CERVICAL, TUBERCULOSIS (Scrofula)

Categories: Infectious Diseases

This is common in children that are
not well nourished, living in badly ventilated and crowded houses, and in

the negroes. Chronic catarrh of the nose and throat and tonsilitis

predispose to it. The glands under the lower jaw are usually the first

involved. They are enlarged, smooth, firm and often become matted

together. Later the skin may adhere to them and suppuration occurs, that

is, pus forms. An abscess results that bre ks through the skin and leaves

a nasty looking sore or scar. The glands in the back of the neck may

enlarge also; or in the arm pit or under the collar bone and also the

bronchial glands. There is usually secondary anemia. A long course and

spontaneous recovery are common. Lung or general miliary tuberculosis may

occur.



Mesenteric Kind. Symptoms are loss of flesh and strength, anemia,

distended abdomen (pot-belly) and bloated, with offensive diarrhea.



MOTHERS' REMEDIES. 1. Consumption, Simple Home Method to Break up. "A

cloth saturated with kerosene oil, bound around the chest at night and

frequently repeated, will remove lung soreness, and it may be taken

inwardly with advantages, eight to ten drops three or four times a day in

sarsaparilla. It has been tried efficaciously as a cure for consumption."



2. Consumption, Physicians' Remedy for.



Arsenic Acid 1 part

Carbonate of Potash 2 parts

Cinnamyllic Acid 3 parts



Heat this until a perfect solution is obtained, then add twenty-five parts

cognac and three parts of watery extract of opium which has been dissolved

in twenty-five parts of water filtered. Dose:--At first take six drops

after dinner and supper, gradually increasing to twenty-two drops. Mild

cases are cured in two months, but the severe cases may require a year or

two. This treatment should be given under the care of a physician, as it

is poisonous and needs close watching.







PHYSICIANS' TREATMENT for Consumption. Tuberculous peritonitis is often

present. General better hygienic measures; fresh air, nourishing food;

cod-liver oil. The glands are now often cut.



Sanitary Care. Prevention of Tuberculosis. The sputum of consumptives

should be carefully collected and destroyed. Patients should be urged not

to spit about carelessly, but always use a spit cup and never swallow the

sputum. The destruction of the sputum of consumptives should be a routine

measure in both hospitals and private practice. Thorough boiling or

putting in the fire is sufficient. It should be explained to the patient

that the only risk, practically is from this source.



The chances of infection are greatest in young children. The nursing and

care of consumptives involves very slight risks indeed, if proper

precautions are taken.



Second. A second important measure, relates to the inspection of dairies

and slaughter houses. The possibility of the transmission of tuberculosis

by infected milk has been fully demonstrated, and in the interest of

health, the state should take measures to stamp out tuberculosis in

cattle.



Individual Prevention. A mother with pulmonary tuberculosis should not

nurse her child. An infant born of tuberculosis parents or of a family in

which consumption prevails, should be brought up with the greatest care

and guarded most particularly against catarrhal affections of all kinds.

Special attention should be given to the throat and nose, and on the first

indication of mouth breathing or any affection of the nose, a careful

examination should be made for adenoids. The child should be clothed in

flannel, and live in the open air as much as possible, avoiding close

rooms. It is a good practice to sponge the throat and chest night and

morning with cold water. Special attention should be paid to the diet and

to the mode of feeding. The meals should be given at regular hours, and

the food plain and substantial. From the onset the child should be

encouraged to drink freely of milk. Unfortunately in these cases there

seems to be an uncontrollable aversion to fats of all kinds. As the child

grows older, systematically regulated exercise or a course of pulmonary

(lung) gymnastics may be taken. In the choice of an occupation, preference

should be given to an out of door life. Families with a predisposition to

tuberculosis should, if possible, reside in an equable climate. It would

be best for a young person belonging to such a family to remove to

Colorado or Southern California, or to some other suitable climate before

trouble begins. The trifling ailments of children should be carefully

watched. In convalescence from fevers, which so frequently prove

dangerous, the greatest care should be exercised to prevent from catching

cold. Cod-liver oil, the syrup of iodide of iron and arsenic may be given.

Enlarged tonsils should be removed. "The spontaneous healing of local

tuberculosis is an every-day affair. Many cases of adenitis (inflammation

of the glands) and disease of the bone or joints terminate favorably. The

healing of pulmonary (lung) tuberculosis is shown clinically by the

recovery of patients in whose sputa elastic tissue and bacilli have been

found."







General Measures. The cure of tuberculosis is a question of nutrition;

digestion and assimilation control the situation; make a patient grow fat,

and the local disease may be left to take care of itself. There are three

indications:



First, to place the patient in surroundings most favorable for the

greatest degree of nutrition; second, to take such measures as in a local

and general way influence the tuberculosis process; third, to alleviate

the symptoms. This is effected by the open air treatment with the

necessary feeding and nursing.



At Home. In the majority of cases patients must be treated at home. In

the city it has many disadvantages. The patient's bed should be in a room

where he can have plenty of sunshine and air. Two things are

essential--plenty of fresh air and sunshine. While there is fever he

should be at rest in bed. For the greater part of each day, unless the

weather is blustering and raining, the windows should be open. On the

bright days he can sit out-doors on a balcony or porch, in a reclining

chair. He must be in the open air all that is possible to be. A great many

patients spend most of the time out in the open air now. In the country

places this can be easily carried out. In the summer he should be out of

doors from eleven to twelve hours; in the winter six to eight at least. At

night the room should be cool and thoroughly ventilated. "In the early

stages of the disease with much fever, it may require several months of

this rest treatment to the open air before the temperature falls to

normal." The sputum is dangerous when it becomes dry. As long as sputum is

moist the germs are held in the sputum; but when it is dry they are

released and roam at will in the atmosphere and are inhaled. They are then

ready to lodge themselves in suitable soil. Always keep the sputum

(expectoration) moist, and then there is no danger.



Diet. Treatment. The outlook in this disease depends upon the digestion.

Nausea and loss of appetite are serious obstacles. Many patients loathe

foods of all kinds. A change of air or a sea voyage may promptly restore

the appetite. When this is not possible, rest the patient, keep in the

open air nearly all day and feed regularly with small quantities either of

buttermilk, milk, or kumiss, alternating if necessary with meat juice and

egg albumin. Some cases which are disturbed by eggs and milk do well on

kumiss. Raw eggs are very suitable for feeding, and may be taken between

meals, beginning with one three times a day, and can be increased to two

and three at a time. It is hard to give a regular diet. The patient should

be under the care of a physician who will regulate the kind of diet,

amount and change. When the digestion is good there is less trouble in

feeding. Then the patient can eat meat, poultry, game, oysters, fish,

animal broths, eggs. Nothing should be fried. Avoid pork, veal, hot bread,

cakes, pies, sweet meats, rich gravies, crabs, lobsters.







Diet in Tuberculosis furnished us by a Hospital.



May Take. Soups. Turtle or oyster soup, mutton, clam, or chicken broth,

puree of barley, rice, peas, beans, cream of celery or tomatoes, whole

beef tea; peptonized milk, gruel.



Fish. All kinds of fresh fish boiled or broiled, oysters or clams, raw,

roasted or broiled.



Meats. Rare roast beef or mutton, lamb chops, ham, fat bacon.

sweetbreads, poultry, game, tender steaks, hamburger steak rare.



Eggs. Every way except fried.



Farinaceous. Oatmeal, wheaten grits, mush, hominy, rice, whole wheat

bread, corn bread, milk toast, biscuits, muffins, gems.



Vegetables. Potatoes baked, boiled, or creamed, string beans, spinach,

onions, asparagus, tomatoes, green peas, all well cooked, cresses,

lettuce, plain or with oil dressing, celery.



Desserts. Farina, sago, tapioca, apple or milk pudding, floating island,

custards, baked or stewed apples with fresh cream, cooked fruits, rice

with fresh cream.



Drinks. Fresh milk, cool, warm, or peptonized, cocoa, chocolate,

buttermilk, pure water, tea, coffee, panopepton.



Must Not Take. Fried foods, salt fish, hashes, gravies, veal, pork,

carrots, parsnips, cabbage, beets, turnips, cucumbers, macaroni,

spaghetti, sweets, pies, pastry, sweet wines.







WHAT EVERY PERSON SHOULD KNOW ABOUT TUBERCULOSIS,

WHETHER HE HAS THE DISEASE OR NOT.



Tuberculosis is caused by a germ.



Tuberculosis is communicable and preventable.



Consumption of the lungs is the most common form of tuberculosis.



Consumption of the bowels is the next most common form.



The germ causing tuberculosis leaves the body of the person who has the

disease by means of the discharges; by the sputum coughed up from the

lungs, by nasal discharge, by bowel excrement, by urine, by abscesses.





If the sputum of the consumptive is allowed to dry, its infected dust

floats in the air, and is breathed into the lungs.







Any person breathing such air is in danger of contracting tuberculosis. It

is best not to stand near a person suffering with tuberculosis who is

coughing, because in this act finely divided droplets of saliva are thrown

from the mouth, and may be carried for a distance of three feet. These may

contain large numbers of the bacilli. They are also sometimes thrown out

in forcible speaking. The ordinary breath of a consumptive does not

contain them.



If the bowels or other discharges from the tuberculous person are not

disinfected, but are thrown into a sewer, privy, river or buried they are

a source of danger, and may pollute a source of drinking water.



Impure milk, that is, milk from a tuberculous cow or milk exposed to

infected dust is a common source of tuberculosis. Milk from suspected

sources should be boiled. The all-important thing to do to prevent

tuberculosis from spreading from one person to another, and from one part

of the body to another, is immediately to destroy all discharges from the

body of a person who has tuberculosis.



Destroy by fire or by disinfectant all sputum, all nasal discharges, all

bowel excrement, all urine as soon as discharged. For such a purpose use a

five per cent solution of carbolic acid (six and three-fourths ounces of

carbolic acid to one gallon of water).



No person, well or sick, should spit in public places or where the sputum

cannot be collected and destroyed.



Flies carry sputum and its infection to food, to your hands, your face,

clothes, the baby's bottle, from which the germs are taken into the mouth,

and thus gain access to the stomach or lungs.



Spitting on the sidewalk, on the floor, on the wall, on the grass, in the

gutter, or even into a cuspidor containing no disinfectant is a very

dangerous practice for a consumptive to indulge.



The person infected with tuberculosis should protect himself, his family,

his associates and the public by not spitting in public places, and by

promptly destroying all discharges.



The well person should defend himself by insisting that the tuberculous

person shall destroy all discharges.



Well persons should set the example of restraint and themselves refrain

from spitting promiscuously. A person may appear quite healthy and yet be

developing tuberculosis without knowing it.



Such a person, if he spits where he pleases, may be depositing infected

sputum where it can endanger the health and lives of other persons.



Do not sleep with a person who has tuberculosis, nor in the room occupied

by a tuberculous person, until that room has been thoroughly disinfected.







Any person is liable to contract tuberculosis, whether he is well or not.

Sickly persons, or those having bad colds, influenza bronchitis or

pneumonia or any general weakness are much more liable to contract

tuberculosis than a perfectly well or robust person. If you have a cough

that hangs on consult at once a reliable physician who has ability to

diagnose tuberculosis.



Prevention is possible; it is cheaper and easier than cure.



Any person having tuberculosis can recover from the disease if he takes

the proper course in time.



Advanced cases of tuberculosis, that is, those cases where the disease is

well developed, are the most dangerous to the public and the most

difficult to cure.



Every advanced case of tuberculosis should be in a sanatorium.



Sanatoria offers the best chance, usually the only chance, of cure to an

advanced case.



They also protect well citizens from danger of infection from advanced

stages of tuberculosis. There are fewer deaths from tuberculosis in those

localities where sanatoria are established for the care of tuberculous

persons.



One person out of every seven who die, dies from tuberculosis.



One child out of every ten dies from tuberculosis.



Homes and school-houses greatly need more fresh air supplied to their

occupants.



Day camps are city parks, vacant lots or abandoned farms where the

tuberculous persons of a community may go and spend the entire day in

rest, receiving instructions in proper hygiene and skillful treatment.

Such camps are supplied with tents, hammocks, reclining chairs, one or

more nurses, milk, eggs and other nourishment.



Dispensaries are centers of sanitary and medical instruction for local

tuberculous persons.



Every locality should establish and maintain a dispensary for the benefit

of tuberculous persons; for their instruction how to prevent the disease

from spreading, and how to conduct themselves to insure relief and cure.



Householders are required by law to report a case within their households

to the local health officers. The local health officer has certain duties

to perform under the law, and co-operation with him by the householder and

tuberculous person, works for the suppression of this disease.



Do not consider a tuberculous person an outcast, or one fit for the

pesthouse. Your crusade is against tuberculosis, not against the person

suffering from the disease.



Give the freedom of a well person to the tuberculous who is instructed and

conscientious in the observance of necessary precautions. Be very much

afraid of the tuberculous person who is ignorant or careless in the

observance of necessary precautions.