Part 38

CURE OF DISEASE.--The first step in the cure of any disease is to obey the law of health which has been violated. If medicine be taken, it is not to destroy the disease, since that is not a thing to be destroyed, but to hold the deranged action in check while nature repairs the injury, and again brings the system into harmonious movement. This tendency of nature is our chief reliance. The best physicians are coming to have diminished confidence in medicine itself, and to place greater dependence upon sanitary and hygienic measures, and upon the efforts which nature always makes to repair injuries and soothe disordered action. They endeavor only to give to nature a fair chance, and sometimes to assist her by the intelligent employment of proper medicines. The indiscriminate use of patent nostrums and sovereign remedies of whose constituents we know nothing, and by which powerful drugs are imbibed at haphazard, can not be too greatly deprecated. When one needs medicine, he needs also a competent physician to advise its use.

DEATH AND DECAY.--By a mystery we can not understand, life is linked with death, and out of the decay of our bodies they, day by day, spring afresh. At last the vital force which has held death and decay in bondage, and compelled them to minister to our growth, and to serve the needs of our life, faints and yields the struggle. These powers which have so long time been our servants, gather about our dying couch, and their last offices usher us into the new life and the grander possibilities of the world to come. This last birth, we who see the fading, not the dawning, life, call death.

"O Father! grant Thy love divine, To make these mystic temples Thine, When wasting age and wearying strife Have sapp'd the leaning walls of life; When darkness gathers over all, And the last tottering pillars fall, Take the poor dust Thy mercy warms, And mold it into heavenly forms."

HOLMES.

HINTS ABOUT THE SICK ROOM

A SICK ROOM should be the lightest and cheeriest in the house. A small, close, dark bedroom or a recess is bad enough for one in health, but unendurable for a sick person. In a case of fever, and in many acute diseases, it should be remote from the noise of the family; but when one is recovering from an accident, and in all attacks where quiet is not needed, the patient may be where he can amuse himself by watching the movements of the household, or looking out upon the street.

The ventilation must be thorough. Bad air will poison both the sick and the well. A fireplace is, therefore, desirable. Windows should open easily. By carefully protecting the patient with extra blankets, the room may be frequently aired. If there be no direct draught, much may be done to change the air, by simply swinging an outer door to and fro many times.

A bare floor, with strips of carpet here and there to deaden noise, is cleanest, and keeps the air freest from dust. Cane-bottomed chairs are preferable to upholstered ones. All unnecessary furniture should be removed out of the way. A straw bed or a mattress is better than feathers. The bed hangings, lace curtains, etc., should be taken down. Creaking hinges should be oiled. Sperm candles are better than kerosene lamps.

Never whisper in a sick room. All necessary conversation should be carried on in the usual tone of voice. Do not call a physician unnecessarily, but if one be employed, obey his directions implicitly. Never give nostrums overofficious friends may suggest. Do not allow visitors to see the patient, except it be necessary. Never bustle about the room, nor go on tiptoe, but move in a quiet, ordinary way. Do not keep the bottles in the continued sight of the sick person. Never let drinking water stand in the room.

Do not raise the patient's head to drink, but have a cup with a long spout, or use a bent tube, or even a straw. Do not tempt the appetite when it craves no food. Bathe frequently, but let the physician prescribe the method. Give written directions to the watchers. Have all medicines carefully marked. Remove all soiled clothing, etc., at once from the room. Change the linen much oftener than in health. When you wish to change the sheets, and the patient is unable to rise, roll the under sheet tightly lengthwise to the middle of the bed; put on the clean sheet, with half its width folded up, closely to the other roll; lift the patient on to the newly-made part, remove the soiled sheet, and then spread oat the clean one.

DISINFECTANTS.

Remember, first, that deodorizers and disinfectants are not the same. A bad smell, for instance, may be smothered by some more powerful odor, while its cause remains uninfluenced. Bear also in mind the fact that no deodorizer and no disinfectant can take the place of perfect cleanliness and thorough ventilation. No purifyer can rival the oxygen contained in strong and continued currents of fresh, cold air, and every disinfectant finds an indispensable ally in floods of scalding water.

An excellent disinfectant may be made by dissolving in a pail of water either of the following: (1), a quarter of a pound of sulphate of zinc and two ounces of common salt for each gallon of water; (2), a pound and a half of copperas, for each gallon of water. Towels, bed linen, handkerchiefs, etc., should be soaked at least an hour, in a solution of the first kind, and then be boiled, before washing. [Footnote: It is best to burn all articles which have been in contact with persons sick with contagious or infectious diseases.

In using the zinc solution, place the articles in it as soon as they are removed from the patient, and before they are taken from the room; if practicable, have the solution boiling hot at the time. In fumigating apartments, all the openings should be made as nearly air-tight as possible. The articles to be included in the fumigation should be so exposed and spread out that the sulphurous vapor may penetrate every portion of them. For a room about ten feet square, at least two pounds of sulphur should be used; for larger rooms, proportionally increased quantities. Put the sulphur in iron pans supported upon bricks placed in washtubs containing a little water, set it on fire by hot coals or with the aid of a spoonful of alcohol, or by a long fuse set on train as the last opening to the room is closed. Allow the apartment to remain sealed for twenty-four hours. Great care should be taken not to inhale the poisonous fumes in firing the sulphur. After the fumigation, allow free currents of air to pass through the apartment; expose all movable articles for as long time as may be to the sun and the wind out of doors; beat and shake the carpets, hangings, pillows, etc.

The disinfectants and the instructions for using them, as given above, are mainly those recommended by the National Board of Health.] Vaults, drains, vessels used in the sick room, etc., should be disinfected by a solution of the second kind; chloride of lime may also be used for the same purpose. Rooms, furniture, and articles that can not be treated with the solution of the first kind, should be thoroughly fumigated with burning sulphur. Where walls are unpapered, re-whitewash with pure, freshly slacked quicklime, adding one pint of the best fluid carbolic acid to every gallon of the fluid whitewash. Powdered stone lime sprinkled on foul, wet places, or placed in pans in damp rooms, will absorb the moisture; and dry, fresh charcoal powder may be combined with it to absorb noxious gases.

WHAT TO DO TILL THE DOCTOR COMES.

The following instructions are intended simply to aid in an emergency. When accidents or a sudden severe illness occur, there is necessarily, in most cases, a longer or shorter interval before a physician can arrive. These moments are often very precious, and life may depend upon a little knowledge and much self-possession. The instructions are therefore given as briefly as possible, that they may be easily carried in the memory. A few suggestions in regard to common ailments are included.

BURNS.--When a person's clothes catch fire, quickly lay him on the ground, wrap him in a coat, mat, shawl, carpet, or in his own garments, as best you can to extinguish the flame. Pour on plenty of water till the half- burned clothing is cooled. Then carry the sufferer to a warm room, lay him on a table or a carpeted floor, and with a sharp knife or scissors remove his clothing.

The treatment of a burn consists in protecting from the air. [Footnote: It is a great mistake to suppose that salves will "draw out the fire" of a burn, or heal a bruise or cut. The vital force must unite the divided tissue by the deposit of material and the formation of new cells.] An excellent remedy is to apply soft cloths kept wet with sweet oil, or with tepid water which contains all the "cooking soda" that it will dissolve. Afterward dress the wound with carbolic acid salve. Wrap a dry bandage upon the outside. Then remove the patient to a bed and cover warmly. [Footnote: In case of a large burn, lose no delay in bringing a physician. If a burn be near a joint or on the face, even if small, let a doctor see it, and do not be in any hurry about having it healed. Remember that with all the care and skill which can be used, contractions will sometimes take place. The danger to life from a burn or scald is not in proportion to its severity, but to its extent--that is, a small part, such as a hand or a foot, may be burned so deeply as to cripple it for life, and yet not much endanger the general health; but a slight amount of burning, a mere scorching, over two thirds of the body, may prove fatal.-- HOPE.] Apply cool water to a small burn till the smart ceases, and then cover with ointment. Do not remove the dressings until they become stiff and irritating; then take them from a part at a time; dress and cover again quickly.

CUTS, WOUNDS, ETC.--The method of stopping the bleeding has been described on page 128. If an artery is severed, a physician should be called at once. If the bleeding is not profuse, apply cold water until it ceases, dry the skin, draw the edges of the wound together, and secure them by strips of adhesive plaster. Protect with an outer bandage. This dressing should remain for several days. In the meantime wet it frequently with cool water to subdue inflammation. When suppuration begins, wash occasionally with tepid water and Castile soap.

Dr. Woodbridge, of New York, in a recent address, gave the following directions as to "What to do in case of a sudden wound when the surgeon is not at hand." "An experienced person would naturally close the lips of the wound as quickly as possible, and apply a bandage. If the wound is bleeding freely, but no artery is spouting blood, the first thing to be done is to wash it with water at an ordinary temperature. To every pint of water add either five grains of corrosive sublimate, or two and a half teaspoonfuls of carbolic acid. If the acid is used, add two tablespoonfuls of glycerine, to prevent its irritating the wound. If there is neither of these articles in the house, add four tablespoonfuls of borax to the water. Wash the wound, close it, and apply a compress of a folded square of cotton or linen. Wet it in the solution used for washing the wound and bandage quickly and firmly. If the bleeding is profuse, a sponge dipped in very hot water and wrung out in a dry cloth should be applied as quickly as possible. If this is not available, use ice, or cloths wrung out in ice water. If a large vein or artery is spouting, it must be stopped at once by compression. This may be done by a rubber tube wound around the arm tightly above the elbow or above the knee, where the pulse is felt to beat; or an improvised 'tourniquet' may be used. A hard apple or a stone is placed in a folded handkerchief, and rolled firmly in place. This bandage is applied so that the hard object rests on the point where the artery beats, and is then tied loosely around the arm. A stick is thrust through the loose bandage and turned till the flow of blood ceases."

BLEEDING FROM THE NOSE is rarely dangerous, and often beneficial. When it becomes necessary to stop it, sit upright and compress the nostrils between the thumb and forefinger, or with the thumb press upward upon the upper lip. A piece of ice, a snowball, or a compress wet with cold water may be applied to the back of the neck.

A SPRAIN [Footnote: "A sprain," says Dr. Hope, in that admirable little book entitled Till the Doctor comes and How to help Him, "is a very painful and very serious thing. When you consider that from the tips of the fingers to the wrist, or from the ends of the toes to the leg, there are not less than thirty separate bones, all tied together with straps, cords, and elastic bands, and about twenty hinges, all to be kept in good working order, you will not wonder at sprains being frequent and sometimes serious."] is often more painful and dangerous than a dislocation. Wrap the injured part in flannels wrung out of hot water, and cover with a dry bandage, or, better, with oiled silk. Liniments and stimulating applications are injurious in the first stages, but useful when the inflammation is subdued. Do not let the limb hang down, keep the joint still. Without attention to these points, no remedies are likely to be of much service. A sprained limb must be kept quiet, even after all pain has ceased. If used too soon, dangerous consequences may ensue. Many instances have been known in which, from premature use of an injured limb, the inflammation has been renewed and made chronic, the bones at the joint have become permanently diseased, and amputation has been necessitated.

DIARRHEA, CHOLERA MORBUS, ETC., are often caused by eating indigestible or tainted food, such as unripe or decaying fruit, or stale vegetables; or by drinking impure water or poisoned milk (see p. 321). Sometimes the disturbance may be traced to a checking of the perspiration; but more frequently to peculiar conditions of the atmosphere, especially in large cities. Such diseases are most prevalent in humid weather, when the days are hot and the nights cold and moist. Especial attention should at such times be paid to the diet. If an attack comes on, ascertain, if possible, its cause. You can thereby aid your physician, and, if the cause be removable, can protect the rest of the household. If the limbs are cold, take a hot bath, followed by a thorough rubbing. Then go to bed and lie quietly on the back. In ordinary cases, rest is better than medicine. If there be pain, have flannels wrung out of hot water applied to the abdomen. [Footnote: If it be difficult to manage the foments, lay a hot plate over the flannels and cover with some protection. By having a change of hot plates, the foments can be kept at a uniform high temperature. This plan will be found useful in all cases where foments are needed.] A mustard poultice will serve the same purpose if more convenient. Eat no fruit, vegetables, pastry, or pork. Use water sparingly. If much thirst exist, give small pieces of ice, or limited quantities of cold tea or toast water. Take particular pains with the diet for some days after the bowel irritation has ceased.

CROUP.--There are two kinds of croup--true and false. True croup comes on gradually, and is less likely to excite alarm than false croup, which comes on suddenly. True croup is attended with fever and false membrane in the throat; false croup is not attended with fever or false membrane. True croup is almost always fatal in four or five days; false croup recovers, but is liable to come on again. The great majority of cases of the so- called croup are simply cases of spasm of the glottis. "Croupy children" are those who are liable to these attacks of false croup, which are most frequent during the period of teething.--DR. GEO. M. BEARD. Croup occurs commonly in children between the ages of two and seven years. At this period, if a child has a hollow cough, with more or less fever, flushed face, red watery eyes, and especially if it have a hoarse voice, and show signs of uneasiness about the throat, send at once for a doctor. Induce mild vomiting by doses of syrup of ipecac. Put the feet in a hot mustard-and-water bath. Apply hot fomentations, rapidly renewed, to the chest and throat. A "croupy" child should be carefully shielded from all physical excitation, sudden waking from sleep, and any punishment that tends to awaken intense fear or terror. Irritation of the air passages through faulty swallowing in drinking hastily, should be guarded against. Good pure air, warm clothing, and a nourishing diet are indispensable.

COMMON SORE THROAT.--Wrap the neck in a wet bandage, and cover with flannel or a clean woolen stocking. Gargle the throat frequently with a solution of a teaspoonful of salt in a pint of water, or thirty grains of chlorate of potash in a wineglass of water.

FITS, APOPLEXY, EPILEPSY, ETC.--These call for immediate action and prompt medical attendance. Children who are teething, or troubled with intestinal worms, or from various causes, are sometimes suddenly seized with convulsions. Apply cloths wet in cold water--or, better still, ice wrapped in oiled silk--to the head, and especially to the back of the neck, taking care, however, that the ice or wet cloths do not remain too long. Apply mustard plasters to the stomach and legs. A full hot bath is excellent if the cold applications fail. Endeavor to induce vomiting. Seek to determine the cause, and consult with your physician for further guidance.

Apoplexy may be distinguished from a fainting fit by the red face, hot skin, and labored breathing; whereas, in a faint, the face and lips lose color, and the skin becomes cold. In many cases, death follows so quickly upon an apoplectic seizure, that little effectual service can be given. Call the nearest physician, loosen the clothing, and raise the head and shoulders, taking care not to bend the head forward on the neck. Keep the head cool. Do not move the patient unnecessarily.