Part 13

Sometimes this contraction affects the hip joint, and causes great distress and lameness. The upper end of the thigh bone is even sometimes drawn a little out of its proper position. For this, the muscles of the back, and specially of the side and hip which is lame, are rubbed with gentle pressure and hot olive oil as often and as long as may be convenient. Strong fomentations are also applied for half-an-hour daily (see Armchair Fomentation). We know of one case in which this treatment has cured such contraction both of the knee and hip joint. Whether the cause be rheumatism or other trouble, or an injury, the treatment is the same.

Convulsions.--For an ordinary convulsive attack in the case of a child, hold the child's head over a basin and pour tepid water (blood heat, 98 deg. F.) over the head. This will usually be sufficient. If not, seat the child in a bath of hot water nearly up to the waist. If bad, indigestible food causes the fit, give teaspoonfuls of hot water every few minutes for some hours. If the case is obstinate, a BRAN POULTICE (see) may be put over the lower back, and cold towels gently pressed over the stomach and bowels.

Fits from children's teething are more troublesome. They may often be prevented by placing a compress wrung out of cool water along the spine while the infant is warm in the cradle, and changing it so as to maintain the cooling effect. A handkerchief folded eight ply does very well. Four or five changes may be sufficient. Rub with a little warm oil when the cloth comes off. If the fits do come on, treat as above directed for fits from indigestion.

Cooking.--The cooking of vegetables requires particular care. The valuable salts and other nutritive ingredients they contain are easily dissolved by water, and when they are drained, and the water thrown away, as is usually done, all this nutriment is lost. Double cooking pots are easily procurable for meat, porridge, etc. These are quite suitable for vegetables--cabbage, turnips, carrots, peas, etc. The vegetable should be placed, without water, in the inner pot; it will take somewhat longer to cook than when boiled in the usual way. The outer vessel should be partly filled with water kept boiling. Any juice which comes out of the vegetable should be served in the dish along with it. It may be thickened with a little flour and butter, or if a regular white sauce is being made, the juice should be used instead of part of the water. If no double boiler is procurable, an ordinary tin can, inside a saucepan will serve very well. Many who consider certain vegetables indigestible, as usually prepared, will find that when cooked in this way they agree with them perfectly. The fact that the colour of cabbage, peas, etc., is not so green as when boiled in a great deal of water, is not of importance, when the flavour and wholesomeness are so much increased. In stews and vegetable soups the salts are, of course, preserved.

Cooling in Heating.--Often it is difficult to get a sufficient cooling effect by means of cold cloths without unduly chilling the patient. When the head has to be cooled, as in the very dangerous disease meningitis, the effect must pass through the mass of the skull before reaching the brain. A large and long continued application is needed for this. The surface is apt then to be overcooled before the interior of the head is affected. In such a case the surface of the head, when the patient feels it too cold, should be gently rubbed, as directed in Eyes, Squinting, until this feeling goes off. Then the cooling may be resumed. Or if rubbing be disagreeable, a warm cloth may be applied for a short time, and cooling then resumed. In this way a succession of waves of heating and cooling can for a long time be sent through the surface, with good effect and no chill. The short heating restores the surface, and does not interfere with the cooling effect reaching the interior parts. The same principle applies to cooling any part of the body (see Bathing). Any deep-seated inflammation is best reached in this way.

For instance, in the large hip-joints it is of vast importance to reach inflammatory action in parts that are not near the surface, and cold cloths, pressed constantly, produce distress in the surface, if there is no intermission in supplying them. The patient is apt to rush to the conclusion that he must just yield to be blistered, painted with iodine, covered with belladonna plaster, or burned with red-hot irons! That is, he will yield to be made a great deal worse in every respect than he is, because he is not aware that it is quite possible to cure him without making him worse even for a moment.

Coughs.--These will be found treated under the various heads of Colds, Bronchitis, Consumption, etc., but some particular cases of mere cough demand special attention. A tickling cough sometimes comes on, and seems to remain in spite of all efforts to get rid of it. It is worse at night, and keeps the sufferer from sleeping, causing much distress. Where the breathing organs are weak, this cough is caused by an extra flow of blood to them, especially on lying down, the blood acting as an irritant by pressing where it should not. In such cases a BRAN POULTICE (see) applied as directed for Bronchitis, with cooling applications to the part where the tickling is felt, should soon effect a cure. See Restlessness.

We had a case lately in which these features were very marked. It seemed as if the patient had caught cold and this was showing itself in severe and alarming coughing. The skin was yellow, and there were other signs of failure in the organs that purify the blood. Irritating substances were passing into the lungs because of failure in the liver and kidneys, and not from anything in the lungs themselves. In such cases the cough is merely a way of throwing off everything which ought not to be in the breathing organs.

The remedy is very simple. Let the patient take about three tablespoonfuls of hot water every ten minutes for four hours. Before these four hours are expired, the substances causing irritation will be so diluted that they will cease to irritate, and the organs failing to do their duty will be in full working order.

Cramp in the Limbs.--The treatment of this is to apply cold cloths to the roots of the nerves which govern the affected limb or limbs. For the legs, the cold is applied to the lower spine; for the arms or hands, it is applied to the upper part. The limbs affected should also be rubbed briskly with the hands, or a rough towel. Often the irritating heat causing the cramp is in but a small part of the spine, and the whole body is cold, or at least too chilly to make the cold cloths a pleasant cure. In such a case FOMENTATION (see) of the feet and legs will supply sufficient heat to make the cure by cold pleasant and safe.

Cramp in the Stomach.--This very severe trouble, though resisting ordinary methods of treatment, is not difficult to cure by right means. If help is at hand, the patient may be placed in a shallow bath, and cold water splashed with a sponge or towel against the back. A bad case has been cured with two minutes of this treatment. After it, the patient must be well dried and put to bed.

When help is not available, a substitute for the cold splashing is a thick cold compress, the length of the spine, which must be laid on the bed, and the patient lie down on it. This must be changed when it grows hot, and a few changes usually give relief.

Persons who are suffering have often very strong prejudices. For example, one who has decided most firmly that he "cannot do at all with anything cold," is suffering from cramp, and nothing but cold will relieve him, but you must not even hint at any such application. You must in such a case consider how this prejudice took its rise. You will probably find that cold has been unskilfully applied to this patient, and bad effects have been produced, not by the cold, but by its unskilful application. For instance, in a case of cramp the irritation and excess of heat may be both confined to a very small space, no more than that which is filled by the root of one nerve; the rest of the body may be cold rather than hot. There is need first that this general cold should be dealt with, and a general heat produced by some means or other. This is usually best done by packing feet and legs in a hot blanket fomentation. But this again is not an easy matter when cramp prevails. If you move the limbs in the least the cramp comes on, and the patient screams with pain. Still, you need not be defeated; you can let the limbs lie, and heat them from above by placing the hot blanket over them as they lie. As soon as you get heat raised in the body generally, by some such means as this, you are safe enough to apply all the cold that is needed. That may be so little that a common pocket-handkerchief will be enough. This wrung out of cold water, and folded so as to cover about three inches square of the lower part of the spine, may be gently pressed. If this is really well done, there will be no shivering from the cold, and there probably will be a cessation of the cramp. The one thing wanted is that the cold cloth shall be placed right over the root of the nerve which is irritated, and consequently overheated. The prejudice is thus overcome, and it is seen that cold is not to be absolutely avoided, because it has been once or twice, or many times, wrongly applied.

To prevent the cramp returning, means must be adopted to increase vital energy in the system. Entire mental rest for an hour after meals must be taken. If the patient says "I cannot get this," then he simply will soon have to give up all work, and perhaps narrowly escape a departure from this working world altogether.

Each morning before rising, the compress should be applied as above for a short time; the back should then be rubbed with hot olive oil before dressing. This treatment, and proper rest, will prevent return of the cramp. If the patient falls asleep on the compress, allow this sleep to continue unbroken: it is invaluable. So also is the avoidance of all anxious thought, which is best secured by complete trust in a loving God and Saviour.

Croup, Less Serious Form.--The less serious croup proceeds from a nervous closing of the windpipe, the attack being brought on by any causes of irritation in the nervous system. In this case, when the fit reaches a certain stage, the throat opens, and breathing proceeds as usual. This croup is a cramp of the windpipe; the cramp is caused by an irritation of the nerves controlling it, which are already in a condition to be easily irritated. The cure is to apply cooling cloths to the spine. Take the child warm in bed in the morning, and rub the little back with warm olive oil. Ring out a towel of cool, not quite cold, water; fold this into a narrow compress, and place it along the spine; place a dry towel above it and wrap up warm. Change for a fresh cool towel in two or three minutes. If the child falls asleep on this, leave him till he wakes voluntarily. Rub the back again with oil before dressing. The cooling may continue for an hour or so. If this treatment fail, the child may be given medicine to produce vomiting, which frequently relieves. Before putting to bed at night wash the child all over with plenty of M'Clinton's SOAP (see), dry and rub over with warm olive oil. Continue this treatment for some days.

Croup, More Serious Form.--This is caused by an accumulation of material in the windpipe, which is coughed up in pieces of pipe-like substance, and which, if not removed, threatens suffocation. For treatment, first give sips of hot water (distilled water is best) frequently. We have seen only five teaspoonfuls of this taken by a child followed by the throwing off of such a quantity of matter from the throat as had nearly caused suffocation. The further treatment is the bran poultice between the shoulders, and cold cloths on the chest, as prescribed in the article on Bronchitis. These may not cure in all cases, but will do so in many apparently otherwise hopeless. The moment the symptoms are perceived, treatment should be begun, as this disease is very rapid in its progress.

When an actual attack of croup of this kind comes on, and is severe, it is usual to put the child in a warm bath. If the water is a little below blood heat, and laved on the back, this will go far to relieve; but it will not have a tenth of the effect which a cold towel will have, if placed along the spine. It is indeed wonderful how spasms and the various forms of cramp give way to this. When a little warm olive oil is first rubbed on and then off, there is no danger of cold or of any bad effect (see Cramp in Stomach). If this croup is obstinate, there may be more serious disease of the throat, and good medical advice should be had.

Cures Losing their Effect.--After a fortnight's treatment often matters seem to come to a standstill in a case, and then the attendants are apt to despair. Such a state of things indicate only the need for some change in treatment, or perhaps for a rest from treatment for some days. Common sense must guide, and the case may be more keenly looked into: it may have changed its character in the time that has passed, and different treatment require to be given. It is well not to give up until all has been tried which in any way seems likely to suit the case. All the various articles bearing on it should be carefully read and pondered, and no doubt the way to change the treatment will open up. See Changing Treatment.

Cures, as Self-Applied.--Often young people in lodgings are in difficulty for want of some one to apply the necessary treatment in their own case. It is often, however, possible to treat oneself quite successfully by exercising care and common sense. Help should always be got if possible, but where it cannot, it may be done without. In the case of applying cold cloths to any part, when it is necessary to change these frequently, a basin of cold water may stand by the bedside so that the patient can wring out towels without getting up. A still better plan is to have several towels wrung out to begin with--these may be hung over a rail or chairs until required. When the first has been heated it must be hung over the rail or chair so as to be as much spread out as possible. Evaporation will then cool it sufficiently to be used when its turn comes again. Each towel is to be treated in a similar way in turn. Four towels will give an hour's cooling with very little trouble in this way. So a bran poultice may be prepared and laid on the bed, so that one can lie down on it, and with the cold towels handy, as above, most effective treatment given. Common sense is the guide here, as everywhere in our treatment, and a little thought will solve difficulties at first apparently insoluble.

Damp Beds.--An ordinary bed which has not been slept in for some weeks, although perfectly dry to begin with, will become damp, even in a dry house, and, unless properly dried, will be a great danger to its next occupant. This is a preventable danger, and all who entertain guests should see that they are not exposed to it. Many a fatal illness is due to the culpable carelessness of those who put a guest into such a bed. Ignorance in such a matter is shameful. All who have charge in a house should fully understand their responsibility in this matter.

But if you are put into such a bed it is infinitely better to rise and dress, and make the best of a night of discomfort, than to sleep among the damp. If, however, you have so slept, and feel the bad effect, the best cure will be the SOAPY BLANKET (see). If this cannot be had, a good hot footbath, with the heat kept just comfortable for half-an-hour or more, will do very well. This should be done at the earliest possible moment.

It will add greatly to the efficiency of such treatment if hot water can be had to drink in small quantities, and often. A few drops of cayenne "tea" in the water will act as a gentle stimulant. Old-fashioned folk place great confidence in a "hot drink" in such a case. This is all very well if they only keep the alcohol out of it: that destroys vital resources, but never supplies them. We have known cases in which all power was lost through a single night in a damp bed. Possibly in these cases it might not have been easy to restore the lost vitality by any amount of treatment; but we rather think that a speedy application of genial heat all over would have restored it. In some apparently hopeless instances it has done so.

Deafness.--See Hearing.

Decline.--See Consumption.

Declining Limb, A.--See Limbs, Drawn up.

Delirium in Fever.--The best way of treating this truly distressing symptom is by cooling and soothing applications to the head. We have seen in one case large cool cloths applied to the head for some time every three hours or so. An almost immediate cessation of the delirium followed this application, and it only returned a few minutes before the time for the next cooling. If the pulse becomes rather slow than rapid, and the body rather cool than hot, while delirium still continues, then hot cloths may be applied to the head. When either hot or cold appliances are removed, rub olive oil into the roots of the hair, and dry off.

An excellent treatment is also to cover the whole head with soap lather. See Head, Soaping.