mustard paper, or cold compress, over the heart during the attacks will sometimes prove of value. The hourly use of sodium bromide, taken in five-grain doses dissolved in water, is one of the most useful remedies in nervous persons, but should not be continued for a longer period than a day at a time. DEFICIENCY IN QUANTITY OR QUALITY OF THE BLOOD-ANEMIA-Blood is a fluid in which float microscopic solid elements-the red and white cells. Anæmia is a condition of the blood in which either the total amount of blood is reduced, or there is a deficiency in the number of red cells, or in the matter which gives to these cells their red color. Until the microscopic examination of blood had reached the development which it has now attained, a person was thought to have anæmia when the face, and more particularly the lips, presented a pale or bloodless color. But examination of the blood shows us that not all persons with even marked paleness have anæmia. This is notably the case with persons living in the tropics (who are not exposed to the sun), in those with nervous exhaustion, and often in patients with beginning consumption. Therefore it is not safe to rely upon color or even symptoms-as in nervous prostration with pallor we have the symptoms common to anæmia-but for accuracy the blood of the pale person must be examined by a competent medical man. Anæmia is ordinarily secondary to some other diseased condition. Among these we have the following: loss of blood as from injury; from bleeding from the stomach, lungs, piles, or the womb; in conditions with a constant drain from the body, as in nursing mothers; in chronic diarrhea; and with discharging sores and wounds; poisons, as by constant exposure to lead and arsenic, and the poisons of germ diseases, as malaria, syphilis, typhoid fever, tuberculosis, etc.; chronic digestive disorders, or starvation and cancer. Various forms of worms infesting the bowels may produce the most severe forms of anæmia, and among these the minute hook worm has recently been discovered to be responsible for much of the disease in certain localities, as in our new insular possessions in the Philippines and Porto Rico and in many parts of the Southern United States. The "clay eaters" of the South owe their color and condition chiefly to the hook worm. Its recognition and expulsion from the body have now become simple matters to the physician. It will thus be impressed upon the mind of the reader that it is incumbent upon pale persons not only to have their blood examined but to employ a physician to discover and remedy the cause. There are, however, certain individual cases in which it may not be possible to assign a cause, and there are two general classes of cases in which there is severe anæmia without apparent cause. These two classes include (a) the "green disease" (chlorosis) of young women between the ages of fourteen and seventeen; generally those who have grown up in the city without proper air, food, and exercise, and who present a peculiar yellowish-green complexion; and (b) the fatal type of anæmia, in which there are waxy pallor and bloodless lips and such great languor and increasing weakness that the patient takes to bed. Symptoms.-Besides paleness of the skin and mucous membrane of the lip inside of the mouth and pearly bluish whiteness of the whites of the eyes, there is the peculiar greenish-yellow complexion of the anæmia of young women; while in the more grave forms the skin has often a waxen or even yellowish hue, and there may be brown pigmentation about the ankles. Among the more frequent results of anæmia are fluttering of the heart and short breath on slight exertion; languor and fatigue after slight mental or physical work; poor appetite and disturbed digestion, with constipation; headache, dizziness, and fainting, with the appearance of spots before the eyes and blurring of the sight. In the severe cases of anæmia there is excessive weakness. Puffiness of the face and ankles is sometimes seen. The skill of a physician will be required to rule out such conditions as disease of the heart or kidneys, or nervous exhaustion associated with paleness, in which the symptoms are somewhat similar. The outlook is usually favorable in the anæmias secondary to other diseases, which can be remedied, and also in the form of green disease" peculiar to young women. The treatment consists in a general way in following an outdoor life, especially in high altitudes; in eating good, nourishing food, particularly the red meats, milk, eggs, and green vegetables; and in the use of iron in the form of Blaud's pills. Two of the five-grain Blaud's pills may be taken three times daily, after meals. Arsenic is valuable, notably in the more severe cases, but should be taken only under a physician's directions. CHAPTER II The Stomach and Bowels - Indigestion - Jaundice — Biliousness Dyspepsia — VomitingDiarrhea-Cholera Infantum-Dysentery-Cholera Morbus -Cholera-Constipation-Worms. ACUTE INDIGESTION.—Acute indigestion is really a catarrhal inflammation of the lining mucous membrane of the stomach, with swelling and redness such as is seen in a bad sore throat; sometimes there is also an acute catarrh of the first part of the bowels (see p. 477). This condition is caused by food which is indigestible or has begun to decompose, in which condition it is favorable to the growth of disease germs, particularly in hot weather. The excessive use of alcohol, overeating, fatigue, and violent emotion may also cause it. Symptoms. At first there is a feeling of weight, fullness, and discomfort just below the breastbone. Sometimes there is actual pain, but this is usually not violent. The mouth is dry, the tongue is coated, and thirst is usually present. Nausea and vomiting are the most characteristic symptoms, together with tenderness on pressure over the stomach. pelled, and then mucus and bile. The food is first ex After vomiting has |