Part 31

There are few illnesses more prevalent than this, few that seem to be less rationally dealt with, and yet few that are more easily cured.

It is distressing to think of what some poor people have to suffer from this disease, while they are still compelled to go on working, and even walking, in the most depressing sufferings. It is still more distressing to think of the painful operations which some have to undergo in having the relaxed portions of these veins cut out. Even when the piles have got to a very advanced stage it is not difficult to cure. It will generally be found that there is Constipation (see), so first of all, the bowels must be regulated. This may be done by means of liquorice and senna mixture, and strict attention to diet and exercise. Then the nerve action in the lower back is to be stimulated by applying to the back below the waist a large BRAN POULTICE (see). Rub the back after this with hot vinegar, dry, rub with olive oil, and wipe off the oil gently. Do this at bedtime. Into the bowels may be injected (with the fountain enema) first one or two injections of warm water; then an injection of warm water and white-wine vinegar. Be particular to have this mixture not too strong. A trial may be made with one tablespoonful of vinegar to a pint of water. If any pain is caused, inject simple lukewarm water and use the vinegar and water next time weaker. A very weak mixture has a wonderfully healing effect. After one pint of this mixture has been injected, an injection of cool water (but not cold) should follow. The vinegar should be so weak that it will cause no pain, properly speaking,--only just the slightest sensation of smarting. It will be possible to use the water colder and the vinegar stronger as you get on with the cure, but in both, your own feelings and good sense will guide you. This direction will suit other cases of internal syringing, in which membranes have got relaxed, and need to be braced with cold and weak acid. In all such troubles it should be remembered that the warm or tepid water is used at first only because the cold might be felt uncomfortable till the surfaces are prepared for it. It is the cold that does the good. After this, protruding piles may be gently manipulated by the fingers and pushed back into their place. During this the patient must press outwards, as if to discharge faeces from the bowel. The anus will then open and permit of the piles being pressed in. The injecting treatment may be given twice a day. If too painful, even bathing the parts with the vinegar and cold water has great healing power.

Let the sufferer, if at all possible, have entire rest for a fortnight during the treatment, and lie down as much as convenient.

In mild cases, simply bathe the piles with cold water and press them back into their places. A daily wash of the anus with SOAP (see) and warm water, followed by a cold sponging, will do much to prevent piles.

Pimples on the Face.--See Face.

Pleurisy.--The pleura is the tender double web, or membrane, which lines the inside of the chest on the one side and covers the lung, or rather encloses the lung with its other fold. Each of the two lungs has its pleura in which it works, and each side of the chest is lined by one side of this sensitive organ. The slender lining passes round the greater part of one whole side of the body with one-fold, and round the whole of the lung with the other. Let us suppose (which often takes place) that the front of the body is defended with what is called a "chest protector," but the sides and back are exposed to a chilling atmosphere. Part of the pleura, and that part which is farthest from the surface, is sheltered, but the greater part of it, and that nearest the surface, has no such protection. In the case especially of women this is the state of things. It seems as if people thought that they only need to keep a few inches of the breast warm--that is keeping the chest all right--though the sides just under the arms, and the back under the shoulder-blades, are of far greater importance. The throat is even muffled, and a "respirator" worn, so that fresh air is not allowed to get inside the lungs, while the pleura is exposed to chill at the back. The consequence of this is that vital action is so abstracted from the pleura that the tension of its small vessels is relaxed, and blood is admitted as it is not intended it should be.

Severe pain is felt on one or both sides, and round under the shoulder-blade. A painful cough arises, and great fever is produced. In such a case the treatment is on the same principle as that given in Lungs, Inflammation of the, which should be read. The inflamed part must be cooled by applying towels well wrung out of cold water round the side, applying a fresh one when that on the part becomes warm. If the pain does not leave in half-an-hour of this treatment, or if the patient be weak to begin with, or if any chilliness is felt, pack the feet and legs in a large hot fomentation. The cooling of the side may then go on safely until a curative effect is produced. We may not be able to give the theory of action of this treatment, but we know that in many cases it has perfectly and very speedily been successful, and that it leaves no bad results, as blistering and drugging are apt to do. We know of one case in which it took twenty-four hours' constant treatment to effect a cure. But it did effect it. Two friends took "shifts," and saw that all was thoroughly done. This will give an idea of the proper way to go about the matter.

Poisoning.--The following are the antidotes and remedies for some of the more common forms of poisoning.

Alcohol.--The patient is quite helpless, and there is usually a strong smell of alcohol. If the patient is intoxicated at the time give an emetic. If there is evident prostration from a long bout, keep him quiet and warm. Hot tea not too strong may be given.

Alkalis (e.g., ammonia, soda or potash).--Give dilute vinegar, followed by white of egg.

Arsenic.--Emetic, followed by white of egg. Keep very warm.

Carbolic.--Readily identified by smell of tar or carbolic. Wash mouth well with oil. Give an emetic.

Chloral.--Emetic; warm coffee, and even an enema of coffee. Artificial respiration (see Drowning) may be necessary if breathing gets very low.

Chloroform or Ether (inhaled).--Fresh air. Pull tongue forward, and begin artificial respiration. If heart has stopped, strike chest two or three times over region of heart.

Chloroform or Ether (swallowed).--Emetic; enema of hot coffee; keep awake. If necessary, artificial respiration.

Copper.--Emetic, white of egg to follow.

Laudanum.--There is intense drowsiness and contraction of pupils of eye. Give an emetic and plenty of strong coffee. Walk patient up and down. On no account allow him to give way to the desire for sleep.

Mineral Acids and Glacial Acetic.--If any neutralising agent, such, e.g., as lime, chalk, soda, or calcined magnesia, is at hand, give it at once. Or give an emetic, followed by oil or milk and water.

Mushrooms.--Emetic; castor oil and enema.

Nicotine (tobacco).--Emetic; stimulate and keep warm; keep patient lying down.

Oxalic Acid.--Neutralise by chalk or lime water, but not by soda or any alkali. Give plenty of water; apply hot fomentations to loins.

Phosphorus.--Often caused by children sucking matches. There is a burning in the throat, and often vomiting. Give an emetic. After this some barley water or milk may be given.

Prussic Acid.--Almost hopeless. Emetic; artificial respiration.

Snake Bite.--Suck the wound, and apply a drop or two of strong ammonia to the bite. Ammonia may be also inhaled. Artificial respiration often necessary.

Strychnine.--Emetic; keep quiet and darken the room. Chloral or bromide of potassium may be given. If spasms threaten respiration, artificial respiration is necessary.

Tartar Emetic or other Antimonial Poisons.--If vomiting is not present, induce it by an emetic. Give doses of strong tea. Keep very warm by hot blankets.

Good domestic emetics are a teaspoonful of mustard in a tumblerful of water, or a tablespoonful of salt in the same quantity of water.

Poisoning, Blood.--Where this arises from a more or less putrid wound, what is aimed at in the treatment is to stop the manufacture of the poison in the wound by cleansing and healing it. This done, the other symptoms will subside. The wound should be carefully brushed with a camel's-hair brush and vinegar or dilute ACETIC ACID (see). This should be followed up with a poultice of boiled potatoes or turnips, beaten up with the same weak acid. Leave this on all night. Brush again well with the acid in the morning. In the matter of diet eat what will produce healthy blood, and by open-air exercise seek the same end. But the daily brushing and poulticing, or even twice daily if necessary, will work wonders on the poisoned wound. Care should be taken where any cut or wound has been made in the flesh, that it is carefully washed, and any dirt or foreign matter removed. Especially is this to be attended to if a rusty nail or penknife has inflicted the injury.