Part 34

Shingles.--Though not often fatal, this illness gives serious trouble. Its outstanding feature is a rash which comes out as a more or less regular belt round the body, or over one shoulder. The rash forms, if allowed to go on, into blackish scabs, and is accompanied in some instances by severe pains shooting through the body. It arises from a failure of the digestive system, therefore the stomach must be as little taxed as possible. Let hot water be sipped in teaspoonfuls for half-an-hour at a time, several times a day. For external treatment, wring a small sheet out of cold water and vinegar, and pack the whole trunk of the patient in this for half-an-hour. Do not use olive oil. The vinegar packing may be renewed in an hour, and as often as the patient feels it agreeable. The mixture of vinegar and water must be weak enough not to be painful on the skin. If the pains in the body persist, then cold cloths may be applied, not very large at first, to the spine, while the patient is warm in bed. Should the feet be cold, this cooling of the spine must not be done until they are wrapped in a hot fomentation up to the knees. If the scabby eruption is very obstinate, the SOAPY BLANKET (see) applied daily for two or three days should clear it away. Wheaten porridge, gruel, and milk diet is best. A drink may be made of hot water and lemon juice, with five or six drops of tincture of cayenne added to a tumblerful, and sweetened to taste. See Drinks.

Shivering.--This is often a trivial matter, but sometimes it is a symptom of a serious chill. It may be only the effect of a thought, or of some mental shock, but in any case it is a nervous disturbance, and failure of energy, causing us to lose control of the nerves which produce the shivering movements.

For ordinary shivering, the result of cold, treat as in Cold, Taking. For cases where the vital action has evidently become very low, foment the patient as directed in Angina Pectoris.

If pain in some part, as in a nursing breast or tender lung, indicates inflammatory action there, cold towels may be applied to that part while this fomentation is on. Renew the cold cloth as often as the patient feels it agreeable, keeping up the heat of the fomentation all the time. Increase the size of the cold cloth if the patient finds this pleasant; stop if it becomes unpleasant. Many serious troubles are checked in the first stage by treatment on these simple lines.

Sick Headache.--See Headache.

Sitting (or Sitz) Bath.--This bath, in whatever form administered, is essentially a sitting in cold water with the feet out. The feet, in fact, are better to be warmly covered up while the patient sits in the bath. The most important thing to be considered in all such baths is the degree of vitality possessed by the patient. If he has much vitality, then the bath may be deep and longer continued--as long as even forty minutes. If the vitality be low, the bath must be brief and very shallow--it may be even necessary to make it as short as one minute, or even less. In some cases, as a beginning, a mere dip is all that is required. This leaves a large discretion to the nurse, and is a matter which common sense should be able to decide. To try a short bath first, and repeat it several times, rather than to give one long one, is the safest plan. It will soon be found out how much the patient can bear. If the vitality be so low as to make the simple sitz-bath a danger, the feet may be immersed, for the one or two minutes of the bath, in a small bath of hot water, and the patient well wrapped up all over in warm blankets.

In some cases it is necessary to pour cold water on relaxed organs, which, especially with females, will sometimes not be braced up by mere immersion. But such pouring must be done with caution. Half-a-minute of it is a long time; one quarter-of-a-minute or less will usually be enough, even in important cases. If longer applications have only done harm, then let our friends try the one-minute bath, or the quarter-minute stream of water. In many cases we have known this make all right. Such short baths may be taken twice or thrice a day.

Skin, Care of.--Among the vast majority of people air and water far too seldom touch the skin. Want of water makes it unclean, and want of water and air make it slow in reaction. Now, a healthy skin is of the utmost value when one is attacked by disease. It can regulate the temperature of the various organs, and the application of heat or cold to it will cause a reaction at once. Much of our treatment as given in this book is directed towards stimulating the action of the skin. It is obvious that in health as in disease the skin can and does so act on the internal organs.

It should be the aim of everyone that this most important part of the body should receive careful attention by a strict watch on the diet, by cleanliness, tonic water baths (cold, tepid, shower, as may be found to suit), and by tonic air baths. Light clothing and porous underwear will also be found of use. We have already drawn attention to the value of Kneipp linen as the most suitable form of underwear (see).

Skin, A Wintry.--Something like an epidemic of skin trouble is often experienced in cold, wintry weather. First, the skin becomes dry and hard. A moist and sticky exudation replaces the ordinary sweat, and great irritation is felt when the skin is exposed to the air. If the sticky exudation be completely rubbed off, this irritation ceases. In this, and in the absence of inflammation, "wintry skin" differs entirely from eczema. The remedy is to rub all over every night for three or four nights with the CAYENNE LOTION (see). If this does not effectually cure, lather all over with soap and olive oil (see Lather; Soap), before rubbing with the cayenne lotion. If the treatment of the whole skin at once is felt to be too severe, it may be cured by taking it in parts.

Skin, Creeping.--A sensation sometimes very much annoys patients, which they describe as like thousands of small creatures creeping over the skin. It most commonly arises from defective working of the pores. A kindred trouble may be noticed along with this creeping. It is as if a stream of cold water were passing down the back. That causes great discomfort in many cases.

The cure is sponging frequently with weak ACETIC ACID (see) or even good buttermilk. The skin being in such cases very sensitive, it is well to treat it bit by bit, a small part at a time. Take one limb, then another, then part of the back, and then another part. Besides this sponging with acid, and before it is done, the skin should be gently covered with lather (see Lather; Soap). If this treatment is not successful, a little olive oil, with cayenne lotion, may be mixed with the soapy lather, and will make its effect more powerful. This creepy feeling is sometimes the result of cold, and some extra clothing may remove it. See Underwear.

Sleep.--No greater mistake could be made than to curtail the hours of sleep. Eight hours should be taken as a minimum, and any weak person should take ten hours. More and better work can be done by a person who takes fully eight hours' sleep than by one who tries to do with less.

Sometimes strong tea or coffee is taken to drive away sleep, and so the nervous system is injured and sleep will not come when it is desired. Tea or coffee should never be taken except very weak, and the person who accustoms himself to this will very soon come greatly to prefer it.

Sleeplessness.--In search of sleep men do many things both dangerous and foolish--sometimes even fatal. Sleeplessness arises in so many ways and from so many causes, that it is often hard for the patient to find a cure, and he will try anything in desperation. A little thought should prevent this state of mind. For instance, we have a man who tries to get sleep by fatiguing himself by long walks in the open air or hard physical work of some kind, but he only grows worse. Now, a little thought will show that sleep requires a certain amount of brain energy. If the supply be below this amount, the brain is too tired to sleep. Violent exercise of any kind will only make matters worse. So "keeping people awake" all day is tried, to make them sleep at night. It fails from the same reason--that it reduces brain power. All narcotics in the end fail similarly. There comes a time when they have so reduced brain power, that even an enormous dose fails to give sleep, and the patient comes dangerously near poisoning himself--sometimes, indeed, does so outright. In all these cases, that which has worn down the brain must be given up as a first condition of cure. Whether brain work, over-excitement and dissipation, alcohol or tobacco, the cause must be removed, and rest taken in the open air, or in well ventilated rooms.

This done, we come to treatment. Soaping the head (see Head, Soaping), or even the application of towels wrung out of cold water, will often, when the cause has been removed, do all that is needed to give sleep. These remedies, especially the first, should be at once applied, if the sleeplessness is accompanied, as is usual, with heat in the head. Even where the fevered head is connected with indigestion, the stomach will be powerfully helped by a good soaping of the head at bedtime. If, on the contrary, the head is cold, then warm fomentations to it will be the proper treatment. Perhaps the very best guide will be to aim at what will make both head and feet perfectly comfortable, and both of natural heat. If cold, the feet must be bathed or fomented, and the legs also up to the knees. Sometimes the pouring of warm water in a douche over the head will act perfectly, instead of the fomentation; but pouring cold water must be avoided, or only very cautiously resorted to (see Sitz-Bath and Restlessness).

Sometimes sleeplessness proceeds from the use of bad drinking water, through its effect on the stomach and bowels. In this case, of course, the first thing is to see that no bad water is drunk. People cannot be too careful about a water supply. Usually boiling for half-an-hour renders water safe enough, but this is not always the case. Care must then be taken to see that water from any corrupted source is not used. When it is given up, treatment as above may be applied.

If the sleeplessness be caused by a nasty tickling cough, put a BRAN POULTICE (see), or similar FOMENTATION (see) on the back behind where the cough catches. Then change cold towels in front over the same place. Soap the head, and sleep will probably soon come.

Where palpitation of the heart causes sleeplessness, change cold towels over the heart, fomenting the feet if necessary, and the palpitation will usually soon yield. See Brain; Children's Sleep; Exercise; Head; Rest.

Smallpox.--If an epidemic prevails in the neighbourhood, or a case occurs in the house, after due and carefully performed vaccination of the family, the important matter to regard is cleanliness. Frequent and thorough washing and changing of all the clothes worn next the skin will do much to prevent possible infection. If the clothes are often changed, then, and well washed, and the skin gets a daily washing with soap and is sponged with hot vinegar, there is little danger of infection during an epidemic of smallpox, or even when nursing the disease. Acetic acid, or white wine vinegar, is even a more powerful cleansing agent than carbolic acid, and has the advantage of being non-poisonous.

It is important in treatment to attack the disease early. We have known an attack completely defeated, and the patient cured, by a wet-sheet pack administered at the right time. The early symptoms are a great weariness and chilliness. In this cold stage, half-a-teaspoonful of cream of tartar, in two tablespoonfuls of hot water, should be given every half-hour. Also (and this is important) wrap the feet and legs up over the knees in a large hot FOMENTATION (see). The head also may be packed in hot cloths. If the fever does not rise, the applications may continue. If the fever does come on, cold cloths must be persistently changed on the head. This we have known reduces the bodily temperature two degrees in half-an-hour, when if left alone it would probably have risen two degrees. The whole body may be packed in a damp sheet, covered with dry blanket, and this continued cooling of the head still proceeded with.

When the eruption has appeared, and the violent itching set in, the eruption must be persistently soaked with weak ACETIC ACID (see), or good white wine vinegar and water. In this soaking, avoid giving the patient pain by too strong acid. The necessary healing power will be found in such a mixture as will only cause the eruption slightly to smart.

It is not necessary to treat a patient all over at once. You will do better if you take one or two pimples at a time. You can then pass from part to part slowly, getting over the whole. You can use a little olive oil after this soaking with vinegar, and so keep off all danger of chill such as might occur if too much of the surface were treated at once.

If these simple means are well applied from the first, it must be a very bad case indeed which will not be cured, and most likely without any marks being left on the skin.

Snake Bites.--A snake bite is only one of a large class of injuries which may be considered under one title. From an insect sting upwards to the most fatal snake bite, we need to note, first, the blow or shock of the bite, and then the fever symptoms which show poison spreading in the system. The blow or shock paralyses or kills a larger or smaller part of the nervous system. The nerve of the heart may be almost instantly so paralysed, with fatal effect. The snake poison especially affects the organic nervous system, and thus attacks the very source of vitality. In smaller stings, rubbing vinegar or weak ACETIC ACID (see) into the wound is sufficient almost instantly to cure. The same substance will cure greater evils. In the case of snake bite, first suck the wound thoroughly, watching that the lips and gums of the person who sucks are free from wound or scratch, or use what is called "dry cupping." Much may be done thus in a few seconds. But it must not be continued longer, and hinder the next step. This is to inject weak acetic acid into the bite. Where snakes are abundant, a small syringe, such as is used to inject morphia, with a rather blunt point, should be always carried, and acetic acid of the right strength. The injection must be thorough, and of course pain must be borne to avoid greater evil. Foment cautiously but persistently over the stomach and along the spine. Pay special attention to the lower back if bitten in the foot or leg, and to the upper part if in the hand or arm. During recovery, give careful diet, and rest. Of course this treatment will fail in some cases, as any treatment may. But if immediately applied, it will save a very large number of lives.

Soaping the Head.--See Head, Soaping.

Soap, M'Clinton's.--Those of our readers who have followed out in practice the suggestions which we have given in these papers, will have seen some reason to believe in the importance of soap. Probably some of them have laughed at patients whose chief need evidently was a good washing of the skin! But there is more in soap applications than mere cleansing. These are found to be of immense value in cases in which there has been no want of perfect cleanliness--in cases even in which the skin has been habitually clean. For instance, in patients with nerves so sensitive that almost no application of any kind can be used, a covering of the back with a fine lather, and over this a soft cloth, has soothed the system so effectively that a great step has been secured by this alone in the direction of cure.

When in search of really good soap we soon find that certain soaps are very harmful. Soaps made from "soda ash," as nearly all hard soaps are, tend to dry and harden the skin, and if used often produce bad effects.