Part 27

Before taking the legs out of the warm pack, dry the chest carefully, rub it with warm olive oil, and wrap it up in good new flannel. Then take out the feet and dry them well; rub them gently and well with warm oil, put on a pair of soft cotton stockings, and allow the patient to rest. Squeeze an orange and give him an orange drink (see Drinks).

When you have used this fomentation to the feet, and cold cloths once or twice, it will be well to place a large bran poultice across the lower part of the back, taking care again that this is only comfortably hot. When you have had the benefit of this once or twice, you may place a similar poultice between the shoulders; but this only after you have so far succeeded in cooling down the inflamed lung or lungs, as the case may be. During the whole of the treatment it will be well to watch what is agreeable to the sufferer. It is not only that a certain treatment, or degree of treatment, comforts, but that it comforts because it heals. Move the patient as little as possible during treatment, and do and say all possible to soothe the mind.

The whole treatment should be gone over a second time within twelve hours. The second day give one application of the treatment only, and repeat once again the third day. Except for the first time, the treatment may be limited to half-an-hour. Avoid hot food or drink, but it is not necessary to have it positively cold. This treatment we have found perfectly successful in many cases.

Lungs, Congestion of the.--Treatment as below. Read preceding and succeeding articles.

Lungs, Inflammation of the.--This is a common trouble in our climate, and, fortunately, one not difficult to cure if taken in time and properly treated. It is usually the result of a chill, and is accompanied with pain and inability to breathe properly, distressing fever, and often delirium. To begin with, all its evils arise from the relaxing of the vessels of the lungs, so that these swell, and the excess of blood causes inflammatory action to supervene. To guard against it, then, those influences must be avoided which reduce vitality; where they cannot be avoided, all must be done to counteract them. Mere exposure to cold or wet, unless accompanied by exhaustion from hunger, or grief, or other influence of the kind, rarely causes this trouble.

Where the trouble has set in, the treatment is the same as recommended above in Lungs, Bleeding from. If the patient be a very strong person, and the fever very great, the fomentation to the feet may be dispensed with; but if any uncomfortable coldness is felt, or the patient not above average strength, it should always be applied. No one who has not seen it can imagine the magical effect such treatment has. It is simple, but its efficiency has been demonstrated in a very large number of cases of cure.

Malaria.--Is now known to be conveyed by the bite of a certain kind of mosquito. Those who live in a malarious district should carefully exclude these from their houses, and by draining swamps and covering water butts prevent their breeding, which is always in stagnant water. If, however, exposure to infection cannot be prevented, much may be done to strengthen the system to resist it. Firstly, note that there is a great deal in the food and drink of a family compelled to live in such a district. If they live largely on animal food, and drink alcoholic liquors, they will seriously add to the power of malarial influence. The use of simple food and pure water will very much lessen it. Let us note that the very opposite of the popular superstition is the truth. A single glassful of gin, whiskey, or brandy, instead of "fortifying" against such infection, actually knocks down the "fortifications" which nature has reared against its power. These drinks, then, must be strictly avoided.

Massage.--This seems a very simple thing to do, but is by no means easy to do right, and it is very desirable that any one who can see it done by a qualified person should take advantage of the opportunity. The rubber must keep his attention closely fixed on the work, and though this is fatiguing to body and mind, it is absolutely necessary if the patient is to derive full benefit from the treatment. The skin should first be lightly rubbed with olive oil; except in very special cases "friction" between hand and skin is to be avoided. The hand should move the skin to and fro over the muscles and bones beneath, and should be always elastic, so as to go easily in and out of the hollows, and avoid violent contact with projecting bones in the case of emaciated patients. The good rubber should know anatomy so far as to understand where bones and muscles lie (See Diagram, page 216). An intelligent moving of all the muscles of a part is almost equal in benefit to gymnastic exercise, and can of course be given to those for whom gymnastics are out of the question. Yet such rubbing may fatigue a very weak patient, and care must be taken not to carry it too far at one time. There should also never be any hurting of the skin. Where the hands are felt too rough, the back may be covered with a soft cloth, oiled with olive oil. All strong strokes in rubbing the limbs should be directed inwards to where the limb joins the body. The lighter strokes should be outwards. It is always well to have a light and heavy stroke, as a joiner has in sawing.

As an instance of how to squeeze, let us take an arm that has got wrong somehow. If you take this arm between your two hands very gently, you feel that it is harder than it should be. The large muscles, even when the arm is at perfect rest, have a hard feeling to your hands, and not the soft, nice feeling which a perfectly healthy arm has. Probably the muscles have been over-stretched, and sprained, or they have been chilled, and so have lost their elasticity and softness. Well, it will be so far good if you can bathe this arm in hot water. It will be better still if the hot water used is full of SOAP (see). You can make this bathing ten times more effective, if you only know what is meant by a proper squeezing of the muscles. You use your two hands in the water of the soapy bath, and taking the arm between them, gently press the muscles between your hands, with a sort of working upon them that makes the blood in the stiff parts rush out and in, according as you press or relieve the pressure. If you can only get hold of the idea, it will not be difficult to do this right. It may be that the cords of the arm are not only hard, but also contracted, so that the arm cannot be straightened or bent as it ought to be, but it is still so squeezable that you can squeeze the blood out of it, and it is still so elastic that when you relieve it of the pressure of your hands the blood rushes back into it. If this squeezing is kindly and slowly done, it will feel very pleasant, and very soon its good effect will be perceptible.

It is sometimes thought that there is some "magic" in one person's hands that is not in another's. Here is a case in which one person has rubbed, he thinks, perfectly right, and no relief has come. Another brings relief in a few minutes. It is concluded that some mysterious "gift" is possessed by the latter. This may do well enough for an excuse when you do not care to have the trouble of curing your fellow-creatures, but it is not true. If we are to "covet earnestly the best gifts," it must be possible for all of us to get them. "The gift of healing" is surely one worth "coveting," and we think must be within reach, or we should not be told so to covet it. See also Head, Rubbing the.

Measles.--An attack of this disease generally begins with a feeling of weariness. Then it appears as running and irritation of the eyes and nostrils, at which stage it is often taken for a common cold, the symptoms being very similar. Then this irritation spreads more or less over all the breathing apparatus, and finally the eruption appears in smaller or larger red patches, sometimes almost covering the face and other parts. The usual advice given is to keep the sufferer warm. It is good to do this so far as avoiding chills is concerned, but if the room be overheated and kept close and dark, only harm will ensue. The blinds of the windows should be kept drawn up to their full height, to admit as much light as possible. Fresh air should be admitted by keeping windows open. If the patient complains of sore eyes, these may be shaded by a screen, but not by lowering the blinds. This admission of free air and light is a very great preventive of the "dregs" which form so troublesome a feature in measles. The room can easily be kept sufficiently warm by fire in winter, even if the window be open. The patient must not be allowed to read or use his eyes much, or very serious mischief may ensue.

When it first appears in eyes and nose, a good large BRAN POULTICE (see) should be placed at the back of the neck and down between the shoulders. Cold cloths should then be pressed over the brow and upper face. Do this for an hour. Give to drink lemon or orange drinks (see Drinks), taken hot, and in small quantities at a time. If this treatment is well done several times, the trouble may possibly be checked at the beginning. Where it has gone further, and cough shows irritation of the air tubes and lungs, then foment the feet and legs while applying cold cloths over the chest, as in BRONCHITIS (see). If there be fever, and no signs of rash, then, to bring it out, pack in the SOAPY BLANKET (see). Where this cannot well be done, a most effectual pack is a small sheet wrung out of warm water and wrapped round the whole body, with a blanket wrapped well round it outside to retain the steam about the skin. But the soap is better. As a rule, there is not much need for further treatment when the rash fully develops. If, however, fever still remains, rub all over with hot vinegar. This is best done in the evening.

When all fever has subsided, a good rubbing of the back only may be given with warm olive oil. This may be done once a day. The feet should be watched lest they get clammy or cold.

For food, wheaten-meal porridge and milk food generally is the best. Do not give too much food at first, and keep the bowels well open.

Medicines.--The delusion that health can be restored by swallowing drugs is so widespread that we think it well to quote the following wise words from the Lancet:--

"An eminent physician not long deceased was once giving evidence in a will case, and on being asked by counsel what fact he chiefly relied upon as establishing the insanity of the testator, replied without a moment's hesitation: 'Chiefly upon his unquestioning faith in the value of my prescriptions.' It might perfectly well be contended that this evidence failed to establish the point at issue, and that faith in the prescriptions of a physician hardly deserved to be stigmatised in so severe a manner. But admitting this, there is still little to be said in favour of the sagacity, even if we admit the sanity, of the numerous people who spend money and thought over the business of physicking themselves, and who usually, if not indeed always, bring this business to an unfortunate conclusion. The whole tendency of what may be called popular pharmacy during the last few years has been in the direction of introducing to the public a great variety of powerful medicines, put up in convenient forms, and advertised in such a manner as to produce in the unthinking, a belief that they may be safely and rightly administered at all times and seasons, as remedies for some real or supposed malady. All this, of course, has been greatly promoted by column after column of advertisement in magazines and lay newspapers; but we are compelled to admit that the medical profession cannot be held free from some amount of blame in the matter or from some responsibility for the way in which drugs have lately been popularised and brought into common use as articles of domestic consumption. Medical men have failed, we think, sufficiently to impress upon the public and upon patients that the aim of reasonable people should be to keep themselves in health rather than to be always straying, as it were, upon the confines of disease and seeking assistance from drugs in order to return to conditions from which they should never have suffered themselves to depart. The various alkaline salts and solutions, for example, the advertisements of which meet us at every turn, and which are offered to the public as specifics, safely to be taken, without anything so superfluous as the advice of medical men, for all the various evils which are described by the advertisers as gout or as heartburn, or as the consequences of 'uric acid,' do unquestionably, in a certain proportion of cases, afford temporary relief from some discomfort or inconvenience. They do this notwithstanding persistence in the habit or in the indulgence, whatever it may be, the over-eating, the want of exercise, the excessive consumption of alcohol or of tobacco, which is really underlying the whole trouble which the drugs are supposed to cure and which at the very best they only temporarily relieve, while they permit the continuance of conditions leading ultimately to degeneration of tissue and to premature death. This is the moral which it is, we contend, the duty of the profession to draw from the daily events of life. The natural secretions of the human stomach are acid, and the acidity is subservient to the digestive functions. It cannot be superseded by artificial alkalinity without serious disturbance of nutrition; and the aim of treatment, in the case of all digestive derangements, should be to cure them by changing the conditions under which they arise, not to palliate them for a time by the neutralisation of acid, which may, indeed, give relief from present trouble, but which leaves unaltered the conditions upon which the trouble really depends. Those who look down the obituary lists of the newspapers will be struck by the fact that large numbers of people, in prosperous circumstances, die as sexagenarians from maladies to which various names are given but which are, as a rule, evidences of degeneration and of premature senility, while many who pass this period go on to enter upon an eighth or ninth decade of life. The former class, we have no doubt, comprise those who have lived without restraint of their appetites, and who have sought to allay some of the consequences thence arising by self-medication, while the latter class comprises those who have lived reasonably, and who, if annoyed by imperfect digestion, have sought relief by ascertaining and by abandoning the errors from which it sprang."

Among the most pernicious and dangerous of all the patent medicines on the market are the so-called "Headache Powders," whose almost instantaneous effects testify to the potency of the drugs they contain. Such powerful agents carry their own condemnation, for they cannot in the nature of things remove the cause of the pain; hence their action is limited to narcotising the nerves. The disease continues, the damage goes on, but the faithful sentinels are put to sleep. These headache powders so increased the deaths from heart failure in New York City a couple of years ago that it became necessary to warn the public against them.

Memory, Loss of.--A more or less complete suspension of this faculty is a not uncommon form of mental and bodily illness. We do not so much mean the mere fading of past impressions as the loss of power to recall them, so that we cannot recall what we wish to remember. This is a result of any serious bodily weakness. It will come on through any exhausting exertion, or prolonged and weakening illness. Stomach disorder will also cause it. In this last case, drinking a little hot water at intervals will usually put all right. A cup of very strong tea will so derange the stomach in some cases as to cause temporary suspension of memory. We mention these cases to prevent overdue alarm at a perhaps sudden attack. The loss of mental power in such cases does not always mean anything very serious.

Just as the stomach affects the memory, so also much use of memory and mental strain tells severely upon the stomach. Digestive failures in strictly temperate persons often arise from an overstrain of the mind.

We explain these two actions, the one of body on mind, and the other of mind on body, so that care may be taken, on both sides, of the complex nature we possess. If this is done, there will be little chance of memory failing.

Mind in Disease.--Often a person, because of physical failure, becomes possessed of an utterly erroneous idea, which no reasoning can change or remove. Indeed, reasoning in such cases is best avoided. Attention should rather be directed to the physical cause of the mental state, with a view to its removal. Very probably you will find there is want of sleep, with a dry hard state of the skin of the head, and too high an internal temperature. You may then work wonders by soaping the head (see Head, Soaping). The back also should be soaped similarly. If too great a cooling effect is produced by this, wipe off the soap and rub hot olive oil on the back instead. If this is not sufficient, rub the limbs also with the hot oil. We have seen the most pronounced insanity yield to this treatment, where the cause has been physical and not mental. The secret of success is in so balancing the heat and cooling applications that the utmost possible soothing can be given without any chill.

Miscarriage.--An expectant mother should lead a quiet, orderly and healthful life (see Child-birth). By this we do not mean laziness nor idleness, nor treating herself as an invalid. On the contrary, plenty of work, both physical and mental, and regular exercise are most beneficial, but care should be taken that work should not go the length of over-fatigue, and excitement, worry and anxiety should be carefully guarded against. The round of parties and other social functions into which many brides are drawn, frequently becomes the cause of miscarriage and other troubles. Any excitement, mental or physical, is most injurious, and the husband and wife who sacrifice present enjoyment will be richly repaid afterwards in the greater vigor and healthiness of the child; while those who live for the present will often have bitter regrets of what might have been.

If any weariness, heaviness, or pain are felt in the region of the abdomen, groin, or back, half-a-day, a day, or a few days in bed should, if possible, be taken. If any appearance of bloody discharge be noticed, there is decided danger of miscarriage, and the patient should immediately go to bed, remaining, as far as possible, perfectly flat on the back until the discharge ceases. It is even useful to raise the feet higher than the head, by placing bricks or blocks under the feet of the bed. The covering on the bed should be light, only just what is necessary to keep one comfortable, and the windows should be kept open. Light food should be sparingly taken for a day or two; not much liquid, and nothing hot should be drunk. A towel, wrung out of cold water, placed over the abdomen or wherever pain is felt, and changed when warm for a fresh cold towel (see Bleeding), will help to soothe the pain, allay the hemorrhage, and induce sleep. The mind should be kept at ease, for such precautions, taken in time, will probably put all right. After the hemorrhage has entirely ceased, and all pain disappeared, some days should be spent in bed, and active life be only gradually and cautiously returned to. When there is danger of miscarriage, purgatives should be avoided; a mild enema is a safer remedy, if needful, but for two or three days perfect rest is best, and if the food be restricted, the absence of a motion of the bowels will not do any harm. The patient should, of course, have the bed to herself.

Miscarriages most frequently occur from the 8th to the 12th week of pregnancy. The time at which the menses would appear if there were no pregnancy, is a more likely time for a miscarriage than any other.

It should be remembered that miscarriages are very weakening and lowering to the general health, and to be dreaded much more than a confinement. The latter is a natural process, and, under healthy conditions, recovery of strength after it is rapid, while a miscarriage is unnatural, and is frequently followed by months of ill-health. Another thing to be remembered is that a habit of miscarriage may be established; after one, or more especially after two or three, there is likelihood of a further repetition of such accidents, resulting in total break-up of health.

Muscular Action, Weak.--The heart is the most important of all muscles. Sometimes the action of this is so weak that the pulse in the right wrist is imperceptible, and that in the left extremely feeble. The heart may be beating at the usual rate, only its stroke is much too feeble; and the effects are found in enfeebled life generally, sometimes shown in fainting fits. If such come on, lay the patient flat on his back, and if consciousness does not return shortly, apply a hot FOMENTATION (see) to the spine.

Sometimes this heart weakness is only a part of a general muscular failure. Muscles elsewhere in the body may even swell and become painful. If strychnine be prescribed, refuse it. It has only a temporary power for good, soon passing into a wholly bad effect. Thoroughly good vapour baths will effect some relief, and may be taken to begin with. The best remedy is found in gentle rubbing and squeezing the muscles in every part, specially attending to any that may be swollen and painful. Squeeze gently the muscular mass, so as to press the blood out of it. Relax the pressure again so as to admit the blood. Where no help can be had, we have known a patient so squeeze herself as to restore action to a useless limb. But of course it is best if it be well and frequently done, say twice a day, by a really careful operator who has some idea of anatomy. This may seem a simple remedy, but we have known two inches added to the length of a shrunken limb by its means, and the patient restored from apparently hopeless lameness to fair walking power. See Massage.

Muscular Pains.--These pains occur usually when a patient has been for some time in one position, sitting or lying, and rises suddenly in a particular way. They sometimes take such hold of the breast or back muscles as to make it appear as if some serious disease were present; even in the limbs they may cause great distress on any sudden motion. They may arise from a gradual overdoing of the muscles concerned. They are similar to what is commonly called a sprain, but as they are gradually produced their cause is often overlooked, and needless distress of mind caused by taking the pain for that of cancer or some such trouble. We write to point out that pains do not always mean serious disease, and before any one becomes despairing about their health, they should make sure they understand their case thoroughly.