaves, renewed three or four times a day, should be kept constantly to
the wound, which should be further cleansed if covered with thick
discharge or slough, by the process of irrigation of tepid water (395).
The Tincture of Datura, in doses of 20 to 30 drops in water, may also be
given internally three or four times daily. The dose must be regulated
by the effect produced, but it may be continued, unless the spasms
previously yield, till it produces full dilatation of the pupil with
some degree of giddiness, drowsiness, or confusion of ideas, beyond
which it is not safe to carry the medicine. If the spasms abate, _i.e._,
if they recur at more distant intervals, and are less severe and
prolonged when they do occur, the medicine, in smaller doses at longer
intervals, may be continued till the spasms cease altogether; but if,
under the use of the remedy, after it has produced its specific effects
on the system, the spasms show no sign of abatement, no good, but
perhaps harm, will result from continuing it. In addition to the above
means, Datura liniment (130) should be well rubbed in along the spine
several times daily. The patient should be confined to a darkened room
and protected from cold draughts of air; the bowels should be opened, if
necessary by turpentine enemas (364). The strength should be supported
by strong beef-tea, or mutton-broth (413), by eggs, beaten up with milk,
and by brandy-mixture (420) or other stimulants; if these cannot be
swallowed they should be given in enemas, for which purpose not more
than four ounces should be used at a time; larger quantities will not be
retained. The treatment detailed in this paragraph is advocated from the
success which has in some cases of Tetanus attended the use of
Belladonna—a drug to which Datura bears a very close resemblance in its
effects on the system: employed as above directed, it may be need with
perfect safety, provided that the case is carefully watched, and the
medicine diminished or discontinued on the full development of its
physiological effects.

132. _In cases of Guinea Worm_, a Datura poultice (130) is said to be
the most useful in relieving the pain, and hastening the expulsion of
the worm.


133. +Dill Seeds.+ The fruit of Anethum Sowa, _Roxb._

 Sóyah, Suvá (_Hind._, _Punj._), Sóyí (_Duk._), Sóí-biól (_Kash._),
 Shulphá, Shonvá, Shóvá (_Beng._), Shatta-kuppi-virai (_Tam._),
 Shata-kuppi-víttulu (_Tel._), Shata-kuftá (_Mal._), Sab-basagi
 (_Can._), Suvá-nu-bi (_Guz._), Sada-kuppa, Sata-kuppi (_Cing._), Samin
 (_Burm._), Shatha-kupay, Adas pudus (_Malay_).

134. The Indian Dill Seed possesses no specific characters to
distinguish it from the European article, for which it may be
substituted. The Distilled Water, when procurable, is the best form, but
in its absence an infusion of the bruised seeds, 3 drachms to half a
pint of hot water, may be used; of this, when strained and cold, the
dose for an infant is a dessert-spoonful or more, sweetened with a
little sugar. It proves very effectual in relieving _Abdominal Pain,
Flatulence, and Colic in Children_. Its efficacy is often much increased
by the addition of a teaspoonful of lime water.


135. +Fish-liver Oil.+

 Mach-chí-ká-tél (_Hind._, _Duk._), Machár-tail (_Beng._), Mín-yenney
 (_Tam._), Chépa-núne (_Tel._), Mínnai, Malsyam-nai (_Mal._),
 Míniná-yanne (_Can._), Mo-solícha-téla (_Mah._), Mín-tel, Mal-tel
 (_Cing._), Miniak hati-yu putch (_Malay_).

136. Oil from the livers of the White Shark (Squalus Carcharias,
_Linn._), the Seir (Cybium Commersonii, _Cuv. et Val._), and other fish,
is now extensively prepared in various sea-coast towns of India. When
properly made it is of a fine amber colour; the smell and taste are
similar to Cod-liver Oil, but more strongly marked and more
disagreeable. The great objection to its use is its nauseous taste, but
this might probably, in a great measure, be obviated by extracting it by
the process of boiling the _fresh_ livers in water, instead of allowing
them to undergo a degree of putrefaction before the process of
extraction is commenced, as is the usual practice. As a medicinal agent
it appears to be quite equal to Cod-liver Oil, for which it forms an
excellent substitute; but where the stomach is very irritable, and the
aversion to it unconquerable, it may be advisable to have recourse to
the European imported article. "Turtle Oil," prepared from "turtles"
(tortoises?) which abound in the Straits of Manaar, between India and
Ceylon, has been proposed by Surgeon Y. Anthony Pillay (_Madras Journal
of Med. Science_, March 1870), as a substitute for Cod-liver Oil, over
which it has the advantage of being much cheaper. After two years'
experience of it in dispensary practice he reported highly of its
efficacy in that large class of scrofulous and anæmic cases in which
fish-oil is indicated. Specimens of this oil sent to the Madras Medical
Stores were pronounced unfit for medicinal use; but the principal
storekeeper (Dr. F. Day) adds, "If this turtle oil were prepared from
the animal after it had been well cleansed from all blood, and the
straining properly carried out, an oil would probably be produced but
little inferior to the present fish-oil." It seems well worthy of notice
in the southern portion of the Peninsula, where it is procurable at very
small cost.

137. _Remarks on its Use._—_a._ The best time for administering the oil
is immediately after or, to those who prefer it, during a solid meal.
Taken on an empty stomach it is almost sure to nauseate. Patients who
can take it at no other time will sometimes retain a dose if given the
last thing before going to bed.

_b._ For disguising the nauseous taste and preventing subsequent
eructations, a good plan is to take a few grains of common salt, both
immediately before and after a dose. As a vehicle, a little orange-wine,
or solution of quinine, or lime juice, or hot strong coffee without
milk, have been advocated by various writers. A little Omum water (317)
is perhaps the best vehicle of all.

_c._ The bulk of the whole dose of the oil and vehicle together should
be so small that it may be swallowed at a single draught; therefore the
vehicle should not exceed a table-spoonful, with, at first, a
teaspoonful of the oil, to be gradually increased to a table-spoonful.
The spoon and glass used for taking it should be kept scrupulously
clean, as any oil left adhering to them soon turns rancid. In taking
this (as well as all other nauseous drugs) it is advisable to prevent,
as far as possible, the tongue from coming in contact with it; to effect
this the tongue should be projected on the surface of the glass or
spoon, and the fluid thrown down as far back in the throat as can
conveniently be done.

_d._ The dose, as a general rule, at the commencement is a teaspoonful
three times daily, gradually increased as the stomach is able to bear
it. It is rarely requisite to exceed a table-spoonful twice or thrice
daily; large quantities either derange the stomach and liver, or pass
off unabsorbed by the bowels.

_e._ The diet during the course of the oil should be plain and
nutritious, consisting of bread, fresh meat roast or boiled, poultry,
game, &c., with a fair proportion of vegetables, and fruit, and a
moderate quantity of liquids. All rich articles of food, as pastry, fat
meat, cream, &c., should be avoided. Wine is preferable to beer, the
latter often disagreeing. Should a bilious attack come on, the oil
should be discontinued, the diet lightened, and an occasional aperient
administered. In a few days, when the attack has passed off, the oil may
be resumed, beginning with the small doses as at the first. In all cases
during the use of the oil, the bowels should be kept regular, if
necessary, by mild aperients.

_f._ During its use the patient should be as much as possible in the
open air, and take gentle exercise.

138. It is _in Pulmonary Consumption_ that the value of Fish-liver Oil
is most manifest, but there are a large number of cases of a scrofulous
character in which it proves almost equally valuable. _In Scrofulous
Abscesses_, _Suppurating Glands_, _Ulcerations_, _Discharges whether
from the Nose or Ears_, _and Skin Diseases_, especially when the patient
is weak and emaciated, the oil is indicated and proves most beneficial.
It proves equally useful in _Scrofulous Affections of the_ _Joints and
Bones_, especially in _Rickets_; and in _Scrofulous Ophthalmia_.

139. _In the Mesenteric Affections of Children_ the best results often
follow its use; the little patient rapidly gains strength and flesh, the
tumefied belly becomes reduced, the stools lose their clayey colour and
become bilious and healthy. It should not only be given internally, but
should be _used as a liniment to the abdomen. The Obstinate Constipation
of Children_ sometimes yields to the use of the oil, and its return is
prevented while the remedy is continued. _In Stricture of the Rectum_,
as an adjunct to dilatation cod-liver oil is an excellent remedy: it
nourishes the patient, and softens the motions, rendering aperients
unnecessary. (_Mr. Curling._) It is also well worthy of a trial in cases
of _Chronic Hydrocephalus, or Water on the Brain_, occurring in children
of a scrofulous habit.

140. _In the advanced stages of Hooping Cough, and in other Spasmodic
Coughs, which often remain after an attack of Bronchitis_, especially
when occurring in weakly children, marked benefit follows its use.

141. _Chorea_ (_St. Vitus's Dance_) _and Epilepsy_ sometimes are
benefited by it when more active remedies have failed. The same remark
applies to some forms of _Neuralgia_, especially _Tic Douloureux_; but
the cases in which it will prove serviceable can only be ascertained by
trials with the remedy.

142. _In Chronic Rheumatism_ attended with much debility and emaciation,
it often proves useful; in fact, in all cases of _Atrophy_ (_wasting or
emaciation_), _whether connected with Rheumatism, Scrofula or defective
digestion or resulting from long-continued confinement in close rooms,
as in jails, &c._, a course of the oil offers the best prospects of
success. In some form of _Paralysis_ it is occasionally very beneficial.
In _Leprosy_ it is a remedy well worthy of careful trial; not so much as
a curative agent as a means of relieving many of the distressing
symptoms.

143. In all the above cases the remedy should be persevered in for weeks
or even longer; and the rules given above for its administration must be
carefully attended to. Its operation is most beneficial in the cold
season.


144. +Galls.+

 Mái-phal, Mázu-phal (_Hind._), Mái-phal, Májú-phal (_Duk._), Máju-phal
 (_Beng._, _Punj._, _Kash._), Máshik-káy (_Tam._), Máshi-káya (_Tel._),
 Máshik-káya (_Mal._), Máchi-káyi (_Can._), Mái-phala, Máshi-ká
 (_Mah._), Máyi-phal (_Guz._), Mása-ka (_Cing._), Pinza-káni-si,
 Pinz-gáni-di (_Burm._), Manjakani (_Malay_).

145. Many varieties of Galls are met with in the bazaars; the best for
medical use are globular, about the size of a nutmeg, of a
yellowish-white colour and very astringent taste, with a small hole on
one side of the surface. In the absence of this kind the other varieties
of Galls may be employed, as they all partake, more or less, of the same
astringent qualities. The dose for an adult is from 10 to 20 grains in
powder or infusion; but a better form is Decoction, prepared by boiling
for ten minutes in an earthenware vessel 1½ ounces of bruised Galls in a
pint of Water; of this, when cold and strained, the dose is from 1 to 2
ounces thrice daily, oftener. This decoction forms also a useful
astringent wash, gargle, &c.

146. _In Chronic Diarrhœa, especially in Natives_, powdered Galls in 15
grain doses thrice daily often prove useful, and in obstinate cases its
efficacy is increased by the addition of half a grain of Opium with each
dose. A little powdered Cinnamon may be advantageously added, and the
whole given in honey. _In the advanced stages of Dysentery_ the
decoction (_ante_) seems to answer better, and it may be given in doses
of 1½ to 2 ounces thrice daily, with the addition of Opium, as above,
and a carminative. This treatment is adapted only for adults.

147. _In Prolapsus_ (_descent_) _of the Rectum_, the daily use of an
enema of decoction of Galls proves useful by constringing the parts; and
this may further be effected, especially in the case of children, by
keeping a pad saturated with the decoction over the external parts after
the protruded bowel has been returned. The same treatment is applicable
(the decoction being used as a vaginal injection) in cases of _Prolapsus
of the Uterus_ (_descent of the Womb_).

148. _In Piles unattended by increased heat or inflammation_, a very
useful application is an ointment composed of 1½ drachms of powdered
Galls, and 1 ounce of Ghee. The ingredients should be thoroughly mixed.
If there should be much pain half a drachm of Opium may be added to it.
It should be applied twice daily. Enemas of the decoction (_ante_) may
also be used with advantage.

149. _In Gleet and long standing Gonorrhœa_, 20 grains of powdered
Galls, twice or thrice daily, have sometimes a good effect in checking
the discharge. _In Leucorrhœa, and other Vaginal Discharges_, the same
treatment is applicable, and at the same time injections of the
decoction may be employed.

150. _In Relaxed sore Throat and Enlargement of the Tonsils_ a very
useful gargle is composed of 40 grains of Alum, six ounces of Decoction
of Galls (145), and one ounce of Honey.

151. _In the Intermittent Fevers of Natives_, powdered Galls, in doses
of 20 to 30 grains, three or four times a day, have been found
serviceable in some cases; or smaller doses (10 to 12 grains) may be
given in 1½ ounces of Infusion of Chiretta (98) repeated every hour, for
four or five times in succession, immediately before the period at which
the fever usually returns. An aperient should, in all cases, be taken
before commencing this treatment, which is only suited for adults.

152. _In Poisoning by Nux Vomica_, _Cocculus Indicus_, _Datura_,
_Opium_, _and Bish_ (_Aconite Root_), after the stomach has been freely
emptied by emetics (which is the first thing to be done), the Decoction
of Galls, in doses of 3 or 4 ounces, should be given every ten minutes
or quarter of an hour, for four of five times in succession. It is
thought to act as an antidote; in some cases it certainly seems to act
very beneficially.


153. +Ginger.+ The dried root of Zingiber officinalis, _Roscoe_.

 Sónth, Sindhi (_Hind._), Sónth (_Duk._, _Beng._, _Punj._), Shó-ont
 (_Kash._), Shukku (_Tam._), Sonti (_Tel._), Chukka (_Mal._), Vanasunthi
 (_Can._), Súnt (_Guz._), Ingúrú, Velichaingúrú (_Cing._), Ginsi-khiáv
 (_Burm._), Hulya-kring (_Malay_).

154. Dried Ginger is preferable to fresh or green Ginger for medicinal
use, but if not procurable the latter may be employed. It is best given
in the form of Infusion, made by macerating 1 ounce of bruised Ginger in
a pint of boiling water in a covered vessel for an hour and straining.
The dose is from 1 to 2 ounces. A very useful domestic remedy is made by
steeping 3 ounces of Ginger in a pint of Brandy for ten days. Of this a
teaspoonful or more may, with great advantage, be added to aperient,
antacid and other medicines.

155. _In Colic_, _Flatulence_, _Vomiting_, _Spasms_, _and other painful
Affections of the Bowels unattended by fever_, the above Infusion,
especially if taken warm, in doses of 2 ounces every half-hour or hour,
often affords great relief. The addition of 20 or 30 grains of Carbonate
of Soda, if at hand, greatly increases its efficacy. For children a
tablespoonful of the infusion is sufficient.

156. _In Chronic Rheumatism_ Infusion of Ginger (2 drachms to 6 ounces
of boiling water and strained), taken warm the last thing before going
to bed, the body being covered with blankets so as to produce copious
perspiration, is often attended with the best effects. The same
treatment has also been found very beneficial in _Colds or Catarrhal
attacks_, and during _the cold stage of Intermittent Fever_.

157. _In Headache_ a Ginger plaister, made by bruising Ginger with a
little water to the consistence of a poultice, applied to the forehead,
affords in many instances much relief. _Toothache and Faceache_ are
sometimes relieved by the same application to the face.

158. _Relaxed Sore Throat_, _Hoarseness_, and _Loss of Voice_, are
sometimes benefited by chewing a piece of Ginger so as to produce a
copious flow of saliva.


159. +Gurjun Balsam+, or +Wood Oil+. The balsamic exudation of
Dipterocarpus lævis, _Ham._

 Garjan-ká-tél (_Hind._), Gorjon-tail (_Beng._), Hora-tel (_Cing._),
 Kanyen-si (_Burm._).

160. Gurjun Balsam, or Wood Oil, is a transparent liquid of the
consistence of olive oil, lighter than water, of a dark-brown sherry
colour, with an odour and taste resembling Copaiba, but less powerful.
It has been used as a substitute for this latter drug in the treatment
of _Gonorrhœa_, and trials with it in the hands of Europeans have shown
that it is a remedy of no mean value in this affection. It is only
advisable in the advanced stages, or when the disease has degenerated
into _Gleet_. In the latter affection it is stated to prove most useful.
It is also well worthy of a trial in _Leucorrhœa and other Vaginal
Discharges_. The dose is about a teaspoonful twice or thrice daily,
given floating on Omum or other aromatic water, or made into an emulsion
with lime water. It is apt occasionally to produce an eruption on the
skin similar to that which, in some instances, follows the use of
Copaiba.

161. _In Leprosy_ the use of Gurjun Balsam was introduced in 1873 by
Surgeon-Major J. Dougall, and the reported success of the remedy gave
rise to sanguine anticipations that a specific for this disease had at
last been discovered. Although subsequent experience proved this hope to
be fallacious, yet the lessons imparted by Dr. Dougall's treatment are
far from unimportant. His treatment consisted in the internal and
external use of the Balsam: for the former purpose it was given in
two-drachm doses, with lime-water, twice daily; for the latter, in the
form of ointment composed of 1 part of the Balsam and 3 of lime-water,
which was directed to _be thoroughly and perseveringly rubbed in over
the whole body for two hours a day by the patient himself, as far as
practicable_. This was insisted upon not only for the sake of the action
of the ointment on the skin, but because it was considered that any
gentle employment conjoined with exercise was likely to prove beneficial
both physically and mentally. Under this treatment (no change having
been made in the diet) Dr. Dougall obtained signal and manifest
improvement in numerous cases; but this was unhappily found to be of
only a temporary character, the discontinuance of the remedy being in
all cases followed by a relapse. Still further to test this treatment,
Dr. A. H. Hilson (_Indian Ann. of Med. Sci._, Jan. 1877) instituted two
sets of trials on leprous subjects (12 of each group), treated
respectively by Gurjun Balsam, used externally and internally on Dr.
Dougall's system, and by the ordinary Til (Sesamum) or Sweet Oil of the
bazaars, used externally only. The results which he arrived at are as
follows: 1. That the application of Gurjun oil removes the local
manifestations of leprosy to a great extent. 2. That it has no specific
influence over the constitutional taint or leprous cachexia. 3. That
ordinary Sweet Oil is equally efficacious as far as the local effect is
concerned, and therefore it is not improbable that the benefit which
patients experience from the application of Gurjun oil is due to the
friction producing absorption of the deposits which are effused into the
skin and cellular tissue during the course of the disease. Dr. Dougall
may have failed in finding in Gurjun oil a specific in leprosy, but he
has rendered important service in leading us to a knowledge of the vast
benefits to be derived from diligent oleaginous frictions in its
treatment; and, as he himself justly remarks, "even temporary
improvement is worth striving after in such a disease."


161_a_. +Hemidesmus Root+, or +Country Sarsaparilla+. The root of
Hemidesmus Indicus, _R. Brown_.

 Híndí-sál-sá, Jangli-chanbéllí (_Hind._), Nanníré-jar (_Duk._),
 Ananto-múl (_Beng._), Nannárí-ver (_Tam._), Sugandhi-pála,
 Pála-chukkam-déru (_Tel._), Nannári-kizhanna, Naru-níntí (_Mal._),
 Sugandha-pála-da-béru (_Can._), Irimusu (_Cing._), Anant-mūl (_Punj._).

162. The specimens of Hemidesmus Root, procurable in most parts of
India, which are best adapted for medical use are medium sized, about
the size of a quill, having a full, peculiar aromatic odour, and a
feebly bitter and agreeable taste. The freshly collected root is
preferable to that bought in the bazaars, as that is often inodorous,
tasteless, and almost worthless. The virtues of the drug reside mainly
in the root-bark, hence if the larger roots are employed you get an
undue proportion of the inner woody portion, which is comparatively
inert.

163. Hemidesmus proves most useful in _Constitutional Debility_, from
whatever cause arising; also in _Chronic Rheumatism_, _Constitutional
Syphilis_, _Skin Diseases and Ulcerations, especially those of
Syphilitic origin_, _Indigestion_, and _Loss of Appetite_. It is best
given in the form of Infusion, prepared by infusing one ounce of the
bruised roots in half a pint of boiling water in a covered vessel for an
hour, and straining. Of this the dose is from 2 to 3 ounces thrice
daily. Its efficacy is much increased by being taken while the Infusion
is still warm; the addition of milk and sugar renders it so like
ordinary tea that children will take it readily; and this is fortunate,
as it is a peculiarly useful tonic for the pale, weakly offspring of
Europeans in India; for such it may be substituted for tea at breakfast
and supper. Some children prefer it to ordinary tea.


164. +Honey.+

 Shahad, Madh (_Hind._), Shahad (_Duk._), Modhu (_Beng._), Tén (_Tam._)
 Téne (_Tel._), Tén (_Mal._), Jenu (_Can._), Mada (_Mah._), Madh
 (_Guz._), Páni (_Cing._), Piyá-ye (_Burm._), Ayer madu (_Malay_), Saht,
 Shahd (_Punj._), Mhách (_Kash._).

165. Honey of fair quality is obtainable in most parts of India. Though
not possessed of any marked medicinal properties, it is always advisable
to keep some in store, as it forms an agreeable sweetening ingredient
for mixtures, is a good vehicle in which to administer powders for
children, and is one of the best substances in making pills, &c. Should
it be dirty and impure, it should be "clarified" by melting in a water
bath and straining through cloth.

166. A mixture of Honey and Distilled Vinegar or Lime Juice, in equal
parts, melted together by gentle heat, is an excellent adjunct to cough
mixtures; and in the _Coughs of Childhood_ this combination, diluted
with an equal quantity of water, and with or without a few drops of
Paregoric, forms a useful and pleasant mixture, which children will
readily take when they will not swallow other more nauseous medicines.

167. An excellent stimulant application, termed CEROMEL, for _Indolent
and other Ulcerations_, is formed by melting together, with the aid of
gentle heat, 1 ounce of Yellow Wax and 4 ounces of Clarified Honey, and
straining. It is admirably adapted for use in hot climates, where animal
fats, the basis of so many ointments, soon become rancid and unfit for
medicinal use.


168. +Hydrocotyle Asiatica+, _Linn._

 Vallári (_Hind._, _Duk._), Thal-kuru (_Beng._), Valláraí (_Tam._),
 Mandúka-bramha-kúraku, Pinna-éaki-chettu, Bokkudu-chettu (_Tel._),
 Kutakan, Kodogam (_Mal._), Von-delagá (_Can._), Hingotu-kola (_Cing._),
 Mink-hua-bin (_Burm._), Dawoon-punga-gah (_Malay_).

169. This small, low-growing plant, common in moist localities in many
parts of India, has obtained considerable repute in European practice as
a remedy for _Leprosy_. It is prepared as follows: The leaves having
been carefully separated, as soon as possible after the plant is
gathered, should be spread on a mat in the shade, and then freely
exposed to the air, but not to the sun. In preparing the powder for use,
avoid using any heat, as this dissipates all its virtues. They lose
about nine-tenths of weight by drying. When thoroughly dried they should
be finely powdered and kept in well corked or stoppered bottles. Of this
powder the dose is from 3 to 5 grains thrice daily. At the same time
some of the powder may be sprinkled on the ulcers, or, which is better,
poultices made of the fresh leaves bruised into a paste, may be applied.
Under its use the patient, in the course of a few weeks, improves in all
respects. After continuing its use for some time, this remedy causes
great itching of the skin over the whole body; under these circumstances
it should be discontinued for a week, aperients administered, and then
recommence giving the medicine. Though it may not effect a cure, it
often does a great deal of good. It may also be tried in _Scrofula_ and
_Syphilis_.

170. _Chronic Ulcerations of Syphilitic and Scrofulous origin_ often
show a marked improvement under the internal and local use of this
remedy, but it requires to be steadily persevered in.


171. +Sulphate of Iron.+

 Hirá-kasis, Kashish (_Hind._), Hírá-kashísh (_Duk._), Hirákos,
 Hírá-kosis (_Beng._), Sang-i-sabz (_Punj._, _Kash._), Híra-kasis
 (_Guz._), Anná-bédi, Anná-bhédi (_Tam._, _Tel._, _Mal._, _Can._),
 Madu-kolpa (_Malay_).

172. Sulphate of Iron, in a more or less pure state, is met with in most
Indian bazaars; that only should be selected for medicinal use which
occurs in the form of crystals or small crystalline masses of a pale
green colour, wholly soluble in water. The dirty yellowish powder
usually associated with it in bazaar specimens, as well as the flat
whitish-yellow cakes sold under the same native names as the Sulphate,
should be rejected. It is a valuable tonic and astringent in doses of
from ¼ grain to 2 grains. In solution it forms a useful external
application.


173. _Remarks on the Use of this and other Preparations of Iron._

_a._ Under its use the stools become black and offensive, but they
resume their natural characters when the medicine is discontinued. The
tongue also, if iron has been taken in solution, becomes black.

_b._ In order to judge fairly of its effects, it requires to be
persevered in for weeks or longer.

_c._ No advantage is gained by giving it in large doses. The fact of the
stools becoming deeply black is an indication that the dose may be
diminished.

_d._ Purgatives increase its efficacy; a dose of castor oil, or other
aperient, every week or ten days, is advisable during a course of Iron.

_e._ Acids and acidulous fruits should be avoided during its use.

_f._ Children may take it not only with safety, but with advantage.

174. _In that form of Constitutional Debility termed Anæmia_, when the
body is apparently bloodless, when, especially in natives, the inner
surface of the eyelids, the tongue, and the palms of the hands, become
very pale or white, the Sulphate proves very valuable. It is best given
in solution as follows: Take of Sulphate of Iron, 4 grains, Omum water
and Infusion of Chiretta, of each 6 ounces; of this the dose is a
wineglassful thrice daily for adults, and from a teaspoonful to a
table-spoonful for children, according to age. Anæmic females, suffering
from _Leucorrhœa_ (_Whites_) and _Amenorrhœa_ (_Suspension of menstrual
discharge_), may advantageously take it combined with Aloes as advised
in paragraph 18.

175. _In Intermittent Fever_ the Sulphate often proves of great service,
especially in obstinate or long-standing cases, where the patient has
become weak and anæmic. It may be given as follows: Take of Sulphate of
Iron, finely powdered, 24 grains; powdered Black Pepper, 30 grains; Beat
them into a mass with a little honey, and divide into twelve pills. Of
these two should be taken twice or thrice daily, with a wineglassful of
Infusion of Chiretta (98), or Gulancha (352). Whilst taking these pills,
all acids and acidulous fruits should be avoided, and the bowels kept
open. They are inadmissible when the stomach is very irritable, or when
diarrhœa exists.

176. Long-continued or repeated attacks of _Intermittent Fever_ are
often accompanied by a swelling or hardness under the ribs of the left
side; this constitutes the affection termed _Enlargement of the Spleen
or Ague Cake_. In these cases the treatment advised in the last
paragraph may be resorted to with benefit, with the addition of a good
active purgative once or twice a week. Local pain may be relieved by
Turpentine stupes or mustard poultices over the affected part.

177. _In Neuralgic or Rheumatic Faceache_, recurring periodically,
especially when occurring in the weak and anæmic (174), Sulphate of
Iron, in 2 or 3 grain doses thrice daily, produces excellent effects; it
may be given in the form of pill, with a little Cinnamon powder and
Honey, or in solution with Infusion of Chiretta (98), or Gulancha (352).
_Chorea and other Nervous Affections_ occurring in anæmic females are
often greatly benefited by the Sulphate, conjoined with Aloes (18).
_Paralysis and Rickets_, associated with anæmia, are likewise benefited
by it.

178. _In Dropsy attended with Anæmia_ (174) _and Debility_, two grains
of the Sulphate of Iron in a quart of water sweetened to taste, and
taken in divided doses as an ordinary drink during the day, is a useful
adjunct to other treatment.

179. _In Bleeding Piles, especially when the patient is much debilitated
by the discharge_, daily enemas of the Sulphate, of the strength of 3
grains to 1 ounce of water, often prove of great service. The same
treatment is well adapted for _Prolapsus_ (_Descent_) _of the Rectum_.

180. _Obstinate Hooping Cough_, which resists Alum (28) and other
remedies, sometimes yields to Sulphate of Iron in small and continued
doses.

181. _In Chronic Diarrhœa_ and _Dysentery of Childhood_ in weak anæmic
children the following mixture has been used with great advantage;
Sulphate of Iron, 4 grains; Laudanum, 6 drops; Omum water, 10 drachms.
Of this the dose is two teaspoonfuls every six hours for a child of one
year of age, and so on in proportion.


182. +Jatamansi+ or +Indian Spikenard+. The root of Nardostachys
Jatamansi, _D.C._

 Jatámásí, Bal-chír (_Hind._, _Punj._), Jhatá-mansí (_Duk._), Játámámsí
 (_Beng._), Bhút-jatt, Kúkil-i-pót (_Kash._), Jatámáshi (_Tam._,
 _Tel._), Jetá-mánchi (_Mal._), Jetá-mávashí (_Can._, _Mah._),
 Jatamánsi, Jaramánsi (_Cing._).

183. These roots, met with in most bazaars, occur in the form of short
pieces of an underground stem, about the thickness of a goose quill,
covered towards its tapering extremity, or almost entirely, with coarse,
dark, hairlike fibres; odour, peculiar and fragrant; taste, aromatic and
bitterish. In selecting specimens for medical use, care should be taken
that they are fresh and of good quality; much of the drug sold in the
bazaars being old, worm-eaten, and worthless.

184. Jatamansi is held in high repute by the natives as an
antispasmodic, and trials made with it by Europeans tend to show that in
this character it is a good substitute for the officinal Valerian; hence
it is worthy of trial in _Hysterical Affections_, especially in
_Palpitation of the Heart_, _Chorea_, _Flatulence_, _&c._ It may be
given in infusion (2 drachms of the bruised root to half a pint of
boiling water, macerated for an hour and strained), in doses of a
wineglassful twice or thrice daily. A Tincture was ordered in the Bengal
Pharmacopœia (5 ounces of bruised Jatamansi, Proof Spirit, 2 pints), of
which the dose is from 1 to 2 drachms. In all cases it may be
advantageously combined with camphor, ammonia, and other remedies of the
same class.


185. +Kala-dana.+ The seeds of Pharbitis Nil, _Choisy_.

 Kálá-dánah (_Hind._, _Punj._), Kali-zirki-ká-bínj (_Duk._), Kálá-dáná,
 Nil-kolomi (_Beng._), Hub-úl-níl (_Punj._, _Kash._),
 Kodi-kakkatán-virai, Jiriki-virai (_Tam._), Jiriki-vittulu,
 Kolli-vittulu (_Tel._).

186. Kala-dana seeds are black, angular, a quarter of an inch or more in
length, weighing on an average about half a grain each, having the form
of the segment of an orange; of a sweet and subsequently rather acrid
taste, and heavy smell.

187. The powdered seeds, in doses of from 30 to 50 grains, act as a safe
and effectual purgative, forming an excellent substitute for Jalap,
though not quite so active in its operation. When the ingredients are
available, the following powder is preferable to the powdered seeds by
themselves: Powdered Kala-dana seeds, 7 drachms; Rock Salt, or Cream of
Tartar, 7 drachms; powdered Ginger, 1 drachm. Rub them well together in
a mortar, and pass the powder through a fine sieve. Of this, the dose,
as a purgative for an adult native, is from 60 to 90 grains. Somewhat
smaller doses suffice for Europeans.


188. +Kamala+ or +Kamela+. The powder from the capsules of Mallotus
Phillippiensis, _Müller_.

 Kaméla, Kamúd (_Hind._), Kaméla (_Beng._), Kamélá-mávu, Kápila-podi
 (_Tam._), Kápila-podi (_Tel._), Kaméla (_Guz._),
 Hampirilla-gedivella-buvá (_Cing._), Rúlyá, Kamíla (_Punj._), Káim-bil
 (_Kash._).

189. Kamala, much employed by the natives as a dye, is met with in most
bazaars in the form of a beautiful purplish-red powder; it should be
free from sand or earthy impurities. In medicine, it has attained
considerable repute as a remedy for _Tænia or Tape worm_. It has little
or no effect on other forms of intestinal worms. The dose for an adult
is from 2 to 3 drachms in honey, or a little aromatic water; no other
medicine being necessary before or after. In the above doses it acts
freely on the bowels, causing, in many instances, considerable nausea
and griping, though not generally more than is caused by other remedies
of the same class; the worm is generally expelled in a lifeless state in
the third or fourth stool. Should the first trial not prove successful,
it may be repeated after the interval of a week; but should this be a
failure also, it will be useless to continue its use farther; then other
remedies may be tried.


190. +Kariyat+ or +Creyat+. The dried stalks and root of Andrographis
paniculata, _Nees_.

 Charàyetah, Mahá-títá, Kiryat (_Hind._), Charàyeta, Kalaf-náth
 (_Duk._), Cherota, Mahá-tita (_Beng._), Shirat-kúch-chi, Nila-vémbu
 (_Tam._), Néla-vému (_Tel._), Nila véppa, Kiriyáttu (_Mal._),
 Nela-bevinágidá (_Can._), Chiráyita (_Mah._), Kiryáta, Kiryáto
 (_Guz._), Binko-hamba, Hín-binko-hamba (_Cing._), Charita (_Malay_).

191. The stem, which is usually sold in the bazaars with the root
attached, occurs in pieces of about a foot or more in length,
quadrangular, of a lightish-brown colour, and persistent bitter taste.
From the similarity between their native names and sensible qualities,
this article is often confounded with Chiretta (96). Kariyát is a
valuable bitter tonic, and may advantageously be employed in cases of
_General Debility_, in _Convalescence after Fevers_, and in _the
advanced_ _stages of Dysentery_. It is best given as follows: Take of
Kariyát, bruised, ½ ounce, Acorus, or Sweet Flag Root, and Dill Seeds
bruised, of each 60 grains; Boiling Water, ½ pint; infuse in a covered
vessel for an hour, and strain. Dose, from 1½ to 2 ounces twice or
thrice daily.

192. The following preparation has been highly spoken of: Take of
Kariyát, cut small, 6 ounces; Myrrh and Aloes, in coarse powder, of each
1 ounce; Brandy, 2 pints. Macerate for seven days in a closed vessel,
occasionally shaking it, strain, press, filter, and add sufficient
Brandy to make 2 pints. Of this the dose is from one to four
teaspoonfuls in a little water taken on an empty stomach. It acts as a
gentle aperient, and is said to prove very useful in many forms of
_Dyspepsia, especially when attended with torpidity of the bowels_.

193. _In the Bowel Complaints of Children_ a decoction of the fresh
leaves of the Kariyát plant has been well spoken of. It is prepared by
boiling 2½ ounces of the fresh leaves in 1½ pints of water down to 6
ounces; of this the dose is one ounce every two or three hours. It may
be used in conjunction with other remedies as required.


194. +Kokum Butter.+ The concrete oil of the seeds of Garcinia purpurea,
_Roxb._

 Kokam-ká-tél (_Hind._).

195. This oil is obtained by first exposing the seeds to the action of
the sun, when sufficiently dry bruising them, and then subjecting them
to boiling; the oil collects on the surface, and on cooling, concretes
into a solid cake. When purified it is rather brittle, of a pale
yellowish colour, bland and mild to the taste, melting in the mouth, and
leaving an impression of cold on the tongue. It melts at 98° F. From its
bland, unirritating properties, as well as from its consistence, it
seems admirably adapted for replacing animal fats in the preparation of
ointments, &c. Were it largely produced, which it unfortunately is not,
it might be extensively utilised in tropical pharmacy.


196. +Lawsonia alba+, _Linn._, or +Henna Shrub+.

 Mhíndí (_Hind._), Mhéndí or Méndí (_Duk._, _Punj._), Méhedi (_Beng._),
 Móhnz (_Kash._), Marutónri, Aivanam (_Tam._), Góranta (_Tel._),
 Mayilánchi, Marutónni (_Mal._), Górante (_Can._), Méndhi (_Mah._),
 Méndi (_Guz._), Maritondi (_Cing._), Dánbin (_Burm._), Hinie (_Malay_).

197. The leaves of this common Indian shrub, in almost universal use
throughout the East for staining the nails, &c., are well worthy of a
trial in the treatment of that troublesome and painful affection of the
natives called _Burning of the Feet_. For this purpose the fresh leaves
should be beaten into a paste with vinegar or lime juice, and applied as
a poultice to the soles of the feet. Another plan, which is sometimes
more effectual, is to use strong friction with the bruised leaves over
the parts. Like all other remedies, however, they not unfrequently fail
to afford more than temporary relief; still, from occasionally
succeeding, they merit a fair trial.


198. +Leeches.+

 Jók (_Hind._), Jónk (_Duk._, _Beng._, _Punj._), Drik (_Kash._), Attái
 (_Tam._), Attalu, Jela-galu (_Tel._), Attá (_Mal._), Jígani (_Can._),
 Jala (_Guz._), Kudallu, Púdal (_Cing._), Míyon, Minyon (_Burm._),
 Lintah (_Malay_).

199. Leeches are procurable, especially during the monsoon, in most
parts of India, in the neighbourhood of tanks and swamps. As they are a
valuable resource in many diseases, when properly applied in proper
cases, a few preliminary remarks may be acceptable.

200. Leeches vary considerably in size; and their blood-extracting
capacity is, as a general rule, in proportion to their size. It has been
found that small Leeches will abstract two and a half times, small
middle-sized four times, large middle-sized five and a half times, and
large ones nearly six times their own weight of blood. Hence, to
abstract a certain quantity of blood, a very much larger number of small
Leeches is required than of large ones. The middle-sized Leech, from 1½
to 2 inches in length when at rest, is in all cases preferable. The very
small leeches so commonly supplied in India are objectionable on account
of the number of bites, the length of time required in their
application, and the indefinite small oozing of blood which follows
their application, and the difficulty in arresting the flow by pressure.
On the other hand, the very large Leech is objectionable, from the large
gaping wound left by its bite, which often results in an ugly scar; this
applies with peculiar force to childhood and infancy.

201. Where only one or two Leeches have to be applied, they may be taken
in the hand and held to the spot where it is desired they should bite,
but this is a long and tedious process; when several are to be applied,
they should be put in a wineglass and thus held to the surface till they
have all taken.

202. In order to make Leeches bite readily, thoroughly cleanse the skin
with soap and water, and then dry it; this is particularly necessary if
a liniment has been previously employed. If they will not bite, one or
more of the following plans may be tried: 1. Remove them from the water
and keep them for ten minutes in a dry, warm cloth. 2. Smear the skin
with cream or sugared milk. 3. Apply a small mustard poultice over the
spot. After carefully cleansing with hot water, apply the Leeches. Not
only will they bite more readily, but the flow of blood will be far
greater than it otherwise would be. 4. Make a small puncture or scratch
on the skin, and smear the blood over the surface; this often succeeds
when everything else fails. It should also be remembered that the fumes
of sulphur, vinegar, or tobacco in a room, will often prevent Leeches
from biting at all.

203. To make Leeches bite on particular spots, take a piece of
blotting-paper and make in it as many small holes as there are Leeches,
the holes corresponding with the spots on which it is desired to apply
the Leeches; they are then to be covered over with a wineglass or
tumbler; the Leeches, finding themselves on a rough surface, creep about
till they come to the holes in the paper, when they instantly bite the
exposed points of the skin; the blotting-paper is easily removed by
being moistened.

204. When Leeches will not drop off naturally, which they generally do
in about fifteen minutes or less, or if you wish to remove them,
sprinkle them with a little salt or vinegar, or touch them with a piece
of onion; the last is an old Bengali practice.

205. To promote the bleeding from Leech-bites, use hot fomentations; to
arrest it apply burnt rag, and make firm pressure with the finger over
the bite. A piece of tobacco leaf, or spider's web, or the nap off a
hat, sometimes succeeds better than burnt rag. If these fail try
powdered alum (25) or sulphate of copper (116). See also _Hæmorrhage_ in
Index.

206. If Leeches get into the rectum or nostrils, or any of the other
passages, they may be dislodged by using an injection of, or by simply
touching them with, vinegar or a solution of salt.

207. Leeches should not be applied immediately over a large prominent
vein, nor to the eyelids, nor to the bosom of a woman, especially during
pregnancy, nor to the loose skin of the penis or scrotum, as the bites
in these situations are apt to be followed by infiltration or
inflammation.

208. Additional care is necessary in applying Leeches to young children,
as they bleed so much more freely than adults; they should, when
practicable, be placed where a bone is near the surface, so that in case
of excessive bleeding pressure may be made against it. Morning is the
best time for their application; if put on in the evening, the bites may
burst out bleeding whilst _the attendants are asleep_, and the _child
die from hæmorrhage_; such cases are on record. As a general rule, one
Leech is sufficient for each year of a child's age up to six; after that
age up to adolescence, the latter number continues to be enough in
ordinary cases.

209. _In Fevers attended with much Headache_, Leeches are very useful,
but they should only be applied in the early stages of the disease; when
the patient is young and vigorous, four or six Leeches to each temple
may be applied, but they sometimes give most relief if put at the nape
of the neck, close to the point where the head joins to the spine. _In
severe Pain in the Chest or Abdomen occurring during Fevers_, eight or
ten Leeches applied immediately over the seat of pain often afford
manifest relief.

210. _In severe Headache, or fulness of Head depending upon the stoppage
of a discharge of blood from Piles_, Leeches close to the anus
frequently afford great relief, but great care is necessary to prevent
them creeping up into the rectum. When the _Headache depends upon the
sudden stoppage of the Menstrual Discharge_, the leeches should be
applied to the inner part of the thighs.

211. _In Acute Dysentery_, a few Leeches (six to nine) to the verge of
the anus are often most serviceable in relieving the pain and straining
at stool, and otherwise prove beneficial. The same measure is also of
great service in _Congestion of the Liver_, or they may be placed over
the region of the liver, but a fewer number afford a greater amount of
relief when applied to the verge of the anus.

212. _In all local Inflammations of the Skin_, _Incipient Abscesses_,
_Boils_, and _in Bruises_, _Sprains_, and _Blows_, where there is much
pain and heat of the part, six or eight Leeches, followed by hot
fomentations, tend to relieve the pain and cause the subsidence of
inflammatory action.

213. _Obstinate Vomiting_ may occasionally be checked by a few Leeches
to the pit of the stomach after ordinary means have failed.


214. +Lemon-grass Oil.+ The oil obtained by distillation from several
species of Andropogon.

 Akyá-ghas-ká-aitr (_Hind._), Hazár-masáleh-ká aatar (_Duk._),
 Agya-ghans-tail (_Beng._), Vásh-anap-pullu-yenney, Karpúra-pullu-yenney
 (_Tam._), Nimma-gaddi-núnay (_Tel._), Vásanap-pulla-enna (_Mal._),
 Purvali-hullú-yanne (_Can._), Lilli-chaya-tél (_Guz._), Pengrimá-tel
 (_Cing._), Sabalen-si (_Burm._), Miniak Sárie (_Malay_), Iz-khar
 (Punj.), Babber-i-Khát (_Kash._).

215. Specimens of Lemon-grass Oil met with in India differ somewhat in
appearance, but they all partake more or less of the same medical
properties, being powerful stimulants whether taken internally or
applied externally. The true Lemon-grass Oil is of a pale sherry colour,
transparent, with an extremely pungent taste and a peculiar fragrant
lemon-like odour.

216. _In Flatulent Colic and other Spasmodic affections of the Bowels_,
a dose of from 3 to 6 drops on sugar or in emulsion often affords great
and speedy relief. Thus given it proves effectual in allaying _Obstinate
Vomiting_. Even in _that of Cholera_ it has been found successful when
other remedies have failed, and in these cases it proves additionally
serviceable by acting as a stimulant to the system generally; it is well
worthy of a more extended trial in the treatment of this disease. The
dose (5 or 6 drops) may be repeated every hour or oftener in severe
cases.

217. _In Chronic Rheumatism_, _Lumbago_, _Neuralgic Pains_, _Sprains_,
_and other painful muscular affections_, an embrocation of equal parts
of this oil and any bland oil, well rubbed in twice daily, has been
found useful in many instances. In old chronic cases it is necessary to
use the undiluted oil in order to obtain relief.


218. +Lime.+ Calcareous earth, the oxide of calcium.

 Chúnah, Chúna (_Hind._), Chunnah (_Duk._), Chún, Chúná (_Beng._,
 _Punj._, _Kash._), Shunnámbu (_Tam._), Sunnam (_Tel._), Núra (_Mal._),
 Sunnú (_Can._), Chunná (_Mah._), Chúno (_Guz._), Hunu (_Cing._),
 Thónphiya (_Burm._), Kapor (_Malay_).

219. Lime in a medical point of view is of great importance as the basis
of LIME WATER (in India it is essentially necessary to see that nurses
and sick attendants understand the difference between Lime Water and
Lime Juice; accidents have been known to occur from their ignorance), a
mild and useful antacid; it is prepared by adding two ounces of slaked
lime to one gallon of water, in a stoppered bottle, shaking well for two
or three minutes, and then allowing it to stand till the lime is
deposited at the bottom. In cases of emergency, as burns, &c., half an
hour is sufficient for this purpose; otherwise it should be allowed to
stand for twelve hours at least before being used. It is _only the clear
water which holds a portion of Lime in solution, which is employed in
medicine_. It is advisable always to keep a supply ready prepared, as it
is useful in many ways, and it will remain good for a long time, if kept
in well-stoppered bottles, so that the air cannot have access to it. The
dose for adults is from 1 to 3 ounces twice or thrice daily; it is best
administered in milk.

220. Another form, called the SACCHARATED SOLUTION OF LIME, thought to
be better adapted for internal use in the diseases of childhood and
infancy, is prepared by carefully mixing together in a mortar one ounce
of Slaked Lime and two ounces of powdered White Sugar, and adding this
to a pint of Water, as described above. It should be kept in a
well-stoppered bottle. The dose of _the clear water_ is from 15 to 20
drops or minims in milk twice or thrice daily.

221. _In Acidity of the Stomach, in Heartburn, and_ _in those forms of
Indigestion arising from or connected with acidity of the stomach_, Lime
Water in doses of 1½ to 2 ounces, is often speedily and permanently
effectual. It is particularly useful in indigestion when the urine is
scanty and high coloured, and when vomiting and acid eructations are
prominent symptoms. It is best given in milk.

222. _In Diarrhœa arising from Acidity_ Lime Water frequently proves
useful; it is best given in a solution of gum arabic or other mucilage,
and in obstinate cases ten drops of Laudanum with each dose increases
its efficacy; it may also be advantageously combined with Omum water
(317). _In Chronic Dysentery_ the same treatment sometimes proves
useful. Enemas of Lime Water diluted with an equal part of tepid milk or
mucilage have also been used with benefit. It is especially adapted for
the _Diarrhœa and Vomiting of Infants and young children which result
from artificial feeding_; in these cases a sixth or a fourth part of
Lime Water may be added to each pint of milk. The Saccharated Solution
of Lime (220) has also been found of great service in this class of
cases.

223. _Obstinate Vomiting_ sometimes yields to a few doses of Lime Water
in milk, when other more powerful remedies have failed. It is worthy of
a trial in the _Vomiting attendant on the advanced stages of Fever_; it
has been thought to arrest even the black vomit of yellow fever. It is
also a remedy of much value in _Pyrosis or Waterbrash_.

224. _To relieve the distressing Irritation of the Genital Organs_
(_Pruritus Pudendi_) bathing the parts well with tepid Lime Water three
or four times a day sometimes affords much relief. _Leucorrhœa and other
Vaginal Discharges_ have in some instances been mitigated and even cured
by the use of vaginal injections of a mixture of 1 part of Lime Water
and 2 or 3 of Water.

225. _In Scrofula_, Lime Water in doses of ½ ounce in Milk, three or
four times a day, proves beneficial in some cases; it is thought to be
especially adapted for those cases in which abscesses and ulcers are
continually forming. To be of service, it requires to be persevered in
for some time. _Scrofulous and other Ulcers attended by much discharge_
have been found to improve under the use of Lime Water as a local
application. For _Syphilitic Ulcers or Chancres_, one of the best
applications is a mixture of Lime Water ½ pint, and Calomel 30 grains;
this—commonly known as BLACK WASH—should be kept constantly applied to
the part by means of a piece of lint or rag moistened with it. Many
forms of _Skin Disease_, attended with much secretion and with great
irritation or burning, are benefited by Lime Water either pure or
conjoined with oil (229). _To sore or cracked Nipples_ it proves very
serviceable. Diluted with an equal part of water or milk it forms a
useful injection in _Discharges from the Nose and Ears_ occurring in
scrofulous and other children.

226. _In Consumption_, Lime Water and milk has been strongly recommended
as an ordinary beverage. The same diet-drink has been advised in
_Diabetes_; but little dependence is to be placed upon it as a _cure_;
it may produce temporary benefit.

227. _In Thread Worm_, enemas of 3 or 4 ounces of Lime Water, repeated
two or three times, have sometimes been found sufficient to effect a
cure.

228. _In Poisoning by any of the Mineral Acids_, Lime Water given
plentifully in milk is an antidote of no mean value, though inferior to
some of the other alkalies. It may also be given in _Poisoning by
Arsenic_.

229. _To Burns and Scalds_ few applications are superior to LIME
LINIMENT, composed of equal parts of Lime Water and a bland oil. Olive
Oil is generally ordered for this purpose, but Linseed Oil answers just
as well, and where this is not at hand Sesamum Oil (338) forms a perfect
substitute. When thoroughly shaken together, so as to form a uniform
mixture, it should be applied freely over the whole of the burnt
surface, and the parts kept covered with rags constantly wetted with it,
for some days if necessary. This Liniment on cotton-wool, applied to the
pustules, is said to be effectual in preventing _Pitting in Smallpox_.


230. +The Lime.+—The fresh fruit of Citrus Bergamia, _Risso_.

 Límú, Níbú Nínbú (_Hind._, _Duk._), Nébu (_Beng._), Niúmb (_Kash._),
 Elumich-cham-pazham (_Tam._), Nimma-pandu (_Tel._), Cheru-náranná,
 Jonakam-náranná (_Mal._), Nimbo-hannu (_Can._), Límbu (_Mah._), Límbu,
 Nímbu (_Guz._, _Punj._), Dehi (_Cing._), Sámyá-si, Tambiya-sí
 (_Burm._), Limowe Nipis (_Malay_).

231. The fresh juice of the Lime is a valuable resource to the Indian
practitioner. In _Scurvy_ it deservedly ranks highest in our list of
remedies, and should be taken to the extent of not less than three
ounces twice daily: the addition of sugar increases its efficacy. Should
the patient be very debilitated, it may be advantageously combined with
tonics, as Infusion of Chiretta (98), or Decoction of Ním Bark (260).
Diluted with half its quantity of water it forms an excellent gargle for
_Scorbutic and other Ulcerations of the Mouth, and Sponginess of the
Gums_. When scurvy appears in a jail or other place where numbers of
people are congregated together, the daily use of Lime Juice should be
strictly enforced amongst the healthy, as it is one of our best
preservatives against an attack of the disease. For other remarks, see
Art. _Scurvy_, in Index.

232. _In Smallpox, Measles, Scarlatina, and other forms of Fever_, where
there is a hot, dry skin, and much thirst, a very useful refrigerant
drink, "Lemonade," may be made by pouring a pint of Boiling Water on
five or six peeled Limes cut in thin transverse slices. When cool,
strain, sweeten to taste, and let the patient drink as plentifully as he
likes. In the same class of cases, when the mouth is dry and clammy,
sucking a fresh Lime cut in slices is often both agreeable and useful,
though when at hand a slice of Pineapple is said to answer the purpose
even more effectually. The stringy portion should not be swallowed. _In
Diabetes_, weak lemonade is preferable to plain water for allaying the
great thirst; like other fluids, in this disease, it is better taken
during the intervals between, than at meals.

233. _In cases of Hæmmorrhage from the Lungs, Stomach, Bowels, Uterus,
Kidneys, or other internal organs_, especially when attended with
feverish symptoms, the drink described in the last section, or made
somewhat stronger, may be taken with advantage in considerable
quantities. The patient should at the same time remain quiet in the
recumbent position, and kept as cool as possible.

234. _In Poisoning by Croton Oil Seeds_, _Castor Oil Seeds_, _the Physic
Nut_, _and the fresh root of the Bitter Cassava_, _Mandioc_, _or Tapioca
plant_, almost immediate relief to the purging, vomiting, and other
urgent symptoms will be obtained by drinking Lime Juice, 4 or 5 ounces
at a time, diluted with an equal quantity of _conjee_ or plain water. It
is an antidote which should always be first tried, because it is
generally at hand, and seldom fails to afford more or less relief. A
full dose of Castor Oil should be subsequently given.

235. _For relieving the irritation, &c., of Mosquito bites_, the local
application of Lime Juice often proves more effectual than anything
else. Applied to the surface at nights before going to bed, it is
thought also to afford protection from the attacks of mosquitoes.


236. +Moringa, or Horseradish Tree.+ Moringa pterygosperma, _Gærtn._

 Shájnah, Ségvá (_Hind._), Mungé-ká-jhár (_Duk._), Sojná (_Beng._),
 Sohánjná (_Punj._), Morúnga, Murungai (_Tam._), Munaga (_Tel._),
 Murinna (_Mal._), Nugge-gidá (_Can._), Munagácha-jháda (_Mah._),
 Murungá (_Cing._), Dándalon-bin (_Burm._), Kaylor, Ramoongie (_Malay_).

237. The fresh root of this tree closely resembles in taste, smell, and
general appearance, the common Horseradish of Europe, hence its ordinary
name amongst Anglo-Indians. There is good reason for supposing that it
possesses similar medical properties as a stimulant and diuretic, and in
these characters it is worthy of trial in _Dropsical Affections attended
with Debility_: it may be given as follows. Take fresh Moringa Root and
Mustard Seed, of each, well bruised, one ounce. Boiling Water, one pint;
infuse for two hours in a covered vessel and strain. Of this the dose is
about one ounce and a half (a wineglassful) thrice daily. It may also be
used as a vehicle for nitre and other more active remedies.

238. _In Hoarseness and Relaxed Sore Throat_, a decoction of Moringa
root (or the above infusion) has been found serviceable as a gargle.

239. In the preparation of mustard poultices when it is desired to make
them act more speedily or energetically, the addition of the expressed
juice of the fresh root, or the scraped root, answers these purposes
effectually.


240. +Mudar.+ Calotropis procera and C. gigantea, _R. Brown_.

 Ák, Ákond, Madár (_Hind._, _Punj._), Ák, Akrá, (_Duk._), Ák, Ákondo
 (_Beng._), Ak-a-múl (_Kash._), Erukku or Erukkam (_Tam._),
 Jillédu-chettu, Mándáramu (_Tel._), Erukka (_Mal._), Yakkeda-gidá
 (_Can._), Ákda-cha-jháda (_Mah._), Ákda-nu-jháda (_Guz._), Vára,
 Vára-gaha (_Cing._), Mayo-bin (_Burm._), Ramegu (_Malay_).

241. One or other of the above species of Calotropis is found everywhere
in India, and although some doubt exists as to which of them is the
Mudar which some years since attained high repute in the treatment of
leprosy, they both possess the same medical properties and may be used
indiscriminately. The only part employed in medicine is the root-bark;
and it is necessary carefully to attend to the subjoined directions for
collecting and preparing it for medical use, a disregard of them having
been, in some instances, the apparent cause of the failure of the
remedy. The roots should be collected in the months of April and May,
from sandy soils, and all particles of sand and dirt having been
carefully removed by washing, they should be dried in the open air,
without exposure to the sun, until the milky juice contained in them
becomes so far dried that it ceases to flow on incisions being made. The
bark is then to be carefully removed, dried, reduced to powder, and
preserved in well corked bottles. In small doses, from 2 to 5 grains,
long continued, its action is that of an alterative tonic; in larger
ones, from 30 to 60 grains, for adults, it acts freely as an emetic, and
in this character it is regarded by some as one of the best Indian
substitutes for Ipecacuanha.

242. _In Leprosy_, _Constitutional Syphilis_, _Obstinate Ulcerations_,
_and in Chronic Rheumatism_; _also in Skin Diseases arising from the
abuse of Mercury_, powdered Mudar (_ante_) has been found highly useful
in some instances, whilst in others it has altogether failed. The
commencing dose is 3 grains, gradually increased to 10 grains or more,
thrice daily.

243. _In the Dysentery of Natives_ it has been highly spoken of. In the
severer class of cases in adults, a large dose, from 20 to 60 grains,
may be given at once, in the same manner as Ipecacuanha (see Art.
_Dysentery_ in Index). In ordinary cases, smaller doses are preferable.
For children the dose is 1 or 2 grains for every year of age, three or
four times a day. Its effects are said to be very similar to those of
Ipecacuanha, like which, it may be given variously combined, as
circumstances may require.


244. +Mustard.+ The seeds of Sinapis juncea, _Linn._ and other species
of Sinapis.

 Rái Ráyán (_Hind._, _Duk._), Rái (_Beng._, _Punj._), Ásúr (_Kash._),
 Kadugú (_Tam._), Áválu (_Tel._), Katuka (_Mal._), Sásave (_Can._),
 Moharé (_Mah._), Ráyi (_Guz._), Abbé (_Cing._), Munniyén-zi (_Burm._),
 Biji Sa-sarvi (_Malay_).

245. English Mustard imported in bottles is procurable in most of the
large bazaars, or is met with as an article of domestic economy in the
household of almost every European. If not at hand, however, the common
country Mustard seed may be substituted, especially in the formation of
poultices. For this purpose, however, they require to be thoroughly
ground down into the required consistence with a little water. If
previously deprived of their fixed oil by expression, their activity is
increased. By long keeping they lose much of their pungency; hence fresh
seeds should, when practicable, be employed.

246. With English Mustard at hand you can never be in want of a safe and
efficient emetic. A full teaspoonful (piled up) in a tumblerful of warm
water, generally produces free vomiting; if it does not, in five or ten
minutes it may be repeated, and should this not produce the desired
effect, a third dose may be given after a similar interval. Should this
fail, then some other emetic may be tried. It is especially indicated in
_Drunkenness_, _Narcotic and other Poisoning_, _and in all cases where
the stomach is overloaded with hard, indigestible food or intoxicating
drinks_, when it is desirable simply to unload the stomach without
producing any depressing effect on the system. It is very doubtful
whether country Mustard may be safely used as an internal medicine.

247. MUSTARD POULTICES are usually made with the flour of Mustard mixed
to the consistence of a poultice with water or vinegar, spread on a
piece of stout brown paper or rag, and applied to the skin. A few points
require notice: _a._ Cold water should be used in their preparation; it
is a mistake to suppose that hot water or vinegar is better suited for
this purpose, _b._ If it be desired to make the poultice act more
speedily or strongly, this may be done by adding a small portion of
bruised Capsicum or the scraped fresh root of the Moringa tree (239).
_c._ For persons of delicate skins, as women and children, it is
advisable to place a piece of thin muslin between the poultice and the
skin; for the sake of cleanliness also this is desirable. _d._ As a
general rule it should be removed when it produces redness of the skin,
whether it causes much pain or not. _e._ Some skins are very susceptible
to its action; in these cases the poultice should be at once removed if
it causes great pain. _f._ If allowed to remain in contact with the skin
for twenty or thirty minutes it is apt to act as a blister, which is
very undesirable, as _the ulcers which result are difficult to heal_.
_g._ In cases of fever and acute disease, the morning or early part of
the day is preferable to the evening for applying a Mustard poultice.

248. _In Apoplexy_, _Convulsions_, _Delirium_, _and violent Headaches
occurring during Fevers or Smallpox_, Mustard poultices to the feet and
calves of the legs are often very useful in relieving the affection of
the head. Where the patient is able to sit up for the purpose, a Mustard
foot bath [an ordinary foot bath, to which is added a handful of
Mustard] is even more effectual. The water should be as hot as can be
well borne, and the higher the fluid reaches up the leg, the better. In
_Delirium Tremens_ it should be used every night before bedtime.

249. _In some Head Affections_, e.g., _the early stages of Insanity, and
Delirium Tremens, where there is determination of blood to the head_,
_with sleeplessness_, _restlessness and anxiety_, a plan which has been
found effectual in some cases has been to envelop the whole of the legs
and lower part of the abdomen in cloths steeped in a mixture of Mustard
and hot water, a cold wet towel being at the same time applied round the
head. It has a very calming effect, and is occasionally productive of
sleep. The Mustard foot bath, described in the last section, is also
worthy of a trial, repeated every night before the usual bedtime.

250. _In Dropsy_ Mustard occasionally proves useful. It is best
administered in the form of Whey, made by boiling half an ounce of the
bruised seed in a pint of milk, and straining. This quantity may be
given daily in divided doses.

251. _In Cholera_, _Colic_, _and Spasms of the Bowels_, when unattended
by inflammation, a Mustard poultice placed over the abdomen in many
cases affords considerable relief. _Vomiting, especially that
accompanying Fevers, and Pregnancy_ may often be allayed by a Mustard
poultice applied to the pit of the stomach. _In Cholera_, when the
patient is very low, the poultice may be placed over the heart, or the
left side of the chest.

252. _In Coughs, attended with much difficulty of breathing_, Mustard
poultices to the chest often afford relief. They may also be
advantageously applied on the back between the shoulder-blades. They may
be used for children as well as adults. _Hooping Cough_ is occasionally
much relieved by Mustard poultices along the spine.

258. _Toothache_, _Faceache_, _and Neuralgic Pains of_ _the Head and
Face_, are frequently relieved by the application of a Mustard poultice
over the seat of pain.


254. +Myrobalans, Chebulic.+ The dried fruit of Terminalia Chebula,
_Retz._

 Har, Harrá, Pilé-har (_Hind._), Haldá, Harlá, Pílá-halrá (_Duk._),
 Hárítakí, Hórá (_Beng._), Zard halélá (_Punj._, _Kash._), Kadú-káy
 (_Tam._), Karakkáya (_Tel._), Katukká (_Mal._), Alale-káyi (_Can._),
 Hiradá (_Mah._), Harlé, Pílo-harlé (_Guz._), Aralu (_Cing._), Buah
 Kaduka (_Malay_).

255. Chebulic Myrobalans, met with in all the bazaars of India, are of
an ovoid shape, about an inch in length, sometimes tapering towards the
lower extremity, round or obscurely five- or six-sided, more or less
furrowed longitudinally, smooth, of a yellowish brown colour, and
astringent taste.

256. Myrobalans is a safe and effective aperient, and given to natives
in the following form, has been found to act very satisfactorily: Take
of Myrobalans bruised 6, Cinnamon or Cloves bruised 1 drachm, Water or
Milk 4 ounces; boil for ten minutes, strain, and set aside till cold.
This quantity taken at a draught generally produces on an adult native
three or four copious stools without griping, vomiting, or other ill
effects. Youths from twelve to fourteen years require only half the
above quantity, or even less. For infants and young children Castor Oil
or Senna is preferable as an aperient. It is well adapted for ordinary
cases of _Constipation occurring in Natives_ and in other states where
aperients are required.

257. _Chronic Ulcerations, Ulcerated Wounds, and many Skin Diseases
attended with profuse discharge_, often manifestly improve under the use
of an ointment composed of equal parts of dried Myrobalans and Catechu,
both finely powdered, and sufficient ghee or some bland oil to make them
into a thick paste: this, spread on a rag, should be applied to the
part, and renewed twice daily.

257_a_. Mr. W. Martindale, chemist, of New Cavendish Street, London, has
forwarded to me a preparation of another kind of Myrobalans, EMBLIC
MYROBALANS, the fresh fruit of _Phyllanthus Emblica_ (_Linn._), a common
Indian tree, preserved in sugar. The pulp, which has an agreeable taste,
is stated by Mr. M. to possess purgative properties in doses of one or
two of the preserved fruit. Commenting on this preparation it is stated
in the _British Medical Journal_ (July 29, 1882, p. 173): "We have tried
it carefully in several cases of habitual constipation, and have no
doubt it is a valuable addition to our list of laxatives.... It may be
eaten at dinner or dessert, and it would be absurd to regard it as a
medicine. It is most valuable for children." It should be added that it
is only in the fresh state that it possesses aperient properties; in the
dried state, as they are commonly met with in Indian bazaars, they are
astringent, containing a large proportion of gallic acid. Their ordinary
vernacular names are Ánvulá, Ánvurah (_Hind._), Ámlá Ánlá (_Beng._),
Nelli-kay, Tóppi (_Tam._), Ámala-kamu (_Tel._), Nelli-káyi (_Can._,
_Mal._), Avalá (_Mah._), Nelli, Nellika (_Cing._), Zíphiyu-sí (_Burm._).


258. +Ním Tree or Margosa.+ Azadirachta Indica, _Iuss._

 Nínb, Nímb (_Hind._), Ním, (_Duk._, _Beng._, _Punj._), Vémbu, Véppam,
 Véppa-marum (_Tam._), Véppa-chettu, Ním-bamu (_Tel._), Véppa,
 Aviya-véppa (_Mal._), Bévina-mará (_Can._), Límbacha, jháda (_Mah._),
 Límbdanu-jháda (_Guz._), Kohum-ba, Nímba-gahá (_Cing._), Tamá-bin,
 Kamákha (_Burm._), Dawoon Nambu, Baypay (_Malay_).

258_b_. The Ním Tree, according to Dr. Pulney Andy (_Madras Jour. of
Med. Sci._, vol. xi. (1867), p. 105), is held in veneration by the
Hindús as being dedicated to the goddess Mariathá, the deity which is
supposed by them to preside over all epidemics: or rather the epidemics
themselves are thought to be visitations of this goddess, in honour of
whom the leaves are in common use amongst Hindús, particularly in
_Smallpox_ epidemics. The leaves are spread on the bed of the patient,
fans made of them are used for fanning him, besides which a bunch of
them is fixed above the door as a sign of the presence of the goddess in
the house. Dr. Pulney Andy was thus led to make trials of the fresh
tender young leaves as an internal remedy in fourteen cases, and of
these thirteen recovered; but how far the recoveries were due to the
remedy is very problematical. He prescribed about five grains made into
a pill, with liquorice powder, and a few drops of water, thrice daily.
In the absence of fresh leaves he suggests the use of dried ones in
infusion or decoction (3j to Water Oj) in doses, for an adult, of one
ounce twice or thrice daily. The efficacy of this remedy is open to
grave doubts.

259. Ním bark varies much in appearance, according to the size and age
of the tree producing it. The bark from the trunk of a tree above three
or four years of age is covered with a thick scaly epidermis, and varies
in thickness from a quarter to half an inch. That from the smaller
branches is smooth, of a dullish purple colour, marked by longitudinal
lines of ash-coloured epidermis from one-eighth to one-twelfth of an
inch apart. The inner layer of the bark, of a whitish colour in the
fresh state, is powerfully bitter, far more so than the outer
dark-coloured layer, which, however, possesses a greater amount of
astringency. According to the analysis of Mr. Broughton it contains a
bitter neutral resin, in which apparently the activity of the remedy
resides.

260. Ním bark is a valuable astringent tonic, and when dried and reduced
to powder, may be given in doses of one drachm three or four times a
day. A better form, however, is a decoction prepared by boiling two
ounces of the bruised inner layer of the bark in a pint and a half of
water for a quarter of an hour, and straining whilst hot; of this, when
cold, the dose is from 2 to 3 ounces. It, as well as the Powdered Bark,
is a remedy of considerable value in _Ague or Intermittent Fever_; and
in these cases it should be given every second hour previous to the time
at which the attack is expected to return. It is chiefly adapted for
mild, uncomplicated cases, especially in natives. _For Convalescence
after Fevers_, _General Debility_, and _Loss of Appetite_, the
Decoction, in somewhat smaller doses than those mentioned above, proves
of great service, and its efficacy is increased and its taste improved
by the addition of a few bruised Cloves or a little Cinnamon. As the
decoction readily spoils in hot weather, it should be prepared fresh for
use when required.

261. _To Indolent and Ill-conditioned Ulcers, especially those of long
standing_, a poultice of Ním leaves acts beneficially as a stimulant. It
is easily prepared by bruising a sufficient quantity of the fresh leaves
with a little tepid water, and applying it, spread on a rag, to the
ulcerated surface; should it cause pain and irritation, as it sometimes
does, an equal weight of rice flour may be added.


262. +Nitre, Saltpetre, Nitrate of Potash.+

 Shórá (_Hind._, _Duk._, _Punj._), Sórá (_Beng._), Saféd-shora
 (_Kash._), Pot-luppu (_Tam._), Peti-luppu, Shúrá-karam (_Tel._),
 Veti-uppa (_Mal._), Pet-luppu (_Can._), Shóra-mítha (_Mah._), Sóro-khár
 (_Guz._), Pot-lunu, Vedi-lunu (_Cing._), Yán-zin (_Burm._), Sun-dawa
 (_Malay_). In Kashmir the term Shorá means Gunpowder, hence one must
 speak of White Gunpowder (_Saféd Shorá_), which is the name of Nitre,
 if it is wished to procure it. (Dr. Aitchison.)

263. Nitre is obtainable in most of the bazaars of India, but often in a
very impure state. To fit it for internal use it should be purified by
dissolving it in boiling water, removing the scum after the liquid has
been allowed to settle, straining the solution through calico and
setting aside to crystallise. Pure specimens, which are sometimes met
with in large bazaars, should be in white crystalline masses or
fragments, colourless, and of a peculiar, cool, saline taste.

264. _In Fever_, when the skin is hot and dry, the tongue parched, the
thirst great, and the urine scanty and high-coloured, an excellent
refrigerant drink may be made by dissolving two drachms of Nitre in a
quart bottle of thin _conjee_, and sweetening to the taste with honey or
sugar candy. This quantity may be taken daily, in divided doses as an
ordinary drink. Tamarind or Lime Juice may be added to improve the
flavour if desired. It will be found to moderate the fever, cause some
perspiration, and increase the quantity of urine. Should the patient
reject the first one or two doses, it should still be persevered in,
unless it should manifestly disagree. _In Smallpox_, _Measles_,
_Influenza_, and _Catarrhal attacks_, the above drink has also been
found useful. For children the strength should be reduced one-half or
more.

265. _For the relief of Headache and Delirium, occurring in the course
of Fever_, a very cold and agreeable lotion for the head may be made by
dissolving two ounces of Nitre, and an equal quantity of Sal Ammoniac,
in a quart bottle full of Water; this should be applied by constant
relays of freshly wetted cloths.

266. _In Inflammatory Sore Throat_, a popular remedy, sometimes
successful in the early stages, is a small piece of Nitre allowed to
dissolve slowly in the mouth.

267. _In Bleeding from the Lungs, Stomach, Uterus, or other internal
organs, attended by Fever_, Nitre proves serviceable though it is not to
be relied upon as the sole means of cure. It may be given in doses of
ten to fifteen grains, in three ounces of _conjee_ or simple water four
of five times a day; the patient at the same time being kept perfectly
quiet and cool.

268. _In Asthma_, great relief in many instances results from the
inhalation of burning Nitre. For this purpose, dissolve four ounces of
the salt in half a pint of boiling water in an open vessel; immerse
moderately thick blotting-paper in it for a few minutes, then dry it by
exposure in the air or to the fire; when quite dry, cut it in pieces
about four inches square, and keep ready for use. Immediately when an
attack threatens, burn one, or, if required, two pieces of this paper,
so that the fumes may be freely inhaled; but it should not be held too
near the face, or the fumes may prove too irritating, and increase
rather than diminish the symptoms. The same measure proves very useful
in _Spasmodic Coughs_, whether connected with _Chronic Bronchitis_ or
not. Persons thus afflicted will do well to burn one or two pieces of
this NITRE PAPER in the bedroom before retiring to rest at bedtime, care
being taken to prevent the too ready escape of the fumes.

269. _In Gonorrhœa_, a solution of a drachm of Nitre in a pint of rice
_conjee_ or decoction of Abelmoschus (2) taken freely as a drink, serves
to allay the heat on passing urine. Obstinate cases of _Leucorrhœa_
sometimes yield to a combination of Nitre (10 grains) and Alum (5
grains) taken thrice daily. It may be advantageously given in
conjunction with infusion of Moringa (237). Nitre has been found to act
beneficially as a diuretic in the early stages of _Dropsy_.

270. _In Acute Rheumatism_, Nitre may be given with advantage,
commencing with doses of 40 grains, twice daily: this may be gradually
increased to 60, 90, up to 120 grains, the vehicle in each case being
half a pint of warm rice _conjee_. The quantity of Nitre may be
diminished as the severity of the symptoms subsides. A strong solution
of Nitre (three ounces to a pint of water) forms a most soothing
application to the swollen and painful joints; cloths saturated with it
should be kept constantly applied; the ease which it affords is often
very great.


271. +Nutmegs and Mace.+ The products of Myristica officinalis (_Linn._).

_Nutmegs._

 Jáé-phal (_Hind._, _Duk._, _Beng._), Záfal (_Kash._), Jádi-káy
 (_Tam._), Jájí-kaya (_Tel._), Játi-ká (_Mal._), Jaji-káyi (_Can._),
 Jái-phal (_Mah._, _Punj._), Jáye-phal (_Guz._), Jádi-ká, Sádi-ká
 (_Cing._), Zádi-phu (_Burm._), Buah-pala (_Malay_).

272. _Mace._

 Jáé-patrí (_Hind._, _Can._, _Tel._, _Guz._), Jótri (_Beng._), Jáuntari
 (_Punj._), Jów-watir (_Kash._), Jádi-pattírí, (_Tam._, _Mal._),
 Vasá-vási (_Cing._), Zadi-phu-apóén (_Burm._), Bunga-pala (_Malay_).

273. Nutmegs and Mace, generally procurable in bazaars, are aromatic,
stimulant, and carminative, closely allied to Cloves and Cinnamon, for
which they may be substituted. Nutmegs in large doses are thought to
possess some narcotic properties, hence some care is necessary in their
use.

274. THE NATIVE OR COUNTRY NUTMEG, the produce of Myristica Malabarica,
_Lam._, is larger than the officinal Nutmeg, possesses little of its
fragrance or its warm aromatic taste, and is very inferior as an
internal remedy. Bruised and subjected to boiling, it yields a
considerable quantity of a yellowish concrete oil, which, when melted
down with a small quantity of any bland oil, is regarded as an excellent
application to _Indolent and Ill-conditioned Ulcers_, allaying pain,
cleansing the surface, and establishing healthy action. It deserves a
trial as an embrocation in _Chronic Rheumatism_.


275. +Opium.+ The inspissated juice of Papaver somniferum, _Linn._

 Afyún (_Hind._), Afím (_Duk._), Afím, Afín (_Beng._, _Punj._, _Kash._),
 Abini (_Tam._), Abhini (_Tel._), Kasha-kasha-karappá (_Mal._), Afímu
 (_Can._), Afín (_Mah._), Afím (_Guz._), Abin (_Cing._), Bhain, Bhín
 (_Burm._), Afíun (_Malay_).

276. Opium is one of the most valuable medicines we possess when
properly employed, but as it is very powerful in its operation, it may
be productive of _great mischief if used without care and caution, or in
unsuitable cases_.

277. The Opium procurable in the bazaars is always more or less
adulterated, hence the quantity procured in one shop is sufficient to
procure a good sleep whilst the same quantity procured at another shop
will perhaps produce no sensible effect whatever on the system. This
shows the necessity of _great caution_ in its employment.

278. The uncertainty which attends the operation of bazaar Opium leads
me to recommend that establishments at out-stations should be always
provided with a supply of genuine Smyrna or Turkish Opium imported from
Europe. It seems advisable to have it in two forms—_a._ In 1 grain
pills, done up ready in an impermeable covering, like those sold by
Kirby and others; by keeping it in this form it is always ready for an
emergency. _b._ In the form of Tincture, LAUDANUM, which is a very
convenient form when small or fractional doses of Opium are required, or
when it is desirable to obtain a _speedy_ effect. Fifteen minims contain
one grain of Opium; this holds good, however, only with recently
prepared or carefully preserved laudanum. It should be borne in mind in
all hot climates that evaporation of the spirit constituent will take
place even in well stoppered bottles, and that in proportion as this
evaporation takes place, the strength of the tincture is _increased_, so
that in long kept Laudanum ten minims, or even less, may contain a grain
of Opium. Hence, in using old Laudanum it is advisable to commence with
smaller doses than in that recently prepared; the dose can be
subsequently altered according to the effect produced or desired.

279. Preparations of Opium should always be kept _under lock and key_,
or they may disappear at a rate which cannot be accounted for by
evaporation or the heat of the climate! Opium in all its forms is a
temptation which few natives have moral courage enough to resist.

280. The preparations of Opium mentioned above should be reserved for
internal administration; for external application, where uniformity of
strength is of comparatively little consequence, bazaar Opium may be
employed, but even here it is desirable that good specimens of the best
kinds should be used. A few additional observations on this point may be
acceptable.

281. Of the several kinds of Opium met with in India the chief are:

1. _Patna Garden Opium_; and 2. _Malwa Opium._—The former, prepared
exclusively for medicinal purposes, occurs in square packages of from
two to four pounds weight, covered with layers of talc, and further
defended by a case of brown wax about half an inch in thickness. It is
solid, brittle in the cold season, of a brown colour, and fine smell; it
yields a large proportion (7 to 8, or even 10 per cent.) of Morphia. Of
Malwa Opium there are many varieties; of these the two principal are,
first, that in flat circular cakes, of about a pound and a half in
weight, without any exterior covering; dull opaque, blackish brown,
externally; internally somewhat darker and soft; odour resembling that
of Smyrna Opium, but less powerful, and combined with a slight smoky
smell; taste, intensely and permanently bitter: it yields only from 3 to
5 per cent. of Morphia. The other, a superior kind of Malwa Opium,
occurs in balls or cakes of smaller size, about ten ounces in weight,
covered with a coarse dust composed of broken poppy petals; colour
internally, dark brown; texture, homogeneous; odour and taste similar to
the other variety; it yields from 7 to 8 per cent. of Morphia. The other
varieties of Indian Opium, the Himalayan or "Hill Opium," the Kandeish,
the Kutch, &c., are less applicable than the preceding for medicinal
purposes, on account of their varying strength. (_Pharm. of India._)

282. There are some points connected with the use of Opium which should
always be kept in mind:

_a._ Some persons are very intolerant to the action of Opium; in these
even the smallest dose produces great nervous excitement, violent
headache, and vomiting. When this peculiarity is known to exist, the
drug should be avoided.

_b._ Infants and young children bear Opium badly; cases are on record in
which _three drops of Laudanum have proved fatal to infants_. Still,
there are diseases of childhood in which it proves valuable, but in
these it _should not be given except under professional advice or
superintendence_.

_c._ It should be avoided as far as possible during pregnancy. Recent
experience seems to show that its frequent or habitual use exercises a
prejudicial effect on the fœtus.

_d._ The previous habits of the patient materially influence the effects
of this medicine. A confirmed Opium-taker requires a far larger dose to
produce a given effect, than one not habituated to it.

_e._ When the use of Opium is clearly indicated, and the patient from
any cause is unable to swallow, it may be given in an enema; in this
case a larger dose, a third or even a half larger, is required than when
given by mouth.

_f._ Whenever in doubt as to the advisability of giving Opium, _take the
safer course and—avoid it_!

For treatment of poisoning by Opium, see Index.

283. There are many diseases as _Rheumatism_, _Tumours of different
kinds_, _Cancer_, _Carbuncles_ (_Rajah Boils_), _Abscesses_, _and Ulcers
connected either with Leprosy, Syphilis or Scrofula_, in which the pain,
especially at night, effectually banishes sleep; here Opium is
invaluable. An adult may commence with one grain pill or fifteen drops
of Laudanum, taken about an hour before the usual bedtime: if this
succeeds in procuring sleep it may safely be repeated nightly; if not,
the dose may be doubled the second night, and trebled the third night;
but it is not advisable to go beyond this quantity except under
professional advice. Even these quantities after a week or two's use
lose much of their power, and may require to be cautiously increased.
When the pains are lessened and the patient is improving, the quantity
of Opium should be decreased gradually, rather than the whole supply
left off at once. _To control the Sleeplessness and Restlessness of
Delirium Tremens_, Opium given as above may be necessary, but each dose
should be combined with four or five grains of Camphor in the form of
pill; in fact, Camphor alone in doses of 2 to 3 grains every three or
four hours, exercises a most soothing influence, and when this treatment
is adopted, the Opium at bedtime may be given alone.

284. _In Spasmodic Affections of the Bowels_, _violent Colic_, _and the
Passage of Gall Stones_, and when the pain is violent, a full dose of
Opium, _e.g._, 20 to 25 drops of Laudanum in a wineglassful of Omum
water, or Infusion of Sweet Flag root (12), often affords speedy relief;
should it not do so, however, in half an hour the dose may be repeated,
and a third dose after an hour, should the pain continue unabated. At
the same time, hot water fomentations, a turpentine stupe, or a mustard
poultice, should be applied externally. When the pain has subsided a
dose of Castor Oil is advisable, especially when there is reason to
suspect that the attack has arisen from the use of crude or indigestible
articles of food.

285. _In Cholera_ the practice of giving Opium in large and repeated
doses, especially in the solid form, in all stages of the disease, _is
fraught with danger_. Administered judiciously at the proper time, and
in proper cases, it is capable of doing much good, but its
indiscriminate use often produces the worst effects. At the outset of an
attack, few remedies are more useful when combined with Acetate of Lead.
(_See_ Index.) Again, it is a valuable adjunct to the "Calomel
treatment" of Dr. Ayre, which consists in giving one or two grains of
Calomel, with from one to five drops of Laudanum, every five, ten, or
fifteen minutes, according to the urgency of the symptoms, till the
quantity of Laudanum has reached altogether 60 or 80 drops, when it
should be discontinued. An essential part of this treatment, which has
sometimes proved very effectual, is the free use of cold water as a
drink.

286. _For relieving the pain and irritation of the Bladder, caused by
the presence of Stone in the Bladder, Gravel_, &c., no medicine gives
more relief than Opium in full doses, as advised in paragraph 284. It
proves, however, even more effectual if introduced into the rectum,
either in the form of suppository (two grains of Opium with four grains
of Soap), or in enema (30 to 40 drops of Laudanum in two ounces of thin
_conjee_ water). It may also be given with great benefit _in Irritable
states and Painful Affections of the Kidneys_.

287. _In Retention of Urine arising from Spasmodic Stricture of the
Urethra_, a hot bath and a full dose of Opium (25 to 30 drops of
Laudanum), followed by a dose of Castor Oil, will often suffice to give
relief in recent cases of no great severity following a debauch,
exposure to wet, &c. The Opium given in an enema of two or three ounces
of rice _conjee_, sometimes succeeds when it fails if given by mouth.

288. _In Diabetes_, Opium occasionally produces the most beneficial
results, especially in old cases occurring in the aged. It requires to
be given in full doses and to be persevered in, the effects being
carefully watched; the dose diminished, or the remedy left off
altogether, if it gives rise to headache or other bad symptoms. It is
worthy of remark, however, that persons suffering from this disease will
take large doses with impunity.

289. _In many painful Affections of the Uterus_ Opium is of the greatest
service. Besides being employed in the form of suppository or enema, as
mentioned in paragraph 286, Camphorated Opium Liniment (291) warmed, may
likewise be rubbed into the loins, or a hot rice poultice sprinkled with
Laudanum applied over the lower part of the abdomen. When given
internally in these cases it requires to be given in full doses, and it
may be advantageously combined with Camphor (73). For the relief of
_After-Pains_, 15 or 20 drops of Laudanum in a wineglassful of Camphor
julep, or Omum water, or a little simple _conjee_, generally affords
speedy relief. _In threatened Abortion from a fall, over-exertion_, &c.,
a similar dose of Laudanum, with perfect rest in the recumbent position,
may suffice to prevent further mischief; should there be great
restlessness or pain, it may be repeated with advantage.

289_a_. _In Dysentery_, Opium in full and repeated doses (one to two
grains three or four times a day) was formerly in great repute, but it
has fallen into disuse since the Ipecacuanha treatment has been
reintroduced; still, amongst the natives it seems, in many cases, to
answer better than the latter drug. Even when Ipecacuanha is employed, a
preliminary dose of Laudanum (25 to 30 drops) is often of great service
in enabling the stomach to bear it and in preventing its emetic
operation. _For the relief of the local pain, bearing down, and
straining in this disease_, a small enema (two ounces) of _conjee_, with
30 to 40 drops of Laudanum in it, affords more relief than anything
else. Opium is a valuable adjunct to Catechu and other astringents in
the treatment of _Diarrhœa_.

290. _Vomiting_ is sometimes speedily relieved by a few drops of
Laudanum (5 to 10 drops) in an effervescing draught, or a little Omum
water. It may also be advantageously combined with Infusion of Cloves
and other remedies.

291. There are many external or local diseases, including _Chronic
Rheumatism_, _Lumbago_, and other _Muscular and Neuralgic Pains_,
_Spasms_, and _Bruises_, _Enlarged Glands_, _Mumps_, &c., in which
simple OPIUM LINIMENT, readily made by rubbing down a drachm of bazaar
Opium in two ounces of Cocoanut, Sessamum, or other bland oil, proves
very useful. Its efficacy, however, is greatly increased by conjoining
it with an equal quantity of Camphor Liniment (68). This, which may be
called CAMPHORATED OPIUM LINIMENT, is an excellent application in many
painful external affections. It should be well shaken before being used,
which it may be night and morning, or oftener if required; care should
be taken not to apply it to an abraded or sore surface; it is only
adapted for the sound skin, and not even then if the pain is attended
with much heat and redness; under these circumstances, cooling lotions
(325, 380) are better adapted. This Camphorated Liniment, well rubbed in
along the course of the spine, is occasionally very useful in _Hooping
Cough_. For _Stiff Neck_, warm Laudanum rubbed in over the part answers
better.

292. _In Ophthalmia attended with great intolerance of light_, great
relief may be obtained by fumigating the eye with the vapour of boiling
water, to which has been added a teaspoonful of Laudanum, or a couple of
grains of Opium. An excellent eyewash in these cases is composed of
Laudanum, Vinegar, and Brandy, each one part, and Water four parts.
_Toothache_, depending upon a decayed tooth, is often relieved by a
grain of Opium put into the hollow of the tooth; the saliva should not
be swallowed. _Earache_ also frequently yields to a mixture of equal
parts of Laudanum and any bland oil, inserted into the outer passage of
the ear on a piece of cotton wool: care should be taken not to push it
in too far.

293. _To Painful Piles_, where there is much swelling and heat, a very
soothing application is a soft rice poultice, the surface of which has
been sprinkled with Laudanum, or smeared over with simple Opium Liniment.


294. +Papaw Tree.+ Carica Papaya, _Linn._

 Popaiyáh (_Hind._), Popáí (_Duk._), Papaiyá (_Beng._), Pappáyi
 (_Tam._), Boppáyí (_Tel._, _Can._), Pappáya (_Mal._), Pópayá (_Mah._),
 Papáyi (_Guz._), Pepolká (_Cing._), Pimbo-si (_Burm._), Papaya
 (_Malay_).

295. The fresh milky juice of the Papaw has been successfully employed
in the treatment of _Worms, especially the common Round Worm or
Lumbricus_. The juice should be collected as it flows out from incisions
made in the unripe fruit; a table-spoonful suffices for a dose for an
adult. It should, whilst quite fresh, be mixed with an equal quantity of
honey and two ounces of boiling water, and the whole well stirred. When
cool, this should be taken as a draught, and two hours subsequently, one
ounce of Castor Oil, with half a table-spoonful of Lime Juice. This
process should be repeated two days in succession. Half the above dose
is sufficient for a child between three and seven years old, and a
third, or about a teaspoonful, for a child under three years of age.
Should colic follow its use, draughts of sugar and water, or sugar and
milk, should be freely given. _In Ringworm_ the unripe Papaw fruit, cut
in slices and rubbed on the spots, is said by Dr. H. H. Goodeve to be a
very simple and efficient remedy.

296. _In Enlargements of the Spleen and Liver_ Mr. Evers (_Indian Med.
Gazette_, February 1875) reports highly of the value of the milky juice
of the unripe Papaw fruit. Of sixty cases treated with it, thirty-nine
were cured. He administered it as follows: About a teaspoonful of the
fresh juice was thoroughly mixed with an equal quantity of sugar, and
the mass made into three boluses, one to be taken morning, noon, and
evening. For children a single drop of the juice with sugar was found
sufficient. A poultice of the pulp of the unripe fruit was placed in
each case over the enlarged organ; but on this Dr. Evers places little
reliance. From 20 to 25 days was the longest period a patient was under
treatment. A nutritious and liberal diet to be enforced. It was found
notably useful in recent cases. No ill effects—nothing beyond a feeling
of heat in the stomach—followed its use. Should there be gastric or
intestinal irritation, a small dose of Opium or Henbane may be combined
with the juice.


296_b_. +Pedalium Murex+, _Linn._

 Bará-ghókrú (_Hind._, _Dak._, _Beng._), Ánai-nerunji, Peru-neranji
 (_Tam._), Enuga-palléru-mullu, Káítu-nerinjil (_Tel._), Ána-nerinnil,
 Káttu-nerinnil (_Mal._), Ánne-galu-gidá (_Can._), Hattí-charátté
 (_Mah._), Motte-ghókru (_Guz._), Ati-naranchi (_Cing._), Sulegí
 (_Burm._).

297. This small plant, with its yellow flowers and sharp-spined seed
vessel, exhaling when bruised the odour of musk, is common on dry sandy
localities, especially on the seaboard of most parts of Southern India.
The fresh leaves and stems briskly agitated in cold water convert it
into a thick mucilage, nearly of the consistency of the white of a raw
egg, inodorous and tasteless. An infusion thus prepared is a highly
prized remedy among the people of Southern India in _Gonorrhœa_. For
this purpose half a pint of the above infusion is taken every morning
for ten days successively; and under its use great relief to the
scalding on the passage of urine is afforded, and a cure in many cases
effected. It seems well worthy of further trial. One of its effects,
indeed its principal one, is greatly to increase the flow of urine;
hence it might prove useful in some forms of _Dropsy_. Water rendered
mucilaginous by this plant soon regains its original fluidity; hence the
infusion should be freshly prepared each time it is to be administered.


298. +Pepper, Black.+ The unripe fruit of Piper nigrum, _Linn._

 Kálí-mirch, Gól-mirch (_Hind._, _Punj._), Kálí-mirchí (_Duk._),
 Kálá-morich, Gól-morich (_Beng._, _Punj._), Martz (_Kash._), Milagu,
 Mulagu (_Tam._), Miriyálu (_Tel._), Kuru-mulaka (_Mal._), Menasu
 (_Can._), Miré (_Mah._), Kálo-mirich, Miri (_Guz._), Kalu-miris
 (_Cing._), Náyu-kon (_Burm._), Lada hitam (_Malay_).

Black pepper, when fresh and of good quality, is a useful stimulant and
stomachic in doses of from 10 to 15 grains or more.

299. _In Cholera_ the following pills were formerly held in high repute
in Bengal. Take of Black Pepper, Asafœtida, and Opium, each 20 grains;
beat them well together, and divide into 12 pills; of these one was the
dose, repeated in an hour if required. On account of the quantity of
Opium they contain, it is inadvisable to continue their use too long
(_See_ Par. 285). They are chiefly indicated at the very outset of the
attack.

300. _For Piles in aged and debilitated persons_ the following
Confection is often of great service: Take of Black Pepper in fine
powder, 1 ounce; Caraway fruit in fine powder, 1½ ounce; Honey, 7½
ounces. Rub them well together in a mortar, and give from one to two
drachms twice or thrice daily. It proves useful also in the case of old
and weak people suffering from _Descent of the Rectum_. An infusion of
Black Pepper (2 drachms of bruised Pepper to 1 pint of Boiling Water)
forms a useful stimulant gargle in _Relaxed Sore Throat, and Hoarseness_
dependent thereon.


301. +Physic Nut Plant.+ Jatropha Curcas, _Linn._

 Jangle-arandí (_Hind._, _Guz._), Jangli-yarandi (_Duk._), Erandá-gách,
 Bon-bhérandá (_Beng._), Kátt-áma-naku (_Tam._), Pépalam (_Tel._),
 Káttá-vanaka (_Mal._), Bettada-haralu (_Can._), Rána-yerandi (_Mah._),
 Val-endaru, Erandu (_Cing._), Késu-gi, Simbo-késu (_Burm._).

302. A common plant in waste places throughout India. The seeds, which
in their native state are an acro-narcotic poison, yield on expression
about 30 per cent. of a pale yellow oil, which in doses of 12 to 15
drops acts as a purgative equal in action to one ounce of Castor Oil,
but is far less certain in its operation and causes more griping than
the latter, hence it is rarely employed. Its ill effects are corrected
by Lime Juice, as in the case of Croton Seeds (Sec. 120). Diluted with a
bland oil (1 part to 2 or 3), it forms a useful embrocation in _Chronic
Rheumatism_. The leaves locally applied to the breasts, as directed in
Sec. 85, are stated notably to _increase the secretion of Milk_; it is
worthy of a trial. More important, however, than the preceding is the
alleged power of the fresh juice to _arrest Bleeding or Hæemorrhage from
Wounds_. Baboo Udhoy Chand Dutt (_Indian Med. Gazette_, Oct. 1, 1874)
details two cases in which a piece of lint, soaked in the juice and
locally applied, at once arrested the bleeding; in one of these cases
alum, perchloride of iron, &c., had been previously used without effect.
He states that it does not cause pain nor act as a caustic, but seems
simply to coagulate the blood, and covers the bleeding surface with a
tenacious layer. Further evidence of its styptic powers is recorded by
Mr. B. Evers (_Indian Med. Gazette_, March 1875), who furnishes also an
interesting account of a pulsating tumour, "a varicose aneurism,"
situated just above the inner ankle, which was cured (?) by the
subcutaneous injection of a drachm of this juice. The styptic properties
of this agent seem well worthy of further trial.


302_b_. +Plantago, or Ispaghúl Seed.+ The seeds of Plantago Ispaghula,
_Roxb._

 Ispaghúl, Isbaghól (_Hind._), Isapghól (_Duk._, _Punj._), Eshopgól
 (_Beng._), Ís-mogul (_Kash._), Ishappukól-virai, Iskól-virai (_Tam._),
 Isapagála-vittulu (_Tel._), Isabakólu (_Can._), Isabagóla (_Mah._),
 Isapghól (_Guz._).

303. Ispaghúl seeds, ovate-elliptical, concave, about an eighth of an
inch in length, of a greyish colour, yielding to water an abundance of
tasteless mucilage, are procurable in most bazaars, and constitute a
highly useful demulcent medicine.

304. _In Dysentery and Diarrhœa_ they have been long held in
well-deserved repute when given, as advised by the late Mr. Twining, of
Calcutta. "_In the Chronic Diarrhœa of Europeans_, who have been long
resident in India, benefit [he remarks] often follows the use of
demulcents followed by mild tonics. For this purpose the Ispaghúl seeds
seem to answer better than any other remedy. The dose for an adult is 2½
drachms mixed with half a drachm of powdered sugar candy. The seeds are
exhibited whole, and in their passage through the intestines they absorb
as much fluid as makes them swell, and by the time they reach the
central or lower portions of the canal, they give out a bland mucilage,
and in general they continue to possess the same mucilaginous properties
until they have passed through the intestines. If the frequency of the
dejections be restrained by anodyne enema, and by using only a small
quantity of food, the mucilaginous properties of these seeds are most
evident. It is said that a slight degree of astringency and some tonic
property may be imparted to the seeds by exposing them to a moderate
degree of heat, so that they shall be dried and slightly browned. This
remedy sometimes cures the protracted diarrhœa of European and Native
children after many other remedies have failed."

305. _In many affections of the Kidneys and Bladder, in Gonorrhœa_, &c.
attended with pain, local irritation and scalding or difficulty in
passing urine, the following decoction is likely to prove serviceable:
Take of Ispaghúl Seeds bruised, 2 drachms; Water a pint; boil for ten
minutes in a covered vessel, and strain. Of this the dose is from 2 to 4
ounces, three or four times daily or oftener.


306. +The Plantain or Banana Tree.+ Musa sapientum, _Linn._

 Kélah-ká-pér (_Hind._), Mouz-ká-jhár (_Duk._), Kéla-gáchh (_Beng._),
 Kadali (_Tam._), Kadali, Arati-chettu (_Tel._), Vázha-marum (_Mal._),
 Bálegida (_Can._), Kéla-jháda (_Mah._), Kéla-nu-jháda (_Guz._),
 Kehal-gahá (_Cing._), Napiyá-bin (_Burm._).

307. The Plantain, or Banana-tree, is extensively cultivated throughout
the tropical portion of both hemispheres for the sake of its fruit,
which forms a valuable article of diet, and in the dried state is of no
mean value as an anti-scorbutic (See Art. _Scurvy_ in _Index_). It is
mentioned in this place chiefly on account of its leaves, which, when
young and tender, are of a beautifully fine texture, and may be utilised
with great advantage in medical and surgical practice.

_a._ _As a dressing for blistered surfaces_, for which purpose they are
admirably adapted in hot climates, where Spermaceti Ointment, usually
employed in European practice, rapidly becomes rancid, and consequently
irritant. After the removal of a blister a piece of plantain leaf of the
required size, smeared with any bland oil, should be applied to the
denuded surface and kept in its place by means of a bandage. The first
sensation it occasions is peculiarly cooling and soothing, and the
blistered surface generally heals satisfactorily in four or five days.
For the first two days the upper smooth surface is placed next to the
skin, and subsequently the under side, until the healing process is
complete. The dressing should be changed twice daily, with fresh leaves,
or oftener if required.

_b._ _As a substitute for India Rubber or Gutta Percha Tissue in the
water-dressing of Wounds and Ulcers._ The younger the leaf the better is
it suited for this purpose. Two points require attention: 1, the piece
used should be sufficiently large to cover or envelop the whole part;
and, 2, it should be carefully kept in its place by bandages, &c. If
properly applied, evaporation of any subjacent fluid is effectively
prevented.

_c._ _As a shade for the eyes in Ophthalmia and other Diseases of the
Eye_, no manufactured shade is superior to it; the older and greener
leaves answer best for this purpose.


308. +Plumbago rosea+, _Linn._

 Lál-chíta, Lál-chítarak (_Hind._), Lál-chitarmúl (_Duk._), Rakto-chitá
 (_Beng._), Chitra (_Punj._), Shitranj (_Kash._),
 Shivappu-chittira-múlam, Kodi-múli (_Tam._), Erra-chitra-múlam
 (_Tel._), Chenti-kotuvéli (_Mal._), Kempu-chitra-múlá (_Can._),
 Támbada-chitramúla (_Mah._), Ratnitúl (_Cing._), Kin-khen-ní (_Burm._),
 Chiraka-merah (_Malay_).

309. The root of this plant, common in gardens throughout India, is of
great value as a means of raising a blister when other articles of the
same class are not available. For this purpose take the fresh bark of
the root and rub it into a paste with water and a little rice flour;
spread this on a piece of rag and apply it to the surface; in about five
minutes it begins to give pain, which increases in severity for about
half an hour, when it may be removed; a rice poultice may then be
applied over the part, and within twelve or eighteen hours a large
uniform blister will be found to have formed. The fluid having being let
out, it may be dressed with plantain leaf, in the usual way. The chief
objection to the use of a Plumbago blister is the great pain it
occasions, hence it should only be used when other blistering agents are
not at hand, and a blister is an immediate necessity.


310. +Pomegranate Tree.+ Punica Granatum, _Linn._

 Anár-ká-pér (_Hind._), Anár-ká-jhár (_Duk._), Dálimgásh (_Beng._),
 Dháun (_Kash._), Mádalai-chedi (_Tam._), Dálimba, Dádima-chettu
 (_Tel._), Mátalam-chetti (_Mal._), Dálimbe-gidá (_Can._), Dálimba-jhàda
 (_Mah._), Dádam-nujháda (_Guz._), Delun-gahá (_Cing._), Salé-bin, or
 Talí-bin (_Burm._), Dalima (_Malay_).

311. Two parts of the Pomegranate tree, common in gardens and elsewhere
throughout India, are employed medicinally, viz., the Rind of the Fruit
and the Bark of the Root or Root-Bark.

312. _In Diarrhœa and the advanced stages of Dysentery_, the rind of the
fruit is a valuable astringent. It is best given in Decoction prepared
by boiling in a covered vessel, 2 ounces of the bruised Dried Rind, and
2 drachms of bruised Cloves or Cinnamon in a pint of water for fifteen
minutes and straining. Of this, when cold, the dose is 1½ ounces three
or four times a day; in obstinate cases, five drops of Laudanum may be
added to each dose. It is said to be especially useful in the _Diarrhœa
of Natives_.

313. _In Relaxed Sore Throat_ the above decoction, with the addition of
a drachm of Alum to the pint, is a very useful gargle, and it also forms
a good astringent injection in _Vaginal Discharges_; in these cases the
cloves or cinnamon should be omitted.

314. _For Tape Worm_ the Root-bark is a remedy of established value
given as follows: Take of the fresh Bark sliced, 2 ounces: Water, 2
pints; boil to 1 pint and strain. Of this, two ounces should be taken
fasting, early in the morning, and repeated every half-hour, until four
doses have been taken. This should be followed by an aperient (1 ounce
of Castor Oil), and the worm will generally be expelled within twelve
hours.


315. +Ptychotis, Ajwain or Omum Seeds.+ The fruit of Carum (Ptychotis)
Ajowan, _D.C._

 Ajváyan (_Hind._), Ajvain, Ajván (_Beng._), Ajván (_Duk._), Ajwain
 (_Punj._), Jáwind (_Kash._), O'mam, or O'mum (_Tam._), Omamu, Vámamu
 (_Tel._), Hómam, Ayamód-kam (_Mal._), Vóma (_Can._), Vóvá, Vóva-sádá,
 (_Mah._), Ajwán (_Guz._), Oman, Assamodagam (_Cing._), Samhún
 (_Burm._), Lavinju-larmisi (_Malay_).

316. These small, pungent, aromatic seeds rank deservedly high in the
list of native remedies; they are considered to combine the stimulant
quality of capsicum or mustard with the bitter property of chiretta, and
the antispasmodic virtues of asafœtida. This remedy, Dr. Bidie remarks,
in moderate quantities increases the flow of saliva, augments the
secretion of gastric juice, and acts as a stimulant, carminative and
tonic. As a topical remedy it may be used with advantage along with
astringents in cases of _Relaxed Sore Throat_. For disguising the taste
of disagreeable drugs and obviating their tendency to cause nausea and
griping, he adds, that he knows no remedy of equal power. Testimony of a
similar character is borne by Mr. J. J. Wood and others, and no room is
left to doubt the value of this medicine.

317. The natives employ the crude seeds in doses of about a
dessert-spoonful with the addition of a little salt; this is chewed and
washed down with draughts of water. They also employ them in decoction,
but this is objectionable, as heat dissipates the essential oil, in
which the virtues of the seeds reside. A far better form is the
Distilled Water, OMUM WATER—Aarqe-ajván (_Hind. et Duk._),
Ajwain-ka-arak (_Punj._), Jawind-húnd-arak (_Kash._), Óman-tí-nír
(_Tam._), Ómam-dráv-akam (_Tel._). It is also sold under the name of
"Sison Cordial." Every Indian domestic medicine chest should contain a
good supply of this useful preparation, which is procurable in all the
large towns in India, being a very popular remedy with the native and
East Indian portion of the community. Where, however, it is not
purchasable it can be readily prepared by any native who has a common
country still; in this case care should be taken that the right
proportions be used—3lb. of the bruised seeds to six quart bottles of
water, and distil over four. In order to prevent the seeds touching the
bottom or sides of the boiler, and thus by becoming charred
communicating a burnt flavour to the water, they should be tied up in a
bag or cloth of loose texture, and suspended in the centre of the water.
The dose is from 1 to 2 ounces, repeated as circumstances may require;
that for a child ranges from a teaspoonful to a table-spoonful,
according to age. The Distilled Oil is also an excellent form of
administration in doses of 1 to 3 drops on sugar, or made into an
emulsion with Gum Arabic.

318. In some forms of _Dyspepsia_, _in the vomiting, Griping or Diarrhœa
arising from errors of diet_; _in simple Flatulence and even
Tympanites_; _in Faintness and Exhaustion_; _in Spasmodic Affection of
the Bowels in Choleraic Diarrhœa, in certain cases of Colic_; _and in
Hysteria_, it has been found, even when given alone, pre-eminently
useful (Wood). _It is especially adapted for the Diarrhœa and Flatulent
Colic of Children._

319. _In Cholera_ much reliance is placed by the natives and
Anglo-Indians on Omum water, and although it appears to have no claim to
the character of a specific in this disease which popular opinion
assigns to it, there can be little doubt that it exercises considerable
power, especially in the early stage, of checking the diarrhœa and
vomiting, and at the same time of stimulating the system. It is not to
be trusted to alone, but forms an admirable adjunct to other remedies.

320. _In Habitual Drunkenness, Dipsomania_, Omum seems worthy of trial.
On this point Mr. Wood observes, "On account of its biting or pungent,
yet pleasant taste, and the sensation of warmth it creates in the
stomach, it has been constantly recommended of late years to those
afflicted with the desire for alcoholic drinks. It does not, of course,
intoxicate, but it is no mean substitute for the ordinary stimulant, in
removing almost immediately the sensation of 'gnawing' or 'sinking at
the pit of the stomach,' which the frequent use of spirits so invariably
brings on. And I have been assured that it has been the means of
rescuing many otherwise sensible and useful men from slavery to the
habit of spirit drinking."


321. +Rice.+ The husked seed of Oryza sativa, _Linn._

 Chával (_Hind._), Chánval (_Duk._), Chál, Chánvol (_Beng._), Chánwal
 (_Punj._), Thomúl (_Kash._), Arishi (_Tam._), Biyyam (_Tel._), Ari
 (_Mal._), Akkí (_Can._), Tándúla (_Mah._), Chókha (_Guz._), Hál
 (_Cing._), Sán, Chán (_Burm._), Bras (_Malay_).

322. Rice may be utilised in the following ways in the treatment of
disease:

_a._ In the form of Decoction—"_Conjee Water_," as it is commonly
called, prepared by boiling one ounce of cleansed Rice in a quart of
Water for twenty minutes, straining, and flavouring with Sugar, and with
Lime Juice if desired, to taste. This forms an excellent drink in
_Fevers_, _Smallpox_, _Measles_, _Scarlet Fever and Inflammations of all
kinds_, also in _Gonorrhœa_, and other cases where there is _pain and
difficulty in passing Urine_.

_b._ In the form of Powder—RICE FLOUR; this dusted thickly over the
surface forms a very cooling and soothing application in _Small-pox_,
_Measles_, _Erysipelas_, _Prickly Heat_, and other _Inflammatory
Affections of the Skin_. It is pleasant to the patient's feelings, and
allays heat and irritation. _To Burns and Scalds_, Rice Flour is an
excellent application: it should be used as soon as possible after the
occurrence of the injury, and it should be dusted thickly over the whole
of the burnt surface, so as to absorb any discharge that may be present,
and at the same time exclude the air as far as possible. If in a few
days this becomes hardened and irritating, a warm Rice poultice should
be applied, so as to soften it and allow its easy removal; the surface
should then be dressed with Lime Liniment (229) or Resin Ointment (372).

_c._ In the form of Poultice.—RICE POULTICE.—To prepare this, place a
sufficiency of Rice Flour in an open vessel over the fire, gradually add
Water, and stir until the mass has the required consistence. A more
ready mode is to place the Rice Flour in a basin, and then gradually to
add Boiling Water, constantly stirring it, as above. A piece of cloth of
the required size being ready at hand, the poultice should be smoothly
spread on it, to the thickness of from a quarter to half an inch, and
applied over the affected part. In most cases it is advisable before
applying it, to smear the surface of the poultice with a bland oil; this
renders it more soothing and keeps it longer soft and moist. A rice
poultice requires changing twice or even thrice daily. It is an
excellent application to _Abscesses_, _Boils_, _Buboes_, _Ulcers_, and
_other local inflammatory affections_, _Inflamed Piles_, _&c._ _In
Chronic Bronchitis and other Chronic Coughs_ considerable relief often
results from the application of a large soft Rice Poultice placed over
the chest at bedtime, and allowed to remain on all night; another may
also be advantageously placed on the back between the shoulder-blades.
The efficacy of these poultices is in many cases increased by the
addition of a little Mustard Flour (1 part to 3 or 4 of Rice Flour), so
as to produce a slight redness of the skin; or the surface of the
poultice may be smeared over with Oil of Turpentine.


323. +Sal Ammoniac.+ Hydrochlorate of Ammonia, Chloride of Ammonium.

 Nousádar (_Hind._), Nouságar (_Duk._), Noshágar (_Beng._), Charám,
 Navá-charám (_Tam._), Navá-charám, Nava-ságaram (_Tel._), Nava-sáram
 (_Mal._), Navá-ságára (_Can._), Nav-sága (_Guz._), Navá-cháram
 (_Cing._), Zavasa (_Burm._), Namu-charum (_Malay_), Nãushádar
 (_Punj._), Nausadan (_Kash._).

324. Sal Ammoniac, procurable in most Indian bazaars, is generally very
impure; occurring in thick translucent cakes or masses of a dirty white
or brownish colour, inodorous, of a bitter, acrid taste. To fit it for
medical use, it should be dissolved in boiling water, strained through
calico, and the clear solution exposed in an open vessel to crystallise.
The crystals and white residuum should be collected and kept in bottles
for use. Thus prepared, it proves valuable in many affections. Its
nauseous taste, which is a great objection to its use, is completely
covered by the addition of a small quantity of liquorice.

325. _Milk Abscesses_ occurring after confinements and in nursing
mothers may often be arrested, if at an early stage, before matter
forms, the breast be kept constantly wet by means of rags saturated with
a lotion composed of one drachm of Sal Ammoniac, one ounce of _Arrack_,
and a pint of Rose Water. It also proves useful in removing any hardness
which may remain after the abscess has burst, and is sometimes
successful in arresting _Abscesses in other parts of the body_, when
applied at an early stage before matter has formed.

326. _In Tic Douloureux and Rheumatic Faceache_, Sal Ammoniac
occasionally proves very useful. Two drachms in six ounces of water
should be taken in divided doses (1½ ounce for a dose), every four
hours, till relief is obtained: if the pain does not yield after the
four doses, no benefit can be expected from persevering with it. _Other
forms of Neuralgia_, as _Sciatica_ and _Lumbago_, have also been found
to yield to it, when administered early in the attack.

327. _In Chronic Rheumatism, especially when the muscles are mainly
affected_, Sal Ammoniac, in doses of 15 to 24 grains, with infusion of
Country Sarsaparilla (163), proves highly serviceable; but it is even
more effectual in relieving those _Muscular pains of the Chest_ and
other parts of the trunk so often met with in the overworked and
underfed portion of the working classes in large cities. In these cases
it requires to be persevered in for some time.

328. _Hysterical, Nervous, and Bilious Headaches_ are often greatly
benefited, or disappear altogether, under the use of this salt in doses
of 10 to 20 grains twice or thrice daily, dissolved in Camphor Julep.
The earlier in the attack it is given, the greater are the chances of
its proving effectual.

329. _In Chronic Coughs, especially in those of old age_, a mixture of a
drachm of Sal Ammoniac, two ounces of syrup of country Liquorice (6),
and four ounces of Water, in doses of one ounce five or six times a day,
occasionally proves serviceable. In doses of from 1 to 5 grains,
according to the age of the child, conjoined with a few grains of
powdered Cinnamon, it has been found useful in _Hooping Cough_; it is
inferior in efficacy to Alum, but may be commenced with safety and
advantage at a much earlier period in the attack.

330. _In Hæmorrhage from the Lungs, Stomach, and other Internal Organs_,
it is worthy of a trial if other more effectual agents are not at hand.
In these cases, two drachms should be dissolved in a pint of _conjee_
water, and a wineglassful given every second or third hour, according to
the severity of the case. The patient should be kept quiet, cool, and in
the recumbent posture.

331. _In Jaundice_, especially when it comes on suddenly, after a great
mental shock, or after exposure, a few doses of Sal Ammoniac (20 grains
every four hours) have often a marked effect. _In Hepatitis and Abscess
of the Liver_, Dr. W. Stewart, after considerable experience in its use,
regards this salt almost as a specific, and he pronounces it very
serviceable in _all cases of Liver Disease_, whether depending on
organic change or on functional derangement. The proper period for its
exhibition is after the abatement of acute symptoms, and when
diaphoresis (sweating) has been freely established, and it should then
be administered in doses of 20 grains night and morning. The evidence he
adduces in support of his views is very strong. He also speaks highly of
its efficacy in _Chronic Dysentery_, and advises its continued use for
some time after the disappearance of acute symptoms. (_Madras Journal of
Med. Science_, 1870, and Feb., March, and Dec. 1872.) _In Dropsy_,
especially in that connected with disease of the liver, or in that
following fevers, it may be administered with advantage in the same
doses, conjoined with Infusion of Moringa (237), or Decoction of
Asteracantha (39).

332. _For Bruises_, _Strains_, _Rheumatic Swellings_, _Enlarged Glands_,
_Indolent Buboes_, _Swollen Joints_, _Boils_, _&c._, and _local
Inflammations of the Skin_ generally, a solution of this salt in _hot_
water (2 drachms to a pint), kept to the parts for a few hours, proves
useful, not only relieving the pain but reducing the swelling. It is
also thought to be more effectual than anything else in removing the
discoloration consequent on bruises and sprains. This has been noticed
especially with reference to blows on the eye (_Black Eye_). It is an
important ingredient in the Cold Lotion described in Sect. 265.


333. +Sandal-wood Oil.+ The oil obtained by the distillation of Sandal
Wood, Santalum album, _Linn._

 Sandal-ká-aitr (_Hind._), Sandal vel Chandan-ká-tél (_Duk._, _Punj._),
 Safed-chandnúk-til (_Kash._), Sandal-ká-tel (_Beng._), Shandanam-talium
 (_Tam._), Miniak Chandana (_Malay_).

334. Sandal-Wood Oil is sold commonly in the bazaars, being a favourite
native perfume. It has been successfully employed in the treatment of
_Gonorrhœa_. Dr. Aitchison strongly recommends commencing with five-drop
doses, each dose to be made up separately, and the oil mixed in the
fluid it is to accompany with the aid of a drop or two of Liquor
Potassæ. It is an excellent remedy, he adds, but must be used with
_great care_, as it is apt to produce baneful effects on the kidneys if
given in too large doses. It is of great importance to use only good or
pure oil; hence it should be procured, if possible, direct from the
manufacturer. Much that is sold in the bazaars is adulterated or of
inferior quality. It seems well worthy of trial in cases of obstinate
_Gleet_. It is best given in a little Omum water or Infusion of Ginger.


335. +Senna.+ The leaves of Cassia lanceolata, _Forsk._, and other
species. Indian or Tinnevelly Senna.

 Saná, Hindí-saná-ká-pát (_Hind._), Nát-kí-saná (_Duk._), Són-pát,
 Shín-pát (_Beng._), Sanna-mákhí (_Punj._), Berg-i-sanna (_Kash._),
 Nilá-virai, Níla-vakái (_Tam._), Néla-tangédu (_Tel._), Níla-váká
 (_Mal._), Nelá-varíke (_Can._), Sana-kola, Nil-ávari (_Cing._),
 Puve-kain-yoe (_Burm._), Sunna Maki (_Malay_).

336. The imported Senna met with in the bazaars is usually of very
inferior quality, consisting of broken pieces of old leaves, pieces of
stem, and other rubbish. That grown in India, especially in Tinnevelly,
is preferable to that imported from Arabia, which is called
_Sana-Makhí_, or _Mecca Senna_. The leaves should be unbroken, clean,
brittle, pale green, or yellow, with a heavyish smell. It is a good safe
aperient, and may be given as follows: Take of Senna leaves, one ounce;
of bruised Ginger and Cloves, each half a drachm; Boiling Water, ten
ounces. Let it stand for one hour, and strain. This is a good aperient
in all cases of _Constipation_, in doses of one and a half to two
ounces; half this quantity, or less, is required for children, according
to age. A simple infusion of Senna leaves, of the above strength, if
taken hot, with the addition of milk and sugar, can hardly be
distinguished from ordinary tea. In this manner it is easily
administered to children, and will be borne by the most delicate
stomachs. As a general rule. Castor Oil is preferable as an aperient for
infants.


337. +Sesamum+, +Jinjili+, or +Til Oil+. The expressed oil of the seeds
of Sesamum Indicum, _Linn._

 Til-ká-tél, Míthá-tel (_Hind._, _Punj._), Mittá-tél (_Duk._), Nal-enney
 (_Tam._), Manchi-núne (_Tel._), Nall-enná (_Mal._), Valle-yanne
 (_Can._), Chokhóta-téla (_Mah._), Mítho-tél (_Guz._), Talla-tel
 (_Cing._), Tíl (_Kash._), Nahu-sí (_Burm._), Miniak-bijan (_Malay_).

338. Til or Jingili Oil, met with in all bazaars throughout India, is
quite equal, when properly prepared, to Olive Oil for medicinal and
pharmaceutical purposes. It is advisable always to keep a small stock of
it on hand for cases of emergency, such as burns, &c., when Lime
Liniment (229) may be required. As a dressing for _Ulcers, Suppurating
Wounds_, "oil dressing" has been successfully applied in Bombay; it
consists of the continuous application of a pledget of common country
cloth or rag saturated with pure Sesamum Oil to the affected part. It is
thought to be superior to any other simple dressing particularly during
the hot season. _In Leprosy_ Dr. Hilson has conclusively shown that
great and manifest benefit, though it may be temporary, results from
diligent frictions of the body with this oil (see Sect. 161).

338_a_. The leaves, which abound in mucilage, have attained some repute
in bowel affections, and Mr. B. Evers (_Indian Med. Gazette_, March
1875) made trials with them in sixteen cases of _Dysentery_. Recovery
followed in each case, but they were all of a mild type, and though the
remedy acted as a demulcent, it did not appear to exercise any specific
influence on the disease; besides, as opium had to be conjoined with it
to control the tenesmus, the benefit may have been due as much, if not
more, to the opiate as to the mucilage. It is evidently a remedy of very
secondary value, and inferior to Ispaghúl Seeds (304). The seeds have
powerfully emmenagogue properties assigned to them, and it is believed
by the natives and Anglo-Indians that, if taken in large quantities,
they are capable of producing abortion. In _Amenorrhœa_ the employment
of a warm hip bath containing a handful of the bruised seeds has been
reported on good authority to be an efficient mode of treatment. It
seems worthy of further trial. In three cases of _Dysmenorrhœa_
(_Painful Menstruation_) Mr. B. Evers (_op. cit._) administered with
benefit the powdered seeds in ten-grain doses three or four times daily.
At the same time he employed the hip bath containing the bruised seeds
as mentioned above.


339. +Sulphur.+

 Gandak, Gandhak (_Hind._, _Duk._, _Mah._, _Guz._, _Punj._), Gandrok
 (_Beng._), Gandakam, Gandhakam (_Tam._, _Tel._, _Mal._, _Cing._),
 Gandhaká (_Can._), Kán (_Burm._), Blerang (_Malay_), Ganduk (_Kash._).

340. Several kinds of Sulphur are met with in the bazaars, but as their
composition is unknown and some of them are reputed to contain a large
proportion of arsenic, they are unsuited for internal administration;
the better and purer kinds, however, may be safely employed as external
applications.

341. As a remedy for _Itch_, SULPHUR OINTMENT holds a high place. One
part of finely powdered or sublimed sulphur to six of kokum butter or
any bland oil is sufficiently strong for ordinary cases. After cleansing
the parts with soap and hot water, the ointment should be thoroughly
well rubbed in for fifteen or twenty minutes, till the pustules are all
broken. Its use should be confined to the hands and wrists and other
parts affected; no good is obtained from applying it extensively over
the whole surface of the body, as is often done. It is best rubbed in at
night before going to bed, allowing it to remain on the whole night, and
then washing it off in the morning with soap and hot water. This process
may be repeated every night till a cure is effected, which will be the
case after three or four applications, provided the ointment is properly
rubbed in. The patient should not resume the clothes he wore previously
until they have been subjected to the process of _boiling_, a
temperature of 212° F. being necessary for the destruction of the
acarus, on the presence of which the disease depends. Simply washing the
clothes in hot water will not destroy the germ of infection.

342. Some other forms of _Chronic Skin Disease in Natives_ improve under
the use of Sulphur Ointment, described in the last section; or, better
still, of "Balsam of Sulphur" so called, which is simply a solution of
sulphur in warm Olive or Sesamum Oil.

343. _In Chronic Rheumatism_ a liniment, composed of two ounces of
powdered or Sublimed Sulphur, and a pint of Ním Oil, well rubbed in
twice daily, has been used with great benefit in many cases. Relief
sometimes follows the practice of dusting the affected part with Flour
of Sulphur at bedtime, enveloping it in flannel, and covering the whole
with plantain-leaf to prevent the escape of the fumes.

344. _In Piles_ few medicines afford more relief to the distressing
local symptoms than a mixture of equal parts of Sublimed Sulphur and
Cream of Tartar; of this a teaspoonful should be taken in milk once or
twice daily, so as to keep the bowels gently open. Should this quantity,
however, operate too powerfully on the bowels, the dose should be
diminished. The ingredients for this powder should be procured from a
regular chemist. The same treatment appears to act beneficially in
_Chronic Dysentery_. It is likewise well adapted for _Habitual
Constipation_, especially when occurring in persons subject to piles. It
is well to bear in mind that in all cases where Sulphur is administered
internally, it communicates to the stools a peculiarly disagreeable
odour of sulphuretted hydrogen.


345. +Tamarinds.+ The Fruit of Tamarindus Indicus, _Linn._

 Anblí (_Hind._), Amlí, Amlí-ká-bót (_Duk._), Imlí (_Punj._),
 Tamar-i-hind (_Kash._), Téntúul, Tintúrí, Ámlí (_Beng._),
 Puliyam-pazham (_Tam._, _Mal._), Chinta-pandu (_Tel._), Chinch
 (_Mah._), Hunashí-hannu (_Can._), Ámblí (_Guz._), Siyambula (_Cing._),
 Magi (_Burm._), Assam-java (_Malay_).

346. The pulp of the fruit, of a reddish-brown colour and acid
saccharine taste, is laxative and refrigerant, and made into sherbet
with water or milk (in the proportion of one ounce of the pulp to one
pint of fluid) forms an agreeable and useful drink in _Febrile and
Inflammatory Affections_. The only objection to it in some cases is (in
others this is an advantage) that it is apt to act on the bowels as a
laxative. In the absence of limes or lemons, Tamarind pulp may be given
with great advantage in _Scurvy_, both as a preventive and as a
curative, but it requires to be discontinued if it cause griping and
diarrhœa; otherwise it is a valuable antiscorbutic, and as such may be
taken on board ship, or form a portion of daily rations in jails, &c.


347. +Telini Fly, Mylabris Cichorii+ (_Fabr._).

 Télní, Télní-makkhí (_Hind._), Zírangí, Bad-bó-kí-zírangí (_Duk._),
 Pinsttarin-í (_Tam._), Ígelu (_Tel._).

348. This insect is of common occurrence throughout India; it has the
following characters: About an inch in length and the third of an inch
broad; the elytra, or wing-cases, of an obscure yellow, with three large
somewhat zigzag transverse black bands; the first band is interrupted
and sometimes reduced to three or four spots. There are met with in
various parts of India other allied species, which differ more or less
from the above description, but they all partake of the same irritant
and vesicant properties, the active principle being the same with that
of the officinal Cantharides, viz., Cantharidine. It is apparently a
complete substitute for the European article as a vesicant, provided
that due care is taken in its preparation, &c. The best season for
collecting the insects is just previous to the setting in of the
monsoon, in the early morning or evening; they should be killed by the
steam of boiling vinegar, thoroughly dried in the sun, and preserved in
well stoppered bottles.

349. Its principal use is as a blistering agent, and for this purpose it
is used in the form of plaster, prepared as follows: Take Telini Fly,
finely powdered; White or Black Dammar, Bees-wax, and Suet (mutton or
goat), of each two ounces; liquefy the three latter with a gentle heat,
then remove from the fire and sprinkle in the Telini; mix the whole
thoroughly, and continue to stir the mixture while it is allowed to cool.

In consequence of the difficulty of preparing this, and the uncertainty
of its strength, I would advise that every establishment should be
provided with a supply of officinal Blistering Liquid of the British
Pharmacopœia; this only requires to be applied for two or three minutes
with a camel's-hair brush, allowed to dry on, and then covered with a
warm rice poultice; in the course of a few hours the blister will be
found to have risen. The Liquid prepared in India from the Telini Fly is
quite equal in power to the European article prepared with Cantharides
or Spanish Fly.

350. _Remarks on the Use of Blisters._—Blisters are of great value in
many cases, but unless used with care and discrimination they may do
_more harm than good_. Thus, a blister applied at the outset or during
the acute stage of inflammation will increase the mischief, whereas in
the advanced stages its action may prove in the highest degree
beneficial. During pregnancy a blister to the chest has been known to
induce premature labour, retention of urine, &c., and applied to a
person suffering from scurvy it is apt to induce troublesome ulceration.
To prevent gangrene, which has occasionally resulted from a blister,
especially in children, it is advisable not to allow it to remain on
more than ten minutes, then to remove it and apply a warm rice poultice.
In infants a thin piece of muslin should be placed between the skin and
the plaster. If strangury follow its use, the patient should drink
plentifully of decoction of Abelmoschus (2), Rice _Conjee_ (322), or
other demulcents, avoiding those of an oleaginous nature. After the
fluid has been let out, which is easily done by snipping the raised
cuticle in two or three places with a pair of sharp-pointed scissors,
the blistered surface should be dressed with plantain-leaf, as directed
in paragraph 307_a_.


351. +Tinospora cordifolia+, _Miers._, +Gulancha+.

 Gulanchá, Gul-bél (_Hind._), Gul-bél (_Duk._), Gul-lanchá (_Beng._),
 Giló, Gúlanch (_Punj._), Bekh-gilló (_Kash._), Shindi-kodi (_Tam._),
 Tippa-tíge, Gadúchi (_Tel._), Amruta, Chitr-amruta (_Mal._),
 Amruta-balli (_Can._), Gula-vélí (_Mah._), Gul-vél (_Guz._), Rasa-kinda
 (_Cing._), Sinza-manné, Singomoné (_Burm._), Piturali, Akar-Sarimtooro
 (_Malay_).

351_b_. This twining shrub is common in most parts of India. The root
and stems, which are the parts employed in medicine, should be collected
in the hot season when the bitter principle is most abundant and
concentrated. As met with in the bazaars it consists of dried transverse
segments of a woody stem, varying in diameter from one quarter of an
inch to two inches, and from half an inch to two inches in length; they
have a shrunken appearance, and are covered with a smooth shrivelled
bark, some of the pieces being marked on their surface with warty
prominences; inodorous, of a very bitter taste.

352. Gulancha is a very useful tonic, and is best given in Infusion; one
ounce of the bruised stem to half a pint of cold water macerated for
three hours and strained; of this the dose is from one and a half to
three ounces thrice daily; it is rendered more agreeable by the addition
of Cinnamon, Cloves, or other aromatics. It has been used with benefit
in mild forms of _Intermittent Fevers_, and in _Constitutional
Debility_, _and Loss of Appetite after these and other Fevers_. It has
also been found useful in some forms of _Dyspepsia_, and in _Chronic
Rheumatism_.

353. An extract (Sat-giló, _Hind._, _Punj._; Gul-bél-kásat, _Duk._;
Sath-gilló'i, _Kash._, Shíndal-sharuk-arai, _Tam._; Palo, _Beng._;
Tippa-satu, _Tel._) prepared by the native doctors, is held in high
repute amongst them in _Intermittents, &c._ It is a white floury
substance, with a strongly bitter taste. It is, however, often
adulterated with, or consists altogether of, gluten of Wheat; its
bitterness, therefore, is a good test of its quality. In doses of one to
three drachms, it is highly esteemed as a tonic in _Debility after
Fevers_, in _Spleen Affections_, &c. Dr. Burton Brown speaks of it as an
efficient remedy in _Diseases of the Bladder, especially in Chronic
Inflammation of that organ_.


354. +Toddy.+ A saccharine juice obtained by the excision of the spadix,
or young flowering branch of the Palmyra, Cocoanut, and other Palms.

 Séndí, Tári (_Hind._, _Duk._), Kallu (_Tam._), Kallu (_Tel._), Henda
 (_Can._), Rá (_Cing._), Tu-ak (_Malay_).

There are many kinds of _Toddy_ in India, and they are named according
to the plants from which they are produced. The names given above are
generic.

355. Amongst its other uses _Toddy_ is valuable as the basis of a very
useful stimulant application, the _Toddy_ POULTICE, which is to the
Indian what the Yeast Poultice is to the European surgeon. It is
prepared by adding freshly drawn _Toddy_ to Rice Flour till it has the
consistence of a soft poultice and subjecting the mixture in an open
vessel to heat over a gentle fire, stirring constantly till fermentation
commences, or it "begins to rise," as it is commonly expressed. This,
spread on a cloth and applied to the parts, acts as a valuable stimulant
application to _Gangrenous or Sloughing Ulcerations_, _Carbuncles_,
_Indolent Ulcers_, _&c._ It hastens the separation of the slough and
establishes subsequent healthy action.

356. _Toddy_ left exposed to the air rapidly undergoes vinous
fermentation, and becomes converted into _Arrack_, one of the most
intoxicating drinks of the country. This _Arrack_, subjected to
distillation until it has a specific gravity of 0·920, may be employed
as Proof Spirit in the preparation of tinctures and other pharmaceutical
purposes, and in the formation of cold evaporating lotions (380).


357. +Turmeric.+ The dried root-stock of Curcuma longa, _Linn._

 Halad, Haldí (_Hind._, _Duk._, _Punj._), Holodí (_Beng._), Lidar,
 Gandar-i-lidar, (_Kash._), Manjal (_Tam._), Pasupu (_Tel._), Mannal,
 Marin-nala (_Mal._), Arishiná (_Can._), Halede (_Mah._), Halad
 (_Guz._), Kahá (_Cing._), Sanó, Tanún (_Burm._), Kooneit (_Malay_).

358. Turmeric has been employed in the following affections with
excellent effects:

359. _In Catarrh, or severe "Cold in the head,"_ the fumes of burning
Turmeric inhaled through the nostrils act as a local stimulant or
irritant, causing a considerable discharge of mucus from the nasal
cavity; this is generally followed by a marked degree of relief to the
congestion or fulness often so troublesome in these cases.

360. _In Catarrhal and Purulent Ophthalmia_, especially in that termed
"_Country Sore-Eye_," a Decoction of Turmeric (one ounce of the bruised
root to 20 ounces of water) proves a very effectual lotion for relieving
the burning and moderating the urgency of the symptoms. A piece of soft
rag soaked in it should be kept constantly over the affected eye.


361. +Oil of Turpentine.+ The oil obtained by distillation from Pinus
palustris. _Lamb._, and other species of Pinus.

 Gandhá-barójé-ká-tél (_Hind._, _Punj._) Gandhá-férózé-ká-tél,
 Káfúr-ká-tailam (_Duk._), Kapúrér-tail (_Beng._), Karppúrat-tailam
 (_Tam._), Karppúra-tailam (_Tel._, _Mal._), Karapúrada-tailá (_Can._),
 Kápúrácha-tela (_Mah._), Karpúrnu-tél (_Guz._), Kapuru-tel (_Cing._),
 Piyo-sí (_Burm._), Nimiak Kapor Baroos (_Malay_), Yárí-kanglun-ki-til
 (_Kash._).

362. Oil of Turpentine is procurable in most large bazaars, but not
generally sufficiently pure for internal administration. It answers,
however, perfectly well for external or local application, and is most
valuable in the preparation of TURPENTINE STUPES or EPITHEMS, which are
made in one of the following ways: 1. By steeping a flannel in hot
water, as hot as can be borne by the hand, wringing it out dry and
sprinkling the surface freely with Oil of Turpentine. 2. By steeping a
piece of lint or rag of the required size in Oil of Turpentine, placing
it over the affected surface, and immediately applying over it flannel
heated before a fire, as hot as can be borne. In either way it acts
admirably as a counter-irritant, and in most cases is superior to
mustard poultices. It is applicable to all cases of _Internal
Inflammations_, _Spasmodic Affections of the Bowels_, _advanced stages
of Dysentery and Diarrhœa_, _Obstinate Vomiting_, _Flatulence, and
Flatulent Colic_, _Chronic Bronchitis attended with Cough and Difficulty
of Breathing_, _Asthma_, _&c._

363. In some cases, greater benefit is derived from applying these
Stupes to a distant point rather than near to the affected part; thus,
in _Apoplexy_, _Insensibility_, _Convulsions_, _Delirium_, whether
arising in the course of fever or otherwise, they produce the best
effects when applied to the feet and to the calves of the legs. _In
Cholera_, when applied successively to the abdomen, over the region of
the heart, along the spine and to the extremities, they often seem
materially to aid other measures in stimulating the system and raising
the vital powers. Turpentine friction and turpentine enemas may also be
resorted to as aids to other treatment.

363_b_. _In "Pecnash," or Maggots in the Nose_, common amongst the
natives of Bengal and other parts of India, "the best treatment is to
inject every opening in the skin of those affected with this disease
with pure Oil of Turpentine, which is found to kill the maggots, and
then to extract any maggots that are visible by means of a pair of
forceps. Chloroform is even more efficacious, but is more expensive."
(Dr. T. E. B. Brown, _Indian Med. Gaz._, Sept. 1879, p. 263.)

364. TURPENTINE ENEMAS (one ounce of the Oil to 15 ounces of _Conjee_)
are valuable agents in many cases, as in _Apoplexy_, _Insensibility_,
_Convulsions, especially in those after Childbirth_, _Hysterical Fits_,
_Spasmodic Affections of the Bowels_, _Flatulence_, _Flatulent Colic_,
&c. They, together with turpentine stupes, have sometimes excellent
effects in stimulating the system and rousing the vital powers in
_Delirium and Exhaustion attendant on Fever_.

365. _For the removal of Thread Worms from the Rectum and Lower Bowel_,
a Turpentine Enema often proves effectual. In the treatment of _Tape
Worm_ Oil of Turpentine is a remedy of established value; it is best
given internally in a dose of three drachms with an equal quantity of
Castor Oil; the latter is considered to prevent the unpleasant head
symptoms which are apt to arise when the Turpentine is given alone. It
is best given two or three hours after a meal; if taken on an empty
stomach it is apt to produce vomiting. The patient should remain quiet
after taking it, and broths and mucilaginous drinks should be taken to
aid its operation. The Oil of Turpentine for this purpose should be
obtained from a regular chemist or other reliable source.

366. TURPENTINE LINIMENT is a valuable application in _Chronic
Rheumatism_, _Lumbago_, _Sciatica_, _and other forms of Neuralgia_, _in
Chronic Enlargement of the Joints_, _Bruises_, _Sprains_, _Muscular
Pains_, _&c._ It is formed by dissolving one ounce of Camphor in 16
ounces of Oil of Turpentine, and then adding two ounces of Soft Soap,
rubbing them together until they are thoroughly mixed. _Chronic Coughs_,
especially of the aged, are much benefited by this liniment well rubbed
into the chest at night.

367. TURPENTINE OINTMENT is prepared by melting together at a gentle
heat one ounce of Oil of Turpentine, 60 grains of White or Black Dammar
(372), half an ounce of Yellow Wax, and half an ounce of Kokum Butter.
The ingredients, when melted together, should be removed from the fire,
and the mixture constantly stirred whilst cooling. It constitutes a good
stimulant application to _Indolent and ill-conditioned Ulcerations_,
_&c._ Diluted with equal parts of _ghee_, it forms a highly useful
dressing for _Carbuncles_, aiding the separation of sloughs, and
stimulating to healthy action. It should be changed twice or thrice
daily. Its action is aided by generous diet, &c., as mentioned in Index,
Art. _Carbuncle_. Some _Chronic Skin Diseases_ improve under the use of
the undiluted ointment, but in those of the _Hairy Scalp of Parasitic
origin_, the pure oil, locally applied, according to Erlach
(_Practitioner_, Oct. 1871), more surely and more rapidly than any other
remedy.


367_b_. +Tylophora, or Country Ipecacuanha.+ Tylophora asthmatica, _W.
et A._

 Antá-múl, Janglí-pikván (_Hind._), Pit-kárí (_Duk._), Anto-mul
 (_Beng._), Nach-churuppán, Náy-pálai, Péyp-pálai (_Tam._), Verri-pála,
 Kukka-pála (_Tel._), Valli-pála (_Mal._), Bin-nuga (_Cing._).

368. This plant is common in sandy localities in Bengal and other parts
of India. Its roots and leaves possess valuable emetic properties; the
former, as met with in the bazaars, occurs in the form of thick,
contorted pieces of a pale colour, and a bitterish, somewhat nauseous
taste. As an emetic, and especially as a remedy in dysentery, it has
long been in repute, but it has been superseded by the dried leaves, the
operation of which has been found more uniform and certain; in fact,
they are justly regarded as one of the best indigenous substitutes for
Ipecacuanha. The dose of the powdered dried leaves as an emetic for an
adult is from 40 to 50 grains; in smaller doses, four to eight grains,
its action is that of an expectorant and diaphoretic.

369. _In Dysentery and Diarrhœa_, even in the earliest stages, and
whilst fever is present, it may be given in doses of 10 to 15 grains
three or four times daily, conjoined with mucilage, and opium if
required; or it may be commenced in one large dose in the same way as
Ipecacuanha (see _Index_). If the dysentery be connected with
intermittent fever, or be of malarious origin, it should be combined
with quinine.

370. _In Chronic Bronchitis_, _Coughs_, _Colds_, _and the_ _early stage
of Hooping Cough_, it has been administered with manifest benefit as an
expectorant and diaphoretic, in doses of five grains thrice daily or
oftener, either alone or combined with Syrup or Country Liquorice (6).


371. +Vateria Indica+, _Linn._, +Resin of+. Piney, or White Dammar.

 Suféd-dámar (_Hind._, _Duk._), Kúndro (_Beng._), Sundras (_Punj._),
 Sindrus (_Kash._), Vellai-kúndrikum (_Tam._), Dúpa-dámaru, Tella-dámaru
 (_Tel._), Vella-kúnturukkam (_Mal._), Hal, Hal-dumlua (_Cing._), Guttah
 rukam putch (_Malay_).

In the absence of White Dammar, Black Dammar, the resin of Canarium
strictum, _Roxb._, may be substituted. Its native names are Kalá-damar
(_Hind._, _Duk._, _Beng._), Karuppu-damar (_Tam._), Nalla-rojan
(_Tel._), Kálo-damar (_Guz._).

372. The specimens of White or Piney Dammar are met with in the bazaars
in irregular masses, which differ in colour, fragrance, and density,
some being of a light greenish colour, dense and uniform in substance,
whilst others are yellow, amber-coloured, and vesicular, or full of
small bladders; these differences apparently arise from the mode of
collection and the age of the trees producing them. This resin burns
with a clear, steady light, giving off a pleasant smell, but very little
smoke; under the influence of gentle heat it combines with wax and oil,
and forms a good substitute for officinal Resin in various ointments and
plasters. The following is an eligible form for common use. Take of
White Dammar, five ounces; Kokum Butter, eight ounces; Wax, two ounces.
Melt with a gentle heat, stirring briskly as it cools. This spread on
rag or lint forms a good stimulant dressing for _Carbuncles and other
Ulcerations_.

373. From the _fruit_ of Vateria Indica, _Linn._, common on the western
coast of the Peninsula, is obtained a solid fatty oil named Piney Tallow
or Vegetable Tallow of Canara, which has obtained considerable repute as
a local application in _Chronic Rheumatism_, and some other painful
affections. Like Kokum Butter, it may be used as a substitute for animal
fats in the preparation of ointments, &c. It is deserving of more
attention than has hitherto been paid to it.


373_a_. +Vernonia Seeds.+ The seeds of Vernonia anthelmintica, _Willd._

 Sómráj, Bukchí (_Hind._), Sómráj (_Beng._), Káttu-shíragam (_Tam._),
 Adavi-jila-kara, Visha-kanta-kálu (_Tel._), Káttu-jírakam (_Mal._),
 Kádu-jirage (_Can._), Ránácha-jíré (_Mah._), Kadvo-jíri (_Guz._),
 Sanni-náegam, Sanni-násang (_Cing._), Justan hutan (_Malay_).

373_b_. The plant which yields these seeds is common in waste places
near villages throughout India, and the dried seeds are met with in
almost every bazaar; they are about the eighth of an inch in length, of
a dark brown colour, covered with whitish scattered hairs, cylindrical,
tapering towards the base, marked with about ten paler longitudinal
ridges, and crowned with a circle of short brown scales; taste, nauseous
and bitter. These seeds enjoy a high repute amongst the natives as a
vermifuge in cases of _Lumbrici or Round Worms_, which, under their use,
are stated to be expelled in a lifeless state, thus showing that they
exercise a specific influence on the worm. The ordinary dose of the
bruised seed, administered in electuary with honey, is about two
drachms, given in two equal doses at the interval of a few hours, and
followed by an aperient. In this character they seem well worthy of
further trials. In Travancore, the bruised seeds, ground up into a paste
with lime-juice, are largely employed as a means of destroying _Lice_
infesting the body. The reports received of their efficacy for this
purpose justify farther trials with them.


374. +Vinegar.+

 Sirká (_Hind._, _Duk._, _Beng._, _Punj._, _Kash._), Kádi (_Tam._),
 Kádi-nóllu (_Tel._), Káti (_Mal._), Hulirasa (_Can._), Kádi, Vená-kiri
 (_Cing._), Pón-ye (_Burm._), Chuka (_Malay_).

375. Many kinds of _Vinegar_ are met with in India, but as they are of
very varying strength and degree of purity the imported English
Distilled or White Wine Vinegar should be preferred, when procurable, as
it generally may be in large bazaars, for medical purposes. In its
absence the best native kinds, especially that prepared from the _Toddy_
of the Palmyra tree, should be used. At Peshaur and on our North-West
frontier a very superior vinegar is manufactured from the juice of the
grape; hence "Peshaur Vinegar" is well known throughout the Punjab and
Kashmir, and even at Bombay and Kurrachee (_Dr. Aitchison_).

376. _In Smallpox_, _Measles_, _Scarlet Fever_, _and other Febrile
Affections_, a mixture of one part of Vinegar and three of Water forms a
soothing and refreshing application, with which the whole surface may be
sponged twice or thrice daily, the temperature being regulated as
described in Sect. 385. Sprinkled about the sick room, in these and
other cases, undiluted vinegar acts in a degree as a deodorant, and is
generally very agreeable to the patient.

377. _In Relaxed, Ulcerated, and other forms of Sore Throat, especially
in that of Scarlet Fever, in Hoarseness, &c._, benefit is often derived
from the inhalation of the vapour of hot Vinegar.

378. _In Phthisis_, sponging the chest with diluted Vinegar is said to
be very effectual in allaying the _profuse perspirations_. A good
mixture for this purpose is composed of one part of Vinegar, one of Eau
de Cologne, and two of Water; it is a measure attended with salutary
effects, and is generally of great comfort to the patient. _As a
preventive of Phthisis_ the practice has been strongly recommended of
washing the chest every morning with Vinegar and Water, beginning with
it tepid, and reducing the temperature gradually, until it can be used
quite cold. The same measure persevered in has been found useful by
persons subject to repeated attacks of _Coughs and Asthmas_; it often
seems to diminish the liability to a return of these attacks, and to act
as a preventive.

379. _In Abortion and other forms of Uterine Hæmorrhage_, the continued
application of cold Vinegar and Water to the pubes is not only agreeable
to the patient, but tends considerably to arrest the discharge of blood.
In the absence of better agents, Vinegar diluted and sweetened to taste
may also be advantageously given internally. _Bleeding from the Nose_
sometimes yields to a piece of rag saturated with Vinegar introduced
into the nostril.

380. _To Bruises, Sprains, Contusions, and local Inflammations_, diluted
Vinegar is a popular and useful application. An excellent "EVAPORATING
LOTION" in these cases is formed of equal parts of Vinegar, _Arrack_,
and Water. This forms also a good application to the head in the
_Headache and Delirium of Fever_. The pains of _Venomous Bites or
Stings_, e.g., _of Scorpions, Centipedes, Wasps, Mosquitoes, &c._, is
often greatly relieved by the constant application of a piece of rag
moistened with Vinegar.

381. _To Milk or Mammary Abscesses_ warm Vinegar, perseveringly employed
for twenty-four hours, is stated on good authority to be one of the best
applications which can be used for relieving the congestion; it is
particularly useful when the breasts are greatly and painfully distended
with milk, and the earlier in the case it is employed, the greater are
its chances of success.

382. _Particles of Lime_ (_Chunam_) _in the Eye_ are effectually
dissolved and the pain eased by bathing the eye with diluted Vinegar,
not strong enough to cause smarting; it requires to be introduced
between the eyelids.


383. +Water.+

 Pání (_Hind._, _Duk._, _Beng._, _Guz._, _Mah._, _Punj._) Áb, Sag
 (_Kash._), Tanni, Jalam, Nír (_Tam._), Jalam, Níllu (_Tel._), Vellam
 (_Mal._), Vaturu (_Cing._), Yé (_Burm._), Ahyer (_Malay_).

384. Water for medicinal purposes, _e.g._, making infusions, decoctions,
&c., should be the purest which can be procured. At certain seasons,
however, especially during the monsoon, the best water is apt to be so
muddy as to be unfit either for medicinal or drinking use. Under these
circumstances, recourse may be had to the native practice of rubbing the
inside of a vessel or _chattie_ with Clearing Nut, the Seeds of
Strychnos Potatorum, _Linn._, Nir-malí (_Hind._, _Beng._, _Mah._, and
_Guz._), Chil-bínj (_Duk._), Tétrán-kottai (_Tam._ and _Malyal._),
Tétrán-parala (_Tel._), Ingini-atta (_Cing._), Kamou-yeki (_Burm._),
bruised or sliced, previous to the water being poured into it. This
simple measure is said to render the muddiest water clear and wholesome.
Where water has been collected from swampy or malarious localities, a
better plan is to subject it (with the addition of a piece of freshly
prepared charcoal) to _boiling_, and subsequent straining or filtering.
The uses of water in medicine are multifarious and important.

385. _As a drink in Fever and Inflammations_, cold water may be taken
without restriction, and it may be rendered more refrigerant and
agreeable by the addition of some mucilaginous agents, as rice, &c., and
some vegetable acid, as tamarind pulp or lime-juice. For _Irritability
of Stomach and Vomiting in Fever_, water drunk as hot as it can be borne
will often prove very effectual; "But," observes Dr. Aitchison, "the
remedy should not consist of merely a mouthful or so of hot water; but
of two or three tumblers full. One would suppose that drinking this
amount of water on an irritable stomach would rather produce vomiting:
this is not the case. The patient may bring up a little of the water;
but usually he simply turns round, and falls asleep as if a narcotic had
been given him." _In Smallpox, Measles, Scarlatina, and other Fevers_,
the practice of freely sponging the surface once or twice daily with
water is extremely grateful and refreshing to the patient, and may be
used with perfect safety unless the heat be high above the natural
standard, when tepid water should be substituted. As a general rule, the
temperature of the water should be regulated by the patient's feelings;
it should be cold, tepid, or quite warm, as is most agreeable. A mixture
of Vinegar and Water (one part of the former to three of the latter) is
even more refreshing than plain water.

386. _In Sunstroke_, the first thing to be done after removing the
patient into the shade and taking off the head-gear and upper clothing,
is to practise COLD AFFUSION. For this purpose he should be held in a
sitting posture, whilst the water, the colder the better, is poured down
in a pretty full stream, at a height of two or three feet over the head,
spine, and chest. After its application for a minute or two, the patient
will probably heave a deep sigh or inspiration, when the affusion should
be discontinued and the patient removed to a dry spot, thoroughly dried
with a warm cloth or towel, and diligent friction maintained till full
consciousness is restored. Mustard poultices (247), Turpentine stupes
(362) to the feet and calves are also advisable if insensibility be long
continued. One or two points demand attention. 1. The water should not
descend all at once, but rather in a small continuous stream, and it
should be directed not so much on the top of the head as on the back
part and upper portion of the spine. 2. It should at once be
discontinued when the patient begins to revive. 3. It is not adapted for
the aged and debilitated, or when the skin is cold and clammy; in these
cases affusion should be restricted to dashing cold water on the face
and chest, together with persevering frictions of the extremities; and
when the patient is able to swallow, administering mild stimulants,
_e.g._, ammonia, weak brandy and water, &c. The above treatment is
adapted for _Apoplexy and Profound Insensibility, such as occurs in
Poisoning by Opium, Bish (Aconite), or the fumes of Datura_. In ordinary
cases of _Fainting, Convulsions in Adults arising from no evident cause,
and Hysterical Convulsions in Women_, simply dashing cold water with
some little degree of violence on the face and bosom, is generally all
that is required.

387. _In the Convulsions of Infancy and Childhood_ the little patient
should be put into a hot bath, with as little delay as possible, the
head at the same time being slightly elevated, and enveloped in cloths
kept wet with cold water, the colder the better. Under the simultaneous
use of the hot bath and the cold lotion to the head, aided by the
administration of a dose of Castor Oil, the convulsions will often
speedily subside. The bath should be as hot as can be borne, about 98°
F., and the child should remain in it for ten or fifteen minutes, but
the cold to the head may be continued for some hours. Should the
convulsions return, the bath may be repeated, followed by small Mustard
poultices (247) applied to the feet. A hot bath is also very useful in
allaying _Colic in Children_.

388. _To check violent Hæmorrhage or Flooding after Labours_, nothing is
much more effectual than dashing _cold_ water in a pretty full stream,
and with some little degree of force, over the abdominal surface,
especially the lower portion. At the same time, a piece of soft rag,
made into a pyramidical form, thoroughly saturated with cold water, or
vinegar and water (in equal parts), should be introduced into the
vagina. After the flooding has been subdued, the external application of
cold water, or vinegar and water, should be kept on for some time.
_N.B._—During a confinement in India, it should be an invariable rule,
to meet such an emergency as the above, to have ready at hand two or
three _chatties_ of _cold_ water, for a patient may die from loss of
blood if the water has to be fetched from a distant source.

389. _In Cholera_, the free use of cold water as a drink appears
materially to aid other treatment, of whatsoever kind that may be; it
should be as cold as procurable, iced if possible, and taken in large
and repeated draughts; although the first four or five draughts may be
rejected, its use should still be persevered in; the stomach will
eventually retain it, and when this is effected, a beneficial change in
the state of the patient generally takes place. Whatever other treatment
is adopted, cold water (iced if possible) in copious draughts is a
valuable auxiliary, perfectly safe, agreeable to the patient, and likely
to be productive of the best effects.

390. _Many forms of Sore Throat, and Coughs attended with Difficulty of
Breathing and Scanty Expectoration_, are much benefited by repeated
inhalations of hot water, and their efficiency is increased by the
addition of mucilaginous agents, as Abelmoschus (1). _In Croup_, relays
of sponges filled with water, as hot as the little patient can bear,
should be applied immediately beneath the chin, along the whole course
of the throat. They should be persevered in for half an hour, and then
discontinued if they fail to produce benefit. In severe cases,
Turpentine stupes (362) prove more serviceable.

392. _In many painful affections of the Kidneys_, _Bladder, and Uterus_,
_in the passage of Gall Stones_, and in _Retention of the Urine from
Spasmodic Stricture consequent on a debauch or exposure_, the hot
hip-bath proves highly serviceable and soothing.

393. HOT-WATER FOMENTATIONS are very serviceable in many cases, _e.g._,
_Local Inflammations_, _Incipient Abscesses_, _Boils_, _Sprains_,
_Lumbago_, _Colic and Spasmodic Affections of the Bowels_, _Congestion
of the Liver_, _Asthma_, _&c._ To obtain their full effect, a few points
require to be attended to. 1. The water should be as hot as can be
borne. 2. Two or more thickly folded cloths (if flannel so much the
better) of a size rather larger than the surface they are to cover,
should be in readiness. 3. One of these having been removed from the
water, should be thoroughly rung, so that it should hold no superfluous
moisture, and should be immediately applied to the surface. 4. A second
cloth having been got ready in the same way, the first, after the lapse
of two or three minutes, should be removed, and the second applied. This
process should be continued for half an hour if necessary, care being
taken that the water be kept at the original temperature by means of
fresh relays, and that there should be no longer interval than possible
between the removal of one and the application of the succeeding
fomentation. Subsequently, care should be taken to protect the fomented
part from exposure to cold draughts of air. Some forms of _severe
Headache, especially those occurring in Fevers_, are far more benefited
by hot-water fomentations, or stupes thus applied, than from cold
lotions commonly employed for the purpose. According to Dr. Aitchison,
nothing relieves the _Headache or great fulness of the Head in Fevers_
so effectually as the continuous application of extremely hot-water
stupes to the nape of the neck. _The Irritative Bilious Diarrhœa of
these Fevers_, he adds, is more frequently improved and arrested by
large warm-water enemas, administered at least morning and evening, than
by any other remedy he knows of.

394. _In the treatment of Wounds, Ulcers, and Inflamed surfaces_, "WATER
DRESSING" possesses many advantages, especially in tropical regions,
over poultices and ointments. The process is exceedingly simple,
consisting only of a piece of lint of thick texture, and of a size
sufficient completely to cover the wound, soaked in tepid water. This is
placed on the affected part, and the whole enveloped in an ample piece
of oiled silk, so as effectually to prevent evaporation. Young plantain
leaf answers the purpose as well as oiled silk. Cold water may be
substituted for tepid, should it be more agreeable to the feelings of
the patient.

395. _Sloughing and Gangrenous Ulcerations, and Carbuncles ("Rajah
Boils") after suppuration_, are more effectually treated by what is
termed "IRRIGATION," which consists in keeping up a continuous stream of
water, tepid or cold, as the patient may prefer, for half an hour twice
daily. A common kettle, or one of the natives' drinking-vessels provided
with a spout, answers well for the purpose, and it should be held so
that the fall of water should be about a foot, or rather more, but the
height should be regulated in a measure by the patient's feelings. If
pain is caused, the height should be diminished. With each irrigation,
more or less of the slough comes away, and in a few days the ulcer will,
in most instances, assume a healthy appearance, when it may be treated
as an ordinary ulcer—with cold water dressing, Turpentine, or Wax
Ointment, &c. In the intervals between the irrigation, _Toddy_ Poultices
(355) should be applied.

396. Another way in which Water may be utilised is in the formation of a
VAPOUR BATH, which is often a most serviceable resource in _Chronic
Rheumatism_, _Obstinate Skin Disease_, _Dropsical Affections_, _the
early stages of Diabetes_, _and in all cases where the skin is dry,
rough, and not much above the natural standard_. It is inadvisable in
fever cases. _Incipient Colds and Catarrhs_ following exposure to wet,
&c., may often be speedily arrested by a vapour bath, taken immediately
before going to bed at night.

397. The Vapour Bath apparatus, which should be kept ready in all large
establishments in India, consists of a bamboo frame of a conical shape,
covered with wax cloth or some other impervious material; it should be
large enough to enclose the whole body (when the patient is in a sitting
posture), and an aperture with a loose frill attached, so as to tie
round the patient's throat, should be left at the apex. Under this the
patient, divested of his clothing, should sit with the head and face
projecting through the opening at the top, and a _chattie_, or open
vessel, of boiling water having been introduced, sweating soon commences
and should be kept up for a quarter of an hour or more. Then the patient
should be thoroughly dried with warm, rough towels and go to bed, or be
carefully wrapped up in blankets so as to be effectually protected from
draughts of cold air.

397_b_. THE WET SHEET has been highly spoken of in the treatment of
_Delirium Tremens_; it is applied as follows: Strip the patient naked
and roll him in a wet sheet till he looks like a mummy, and then roll a
blanket round this again. In many cases the delirious excitement will
subside as soon as a hot vapour surrounds the patient, and he will fall
into a quiet sleep. It should be used with caution in the case of an old
debilitated drunkard.


398. +Wax.+

 Móm (_Hind._, _Duk._, _Beng._, _Punj._), Si'úth (_Kash._), Mozhukka
 (_Tam._), Máinam (_Tel._), Mezhuka (_Mal._), Ména (_Can._, _Mah._), Mín
 (_Guz._), Ittí (_Cing._), Phayoui (_Burm._), Libu lubah (_Malay_).

399. Wax, obtainable of good quality in most bazaars, has no especial
medicinal properties; it is, however, extensively used in the formation
of ointments, plasters, &c., for the purpose of giving them consistence,
and a mildly stimulant action. The following is stated to be an
excellent stimulant application to "_Blind Boils_," so common at certain
seasons in many parts of India; it is thought to bring them to a head
sooner than any other remedy. Take of Indian Bdellium—Gúgul (_Hind._,
_Punj._), Kánt-i-gun (_Kash._), the gum resin of Balsamodendron Mukul
(_Hooker_), and B. pubescens (_Stocks_)—Wax, and Sesamum oil, of each
one ounce; melt together with a gentle heat, stirring well, and strain.
A portion of this, spread on rag or lint, should be placed over each
boil. It is also a good dressing for subsequent _Ulceration_.




ADDENDA.


400. +Cinchona Febrifuge, or Darjeeling Cinchona Alkaloid.+ This was
really employed as a cheap substitute for Quinine.

In 1875 Mr. Wood, the Government Quinologist, prepared from the bark of
Cinchona succirubra and other species under cultivation at Darjeeling an
alkaloid, or rather a mixture of alkaloids, which has received the
provisional names of "DARJEELING CINCHONA ALKALOID," and "CINCHONA
FEBRIFUGE." A rough analysis shows that it contains: Quinine, 15·5;
Cinchonidine, 29·0; Cinchonine, 33·5; Amorphous Alkaloid, 17·0; and
Colouring Matter, 5·0 in 100 parts. It occurs in the form of a
buff-coloured powder, of a peculiar disagreeable smell, and bitter,
nauseous taste; insoluble in water, soluble in mineral and vegetable
acids.

401. In the treatment of _Intermittent Fever_ this remedy ranks next to
Quinine, over which it possesses the advantage of being comparatively
cheap, and, from its being manufactured in India, is within the reach of
all. It has its disadvantages, however, being apt to create nausea,
vomiting, with a burning sensation at the pit of the stomach, extending,
in some instances, to the throat, and occasionally diarrhœa. Like
Quinine, if given in sufficient doses to produce its specific effect, it
gives rise to headache, singing in the ears, giddiness, and other
symptoms included under the term "Quinism;" but all these pass away on
the discontinuance of the remedy, leaving no after ill effects. It is,
in fact, a thoroughly safe and efficacious remedy in ordinary simple
Intermittents, but its use is limited to these. In the severer forms and
in Remittent Fevers it is not to be depended upon: here Quinine remains
the sheet anchor. The dose is from 5 to 10 grains twice or thrice daily
during the intermission or in anticipation of an expected paroxysm.
Dilute Sulphuric Acid (one and a half minim to one grain of the
alkaloid) is said to be the best solvent, but given with Dilute
Hydrochloric or Citric Acid, its disagreeable taste and smell are
partially masked, and hence is more easily borne. Fresh Lime Juice is
recommended as an eligible vehicle for popular use.

402. _In Debility after Fevers_ it promises to be of great value as a
tonic, given in small doses. It is worthy of a trial in _Enlargement of
the Spleen_ in combination with Sulphate of Iron (176). In _Neuralgia_,
_Faceache_, _Tic Douloureux_, when assuming a periodical form, this
remedy is well worthy of a fair trial. It should be given in full doses
(10 grains) thrice daily for adults.

403. Closely allied to the foregoing is another form of collective
Cinchona Alkaloids, to which its discoverer, Dr. de Vrij, has given the
name of QUINETUM. It is said to represent the whole of the alkaloids in
Cinchona succirubra bark in proportion of Quinine, 25; Cinchonidine, 50;
and Cinchonine, 20 in 100 parts. Dr. Vinkhuysen, who tried it
extensively in the treatment of _Intermittent Fevers_, says that
"Quinetum is of great value as a febrifuge, but that it takes longer to
act, and will not replace Quinine in pernicious fever. It has the same
apyretic effect as Quinine, but is less powerful; larger doses are
therefore required at longer intervals before the paroxysms. It produces
no ill effects, no noises in the ear, and can be taken by those who
cannot take Quinine. It is more efficacious in chronic cases and as a
tonic, whilst in masked malaria it is incomparably superior to Quinine."
This statement is quoted from Sir Joseph Fayrer's valuable work _On the
Climate and Fevers of India_ (London, 1882), and to it he (Sir Joseph)
adds the expression of his own belief that "it is a very valuable drug."
We learn from the same authority that it is now largely prepared in
India. This being the case, and as it is less than half the price of
Quinine, it may be regarded as an important addition to Indian Materia
Medica. The dose is from 8 to 16 grains in diluted Lime Juice or other
acidulated water.


404. +Sugar.+

 Shakar (_Hind._, _Duk._), Bhúra, Chiní (_Beng._), Misri (_Punj._),
 Sakkará, Sharukkarai (_Tam._), Shakkara (_Tel._), Sharkkara, Panjasára
 (_Mal._), Síní, Sakkere (_Cing._), Saghia or Tagiya (_Burm._), Gúla
 (_Mal._).

405. This article is not usually regarded as a medicine, but Dr.
Aitchison in his valuable notes, points out how he has utilised it as
such with excellent effect; and as it is procurable throughout the
length and breadth of India, it seems well worthy of notice in this
place. Only the best and purest kinds should be employed for medicinal
purposes.

406. In all forms of _Ophthalmia_ (_Country Sore Eyes, &c._), Dr. A.
states that he has found a solution of one drachm of Sugar in three
drachms of Water dropped into the eye every hour or so, never fail to
afford relief, and that generally, if applied early, cuts short the
disease at once. This practice, he adds, he has followed for twelve
years, and used nothing else. Children, according to his experience,
will actually come and ask to have the remedy dropped into their eyes,
so great is the relief it affords. At bedtime, in these cases, it is
advisable to apply to the eyelashes a little sweet oil or grease, and
the first thing in the morning carefully to wash the eyes with hot milk
and water. This solution is also useful for _removing small foreign
substances from the eye_.

407. _In Gonorrhœa and Vaginal Discharges_ the above solution is an
excellent application, though not so uniformly useful as in Ophthalmia.
In Gonorrhœa, it may be commenced with at once, the injections being
repeated frequently during the day, in addition to general remedies; but
in Vaginal discharges other remedies may be tried first. (See _Index._)

408. Sugar is an excellent dressing for certain forms of _Foul,
Gangrenous looking Ulcers_, the Sugar (white or refined) in grain being
merely sprinkled over the sore, which under its use soon assumes a
healthy appearance. As a drawing plaster for _Boils_ equal parts of
Sugar and Yellow Soap, is an old remedy. (Dr. Aitchison.)


409. +Petroleum. Rock Oil.+

 Mittí-ká-tél (_Hind._, _Duk._), Mátiyá-tail (_Beng._), Man-yenney,
 Man-tayilam (_Tam._, _Mal._), Manti-tayilam, Manti-núné (_Tel._),
 Mannunyanné (_Can._), Mattí-cha-téla (_Mah._), Mattí-nu-tel (_Guz._),
 Yé-ná (_Burm._).

409_a_. Petroleum, a mineral oil, semi-liquid, somewhat of the
consistence of treacle, tenacious, semi-transparent, of a deep sherry
red or nearly opaque, tar-like brown, with a peculiar though not
unpleasant aromatic odour and pungent acrid taste, exudes spontaneously
from the rocks in volcanic regions, and collects on the surface of
certain lakes in Persia, Burmah, Assam, and the islands on the Arracan
Coast, as well as in Barbadoes, Trinidad, and other West Indian Islands.
As a medicinal agent, it is a terebinthinate (turpentine-like)
stimulant, and as such appears to act specially on the kidneys,
increasing in a marked degree the urinary secretion. The dose is about
half a fluid drachm (thirty drops) suspended in mucilage.

410. Petroleum is very generally employed by the Native practitioners
externally as a stimulant in _Paralytic Affections_ and in _Chronic
Rheumatism_, and Dr. Fleming (Cat. p. 53), commenting on this, adds that
he can, from his own experience, recommend it in the latter disease as
an efficacious remedy, having derived more benefit from it than from the
more costly Cajeput Oil, which he had previously used. A case of
_Beri-beri_ successfully treated by it, externally and internally, is
recorded by Mr. S. Arokeum (_Madras Quart. Med. Journ._, July 1863), but
how far the recovery was due in this instance to the Petroleum seems
doubtful. Still, it seems worthy of further trials in this obscure
affection.

411. _In Skin Diseases_, it is a useful external application, and a case
of _Chronic Eczema_, which had resisted a host of remedies cured by it,
is recorded by Dr. J. W. Mudge (_Indian Ann. of Med. Science_, 1854, p.
450). He used it incorporated with Soap in the proportion of a drachm to
an ounce.

412. _As an Antiseptic agent in Surgical Practice_, some trials have
been made with it by Sir Joseph Fayrer (_Indian Med. Gazette_, Sept.
1869, p. 184), and he comes to the conclusion that it possesses some, if
not all, the advantages assigned to Carbolic Acid in this character. He
used it, pure or diluted, with equal parts of oil or glycerine; and he
states that whilst it certainly has some deodorising power, it appeared
also to have that of limiting suppuration and of restraining the
development of septic miasmata in the discharges. He likewise found it
useful as a stimulating and detergent application to _Sloughing and
Ulcerated Surfaces_, and in one case of _Carbuncle_ it proved most
efficacious. It causes little inconvenience beyond slight smarting. "The
evidence of its virtue," Sir J. Fayrer observes, "is as yet but limited,
yet it is such as to suggest the advantage of making further trial of
what may prove to be a valuable addition to our surgical resources, and
it has the advantage of being produced in the country." The summaries of
twenty cases are appended to illustrate the use of this hydrocarbon. It
is to be hoped it will meet with further trials.


413. +Kerosene Oil.+ A burning oil, refined from crude Petroleum.

 Pathar-ka-tél (_Punj._).

414. Owing to the extensive use of this mineral Oil for lighting
purposes during the past few years, it can now be obtained in nearly
every bazaar in the country. According to the experience of Dr.
Aitchison, no local remedy is so pre-eminently useful in all _Skin
Diseases_ as this, especially when of a parasitic origin. It is
comparatively of little use in syphilitic eruptions.

415. The oil may be employed pure when no large surface is involved, but
if the disease to be treated extensively covers the body, it should be
diluted with equal parts of sweet oil. Nothing can come up to it, he
asserts, in removing and _destroying bugs_ from old wood. It is also
said to be of use in _removing white ants_.

416. _In Itch_, when of limited extent, after opening each pustule, rub
into the part carefully twice or thrice daily pure Kerosene Oil. If it
be extensively diffused over the whole body, after thoroughly washing
with soap and water, rub in a solution of equal parts of Kerosene and
Sweet Oil. This, observes Dr. Aitchison, far surpasses the Sulphur
treatment. _In Ringworm_ it is sufficient to paint the affected spot
with the pure oil twice or thrice daily. _In Scalled Head_, after
cutting the hair as short as possible, apply a poultice to clean off the
scab from the scalp, and then thoroughly saturate the cleansed surface
with Kerosene Oil. During treatment the patient should wear an oil-skin
cap. Oil alone, applied thus, adds Dr. Aitchison, will cure the disease,
but Kerosene does it more quickly and effectually. _Lice_ of all kinds
are at once destroyed by rubbing Kerosene Oil into the parts they
occupy, and are totally exterminated by two or three free applications.
(Dr. Aitchison.)


417. +Rock Salt+, an impure Chloride of Sodium.

 Senda-lon, Senda-namak (_Hind._, _Duk._), Indúppú (_Tam._, _Tel._),
 Intúppa (_Mal._), Nímak, Lun (_Punj._).

418. Rock Salt occurs in large masses varying in weight from 2 or 3 to 8
or 10 lb.: dull or brownish-white externally, white and crystalline
internally, of a pure saline taste; procurable in all large Indian
bazaars at four or five annas per lb. Though known to be a mere variety
of Chloride of Sodium (common salt) it is possessed of far stronger
purgative properties, it is also stronger than Cream of Tartar; but like
this, it is not a satisfactory cathartic given alone; in combination
with other purgatives, however, it is equal if not superior to it, and
may advantageously replace it in Kaladana and other officinal Powders.
(Dr. Moodeen Sheriff.)




COOKERY FOR THE SICK.


419. +Mutton Broth and Beef Tea.+

Take a pound of meat, free from fat; chop it up fine, and let it stand
for one hour in a pint of cold water. Then add half a dozen Okra (1) cut
transversely, and boil at a gentle heat to half a pint; strain and
flavour with salt and pepper to taste. It should be freshly prepared
daily.


420. +Chicken Broth.+

This is prepared in the same manner as the preceding, a full-grown fowl
being substituted for the pound of meat. The two essential points to be
attended to being that the flesh is cut small or well bruised, and that
it stands for an hour in cold water previous to being put on the fire.
Half-grown fowls will answer for children. Like the preceding, it should
be prepared fresh daily.


421. +Raw Meat Juice.+

The juice of raw meat is an invaluable remedy in sickness, more
especially in the many diseases of the intestinal canal from which
Europeans suffer in Indian, whether during infancy or in adult life. For
obtaining this juice any meat will do, but beef is to be preferred. From
a piece, say, a pound in weight, remove all the fat; then mince the
meat; after which cover the mince with as much water as it will absorb
in four or five minutes; then reduce the soft mass into a pulp in a
mortar by means of a pestle. Pass this pulp through a cloth forcibly:
the fluid which passes through the cloth is meat juice. Children will
take this readily without any addition being made to it. Adults,
however, frequently cannot do so, owing to its peculiar raw odour. In
such cases it can be made palatable by the addition of a little salt,
sometimes sherry, Worcester sauce, or even a little acid jelly; but
whatever is done to this juice to make it palatable, on no account add
mineral acids, or cook it, as in both cases the albumen of the juice
becomes coagulated, making it less digestible. Where ice is procurable,
meat in this form can be conveniently kept fresh for more than
forty-eight hours. Where ice cannot be obtained, and the climate is at
summer heat, the juice should be extracted from the meat fresh each time
it is to be given. (Dr. Aitchison.)


422. +Rice Milk.+

Boil one table-spoonful of ground Rice with a pint and a half of Milk,
or equal parts of milk and water; stir it smooth, and boil for two
minutes; flavour with sugar and nutmeg. A very nourishing food for
children.


423. +Arrowroot.+

Take a table-spoonful of the best Arrowroot, and make it into a thin
paste with a little water; then add gradually half a pint of boiling
water, stirring it the whole time. Put it on the fire for two or three
minutes, still continuing to stir it till the whole is uniformly mixed;
then remove it from the fire and add grated nutmeg, sugar, &c., to
taste. If made with milk instead of water, it is more nourishing, but
when the stomach is weak it sometimes disagrees, and then water is
preferable. It should be prepared fresh when required.


424. +Sago.+

Add a table-spoonful of the best Sago to a pint of Water, and let it
stand for two hours, then boil for a quarter of an hour, stirring the
whole time, till it forms a clear uniform jelly. Remove from the fire,
and flavour with sugar, nutmeg, &c.


425. +Pish-Pash+ (_Puss-Pass_).

This is a regular Indian dish for invalids, and consists of fresh meat
cooked amongst rice. Usually a chicken is cut up into small pieces, put
into the bottom of a small pan, to which are added three table-spoonfuls
of rice, well cleaned, and over the whole is poured two breakfast-cupfuls
of cold water. This is now allowed to cook over a slow fire for three or
four hours. Spices and salt, of course, can be added during the cooking
process. If the patient is extremely ill the rice part alone is used,
which has absorbed nearly the whole of the strength of the meat. Besides
being given to invalids, this is a common diet amongst European children
in India (Dr. Aitchison).


426. +Brandy Mixture.+

Take of Brandy and of Water each four table-spoonfuls, the yolks of two
eggs, and half an ounce of powdered white sugar. Beat the yolks and
sugar well together, then add the spirit and water, and flavour with
grated cinnamon or nutmeg.

This is a valuable stimulant and restorative in the low forms and
advanced stages of _Fever_, _Smallpox_, _Measles_, _Exhausting
Hæmorrhages_, _Cholera_, and other cases where the vital powers are
greatly depressed. The dose for adults is from one to three
table-spoonfuls repeated according to circumstances; for children from a
teaspoonful to a table-spoonful according to age or the urgency of the
symptoms.

427. _In Delirium Tremens_ this is one of the best forms of stimulant,
combining as it does nutritive with stimulant properties; indeed, when
other food is rejected, the proportion of eggs may be doubled or
trebled. In the young and vigorous, and in first attacks, all alcoholic
drinks may be safely and strictly withheld, but should there be a great
craving for drink, Omum water (320) may be tried, as it is said to
relieve this condition. In the old debilitated confirmed drinker,
however, stimulants become a necessity, and Brandy Mixture in doses of
one to two ounces may be given at stated intervals as required, but the
patient should not be allowed to sip it, or take it occasionally as he
thinks fit.


428. +White Wine Whey.+

Take one pint of fresh Milk, add Mace, Nutmeg and Cinnamon, with Sugar
to taste. Put it on a clear slow fire, stirring until the milk is on the
point of boiling over. Then take it off, and throw in one or two
wineglassfuls of Sherry or Madeira. Put it on the fire again, stirring
it gently one way until it curdles; then remove, and strain through
cloth or muslin. This taken at bedtime, the patient being well covered
with clothes, so as to produce copious perspiration, has often an
excellent effect in arresting incipient attacks of _Catarrh_,
_Influenza_, _&c._


429. +Egg Wine.+

Beat up one Egg (both yolk and white) with a table-spoonful of cold
Water. On this pour a mixture of a glass of Sherry and half a glass of
water previously heated together (not boiling), stirring all the time.
Then sweeten with white sugar, and add a little grated nutmeg, to taste.
Taken in this form it is more digestible, but its flavour is improved by
heating the ingredients in a clean saucepan over a gentle fire (not to
boiling), stirring them one way till they thicken. This, with a small
piece of toast or biscuit, may be advantageously taken by invalids twice
daily, or as occasion requires.


430. +Strengthening Jelly.+

Steep two ounces of Isinglass or Prepared Gelatine, one ounce of Gum
Arabic, five ounces of Sugar Candy, and a grated Nutmeg in a bottle of
Port wine all night. In the morning, simmer over a slow fire till quite
dissolved; then strain and set aside in a cool place till it forms a
firm jelly. A piece the size of a nutmeg may be taken five or six times
a day. This jelly is admirably suited for cases of debility when the
stomach is unable to bear animal food.




PART II.

SYNOPSIS OR INDEX OF DISEASES.

_The numbers have reference to the paragraphs; the asterisk_ (*)
_denotes those most deserving of attention_.


_Abdomen, Flatulent Distension of._ See _Flatulence_.


_Abortion._ Use Vinegar externally and internally (379); if great
restlessness or pain is present, give Opium (289); if the hæmorrhage
continue unabated, apparently from want of power in the uterus to
contract, try Borax and Cinnamon (58), or administer a Turpentine enema
(364). In cases where there is much hæmorrhage, which does not abate
under the above means, the Acetate of Lead and Opium Pills advised for
_Hæmorrhage, Internal_, may be given with signal advantage. With these
exceptions, let nature complete her work by herself; more harm than good
may result from meddlesome interference. Perfect rest of mind and body,
a strictly recumbent posture in a cool, well-ventilated apartment, and
careful avoidance of all stimulant articles of diet and mental
excitement, are essentials to successful treatment. _Threatened Abortion
from a fall, over-exertion, &c._, may sometimes be averted by a dose of
Opium (289), and strict attention to the above hygienic rules. See also
_Hæmorrhage, Internal_.


_Abscess._ In the early stage apply Hot Water Fomentations (393); if
there be much inflammation and pain, apply Leeches (212), and keep
constantly to the part a solution of Sal Ammoniac (325), or Evaporating
Lotion (380). If matter forms, apply Rice Poultices (322); when it comes
so near the surface that it can be felt fluctuating under the finger the
abscess should be opened with a lancet at the most prominent point; and
after the matter has been evacuated by gentle pressure, the Rice
Poultices should be continued, and changed twice or thrice daily. Should
the pain be so great as to prevent sleep, a dose of Opium (283) or
Tincture of Datura (128) at bedtime is advisable. Should the discharge
be profuse and the patient weak, support the strength with a liberal
diet and tonics, as Chiretta (98, 99), or Country Sarsaparilla (163), or
Ním Bark (260). N.B.—_Abscesses in the neck should be opened only by a
doctor, or by one who is conversant with the anatomy of the part._


_Acidity of the Stomach._ See _Stomach, Acidity of_.


_Acids, Poisoning with._ Give copious draughts of Lime Water (228) and
milk, or, if this be not at hand, soap and water, or chalk, or the
plaster of the apartment beaten up with water. Rice _Conjee_ (322) and
other mucilaginous drinks, white of eggs, or draughts containing any
bland oil, should be given freely. Much of the success in these cases
depends upon the promptitude with which the remedies are applied.


_Ague._ See _Fever, Intermittent._


_Ague Cake._ See _Spleen, Enlargement of_.


_Albuminuria._ Try Alum (27).


_Amenorrhœa._ See _Menstrual Discharge, Suspended_.


_Anus, Prolapsus of._ See _Bowel, Descent of_.


_Aphthæ, or Aphthous Ulceration._ See _Mouth, Ulceration of_.


_Apoplexy._ If the patient is young and vigorous, pour cold water from a
height on the head and spine as directed in 386. Keep Evaporating Lotion
(380) to the head; give a Croton Pill (120), or if the patient is unable
to swallow, place a drop or two of Croton Oil (121) at the back of the
tongue. Apply Turpentine Stupes (363) or Mustard Poultices to the feet
and calves. Should the insensibility continue, give a Turpentine enema
(364). For the old and debilitated, and for natives generally, a little
Brandy Mixture (426), or other stimulant judiciously given, offers a
better prospect of success than _bloodletting, which should never be had
recourse to except under medical supervision_.


_Appetite, Loss of._ First try Chiretta (98, 99*); should this fail,
give one of the following: Sweet Flag Root (12), Country Sarsaparilla
(163), Ním Bark (260), or Gulancha (352). Stomachics, as Capsicum (79),
Cinnamon (102), or Cloves (105), may be advantageously combined with
them, care being taken at the same time to regulate the bowels.


_Arsenic, Poisoning with._ As speedily as possible empty the stomach by
an emetic of Sulphate of Copper (117) or Mustard (246), and then give
copious draughts of white of eggs beaten up in milk, or a mixture of
equal parts of Lime Water and Sesamum, Cocoa-nut, or other bland oil.
Powdered Sugar has been advised in these cases, but if of any service,
it can only act like the preceding mixtures, mechanically, by enveloping
the particles of the poison; this remark applies also to Powdered
Charcoal, which has also been well spoken of. When the vomiting has
abated, give a full dose of Castor Oil (83) to carry off any of the
poison which may have passed into the intestines, and this may be
repeated every day for two or three days. Should there be great
exhaustion, a little stimulant, as Brandy Mixture (426), may be given,
and a dose of Opium may be advisable, to subdue any subsequent great
pain and restlessness.


_Asthma._ To relieve the severity of a paroxysm, try one or more of the
following: Turpentine Stupes (362*), or Hot Water Fomentations to the
chest (393), Camphor (70*), or Asafœtida (37) internally, and the
inhalation of the fumes of Nitre Paper (268*) or of Datura (129*). A cup
of hot, strong, milkless, sugarless Coffee _café noir_, drunk as hot as
can be borne, sometimes gives great relief. Daily sponging the chest
with Vinegar is thought to act in a measure as a preventive (378). A
better preventive is the careful regulation of diet. Many a fit of
asthma can be clearly traced to a hot supper, or some other error of
diet.


_Atrophy, or Wasting of the Body._ Try Fish Liver Oil (142), with
tonics, as Chiretta (98, 99), and change of air.


_Bed Sores._ To prevent these, bathe the parts daily with a solution of
Camphor in spirit (75), or with Brandy or Eau de Cologne, or apply Alum
and White of Egg (31*), and relieve the local pressure as much as
possible by change of position, &c. A small circular pillow with a
hollow centre (just like the pads worn by the _coolies_ on their heads
in carrying weights, only thinner) is most useful for this purpose.
Should a sore form notwithstanding, it should be treated as an ordinary
ulcer. See _Ulcer_.


_Beri-beri_, Petroleum (410).


_Bish_ (_Aconite Root_), _Poisoning with._ Strong stimulants, as Brandy
and Ammonia; Cold Water Affusion (386), and persistent friction of the
limbs and spine, appear to offer the best chance of success. Decoction
of Galls (152) has been advised as an antidote. Strong hot Coffee, _café
noir_, is worth a trial, if the patient can swallow.


_Bites, Venomous, and Stings, e.g., of Centipedes, Scorpions, Wasps._
All that is required in ordinary or mild cases, after immediate suction
of the bite, is application of Vinegar (380), or Alum (32), or a strong
solution of salt and water. Inunction of warm oil has been highly
recommended. If Ipecacuanha is at hand, a small portion of it made into
a thick paste with a few drops of water, and locally applied, is said in
many instances to afford great and immediate relief. Brown Sugar is said
to be specially useful in _Wasp Stings_. Soda is also said speedily to
relieve the pain in these cases. Should the symptoms be severe, as is
sometimes the case, Liquor Ammoniæ and stimulants, as advised for Snake
Bites (Appendix B), should be given.


_Bladder, Painful Affections and Irritable States of_, are best relieved
by Opium (286*), the free use of demulcents, as the Decoctions of
Abelmoschus (2), Ispaghúl seeds (305), or Rice _Conjee_ (322), and the
use of the Hip Bath (392). The Extract of Gulancha (353) seems well
worthy of a trial, especially in _Chronic Inflammation of the Bladder_.


_Bleeding._ See _Hæmorrhage_.


_Blows._ See _Sprains_.


_Boils_ are to be treated much in the same way as Abscesses, by Hot
Water Fomentations (393), Sal Ammoniac Lotion (332), and Rice Poultices
(322). Leeches (212) are rarely necessary, unless there should be much
pain and inflammation. Decoction of Country Sarsaparilla (163) may be
given internally if there is any constitutional disturbance. A popular
and useful "drawing plaster" is a compound of equal weights of Brown
Sugar and English Yellow Soap; a still better one is the ointment
described in paragraph 399; a portion of either of these spread on rag
should be applied over each boil. _Rajah Boil._ See _Carbuncle_.


_Bones, Scrofulous Affections of._ Give Fish Liver Oil (138).


_Bowel, Lower, Descent of._ The protruded part having been carefully
washed, should be replaced by gentle pressure with the hand: should
there be any difficulty in doing this, the forefinger well oiled should
be pushed up into the anus; and it will, unless the parts be greatly
swollen, carry the protruded part in with it. The patient should then
remain quiet for some hours in a recumbent posture, and apply cloths
saturated with Decoction of Galls (147), or Babúl Bark (9), holding Alum
(25*) in solution. Subsequently enemas of the above solutions, or others
containing Sulphate of Iron (179), act usefully in constringing the
parts and preventing a return of the accident. In weak, debilitated
subjects, Confection of Pepper (300) proves very serviceable. The bowels
should be kept open by mild aperients, of which Sulphur and Cream of
Tartar (344) is by far the best. All straining at stool should be
carefully avoided. A person subject to this accident should wear a pad
to keep the parts up.


_Chronic Descent of the Bowel in Children_ may be frequently cured by
making the child, when at stool, sit on a seat sufficiently high, so
that its feet cannot touch the ground or have other support. (Dr.
Aitchison.)


_Bowels, Spasmodic, and other Painful Affections of._ Mild cases
generally yield to Omum Water (318*), Lemon Grass Oil (216), or the
Infusions of Ginger (155), Dill Seeds (134), or Cloves (105), with or
without a single dose of Opium (284). Severe cases require the
repetition of the Opium (284) in Omum Water, &c., together with either
Hot Water Fomentations (393), Mustard Poultices (251), or Turpentine
Stupes (362) externally to the abdomen; followed in protracted cases by
an enema of Turpentine (364), or Asafœtida (36). In all cases a dose of
Castor Oil is advisable when the pain has abated. _In Children._ See
_Colic_. _For Irregularity of the Bowels_, try Bael Sherbet (45); _in
that of Children_, Decoction of Kariyát Leaves (193). _Constipation of._
See _Constipation_. _Bleeding from._ See _Hæmorrhage_.


_Breast, Abscess of, in Women._ See _Milk Abscess_.


_Breathing, Difficulty of, occurring without evident cause or in
connection with a cold_, sometimes yields to Camphor and Asafœtida Pills
(70), and Turpentine Stupes (362), or Mustard Poultices (247) to the
chest. Great relief, especially in the case of children, is often
derived from external application of Betal Leaves (48), or bags of hot
salt. See also _Cough_.


_Bronchitis, Chronic._ Decoction of Sweet Flag (13), Country Ipecacuanha
(370), Asafœtida (37), and Fish Liver Oil (140) internally, with Rice
Poultices (322), Croton Liniment (122), and Turpentine Stupes (362)
externally, may be used with advantage. The inhalation of the vapour of
hot Decoction of Abelmoschus (2) is also serviceable. The temperature of
the apartment should be kept as uniform as possible. For the relief of a
paroxysm of cough, the fumes of burning Nitre Paper (268) are worthy of
a trial in all cases. A blister to the chest often affords great relief.


_Bronchocele._ See _Goitre_.


_Bruises._ See _Sprains_.


_Buboes_ often subside under a non-stimulant diet, perfect rest in the
recumbent posture, and the continued application of Sal Ammoniac Lotion
(332), the bowels being at the same time carefully regulated. Should
matter form, treat as Abscess (_which see_). Should ulceration result,
apply Borax Lotion (59), Resin Ointment (372), &c., as advised for
ulcers. "Buboes, especially of the groin, when not in an inflamed
condition, are often immensely benefited by having a smooth stone of two
pounds weight or thereabout, laid over them; this rapidly causes
absorption." (Dr. Aitchison.)


_Burning of the Feet in Natives._ Apply Henna or Mhíndí Poultice (197)
locally, and try Bromide of Potassium, 5 to 10 grains dissolved in
water, twice or thrice daily.


_Burns and Scalds._ As soon after the accident as possible, apply freely
to the whole of the burnt surface Lime Liniment (229), or in its absence
Jinjili Oil (337), or any other bland oil, dusting thickly over with
Rice Flour; or even with simple Rice Flour without any oil as directed
in paragraph 322. The object in each case is to prevent, as far as
possible, the access of air to the burnt surface. These first dressings
should remain undisturbed for at least twenty-four hours, and should
then be repeated in the same, or in a modified form. Subsequent
ulcerations should be treated with Ceromel (167) or Resin Ointment
(372). Carbolised Oil or Liniment is advocated by Dr. Aitchison. Dr.
A.'s directions are as follows: "Employ a Liniment of Carbolic Acid, one
part Acid to 15 of a sweet Oil, carefully mixed; apply this freely over
the burnt or scalded surface, cover the whole with a thick piece of
cotton wool, and apply a bandage over all. On no account change the
cotton dressing unless there is any disagreeable odour. If the dressing
is becoming dry and thus causing irritation, take off the bandage and
moisten cotton wadding thoroughly with the same Liniment without moving
it. On no account allow water to come in contact with the injured part."
The treatment of very extensive burns of the lower limbs with carbolic
acid is considered to be prejudicial, but not so of the upper
extremities. Should the injured surface be extensive, the constitution
should be supported by liberal diet, tonics, and stimulants, as Brandy
Mixture (426) at stated intervals. Any great restlessness or excessive
pain may require a dose of Opium at bedtime (283). N.B.—Whenever the
burn is in the neighbourhood of the joint, or in the neck, it is
important that the parts should be kept in a straight or stretched
position, otherwise contraction is apt to result during the healing
process.


_Cancer._ To relieve the pain and restlessness, give Opium (283) or
Tincture of Datura (128). _To correct the fœtor of the discharge_, apply
relays of Charcoal Poultices (91), cleansing the ulcer each time the
poultice is changed with Borax Lotion (59). N.B.—On the smallest
suspicion of a cancer forming, no time should be lost in placing the
case under regular medical care.


_Carbuncle "Rajah Boil" of the Natives._ The treatment of the early
stages is similar to that for Abscess (_ante_); only if leeches are
deemed necessary, they should be placed round the edge and not on the
hardened surface. When ulceration sets in, the _Toddy_ Poultice (355) is
useful in stimulating to healthy action; and the removal of the slough
is greatly accelerated by the daily practice of Irrigation (395).
Turpentine Ointment (367) or Petroleum (412) also prove useful in this
stage. Should there be much fœtor, apply Charcoal Poultices (91) and the
Borax Lotion (59) as advised in _Cancer_. Opium (283) may be necessary
to relieve pain and give rest. When the slough has come away, the
ointments advised in paragraphs 367 and 372, or Ceromel (167), may be
used as dressing. A generous animal diet, with a daily portion of
stimulants, should be allowed, and tonics as Chiretta (98, 99), or
Country Sarsaparilla (163) administered. Whenever practicable, the case
should be placed _under proper surgical care_, as incisions are often
necessary for the removal of the slough.


_Cassava Root, Poisoning by._ Give Lime Juice (234).


_Castor Oil Seeds, Poisoning by._ Give Lime Juice (234).


_Cataract._ Datura (128).


_Catarrhs or Colds_ may often be cut short at the outset by a draught of
hot Infusion of Ginger (156) or White Wine Whey (428) at bedtime, and
covering the body well, so as to produce copious perspiration. A Vapour
Bath (396) will answer the same purpose. To relieve feverishness give
Solution of Nitre (264), Decoction of Abelmoschus (2), and Country
Ipecacuanha (370). Inhalation of the fumes of burning Turmeric (359)
manifestly relieves troublesome congestion or fulness of the head, nose,
&c. See also _Cough_.


_Caterpillar's Hairs, to Extract._ Some Indian Caterpillars are armed
with a thick hairy covering, and if these come in contact with the skin
the hairs are apt to pierce the cuticle, and by their presence create
great pain, irritation, &c. To extract them the following ingenious
plan, devised by Dr. Alexander Grant, late Bengal Medical Service, is
said to be very effectual. Take a lock of human hair, tie firmly with
thread about one-eighth of an inch from the cut end, so as to form a
short, firm, even brush, not however to be used as such, but as forceps.
This held between the thumb and forefinger, is allowed to descend
perpendicularly and uncompressed among the caterpillar hairs. When the
two sets of hairs are commingled, the brush is compressed as forceps
are, and drawn straight up, bringing the hairs with it, and so on until
all the hairs are pulled out.


_Centipedes, Bites of._ See _Bites, Venomous_.


_Chest, Pains in, during Fevers._ See _Fevers_.


_Childbirth._ See _Labours_.


_Children, Debility of._ To relieve pallor and wasting, give Country
Sarsaparilla (163), and Fish Liver Oil (139), with generous diet, and
gentle outdoor exercise. A change of air will often do more good than
medicine. _Constipation of_, see _Constipation_, _Convulsion of_, see
_Convulsions_. _Colic of_, see _Colic_. _Coughs of_, see _Coughs_.
_Diarrhœa of_, see _Diarrhœa_. _Difficulty of Breathing_, see
_Breathing, Difficulty of_.


_Cholera._ To check the premonitory diarrhœa or purging, give the Alum
Powders (26), or Alum with Infusion of Sweet Flag (12), or Omum Water
(319); should these not succeed in checking it, try a few of the
Compound Pepper Pills (299), but it is unadvisable to continue them long
on account of the large proportion of Opium which they contain (285).
One of the most useful forms of Cholera Pills, which should be commenced
at the earlier stages when the purging sets in, is composed of 24 grains
of Acetate of Lead, and two grains of Opium, made into a mass with a few
drops of Honey, and divided into eight pills. Of these one may be given
every hour or half-hour, according to the urgency of the symptoms, till
the whole eight have been taken; but this number should not be exceeded,
in consequence of the quantity of Opium they contain. Each pill may be
taken in a wineglassful of Omum Water. Should the disease progress, Dr.
Ayre's plan of treatment (285*), if the ingredients are at hand, should
be pursued, together with the persevering use of Lemon Grass Oil (216)
and Omum Water (318), for the purpose of checking the vomiting and
stimulating the system. For the latter purpose also give an ounce (two
table-spoonfuls) of the Brandy Mixture (426) every half-hour or oftener,
unless Champagne or other sparkling wine is available, this being
decidedly the best form of stimulant in these cases—only it must be
given in moderation at stated periods; more harm than good is done by
over-stimulation. The patient should be encouraged to drink plentifully
of _cold_ water, iced if possible; though the first draught or two may
be rejected, it will soon be retained if persevered in. Chicken Broth,
or Lime Water and Milk, may also be given plentifully as a drink. The
other accessories to the above are Mustard Poultices (251) or Turpentine
Stupes (363) over the heart (left side of the chest), bags of hot sand
or salt to the spine, feet, and legs, and diligent friction with the
hand or hot towels. At the same time the patient should not be moved
about more than can be possibly helped.—N.B. During an epidemic of
Cholera _impress_ upon everybody the necessity of applying for medicines
_directly they feel unwell or have the slightest purging_; those who
come thus early for treatment stand a much better chance of recovery
than those who delay even a few hours. _Here time is of the most vital
importance._


_Chorea, St. Vitus's Dance._ Fish Liver Oil (141), Infusion of Jatamansi
(184), and Sulphate of Iron (177), alone or in combination, according to
circumstances, are worthy of a trial. N.B.—This, as well as other
nervous affections, is often due to intestinal worms: attention should
therefore be paid to this point. (See _Convulsions_.)


_Cocculus Indicus, Poisoning by._ Having emptied the stomach by an
emetic of Sulphate of Copper (117) or Mustard (246), give copious
draughts of Decoction of Galls (152), followed by a full dose of Castor
Oil to carry off any of the poison which may have passed into the
intestines. Brandy or other stimulants are required should there be
great depression or exhaustion.


_Colds._ See _Catarrhs_.


_Colic in Adults_ is to be treated in a manner described in Spasmodic
Affections of the Bowels. _The_ _Colic of Children_, usually connected
with flatulence, generally yields to Omum Water (318*), Infusion of Dill
(134), with or without Asafœtida (36), and a Hot Bath (387), followed by
a dose of Castor Oil.


_Constipation._ For the immediate relief of this, aperients are
required. Castor Oil (83) and Senna (336) are best adapted for children
and delicate females; Aloes (18, 19) for women suffering from
irregularity or suspension of the menstrual discharge; Myrobalans (256)
and Kaladana (187) for otherwise healthy adults; and Croton Pills (120)
or Croton Oil (121) when strong and speedy purgation is indicated. _The
Constipation of Hysterical Females_ is best treated by Aloes and
Asafœtida Pills (19); _Habitual Constipation_, by Aloes, as directed in
Paragraph 20, or by Sulphur (344); _that of Children_ by Fish Liver Oil
(139), together with the use of oatmeal as an article of diet. A remedy
for habitual constipation in children, as well as in adults, is to be
sought for in tonics rather than in purgatives; the repeated use of the
latter lays the foundation of great subsequent mischief. N.B.—The
practice of native _ayahs_ (female servants) of inserting a piece of
tobacco stem into the anus of young children to relieve constipation,
_cannot be too strongly reprobated_.


_Consumption, Pulmonary (Phthisis)._ The persevering use of Fish Liver
Oil (138) is chiefly to be relied upon, with or without Lime Water and
Milk (226), as an ordinary drink. _As a preventive_ sponge the chest
daily with diluted Vinegar (378). Mustard Poultices (247) or Croton
Liniment (122) to the chest sometimes gives relief to _the Cough and
Difficulty of Breathing_, as does the inhalation of the vapour of Hot
Water (390) or Decoction of Abelmoschus (3). _For the Diarrhœa_, try the
Alum Powders (26) or Sulphate of Copper (110). _For the excessive
Perspirations_, sponge the chest with Vinegar (378). _For the Sore Mouth
or Fissures of the Tongue_, apply Borax (55), or Alum (29). _For
Bleeding from the Lungs_ try some of the means mentioned in _Hæmorrhage,
Internal_.


_Convulsions in Adults, arising without evident cause_, are best treated
by cold Affusion (386), Mustard Poultices (248), or Turpentine Stupes
(363) to the feet and legs, and a strong purgative, as Croton Pills
(120), Croton Oil (121), or Kaladana (187). If the patient be unable to
swallow, a Turpentine enema (364) may be used. _When the Convulsions are
due to poisons, &c., taken into the stomach_, an emetic of Mustard (246)
or Sulphate of Copper (117) should precede all other measures. _In the
Convulsions of Labour_, Turpentine Stupes (363) or Mustard Poultices
(248) should be applied to the extremities, and Evaporating Lotion (380)
to the head, whilst Camphor and Calomel Pills (73), or Borax and
Cinnamon (58), are given internally. A Turpentine enema (364) may also
prove useful. _The Convulsions of Children_ are best treated with a Hot
Bath (387), and a full dose of Castor Oil (83), preceded by one or two
grains of Calomel when at hand, or a dose or two of Asafœtida Mixture
(36). _In the Convulsions of Infancy and Childhood_, especially when the
cause is obscure, unconnected with teething, &c., Bromide of Potassium
is often more serviceable than any other remedy, in doses of a quarter
of a grain for a child under six weeks of age, half a grain under three
months, one grain above that age to nine months, and one grain
additional for every year up to three or four years of age. And these
doses may be safely repeated every two, three, or four hours until the
convulsions subside. The smaller doses may be obtained with exactitude
by dissolving, say, one grain of the Bromide in four teaspoonfuls of
water, and giving one, two, or three spoonfuls, or the whole quantity,
as one quarter, one half, one third, or one grain respectively is
required. It is worthy of a fair trial in all cases which resist
ordinary means, but should not be used to the exclusion of the hot bath
and careful regulation of the bowels. When the child is very much
exhausted, a few drops of Brandy, three to six, or more, according to
age, are often most useful. Convulsions of early childhood are
frequently connected with teething, hence lancing the gums is often of
essential benefit.

N.B.—Convulsions and nervous affections occurring in Natives and
Anglo-Indians are very frequently due to the presence of worms in the
intestines; their existence may perhaps be unsuspected, or even denied;
hence in all cases which resist ordinary treatment, it is advisable to
give a trial to one or more of the remedies recommended for _Worms_,
especially those for the _Lumbricus_ or _Round Worm_, which is so
extensively prevalent in India.


_Corns_ are best treated by immersion in hot soap and water, paring off
the hardened cuticle and wearing a piece of thick plaster, with or
without a hole in the centre, to ward off the pressure and friction.
_For Corns between the Toes_ nothing is more effectual than a piece of
thick blotting-paper worn so as to protect the opposing surface: it
should be renewed daily. If only ordinary thin blotting-paper be
available, two folds are advisable.


_Corrosive Sublimate, Poisoning by._ See _Mercurial Salts, Poisoning by_.


_Coughs._ Try Sal Ammoniac (329) and Country Ipecacuanha (370); with
Rice Poultices (322) or Mustard Poultices (247), Turpentine Liniment
(366), or Camphorated Opium Liniment (291) externally, and the
inhalation of the vapour of Hot Water (390) or Decoction of Abelmoschus
(2). If severe, a blister (349, 350) to the chest may be necessary. _In
Chronic cases, especially when attended with much expectoration and
debility_, give Fish Liver Oil (140). _In Spasmodic Coughs_, violent
paroxysms may be relieved by inhaling the fumes of Nitre Paper (268), or
by smoking Datura (129). _For the Cough of Old Age_, Cubebs (126) is
worth a trial. _For the Cough of Childhood_, Syrup of Country Liquorice
(6), Asafœtida (37), Honey and Vinegar (166), and Fish Liver Oil, may be
resorted to according to circumstances. Camphor Liniment (70), Mustard
Poultices (247), or bags filled with hot salt, or better still, Betel
Leaves (48), applied externally, tend to _relieve difficulty of
breathing in these cases_. Sponging the chest with Vinegar is thought to
lessen the liability to attack (378).


_Coup de Soleil._ See _Sunstroke_.


_Croton Oil Seeds, Poisoning by._ See Par. 234.


_Croup._ Sulphate of Copper (111) as an emetic, and Hot Water Stupes
(390) externally, are valuable accessories in the treatment of this
disease.

"The best and readiest emetic," writes Dr. Aitchison, "is a pinch of
Ipecacuanha Powder placed dry at the back of the child's tongue. This
usually acts instantaneously, so be prepared for the emergency. Sponges
dipped in extremely hot water, then rinsed out, and continuously applied
over the throat, will often check a coming attack. Poultices are useful,
but are apt to do much harm if allowed to become cold. Mustard poultices
should not be applied, as without due care they are apt to make the skin
tender, and thus prevent the use of hot fomentations."


_Datura, Poisoning by swallowing the seeds of, &c._, is to be treated in
the manner directed for Opium poisoning. _Where Insensibility arises
from the Inhalation of the Fumes_, Cold Water Affusion (386) in the open
air often succeeds in removing it at once. The patient should be aroused
by any or all of the means enumerated in poisoning by Opium. The nervous
symptoms may continue for two or three days, and yet recovery follow.


_Debility, Constitutional_, requires the use of the following tonics,
either alone or combined: Chiretta (98, 99*), Sweet Flag Root (12),
Country Sarsaparilla (163), Kariyát (191), Ním Bark (260), or Gulancha
(352). _When attended with Anæmia or great pallor of the surface,
especially of the inner surface of the eyelids and tongue_, Sulphate of
Iron (174) is indicated. The efficacy of all these remedies is increased
by a liberal animal diet, and gentle exercise in the open air. _Debility
after Fevers._ See _Fevers_.


_Delhi Sores._ The Borax Ointment (59) is strongly recommended. See also
_Ulcers_.


_Delirium_ generally is best treated by Evaporating Lotion (380) to the
head, the Mustard Foot Bath (248), or Turpentine Stupes (363) to the
extremities and a strong purgative; _for that occurring in Fevers_, see
_Fevers_.


_Delirium Tremens._ _To relieve sleeplessness and anxiety_, give Opium
and Camphor (283), or better still, Bromide of Potassium, as advised in
_Sleeplessness in Head Affections_. See that article. Try also the
Mustard Foot Bath (248, 249), or the Wet Sheet (397b). _To support the
strength_, give Brandy Mixture (427*) and a nourishing diet.


_Diabetes._ Vapour Baths (396) in the early stages, Alum Whey (27) and
Lime Water (226) internally, with Opium (288), at bedtime, prove
occasionally useful as palliatives. Their operation is assisted by a
full animal diet, with a diminished quantity of rice and other
farinaceous food, and by warm clothing. Use Lemonade as a drink (232).


_Diarrhœa._ _In the early stages, especially if attended with heat of
skin_, &c., give Country Ipecacuanha (369) and Ispaghúl seeds (304),
with a mild aperient, as Castor Oil, if there is reason to think that
the attack arises from crude, undigested food in the intestines. The
Acetate of Lead and Opium Pills advised for Cholera are often very
successful in these cases. One may be given every two or three hours, or
oftener, according to the urgency of the symptoms; they are especially
useful in _Epidemic Diarrhœa_. _In the advanced stages or in Chronic
Diarrhœa_ try Sulphate of Copper (110), Catechu (88), Alum (26), or one
of the following: Decoction of Babúl Bark (9), Infusion of Sweet Flag
(12), Bael (44), Butea Gum (62), Galls (146), Decoction of Pomegranate
(312), and Omum Water (317), with or without the addition, in each case,
of a small portion of Opium (289). Turpentine Stupes (363) to the
abdomen are useful if much pain is present. _When the disease is
apparently of malarious origin or connected with periodic Fevers of any
kind_, Quinine (three to five grains twice or thrice daily) should be
associated with whatever other remedies are being employed. Try also
Warm Water Enemas (393). _When connected with Acidity of the Stomach_,
give Lime Water (222). _When caused by Over-eating or by Indigestible
Food_, follow up an emetic of Mustard (246) or Country Ipecacuanha
(368), to unload the stomach, by Omum Water (318), and subsequently by a
dose of Castor Oil. Capsicum (79) is thought to be specially useful _in
Diarrhœa arising from the use of putrid food, e.g., fish. The Diarrhœa
of Children_ often yields to a dose of Castor Oil, if given early; if
not, one of the following may be tried: Acorus or Sweet Flag (13*), Bael
(44), Catechu (88), Sulphate of Copper (110), Sulphate of Iron (181*),
Saccharated Solution of Lime (220), or Ispaghúl Seeds (304). Omum Water
(318) may be advantageously combined with any of the above. _The
Diarrhœa which precedes Cholera._ See _Cholera_. N.B.—In all cases of
diarrhœa the food should be mild and unirritating, thick Arrowroot (423)
being the best suited for the purpose, and, in every obstinate or
chronic case, a flannel bandage should always be worn round the abdomen.


_Dropsy_ occurring in the young and vigorous is best treated at the
outset by strong purgatives, as Croton Pills (120) or Croton Oil (121),
or Kaladana (187), followed by medicines which increase the flow of
urine, as Decoction of Asteracantha (39), Infusion of Moringa (237),
Mustard Whey (250), or Infusion of Pedalium (297), with which Nitre
(269) or Sal Ammoniac (331) may be combined, as circumstances require.
The Vapour Bath (396) twice a week proves useful in recent cases, where
the patient is strong enough to bear it. Where the patient is very
debilitated and anæmic, Sulphate of Iron (174, 178) should be tried.


_Drunkenness._ After a debauch, a Mustard emetic (246) proves most
useful in unloading the stomach of any spirit remaining in it. A few
drops, six to twelve, of Liquor Ammoniæ in water subsequently given, are
often of signal success. Strong Coffee, _café noir_, is also most
useful. _To allay the subsequent cravings for drink_ try Omum Water
(320).


_Dysentery._ In the early stages give Country Ipecacuanha (369) and
Ispaghúl Seeds (304), or Sesamum leaves (338_a_), with or without Opium
(289*, 289_a_), and apply Hot Fomentations to the abdomen and Leeches to
the verge of the anus (211); the latter tend much to relieve the pain
and straining, as do also Opiate enemas (289_a_). The treatment of Acute
Dysentery by large doses of Ipecacuanha, reintroduced into practice in
1858 by Dr. Docker, is acknowledged by the most experienced authorities
to be far more effectual than any other. It consists, in the main, of
administering, as early in the disease as possible, 25 to 30 grains of
Ipecacuanha, in as small a quantity of fluid as possible, premising half
an hour previously 25 to 30 drops of Laudanum. The patient should keep
perfectly still in bed, and abstain from fluids for at least three
hours. If thirsty, he may suck a little ice, or may have a teaspoonful
of cold water. It is seldom, under this management, that nausea is
excessive, and vomiting is rarely troublesome, seldom setting in for two
hours after the medicine has been taken. Mustard Poultices (247) or
Turpentine Stupes (362) should be applied to the abdomen. In from eight
to ten hours, according to the urgency of the symptoms and the effect
produced by the first dose, Ipecacuanha in a reduced dose should be
repeated, with the same precautions as before. The effects of this
treatment are soon manifest and surprising; the griping and straining
subside, the motions quickly become feculent, blood and slime disappear;
and often, after profuse action of the skin, the patient falls into a
tranquil sleep and awakes refreshed. The treatment may require to be
continued for some days, the medicine being given in diminished doses,
care being taken to allow a sufficient interval to admit of the patient
taking some mild nourishment suited to the stage of the disease. As the
disease abates, the dose should be reduced. It is well, however, to
administer 10 or 12 grains at bedtime for a night or two, after the
stools are, to all appearance, healthy. Fomentations or Turpentine
Stupes to the abdomen lessen griping and diminish suffering. If a little
diarrhœa without the dysenteric odour remain, it may be checked with a
little astringent mixture, with or without Opium. Astringents in any
shape during the acute stage are not _only useless, but dangerous_. (Dr.
Maclean.) To sum up, it appears—1. That acute dysentery is more
successfully and speedily treated by large doses of Ipecacuanha than by
other means. 2. That it is more effectual in the acute than in the
chronic forms. 3. That large doses, such as are mentioned above, may be
given with perfect safety, without fear of ill effects; and 4. That it
is less successful with the natives of India than with Europeans. In the
acute dysentery of natives, small doses, _e.g._, from six to eight
grains thrice daily, so as to keep up a slight degree of nausea, short
of actual vomiting, seem to answer better than the large doses mentioned
above. It may be advantageously combined with Opium, from a quarter to
half a grain with each dose.

_When of malarious origin or when occurring in the course of periodical
Fevers_, Quinine (three to five grains twice or thrice daily) should
form part of whatever other treatment is being followed. _In the
advanced stages, or when it passes into Chronic Dysentery_, apply
Turpentine Stupes (362) to the abdomen, and give Sulphate of Copper
(110), Bael (44), Infusion of Kariyát (191), Decoction of Pomegranate
Rind (312), or Sal Ammoniac (331). When an aperient is required, give
Sulphur and Cream of Tartar (344) or Castor Oil, with the addition of a
small portion of Opium. _For the Dysentery of Natives_, Decoction of
Sweet Flag (13), Galls (146), Mudar (243), Opium (289a), and Decoction
of Pomegranate Rind (312) seem best suited. _For the Chronic Dysentery
of Children_ the Saccharated Solution of Lime (220), Bael (44), Sulphate
of Copper (110), or Sulphate of Iron (181) are indicated. See also
_Diarrhœa of Children_. N.B.—In all cases of dysentery the food should
be mild and unirritating, and a flannel bandage worn round the abdomen.
Soups containing mucilage of Abelmoschus (2) prove useful.


_Dysmenorrhœa._ See _Menstruation, Painful_.


_Dyspepsia._ See _Indigestion_.


_Ear, Discharges from, in Scrofulous Subjects._ Syringe the ear daily
with Lime Water (225), or tepid water, or milk and water, and give Fish
Liver Oil internally (138). _Buzzing or Noises in the Ear_ often depend
upon an accumulation of wax in the outer passage; to remove this and
effect a cure all that is necessary in many cases is to insert a drop or
two of sweet oil for an hour or two, and then to syringe the ear well
out with tepid water or soap and water, and repeat the same twice or
thrice daily. This also sometimes relieves _Ear-Ache_: if not, use Opium
as directed in Paragraph 292.


_Elephantiasis._ The paroxysms of fever which accompany this disease are
to be treated in the manner directed for Intermittent Fever (_infra_).
The only means of arresting the progress of the disease is to remove
permanently from a locality in which it is endemic or prevalent to
another situated at least ten miles distant from the sea-coast; the
higher and drier the site the better.


_Epilepsy_ sometimes improves under Fish Liver Oil (141); its use may be
combined with Sulphate of Copper, in doses of a quarter of a grain twice
or thrice daily. For this purpose, dissolve two grains in one ounce of
Omum Water; of this, the dose is a teaspoonful. Far superior to all
other remedies for _Epilepsy_ is Bromide of Potassium in doses of 10 to
15 grains, in a wineglassful of water, thrice daily. Should the disease
not yield to these doses, they may be gradually increased to double or
even treble these quantities. The earlier in the disease this remedy is
resorted to, the greater are its chances of success; and as a general
rule it proves more useful when the fits are severe and frequent, and
occur mainly in the daytime, than in the milder attacks, which come only
at night. In all cases it is worthy of a fair trial. See also remarks at
the end of _Convulsions_ in this Index.


_Exhaustion from Hæmorrhage after Fevers or other causes_, give Brandy
Mixture (426).


_Eyes, Affections of._ Datura (128β). For "_Country Sore Eye_," apply
Alum, as directed in Paragraph 23, and Decoction of Turmeric (360) to
relieve the burning sensation. Try also Solution of Sugar (406). _For
other forms of Ophthalmia, attended with copious discharge_, try
Sulphate of Copper (113). _To relieve great pain and intolerance of
light_, use Opium locally (292). _Blows on the Eye_: Alum Poultice (24),
followed by Sal Ammoniac Lotion (332), to remove discoloration.
_Particles of Lime in the Eye_ may be dissolved and removed by dilute
Vinegar (382). _Particles of Dirt, &c._, may often be speedily dislodged
and removed by drawing the upper eyelid well over the under one as far
as possible for a few seconds. This simple plan is often successful when
others fail. If this fail, try Solution of Sugar (406). Fresh Plantain
Leaf (307) forms an excellent shade for the eyes in all affections of
those organs.


_Face-Ache, Neuralgic or Rheumatic._ Sal Ammoniac (326), Sulphate of
Iron (177), or Fish Liver Oil (141) internally; and Datura (130), and
Mustard (253), or Ginger (157) Poultices locally, are measures which,
used conjointly, often prove successful. _When periodical_, Cinchona
Febrifuge (402*).


_Fainting_ generally yields to dashing cold water over the face and neck
(386), and applying strong smelling salts to the nostrils; when
partially recovered, Omum Water (318) or Asafœtida (35) may be given, or
should there be much exhaustion, a dose of Brandy Mixture (426).


_Fevers, Ardent or Continued._ In most cases it is advisable to commence
with a purgative of Kaladana (187), Castor Oil (83), or Myrobalans
(256), or if the patient be a strong adult, a Croton Pill (120); after
its operation the Solution of Nitre (264) may be given, and Decoction of
Abelmoschus (2), Lemonade (232), or Tamarind Infusion (346), _to allay
the thirst and cool the system_. A very useful and refreshing drink in
all fevers, especially if there is irritability of the stomach, is a
mixture of equal parts of Milk and Soda Water, with the addition of a
piece of ice if procurable. Sucking small pieces of ice also allays
thirst and cools the system; for this latter purpose, also, sponging the
surface with Water (385) or diluted Vinegar (376) may be employed. The
diet should consist chiefly of Rice _Conjee_ (322) and other farinaceous
articles, and the apartment should be kept cool and well ventilated. _To
relieve Headache or great fulness of the head_, apply constantly
Evaporating Lotion (380) or Nitre Lotion (265), or, if these fail to
afford relief, Hot Water Fomentations (393). Leeches to the temples or
nape of the neck (209) and Mustard Poultices to the feet (248) may also
be necessary in severe cases. _For any severe or acute pain arising in
the chest or abdomen_, Leeches (209) over the seat of pain should be
applied, but if these fail try a Blister (349). _For Vomiting and
Irritability of Stomach_ give Lime Water (223), or else give Hot Water
as a drink (385), and apply Mustard Poultices (251); _for Bilious
Diarrhœa accompanying_ use Warm Water Enemas (393). _For Sore Throat or
Fissures of the Tongue_, apply Borax (55) or Alum (29); _for Dryness of
the Mouth and Fauces_ sucking sliced limes, or, better still,
pineapples, generally suffices. _In the advanced stages, when great
exhaustion, delirium, &c._, are present, give Camphor (74) and Brandy
Mixture (426) internally, and apply Turpentine Stupes (363) to the
extremities; Turpentine Enemas (364) are also valuable in this
condition. _For subsequent Debility and during Convalescence_ give one
of the following tonics: Chiretta (98), Atís (42), Bonduc (52), Kariyát
(191), Ním Bark (260), Gulancha (352-3), or Cinchona Febrifuge (402). A
combination of Chiretta and Sweet Flag Root (12) or Chiretta Wine (99)
is perhaps best suited for this purpose. A liberal animal diet should be
allowed. N.B.—Throughout the attack it is essential to keep the bowels
properly regulated.


_Fever, Intermittent or Ague, and Remittent or Jungle Fever._ Commence
with an aperient, as in Fever (_ante_), and should the stomach be foul
give an emetic of Country Ipecacuanha (368). _In the cold stage_, cover
the body well up with blankets, give Infusion of Ginger (156), and place
bags containing hot sand or hot salt along the spine. _In the hot
stage_, give plentifully of Lemonade (232), Solution of Nitre (264), and
adopt generally the other measures advised above in Fever. _In the
sweating stage_, do nothing but protect the surface from cold draughts
of air or cold wind. In the intermission or periods between the
paroxysms give one of the following: Atís (42), Bonduc Nut (52),
Chiretta (98), Sulphate of Iron (175), Ním Bark (260), or Gulancha
(352). When one fails another may succeed; when each fails, given
singly, they will sometimes prove effectual given in combination. They
are all greatly inferior in efficacy to Quinine and Cinchona Febrifuge
(401, 403). _For these Fevers in Natives_, Galls, with Chiretta and
Sweet Flag Root (12), have been favourably spoken of. _Swelling of left
side after Ague_, see _Spleen, Enlargement of_.

In mild, ordinary, uncomplicated cases of _Intermittent Fever_, all that
is required, due attention being paid to the state of the bowels and
secretions, is to administer Quinine in doses of from three to five
grains, so that 10 or 12 grains be taken in the intermissions between
the paroxysms. It is best given in solution, in water or coffee. In the
severer forms, or even in ordinary cases, Professor Maclean, of the
Netley Hospital, has proposed a treatment which appears very judicious,
and which in his hands has for years proved very successful. It consists
in administering 30 grains in three equal doses during the period of
intermission; the first dose, in solution, should be given towards the
close of the sweating stage, and the last about as far as can be
calculated, an hour before the next anticipated paroxysm. Should there
be much irritability of the stomach, it should be given in enema in
doses of 15 grains in place of 10 grains. After the paroxysm has by this
means been arrested, a moderate degree of cinchonism, _i.e._, giddiness,
buzzing in the ears, flashing before the eyes, &c., should be maintained
for some days, by giving three or four grains in solution every four
hours. In cases where the fever returns at the first lunar period, as it
is apt to do, the patient a day or two previously should be brought
under the influence of Quinine, which should be maintained until the
time is past. Should it fail to influence the fever, attention should be
directed to the state of the liver and bowels. When from any cause it
cannot be given internally, trial may be made with it applied
endermically; the experiments of Dr. Guastamacchia and others tending to
prove that it becomes absorbed into the system through the skin, and
operates as an antiperiodic almost as certainly as when given
internally. He dissolved eight grains in half an ounce of spirit, and
rubbed first one half, and after the interval of a quarter of an hour,
the second half along the spine. When this was done at the commencement
of the cold fit, it very often prevented even a single recurrence. Dr.
Daunt also bears testimony to this method in the fevers of South America.

In _Remittent and Jungle Fever_, Quinine is a remedy of the highest
value, but its exhibition requires more caution and discrimination than
in simple intermittents. Dr. Maclean's treatment appears to be worthy of
every attention. After premising, in most cases, a cathartic,
immediately on the first signs of remission, he administers a full dose
of Quinine, 10 grains, often 15, sometimes 20 grains, never exceeding
that dose, and not deterred by the presence of headache or a foul
tongue, nor because the remission is slight or imperfectly marked; and
this dose he repeats every second hour until 30 or 35 grains have been
taken before the hour of the expected exacerbation. Should the stomach
be too irritable to bear it, it should be given in enema in large doses
(20 grains). As soon as the second remission appears, it must be given
as before until full cinchonism or distinct abatement of the disease
occurs. During the remission the patient should have mild farinaceous
diet, milk, chicken-broth, &c.; as soon as gastric irritability
subsides, beef tea should be given, and on the first sign of exhaustion,
nourishment and stimulants should be resorted to at short intervals.
With regard to the administration of Quinine during exacerbations, Dr.
Maclean is of opinion that in the adynamic forms of fever, as met with
in some parts of India, and in neglected or mismanaged cases, where
depletion has been carried too far, and the fever assumes more of a low
continued type, it may be given at any period irrespective of remission.
Here it requires to be conjoined with the assiduous use of support and
stimulants at short intervals.

As a preventive of _Malarious Fever_, the power and value of Quinine
have been proved beyond a doubt. Every person engaged in forests,
swamps, or low, malarious sites, should be provided with a stock of it,
and four grains of it in a cup of hot coffee should be taken the first
thing in the morning or in a glassful of wine later in the day. Even if
it should fail, which it rarely does, no harm can result from its use,
and it is essential that it should be continued for at least fourteen
days after quitting a malarious locality.


_Fits._ See _Convulsions_, and _Hysterical Affections_.


_Flatulence, and Flatulent Colic._ Give Omum Water (318*), Lemon Grass
Oil (216), infusion of Ginger (155), or of Jatamansi (184); with Mustard
Poultices (251) and Turpentine Stupes (362) externally; in severe cases
an enema of Asafœtida (36) will generally afford relief. See also
_Bowels, Spasmodic Affections of_. _Of Children_, see _Colic_.


_Gall Stones._ _To allay the severe pain attendant on passing_, give
Opium (284) and a Hip Bath (392).


_Genital Organs, Great Irritation of._ Try Camphor (72) internally (in
these cases Bromide of Potassium, in doses of eight to ten grains
dissolved in water, twice or thrice daily, is well worthy of a trial,
especially in females) and use Borax (57) and Lime Water (224) locally.
Sitting over the steam of hot water, or a tepid hip-bath, often affords
great relief. When the irritation arises, as it often does, from worms
in the intestines, give some of the remedies for _Worms_. Crab-lice,
which are very difficult to distinguish on a dark skin, are also a
frequent cause; if present, use Kerosene Oil (413), or other remedy
named in Art. _Lice_.


_Glands, Enlarged._ Apply externally, in the early stages, Sal Ammoniac
Lotion (332), Betel Leaves (48), Camphor Liniment (68), or Opium
Liniment (291). If matter forms, treat as abscess, and give Fish Liver
Oil internally.


_Gleet_ may be treated with Cubebs (125), Galls (149), Gurjun Balsam
(160), or Sandal Wood Oil (334) internally, and Alum Injections (30);
these last named, however, _require great caution_, and should not
generally be used except under medical supervision.


_Goitre._ Give Sal Ammoniac (324), in ten-grain doses, thrice daily,
persevering in its use for weeks or months if necessary. Dr. Stevens
(_London Med. Record_, June 15, 1880) obtained signal benefits from it
in six cases. Biniodide of Mercury, in the form of Ointment (16 grains
of the Biniodide to one ounce of Simple Ointment), is the best local
application we possess. Its effects are best produced by exposing the
surface on which it has been rubbed to the direct rays of the sun. If
this cannot be done, then to the heat of a fire; this, however, is not
nearly so efficacious as the solar heat. (Dr. Aitchison.)


_Gonorrhœa._ After a purgative of Kaladana (187), Myrobalans (256), or
Castor Oil (83), give Nitre (269) with Decoction of Abelmoschus (2),
Ispaghúl (305), or Rice _Conjee_ (322), for the purpose of allaying the
pain and heat in passing urine. Pedalium (297) is said to be very
effectual for this purpose, and should be tried if procurable.
Injections of a solution of Sugar (407) are recommended by Dr.
Aitchison. When the inflammatory symptoms begin to abate, one of the
following should be given: Cubebs (125*), Gurjun Balsam (160), Sandal
Wood Oil (334), or Galls (149), Alum (30*), locally, is of great use in
certain cases. _To relieve Chordee_ (painful erection at night), Camphor
(72) is one of our best remedies. Bromide of Potassium, in doses of 20
to 30 grains, in a wineglassful of water at bedtime, is highly spoken
of, as preventing the occurrence of this symptom.


_Guinea Worm._ On the head of the worm appearing, it should be gently
drawn down so as to secure it by rolling it round a small piece of
twisted rag, or a thin piece of quill (let a native practitioner perform
this operation); and Water Dressing (394) applied, or should there be
much pain, a Datura Poultice (132). Every day gentle traction should be
made, and if this can be done whilst the limb or part is immersed in a
running stream or in a _chattie_ of cold water, the extraction is
rendered additionally easy. _Great gentleness and skill_ are requisite
to prevent the worm breaking, as this accident is followed by
inflammation and the formation of abscesses, which are difficult of
healing. See _Abscess_.


_Gums, Ulceration and Sponginess of_, may be treated with one of the
following:—Decoction of Babúl Bark (9), Alum (29*), Catechu (89*), or
Lime Juice (231).


_Hæmorrhage from Cuts, Wounds, &c._ When the blood is of a bright red
colour, and comes out in jets, indicating that an artery is wounded,
apply first a stream of _cold_ water, iced if possible, from a large
sponge, which will not only wash away all clots, dirt, &c., but promote
contraction of the vessel, and _perhaps_ arrest the bleeding at once. If
not, try the fresh juice of the Physic Nut Plant (302*), or Alum (25).
If these fail, or are not at hand, at once apply pressure with the
finger or fingers upon the exact point from which the blood is found to
issue, and there retain for some time, pressing against the bone or hard
substance. If the mouth of the bleeding vessel be clearly visible, and
the hæmorrhage still continues, it may be pinched up firmly between the
finger and thumb, or it may be seized with a pair of pincers or forceps,
drawn forward, and a ligature, silk if procurable, passed round it and
firmly tied. Not more of the surrounding flesh should be included in the
ligature than can be possibly avoided. If none of these plans succeed or
are applicable, or if the wound be large and bleeds much, apply pressure
to the limb by means of the STICK TOURNIQUET figured below.[2]

[Illustration]

In order to apply this properly, "tie tightly, at some little distance
above the wound, a pocket-handkerchief or cravat once or twice passed
round the limb; then, obtaining a piece of tough stick, push it under
the handkerchief, and, by turning the stick, twist the handkerchief more
and more tightly until the bleeding ceases. As soon as this result has
been attained, fasten the stick by another handkerchief round the stick
and limb together. This rude tourniquet may save life not unfrequently,
by enabling the injured person to be transported even for some distance
without fear of further bleeding." Position is a very important
consideration in wounds, the bleeding sometimes being at once arrested
by raising the injured limb above the level of the body.

[Footnote 2] The above woodcut, and the mode of applying it, is
reprinted by permission from _First Help in Accidents_, by Dr. C. H.
Schaibe, published by R. Hardwicke, 192 Piccadilly, London. A very
useful little book.


_Hæmorrhage from the Lungs, Stomach, Bowels, Kidneys, Uterus, or other
Internal Organs_, if attended by feverishness and heat of skin, a
solution of Nitre (267) or Sal Ammoniac (330) may be given, with the
plentiful use of Lemonade (233), Tamarind drink (346), Vinegar (379),
and other refrigerants. In the absence of fever, Alum (25) may be given
with safety and advantage. A far more effectual remedy in these cases is
the Acetate of Lead in doses of three or four grains, made into a pill
with half a grain of Opium, and followed immediately by a draught
containing a little vinegar. These pills and draughts may be repeated
every three or four hours till the bleeding begins to abate, when the
interval between the doses may be lengthened, and the quantities
decreased. In all these cases a perfect rest in a recumbent posture, in
a cool, well-ventilated apartment, and the avoidance of all excitement
and stimulants, are essential to the success of the above, or any other
remedies. In these cases Ice externally applied in bags exercises a
marked influence in checking internal hæmorrhage, especially from the
lungs. It should not be kept on sufficiently long to produce a chill.
Sucking small pieces of ice is also a useful practice. _Exhaustion from
excessive Hæmorrhage_ requires Brandy Mixture (426) and other
stimulants. _Hæmorrhage after Labour_, see _Labours_. _From Piles_, see
_Piles_.


_Hæmorrhage from the Nose_ may generally be checked by one of the
following simple means: 1. the application of a cold body, as a key or a
piece of ice to the nape of the neck. 2. By compressing the _opposite_
nostril. 3. By standing in the upright position and holding both arms in
the air for a few minutes. If these measures fail, recourse may be had
to Alum (25*), Sulphate of Copper (116), or Vinegar (379). Should
feverishness be present, treat as directed in preceding article.


_Hæmorrhage from Leech Bites._ _See_ Paragraph 205.


_Head, Affections of, where there is determination of blood to the head,
with sleeplessness, restlessness, and anxiety._ Mustard Bath (249*).


_Headaches_ generally must be treated with reference to their cause. _If
from Constipation_, Castor Oil (83), Kaladana (187), Myrobalans (256),
or other purgatives. _Of Fever_, hot water stupes to the nape of the
neck (393). _From Bilious derangement_, the same purgatives preceded by
a dose of Calomel (three grains) if at hand, and followed by Sal
Ammoniac (328*). _Nervous, Hysterical, and Rheumatic Headaches_ often
yield to Sal Ammoniac (328), persevered in for a few days, and the local
use of Camphor Lotion (71*). _From suppression of the Menstrual_
_Discharge_, Leeches to the inner surface of the thighs (210). _From
stoppage of bleeding from Piles_, Leeches to the verge of the anus
(210); in both these last cases Aloes (19) should be given internally.
The other measures occasionally useful are Ginger Plaster (157), Hot
Water Fomentations (393), and Mustard Poultices or Mustard Foot-baths
(248) to the extremities.


_Heart, Palpitations of._ See _Palpitations_.


_Heartburn_ often yields to Lime Water (221) given with milk or with
Omum Water (317); or with Chiretta (98), if associated with indigestion.


_Hepatitis._ See _Liver, Inflammation of_.


_Hoarseness_ may be treated by inhalations of the vapour of Hot Vinegar
(377*), or Decoction of Abelmoschus (3), by gargles containing Capsicum
(78*), Black Pepper (300), or Moringa root (238); by chewing Ginger
(158), or allowing a piece of Catechu (89) to dissolve in the mouth.


_Hooping Cough._ In the early stages regulate the bowels with Castor Oil
(83), and give Country Ipecacuanha (370) and Sal Ammoniac (329). As soon
as the feverish symptoms have subsided give Alum (28*); should this
fail, try Sulphate of Iron (180), with or without Asafœtida (37). If
weakness and emaciation exist, or in very obstinate cases, give Fish
Liver Oil (140); Mustard Poultices (252) and friction with Opium
Liniment (291) to the spine seem useful in the chronic stage.


_Hydrocephalus_ (_Water on the Brain_) occurring in weak, emaciated
children of a scrofulous habit occasionally improves under Fish Liver
Oil (139).


_Hysterical Affections._ Amongst the means useful in controlling these
are Asafœtida (35*), Aloes and Asafœtida Pills (19), Jatamansi (184),
Omum Water (318), Turpentine Enemas (364), and Cold Water Affusion (386).


_Indigestion, or Dyspepsia._ Tonics, as Chiretta (98, 99*), Sweet Flag
Root (12), Country Sarsaparilla (163), and Guluncha (352), combined with
stomachics, as Cloves (105), or Cinnamon (102), Capsicum (79), and Omum
Water (318*), offer the best prospect of success. _With great increased
Secretion_, Butea Gum (62). _With acidity of the Stomach_, Lime Water
(221). _With torpidity of the Bowels_, Tincture of Kariyát (192),
Without strict attention to diet, and careful regulation of the bowels
and other secretions, medicines will have comparatively little effect.


_Inflammations, Local or External_, require, according to circumstances,
Leeches (212), Hot Water Fomentations (393), Water Dressings (394),
Evaporating Lotion (380), Sal Ammoniac Lotion (332), and Rice-Flour or
Rice Poultices (322) as external applications. A solution of Acetate of
Lead (30 grains in a pint of water) forms an excellent soothing lotion,
and one which may always be resorted to with safety. The inflamed parts
should be kept constantly wet with it by means of moistened cloths.


_Influenza._ Give plentifully of Solution of Nitre (264), and treat
otherwise as described in _Catarrh_.


_Insanity._ A free action on the bowels by Croton Pill or Croton Oil
(120, 121), and the employment of a Mustard Bath (249), are of service
in the early stages. No time should be lost in placing the patient under
proper medical care.


_Insensibility_, from whatever cause arising, may be treated in the
first instance by the cautious use of Cold Water Affusion (386). A
Turpentine enema (364) may also be of service.


_Irritation of the Genital Organs._ See _Genital Organs_.


_Itch._ Use Sulphur Ointment (341), or Kerosene Oil (416).


_Jaundice._ Mild cases often yield to Sal Ammoniac (331), and the free
use of purgatives, as Kaladana (187), or Myrobalans (256).


_Joints, Injuries or Enlargement of._ In the early stages apply lotions
of Alum (32), and Sal Ammoniac (332), and subsequently liniments of
Camphor (68), and Turpentine (366). _In Chronic Enlargements_, Croton
Liniment (122). _Scrofulous affections of the Joints_ improve under the
use of Fish Liver Oil (138).


_Kidneys, Irritable state, and painful affections of._ Give plentifully
of diluents, as Decoction of Abelmoschus (2), Ispaghúl Seeds (305), or
Rice _Conjee_ (322). These, with Opium (286), and the use of the Hip
Bath (392), are calculated to afford great relief.


_Bleeding from._ See _Hæmorrhage_.


_Labours._ Don't interfere unnecessarily; Nature, if left to her own
unaided efforts, will accomplish her work in natural, uncomplicated
labours. Many a woman has _lost her life through meddlesome interference
on the part of ignorant midwives. Should the labour be very prolonged,
apparently for want of action or power in the womb_, a few doses of
Borax and Cinnamon (58) may be given. _For Flooding_ (_hæmorrhage during
or after labour_) lose no time in resorting to Cold Water Affusion
(388), and subsequently use Vinegar locally (379). _To promote the
Lochial Discharge, if scanty or arrested_, use Hot Water Fomentations
(393). _For After-pains_ give a dose of Opium (289). _Convulsions,
attendant on_, see _Convulsions_.


_Leech Bites, to arrest bleeding from._ See Paragraph 205.


_Leeches, to dislodge from nose and other passages._ See Paragraph 206.


_Leprosy._ Chaulmúgra (94), Gurgun Balsam (161*), Hydrocotyle (169*), or
Mudar (242); with these may be advantageously conjoined a prolonged
course of Fish Liver Oil (142), or the latter may be tried alone. _For
the ulcerations_, poultices of Hydrocotyle (169) or Ním Leaves (261) may
be applied with advantage. Opium (283) is often necessary _to relieve
pain and procure sleep. Whatever other treatment may be adopted,
diligent oily frictions over the whole body should form an essential
part of it_ (161-338). Carbolic Acid promises to prove a most valuable
agent in this disease. The treatment of Leprosy by Carbolic Acid Vapour
Baths, introduced by Surgeon-General W. Johnston, M.D. (_Times_, June 3,
1882), promises good results, and seems well worthy of further trials.
All that is required is an ordinary vapour bath apparatus (397), in
which the patient sits, and _outside a chattie_ or vessel of sufficient
size to contain about a quart of liquid, and made with a lengthened
curved spout, to fit accurately on an elastic tube of sufficient length
as to pass within the vapour-proof envelope. The calibre of this elastic
tube should be such as would admit of a continuous and abundant supply
of the vapour as it comes from the vessel, resting on a spirit-lamp
having a flame sufficient to keep the fluid in the vessel boiling
briskly. Prior to the use of this bath, sponging the body with tepid
water, holding a piece of washing soda in solution, seems to aid the
absorption of the vapour. The Carbolic Acid should be Calvert's
Disinfecting Fluid, of which a mixture of three or four parts to six or
seven of water may be employed. In this vapour bath the patient should
remain from 30 to 60 minutes (care being taken that a continuous supply
of vapour is kept up from outside), and it may be repeated every second
or third day according to circumstances. Dr. Johnston informs me that he
has never seen any ill effects result from the use of this carbolised
aqueous vapour, even in cases presenting extensive ulcerated surfaces.
Some care is requisite in arranging the fold or frill round the aperture
through which the head protrudes. "Were the patient to breathe a little
of it," Dr. J. remarks, "little injury would result, possibly good, but
still, for obvious reasons, he should not be allowed to breathe too
much." Dr. Aitchison directs leprous ulcerations to be treated with a
solution of Carbolic Acid (one to seven or ten of Sweet Oil, according
to circumstances), and that at the same time the whole body should be
rubbed with a weaker solution (1 to 20). This treatment, he remarks, at
once removes the horrid odour usually attendant upon these cases, and
the patients will readily adopt it, when they distinctly refuse to wash
or clean themselves. With a change in diet, under this treatment, these
cases, he adds, improve remarkably.


_Leucorrhœa_ ("_Whites_"). Cubebs (125), Nitre (269), Gurjun Balsam
(160), or Sulphate of Iron (174*), internally; with vaginal injections
containing Babúl Bark (9), Alum (30*), Galls (149), or Lime Water (224),
are indicated.


_Lice infesting the hair on various parts of the body, especially the
pubes_, may be destroyed by Cocculus Indicus Ointment (107), Vernonia
Seeds (373_b_), or Kerosene Oil (416). Carbolised Oil (1 Acid to 20 of
Sweet Oil), applied night and morning, is said to be an effectual remedy.


_Lime, Particles of, in the Eye_, may be dissolved and removed by dilute
Vinegar (382).


_Liver, various Affections of_, are often greatly benefited by Sal
Ammoniac (331). _Enlargement of_, Sal Ammoniac (331*), Papaw Juice
(296). _Congestion of this organ, especially if arising from
over-feeding_, often subsides under a dose of Calomel (three or four
grains) at night, followed, in the morning, by an active aperient of
Kaladana (187), or Castor Oil (83). Further relief may be obtained by
Hot Water Fomentations (393), Turpentine Stupes (362), or Betel Leaves
(48) over the region of the liver; if these fail, Leeches to the same
site, or to the verge of the anus (211), may afford manifest relief.
All, however, will be useless without strict attention to diet, and
careful avoidance of all stimulating articles of food and drink.


_Lock-jaw._ See _Tetanus_.


_Loins, pain in the._ See _Lumbago_.


_Lumbago._ Sal Ammoniac (326) internally, with Liniments of Camphor
(68), Lemon Grass Oil (217), Opium (291*), Datura Liniment or Poultices
(130), or Turpentine (366) externally, often succeed in affording
relief. Turpentine Stupes (362) may be tried in severe or obstinate
cases.


_Lungs, Affections of._ See _Coughs_, _Consumption_, _and Bronchitis_.
_Bleeding from._ See _Hæmorrhage_.


_Maggots on surface of Ulcers, to destroy._ Butea Seeds (65).


_Maggots in the Nose_ (_Pecnash_). Injections of Oil of Turpentine
(363_b_).


_Measles._ An occasional mild aperient, just sufficient to keep the
bowels gently open, the plentiful use of Lemonade (232), or Rice
_Conjee_ (322), with or without Nitre (264), together with confinement
to bed in a cool, well-aired apartment, and farinaceous diet for a few
days, will generally suffice for recovery in mild, uncomplicated cases.
_To allay irritation of the surface_, sponge with diluted Vinegar (376)
or Water (385), and dust the surface well over with Rice Flour (322).
_Should Cough occur_, use some of those means enumerated under Coughs.
_The advanced stages, in bad cases, characterised by great exhaustion_,
call for the use of Camphor (74), Brandy Mixture (426), and plentiful
nourishment.


_Menstrual Discharge, Suspension, or Irregularity of_ (_Amenorrhœa_).
Aloes (18), Borax (58), and Sulphate of Iron (174*), alone or combined,
may prove serviceable. Try also hip bath with Sesamum Seeds (338_a_).
_Excessive or long-continued Menstruation_, Alum (25) and Vinegar (379).
_When attended with much pain and distress_ (_Dysmenorrhœa_), Opium
Liniment (291) or Datura Poultice or Liniment (130) to the loins; also
hip bath containing Sesamum Seeds, which also may be tried internally
(338_a_).


_Mercury, salts of, as Corrosive Sublimate, Poisoning by._ If vomiting
is not already present it must be excited by a Mustard (246) or other
emetic, and the stomach having thus been emptied of any of the poison it
may contain, prompt recourse should be had to the white and yolk of raw
eggs, which may be given alone or beaten up with rice-flour into a paste
with milk or water. The after-treatment consists in the free use of Rice
_Conjee_ and other demulcent drinks, gargles of Alum (29) or Borax (55),
to control the salivation; small doses of Opium, should there be much
pain, and a milk or farinaceous diet.


_Mesenteric Affections of Children_ are best treated with Fish Liver Oil
(139).


_Milk, for Increasing the Secretion of_, Leaves of Castor Oil Plant
(85), or of Physic Nut Plant (302); _for Diminishing or Arresting the
Secretion of_, Betel Leaves (49), or flowers of Jasminum Sambac (Aiton).

This twining plant is cultivated throughout India for the sake of its
white fragrant flowers, which are used as votive offerings. The
lactifuge property of these flowers was first brought to notice by Mr.
J. Wood (_Ph. of India_, p. 136), who speaks of the fact being well
known in Madras. Two cases illustrative of their efficacy occurring in
the practice of Dr. Mackenzie, C.B., are recorded by Dr. Bidie (_Madras
Jour. Med. Sci._, Aug. 1870). In one case especially, an English lady,
all ordinary means had failed to arrest the flow of milk before the
flowers were applied; within a few hours they afforded complete relief,
and the secretion of milk, which had been unusually copious, was from
that time entirely arrested. The results of the other trial were equally
satisfactory. For this purpose two or three handfuls of the fresh
flowers bruised are to be applied unmoistened to each breast and renewed
once or twice a day. The secretion is sometimes arrested in twenty-four
hours, though this generally requires two or three days (Wood). The
native names of these flowers are Mogra ka phúl (_Hind._, _Duk._), Mogra
phúl (_Beng._, _Guz._), Malligraip-pú, Mallip-pú (_Tam._), Mallelú
(_Tel._), Mullup-pú (_Mal._), Pich-chi-mal (_Cing._), Múgra (_Punj._).


_Milk Abscess._ In the early stages apply either Sal Ammoniac Lotion
(325), or hot Vinegar Stupes (381). Should matter form, treat as
_Abscess_.


_Mouth, Ulceration of._ Try first Sulphate of Copper (112) or Lime Juice
(231); if these fail use some of the other remedies mentioned in Art.
_Gums, Ulceration and Sponginess of_. _For Aphthous Ulcerations, i.e.,
small white specks or ulcers in the mouths of infants and young
children_, apply Borax (55*), or Alum (29), or Sulphate of Copper (112);
Country Sarsaparilla (163) may at the same time be advantageously given
internally. _In severer forms_ (_Ulcerative Stomatitis_), try Alum (29).


_Mumps._ Beyond a dose of Castor Oil (83) or Infusion of Senna (336), so
as to keep the bowels gently open, little is required beyond keeping the
swollen parts covered with a piece of flannel, to protect them from cold
draughts of air, and the use of a farinaceous diet for a few days.
Should there be much pain, Opium Liniment (291) may be smeared over the
surface of the swollen gland at bedtime. Should there be much fever,
heat of skin, &c., a few doses of solution of Nitre (264) may be given.


_Muscles, Pains in._ Give Sal Ammoniac (327) internally, and use
Liniments containing Camphor (68), Lemon Grass Oil (217), Opium (291),
or Turpentine (366) externally.


_Mosquito Bites, to relieve the irritation_, try Lime Juice (235), or
Vinegar (380).


_Nettle-rash, to allay irritation_, apply Borax Lotion (57).


_Neuralgia._ Try Sal Ammoniac (326), or when the pain returns
periodically, Sulphate of Iron (177), or better still Cinchona Febrifuge
(402*). When Neuralgia of the Head or Face (_Tic Douloureux_) recurs at
stated periods, and is apparently of malarious origin, no remedy is
equal to Quinine, which may be given in one large dose (ten grains)
shortly before the time when the pain is expected to return. Should it
not yield after three or four doses, no advantage will be gained by
continuing it. Another plan is to give it in three-grain doses in a
glass of wine thrice daily between the paroxyms of pain. Some obstinate
cases which resist these and other remedies yield to a course of Fish
Liver Oil (141). Among external applications are Datura Liniment or
Poultices (130), Lemon Grass Oil (217), Mustard Poultices (253), and the
Camphorated Opium (291), or Turpentine Liniment (366).


_Nipples, sore or cracked_, are benefited by Borax Lotion (56), or
Castor Oil (84), or Lime Water (225), locally applied. As a preventive
use Infusion of Catechu (90). [To ensure prevention, the nipple should
be carefully washed and dried immediately the child is removed from the
breast, and the tissues may be hardened by washing them for a short time
before delivery, and after each application to the breast, with a little
brandy and water. It is also a useful practice to wear over the nipple a
metallic shield, which should be constantly applied when the child is
not at the breast.—_Prof. Ringer._]


_Nodes, or Painful Swellings on the Shin-bone._ Apply Datura Poultice
(130), or other means mentioned in _Tumours, painful_.


_Nose, discharge of Matter from._ Use injections of Lime Water (225), or
tepid Milk and Water, and give Fish Liver Oil (138) internally. _Maggots
in_, see _Pecnash_.


_Nux Vomica, Poisoning by._ Follow the treatment advised for poisoning
by Cocculus Indicus (see _Index_). Bland Oils, _e.g._, Til, Cocoa-nut,
or Ground-nut Oil, seem to retard its action, hence may be given largely.


_Ophthalmia._ See _Eyes, Diseases of_.


_Opium, Poisoning by._ The stomach having been emptied as speedily as
possible by an emetic of Sulphate of Copper (117) or Mustard (246),
every means should be adopted for rousing the patient; this is to be
effected by dashing cold water over the head and chest, walking him
quickly about, supported by two attendants in the open air, applying
strong salts, &c., to the nostrils, irritating the leg by flagellation
with a wet towel, and administering strong coffee, _café noir_, or if
there should be great depression, a little brandy or other stimulant.
When the patient can swallow, Decoction of Galls should be given as
directed in Paragraph 152. In extreme cases artificial respiration
(subsequently described in Appendix, in Art. _Drowning, Recovering
from_) must be tried. These measures should _be long persevered in_; as
long _as life lasts, hope_ of recovery is _not to be banished_.


_Pains, Muscular._ See _Muscles, Pains in_.


_Palpitations of the Heart, Nervous._ These may in a great measure be
controlled by Asafœtida (35), Camphor (70), or Infusion of Jatamansi
(184), either alone or used conjointly. _Palpitations or flutterings in
the region of the Heart_ which occur in weak, nervous, hysterical
subjects, often yield to Bromide of Potassium, in dose of five to ten
grains dissolved in water, twice or thrice daily.


_Paralysis._ Little can be done by non-professionals beyond giving
internally Fish Liver Oil (142), alone or with Sulphate of Iron (177),
in anæmic or debilitated subjects, and applying irritants, as Croton
Liniment (122), Petroleum (410), externally.


_Pecnash_ (_Maggots in the Nose_). Oil of Turpentine (363_b_).


_Phthsis._ See _Consumption, Pulmonary_.


_Physic Nut, Poisoning by._ See _Croton Seeds_.


_Piles._ Sulphur (344) internally, and Gall Ointment (148), or
astringent enemas, as Decoction of Babúl Bark (9), or Galls (148),
suffice in ordinary cases. In old debilitated subjects Confection of
Pepper (300) proves very useful. _When inflamed and painful_, the Hip
Bath, or sitting over the steam of hot water (392), and the application
of a solution of Borax (56) and soft Rice Poultices (322), with or
without the addition of Opium (293), give great relief. The Acetate of
Lead Solution advised for _Inflammations_ (see _Index_) is peculiarly
serviceable in these cases. It may be used cold or warm, as is most
agreeable to the patient's feelings. _To control bleeding from_, use
Alum (25), or enemas of Sulphate of Iron (179). When bleeding from piles
in residents in hot climates has been long continued, it is unadvisable,
so long as it remains within moderate bounds, to take any means of
arresting it suddenly; the suppression of the discharge having in some
instances been known to be followed by congestion and even abscess in
the liver, and in others by congestive headaches and determination of
blood to the head. It seems to be an effort of nature to relieve the
abdominal circulation, which it is unwise to interfere with, unless the
discharge be so profuse as to debilitate the patient, and then the
object should be rather to moderate than to arrest it altogether.
Persons subject to Piles will do well to avoid the use of coffee, as
this often appears to aggravate the severity of the symptoms.
Cleanliness in these cases is of the greatest importance: the parts
should be well washed with soap and water after each motion, and if the
piles are internal and protrude during evacuations, they should be
washed before they are returned.


_Pregnancy._ _For Pains in the Loins_ use Camphor (68) or Camphorated
Opium Liniment (291). _To allay the Vomiting_ try Infusion of Cloves
(105), Mustard Poultice (251). A cup of hot coffee and a piece of dried
toast should be taken in bed very early in the morning, after which the
woman should remain quiet until the usual hour for rising; by this means
the vomiting may often be prevented. When procurable, a glass or two of
Sparkling Moselle is often productive of the best effects, allaying the
vomiting, and enabling the patient to retain and digest food.


_Prickly Heat_ may in a great measure be relieved by Solution of Borax
(57) or Sulphate of Copper (115), and subsequently dusting the surface
with Rice Flour (322) or finely powdered Sandal Wood (333).


_Pyrosis._ See _Water Brash_.


_Rectum, Stricture and Painful Affections of._ Castor Oil (83), Fish
Liver Oil (139).


_Rheumatism, Acute._ _Rheumatic Fever_ may be treated much in the same
way as _Ardent or Continued Fever_ (see _Fever_, Index); by confinement
to bed in a cool, well-ventilated apartment, farinaceous diet, and
abstinence from alcoholic and other stimulants. Nitre (270) should be
given freely, with Lemonade (232) as an ordinary drink. The bowels
should be carefully regulated, one or two motions procured daily by a
dose of Calomel (three or four grains) and Opium (one grain, or even two
grains if there should be great pain or restlessness) at bedtime,
followed by Infusion of Senna (336), or Castor Oil (83), in the morning.
To the swollen and painful joints a strong solution of Nitre (270)
should be kept constantly applied; it generally affords great relief; if
not, a Datura Poultice or moistened Datura leaf (or Tobacco leaf),
applied as directed in Paragraph 130, may be tried.


_Rheumatism, Chronic._ Here Sal Ammoniac (327) and Country Sarsaparilla
(163) promise to be of much use. Chaulmúgra (94), Mudar (242), and
Gulancha (352), have been advised, but in long-standing cases more
benefit may be expected from Fish Liver Oil (142). The action of the
skin may be kept up by Camphor, both internally and in the form of
Vapour Bath (69), and by hot Infusion of Ginger (156) at bedtime, and by
constantly wearing flannel next to the skin. _Amongst external
applications_, Camphorated Opium Liniment (291) and Lemon Grass Oil
(217) are the best; the others comprise liniments containing Camphor
(68), Croton Oil (122), Oil of Country Nutmeg (274), Petroleum (410),
Physic Nut Oil (302), Sulphur (343), and Turpentine (366); Piney Tallow
(373) has been well spoken of. Should one or more joints be specially
attacked, make trial of the applitions advised in Acute Rheumatism, or
of Flour of Sulphur, as directed in Paragraph 343.


_Rickets._ Fish Liver Oil (138) may be used with great advantage: it may
be combined with Sulphate of Iron (177) if the child is weak and anæmic.
Lime Water and Milk (222) forms an eligible ordinary drink.


_Ringworm._ Apply Borax and Vinegar (60), Cassia alata Ointment (81),
Unripe Papaw fruit (295), Sulphate of Copper (115), Oil of Turpentine
(367), or Kerosene Oil (416).


_St. Vitus's Dance._ See _Chorea_.


_Salivation._ Use gargles of Alum (29) or Borax (55), or try Catechu in
substance (89).


_Scalled Head._ See _Ringworm_.


_Scarlatina or Scarlet Fever._ Commence with an emetic of Country
Ipecacuanha (368) or Mudar (241); place the patient in a cool,
well-ventilated apartment; give plentifully of Lemonade (232) or rice
_Conjee_ (322) to allay thirst and feverishness, and give Capsicum
Mixture (78) internally. _For the sore throat_, inhale the fumes of hot
Vinegar (377), and use Capsicum gargle (78). Sponging the surface with
diluted Vinegar (376) or Water (385) is attended with great comfort to
the patient, and is otherwise beneficial. The advanced stages,
complications, and subsequent debility, are treated in the same manner
as in Fevers (see _Index_).


_Sciatica._ See _Neuralgia_. Enveloping the whole of the painful limb in
the "Wet sheet" (397_b_) proves sometimes successful when other remedies
fail. Quinine in full doses, five to eight grains thrice daily, may be
given at the same time.


_Scorpions, Stings of._ Alum (32). See also _Bites, Venomous_.


_Scrofula._ Fish Liver Oil (138) proves most useful in cases in which
_Abscesses, Ulcers, or Skin Diseases_ are present. _Scrofulous
Ophthalmia_ is also greatly benefited by it. When the patient is
debilitated and anæmic, the Oil may advantageously be combined with
Sulphate of Iron. Chaulmúgra (94), Hydrocotyle (169), and Lime Water
(225), are amongst the remedies occasionally useful. A dose of Opium
(283) or Tincture of Datura (128) may be given at night, if the pain or
irritation from ulcers or skin disease occasion sleeplessness. A liberal
animal diet, gentle outdoor exercise, and sea-bathing are valuable
adjuncts to the above remedies.


_Scurvy._ Lime-juice (231) holds the highest rank both as a curative and
preventive agent. All acidulous fruits, Lemons, Oranges, Tamarinds
(346), &c., may be used with the greatest advantage. As a preventive of
Scurvy in jails, &c., Lime Juice and other analogous agents will prove
of comparatively little use unless attention is paid to hygienic
measures, _e.g._, the cleanliness, ventilation, dryness of the building,
reduction of numbers in cases of overcrowding, and the use of a liberal
and wholesome diet, containing a large proportion of fresh vegetables.
_Diarrhœa of_, give Bael (44).

A new antiscorbutic called ÁM-CHUR has lately been brought into use
amongst our native troops in India, and promises to be a powerful rival
to Lime Juice. It consists of green Mangoes, skinned, stoned, cut into
pieces, and dried in the sun. According to Dr. Clarke, Deputy
Surgeon-General Eastern Frontier District, Ám-chur not only maintains
the digestive energy of the men, but its use amongst troops, where
neither a variety of food nor vegetables is obtainable, commends itself
strongly as a result of practical experiment to the military
authorities. One ration should be half an ounce, which would be
equivalent to an ounce of Good Lime Juice. (_British Med. Jour._, Sept.
30, 1882.) Another anti-scorbutic well worthy of attention, especially
as an article of diet on long voyages, consists of DRIED OR PRESERVED
BANANAS. When carefully prepared, they are agreeable to the taste, much
resembling dried figs, of small cost, and will keep good for a
lengthened period.

Sweet Mango pickle, _freely_ eaten with the diet, is an excellent method
of administering Ám-chur.


_Seminal Discharges, Involuntary._ Give Camphor (72) at bedtime. When
attended with much sexual excitement, a full dose of Bromide of
Potassium, 20 to 30 grains in a wineglassful of water at bedtime, is
often most serviceable. These discharges being sometimes due to
irritation caused by Thread Worm in the lower bowel, attention should be
directed to this point. See _Worms_.


_Skin Diseases._ Country Sarsaparilla (163*), Chaulmúgra (94), or Mudar
(242); or where the affection occurs in debilitated, scrofulous, or
leprous individuals. Fish Liver Oil (138) may be given internally. One
of the following may at the same time be applied externally: Cassia
alata (81), Chaulmúgra (94), Lime Liniment (225-229), Myrobalan Ointment
(257), Sulphur (342), Turpentine (367), Kerosene Oil (414*), or
Petroleum (411). The Vapour Bath (396) is often very useful where the
skin is hard, dry, and rough. Borax lotion (57) in many instances will
allay the irritation.


_Sleeplessness in Head Affections._ Mustard Bath (249). A full dose of
the Bromide of Potassium, 20 to 30 grains in a wineglassful of water,
taken at bedtime and persevered in for days and weeks, will often be
found more effectual and less hurtful than the most powerful narcotics.
_From pain attendant on Ulcers, Rheumatism, &c._, Opium (283) or
Tincture of Datura (128) at bedtime. [N.B.—_Sleeplessness, arising from
no evident cause, as bodily pain, mental anxiety, &c., is often
dependent on an empty state of the stomach_, and many a sleepless night
may be prevented, and many a wakeful hour obviated, by the simple
process of eating a few biscuits or a crust of bread before going to
bed, or during the night as occasion may require.]


_Small-pox._ Commence with a mild aperient of Castor Oil (83) or Senna
(336); place the patient in a cool, well-ventilated room, and give
freely Lemonade (232), Rice _Conjee_ (322), &c., with solution of Nitre
(264); sponge the surface daily with diluted Vinegar (376) or Water
(385); and, still further, to _allay irritation_, dust the eruption
freely with Rice Flour (322). The Carbolic Acid treatment promises the
best results. Carbolic Acid, as an external application in Small Pox, is
strongly recommended by Dr. Aitchison. He directs that from the very
earliest stage of the disease the whole body be rubbed with a mixture of
the Acid (one part) and Sweet Oil (ten parts) twice daily. "This
application," he remarks, "relieves the patient marvellously—the oil
soothing and cooling the skin, the acid deodorising the stench, and
destroying the contagious influence of the particles thrown off from the
skin. The oil is as much a part of the treatment as the disinfectant,
and is an old Egyptian remedy for this disease. In many cases the
application seems to destroy the Smallpox poison to the extent that the
disease does not reach the pustular stage; the vesicles form themselves
into hard lumps, dry up, and disappear, without the usual Small-pox
pustular cicatrix." (See Appendix C for details of treatment.) With the
view of _preventing pitting_, apply Lime Liniment (229). _In the
advanced stages, attended with great exhaustion, delirium_, &c., give
Camphor (74), Brandy Mixture (426), and other stimulants, with
nutriment. _Subsequent debility and Convalescence_, treat as in Fever.
(See _Index_).


_Snake Bites._ See Appendix B.


_Sneezing, when violent or prolonged._ Insert lightly into the nostrils
a small piece of cotton wool. A case in which this gave instantaneous
relief, when all other remedies had failed, is recorded by Dr. Bradley.
(_British Med. Jour._, Dec. 1879.)


_Spermatorrhœa._ See _Seminal Discharges_.


_Spleen, Enlargement of, "Ague Cake."_ Give Sulphate of Iron and
purgatives, as advised in Paragraph 176, or Papaw juice (296), or,
better still, Cinchona Febrifuge (402). Extract of Gulancha (353) is
worth a trial. Quinine, in doses of five to eight grains thrice daily,
produces the best effect in these cases; it may be advantageously
combined with Sulphate of Iron (176). The most effectual local
application is Biniodide of Mercury Ointment (16 grains of the Biniodide
to simple Ointment, one ounce). In obstinate cases change of air is the
best and only remedy.


_Sprains, Blows, and Bruises._ Solution of Sal Ammoniac (332), Hot Water
Fomentations (393), or Evaporating Lotion (380) are most suitable
applications for the early stages. Should there be much swelling and
heat of skin, Leeches (212) may be necessary. When the active symptoms
have subsided, Liniments of Camphor (68), Opium (291), Lemon-grass Oil
(217), or Turpentine (366), are indicated. _In Sprains_, warm
applications, with perfect rest of the part, are best suited for the
first few days. The sprained part should be kept in a raised position,
well supported, and should on no account be allowed to hang down. The
following treatment is highly spoken of in cases of _Sprained Ankle_. As
soon after the accident as possible immerse the foot in a tub of _hot_
water for ten minutes, and then into a tub of cold water for a similar
period. Afterwards put on a wet bandage pretty tight, and cover with
oil-silk, plantain leaf, or other impermeable covering. _To remove
subsequent swelling_, apply Alum Lotion (32). _To remove discoloration_,
Solution of Sal Ammoniac (332).


_Stiff Neck._ Apply Opium Liniment (291).


_Stomach, Acidity of._ Give Lime Water (221). _Bleeding from._ See
_Hæmorrhage from internal organs_. _Pains in._ See _Flatulence,
Flatulent Colic, and Bowels, Spasmodic Affections of_.


_Stomatitis._ See _Mouth, Ulceration of_.


_Sunstroke._ Employ Cold Water Affusion and other measures advised in
Paragraph 386. Artificial Respiration, as described in Appendix A, is
worth a trial where the insensibility is deep and prolonged.


_Syphilis._ On the first appearance of a chancre or ulcer on the penis,
sprinkle its surface with a little very finely powdered Sulphate of
Iron, and this having been removed, dress subsequently with Black Wash
(225) till the sore shows signs of healing. As a local application, Dr.
Aitchison advocates Carbolic Acid. "No time should be lost," he remarks,
"in obtaining medical aid when an ulcer on the penis has formed. But
when it is impossible to get such aid, touch the sore with pure Carbolic
Acid, taking care that the healthy parts are not touched with it. Apply
Sweet Oil to the parts after burning the ulcer, and then dress it as you
would any healthy ulcer until the slough caused by the acid falls off."
Mercury (if at hand) should be given so as to induce slight soreness of
the gums.

To effect this, give one grain of Calomel, with a quarter or half a
grain of Opium, night and morning, and should the gums at the end of a
week not be affected, the dose of Calomel may be doubled. Soreness of
the gums, with a peculiar (mercurial) fetor of the breath and metallic
taste in the mouth, may be taken as an indication that the remedy has
been carried to the required extent, and this condition it is desirable
to maintain until the sore heals or the symptoms subside; this may
occupy four or five weeks. No good, but rather great harm, will result
from carrying the use of mercury beyond this point. Should it cause much
increased flow of saliva (which is very undesirable), use the remedies
advised for _Salivation_, or if during a course of mercury, the sore,
instead of improving, becomes worse, it should at once be discontinued.
Stimulants and all kinds of excitement, as well as exposure to
atmospherical changes, especially wet, should be avoided during its use;
in fact, this treatment requires the greatest care throughout, and
should, if possible, _be never undertaken except under proper medical
supervision_.

Country Sarsaparilla (163), Hydrocotyle (169), and Mudar (242), are
better suited for the more advanced stages of the disease, or when it
becomes constitutional. The use of the Country Sarsaparilla, however,
may well be conjoined with the mercurial treatment from the very
commencement. N.B.—Avoid all the crude preparations of Mercury in use by
the native doctors, or sold in the bazaars; they are likely to do
_incalculable mischief_.


_Tetanus_ (_Lock-jaw_). Try Datura (131). The treatment of Tetanus by
smoking GUNJAH (INDIAN HEMP), introduced by Assistant-Surgeon A. C.
Khastagir (_Indian Medical Gazette_, August 1878), promises to supersede
all others in India if it were only from the fact that the remedy is
procurable at a trifling cost in every bazaar throughout the country,
and that its application is simple in the extreme. A pipe, _hookah_, or
Indian hubble-bubble, charged with about 15 grains of dried Gunjah
leaves, alone or mixed with twice as much tobacco leaves, is to be kept
in readiness, and immediately on the indication of a spasm coming on it
is to be lighted and handed to the patient with directions to smoke. By
the time this is finished, or even before, the spasm relaxes, the eyes
close, and the patient falls into a kind of slumber. The pipe is again
charged, and kept in readiness for the approach of the next spasm, when
the process is repeated with similar results. In this way the drug is
administered day and night uninterruptedly, during which the irritation
of the nervous system slowly but steadily yields to its influence. Mr.
K. details five cases successfully treated in this manner. No auxiliary
medicine, beyond an occasional purgative if required; no solid food
allowed; milk and soup the only nutriments. This treatment is further
advocated by Dr. J. C. Lucas, of the Bombay Medical Service (_Med. Times
and Gaz._, February 21, 1880). The advantages which he claims for it
are—(1) the spasms are cut short; (2) they reappear gradually at longer
and longer intervals; (3) they gradually become not only less frequent,
but less severe; this (4) saves the patient's vital powers, and thus, by
prolonging life and preventing death, life, which would otherwise have
succumbed, may eventually be saved. He places the dose at from eight to
thirty grains, commencing with the smaller dose, and gradually
increasing it as tolerance is established. He insists, properly, on the
vast importance of quiet, _perfect quiet_, in a pure air (without too
much breeze or draught), and he directs that the patient should on _no
account be disturbed to take his food or for any other reason_, for
which opportunity is to be taken when the patient awakes of his own
accord, or from the recurrence of spasm. In the case of very young
children, this mode of treatment cannot, of course, be carried out, but
in all others it seems well worthy of a fair trial.


_Throat, Dry and Irritable States of, giving rise to Cough_, inhale the
vapour of Hot Decoction of Abelmoschus (3) or of Hot Water (390). _In
Inflammatory States of, without Ulceration_, use the same inhalations,
and allow a piece of Nitre to dissolve in the mouth (266). _Relaxed or
Ulcerated Sore Throat._ Use gargles of Alum (29), Capsicum (78), Moringa
(238), Black Pepper (300), or Pomegranate Rind (313), Catechu (89),
Ginger (158), and Omum Seeds (316), used in substance, prove useful in
some cases, as do inhalations of the vapour of Hot Vinegar (377), or
simple Hot Water (390).


_Tic Douloureux._ See _Face Ache and Neuralgia_.


_Tongue, Fissures or Cracks of, in the advanced stages of Fever, &c._
Use Borax (55) or Alum (29).


_Toothache_ sometimes yields to Opium (292*) or Catechu (89) locally
applied, with or without Ginger (157), or Mustard Poultices (253)
externally. Extraction is the only certain cure in the majority of cases.


_Tumours, Painful._ Apply Datura in one of the forms advised in
Paragraph 130, and give Opium (283) or Tincture of Datura (128) at night
to procure sleep. A Tobacco leaf may often be advantageously substituted
for Datura.


_Ulcers_ may be successfully treated by the local application of
solution of Sulphate of Copper (114*). Ceromel (167*) "Oil Dressing"
(338) "Water Dressing" (394), (Dr. Aitchison states that for years he
has discarded Water Dressing in any form to ulcers, but has substituted
for cleansing and dressing them a mixture of one part of Carbolic Acid
and ten of Sweet Oil. He pronounces this a far more effectual mode of
treatment), and Rice Poultices (322), varied according to circumstances;
_if attended with fetid discharge_, Charcoal Poultices (91); _if with
much discharge_, Catechu Ointment or Lotion (90) and Myrobalans Ointment
(257). _To destroy Maggots on surface of_, Butea Seeds (65). _Sloughing,
Gangrenous, or Ill-conditioned Ulcers_ require Alum Ointment (31), Borax
(59), Camphor (75), Ním Poultices (261), Oil of Country Nutmeg (274),
Petroleum (412), _Toddy_ Poultices (355*) Turpentine Ointment (367),
Resin Ointment (372), or Sugar (408). "Irrigation" (395) is most useful
in removing the slough and stimulating to healthy action. _If the pain
and irritation are so great as to prevent sleep_, Opium (283) or
Tincture of Datura (128). _To excessive Granulations_ ("_Proud flesh_"),
apply Sulphate of Copper (114). In all cases Country Sarsaparilla (163),
Hydrocotyle (170), or Mudar (242) may advantageously be given
internally; and _for Ulcers occurring in Scrofulous subjects_, Fish
Liver Oil (137, 138) proves most useful. "Whenever in India an ulcer
looks angry and is in an _unhealthy_ and _non-healing_ condition, as is
the case with Scind boils, Multan sores, Delhi sores, &c. &c., all
applications to the ulcer itself are useless until the general health of
the patient undergoes a thorough alteration. The want of power to heal
in the ulcer shows that the system is in an unhealthy condition and that
it is incapable of putting on the healing process in the ulcer. This
state of things is no doubt due to the climate, malaria, poor food, and
bad water; these combined develop in the system, scurvy, or a condition
of the body allied to scurvy.

"An addition to, and a change in the diet is of the first consequence.
This is to be done by administering _as drugs_ a daily liberal
proportion of _good butter_, _sugar_, and _lime-juice_.

"In many parts of India, especially during the hot weather, _good_
butter is not to be got as a fresh article of food; an excellent
substitute for it is the tinned article, now so readily obtainable,
which, if salt, can be carefully prepared for use by having the salt
washed out of it. The lime-juice should be, if possible, in the form of
_fresh_ limes, lemons, or oranges; rather than the lime-juice of
commerce. Where fresh limes, &c., or lime-juice cannot be procured,
sweet mango pickles, lime pickles, or the bazaar commodity Ám-chur (see
_Index, Scurvy_) should be employed; from the last excellent preserves
and tarts can be made, which are relished as a diet.

"The water supply should be changed, and even, if necessary, condensed
water be drunk, in place of the saline stuff so common along our
north-west frontier, where the river water is to be preferred to that of
brackish wells full of nitrates.

"Other vegetables, such as potatoes, cauliflower, and artichokes should
be added to the dietary if obtainable, and when possible an immediate
change of climate, even for a few days, and to another _water supply_ is
of immense importance.

"The good results in following up the above proposals can be at once
seen in the rapid alteration of the conditions of the ulcer, or ulcers,
which at once begin to take on a healing action. They require after this
but simple dressing, and indeed disappear as if by a miracle, leaving,
however, behind them a _scar_, a well known momento of having once lived
in an unhealthy climate."—_Aitchison._


_Urine, to relieve pain and scalding on passing._ Nitre (269), with Rice
_Conjee_ (322), Decoction of Abelmoschus (2), or of Ispaghúl Seeds (305)
and the Hip Bath (392) generally afford relief. _For Retention_ _of
Urine_, Opium (287*) and a Hip Bath (392), with Hot Water Fomentations
to the pubes, often succeed in recent cases; if these fail, _no time
should be lost in placing the patient under medical care_.


_Uterus, Painful Affections of._ Camphor (73), Opium (289*), Datura
Poultices (130), and Hip Bath (392), either alone or conjointly, are
calculated to afford relief. _Chronic Affections of_, Borax and Cinnamon
(58). _For Prolapsus or descent of_, use vaginal injections of Decoction
of Galls (147), or of Babúl Bark (9), holding Alum (25*) in solution.
_Bleeding from_, see _Hæmorrhage_, and _Menstrual Discharge, Excessive_.


_Vaginal Discharges._ Cubebs (125), and Gurjun Balsam (160) internally
(_given by the mouth_) and vaginal injections of Lime Water (224), Alum
(30) and Decoctions of Babúl Bark (9), Galls (149), or Pomegranate Rind
(313) are indicated. [Employ at first simply cold or warm water
injections, regulating the temperature according to the feelings of the
patient; if these do not benefit, try Solution of Sugar (one part),
Water (four parts). Add Alum or other astringents, if necessary, but do
not commence with them until a fair trial has been given to the simpler
means.—_Aitchison._] For the _Vaginal Discharges of Young Children_, the
local application of Lime Water (224), with Fish Liver Oil (138)
internally offer the best chance of success.


_Vaginal Irritation_ is often removed, like a charm, by the application
to the parts of a very weak solution of Carbolic Acid (one to twenty of
Sweet Oil); if used stronger it is apt to cause pain, this pain is at
once removed by a free application of sweet oil alone (_Aitchison_).


_Voice, Loss of._ Catechu (89), or any of the other measures directed
for _Hoarseness_.


_Vomiting._ Amongst the remedies to allay this, are Infusion of Cloves
(105), Infusion of Ginger, (155), Lemon Grass Oil (216*), and Omum Water
(318), with or without the addition of a little Opium (290). Apply
Mustard Poultices (251), or Turpentine Stupes (362). In obstinate cases
try Leeches (213). Lime Water (223*), though especially adapted for
_Vomiting arising from Acidity of the Stomach_, is well worthy of a
trial in all obstinate cases, especially in the _Vomiting of Infants and
Young Children_. It is best given in milk. _Vomiting in Fevers._ Hot
Water (358).


_Warts_ seldom resist the persevering application for a week or two of
Sulphate of Copper (108); a piece of it moistened should be rubbed
lightly over the wart, avoiding the surrounding skin. It may be applied
once every day, or every other day.


_Wasps Stings of._ See _Bites, Venomous_.


_Water on the Brain._ See _Hydrocephalus_.


_Water-brash (Pyrosis)._ Butea Gum (62), and Lime Water (223) may often
be used with advantage.


_Whites._ See _Leucorrhœa, and Vaginal Discharges_.


_Womb, Affections of._ See _Uterus, Affections of_.


_Worms._ _For Tænia, or Tape Worm_, give Kamala (189), Pomegranate Root
Bark (314), or Turpentine (365). When one fails another will often
succeed. _For Lumbricus or Common Round Worm_, try Butea Seeds (64),
Vernonia Seeds (373_b_), or Papaw Juice (295).

The best remedy in these cases is SANTONIN, and considering the great
prevalence of these worms amongst the people of India, and the many
anomalous nervous and other affections to which they give rise, it is
advisable always to have on hand a supply of this drug. The dose for
children under four years is from two to four grains; above twelve years
from six to eight grains, rubbed up with about twice its weight of sugar
repeated every six or eight hours thrice in succession. A good plan is
to give the Santonin at bedtime, and a small dose of Castor Oil in the
morning, three days in succession. In many cases, it has been stated, no
aperient is needed, one or two stools succeeding its administration
containing the worms, if any are present; still, it is safer to follow
up its use by an aperient. It is of little or no use in Tape Worm; and
in Thread Worm, though it will aid, often strikingly, in removing the
worms, it will not prevent their reappearance. For Round Worm it is by
far the most effectual remedy we possess. _For Ascarides, or Thread
Worm_, use enemas of Lime Water (227), Asafœtida (36), or Turpentine
(365).


_Wounds, Ulcerated._ See _Ulcers, Bleeding from_. See _Hæmorrhage_.




APPENDIX A.

DIRECTIONS FOR RESTORING THE APPARENTLY DEAD FROM DROWNING.

(_Reprinted by permission from the Directions issued by the
Royal Humane Society._)


As soon as the body is taken out of the water, lay it on the ground,
wipe it dry, and let the wind blow freely upon the surface. With this
view, on no account let people crowd round the body.

The points to aim at are—first, and immediately, the RESTORATION OF
BREATHING; and secondly, after breathing is restored, the PROMOTION OF
WARMTH AND CIRCULATION.


Treatment to Restore Natural Breathing.

RULE 1.—_To maintain a Free Entrance of Air into the Windpipe._—Cleanse
the mouth and nostrils;[3] open the mouth; draw forward the patient's
tongue, and keep it forward; an elastic band over the tongue and under
the chin will answer this purpose. Remove all tight clothing from about
the neck and chest.

RULE 2.—_To adjust the Patient's Position._—Place the patient on his
back on a flat surface, inclined a little from the feet upwards; raise
and support the head and shoulders on a small firm cushion or folded
article of dress placed under the shoulder blades.

RULE 3.—_To imitate the Movements of Breathing._—Grasp the patient's
arms just above the elbows; and draw the arms gently and steadily
upwards, till they meet above the head (this is for the purpose of
drawing air into the lungs), and keep the arms in that position for two
seconds. Then turn down the patient's arms, and press them gently and
firmly for two seconds against the sides of the chest. _See_ Engravings
I. and II. (This is with the object of pressing air out of the lungs.
Pressure on the breastbone will aid this.)

Repeat these measures alternately, deliberately, and perseveringly,
fifteen times in a minute, until a spontaneous effort to respire is
perceived, immediately upon which, cease to imitate the movements of
breathing, and proceed to INDUCE CIRCULATION AND WARMTH (_as below_).

Should a warm bath be procurable, the body may be placed in it up to the
neck, continuing to imitate the movements of breathing. Raise the body
in twenty seconds in a sitting position, and dash cold water against the
chest and face, and pass ammonia under the nose. The patient should not
be kept in the warm bath longer than five or six minutes.

 [Illustration:
 I.—INSPIRATION.
 II.—EXPIRATION.
 _To illustrate the position of the Body during the employment of
 this Method of Inducing Respiration._]

RULE 4.—_To excite Inspiration._—During the employment of the above
method excite the nostrils with snuff or smelling salts, or tickle the
throat with a feather. Rub the chest and face briskly, and dash cold and
hot water alternately on them.


Treatment after Natural Breathing has been Restored.

RULE 5.—_To induce Circulation and Warmth._—Wrap the patient in dry
blankets and commence rubbing the limbs upwards, firmly and
energetically. The friction must be continued under the blankets or over
the dry clothing.

Promote the warmth of the body by the application of hot flannels,
bottles or bladders of hot water, heated bricks, &c., to the pit of the
stomach, the armpits, between the thighs, and to the soles of the feet.
Warm clothing may generally be obtained from bystanders.

On the restoration of life, when the power of swallowing has returned, a
teaspoonful of warm water and subsequently small quantities of wine,
warm brandy and water, or coffee should be given. The patient should be
kept in bed, and a disposition to sleep encouraged. During reaction
large mustard plasters to the chest and below the shoulders will greatly
relieve the distressed breathing. Great care is requisite to maintain
the restored vital actions, and at the same time to prevent undue
excitement.

The above treatment is to be persevered in for three or four hours, or
until the pulse and breathing have ceased for at least one hour. It is
an erroneous opinion that persons are irrecoverable because life does
not soon make its appearance; as cases are on record of a successful
result even after five hours' perseverance in the use of the above means.


APPEARANCES WHICH GENERALLY INDICATE DEATH.

There is no breathing or heart's action; the eyelids are generally half
closed; the pupils dilated; the jaws clenched; the fingers
semi-contracted; the tongue appearing between the teeth, and the mouth
and nostrils are covered with a frothy mucus. Coldness and pallor of
surface increase.

[Footnote 3] A good plan is to turn the body gently over for a few
seconds with the face to the ground, one of the hands being placed under
the forehead. By this means the water will run out of the mouth and the
tongue will fall forward, leaving the breathing opening free. On no
account should the body be held up by the feet as has been advised by
some old writers.




APPENDIX B.

SUMMARY OF TREATMENT OF PERSONS BITTEN BY VENOMOUS SNAKES.[4]


As soon as possible after a person is bitten by a snake, apply a
ligature, made of a piece of cord, round the limb or part at about two
or three inches above the bite.

Introduce a piece of stick or other lever between the cord and the part,
and by twisting tighten the ligature to the utmost (See Stick
Tourniquet, p. 224).

Apply other two or three ligatures above the first one at intervals of
four or six inches, and tighten them also. After the ligature has been
applied, scarify by cutting across the puncture to the depth of a
quarter of an inch with a penknife or other similar cutting instrument,
and let the wounds bleed freely; or better still, excise the punctured
part.

Apply either a hot iron or live coal to the bottom of these wounds as
quickly as possible, or some carbolic or nitric acid.

If the bite be not on a finger or toe or part where a ligature can be
applied, raise up the integument with the finger and thumb, and with a
sharp penknife cut out a circular piece as big as a finger nail round
each puncture, _i.e._, round the points of the finger and thumb, to the
depth of quarter to half an inch. Then apply the hot coal or hot iron to
the very bottom of the wounds.

Give fifteen drops of Liquor Ammoniæ, diluted with an ounce of water,
immediately, and repeat it every quarter of an hour for three or four
doses, or longer, if symptoms of poisoning appear.

Or give hot brandy, or rum, or whisky, or other spirit, with an equal
quantity of water, about an ounce of each (for an adult) at the same
intervals.

Should no symptoms of poisoning appear in half an hour after the
application of the ligatures they should be relaxed, or the part will
perish from gangrene; if they should, however, appear, the ligatures
should not be relaxed until the person be recovering from the poison, or
until the ligatured part be cold and livid.

Suction of the wounds is likely to be beneficial, but as it may be
dangerous to the operator, it cannot be recommended as a duty.

If, notwithstanding, symptoms of poisoning set in, and increase, if the
patient become faint or depressed, unconscious, nauseated or sick, apply
Mustard Poultices, or Liquor Ammoniæ on a cloth, over the stomach and
heart; continue the stimulants, and keep the patient warm, but do not
shut him up in a hot, stifling room or small native hut; rather leave
him in the fresh air than do this.

Do not make him walk about if weary or depressed; rouse him with
stimulants, mustard poultices, or ammonia, but let him rest.

If the person be first seen some time after the bite has been inflicted,
and symptoms of poisoning are present, the same measures are to be
resorted to. They are less likely to be successful, but nothing else can
be done.

In many cases the prostration is due to fear; the bite may have been
that of a harmless or exhausted snake, and persons thus bitten will
rapidly recover under the use of the above measures. If poisoned, but,
as is frequently the case, not fatally, these measures are the most
expedient; if severely poisoned, no others are likely to be more
efficacious.

People should be warned against incantations, popular antidotes, and
loss of time in seeking for aid.

To the above remarks, Sir J. Fayrer adds: "The measures suggested are no
doubt severe, and not such as under other circumstances should be
entrusted to non-professional persons. But the alternative is so
dreadful that even at the risk of unskilful treatment, it is better that
the patient should have this chance of recovery."


PRECAUTIONS TO BE OBSERVED BY PERSONS RESIDING IN SNAKE-INFESTED
LOCALITIES.

That prevention is better than cure is admitted on all hands; hence
those persons whose lot is cast in snake-infested localities will do
well to lay to heart the following passage from the official "Report on
Indian and Australian Snake-poisoning," by Drs. Joseph Ewart, Vincent
Richards, and S. Coull Mackenzie (Calcutta, 1874).

The poisonous snakes of India, as a general rule, "are, until provoked,
perfectly inoffensive to all animals not required by them as food. They
seldom assume the aggressive until they are rudely and accidentally
disturbed. Thus a native sleeping on the ground rolls over a venomous
snake, or whilst walking in the jungle, or long grass, or in the dark,
treads upon some part of a snake's body. In either case the snake bites
if he can. It is in this way that a large proportion of snake accidents
happen.

"A large number of lives would be saved annually if the native
population could be prevailed upon to _sleep on charpoys_, and if they
got into the habit of _never stepping from their beds at night without
first seeing, by means of a light, that the ground below is clear, and
free from snakes_. Much of the immunity which Europeans and educated
natives enjoy from snakebite is due to their using these very necessary
precautions, especially during the rainy season, and in the mofussil by
their _never walking abroad at night without a light_. There is scarcely
a European of experience in the mofussil who cannot recount examples of
lives (often their own) having been saved by means of these simple
precautions."

To the above judicious advice (the most important points of which I have
italicised) may be added the following excellent practical precautions,
communicated to me by friends whose Indian experience gives great weight
to their suggestions.

1. Snakes never voluntarily traverse rough or broken ground: it is
therefore advisable in snake-infested localities to surround your
dwelling with a cordon or belt of broken bricks or kunkur—a breadth of
three or four feet is quite sufficient for the purpose.—_Dr. Norman
Chevers._

2. Be careful, especially during the wet season, to keep the verandahs,
&c., free from frogs: a frog is a temptation which a snake has little or
no power to resist.—_Dr. Norman Chevers._ The same remark is equally
applicable to rats.

3. In the cold season, if you see a snake coiled up or in an apparently
lifeless state in an open, well-frequented road or pathway, be careful
how you approach him. Should you handle or disturb him roughly, he will
in all probability rouse up and bite you. He is only torpid from cold,
not dead.—_Dr. Norman Chevers._

4. Have a piece of perforated zinc or tin fitted to the opening made for
the purpose of carrying off the water out of the bath-room, if it be on
the ground floor. A similar piece should be added to the bottom of the
bath-room door should it not (as it rarely does) reach the ground
beneath.—_Mr. Arthur J. Waring._

5. Discard vegetation, especially thick straggling shrubs like the
Rangoon Creeper, close to your house. They are very apt to harbour
snakes.

6. Important as are the above "Precautions," they are comparatively of
small moment compared with the destruction—extermination if possible—of
the snakes themselves. And this can only be efficiently carried out
under Government supervision. That this is the only mode of effectually
grappling with this gigantic evil, under which thousands of lives are
annually sacrificed—the numbers are 19,060 in 1880, and 18,610 in 1881,
besides 4568 cattle in the two years—is forcibly set forth by Sir Joseph
Fayrer in two able papers in _Nature_, December 28, 1882, and January
18, 1883. Most earnestly is it to be hoped that Government, agreeably to
his suggestion, will lose no time in establishing a department, with a
responsible chief and subordinate agents, under whom a system of
organised, determined, and sustained efforts for the destruction of the
snakes shall be adopted and carried out. It would be a public boon if
Sir Joseph's two papers were reprinted in pamphlet form, and circulated
throughout the length and breadth of India.

In the meanwhile zealous individual effort should be brought to bear in
the same direction. To this end money rewards (heading the list with
eight annas for a Cobra) should be freely offered to the natives for
every dead poisonous snake brought in, but _for poisonous ones alone_.
Of these there are life-like coloured plates in Fayrer's _Thanatophidia
of India_, and in Ewart's _Poisonous Snakes of India_, one or other of
which works is to be found in almost every large station, and which it
is highly desirable for every one to make himself acquainted with. One
other point remains to be noticed, namely, the necessity of carefully
impounding every such dead snake brought in and paid for; otherwise it
is likely to do duty a few hours later, or even next day, or it may be
made the means of extracting further "buck-sheesh" from one or more of
the neighbouring "_Sáhib-lóg!_"

[Footnote 4] Reprinted by permission from Sir Joseph Fayrer's splendid
work, _The Thanatophidia of India_. Folio. London: Churchill. 1874.




APPENDIX C.

METHOD OF TREATMENT OF SMALL-POX BY MEANS OF CARBOLISED OIL.


My reason for giving this treatment of small-pox in detail is the
frequent presence of the disease in India, in an epidemic form amongst
the natives, with the hope that it may prove useful in ameliorating it,
and thus save many useful lives which otherwise would probably succumb
to its ravages from the terrible purulent discharge acted upon by a hot
climate, creating a form of disease scarcely known in colder latitudes.

Before attending upon or assisting in the treatment of a case of
small-pox, it is the duty of every one to see that they, their
households, and those others who are likely to attend upon the case are
sufficiently protected from the likelihood of infection by having been
properly vaccinated, and that this operation had been successfully
performed within at least four years. When there is a necessity for any
one coming into immediate contact with the disease, as on the occurrence
of an epidemic, it is advisable to be vaccinated whenever such epidemics
occur.

There is a general belief that vaccination does not prove a success in
the hot weather in India; do not credit this. If small-pox occurs as
virulently as it does during the hot weather, on occasion, the success
of the vaccination is also a certainty, if performed with care and a
determination in its success.

Never mind how young an infant is, vaccinate it, even if it is only a
day old, if you believe there is any probability whatsoever of its
having come into, or likely to come into, contact with the infection of
small-pox. Remember "the mortality of small-pox in childhood is very
high up to the age of ten years. Infants usually succumb to the disease
even in the discrete form."

Since the time that I first gave my opinion to Dr. Waring (in 1872) upon
the treatment of small-pox with carbolised oil, I have seen a good deal
more of the disease, and I still, with slight modifications, maintain my
preference for this form of treatment. When I first used the application
I employed a mixture of one part of Carbolic Acid and ten parts of Sweet
Oil, applied twice daily over the whole body. I now advocate the
employment of one part of Carbolic Acid to fifteen parts of any bland or
Sweet Oil, moistening the body on such parts as may require it,
frequently during the day and night.

Sesamum or Til Oil is ordinarily the most easily procurable throughout
India, but any of the following will do: Poppy, Ground-nut, Apricot,
Walnut, Cocoa-nut, Linseed, Almond, or Olive Oil, the two last being
rather expensive. On no account be led into using any of the Mustard
oils, which, owing to the natives using some of them in their diet, are
occasionally spoken of as "sweet oils."

At whatever stage of the disease the patient comes under treatment, at
once apply this liniment over all the parts being affected, or are
affected by the eruption, by means of a mop of soft cotton-wool (_never
on any account employ a sponge_); apply the liniment freely as if you
were treating a severe burn, and then carefully cover the oiled surface
with cotton-wool, so as to exclude all air, and keep the cotton-wool
dressing in position. The carbolised oil to be freshly reapplied every
four or six hours, so as to keep the parts moist, and the cotton-wool to
be renewed every forty-eight hours. If flakes of wool stick into the
broken skin, moisten these freely with oil, but do not tear them away.
Any amount of cotton-wool can be obtained throughout India at the
smallest hamlet, on a few hours' notice; and at all hours in any bazaar.

Let the patient lie between blankets, not cotton sheets; in commencing
to dress the patient on the first occasion have a layer of cotton-wool
placed upon the lower blanket, then place the patient on this
cotton-wool naked, cover with a similar sheet of cotton-wool and over
this again a blanket; having done this, set to and piecemeal dress the
whole body, where the presence of the coming eruption requires it, with
the carbolised oil, and cotton-wool, supporting the position of the
cotton by means of very light bandages, or by a few stitches with a
needle and thread, so as to keep the wool carefully together as well as
firmly against the body. If suitable under the circumstances, a thin
elastic gauze jersey and drawers keep the cotton protected from being
rubbed off by restless patients.

So soothing and comforting is the application of the oil, that almost
the youngest patients look forward to its re-application, will at once
tell you when the body is getting hot and dry, and will in all
probability ask to be allowed to apply the liniment themselves when they
begin to feel uncomfortable, especially at the inflammatory stage of the
vesicles when they are just changing to their pustular condition.

What is gained by the above treatment?

1. The carbolised oil soothes and cools down the inflamed surface of the
skin, exactly as is done when oil is applied to a burn.

2. The cotton keeps all air from the skin, and aids in keeping the skin
moist with the oil.

3. The oil saturates the surface of the eruption, penetrates into the
skin desiccation, and as the oil becomes heated by the temperature of
the body it gives off some of its carbolic acid in the form of gas.

4. The carbolic acid keeps the oil from becoming rancid.

5. If the liniment is applied to the eruption at a sufficiently _early_
stage, viz., when the eruption is becoming vesicular, the carbolised oil
on the surface of the eruption, and the gaseous carbolic acid, between
the skin and the cotton and in the interstices of the cotton, prevent
the microbes of the atmosphere from coming into direct contact with the
epidermis, and subsequently with the contents of the vesicle, the result
of which is the contents of the vesicle do not become pustular and
purulent; and the eruption dries up without ulceration.

6. If the liniment is applied _late_ in the vesicular stage, or not
until the pustular stage has set in, the carbolised oil penetrates more
or less into the epidermis which is being thrown off by the suppuration
of the pustule; as the pus is discharged by rupture of the epidermis the
oil mixes with the pus, disinfects it, and keeps it sweet, as is to be
observed by the entire non-existence of, or extremely modified condition
of, the horrid stench that accompanies small-pox, subsequent to the
pustular stage of the disease.

7. The exuviæ becoming loaded with the carbolised oil, are (probably)
disinfected and are incapable of spreading the disease.

8. If the eruption is prevented from reaching the pustular stage, the
complications that would otherwise have resulted from pus absorption are
no longer to be dreaded, such as the secondary fever, boils, abscesses,
acute cellulitis, erysipelas, pyæmia, &c. &c.

No eroding ulcers with deep cavities, leaving the well-known cicatrices
of small-pox, are produced.

9. The pustular stage having occurred before the carbolised oil
treatment was applied, it still proves of immense value, as it prevents
the pus becoming impure and poisonous, and this greatly ameliorates the
results of the disease even at this stage.

So long as the disease lasts is this application to be applied, limited
certainly to the extent of the eruption; as long as this treatment is
being adopted, not a drop of water should be allowed to touch any part
of the skin surface (no washing of any sort) until healthy action of the
skin has set in, recognised by the falling off of the crops of scabs,
without any raw, ulcerated surfaces.

Is there any danger to the patient from the absorption of the carbolic
acid into the system? So long as the oily solution is used, and no water
allowed to come into contact with the skin, I consider there is little
or no danger, but it is necessary _always to be careful_. Should the
patient be suffering from the absorption of the carbolic acid, you will
find a cold, clammy skin, rapid fall of both temperature and pulse, and
the urine of a smoky _greenish-brown_ colour, and having the odour of
carbolic acid. In many cases of small-pox, but where no carbolic acid
has been employed, the urine becomes smoky-brown, but it has not the
peculiar greenish tinge of where carbolic acid is present. To judge the
odour correctly, the urine should be put into a fresh dish and examined
in some other room, or, what is better, the open air, so that there can
be no mistake, as the air of any house gets so saturated with the odour
of carbolic acid that it is not easy to judge whether the odour is that
of the air or of the urine. If danger from excess of absorption of
carbolic acid is feared, do not give up the treatment, but lower the
strength of the carbolic acid in the oil to 1 in 20, and more or less
limit the number of the applications. But what is far more important,
see that there is abundance of ventilation in the room. I would fear
more from a close chamber and excess of carbolic acid vapour in the air
than the possibility of the excess of acid having been absorbed from the
oil. Remember you are not dealing with a _watery_ solution where there,
I believe, _is danger_, as water, besides quickly evaporating, rapidly
yields up its carbolic acid to the tissues, which too readily absorb it.
Oil but slowly evaporates, and with difficulty parts with the carbolic
acid it holds in solution to the tissues.

All the swabs, mops, &c., of cotton-wool, and the wool itself that may
have been employed in treating a case, should be burnt at once when they
are no longer required.

The blankets and bedding, after a good washing and exposure to sun, will
be found to be free of infection, and may be again with safety employed.

Upon the above principles I have treated the vesicle of vaccination,
with much comfort to the patient, and in most of the cases entirely
prevented the pustular stage.

 AITCHISON.




APPENDIX D.

THE CLINICAL THERMOMETER.


The possession of a self-registering Clinical Thermometer in every
household, in a tropical or malarious climate is a necessity, more
especially when at a distance from medical aid. It is a means for
assisting to ascertain most accurately, in a very few minutes, whether a
child or patient is really ill, and the necessity there might be for the
administration of remedies; for calling in other and more proficient
assistance; or to allay anxiety that might have accrued from a nervous
fear, when possibly no actual illness existed.

From one single observation of an _abnormal_ temperature, we learn:

"1. That the patient is really bodily ill.

"2. When there is considerable elevation of temperature, we know that
there is fever.

"3. When there are extremes of temperature, we know that there is great
danger.

"The mean normal temperature of the human body in health is 98·6°
Fahrenheit's scale."[5] This may vary in health, in exceptional cases
from 97·5° to 99·5° Fahrenheit.

The accompanying diagrams represent (_A_) a thermometer that has been
employed, we will say, in a case of Intermittent fever, the Index
showing the temperature to have been 104°; (_B_) a thermometer with the
Index at 95°.

The Index in a Clinical Thermometer is a small quantity of mercury
separated by a bubble of air from the rest of the mercury; or, owing to
the peculiar construction of the glass tube, without any air being
present, a portion of the mercury separates itself from the bulk, and
remains separated in the tube, as an Index. Upon placing the Thermometer
in a favourable situation, in or against the body of a patient, owing to
the amount of heat with which it there comes in contact, the mercury in
the bulb expands, and the Index is pushed up to the highest point in the
Thermometer that the heat of the body at that time is capable of
causing, if the Thermometer is kept in contact with the body for the
requisite time; and when the Thermometer is removed from its contact
with the body, the mass of mercury suddenly cooling down, contracts, and
returns into the bulb, the Index being left behind at the point to which
the heat of the body had forced the mercury in the bulb to raise it;
thus the Thermometer in Diagram A shows that in that instance the Index
had been raised to 104° Fahrenheit and that that was the temperature of
the body at that observation.

In commencing to take the temperature of a patient, first of all see
that the Index is in the position as seen in Diagram _B_, not
necessarily always as low as 95°, but at all events well under the arrow
→, which marks off the mean normal temperature of any one in healthy
viz., 98·4° Fahrenheit, as given in most English thermometers (98·6° as
used on the Continent). The temperature of an infant or young child is
frequently found to be 99° whilst in health.

Supposing a Thermometer is put into any one's hands, reading as at
Diagram _A_ 104°, how is the Index to be replaced to the position it
occupies in Diagram _B_? Hold the Thermometer by its upper end (the bulb
being considered the lower end) then swing it round with your arm,
suddenly stopping the arm with a jerk, this jerk causes the Index to
fall towards the bulb, continue this, and after each jerk see how far
the Index has fallen, when it has got well under the arrow →, the
Thermometer for an ordinary case is ready for use.

When, however, one expects a low temperature, it is best to have the
Index of the Thermometer at or under 95°.

[Illustration: Fahrenheit's Scale.]

How and when to apply the Thermometer. With grown up children and adults
I have always found it more convenient to take the Temperature by
placing the bulbous end of the Thermometer into the mouth under the
tongue, keeping it there, with the mouth, shut, for the requisite time,
the patient in the meanwhile breathing only through the nostrils; with
infants the most convenient place is to put the Thermometer in the
flexure of the thigh, laying one of the thighs somewhat across the
other, but being careful not to allow the clothes to touch the
Thermometer; some prefer to place it in the armpit, or axilla. This I
have not found always as convenient as the other two localities; any of
these, however, is good for the purpose. Use the one you may deem most
convenient, but be careful to keep the clothes from coming into contact
with the Thermometer.

Thermometers are now made with such a rapid action, that at the very
longest they do not now require to be kept in position for more than
three minutes.

Immediately after having made an observation note down the temperature,
along with the time at which the observation was taken; having done so,
and not before, wash the Thermometer, but _not with hot water_, _and
then_ jerk down the Index; so that the Thermometer is ready for future
use. If the reading is in any way a doubtful one, take another
observation at once.

If there is any anxiety connected with the case, it is advisable to take
an observation every three hours, so long as the patient is awake;
_never disturb_ a patient during natural sleep for the purpose.
Ordinarily take an observation two or three times during the day, but at
set hours and at regular intervals, always noting the time.

Whenever the temperature of a patient is found to be below or above the
_normal_ 98·4°, viz., the arrow-mark on the Thermometer, then watch the
case, as one requiring care. If the temperature has fallen as low as
97°, or gone up to 100°, make up your mind that there is something
wrong; be vigilant. But a falling temperature below 97° means danger
from collapse, and a rising one reaching 105° is a dangerous fever heat.
In the last two occurrences remedial agents require to be applied to at
once, and medical assistance urgently asked for.

Along with each thermometric observation, it is advisable to count the
pulse, and the number of respirations [the average number of pulsations
in a minute of a healthy adult are about 72, and the number of
respirations about 16. In _young_ children and _infants_ the number of
pulsations and respirations are usually much higher than in the adult,
and so irregular that to the non-professional their value alone in
diagnosing disease may be considered as doubtful, other signs and
symptoms require to be more carefully studied, and taken into
consideration along with them, and the temperature] that occur during
the minute (the latter is easily done by laying the open hand on the
upper part of the abdomen, and counting the number of _rises_) noting
these, along with the temperature, and the time. Such data, if taken
carefully and at regular intervals of time, form an invaluable means for
assisting the physician in his diagnosis.


 EXAMPLE.

 +-----------------------+---------+---------+---------+
 |                       | May 17. | May 17. | May 17. |
 +-----------------------+---------+---------+---------+
 |Time                   |  9 A.M. | 12 noon |  3 P.M. |
 |Temperature            |   98·4° |   100°  |   100°  |
 |Number of Pulsations   |   72    |    80   |    80   |
 |Number of Respirations |   16    |    20   |    20   |
 +-----------------------+---------+---------+---------+

 AITCHISON.

[Footnote 5] _Medical Thermometry_, by Dr. C. A. Wunderlich, translated
by W. Batherst Woodman, M.D. 1871, p. 6.




APPENDIX E.


List of articles required for carrying out the directions
contained in this work:

   A set of Apothecaries' Scales and Weights (with
   an extra set of Weights).
 1 Wedgwood Pestle and Mortar (medium size).
 2 Measure Glasses (up to 6 ounces).
 2 Minim Glasses.
 1 Imperial Pint (20 ounces) Pewter Measure.
 2 Glass Male (Urethral) Syringes.
 2 Pewter ditto.
 2 Glass Female (Vaginal) Syringes.
 1 Metallic ditto ditto (large).
 1 Enema Apparatus, fitted with metallic tubes,
   &c. Those with India-rubber or Caoutchouc
   flexible tubes are to be avoided, as they
   readily spoil in hot climates.
 1 Self-registering Clinical Thermometer.
 2 Earthenware Slabs for mixing Ointments,
   Pills, &c.
 3 Spatulas varying in size and length.
 1 Nest of Wedgwood or Tin Funnels.
 1 Nutmeg Grater.
 2 Lancets in a case.
 3 Yards of best Diachylon or Sticking Plaster (in
   tin case).
 2 Yards of Lint.
 1 Small Actual Cautery Iron.⎫ For snake-bites, advised
 1 Sharp Penknife or Scalpel.⎬  by Sir J. Fayrer.
 6 Pieces of Whipcord.       ⎭  See Appendix B.


MEDICINES.

(These had better be purchased from some good firm of chemists and
druggists.)

All should be kept in glass-stoppered, or well-corked bottles,
protected, as far as possible, from the action of light and heat, and
placed under lock and key; some special person being responsible for
their being given out for use.

(It is as well to note here that _all_ the _Poisonous drugs_ and _their
preparations_ that are being dispensed should be _equally carefully_
cared for, and placed in a special locker of their own, marked POISON,
under a caretaker, who ought to be held responsible for their safe
custody.—_Aitchison._)

 Sulphate of Quinine,    2 ounces.
 Powdered Ipecacuanha,   8   "
 Santonin,               4   "
 Bromide of Potassium,   4   "

The following should be marked:

 POISON
 (To be administered with caution).

 Calomel,                4 ounces.
 Acetate of Lead,        8 ounces
 Opium (in 1 grain pills), No. 200
   "     as Laudanum,    8 ounces
 Liquor Ammoniæ,         8   "

(In a hot climate great care should be taken in handling and opening a
bottle containing Liquor Ammoniæ, as on very little provocation, as
shaking the bottle in trying to remove the stopper, which nearly always
becomes fixed, it is almost certain to burst. The stopper therefore
should be extracted with as little force as possible, and at the same
time care should be taken that the contents do not fly up into the face
and eyes.—_Aitchison._)

 The following should be marked:

 POISON
 (For external application only).

 Biniodide of Mercury,   4 ounces.
 Blistering Fluid,       4   "
  (this is the Liquor Epispasticus of the British Pharmacopœia.)
 Carbolic Acid,          2 pints.

(When pure this is solid at a temperature of nearly 102° Fahr., above
that it becomes liquid; before giving it out therefore for use, liquefy
a sufficiency, by placing the _unstoppered_ bottle in the sun, or near a
fire, or in a little warm water, and then from the bottle measure out
the quantity required; in doing so, remember the fact that whilst pure
it is a _severe caustic_.—_Aitchison._)




 INDEX OF ARTICLES.
 PAGE


 Abelmoschus esculentus, 9

 Abrus precatorius, 10

 Acacia Arabica, 12
   „    Catechu, 41

 Aconitum heterophyllum, 24

 Aconite root, 191

 Acorus Calamus, 13

 Ægle Marmelos, 25

 Affusion, Water, 163

 Ajwain Seeds, 130

 Aloe Indica, 15
   „  litoralis, 15
   „  Socotrina, 14

 Aloes, 14

 Alum, 17
   „  Poultice, 18
   „  Whey, 18

 Am-chur, 245

 Ammonia, Hydrochlorate of, 135

 Ammonium, Chloride of, 135

 Anamirta Cocculus, 48

 Andrographis paniculata, 82

 Andropogon, Sp. of, 89

 Anethum Sowa, 61

 Arrack, 150

 Arrowroot, 182

 Asafœtida, 22

 Asteracantha longifolia, 23

 Atís or Atees, 24

 Azadirachta Indica, 105


 Babúl Bark, 12

 Bael Fruit, 25
   „  Dietetic, 26

 Banana Tree, 127

 Bananas, Dried, 246

 Barleria longifolia, 23

 Beef Tea, 180

 Bengal Kino, 32

 Betel or Betle Leaves, 27

 Biniodide of Mercury, 221, 249

 Blistering fluid, 288
   „        liquid, B.Ph., 147

 Blisters, Remarks on, 147

 Blue Stone, 49

 Bonduc Nut, 28

 Borax, 29

 Brandy Mixture, 183

 Butea frondosa, 32
   „   Gum, 32
   „   Seeds, 33


 Cæsalpinia Bonducella, 28

 Calcareous earth, 90

 Calotropis gigantea, 97
   „        procera, 97

 Camphor, 34
   „     Water or Julep, 34
   „     Liniment, 34
   „     Vapour Bath, 35

 Cantharides, 146

 Capsicum fastigiatum, 37
   „      Fruit of, 37

 Canara, Vegetable Tallow of, 157

 Canarium strictum, 156

 Carbolic Acid in Burns, 196
   „           in Leprosy, 231
   „           in Small-pox, 247-274
   „           in Syphilis, 250
   „           in Ulcers, 254

 Carica Papaya, 120

 Carum Ajowan, 130

 Caryophyllus aromaticus, 47

 Cassia alata, 38
   „    lanceolata, 140

 Castor Oil, 39
   „        Plant, Leaves of, 40

 Catechu, 41

 Ceromel, 74

 Charcoal, 43
   „      Poultice, 43

 Chaulmúgra, Seeds and Oil, 44

 Chavica Betle, 27

 Chicken Broth, 180

 Chiretta, 45

 Chloride of Ammonium, 135

 Cinchona Febrifuge, 171

 Cinnamon, 46
   „      Country, 46

 Cinnamomum iners, 46
   „        Zeylanicum, 46

 Citrus Bergamia, 94

 Cloves, 47

 Cocculus Indicus, 48

 Conjee Water, 134

 Cookery for the Sick, 180

 Copper, Sulphate of, 49

 Country Ipecacuanha, 155
   „     Nutmegs, 111
   „     Sarsaparilla, 72

 Creyat, 82

 Croton Tiglium, 52
   „    Seeds, 52
   „    Oil, 53

 Cubeba officinalis, 54

 Cubebs, 54

 Curcuma longa, 150

 Cybium commersonii, 61


 Dammar, White, 156
   „     Black, 156

 Darjeeling Cinchona Alkaloid, 171

 Datura alba, 55
   „    fastuosa, 55
   „    Poultice, 58
   „    Epithem, 58
   „    Liniment, 59

 Dill Seeds, 61
   „  Water, 61

 Dipterocarpus lævis, 70

 Drowning, Treatment of, 261


 Egg Wine, 184

 Evaporating Lotion, 160


 Feronia Elephantum, 26

 Fish-liver Oil, 61

 Fomentations, Hot Water, 166


 Galls, 66

 Garcinia purpurea, 83

 Ginger, 69

 Guilandina Bonducella, 28

 Gulancha, 148
   „      Extract of, 149

 Gunjah in Tetanus, 252

 Gurjun Balsam, 70

 Gynocardia odorata, 44


 Hemidesmus Indicus, 72

 Henna Shrub, 84

 Hibiscus esculentus, 9

 Honey, 74

 Horseradish Tree, 96

 Hydnocarpus inebrians, 44

 Hydrochlorate of Ammonia, 135

 Hydrocotyle Asiatica, 75


 Indian Hemp in Tetanus, 252
   „    Sarsaparilla, 72
   „    Spikenard, 79
   „    Liquorice, 10
   „    Senna, 140

 Ipecacuanha, Country, 155
   „         in Dysentery, 210
   „         as an Emetic, 206

 Iron, Sulphate of, 76

 Irrigation, 167

 Ispaghúl Seed, 125


 Jasminum Sambac, 235

 Jatamansi, 79

 Jatropha Curcas, 124

 Jelly, Strengthening, 185

 Jinjili Oil, 141

 Kala-dana, 80

 Kamala or Kaméla, 81

 Káriyat, 82

 Kerosene Oil, 177

 Kino, Bengal, 32

 Kokum Butter, 83


 Laudanum, 112

 Lawsonia alba, 84

 Leeches, 85

 Lemon-grass Oil, 89

 Lemonade, 95

 Lime, 90
   „  Liniment, 94
   „  Saccharated, 91
   „  Water, 91

 Limes (The Lime), 94
   „   Juice of, 95

 Liquor ammoniæ, 267-288

 Liquor Epispasticus, 288

 Liquorice root, country, 10


 Mace, 111

 Mallotus Phillippiensis, 81

 Mangoes, Dried, 245

 Margosa Tree, 105

 Meat Juice, Raw, 180

 Moringa pterygosperma, 96

 Mudar, 97

 Musa sapientum, 127

 Mustard, 99
   „     Poultices, 100

 Mutton Broth, 180

 Mylabris Cichorii, 145

 Myrobalans, Chebulic, 103
   „         Emblic, 104

 Myristica officinalis, 110
   „       Malabarica, 111


 Nardostachys Jatamansi, 79

 Ním Tree, 105

 Nitrate of Potash, 107

 Nitre, 107
   „   Paper, 109

 Nutmegs, 110
   „     Country, 111

 Nux vomica, 239


 Oil, Castor, 39
   „  Chaulmúgra, 44
   „  Croton, 53
   „  Fish-liver, 61
   „  Jinjili, 141
   „  Lemon-grass, 89
   „  Nutmeg, Indian, 111
   „  Omum, 132
   „  Rock, 175
   „  Sandal-wood, 139
   „  Sesamum, 141
   „  Til, 141
   „  Turpentine, 151
   „  Turtle, 62
   „  Wood, 70

 Okra, 9

 Omum Seeds, 130
   „  Oil, 132
   „  Water, 131

 Ophelia Chirata, 45

 Opium, 111
   „   Rules for administering, 114

 Oryza sativa, 133

 Oxide of calcium, 90


 Papaver somniferum, 111

 Papaw Tree, 120

 Pedalium Murex, 122

 Pepper, Black, 123

 Petroleum, 175

 Pharbitis Nil, 80

 Phyllanthus Emblica, 104

 Physic Nut Plant, 124

 Piney Resin, 156
   „   Tallow, 157

 Piper Betle, 27
   „   nigrum, 123

 Pish-pash, Puss-pass, 182

 Plantago Ispaghula, 125

 Plantain, the, 127

 Plumbago rosea, 128

 Pomegranate Tree, 129
   „         Rind, 129
   „         Root-bark, 129

 Potash, Nitrate of, 107

 Proof Spirit, 150

 Pterocarpus Marsupium, 32

 Ptychotis Ajowan, 130

 Punica Granatum, 129


 Quinine in Fevers, 217-220
   „     in Neuralgia, 238

 Quinetum, 172


 Raw Meat Juice, 180

 Resin of Dammar, 156

 Rice, 133
   „  Flour, 134
   „  Milk, 181
   „  Poultice, 134

 Ricinus communis, 39

 Ringworm Shrub, 38

 Rock Oil, 175
   „  Salt, 178


 Sago, 182

 Sal Ammoniac, 135

 Saltpetre, 107

 Sambac Flowers, 235

 Sandal-wood Oil, 139

 Santalum album, 139

 Santonin, 259

 Sarsaparilla, Country, 72

 Sat-giló (_Hind._), 149

 Seir, 61

 Senna, 140

 Sesamum Indicum, 141
   „     Oil, 141

 Shark, white, 61

 Sinapis juncea, 99

 Sison Cordial, 131

 Snake Bites, Treatment of, 266
   „          Prevention of, 268

 Soda, Biborate of, 29

 Spikenard, Indian, 79

 Squalus Carcharias, 61

 Strengthening Jelly, 185

 Sugar, 173

 Sulphate of Copper, 49
   „         Iron, 76

 Sulphur, 143
   „     Ointment, 143

 Sweet Flag Root, 13


 Tallow, Vegetable, 157
   „     Piney, 157

 Tamarinds, 145

 Tamarindus Indicus, 145

 Telini Fly, 145

 Terminalia Chebula, 103

 Thermometer, Clinical, 280

 Til Oil, 141

 Tinnevelly Senna, 140

 Tinospora cordifolia, 148

 Toddy, 149
   „   Poultice, 149

 Tourniquet, Stick, 224

 Turmeric, 150

 Turpentine, Oil of, 151
   „         Enema, 153
   „         Epithem, 152
   „         Liniment, 154
   „         Ointment, 154
   „         Stupes, 152

 Turtle Oil, 62

 Tylophora asthmatica, 155


 Vapour Bath, 168

 Vateria Indica, 156

 Vernonia anthelmintica, 157

 Vinegar, 158


 Water, 161
   „   Affusion, 163
   „   Fomentations, 166
   „   "Irrigation", 167
   „   Dressing, 167

 Wax, 169
   „ Ointment, 169

 Wet Sheet, the, 169

 White Wine Whey, 184

 Wine, Egg, 184
   „   Whey, 184

 Wood Apple, 26
   „  Oil, 70


 Yeast Poultice, 150


 Zingiber officinalis, 69


 _Printed by_ BALLANTYNE, HANSON & CO.
 _London and Edinburgh_








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