Part 32

Polypus.--See Nostrils.

Potato Poultice.--Potatoes boiled and beaten up with buttermilk, spread out in the usual way, make this useful poultice. Weak acid or vinegar may also be used instead of buttermilk. The potatoes should be boiled as recommended below.

Potato, The.--The proper cooking of this root is so important for health, owing to its universal use, that we here give directions which, if followed out, make potatoes a dish acceptable to even a very delicate stomach. Difficulty of digestion often arises from the potatoes not ripening properly, especially in cold soil, and since disease has become so widespread. Their unripe juice is positively poisonous, and when they are merely boiled is not completely expelled. The potatoes should be steeped in warm water for an hour before they are boiled. The water in which they have been steeped will be greenish with bad juice, and must be thrown away, and the roots boiled in fresh water as usual, giving a thorough drying after the boiling water is poured or strained off. So prepared, the potatoes make a very digestible dish.

Poultice, Bran.--See Bran Poultice.

Prostration, Nervous.--The various articles under Nerves and Nervousness should be read. Here we give simply the treatment for failure in the digestion and bowel action. This arises from failure in the great nerve centres near the middle of the body. External treatment may be given as follows:--Dip a cotton cloth, four-ply thick, and large enough to cover the stomach and bowels, into cayenne Lotion (see), and lightly wring it. Lay this gently over the stomach and bowels. Over this an india-rubber bag of hot water is laid. Take care that the heat is not too great or the mixture too strong. All must be just hot enough to be comfortable. This application may remain on for two hours, and then be repeated. The cayenne is greatly to be preferred to mustard for many reasons. Give the most easily assimilated food possible. A teaspoonful of gruel each half-hour, increased to a dessertspoonful, if the digestion will bear it, and preceded in all cases by a tablespoonful of hot water. This should be continued for twenty-four hours. Proceed very cautiously then to increase the nourishment, on the lines of Assimilation, Diet, Digestion, etc., giving oatmeal jelly, wheaten porridge, Saltcoats biscuits, and such diet, gradually bringing the patient back to ordinary food.

Pulse, Counting the.--Most valuable information as to the nature and progress of disease is derivable from the pulse. Every one should learn to count it, and to distinguish the broad differences in the rapidity and nature of the beat. Such a distinction as that between BRONCHITIS and ASTHMA (see these articles), which require almost directly opposite treatment, is at once discerned from the pulse. In bronchitis it beats much too quickly, in asthma it is natural or too slow. In many cases we have seen asthma, which in cough and spit is very like bronchitis, treated as bronchitis, with bad results. These would all have been avoided if the pulse had been intelligently counted. Count the pulse, if at all possible, for half-a-minute. This multiplied by two will give the rate per minute, by which it is judged. If this rate per minute be above 100, there is a good deal of feverish or inflammatory action somewhere. If below 60, there is considerable lack of vital power, requiring rest and food to restore it.

In adults the rate for males is from 70 to 75 beats per minute, and for females 75 to 80. In infants the healthy pulse may be at birth 130 to 140 per minute, diminishing with increase of age. In the case of any child under five and over one year, if the pulse beats, say, 108 in the minute, it is too fast. The pulse of an adult may go down as low as 60 or even 50 per minute, but there is then something wrong.

Cooling the head is always safe with high pulse and feverishness, and often this alone will ward off disease and restore the healthy condition. If the pulse be low, fomentations to the feet should be applied, along with cooling action elsewhere, if necessary.

Purple Spots on Skin.--These arise first as small swellings. The swellings fall, and leave purple patches behind, which, if the trouble continues, become so numerous as to spoil the appearance of the skin. This especially occurs in children or young people, whose skin is exceptionally delicate. What has occurred is really much the same as the result of a blow or pinch, leaving the skin "black and blue." Some of the delicate vessels in the skin have given way, and dark blood collects on the spot.

The treatment is to sponge all over the body and limbs with warm CAYENNE "TEA" (see), only strong enough to cause a slight smarting. It should never cause pain. If it does so, the tea is too strong, and should be diluted with warm water. The soapy LATHER (see) may also be used, and olive oil may with advantage be rubbed on as well. Milk and boiling water should be given to the patient every two hours during the day, with a few drops of the cayenne "tea" in it. This is a true stimulant, and worth all the whiskey in the world. The object of the treatment is to nurse the patient's strength, and stimulate the skin. An intelligent study of many articles in this book will guide the thoughtful how to act.

Racks from Lifting.--See Muscular Pains; Sprains.

Rash, or Hives.--Infants are often troubled with large red, angry-looking spots, breaking out over the body, and causing trouble by their heat and itching. These are commonly known as hives. If the water in which a child is washed be hard, it will sometimes cause the skin to inflame and become "hivey." If the soap has much soda in it, it will also cause this. What is called glycerine soap, and much of what is sold as peculiarly desirable, is utterly unsuitable for an infant's skin. Soda soap will cause serious outbreaks even worse than "hives," and will often not be suspected at all, as a cause.

Only M'Clinton's soap, which is made from the ash of plants, should be used on tender skins.

When the "hives" are not very troublesome, they are apt to be neglected; but this should not be, as in most cases this is the time they may be easily cured. The true element in cure is found in attention to the skin, as distinct from the stomach or blood. M'Clinton's soap (see Soap) applied as fine creamy lather will cure hives, and will never, we think, fail to do so. We know of a nurse plastering an infant's body with this soap, so that it was blistered. This is a totally wrong way of working. The right way is to work the soap and hot water as described in article Lather, and to apply it gently with the brush to the parts affected. After applying it with gentle rubbing for some time, and leaving some on the sore places, the infant will usually be soothed to sleep. Where over-cooling is feared, with a weak child, a little olive oil is gently rubbed on with the second coat of lather. In any case of itchiness the above treatment is almost certain to cure. Often the infant is suffering from too rich diet. (See Children's Food.) In such cases, thinner milk, and a little fluid magnesia administered internally will effect a cure.

Remedy, Finding a.--It will sometimes occur, in the case of those endeavouring to cure on our system of treatment, that on applying what is thought to be the correct remedy, the trouble becomes worse. For example, where there are violent pains in the legs, a bran poultice is put on the lower back, and it is rubbed with oil. The pains become worse instead of better, and perhaps our whole system is abandoned and condemned. Now, all that is required here is to think and try until we find the true remedy. If the pain in the legs is rheumatic, the hot poultice is all right. If it has been cramp, what is needed is a cold cloth on the lower back, instead of heat. In the example above given, what is needed is not to abandon the treatment, but to rectify the mistake, and apply cold instead of heat. In a great many forms of illness the same principle holds good. It is safer, where there is any doubt, to try heat first, but not in a very strong manner. If this gentle heating makes matters worse, gentle cooling may be tried. If the heat does good, it may be continued and increased, but never beyond the point of comfort. If the cold does good, it also may be continued on the same principle. What the patient feels relieving and comforting, is almost sure to be the cure for his trouble, if persisted in. See Changing Treatment.

Rest.--In every person there is a certain amount only of force which is available for living. Also this force, or vitality, is produced at only a certain definite rate. Where the rate is very low, only perfect quiet in bed for a time can bring down the expenditure far enough to enable the vital force gradually to accumulate, and a cure to be effected. Sitting, in such cases, may be serious overwork.

When rest is ordered, we are often met by the reply that it is impossible, as work cannot be given up. It is, however, often possible to get a great deal more than is taken. Every spare moment should be spent lying down in the most restful position. It is an important element in nursing to give such a comfortable recumbent position to a patient as constitutes perfect rest, and the nurse who does so, does a great deal to cure.

There is with many a prejudice against rest. It is somehow believed that it is a weakening thing to lie still in bed. "You must get up and take exercise, and enjoy the fresh air." This is a very good order for a person who has the strength for bracing exercise and fresh air. But this is absent in a person truly ill. That person's vital force is low, and the organs that supply it are feeble in their action. The fresh air may enter the chest, but the lungs are not in a state to make good use of it. "Exercise and fresh air" only consume the sufferer. On the contrary, rest and fresh air allow the weak vital force to recruit. The sort of exercise which is wanted in such cases is given by others in massaging or such squeezing the muscles as stimulates the organic nerves without using vital force in the sufferer. We have repeatedly succeeded in giving new strength by some weeks in bed, when it could not have been given otherwise. It is all very well for a young, strong person, only a very little out of sorts, to take a cold sitz-bath for ten minutes, and then a walk of a mile or two in mountain or seashore air. But this treatment would be death to one really ill. Perfect rest in bed, with an abundant supply of air through windows open night and day, would save the life which such "exercise and air" would send out of the world. It requires only a little common sense to see this. "He must be weakened by lying in bed so long." There is no such "must" in the nature of things. On the contrary, it may be absolutely necessary to his getting strength that he should lie still for weeks on end. You may, no doubt, give us instances in which a person was compelled to get up, and was thereby made to lose the delusion that he was not able to do so; but such instances in any number will not make one strong who is actually weak. Make sure first that vital energy is supplied, and when that supply rises to a certain degree it will not be easy to keep your patient in bed.

We would also note that true rest can never be had in a forced position. A limb bound down is not resting. The agonising desire to change its position shows this. True rest is found always in freedom and ease. It may be necessary to put splints on a limb, but it must never be done where rest is aimed at. Usually there is a position of comfort to be found. Let the patient find and keep that. He will then have rest.

For instance, an exhausted patient is lying at full length in bed, but under the waist there is a hollow which is bridged over by the back. This part of the back calls for a considerable amount of force to hold it over this hollow, but we get a pillow inserted under the back, the muscles relax, and the patient rests. In packing and fomenting an inflamed knee, for example, it is usually better done in a slightly bent position, which is more restful than a straight one. Employ two or three small pillows to prop it comfortably. And so on, in multitudes of cases, the earnest healer will be guided by the patient's own restful feelings. See also Noise; Veins.

Restlessness.--In slight cases, where the patient simply cannot sleep for tossing about in bed, a cold towel placed along the spine, with a dry one above, will usually relieve, especially if changed and cooled several times as it grows warm. If heat be specially in the head, then that may be cooled in the same manner till peace settles down in the brain.

But we must go on to consider those cases of restlessness in which there is no extra heat in either spine or brain. Tea may have been taken in a rather strong infusion, or so late that its peculiar influence may be the cause of the restlessness. It is necessary to avoid this beverage if such restlessness is to be escaped; still it will generally be found that in cases in which tea has caused serious wakefulness and restless tossing, that there is more than the mere effect of the herb, and that superabundant heat is present also; then the application already pointed out will give relief.

Now take an instance in which it seems to be the mind that causes the tossing rather than the body. Preachers after earnest preaching are in many cases sleepless and restless too; so are almost all persons when currents of exciting thoughts have been set agoing in their minds. Then, no doubt, it is necessary to get at relief from the spiritual side, by means of thought fitted to calm down the excitement that has been raised. But it is never well to forget that in all such cases there is a material as well as a spiritual aspect of the experience. Many preachers take a sitz-bath before going to bed after a day of service, and find that somehow when sitting in the cool water the over-driven brain begins to slacken pace. If from any cause you are restless and cannot lie still, even after the head and spine have been cooled as we have described, it is well to take a sitz-bath in cold water for a few minutes. Dry and wrap up well, and you will be quiet after. Certain forms of coughing apparently cause the most serious restlessness. A warm poultice should be placed between the shoulders, and cold cloths pressed gently on the breast.

If there is extreme shrinking from everything in the least degree cold, then you need to go a step back in your treatment. A sponging of the most gentle kind, with CAYENNE LOTION (see) and water, all over the body, given very carefully for three or four days, once a day, will put away the shrinking to which we refer. This should be done with tepid water at first, but as the skin freshens it will be found comfortable to do it with cool water. In tender cases the poultice or hot bag will need to be comfortably warm, and not hot. The cool cloth must not be wintry cold, nor even at first summer cold. It is, however, necessary to get at the hot and irritating surfaces that are causing the cough, with more or less that is cooling. We may do this ever so gradually, but we must do it, if we would succeed in giving rest from the cough. In a strong person's case there is really no difficulty. It is an easy matter to put on cloth after cloth till the irritated part is reached and cooled. But when the patient is spent to all but a skeleton, and has restlessness from frequent coughing, it is a very different matter. Still to the very last the irritating heat may be kept down, and long sleeps given, when otherwise it would be hard work indeed to get through the last stages of illness. We write thus because we know it is possible to give precious relief even when it is out of the question to save life. It is possible to make even the last night on earth comparatively a peaceful one, instead of its being so very restless as it often is. This is to be done just by cooling the parts that irritate, and these only. Generally, heat may be required rather than cold, but at the part which is irritating and keeping up the coughing, there must be cooling. The kind and capable nurse who can carry out this cooling is beyond all price. Those only can understand this who have been delivered from an all but incessant cough by means that produce no reaction. It is also well to remember that we now and again give life by means of rest when we had no idea of giving more than temporary comfort. We have repeatedly had cases in which there seemed no hope of doing anything further than giving relief, but that relief has turned out to be the commencement of cure.

Rheumatic Fever.--See Fever, Rheumatic.

Rheumatism.--We feel urged, in first considering this sore and very common trouble, to quote the old adage that "prevention is better than cure." Many people laugh at wettings, and some foolish young ones even seek exposure. We would impress upon all such that the effects of exposure may be, and often are, cumulative: that is, you may escape any direct effect for years, and then find your recklessness end in rheumatism for the rest of your life. Let care, then, be taken to avoid wettings, unless these lie in the way of duty. Change clothes as speedily as possible when they are wet, and encourage the skin to all healthy action by proper care and exercise. Even with the skin all right, a wise man will not act in a foolhardy way, but if he must get wet and chilled, he will probably not suffer very much.

We would strongly recommend the use of Kneipp linen underclothing (see Underwear). It powerfully stimulates the skin, and, by conducting away the perspiration, prevents chills. We have known many who suffered severely from rheumatism being quite cured by the use of this material. It is as comfortable as it is hygienic.

But supposing the rheumatism does come on, it may be treated, in mild cases, by gradual and steady moist heating. For the method of applying this, see Fomentation and Armchair Fomentation. If the case is comparatively a fresh one, there will be need for no more than this fomenting, repeated several times at intervals of two to four hours.