Acetanilid 160 grainsCitrate Caffein 1 dramSodae Bicarbonatis 15 grainsTartaric Acid 5 grainsSimple Elixir to make 4 ounces
Mix. Dose: One-half to one teaspoonful half hour apart for two doses.
Two doses of this remedy will generally relieve any headache. Be careful of this. It is good but all these are sometimes dangerous. The above amount would cost about 35 cents.
Oil of Sassafras 2 dramsOil of Hemlock 2 dramsSpirits of Turpentine 2 dramsTincture of Capsicum 2 dramsTincture of Myrrh 1 ounceLaundanum 2 dramsOil of Origanum 2 dramsOil of Wintergreen 1 dramGum Camphor 1/2 troy ounceChloroform 3 dramsAlcohol, to make 1 pint
Mix. The above amount, about twenty ounces, would cost about 90 cents.
Tincture Nucis Vomicae 1 ounce
Dose: Take five drops three times a day before meals. This is good.
The above amount would cost about 15 cents.
One green paneled bottle contains seven and one-half fluid ounces of a brownish-yellow, semi-clear, very sweet, thickish liquid, of a tarry odor, and pronounced taste and smell of chloroform. From a close examination we have ascertained that an exactly similar preparation is easily made In the following way:
Rub well together:—
Liquid Tar 5 grainsFluid Extract Hemlock 1 fluid dramPowdered White Sugar 2 ounces av.
and add
Alcohol 1/2 fluid ounceAquae 1-1/2 fluid ouncesMolasses 3 ounces av.Fluid Extract Ipecac 8 minims
Mix well and add finally
Chloroform 1 fluid dram
Mix. The above amount would cost about 25 cents.
Tincture Digitalis 2 dramsElixir Valerian 1 ounceSimple Syrup to make 4 ounces
Mix. Dose: Teaspoonful at once. In ten minutes another, and afterward every four hours for twenty-four hours or less.
When there is fluttering or palpitation of the heart, do not get excited but use the above, it is the best thing you can use in this trouble.
The above amount would cost about 30 cents.
Resin 1 poundBurgundy Pitch 1 ounceBeeswax 1 ounceMutton Tallow 1 ounceOil of Hemlock 2 dramsBalsam Fir 2 dramsOil Origanum 2 dramsOil of Red Cedar 2 dramsVenice Turpentine, 2 dramsOil Wormwood 1/2 dramCopper Acetate 2 drams
Melt the first articles together, and add the oils; having rubbed up the copper acetate with a little oil, put it in with the other articles, stirring well; then put into cold water and work until cold enough to roll.
The above amount, over thirty-six ounces, would cost about 50 cents.
Elixir Calisay and Iron 4 ouncesAlcohol 1 ouncePure Water 2 ouncesSyrup Simple 1 ounce
Mix. Dose: One teaspoonful four times a day.
The above amount would cost about 35 cents.
Oleum Olivi 1 ounceOil Cedar 1 ounceOil Amber 1 ounce
Take camphor gum one-half ounce; rub in a mortar with alcohol or sulphuric ether till pulverized, and while damp add
Oleum Olivi 1/2 ounceTurpentine 1/2 ounceLaudanum 1/2 ounce
After which add the first three articles. The above amount would cost about 40 cents.
Lac. Sulphur 160 grainsNaphthaline 10 grainsOil Bergamot 4 dropsCosmoline 1 ounceThis is good.
Rub Lac. Sulphur into fine powder, sift it into the melted cosmoline and stir until nearly cool, then add napthaline and oil bergamot. Stir until cool.
The above amount would cost about 25 cents.
Myrica Cerif 8 ouncesGinger Powdered 3 ouncesCapsicum, powdered 1/2 ounceMix. The above amount would cost about 40 cents.
Fluid Extract Cascara Sagrada 1 ounceFluid Extract Uva Ursi 1 ounceFluid Extract Buchu 1 ounceTincture Gentian Compound 1/2 ounceSyrup Simplicis to make 16 ounces
Mix. Dose: Teaspoonful four times daily or less dose if bowels move too freely.
The above amount would cost about 80 cents.
Potassii Iodidi 1 ounceTar Water 16 fluid ouncesCarmel sufficient to color light brown or about 30 grains
The above amount would cost about 60 cents.
Chloroform 3 dramsOil Cloves 1 dramTincture Opii 1 ounceOil Sassafras 2 dramsAromatic Spirits Ammonia 2 dramsAlcohol to make 6 ouncesMix. This is excellent.
This liniment is for household use; in sprains, bruises, cuts, and bites from insects it cannot be excelled. It is a very fine liniment to keep on hand.
The above amount would cost about 50 cents.
Sulphur Precipitated 1/2 dramLead Acetate 1/2 dramSodium Chloride 1 dramGlycerin 4 ouncesBay rum 1 ounceJamaica rum 2 ouncesWater enough to make 8 ounces
The above amount, nearly pint, would cost about 35 cents.
Camphor Gum 1/2 ounceTincture of Capsid 1/2 ounceOil of Turpentine 1/4 ounceWater Ammonia, U. S. P 5 ouncesAlcohol enough to make 12 ounces
Dissolve camphor gum and turpentine in alcohol and add balance of ingredients. Do not use internally. The above amount would cost about 35 cents.
Powdered Socotrine Aloes 1-1/2 ouncesAmerican Saffron 1/2 ounceTincture Myrrh 16 ounces
Macerate for fourteen days and filter through paper.
The above amount would cost about $1.00.
Aloin 5 grainsPodophyllin 10 grainsCapsicum Powder 5 grainsExtract Nux Vomica 10 grainsHenbane 1 grain
Mix. Make fifty pills. Dose: Take one or two at night.
This little pill is one which you can always depend on and in old chronic cases, torpid liver and constipated bowels, these pills if kept up will make a permanent cure. The above amount would cost about 40 cents.
Alcohol 1 pintGum Camphor 1 ounceOil Sassafras 1/2 ounceTincture Myrrh 1/2 ounceTincture Capsicum 1/2 ounceChloroform 1/2 ounceMix.
I consider this recipe as harmless (and useful too) as Hamlin's famousWizard Oil, and I believe it is as perfect an analysis as we can get.
The above amount would cost about 60 cents.
Essence Peppermint 1 ounceLaudanum 1 ounceTincture Rhei 1 ounceTincture Camphor 1 ounceTincture Capsicum 1 ounce
Mix. Dose: Teaspoonful every ten minutes for three doses if necessary.
This preparation has a national reputation, and is certainly the very best preparation you could keep on hand for immediate relief from cramps, colic, and diarrhea, and no family should be without it. This preparation alone is worth the price of the book.
The above amount would cost about 50 cents.
Oil of Wormwood 40 minimsOil of Hemlock 2 dramsOil of Thyme 2 dramsOil of Turpentine 4 dramsFluid Extract Capsicum 1 dramAlcohol to make 4 ouncesMix. The above amount would cost about 25 cents.
Tincture Chloride of Iron 1 ounceAromatic Spirits Ammonia 1 ounceCompound Spirits Lavender l ounce
Mix. Good when run down. Dose: Fifteen drops four times a day.
People suffering from nervousness, fainting spells or shortness of breath, can obtain relief from a few doses of this medicine. The above amount would cost about 30 cents.
The formula for this preparation is said to be:
Yellow Wax 2-1/2 dramsWhite Wax 2-1/2 dramsTerebinth 6 dramsLard 13 dramsSweet Oil 19 drams
Mix. The above amount would cost about 40 cents.
Acetanilid 160 grainsSodium Bicarbonate 15 grainsTartaric Acid 5 grainsSimple Elixir 4 ounces
Mix. Dose: Teaspoonful at a dose. Should not take more than two doses.Shake bottle. The above amount would cost about 30 cents.
Spirits of Camphor 1 ounceSpirits of Origanum 1 dramOil of Sassafras 1 dramOleum Terebinth 2 dramsColor Tincture (about) 2 ouncesMix. The above amount would cost about 25 cents.
Chloroform 3 dramsTincture Opii 3 dramsTincture Camphor 3 dramsAromatic Spirits Ammonia 3 dramsSpirits Vini Gallici 4 ounces
Mix. Do not use internally. Good liniment.
The above amount would cost about 35 cents.
Camphor Gum 1/2 ounce troyOil Turpentine 1 fluid dramOil Peppermint 1/2 fluid dramOil of Wintergreen 1/2 fluid dramTincture Capsicum 1/2 fluid ounceAlcohol sufficient to make 1 pint
The above amount would cost about 60 cents.
Zinci Oxide 1 dramBismuth Sub. Nit. 1 dramCarbolic Acid 10 dropsGlycerin 2 ounces
Mix. This is excellent. There are a number of remedies, but this is the best known for poison oak. The above amount would cost about 20 cents.
Iodide Potash 1/2 ounceFluid Extract Phytolacca Decandra 1 ounceCompound Syrup Sarsaparilla to make 8 ounces
Mix. For Chronic Rheumatism.
This is the oldest rheumatism remedy known. Rheumatism being a blood disease, requires constitutional treatment. The above amount would cost about 80 cents.
Saxoline Snow White 175 grainsWhite Wax 65 grainsZinc Oxide 22-1/2 grainsOxide of Mercury 2-1/2 grainsOil of Lavender 5 drops
Melt the white wax and saxoline together, and stir constantly while cooling. As soon as the mass begins to solidify incorporate the oxides and oil of lavender.
The above amount would cost about 25 cents.
Iodide Potash 192 grainsFluid Extract Queen's Root 1 ounceFluid Extract Prickly Ash Bark 1/2 ounceFluid Extract Yellow Dock 1 ounceCompound Syrup Sarsaparilla 8 ounces
Mix. Dose: Teaspoonful four times a day.
We do not claim this remedy will cure every case of scrofula, but will give relief, and if continued for several weeks will generally produce a cure. The above amount would cost about 75 cents.
Conc. Decoction of Aloes (1 to 4) 60.0 m.Borax 1.3 gm.Capsicum, Powdered 0.13 gm.Gentian, Powdered 2.3 gm.Sassafras Oil 0.3 gm.Wintergreen Oil 0.12 gm.Rectified Spirits 7.5 gm.Fluid Extract Taraxici 7.5 gm.Syrup 125. gm.
The above amount would cost about 40 cents.
Acidi Boracici 2 dramsSalol 2 dramsBalsam Peru 1 dramCarbolic Acid 20 dropsVaselin 1 ounceLanoline 2 ounces
Mix. This is excellent. First wash the head thoroughly with castile soap and apply morning and night. The above amount would cost about 25 cents.
Patterson's Emulsion of Pumpkin Seeds is said to be a good emulsion for expelling tapeworms. Take two ounces of pumpkin seeds, peel and pound to a paste with sugar, then add by degrees eight fluid ounces of water, the whole to be taken in two or three draughts at short intervals. The above amount would cost about 25 cents or less.
Powdered Kamalia 3 dramsSyrup Simple 3 ounces
Mix. This is very good. Two doses of this mixture hardly ever fails to bring the worm. Give oil and turpentine two hours after the last dose.
The above amount would cost about 25 cents.
Tincture Laudanum or Opii 1 ounceTincture Capsicum 1 ounceSpirits Camphor 1 ounceChloroform 180 minimsAlcohol to make 5 ounces
Mix. Dose: One-half to one teaspoonful fifteen minutes apart for two doses or one-half to one teaspoonful every four hours. The above would cost about 40 cents.
Turkey Corn Root 1/4 lb.Stillingia Root 1/4 lb.Sarsaparilla Root 1/4 lb.Yellow Dock Root. 1/4 lb.Sassafras Bark 2 ouncesSimple Syrup 1 qt.Diluted Alcohol 4 ounces.Iodide of Potassa 1/4 lb.Water sufficient
Percolate roots and bark with diluted alcohol, add syrup, then iodide of potassa. Dissolve in water to make 6 gallons. The above amount, six gallons, would cost about $2.00.
Gum Camphor 1 grainChloral Hydrate 1 grainOil of Cloves 2 dramsChloroform to make 1 ounce
Mix. Put on some cotton and put around the tooth. No physician can give a better prescription for toothache than this.
The above amount would cost about 25 cents.
Gum Myrrh 7-1/5 ouncesCayenne Pepper 2 ouncesGum Opium 1-3/5 ouncesGum Benzoin 1-1/5 ouncesGum Guaiac 3/5 ounceGum Camphor 2 ouncesAlcohol enough to make 1 gallon
The above amount would cost about $3.50 or 45 cents per pint.
Extract Belladonna 1 grainPowdered Alum 1/2 dramMucilage Acacia 1 ounceSyrup Scillae 1/2 ounceSyrup Simple to make 4 ounces
Mix. Dose: Ten drops to use for whooping cough. It has been in use for years and some of our best doctors employ it in their practice. The above amount would cost about 30 cents.
Oil of Queen's Root 4 dramsOil of Cajeput 2 dramsOil of Lobelia 1 dramAlcohol 1 ounce
Mix. Bathe the chest and throat three times a day. The above amount would cost about 35 cents.
Chloroform 4 dramsSulph. Ether 4 dramsOil Spearmint 2-1/2 dramsOil of Wintergreen 2-1/2 dramsTincture Myrrh 1 ounceTincture Capsicum 1 ounceTincture Arnica 1 ounceWater of Ammonia 2 ouncesAlcohol enough to make 32 ounces
Mix. The above amount would cost about $1.10.
Powdered Hydrastis Canadensis 1 ouncePowdered Borax 10 grainsSodium Chloride 10 grainsFerro-cyanuret of Iron sufficient to color
Mix. The above is the formula of Dr. Sage, and sold by him to Dr. Pierce, of New York, for $500.00. The above amount would cost about 35 cents.
Tincture of Benzoin Compound 1 ounceTincture of Tolu 1 ounceChloroform 1/2 dramSulphuric Ether 1/2 dramAromatic Spirits of Ammonia 4 dramsOil of Tar 1/2 dramRectified Spirits 2-1/2 ounces
Mix. Use with Cutler's Inhaler. The above amount would cost about 40 cents.
Stearns' Bay Rum 7 fluid ouncesDist. Extract of Witch-Hazel 9 fluid ouncesSodium Chloride 1 dramHydrochloric Acid (5 per cent) 1 dropMagnesia sufficient
Mix the bay rum and distilled extract of witch-hazel, and shake with a little magnesia; filter, and in the filtrate dissolve the salt and add the hydrochloric acid. The agitation with magnesia causes the preparation to assume a yellow color; but by rendering it very slightly acid, with one drop of five per-cent hydrochloric acid, this color all disappears. The above amount would cost about 50 cents.
Hydrate of Chloral 1 dramGlycerin 4 dramsBay Rum 16 drams
The above amount would cost about 25 cents.
Gum Camphor 1 ounceChloral Hydrate 1 ounceChloroform 1 ounceSulp. Ether 1 ounceLaudanum 1/2 ounceOil Origanum 1/2 ounceOil Sassafras 1/2 ounceAlcohol enough to make 1 gallon
Mix. The above amount, eight pints, would cost about $2.25 or 30 cents per pint.
Senna Leaves 7 ouncesCoriander Seed 3 ouncesFigs 12 ouncesTamarind 9 ouncesCassia Pulp 9 ouncesPrunes 6 ouncesGlycyrrhizae 3/4 ounceEssence Peppermint 3/4 ounceSyrup Simple, to make 1/2 gallon
The formula omits directions; but probably a water extract should be made of the drugs, so as to measure about four pints, and in this dissolve eight pounds of sugar to make the syrup. The above amount, four pints, would cost about $1.00.
THOMAS'S ELECTRIC OIL.Gum Camphor 1 dramOil Wintergreen 1 dramOil Origanum 1 dramChloroform 2 dramsTincture Opium 2 dramsOil Sassafras 2 dramsOil Hemlock 2 dramsOil Turpentine 2 dramsBalsam fir 2 dramsTincture Guaiacum 2 dramsTincture Catechu 2 dramsAlcohol, to make 1 pintAlkanet sufficient to color
Mix. The above amount would cost about 40 cents.
Tincture Nux Vomica 2 dramsDilute Nitro-hydrochloric Acid 3 dramsCompound Tincture Cinchona 1-1/2 ouncesCompound Tincture Gentian 3 ounces
Mix. Dose: Two drams in water three times a day.
The above amount would cost about 35 cents.
The following formula may be regarded as making an article identical with the original in all essential features:
Alcohol 1 fluidounceWater 1-1/4 fluidouncesSoap 120 grainsOil of Gaultheria 2 minimsRed Sanders sufficient
Dissolve the soap in the mixture of alcohol and water; add the color, perfume with oil of wintergreen, add enough water to make the fluid measure three ounces.
The above amount would cost about 15 cents.
The following is suggested as a similar article to the Fragrant Sozodont powder, which accompanies the liquid.
Infusoria1 Earth 40 grainsOrris Root 125 grainsPrecipitated Chalk 200 grainsTo make 365 grains
Perfume very tightly with Oil of Cloves. The above amount would cost about 10 cents.
Powdered Aloes 4 dramsPowdered Gamboge 4 dramsPowdered Hellebore 2 dramsPowdered Guaiac 1/2 dramHydrargyrum Chlorid Mite 1/2 dramPrecip. Sulphide of Antimony 15 grainsOil of Cloves 1/2 fluid dramSoap 1 dramSpirits of Camphor. sufficient
Mix. Make into five-grain pills. The above amount would cost about 50 cents.
WHITE'S COUGH SYRUP.Syrup Tolutani 4 dramsGlycerini 8 dramsHive Syrup 12 dramsSyrup Ipecacuanhae 12 dramsTincture Lobelia 12 dramsTincture Opii Camphor 12 dramsExtract Pilocarpi Fluid 4 dramsAmmonia Chloridi 2 drams
Mix. Dose: Take a teaspoonful three times during the day, and every hour or two before going to bed. The above amount would cost about 60 cents.
Fluid Extract of Hops 2 ouncesFluid Extract of Red Cinchona 2 ouncesFluid Extract Sarsaparilla 6 dramsFluid Extract Golden Seal 6 dramsFluid Extract of Podophyllum 4 dramsOil of Wintergreen 6 dramsOil Sassafras 3 dramsOil of Peppermint 2 dramsOil of Lemon 2 dramsSugar 12 ouncesAlcohol 1 quartWater enough to make 6 quarts
The above amount would cost about $1.75.
Wild Cherry Bark 1 ounceYellow Cinchona Bark 1 dramOrange Peel 2 dramsCardamon Seed 1 dramWild Ginger 1/2 dramAlcohol Dilute 12 ouncesHoney 2 ouncesSyrup 2 ounces
Percolate the drugs in moderately fine powder, with the dilute alcohol and when six pints are obtained add the honey and syrup.
The above amount would cost about 40 cents.
Marshmallow Flowers 2 ouncesGlycrrhiza Root 6 dramsIris Florentina 2 dramsColtsfoot 1 ounceMullein Flowers 1/2 ounceAnise Seed 1/2 ounce
Mix. The above amount would cost about 25 cents.
Celery Seed 2 ouncesRed Cinchona Officinalis 1 ounceOrange Peel 1/4 ounceCoriander Seed 1/4 ounceLemon Peel 1/4 ounceHydrochloric Acid 15 min.Alcohol 5 fluid ouncesGlycerin 3 fluid ouncesWater 4 fluid ouncesSyrup 4 fluid ounces
Grind the solids to No 40 power, mix the acid and the water, add the glycerin and alcohol, and in the menstruum so prepared macerate the powder for twenty-four hours; then percolate, adding enough alcohol and water in the proportion given to make twelve fluid ounces. Finally add the syrup, and, if necessary, filter. The above amount would cost about 60 cents.
Aloes 4 partsJalap 2 partsZingiber 2 partsMyrrh 2 parts
Make into a mass with mucilage and divide into two grain pills, of which about four dozen are put into each box. The above amount would cost about 35 cents.
Petroleum 1 ounceOil Juniper 1 dramOil of Terebinth 1 ounceOil Amber 4 ouncesLinseed Oil 12 ounces
Mix. The above amount would cost about 50 cents.
Smartweed 10 dramsAlcohol 6 ouncesWater 2 ouncesCamphor 22-1/2 grainsOil of Hemlock 30 dropsOil of Sassafras 30 drops
Extract the smartweed with the alcohol and water and to the liquid obtained add the camphor and oils. The above amount would cost about 30 cents.
ICAUSES, SYMPTOMS AND TREATMENT OFDISEASES OF WOMEN,With Advice regarding the Health ofYOUNG WOMEN AND GIRLS
"Sickness is the vengeance of nature for the violation of her laws,"—C.Simmons.
Our busy life, our manner of dress, with all its attending demands are causing havoc with the health of women who are under its terrible strain. The number of women undergoing operations in our public and private hospitals from day to day bears witness to the ravages of the strenuous social life and mute testimony of the neglect of the laws of nature. Good health is the fruition of eternal vigilance and a blessing that money cannot buy. The conduct and health of our women represents the life of our nation; individually, in a measure at least, health governs the happiness of the home. Steele says: "All a woman has to do in this world is contained within the duties of a daughter, a sister, a wife, and a mother." But how many girls grow to womanhood untaught; enter wifehood in ignorance, and assume motherhood wholly unprepared for the duties that are thrust upon her. It would be out of place in a work of this nature, a family table book, to take up all the questions involved in such a subject; we can only leave with you a word of warning. Before puberty the girl should be taught to lead a life that will make her strong and healthy to prepare her for the coming strain upon her system. Once she has reached puberty parents should remember, above all things, that HEALTH is far more important than high grades in school. Do not offer prizes for high marks and otherwise add to the pressure of the present school system. Relieve her of worry, do not add to it. A cheerful mind, plenty of fresh air and sunshine is more important at this period than school work. We have paid special attention to "Causes" in this department; may we ask you, Mother and Daughter, to read "CAUSES" of disease and thus render unnecessary in later life, drugs, medicines, headache tablets and, perhaps, operations.
The Pelvis. It is so called from its resemblance to a basin, is stronger and, more massively constructed than either the skull or chest cavity; it is a bony ring, interposed between the lower end of the spine, which it supports, and the lower extremities, upon which it rests. It is composed of four bones, the two innominated, (nameless), which bound it on either side and in front, and the Sacrum and Coccyx, which complete it behind. Further description will be given in the department of Obstetrics. The cavity of the pelvis contains the bladder, the rectum, and some of the generative organs peculiar to each sex and some windings of the small intestine; they are partially covered by the peritoneum (lining membrane of the abdominal cavity).
Anatomy of the Female Genital Organs.—The external genital organs, to which the term vulva is usually given, consist of the mons veneris, labia majora, labia minora, clitoris, vestibule, meatus urinarius, hymen, fossa navicularis, fourchette and perineum.
Mons Veneris.—This is a rounded eminence surmounting the pubic bones, and is composed of fatty tissue, covered by skin and hair.
The Labia Majora.—There are two more or less prominent longitudinal folds of cutaneous (pertaining to the skin) tissue, covered by hair and mucous membrane, which is continuous with the mucous membrane of the genital organs and urinary tract. They join at each extremity, forming the anterior and posterior commissures (uniting together). Between the posterior commissure (union) and the margin of the bowel is a space of about an inch in extent, the Perineum. It is important to remember this part, for it is often torn in labor, to a greater or less extent.
The labia are the analogue of the scrotum in the male.
The Labia Minora.—These are two smaller folds situated within the labia majora, extending from the clitoris, downward and outward for about one and one-half inches on each side of the vaginal opening. At their convergence at the clitoris each lip (labium) divides into two folds and these surround the glans (clitoris) forming its covering (prepuce) above and the bridle (frenum) below. These lips (labia) are composed of mucous membrane covered by a thin epithelial layer. They contain a network of vessels and numerous large mucous crypts (small sacs or follicles) which secrete a quantity of (fatty) matter.
The Clitoris.—This is an erectile structure, the analogue anatomically of the cavernous body of the penis, and is an elongated organ partially covered by the anterior extremities of the labia minora and connected on each side with the rami (slender process of the bone) of the pubic bones and the ischia (two bones) by a band. The clitoris is surmounted by a small tubercle (a small nodule) of spongy erectile tissue, the "glans clitoris," Two cavernous bodies of erectile tissue enclosed in dense fibrous tissue compose the body of the organ.
The Vestibule.—This is the smooth surface of triangular form situated between the clitoris and the entrance to the vagina. The labia minora bound it on either side. It contains the opening of the urethra.
The Hymen is a thin fold of mucous membrane of half moon in shape (semi-lunar) and is spread across the lower opening of the vagina.
The Glands of Bartholin are small oblong bodies, two in number, situated on each side of the commencement of the vagina above the deep fascia band like tissue. Each gland has a single duct and by this duct opens the inner surface of the adjacent labia minoris just external to the hymen. They are made up of mucous glands and a colorless tenacious fluid is secreted by them, which lubricates the vagina. These glands sometimes become diseased. Hence the description.
The Vagina.—This is a membranous canal and extends from the vulva to the uterus (womb) and connects the external and internal organs of generation. It is four to six inches in length, the anterior wall being from one to two inches shorter than the posterior. It lies in the cavity of the pelvis in front of the rectum, behind the bladder and follows first the line of axis of the cavity of the pelvis, and afterwards the axis of the outlet.
The vagina consists of an internal mucous lining (membrane) continuous above with the mucous membrane lining the womb and below with the covering of the labia majora. The next covering (inward) is a muscular coat consisting of two layers—an external longitudinal and an internal circular. There is a layer of erectile tissue between the muscular coat and mucous lining. The lower end of the vagina is surrounded by a band of striped muscular fibers comprising the sphincter muscle of the vagina (sphincter vagina).
The internal organs of generation, more commonly called the pelvic organs.These comprise the womb, fallopian tubes and ovaries.
The womb is the organ of pregnancy, and receives the fruitful egg (ovum), supports it during its development and expels it at the time of labor (parturition). In form it is pear-shaped, weighs from 12 drams to 3 ounces and is situated in the pelvic cavity, between the bladder and the rectum, with its base upwards and its apex, smaller end downward. Its upper broad extremity is called the fundus—base of the organ, and the lower, constricted, narrowed portion is called the Cervix (neck or constricted portion). The body of the womb gradually becomes narrower from the fundus to the Cervix.
Its anterior surface is covered on its upper three-quarters by the peritoneum, while the lower fourth is connected with the bladder. The peritoneum covers the whole of the posterior surface. The womb is held up (suspended) in the pelvis by ligaments; two anterior, womb and bladder (utero-vesical), two posterior, womb-sacral (utero-sacral), two lateral broad ligaments, and two round ligaments. The womb sacral (utero-sacral) which holds the womb well up in the hollow of the sacrum and the round ligaments which keep the womb well forward enter most actively into the support of the womb. The round ligaments are strong muscular fibrous cords and serve to hold the womb forward. When pregnancy exists they increase in size with the womb, and keep the fundus forward in its excursion upwards into the abdominal cavity, and after confinement, become smaller with the womb, guiding the womb back again to its regular position. The broad ligaments are little more than reflection of the peritoneum serving to support the vessels that nourish, as they go to and from the womb.
The womb has three coats, enclosing a central cavity. This cavity of the womb is small by comparison with the size of the organ and it communicates with the Fallopian tubes by two minute openings at each side of the body, and with the vagina below, through the mouth or opening of the womb.
The external coat of the womb is called servos, derived from the peritoneum; the middle or muscular coat, which forms the chief substance of the womb, consists of bundles of unstripped muscular fibers intermixed, with loose connective tissue, blood vessels, lymphatics and nerves; the internal or mucous coat is continuous through the fringed extremity of the fallopian tubes, with the peritoneum, and through the mouth of the womb (os uteri) with the mucous membrane of the vagina. This mucous membrane is lined in the body of the womb by epithelium arrayed in columns (Columnar Epithelium) which loses its ciliated (eye-lash) movement character during pregnancy. In the lower half of the Cervix, the epithelium (this kind of cell lines all canals having communication with the external air) is of the stratified (arranged in layers) variety. The appendages of the womb are the fallopian tubes, the ovaries and their ligaments and the round ligaments. The fallopian tubes convey the ova (eggs) from the ovaries to the cavity of the womb. They are two in number, one on each side, situated in the free border of the broad ligaments and extend from each horn, an excrescence of the womb that looks like a horn, of the womb outward to the sides of the pelvis; each is about five inches in length, and has a small canal beginning at the womb in a very small opening called the internal mouth (ostium internum). This canal gradually widens to its ending, the abdominal mouth (ostium abdominal) by which it communicates with the peritoneal cavity, the timbrae. A series of fringe-like processes surround this mouth or opening and this farther end is known as the fimbriated extremity. The tube has three coats, serous or external or peritoneal; the middle or muscular, continuous with that of the womb, and an internal or mucous coat continuous also with the lining of the womb and peritoneum (covered with ciliated Columnar Epithelium).
The Ovaries.—They are analogues, anatomically, of the testes in the male. They are two egg-shaped bodies situated one on each side of the womb on the posterior aspect of the broad ligament, below and behind the fallopian tubes; each is connected by its anterior margin to the broad ligament; internally to the womb by the ovarian ligament, externally to the fringe-like extremity of the fallopian tubes by a short cord-like ligament. They are white in color; about one and one-half inches long, three-quarters of an inch wide and one-third of an inch thick and weigh about two drams each.
The ovarian ligament extends from the inner side of the ovary to the superior angle of the (Uterus) womb. The round ligaments, two in number, are about five inches long and are situated between the layers of the broad ligament, one on each side of the womb in front and below the fallopian tube. They pass forward and outward from the womb through the internal abdominal ring, along the groin canal and out at the external abdominal ring.
I have given a lengthy description of these organs; I think it will repay a careful reading. To understand a disease one should understand the organs that are subject to the disease.
Dr. Child says among primitive people, woman is notoriously free from many of the diseases to which her sister in our present-day civilization is especially prone. As we ascend the scale of civilization, departing from a natural and adopting an artificial mode of life we find nature enacts due penalties for the transgression of her laws. The female among savage tribes has every advantage and opportunity to develop physical perfection, and her endurance suffers little, if any, by comparison with the male. How different is our modern system when the young girls are sent early to school and subjected daily to long hours of study, often in badly ventilated class-rooms, for nine months in the year, and this at the time of puberty, one of the most important periods of their life when they need plenty of out-door exercise. Surely, as Goodell says, "If woman is to be thus stunted and deformed to meet the ambitious intellectual demands of the day, if her health must be sacrificed upon the altar of her education, the time may come when to renew the worn out stock of the Republic it will be necessary for our young men to make matrimonial excursions into lands where educational theories are unknown."
Menstruation.—Many of the disorders of menstruation are due to carelessness and neglect of this function. There should be rest of both body and mind at this time, and especially at puberty. Rest is seldom allowed, but the daily routine is gone through, regardless of what may happen.
Dress.—The way the abdomen is now constricted, and this is now a prominent feature of women's mode of dress, is without doubt an important predisposing cause in female diseases. This contraction of the normal size of the cavity of the abdomen, with the subsequent compression and displacement of its organs, must of necessity produce dynamic (powerful) changes in the pelvis that cannot be otherwise than injurious to the pelvic organs. Tight lacing or any lacing, aside from the remote effects so unnatural a practice must produce, causes marked atrophy (dwindling) of the abdominal muscles. These are often so weakened that during labor they cannot properly assist the uterus (womb) in effecting delivery, and as a result instrumental interference, with its attendant dangers becomes necessary.
Prevention of Conception.—This is a very common practice among civilized women, and it has a most destructive effect upon the pelvic organs, as well as upon the general system.
Criminal abortion.—The chief danger from the criminal interruption of pregnancy is sepsis (absorption of poisons) into the system. This may be acute in character and have a fatal termination, or chronic in nature, leading to permanent injury of the womb and fallopian tubes, sterility and chronic invalidism.
Child birth.—Pelvic diseases frequently come from injuries received during labor.
Venereal diseases.—Dr. Child says, "Syphilis exerts its usual baneful influence, but gonorrhoea is responsible for more pathological (diseased) lesions (conditions) in the female pelvis than any other one factor. Its attack, if not resulting in ultimate loss of life, always leaves the tissue in an impaired condition, from which resolution (returning to natural condition) is rare. It is doubtful if a woman once infected with gonorrhoea ever recovers from its ravages. As a cause of sterility its power is beyond estimation."
INFLAMMATION OF THE VULVA.—(Vulvitis).—An acute or chronic inflammation of the vulva (external genitals) either from a specific, like gonorrhoea, or non-specific cause.
Causes.—Veit says, "Seventy-five per cent of the cases are caused by gonorrhoea."
Other Causes.—Accumulation and decomposition of discharges from the womb and vagina, inflammation of the inner lining of the womb and of the vagina. Foul, putrid discharges from neglected supports (pessaries) and tampons in the vagina; sloughings from cancer may act as exciting causes. Contact with ammoniacal and sugar urines has a similar effect.
In Infants.—It is usually due to want of cleanliness in failing to remove decomposing urine and feces. Mothers often allow soiled, foul smelling diapers to remain for a long time on the baby.
Symptoms and Condition of the Parts.—In the acute stage the mucous membrane around the opening of the vagina is red, swollen, painful and bathed in pus. The glands in the groin and glands of Bartholin are usually enlarged and tender. The glands of Bartholin and those around the urethra may become infected and fill with pus. The fatty glands of the labia majora are also sometimes affected and then appears the disease called Follicular Vulvitis (in the chronic stage secretion is abundant). The parts feel hot and there is more or less burning and itching. Walking makes the trouble worse, due to rubbing of the parts. Passing of urine increases the distress.
When the disease is caused by gonorrhoea it is more extensive and involves the vagina, urethra, the glands around the urethra and glands of Bartholin. This gland infection frequently results in an abscess.
Treatment.—In the acute form the patient should go to bed and remain there for some time. The parts should be kept constantly moist with a wet antiseptic dressing, listerine, hot water, etc., applied to the vulva and kept there.
1. If there is much pain the following solution may be used:
Acetate of lead 1 dramLaudanum 1/2 ounce
Water enough for six ounces.
Mix and apply constantly with sterile cloths.
2. For chronic form Dr. Child says, "The vulva should be shaved, thoroughly cleansed and a mild ointment applied daily thereafter," such as:
Salicylic acid 20 grainsOxide of zinc 2 dramsPetrolatum enough for 1 ounce
Mix and make an ointment and apply daily.
If it is due to irritating discharges that cannot be checked, cleanse the parts thoroughly and use the Zinc ointment to protect.
ITCHING OF THE VULVA.—Vulvae or Pruritus.—This intense itching is the characteristic symptom. With the itching there is more or less swelling of the parts and extreme nervous irritability.
Causes.—This is doubtful; some think it is a purely nervous condition.
Parts irritable.—The upper angle of the labia majora and the mons veneris are the usual locations. The skin is inflamed thickened, raw, from the continual scratching."
Symptoms.—The itching and burning are almost unbearable at times, beginning most often around the clitoris, coming in paroxysms and made worse by warmth and motion.
In chronic cases the skin is a little thickened and looks dull and dry and is covered with small cracks and scratches, the result of the patient's efforts to stop the itching.
Treatment.—Systematic, general tonic treatment. Diabetes, gout, irritating discharges from the vagina and rectum should be removed. Pin worms and highly acid urine sometimes cause it in children. Internally the bromides to quiet the nerves and arsenic to build up the system should be given.
Local.—Strong solutions of corrosive sublimate (1 to 1000), nitrate of silver, tincture of iodine, and cocaine ointment give temporary relief.
Sometimes an operation is necessary.
CYSTS OF THE VULVA.—A cyst is a cavity containing fluid and surrounded by a covering (capsule). The duct (canal) of the gland of Bartholin, situated in the labia majora, sometimes closes and the secretions of the gland are not cast out, thus forming the cyst.
Cause.—The closing is nearly always the result of gonorrhea.
Condition.—The cyst is formed in the duct, the gland itself being affected rarely. It contains a thin sticky mucus. If the cyst arises in the gland, the swelling is more deeply situated. These cysts may be attacked with an acute inflammation and finally pus is formed in them, and a very painful abscess is the result,
Symptoms.—There are no symptoms except from the size of the swelling unless an abscess occurs. Then there is an acute local pain, quite tender on pressure, and often high fever.
Treatment.—If the cyst is large it should be removed, especially if it causes annoyance. If it becomes inflamed, rest in bed and cold applications are indicated. If it goes on to an abscess, a free cut should be made, the abscess scraped and good drainage given. Sometimes it is best to use pure carbolic acid in the walls of the cyst.
INFLAMMATION OF THE VAGINA, (Vaginitis).—Vaginitis is an inflammation of the mucous membrane of the vagina.
Varieties.—l. Catarrhal or simple 2. granular; 3. gonorrheal; 4. diphtheritic, and 5. senile.
1. Catarrhal or simple form.—This is the most usual form. There is a general redness of the membrane with swelling and increased secretion.
2. Granular.—This is an advanced stage of the simple type, and is due to long continued or repeated attacks.
3. Gonorrheal form.—Is due to infection by the gonococcus of Neisser (due to gonorrhea). This form is hardest to cure and may continue for years or life, The infection may extend to the womb, fallopian tubes and peritoneal cavity and produce inflammation of the womb (endometritis) pus in the tubes, (pyosalpinx) and peritoneal cavity. This is more common than even some physicians realize.
4. Diphtheritic—Due to diphtheria, not frequent.
5. Senile type.—This comes only after the change of life.
Symptoms.—There is pain in the lower abdomen. Passing of urine is frequent and is attended with smarting and burning pain. There is a feeling of heat and burning in the vagina, and a copious discharge of mucus and pus. In the gonorrheal variety the urinary disturbances are most marked.
In gonorrheal variety the symptoms date from a distinct onset, last longer, do not yield so rapidly to treatment, and complications, such as enlarged glands in the groin and in the vulva and vagina, inflammation of the lining of the womb and fallopian tubes, inflammation of the bladder, often make their appearance early.
Treatment (in acute cases).—Rest in bed and prolonged vaginal injections of a solution of corrosive sublimate (1 to 4000 strength) three times a day. If the gonorrheal poison is present in the pus, the walls of the vagina, cervix and cervical canal should be dried and thoroughly painted with a twenty per cent solution of nitrate of silver. The patient should be in the knee-chest position for this treatment.
In chronic cases the gonorrhea poison (gonococcus) is found most frequently just behind the posterior lip of the cervix and here the silver solution should be applied very thoroughly.
VAGINISMUS.—This is a painful reflex muscular contraction of the vaginal orifice, and is most often observed in patients of a nervous and sensitive temperament. Treatment.—Any local cause of irritation should be removed. If there is no local irritation, the opening should be dilated under an anesthetic. Tonics, exercise, and a complete change of scene are beneficial.
TEAR OF THE CERVIX (Laceration).—This is a tear in the lower part of the cervix. There may be one or more. The left one-sided tear is the usual form. Next comes the tear on both sides (bilateral). Tears on front and behind are not frequent. Tears are found in about thirty per cent of women who have had children.
Causes.—The majority of cases are caused by labor, and is due to a cervix that is not perfectly dilated. Very hurried, quick labors cause it sometimes, but the greatest injuries are due to the various operations for delivering the child through a cervix that is not fully dilated.
Symptoms. Immediate and remote.—On the immediate, when the tear is severe, there is bleeding; later, sub-involution, that is, the womb does not return to its normal size and weight.
Remote symptoms.—Leucorrhea, thick and mucus in character; profuse menstruation and inability to become pregnant. When the tear has extended through the internal opening the woman win not be able to carry the child to full term, even if she becomes pregnant.
Treatment.—Tampons of ichthyol (ten per cent), mixed with glycerin, introduced twice a week against the cervix and permitted to remain forty-eight hours will often afford relief.
The tear should be repaired after child-birth, if possible. If not then, and if it does not heal, it should be repaired later when the tear extends through the internal (opening) or in case of extensive raw surface on the cervix.
INFLAMMATION OF THE CERVIX.—This is an inflammation of the mucous membrane lining the canal of the cervix (cervical canal), known as Endocervicitis; it may be acute or chronic. The acute form is seen most often as a part of a general infection involving both womb and cervix, and will be described later. The chronic form is a very common condition and it is difficult to treat.
Cause.—Injury and tear of the cervix.
Symptoms.—Leucorrhea, profuse and frequent menstruation, pain in the back and loins. On examination a string of thick mucus is seen at the external opening (os) of the cervix; and of women who have borne children there are usually signs of tear and rawness of the cervix present; (Endometritis usually produces a thin watery discharge, while gonorrhea produces a thick, pus-like discharge).
Treatment.—Hot vaginal douches, containing one dram of sulphate of zinc to one pint of water, used every night for ten minutes. Hot water with witch-hazel, about four drams to the pint, is also good. Tincture of iodine applied locally twice each month. White oakbark tea used as an injection once a day for this trouble; also good for vaginitis.
INFLAMMATION OF THE LINING OF THE WOMB. Endometritis.—Endometritis is an inflammation of the lining membrane of the womb, with a tendency to extend to the lining membrane of the fallopian tubes and to the peritoneum. These are the acute and chronic varieties.
Causes.—It may occur during an acute skin disease eruption, like that of scarlet fever, and occasionally upon exposure to cold during menstruation. The most frequent exciting causes are the microorganisms, like the gonorrhea poison, etc.
Acute Variety.—The whole mucous lining is inflamed. In severe cases the whole mucous lining is destroyed and the deeper muscular tissues of the womb are invaded.
Gonorrheal Variety. Symptoms.—There is general pain in the lower bowel region, in spells at first, later constant, with rapid rise of temperature and pulse. A purulent (pus) discharge appears early from the cervix, usually about the second day, and difficult and burning passing of urine are early symptoms. There is inflammation of the vagina accompanying it in about fifteen per cent of the cases, while inflammation of the fallopian tubes, pus in the tubes, and local peritonitis are common results.
MOTHER'S REMEDY. Inflammation of the Womb. 1. A Good Tonic for.—"For inflammation of the uterus or ovaries try a hot sitz bath every day for a week, and then every other day. In case of hemorrhage this bath is invaluable, and will relieve when all other means have failed. It can be taken during the hemorrhage, or at frequent intervals between times. Remember, one should always lie down after a sitz bath. If desired you may give aconitum tincture. Dose:—Two drops in a half glass of water, tablespoonful doses every ten to thirty minutes according to the severity of the case." If a woman has taken a severe cold, then the aconite should be given, but under no other condition.
PHYSICIANS' TREATMENT.—Dr. Child advises that the cervix be dilated, and the interior of the womb, cervical canal and vagina swabbed out with a ten per cent silver nitrate solution. Subsequently vaginal douches (1 to 5000) corrosive sublimate solution followed by a salt solution, one dram of salt to a pint of water, should be given for at least one week. Keep the bowels open.
SEPTIC PUERPERAL ENDOMETRITIS.—This is an inflammation of the inner lining of the womb that occurs after child-birth during the first few weeks, and is due to a poison.
Symptoms.—The attack usually begins with a chill, preceded by a regular increase of the temperature and pulse. The face looks flushed at first, but it soon becomes pale and the patient has an anxious look, as the disease goes on. There is very little pain, if any. The discharge that always follows labor is diminished or stops and has no odor, if there is any discharge.
The death rate is from five to twenty-five per cent.
Treatment.—Never scrape out (curette) the womb for this disease. The womb should be washed out with a hot salt solution, one teaspoonful of salt to one pint of water, and then packed with ten per cent iodoform gauze. This solution should also be injected hot into the rectum and frequently. The bowels should move freely, and if necessary injections may be given for that purpose.
The strength must be kept up by a liquid diet. Milk, brandy and strychnine, if necessary; 1/100 of a grain of strychnine can be given every four hours. Milk should be given every half hour, about two ounces at one time: or more if it agrees well.
The gauze should be removed gradually, beginning on the third day and ending on the ninth day.
In this disease the interior of the womb is smooth and contains no broken down or foreign tissue. In the next disease, Putrid Endometritis, it is far different, for this is caused by the presence of dead material, such as parts of the after-birth, left in after labor, or sloughing tumors. This material becomes putrid (rotten), and thus causes the disease called "Putrid Endometritis."
PUTRID ENDOMETRITIS.—An inflammation of the inner lining of the womb caused by putrid (rotten), decaying material.
Symptoms.—A chill is sometimes present at the beginning. The fever is high, pulse bounds and feels hard and strong, the face is flushed but there is little or no pain. The discharge from the womb, unless it is blocked by a clot, is foul smelling. The flow after childbirth is scanty, sometimes suppressed. The womb and ovaries are not very tender.
Treatment.—The first thing to do, of course, is to get the dead material, such as parts of an after-birth, clots, shreds, etc., out of the womb, and then scrape the rough surfaces. This must be done carefully and with perfectly clean tools and liquids of every kind. Then wash the womb thoroughly with the hot salt solution. One teaspoonful of salt to one pint of boiled water. After this pack the womb with ten per cent iodoform gauze, which may be bought in this strength. Remove this from the womb about the third to the ninth day. The bowels should be kept open.
Diet.—Should be of milk or at least of liquids only. The patient can be given whisky or brandy and 1/60 grain of strychnine every four hours if needed.
MALIGNANT DISEASES OF THE WOMB.—Cancer or carcinoma is a malignant disease of the neck (cervix) of the womb.
Causes.—The immediate cause is not yet known. Tears and erosions (scraping off and making raw) are supposed to act as direct causes.
Symptoms.—Bleeding is the early and very important symptom. After the change of life (menopause) is over if bleeding occurs and continues it is a very bad sign and the womb should be examined immediately. Later, a watery bloody discharge appears, with pain, loss of weight and general weakness. Pain is not an early symptom. It appears when the disease has spread to the nearby tissue.
Treatment.—The only thing to do is to operate and the earlier the better. The womb and all its belongings should be removed. If this is done early it is very successful. If the case is too far advanced, the only thing to do is to make the patient as comfortable as possible.
For the pain, morphine or opium should be given.
For the discharge, hot water and corrosive sublimate (1 to 2000) is the strength to be used. This should be used daily as an injection into the vagina.
Cancer of the Body of the Womb is found in only about two per cent of womb cancers.
Treatment.—An early operation is then necessary. The chances of obtaining a cure if operation is done is better even than in cancer of the neck of the womb. There is less chance for the adjoining structures to be affected so early and readily.