Part 36

See that the patient has plenty of rest, and only as much walking exercise as is evidently enjoyed. There may be complications with other troubles--for example, a quick pulse and some fever heat, if the temperature is tested. That will require to be itself treated with repeated rubbings of finely wrought lather over the stomach and bowels. Until you have in some measure subdued this fever, you will not do much in the way of improving the muscles of the back. In many cases you will be able to bring the fever down completely, and then you will be free to exercise the muscles, and so to strengthen them that they will bring the spine to something like its proper shape. (See Assimilation; Diet; Digestion; Nerves; Nourishment; Paralysis; Massage.)

Spine, Weakness of the.--See Children's Healthy Growth.

Sprains or Racks.--A sprain is usually the result of some involuntary stress coming upon the part. If the injury be to the muscular substance only, it is easily healed; hot fomentations should be given to the sprained parts, with perfect rest and every possible ease and comfort by position, etc., and nature will soon effect a cure. If the injury be really to the nerves which control the muscles, as is generally the case, the matter is more difficult. The muscle swells, but this is primarily due to the overstrain of the nerves in the sudden effort they make to bear a crushing load on the muscle. The pain is from pressure in the swelling, and also from inflammatory action.

The cure, then, must be applied to the motor nerves controlling the muscles, and is best applied at their roots in the spinal cord. If the arm, hand, or wrist be sprained, rub gently the upper spinal region with warm olive oil, continuing the rubbing gently down the arm to the injured part (see Rubbing) until the whole shoulder and arm glow with comfortable warmth. But all rubbing such as causes pain must be avoided. If such rubbing cannot be managed, then a hot BRAN POULTICE (see) must be placed between the shoulders, and a warm fomentation given to the shoulder and arm. The treatment should be given once a day, and ere many days the sprain should be cured. For ankle and knee sprains, the lower back and leg must be treated on similar principles.

Where the chest muscles that cover the ribs are sprained, rubbing and moist heat should be applied over the back and round the side where the sprain is, paying especial attention to the spine opposite the sprain, and using hot olive oil before fomentation and after, as well as to rub with.

If the belly be sprained, similar treatment should be given lower down the back.

If the back muscles are sprained, then the same treatment should be applied, taking special care to stimulate with moist heat and rubbing the part of the spine on a level with the injury, where the roots of the nerves lie which supply the sprained muscles. Care must ever be taken to avoid giving pain--to give pain is to increase the injury. To produce a glow of heat all through the parts is to cure it. (See Muscular Pains.)

For a sprained heel, when there is some degree of inflammation about it, we should pack the whole foot in fine soap lather. Let it be in this all night, and also during the day when resting. Wash the foot with a little weak acetic acid, after being packed in the lather, to keep it quite clean. Now rub the whole limb from the ankle upwards in such a way as to press the blood onwards in the veins. Use a little oil, so that the skin may not suffer till a fine heat is raised in the whole limb. This may be done for a quarter-of-an-hour twice or thrice a day. It relieves the heel of all congestion, and lets good arterial blood flow to it, as it would not otherwise. An elastic bandage, not very tight, put on above the knee will help the cure. Sprained joints and muscles should have perfect rest for a fortnight, and be used very cautiously for some time longer.

Spring Trouble.--Many persons are distressed by some form of eruption or inflammation in the skin in spring. The change of atmosphere and temperature at this time greatly increases the demands made upon the skin as an organ of perspiration, and this strain it is in many cases unable to stand--hence the trouble referred to. To prevent this, the skin must be brought into a better state of health and fitness for any extra work, so that it can bear without injury even very great changes of air and temperature. This may be done by regular application of soap lather (see Lather and Soap) to the entire skin each evening for three or four days, and then twice a week through all the season. Good olive oil may be rubbed on before and after the lather, or even mixed with it in rubbing on; if the cooling effect is found too great, two or three thick coats of lather should be put on, and then gently wiped off, and the oil applied. This, continued during the later winter and spring, should entirely prevent eruptions. But if these do appear, or have already come on, the irritation is apt to be so great that only very fine and carefully made lather can be used. It is better then to use buttermilk instead of lather. But the BUTTERMILK (see) must be new, and if necessary weakened by addition of sweet milk; if old and strongly acid buttermilk be used, harm may be done. Do not rub the milk on: soak it into the parts by gentle dabbing with a pad of soft cloth. This done frequently, even twice or three times a day, will almost always effect a cure.

It should be remembered that no amount of washing or bathing will do in this state of the skin. Water somehow, especially hard water, fails to produce this fine state of the surface. When spring trouble has set in, we would keep water entirely from the skin. Nothing does so well as good buttermilk. In some forms of spring eruption, a strong mixture of salt and water may be freely applied with great advantage. If this irritates, it should at once be discontinued, but in many cases the eruption will disappear under a few applications. The salt solution should be gently rubbed on, and left to dry on the skin (see Skin, Care of; Underwear).

With the increasing warm weather the body ceases to require as much food as in the cold days. Heavy stimulating food in warm weather will certainly cause an unhealthy skin.

Squeezing.--See Rubbing.

Stammering.--This trouble is simply a loss of command of the vocal organs, and is distinctly nervous in its cause. Especially must we look to the roots of the nerves controlling the vocal organs, if we are to see the real difficulty. There is evidently a state of irritability and undue sensitiveness in these nerves which must be soothed down, if a cure is to be obtained. The roots of such nerves lie in the back of the head and neck, and they are best soothed by application of soap lather (see Lather; Soap). This must be well wrought, and applied warm to the back of the head and neck in three or four coats. Then mix some hot OLIVE OIL (see) with the lather, and apply with the brush gently to the parts. Altogether, in applying the various latherings, and the final oil-and-lathering, an hour should be spent, so as to continue the soothing effect during that time. The head may be soaped one night (see Head, Soaping the), and this treatment given the alternate night. Where the case is of long standing, it may take long to cure it, or a cure may be impossible, but some mitigation will result from this treatment. The Sabbath should in all cases be a day of rest from treatment, and generally common sense will indicate that it be not continued too long. The patient may do a great deal for himself by the strictest watch on his enunciation, speaking slowly and deliberately, and breathing deeply. This will be difficult to maintain at first, but practice will make the habit unconscious. An instrument called a metronome may be had from a music shop (used for keeping time in practising), if a book be read aloud by the stammerer, pronouncing one syllable only to each beat, he will soon gain complete control of his voice.

Stiffness, General.--This is often an adjunct of old age, and sometimes occurs in the young and middle-aged as the result of chills. In neither case is it incurable, but for a cure rest is a first necessity. If there be standing and working for twelve or fourteen hours a day, we should not expect a cure at all. Rest must be had, at least twelve hours out of the twenty-four, and it is well if sixteen or even eighteen hours' rest can be taken (see Rest). Then there must be heating the spine with moist heat (see Fomentation). This is done to revive the organs which supply oil to the joints, by giving fresh vitality to the roots of the nerves which control these organs. But the heating requisite to do this must be gently and persistently applied. An hour's gradual heating is worth far more than half-an-hour's half-burning. Then, after the spine fomentation, which must be applied in bed, rub (see Massage) the back with hot olive oil for a considerable time--say half-an-hour, if the patient can bear it (see Exercise). Then the joints may be similarly fomented and rubbed at another time, back and joints being treated, say, every other day. If there be costiveness, treat as in Constipation, and give easily digested food (see Assimilation; Digestion; Nourishment). Such treatment daily should remove stiffness, even in very bad cases.

Stimulants.--See Alcohol; Narcotics.

Stomach Trouble.--If you would cure thoroughly, you must first make sure that the skin is doing its part well. Very often indigestion arises from irritation of the stomach, caused by the impurities in the blood which arise from defective skin action.

With strong people, exercise causing perspiration will often suffice to cure, in other cases where exercise cannot be had the Soapy Blanket (see) is effective. After the blanket, give a warm, gentle rubbing with hot vinegar or diluted acetic acid; and, finally, a similar rubbing with warm olive oil. This rubbing may be given by itself, where the patient is too weak to endure the blanket, or where the lather cannot be well applied. Even the rubbing with oil alone will do much to cure.

The problem in this case is to remove from the blood the irritating waste which is inflaming the stomach, and this is better done by cleansing and stimulating the skin than by means of drastic drugs. A lazy man will swallow a peck of pills rather than go through an ordeal of cleansing like this, but in that case he need not be surprised if his poor stomach become only poorer still, while his purse will not get any heavier. Besides this cleansing, take sips of hot water as recommended under Indigestion. A very plain and sparing diet should be taken, and great attention given to chewing all food till reduced to a liquid. For it must be remembered that the majority of stomach troubles have their origin in abuse of this organ, through overloading with food, or other dietetic errors. See Diet; Assimilation; Biscuits and Water; Constipation; Cramp in Stomach; Diarrhoea; Digestion; Flatulence; Indigestion; Weariness.

Stomach Ulcers.--Generally the tongue will tell whether the stomach is ulcerated or not. If the tongue is fiery-looking, and small ulcers show themselves on it, while food produces pain in the stomach, there is little doubt of the presence of ulcers there. The tongue may at once, in such a case, be brushed with weak acid (see Acetic Acid) or vinegar, so as to cleanse the surface and produce a gentle smarting. This brushing will quickly produce a healing change in the tongue, which guides us to the cure of the stomach. This will be attained by swallowing teaspoonfuls of the same weak acid. Two or three of these should be taken at intervals half-an-hour before food. If the case is severe, the skin over the stomach must be carefully soaped, as directed in article on HEAD SOAPING (see also Lather; Soap). The four-ply flannel BANDAGE (see) should also be worn. Do not use drugs, such as iron, arsenic, or soda, and avoid all narcotics. Persevere with the weak acid, and a cure will come unless in very obstinate cases indeed. Care must be taken to avoid irritating food. Milk, or milk and boiling water is the best diet. A general symptom is severe pain after eating, relieved by vomiting.

No fluid should be taken hotter than the finger can be held in it. This is indeed a good rule always in matters of food and drink, which are often taken too hot, to the injury of the stomach.

Stone.--See Gravel.

Stoutness.--See Breath, and the Heart.

Strangulation or Hanging.--Often accidentally caused in children or intoxicated persons. Waste no time in going for or shouting for assistance. At once cut the rope, necktie, or whatever else causes the tightening. Pull out the tongue and secure it, commence artificial respiration at once (see Drowning), open the windows, make any crowd stand back.

St. Vitus' Dance.--This proceeds from a simple irritation of the spinal nerves, and is to be cured by soothing the spine with persistent cooling. In mild cases this cooling is easily applied with towels wrung out of cold water, and folded so as to lie at least four-ply thick along the whole spine. If narcotic drugs have been largely used, and the nervous system spoiled thereby, a severer form of the trouble comes on, and requires a good deal of care and persistence in cooling. In all cases the cooling of the spine must only be done when the patient is warm in bed.

It will be of great importance, in carrying out this process, to use olive oil in such a way, all over the body, as to help in maintaining the general normal heat. In addition to these suggestions, it may be well to remark that the appearances in such cases are, as a rule, worse than the reality. For instance, the motion of the eyes and of the tongue makes one imagine that the sufferer has lost all reason, and even consciousness of normal character. But this is not so; the brain may not be affected at all, and the worst feeling is that of weariness. We have seen a patient smiling through the most distressing contortions--that is, most distressing to the ordinary observer. It is of great importance that any one who treats such cases should be cool and kind.

It will sometimes be impossible for one person to keep the patient in bed and covered with the clothes so as to keep warm. If so, two must do it. It is, however, to be remembered constantly, that the patient feels it much more agreeable to be held within even close limits than to be allowed to throw arms and legs, and head and body about in all directions. This is a most invaluable truth in such cases. It will not do to hold as with an iron grasp, so that no degree of movement is allowed; but you may hold softly, so that no motion, such as will even disturb the bedclothes, shall take place. This must be done so that all the body shall be comfortably warm when the cold towel is laid along the spine and pressed gently to the centre of the back. In comparatively mild cases, we give an hour of this cooling process every morning only, and the warm washing and anointing with olive oil at bedtime; but in such cases as we sometimes meet with, where drugs have done their mischievous work, it is necessary to cool much more frequently. For instance, when the morning cooling has laid the irritation, and the patient is quiet for an hour, or, perhaps, only half-an-hour, the movement returns. The persons applying the cure are afraid to repeat it till another morning has come. But they need not be so. Or, they apply it for five minutes, and are afraid to continue it longer. They may quite safely apply it as long as they can keep the rest of the body comfortably warm. If they can keep nice, soft blankets well round the patient, as a rule it will not be difficult to keep up all general heat. Let us suppose that, when warm in bed and asleep, the patient wakes up, and the diseased movement begins; it will be well then to ply the back with the cold towel. If the movement is perfectly still in half-an-hour, a rest may be given. If the movement soon returns, the cold can be applied till perfect quiet is had again. This will, perhaps, be secured in twenty minutes or so. A rest and comfortable warming may be given again. If the movement still returns, it may be met by the same cooling process again. If only the heat is kept up all right, the cold towel may be used till the spinal irritation is finally gone.

This simple mode of treatment we have found to be perfectly successful, not only in removing every symptom of nervous irritation, but in giving most vigorous health to patients who, to begin with, were truly miserable-looking subjects. This may be looked for, as well as the mere removal of the malady.

It should be noted that one outstanding feature of St. Vitus' Dance is that the movement ceases during sleep. If this is not the case, other treatment is called for. See Paralysis, and articles under Nerves; Spine, etc.