quantity of hot water be used, say half a pint, and hold a towel to the anus afterward, in order to have the water retained as long as possible. Along with this give internally spirits of camphor, from six to ten drops. It may be put in with the brandy, and the two given together for a few hours. In any case of diarrhoea, where these symptoms of great exhaustion occur with the coldness of the extremities, the hot water enemata may be given. Beef-Tea. The very common habit of giving beef-tea in the diarrhoea of children, prompts me to say a word in regard to its use. Of course, it is given with a view to sustain the strength of the child, but I have found that almost invariably it acts as an irritant and aggravates the disease. Sometimes it seems to pass the bowels in the same form in which it was taken. In any case of acute diarrhoea I would advise you not to give beef-tea. Opium.-I believe that opium is given too indiscrimi nately in the diarrhoeas of children. It has its uses, and is an orthodox remedy in such disorders, but it is given very frequently when other remedies would do quite as well and much better, and would produce none of the ill effects of opium. Good nursing; removal of causes; keeping the patient quiet; regulation of the diet: improving the hygiene; reducing the temperature; removing the causes of disturbance of the nervous system, will, in the great majority of the cases of diarrhoea in children, do away with the necessity for medicines. Medication for young children, so far as concerns the therapeutic application of remedies in doses appropriate to the age of the child and other governing circumstances, has been fully discussed in an earlier chapter of this book (page 94), under the head of "Doses for Children." A tabular classification of "Doses for Young Children," as compared with the adult, may be found on page 98. Mention is made, under these subjects, of the tolerance of children for certain remedies, and their intolerance of others. Much might be added in regard to the hygiene of infants-their clothing, baths, hours of rest, exposure to atmospheric changes, etc. Some of these points have already been referred to, but their full discussion would not be within the scope of this work. DIAGNOSTIC SYLLABUS OF UTERINE INFLAMMATIONS. The usual means of diagnosis may be thus arranged to show at a glance what they reveal: Means of Diagnosis of Uterine Diseases.1 Having thus learned what general information may be obtained by the different means of diagnosis employed in uterine affections, we may now make the application of it to the specific varieties of uterine inflammation. The arrangement in a syllabic group is well calculated to fix in the mind the various symptoms of each affection as thus diagnostically revealed. 1 Prof. J. H. Etheridge, M.D., Chicago Med. Journal and Examiner Sept. 1876, p. 812. 251 1. General Acute. See Acute a. Violent pelvic a. Dull, heavy, pain, accompanied dragging pain in with rectal, vesical, pelvis, increased by Metritoms. and uterine tenes- locomotion. symp 2. Touch. mus, and sometimes b. Defecation and with nausea and coition painful. vomiting. b. c. Menses accom Pressure over panied with pain, which begins several abdomen reveals great sensitiveness. days previous. a. Vagina hot and dry, unless from coexisting endometritis there be purulent discharge. b. Organ low in pelvis, os enlarged, cervix swollen, pressure on cervix very painful. c. Painful tenderness most apparent upon rectal touch and conjoined ma-] nipulation. d. Pain in mammæ during and before menstruation. e. Darkening of areolæ of the breast. f Nausea and vomiting. g. Great nervous disturbance. h. Pressure on rectum with hæmor rhoids and mus. tenes tis. 2. CERVICITIS. Chronic. a. Pain in back and loins. b. Pressure on bladder or rectum. c. Painful and sometimes profuse menstruation. d. Difficulty of locomotion. e. Nervous disorders. J. Pain during sexual intercourse. g. Dyspepsia, headache, general lassitude, and debility. a. Uterus low down. b. Cervix large, swollen, and painful, and os may admit finger. c. Usually tender ness. duces too much pain specially. to be used. 4. Probe. a. Produces intol- a. Usually reveals erable pain, and can- some flexion or vernot usually be re- sion, tenderness. sorted to. Reveals great sensitiveness before reaching OS internum, but nothing beyond that. a. Leucorrhoea Acute. 4. ENDOCERVICITIS. Chronic. See a. Dragging weight| a. Dragging sensation in the Acute streaked, glairy, and pain in pelvis, pelvis. Endo- and bloody. pain in back, groin, b. Pain in back and loins increased by exercise. cervicitis. b. Menstrual dis-and thighs. d. Nervous dis-after 3 or 4 days. pregnancy. g. Sterility. c. Profuse, irritating leucorrhoea, like boiled starch. d. Menses too scanty or vice versa,too frequent or vice versa. e. Nervous, irascible, moody, or even hysterical. f. Digestion impaired, ultimately spanæmia, sometimes nausea, etc. a. Conjoined ma- a. Vagina hot and a. Os in normal position, nipulation reveals dry, or covered with may be enlarged, lips puffy, or tenderness of fun-above discharge. may be roughened." dus. b. Os gaping, cervix b. Pain results from placing swollen and tender, the finger under the cervix body slightly enlarged, and pressing upwards. whole organ lower in pelvis than normal. a. Reveals nothing special. a. Cervix puffy, swollen, and red, fluid a. Patulous os internum. b. Uterine cavity prolonged. c. Tenderness. Withdrawal followed by blood. a. Long, stringy, tough, tenacious mucus, difficult to reexuding from os either move, exuding from os. clear, albuminous b. Cervix not usually en looking, muco-pus, or a. Great tenderness larged, may be puffy ard swollen and very red, as if ulcerated, due to removal of investing epithelium. a. Meets with obstruction throughout whole or- at os internum. 1 Prof. J. H. Etheridge, M D., loc. cit. |