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great destruction of the red blood corpuscles results, and more blood pigment being liberated than the liver, spleen and kidneys can dispose of, is deposited in the skin in the form of bilin.

Any cause producing an irritation, congestion, or inflammation of the liver is apt to be followed by jaundice; consequently we frequently have a jaundiced condition attending an attack of pneumonia, when the lower lobe of the right lung is involved.

The obstructive form of jaundice may result from tumors encroaching upon the common duct, calculi, or, what is probably the most common source of all attacks of jaundice, a gastro-duodenal catarrh, extending into and closing the lumen of the duct. We have an icterus neonotorum which is familiar to all. The cause of this trouble does not seem to be well settled. A number of theories are advanced, among which may be mentioned a diminished pressure in the portal vessel, following a cessation of the placental circulation. It occurs to me the icterus would be a universal result if this was the cause. It is also suggested that the ductus venosus may temporarily remain open, allowing some of the portal blood to gain entrance to the general circulation.

I am inclined to believe that if the blood continued to flow from the portal vein through the ductus venosus to the vena cava for any considerable time that there would be a strong tendency to a permanency of this condition.

destruction of the red. This would imply an

It is also supposed to be due to a great blood corpuscles immediately after birth. anæmic condition which does not necessarily obtain in a case of infantile jaundice. In fact, beyond the icteric condition, there is rarely any evidence of disease. I am of the opinion that it is more often due to slight gastro-duodenal catarrh, produced by some indiscretion in feeding, than to any other cause.

Ordinarily it is of but little consequence, but when it proceeds from a sympathetic hepatitis, or congenital obstruction of the common duct, the results are disastrous.

In an attack of jaundice we will usually observe at first a slight yellowish tinge of the sclerotic coats of the eyes; the patient complains of a feeling of lassitude and slight gastric irritability, usually a feeling of weight in the hypochondrium, loss of appetite and constipated bowels.

If the jaundice is caused by biliary calculi obstructing the duct the above symptoms will likely be preceded by violent attacks of hepatic colic. From any cause these symptoms increase until the eyes, skin, nails, and frequently the urine are as yellow as saffron. The discharges from the bowels are usually clay colored; the feeling of languor grows in intensity until it frequently amounts to mental hebetude. We do not often observe much febrile movement.

The disease usually runs a course of two or three weeks, and the prognosis is usually favorable; this, however, will depend upon the cause underlying it.

If it is due to malignant tumors encroaching upon the common duct, an hypertrophy or atrophy of the liver, brought on by prolonged dissipation or from any other cause, permanently obstructing the duct or destroying the function of the liver cells, the case is a hopeless one.

If

The successful management of this trouble will also depend upon the cause from which it proceeds. Calculi, or tumors, obstructing the duct, will likely require operative measures, with but slight hope of relief in most cases. Jaundice resulting from a destruction of the function of the liver cells, due to prolonged use of intoxicants, will not likely yield to any treatment. treatment is commenced with early, and the patient can be induced to abandon the use of alcoholics, some hope of recovery may be entertained. The Nitro-Muriatic Acid pack, and agents looking to a restoration of the functions of the liver, such as Chionanthus, Nux, Cheledonium, Podophyllin, Leptandrin, etc., will be in order.

For the more mild forms, such as results from the malarial poisoning, gastro-duodenal catarrh, etc., we have in the Chionanthus a positive remedy. It is one remedy that I have learned to regard as absolutely certain to bring about good results in these conditions. Of course it may be given in connection with other indidicated remedies, such as Nux, Phosphate of Soda, Podophyllin, etc. We will find Hydrastis an excellent remedy, more especially when a severe form of poisoning exists. A tonic composed of: Quinia, grs. xx.; Hydrastis, pul., grs. xxx.; Hydrochloric Acid, c. p., dil., q. s.; Aqua, q. s., ad.,. iv., will be found in many cases of jaundice, with a chronic form of malarial poisoning as a cause, an excellent remedy.

THE ESSENTIALS OF MODERN MATERIA MEDICA AND
ECLECTIC THERAPEUTICS.

BY PROF. JOHN W. FYFE, M.D., SAUGATUCK, CONN.
[Copyright, 1897, by John W. Fyfe. All rights reserved.]

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Description. This plant has a thick root and a slender stem, from one to two feet in height. Its leaves are narrow and chiefly alternate. It flowers in summer.

Doses.-Fluid extract, 1 to 60 drops; specific medicine, 1 to 60 drops.

Usual Dosc.-10 to 40 drops every three or four hours.

Indications.-Tongue coated black; putrescent odor from excess of broken-down material being eliminated from the system, as in scarlet fever, diphtheria, spinal meningitis and typhoid fever; strumous diathesis; old sores and wounds; snake-bites and bites of rabid dogs; tendency to boils and carbuncles.

In poisonous stings of insects and bites of snakes and animals. this agent should be used locally and internally. Cerebro-spinal meningitis, diphtheria, remittent and intermittent fevers, typhoid fever, scarlet fever, cholera-infantum, erysipelas, syphilis and typhoid-pneumonia are among the prominent diseases likely to present indications for this medicament.

Echinacea Augustifolia is alterative, stimulant, tonic, sedative and antiseptic.

EPIGEA REPENS.- Common Name: Trailing Arbutus.
Natural Order.--Ericaceæ.

Part Used.--The leaves.

Description. This indigenous plant has a woody stem from six to twenty inches in height. Its leaves are evergreen.

ers are white, or tinged with various shades of red.

in April and May.

Doses.

30 drops.

The flowThey appear

Fluid extract, 30 to 60 drops; specific medicine, 5 to

Usual Dose.-5 to 20 drops every two to six hours.

Indications.-Irritation and increased secretion of mucous in affections of the genito-urinary organs; purulent discharge from urinary organs; lithic acid gravel.

Epigea Repens is diuretic and astringent.

EPILOBIUM AUGUSTIFOLIUM.--Common Name: Willow Herb.
Natural Order.--Onagraceæ.

Part Used.-The leaves and root.

Description.

This perennial plant has an erect stem from four

to six feet in height.

Its leaves are from two to five inches long. The flowers are numerous, very showy, and pinkish-purple in color. They appear in July and August.

Doses.--Fluid extract, 10 to 60 drops; specific medicine, 5 to 60 drops.

Usual Dose.-10 to 20 drops.

Indications.-Diarrhoea of a watery character; diarrhoea with colicky pain; feculent discharges with tenesmus; chronic diarrhoea, with harsh, dirty appearing and contracted skin; cholerainfantum, with greenish discharges; diarrhoea of typhoid fever.

Epilobium Augustifolium is tonic, astringent, demulcent and emollient.

EQUISETUM HYEMALE.--Common Name: Scouring Rush.
Natural Order.-Equisetaceæ.

Part Used.--The plant.

Description. This perennial plant has a stout, erect, jointed and hollow stem, from two to three feet high, bearing a terminal ovoid spike. Frequently two or more stems unite at the base from the same root.

Doses.-Fluid extract, 5 to 30 drops; specific medicine, 5 to 30 drops.

Usual Dose.-10 to 20 drops.

Indications.

Suppression of urine; dysuria; irritability of the

surfaces of the urinary tract; dropsical conditions; gravel and irri

tation of the urinary organs.

Equisetum is diuretic and astringent.

ERGOTA:

Common Names: Ergot, Spurred or Smut Rye.

Natural Order.-Graminaceæ.

Part Used.-Degenerated seeds of Secale Cereale and a fun

gus.

Description.--Cultivated rye has a stem four to six feet high, but in a wild state the stem is usually about foot a high. The leaves have a rough edge, and the lower ones are covered with a soft down. Rye is frequently rendered poisonous by a fungus. This fungoid structure contains from one to twelve greenish granules. The fungus is called Spur or Ergot.

Doses.-Fluid extract, 10 to 60 drops; specific medicine, 5 to 60 drops.

Usual Prescription.--R. Ergot, gtt. x. to 3i.; Water, ziv. M. Sig. Dose, one teaspoonful every hour or two.

Indications.-Hemorrhage, when the tissues are full and inelastic, the patient inclined to sleep and intellect dull; uterine hemorrhage; excessive lochial or catamenial discharges; hydatids or polypi in the uterus; accumulation of blood-clots in the uterus; retained placenta from want of uterine contraction.

Ergot is indicated as a parturient when the contractile power of the uterus is not sufficent to expel the foetus; always provided, however, that the presentation is such as to permit natural delivery, that there is no deformity of the pelvis or soft parts, that the os uteri is dilated, and that the head has descended into the pelvis. The labor pains (contractions), when the uterus is brought fully under the influence of Ergot, are violent and unceasing--tonic-so that there is in some cases danger of their causing rupture of the uterus and death of the child. As soon as the uterus responds to the action of the Ergot, the natural intermittent (clonic) contractions cease. The claim of some writers that Ergot does not influence the uterus unless labor has actually commenced, is not in accord with the experience of most practitioners of medicine.

Ergota promotes muscular contraction. chiefly upon the muscles of the uterus. acute poisoning, and sometimes death. may result in gangrene of the extremities.

As a stimulant it acts Very large doses cause Its long-continued use

ERIGERON CANADENSE.—Common Name: Canada Fleabane.
Natural Order.--Asteraceæ.

Part Used.-The whole plant.

Description. This indigenous annual herb has a branching and furrowed stem, which is sometimes nine feet in height. The flow

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