Treatment is in some cases very simple; good food, quietness, and rest being all that is required to complete recovery in a week or two. What medicines are best in severer cases is not certain. Tonic treatment, however, it ought to be. Quinine and iron may be used, or qui nine (2 grains for each dose) with dilute hydro chloric acid (10-15 drops) taken in water three or four times a day. Arsenic is also used, but it should not be employed without medical ad vice. Attacks of purpura may return. There fore attention should be given to the diet, which should be of a mixed kind, with, that is, both vegetable and animal food.
Tendency to Bleeding (hemorrhagic dency, Heemophilia).—This is an inherited con dition in which bleeding, very difficult to stop, is apt to occur for very slight reasons. It is handed down chiefly by the females of a family, but is manifested specially by the males. Fami lies in which the tendency is exhibited are called " bleeders." The bleeding may occur from any part of the body—nose, throat, lungs, stomach and bowels, bladder, &c., as well as into the skin. It may be provoked by a pin-scratch, a leech-bite, ex traction of a tooth, &c. Bloodlessness may be a consequence of repeated attacks. Painful swellings of the larger joints are also liable to trouble persons affected with the tendency. Death may be occasioned by bleeding into the brain.
Treatment consists in taking care to avoid any occasion of exciting an attack, caution against accidents, injuries, &c. If bleeding arise it must be stopped, if possible, by means of pressure on the part, or where the part can not be reached, by the use of such remedies as are ordered for bleeding from the stomach (p.
237), bleeding from the lungs, &c.
Worms in the Blood (Filaria Sanquinis Hominis). —Some years ago (1870) a worm of microscopic size was found in the blood of per sons suffering from a disease called chyturia, in which the urine is milky, due to the presence of chyle (p. 276) in it. Researches made by various observers since then have shown the presence of such parasites in a considerable number of cases. They seem to exist specially in the lymphatic vessels, which may become blocked by them or their eggs, swelling and overgrowth of the part below the place of ob struction resulting, the swelling being inde pendent of inflammation. From the lymphatic vessels the worm, which is of the thread class, may find its way into the blood, and so be dis tributed throughout the body. It is in tropical countries that the disease occurs. The parasites may exist in large numbers without producing symptoms of their presence. There is no treat ment for their destruction known.
"Heart Disease" is a term which conveys a very serious meaning to most persons. Apart, however, from the fatal termination it is com monly held to indicate it implies nothing defi nite to the popular mind. It is indeed a very vague phrase, for, as we shall see, heart disease may exist iu a great variety of forms, some of which are not nearly so serious as others. Either the double bag (pericardium) which en velops the heart, or the heart substance itself, or its valves, may be the seat of disease; and the general term "heart disease" includes un usual conditions in any of these., It will be necessary, therefore, to consider the principal affections of the pericardium, of the heart sub stance, and of the valves.