Several decades ago, in a Michigan village, a small boy named William Cardey came home from school complaining of a pain.

Mrs. Thomas Cardey eyed her son with some concern. Although the freckled, energetic youngster of nine had run the gamut of most childhood diseases, he seldom was ill, and indeed it took a noticeable illness to wring a word of com­plaint from him. Now, Mary Cardey felt of her son's fore­head for an indication of temperature.

"Just where is the pain, darling?" she asked. "What kind is it?"

"It's a bellyache."

"Stomach-ache," she corrected gently, in the etiquette of the day. "Is it very bad?"

"Real bad, Ma."

"Did you throw up?"

"No. It just hurts."

"You haven't eaten any apples or anything?"

"Nothing, Ma. Honest. It just started to ache."

"You go in to the couch. I'm going to fix you a little hot water and peppermint. Maybe that will help."

A few moments later the boy sipped the drink.

"It ought to be better in a little while," Mary Cardey told her son. "I have to start dinner. Your father will be home soon. Where is Martha?"

William shrugged a small .boy's indifference to an older sister's activities. "I think she went over to Susan's house. I dunno."

"Well, you rest and be quiet. Let the peppermint work."

"It still aches, Ma."

"I'll come back in a few moments. Maybe it will be stopped by then."

Mary Cardey returned to her kitchen and started the family dinner. Twenty minutes later she returned to the living room. William was stretched out on the couch, looking unhappily at the ceiling.

"It ain't quit, Ma."

"Hasn't," she corrected. "Not a bit?"

"Nope."

She felt his forehead again. "You don't seem to have a fever," she said thoughtfully. "I think I'll go next door and ask Mrs. Hunninger what she uses for the children. That will probably help."

"Ma, what did you give Martha that time?"

"That was different, darling. That was something to do with girls when they get to be Martha's age. I'm going to see Mrs. Hunninger."

She went out the back door and into the kitchen of the house next door. A matronly woman with gray hair and a pleasant, kindly smile greeted her.

"William has a stomach-ache," Mary explained. "I gave him some peppermint in hot water, but it didn't seem to help. Do you know anything to use?"

"Well, now—let me see. Sometimes I used a little ginger. And mustard in water is good. Then again, I've known a little lemon juice to help, especially if a child's bilious. Is William?"

"You mean throwing up and like that? No. It isn't that. He says it's just a pain."

"Is he constipated?"

"I didn't think to ask. I suppose it could be that!"

"Well, if he is, there's nothing like a good dose of castor oil, Mary."

"I'd better find out if he is."

"Or if it's the other—if he has diarrhea, I always think it's best to use what my grandmother used. She boiled parched corn and meal in skimmed milk. Browned rice is good, too. Mrs. Tollinger over at Ann Arbor always gives her children a little raw wheat flour thinned with water so they can drink it."

"I don't think he has that. I'm sure of it. But I do wonder if he's constipated."

"Well, for that, I say either castor oil or an enema." Mary Cardey thanked her neighbor and returned to her home. William still was on the couch. The pain still was with him. He said that he was not constipated; nor did he have diarrhea.

Mary frowned. "I guess I'll put a hot iron on your stomach. Maybe that would help."

She went to the kitchen and took a flatiron from the back of the kitchen stove. It was hot to the touch and she wrapped it carefully in a towel and took it to her son. She put it on his abdomen.

"There! Maybe that will ease the pain," she said a little doubtfully. "I wish your father would come home. He knows so many remedies."

"I don't want any castor oil!" William said. "That's what Pa always wants to give me. I don't want none of that!"

"Any of that," Mary said automatically. "But you listen to me, young man. You tell me the truth. Do you need castor oil? I'm not sure that you don't. When did you go last?"

"Well . . . yesterday, I think."

"Are you sure it wasn't the day before yesterday?"

"Maybe it was. I forget," William said evasively.

"Hmm. I think perhaps your father's remedy may be what you need!"

"Aw, Ma! I don't want none of that. It's awful."

"Any of that. And I know it's awful, but it'll help."

"Harold Withers was sick in the stomach and they gave him some pare . . . parygore ... or something like that."

"Paregoric. And I'm not going to give you any. Nor any calomel like Constance Maclovelace gives her youngsters. That isn't what you need. We'll wait for your father to come home."

In this brief bit of Americana from the early part of this century, we see a scene that probably was repeated hundreds and thousands of times in homes across the country. In this case, William's dose of castor oil helped him.

The "stomach-ache"—the "bellyache"—is one of man­kind's greatest symptoms of physical disorders.

Remedies for the abdominal ache are almost multitudinous, ranging over a broad area of herbs, animal, and mineral sub­stances. Witch doctors have used sorcery for the aches. Charms have been worn to prevent the aches or cure them. Acupuncture and its allied practices have been used.

Today the mother of another William probably would be very careful about using castor oil under the circumstances. Most well-educated mothers realize that a "pain in the stomach" can mean appendicitis, in which case a purgative or enema could be dangerous.

Probably in few other instances are the folk remedies more doubtful than in the case of the abdominal pain. And again it is the story of diagnosis.

When a backwoodsman came down with a "bellyache" in days when Indians still were on the warpath, and sometimes a doctor was not within a hundred miles, the "bellyache" was simply a "bellyache" and nothing more to the sufferer, his family and his friends. And quite possibly it would have been very little more to some of the frontier doctors. Diagnostic techniques were far short of what they are today. Knowledge of what a "bellyache" might mean was not pinpointed in those days.

Thus a sufferer unknowingly might have appendicitis, gall stones, food poisoning, a peptic ulcer, cancer, cholera, a tumor, a bowel obstruction, indigestion, peritonitis, chronic enteritis, gastritis, and—in a woman—a tubal pregnancy or a twisted ovarian cyst. Even a coronary thrombosis, peri­carditis, pneumonia and pleurisy can, in the words of The Merck Manual: "Cause epigastric pain and must always be considered in the differential diagnosis of abdominal pain."

As a matter of fact, it was not until 1886 that appendicitis, the most common of all conditions requiring abdominal sur­gery, was actually recognized.

Since the cause of abdominal pains may vary greatly, it is obvious that one cure—or the "shotgun" type of medicinal cure—could hardly be expected to be unerringly effective in the practice of folk medicine.

The purgative or enema, for instance, might aggravate rather than relieve a condition. In some instances such medi­cation might be very dangerous.

However, certain of the folk medicines occasionally proved to be helpful, probably because they happened, luckily, to be administered for an illness that could benefit by such medi­cation.

For many years thousands have resorted to a little baking soda in water, milk of magnesia, or some other antacid to relieve the "heartburn" that may attack within the hour after a meal.

On the other hand, some coronary cases report that their "angina" resembles "heartburn," so the home remedy might be wholly inadequate for a serious condition.

As one doctor told a patient recently, "Whenever you keep on having pains like that, it's time to see me. It's when you don't see your doctor that you may get in trouble."

He was right. Whenever an abdominal pain lasts a few hours, frequently recurs, or becomes chronic, a doctor cer­tainly should be consulted. The great improvements in medi­cal care are most effective when trouble is caught early—the earlier the better.

Before diagnosis became so vastly improved, remedies for "stomach-ache" frequently involved the use of herbs.

Again, the ancient Aztec doctors had evolved treatments. It is noteworthy that they made a distinction between the upper and lower regions of the abdomen. For the upper, herb extracts and stones were given in a potion to relieve distress. For the lower area enemas were used.

Our North American Indians used lobelia tea, cascara bark, black sage, anise, or a number of other substances for laxa­tives. Blue flax was used for a disordered stomach and gas. And even the Indians used peppermint tea for gas pains.

Mint has been used for years for nausea and stomach disorders. Herbalists suggest avens, masterwort, monks rhu­barb, poplar and camomile among other treatments for indi­gestion. Some of them advocate blackberry for diarrhea and, indeed, blackberry wine still is frequently used for this discomfort.

Some of the herbal treatments are a holdover from thera­peutic theories and treatments established by the famous Greek physician Galen, born in 130 A.D.

Galen believed that the body, like the universe, was made of four elements: fire, air, water, and earth. These elements, thought Galen, represented qualities of the body. Fire was hot, air was dry, water was wet, and earth was cold, and to be healthy, a person must preserve the qualities in their proper proportions.

He observed that drugs had similar qualities. Some were cooling, some heating, some drying, some moistening. There­fore, the theory claimed, if the patient had a fever, he needed a cooling drug. If he was chilled he needed a heating agent.

Several thousand drugs were used in the Galenic system of therapeutics. Some of them may still be found in the ad­ministrations of untrained "herb doctors" and in some of the old stand-by, much advertised "proprietory" drugs.

One treatment—purging—seems to have been general for stomach disorders (and most other ailments) since the days of the ancient Egyptians, and actually has been discontinued only within comparatively recent times.

One type of "stomach-ache" was identified with disastrous results in the United States in 1832, and continued sporad­ically for a good many years afterwards. In 1832 an emigrant ship which landed in Quebec carried Asiatic cholera.

Within months the disease had crept down into the New England States. Deaths began to be reported with alarming frequency, and the spread of the disease was to continue.

Troops on the way from Buffalo to the Black Hawk War arrived in Detroit bringing cholera with them.

Death followed. Panic swept over the town. Within a short time 58 cases were reported. Twenty-eight deaths came in two weeks. The top floor of the capitol building was converted into a hospital.

In the street the ominous death cart made its way with an attendant crying: "Bring out the dead!"

What was left of the troops went on to Fort Dearborn to bring the disease to Chicago. After the soldiers arrived on July 10th, 18 of them died within 30 hours. The death-dealing disease spread to the inhabitants. Quickly, there were 30 or more cases and inhabitants began to flee the town.

So the disease spread. Late in July a newspaper in Indian­apolis listed 150 cases and 50 deaths. The plague spread to the Wisconsin country, Ohio, New Orleans, into the South.

In 1833 it increased in intensity. In Lexington the popu­lation was reduced from 6,000 to 4,000 in weeks. Other communities were hit almost as hard.

In 1848 another siege of cholera spread in almost the same manner. Cincinnati had 5,969 deaths in 15 weeks.

How did it strike? What did they do for it?

Webster Bronson, a young man living in Cincinnati during that time, went to work at his blacksmith shop feeling in excellent health one morning.

At the door, before leaving, he tried to reassure his wife— a tall, dark and very pretty girl from Ypsilanti, Michigan. They had been married less than a year.

"You mustn't worry about the cholera," he told her. "Stay in the house. Don't go out."

"But you'll be out there, Web. I'm scared."

"Look at me, Sally. I'm as strong as a horse. It'll take more than a sickness to get me down!"

He kissed her hard and brought a smile to her face as he lifted her up with his strong, workman's hands and swung her around.

By midmorning, Webster Bronson suddenly had a deep sense of uneasiness. Something was wrong. He stopped his work at the anvil for a moment and went to the door of his shop for some fresh air.

"Must be something I ate," he told himself.

He returned to the anvil, but before long he felt an inward burning. He used a dipper at his bucket of drinking water, wishing the water were colder.

/ feel like I'm burning up inside, he thought. Then he realized that these were the symptoms he had heard about. He set his lips in a burst of determination. "No. Not me. I'm too strong!"

Webster Bronson was not strong enough. Soon he was ex­periencing the vomiting and severe intestinal spasms brought on by Asiatic cholera.

Shortly afterwards, at home, his wife watched him with fright and concern. A friend down the street had brought some calomel. But it hadn't helped. Another said doctors were recommending jalap.

Dr. Drake recommended bleeding. Probably the best-known doctor in the West, his writings on cholera were widely copied in newspapers. To. combat cholera, he said, the city should be cleaned up. He advised normal diet, "a calm and hopeful mind" and wearing of thin flannel over the trunk of the body. But for treatment, he suggested, in addition to various drugs, that bleeding was to be recommended:

"To bleed a patient who cannot be raised from his pillow without fainting, whose pulse is nearly imperceptible, whose skin is cold, and extremities shrunk up to half their ordinary size, would at first view, seem rash and unwarrantable. But experience, which in medicine can grant warrants for any procedure, has sanctioned the use of the lancet even when all these and other symptoms of extreme prostration, are present . . ."

Today, of course, we know the source of cholera infection through bacilli; and that the treatment of streptomycin and terramycin can destroy the bacteria and cure the illness, if given in time.

But none of this was known when Webster Bronson was stricken with Asiatic cholera well over a hundred years ago. A little calomel was tried, without success. Desperately the young wife tried to find a doctor, but no one was available in the near-panic created by the pestilence.

Webster Bronson died.

Modern medicine has brought us very far along the road of diagnosis. Today the "stomach-ache"—more properly called the "abdominal pain"—is known to be the symptom of many diseases, and may arise from a multitude of disorders.

"Doc, what else but indigestion?" an electrician asked his family doctor recently.

"Your pain, for instance," said Dr. Mort Carmichael. "Bill, that pain in the pit of your stomach—as you describe it— actually is being caused by your appendix."

"I thought the appendicitis pain is always lower on the right side."

"Not necessarily."

"Then it isn't an ulcer?"

"It could be. It could also be a tumor, a renal carbuncle, hepatitis, liver abscess, carcinoma, pancreatitis—"

"That's enough, Doc, It's all Greek—or Latin—to me. What do we do about it?"

"Take out the appendix."

"Well—you're the doctor," the electrician grinned. "I guess it's not a tough operation these days."

"Not when it's uncomplicated. It shouldn't be with you. You'll probably be up the next day. Home in a week if all goes well."

Within the hour Dr. Carmichael was carefully examining another patient whose principal symptoms seemed to be a "pain in the stomach." She was a middle-aged housewife by the name of Mrs. Kronbein, a little on the plump side and very matronly in appearance.

"The pains are really terrible, Doctor," she explained. "Arthur, my husband, thinks they have something to do with the 'change'—but I don't know."

"Knife-like pains?"

"Exactly. Up here—in this part." She indicated the upper right part of the abdomen. "Arthur—he sells insurance, you know, and knows about medical examinations and things— says at my age things like this can happen. He said to get right down here to see you. Maybe there are some hormones or something."

"Mrs. Kronbein, does this pain ever seem to knife right through to your back, and even up into your right shoulder?"

"How did you know that, Doctor? That's exactly what it does sometimes."

"Do you ever have indigestion?"

"Yes. A lot. Sometimes from things like turnips, or cabbage and, occasionally, from fruits."

"After you eat fried things, or fatty foods?"

"Yes. Sometimes I really come down with a sick spell. Arthur says they're almost like an old-fashioned bilious attack. But it's probably the menopause."

Dr. Carmichael asked a few more questions and then nodded in decision.

"We're going to take some X-rays, Mrs. Kronbein."

The woman looked startled and suddenly frightened. "You mean—you think there's something there? A tumor or a cancer or something?"

The doctor shook his head and smiled reassuringly. "Much more simple than that, Mrs. Kronbein. I think you have gallstones."

"Gallstones!"

The doctor nodded. "About twenty-five per cent of all women have them before they reach sixty. You're no exception."

"But you can do something, can't you? I mean, dissolve them or make them go away?"

"I'm afraid not. I recommend surgery. It's not a dangerous operation if you have it done when the gall bladder is not kicking up trouble. If you wait, and a gallstone lodges in the bile duct you can be in serious trouble."

Within two hours the doctor had encountered two cases in which abdominal pains were symptoms of two different con­ditions. During the day Dr. Carmichael had several similar cases.

Although the Pennsylvania-Dutch may have found some relief for a "pain in the belly" with bitters made of buds from balm of Gilead steeped in whiskey, or a harsh purge may have apparently remedied a temporary ailment of a Kentucky colonel, and even a session of blood-letting might have been administered to a woman in Detroit during the days of the cholera scourge—we may safely assume that some patients such as these recovered despite the remedies.

Of the thousands of herbs and kindred substances used in that branch of healing, there undoubtedly are some, and pos­sibly many, that are effective in helping to relieve some conditions.

Again, however, it is a question of diagnosis. Chemother­apy and all the many developments in a new world of medicine offer treatments that were undreamed of a few years ago. Furthermore, modern diagnostic techniques enable the competent physician to know what to use, how to use it, and when.

Meanwhile, even though we might feel a little more com­fortable about "stomach-aches" if we did have a little some­thing in the house to take when we've eaten too much or unwisely, it probably is best to consult our doctors and ask what to take, and when.

But remembering that a burst appendix can be most seri­ous; a gallstone obstructing a bile duct can result in peri­tonitis, jaundice, and occasionally in death; and that curable cancer may be incurable if not discovered in time—we should always remember that one of the initial symptoms of any of these conditions may be abdominal pain.

In other words, a "stomach-ache" can be a good deal more than a "stomach-ache." Treat it with respect.

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