Part 38

Where there is fever with the sore throat, first make sure whether the feet are hot or cold. If cold, put on fomentations as above. Even if the feet are only cool this should be done. While the feet and legs are thus fomented thoroughly, change cold towels on the throat every three minutes for an hour. Sponge all over as above directed, and allow to rest. If the feet are hot, cold towels alone are applied to the throat; but if the feet get at all chilled while such cooling is going on, they must be fomented.

If there is vomiting and sickness along with the sore throat, the other symptoms of scarlet fever should be looked for, and medical aid obtained if possible.

But here is a case where the most experienced eye, aided by the best possible instrument, sees nothing wrong in the throat itself, but the cough and difficulty of breathing point to the throat. The trouble is not there, but in the roots of the nerves by which vital energy is supplied to the windpipe and other vocal organs. You must go to the back of the neck, and to the back between the upper parts of the shoulders, and there affect the roots that are really in a state of distressing over-action. If you are skilful enough in applying cold, and your patient has plenty of general warmth, you need nothing more than a cold towel, changed pretty often, and nicely pressed over the proper parts. If this fails, have recourse to a cloth with mustard spread like thin butter on it, say about six inches broad and a foot long. Lay this gently on the spine at the back of the neck, and down as far as it goes. Apply your cold compresses now over this as well as you can, and the violent spasmodic symptoms will be mitigated. If one trial is not sufficient, sprinkle the cold cloth with cayenne. If the result can be reached by the cold cloth alone, it will be best. If mustard or cayenne must be applied, observe very carefully that they should never distress the patient. As much as can be borne quite easily, and no more, should be employed. Whenever a remedy becomes seriously distressing, we may be pretty sure it has ceased to be remedial, for the time at least.

Throat, Sore (Clergyman's).--Those who are in the habit of using their voice much should be very careful to produce it in the proper way. It is noticeable that actors (who learn to produce their voice properly) do not suffer from what is known as clergyman's sore throat.

The voice in speaking should be pitched, as a rule, considerably lower than is usually done, especially if speaking in public. Any tightening of the throat muscles should be avoided, and the voice sent out from a full chest well expanded.

Those who are musical should take a note on the piano enunciating the vowels in their natural order ([=a], ay, ee, o, oo) on this note. Then proceed to the next note; the whole of the octave may thus be gone over. Choose an octave most consonant with the range of the voice.

Then add the consonants: b[=a], bay, bee, c[=a], cay, etc., etc. Thus a perfect command over all the possible combinations of vowels and consonants may be attained.

There is absolutely no reason why any musical person should have an unmusical voice, especially since this bad production of the voice often strains the muscles and inflames the mucous membrane of the throat. In connection with this question of music, it should be remembered that almost irretrievable injury to the voice may be done by allowing a boy to continue singing after his voice has begun to "break."

It is not a good plan to be constantly "clearing" the throat whilst speaking. One gets to imagine after a while that it needs clearing when it really does not.

Alcohol and tobacco are both undoubtedly injurious to the voice. A little honey and lemon juice will be found the best gargle if a gargle is required.

Deep breathing is of great assistance in endeavouring to produce the lower note, in fact it is not possible to produce a full note except from a full chest. In this connection it may be said that it has been observed that deep-chested, deep-breathing, slow-speaking people are frequently possessed of certain estimable points of character, such as prudence, firmness, self-reliance, calmness. If one is going to be angry, ten deep breaths might save a world of trouble. (See Breathing, Correct method of).

Thumb, Bruised and Broken.--Frequently a tradesman will strike the thumb or finger a serious blow with a hammer, in missing a stroke. If not treated properly, the whole hand may be destroyed, but if promptly plunged into warm clean water and kept there, even the broken bones can be handled quite comfortably, and all pain and uneasiness pass away ere very long. Plenty of bathing in clean warm water, and proper setting and dressing, are all such an injury requires.

Toothache.--This trouble appears in two opposite characters. In the one it is cured by rightly applied heat, and in the other by cold. If it is merely the soft substance in the tooth which is affected, local cooling applications will cure, if persisted in. If it be the nerve terminating in the tooth which is irritated, then even the extraction of the tooth may fail to give relief. Both cold and hot applications to the tooth or cheek will then probably prove useless.

In such a case, apply COLD TOWELS (see) gently pressed over the head and back of the neck. If the case be a bad one, the feet may be put in a hot bath, or fomented. Persevered in for an hour, this treatment is almost certain to cure. It may take away all pain in a few minutes. After the pain is cured, dry well, and keep the head moderately warm.

But if the toothache is caused by a severe chill to the head, and that be still cold, it should be packed in a hot fomentation. This gives almost instant relief. Rub on a little oil when the fomentation comes off, and keep the head warm.

It should not be difficult to distinguish the cases requiring heat from those requiring cold. In any case, if the first application of either increases the pain, try the other.

Towels, Cold Wet.--A towel of the ordinary kind, and full size, is soaked in a basin of cold water and carefully wrung out until it is merely damp. Prejudice against this treatment is often aroused by putting on the cloths wet, and in a slack, blundering way, so as to make the patient most uncomfortable. It is then folded and applied to the skin, as directed. While applying the first, a second towel may be in the water. It is then wrung out and applied, while the first is placed to soak afresh. In prolonged cooling, care must be taken that the water in the basin does not get too warm. It should be frequently changed. The nurse should gently press the towels on the part, frequently changing the position of her hands. They should not merely be laid on, but gently pressed, unless this causes pain. The towels will need to be changed when hot, and will take from two to five minutes to lose their cooling effect, according to circumstances. Where cold increases the patient's distress, it is almost always safe to substitute heat. See Cooling in Heating; Fomentation.

Tumours.--A large, soft, fleshy tumour is usually simply an accumulation of waste material, which should have been excreted from the body if all the organs were in healthy working order. Where such a swelling exists, the first consideration is diet. For this, Barley (see) as chief food will do very well. Lemon and orange juice (see Drinks) should be the drinks. The barley must not be cooked with milk, and the drinks must be made with pure water. This plain diet will help very much towards the removal of the tumour.

Then the back should be rubbed (see Massage) with hot olive oil twice a day. This treatment alone has often removed the disagreeable swellings on the neck so often afflicting women.

Also, fine soap lather (see Lather; Soap) should be gently rubbed repeatedly over the tumour itself. This alone we have known remove tumours, so it is important.

The three forms of treatment, all applied carefully, will cure all but very obstinate cases. See also Armpit Swelling; Hydrocele.

Where fibrous tumours exist, the treatment is to douche cold water on the part affected, while the rest of the body is kept warm. In case of such a growth in the abdomen, the patient sits in cold water, while the feet are placed in hot water, and the whole body warmly wrapped in blankets. Cold water is then thrown against the spot where the tumour lies. If the tumour is discovered early, its growth may be entirely stopped by this means. Such treatment for several minutes twice a day has in our own experience cured cases pronounced incurable. See Sitz Bath.

Turnip Poultice.--Part of a raw turnip is grated down to a pulp. As much of this is prepared as will cover the inflamed part. It is put on next the skin, and covered with a soft cloth. All is then tied nicely up in another cloth. In violent inflammation of the knee joint, this is a most valuable soothing application. Placed on discoloured and shrivelled skin, it is marvellously curative. When applied, the patient must be thoroughly warm. This warmth must be maintained while the poultice is on, as it has a powerful cooling effect.

Typhoid Fever.--See Fever, Typhoid.

Ulcers.--An ulcer is an "eating sore": that is, a sore containing matter which eats away the skin and flesh, thereby extending itself, and increasing in depth as well. To stop this diseased process, the virulent matter in the ulcer must be killed or neutralised, and this can usually best be done by means of vinegar or weak ACETIC ACID (see), which is most powerfully antiseptic. The only difficulty is to avoid irritating the sore by the application of too strong acid. The treatment by weak acid is very effective, but it must be a fairly prolonged and thorough soaking. Apply a little at a time to the sore. Use warm water if pain be caused. Continue the soaking for even an hour at a time, twice or even three times a day. The wound may be dressed with good fresh olive oil after each soaking. Usually, nothing else will be required, but it must be thoroughly done.

In a very severe case, mix in a teacupful of hot water as much saltpetre as the water will dissolve. Add to this a teaspoonful of acetic acid, and use this to soak the sore instead of simple weak acid. Then, if healing does not come, it is probably because rest is not taken, and most likely also because there is deficient vitality in the whole system. Let the treatment with the lotion be given in the morning. Secure rest during the day, and in the evening, for an hour, thoroughly foment the feet and legs up over the knees. Once a week for two weeks give the SOAPY BLANKET (see) instead of this treatment, and in the morning rub all over the body with hot vinegar. This powerfully stimulates the vitality of the whole system. Even a very bad ulcer should give way under a careful course of united acid soaking, rest, and this stimulating treatment.

Unconsciousness.--There are two opposite causes of unconsciousness. One is congestion of the brain, the other sheer nerve exhaustion. Either will produce a prolonged suspension of consciousness very different from a mere passing faint. In the case of congestion, the head will be hot and the feet cold. The cure is therefore at once seen to be to cool the head and foment the feet in a hot blanket up to the knees. This is the treatment usually to be given to young children. When aged people, or those much exhausted from any cause, become unconscious from lack of vitality, there will be rather a general coldness, and no special heat in the head. We have seen such a case of "coma," which had lasted for forty-eight hours, come all right in ten minutes, by simply fomenting the back of the head and neck, and all down the spinal column. Press a thickly-folded piece of flannel wrung out of hot water carefully and gently over these parts, and often in a few minutes the mental power comes back. Care must be taken not to scald the patient. See Fomentation.

Underwear.--There is a common and very popular error, namely, that of putting too much clothing on our bodies, under the mistaken idea that additional weight means additional warmth. The fact that the main object of clothing is to preserve the natural heat of the body is lost sight of, and little attention is paid to the selection of proper garments for wearing next the skin. Every day the skin of an average healthy individual gives off so many pints of moisture, which must not be allowed to settle on the body if health is to be maintained. After long and exhaustive trials, we have come to the conclusion that the best material for wearing next the skin is knitted linen, and the best knitted linen of the kind, and in fact, the only pure linen mesh material which we have seen, is known as Kneipp linen, and can be obtained from all leading retailers and outfitters in this and other countries. The name of the nearest agent may be had by sending a card to the Kneipp Linen Warehouse, 2 Milk St., London, E.C. In winter light woollen underwear can be worn over the linen if desired, thus retaining the hygienic advantages of the linen, as well as the warmth of the wool. As the wool does not touch the skin, it will not require frequent washing, and so will not become felted up.