Part 41

If any matter needs much thought, devote thought to it, reflect and weigh carefully. If it requires time, take it up at separate times. Only make up your mind to this one thing, that you are the master and the arbitrator as to when it shall be taken up. If it intrudes, dismiss it as you would a servant from the room when you no longer require his presence. It is bound to go when you do so dismiss it. When you summon it to your consciousness concentrate your mind upon it. Want of concentration, being a dissipation of the mental powers, is a cause of worry.

Worry becomes doubly baneful when it is directed towards the "might have been." Legitimate regret should be an emotion always accompanied by the determination to learn by experience. Every aid to enable the dispossessed will to regain its rightful throne should be employed. Properly chosen books, companions, and surroundings, are of great use, but perhaps quiet persistent self culture of the will, will be found to be the best. It matters little whether you call this "self suggestion" or not. As a matter of fact it is simply the common-sense of the question. It is the making up of the mind to do a thing with certain aspirations, emotions, and desires towards this thing. Thousands of people do it every day, especially in religious matters. It needs an adequate motive or a great ideal to carry it out. Such a motive here, might be the realisation of the uselessness and the positive harm of worry. Actually realise this, then affirm your determination to avoid worry and you have well begun the battle. Go through this mental exercise each time you feel you are worrying again. After a while you may omit it all but the mental determination.

The mind cannot act rightly in an unsound body, and there is no doubt that good health wards off worry. Deep breathing of fresh air by producing well oxygenated pure blood, will do much to restore mental balance, especially if this want of mental balance is, as is often the case, partly due to inattention to the laws of health.

Worry is by no means a necessary concomitant of high civilisation, it is rather an accompanying mental disease due partly to low nerve power, which itself is due to erroneous methods of life--errors of diet, want of pure air, cleanliness, exercise, etc. Partly, too, is this low nerve power due to mental causes peculiarly Western. The Asiatic with his power of concentration, reflection, contemplation, with his patience, endurance, calmness, knows nothing of this scourge of European and American life. Even the Japanese, progressive and efficient as they are, possess this native contented, sweet, calm disposition, a habit of mind which, if they can retain, will be of enormous value to them in coming years.

Wounds, Bleeding of.--After sending for a surgeon the first thing to be looked at in case of any wound is the bleeding. Sometimes this is trifling and needs no particular effort to staunch it. When, however, a vein or artery has been lacerated the flow must immediately be attended to.

If the blood be welling up from the wound and of a dark red colour it is venous blood, if it spurt up from the wound and be of a bright red colour it is arterial blood. What has to be done is to place a pressure on the vein or artery to prevent the blood escaping.

Venous bleeding may generally be stopped by putting a pad of lint dipped in cold water on the wound and tying it on with a bandage. If the blood continues to flow, tie a bandage round the limb on the side of the wound away from the heart and keep the limb raised.

Arterial bleeding must be treated by tying on the pad and bandage, and if the bleeding continues, stopping the flow in the artery on the side of the wound nearest the heart, and at some point where it passes over a bone so that pressure may be efficiently applied. The bandage for thus tying an artery may be simply made by knotting a handkerchief (Diagram IV.), putting something solid inside the knot, then placing the knot on the artery at the desired point and tying tightly. If required this may be tightened by putting a stick under and twisting round, then tying the stick in position (Diagram II.).

If the palm of the hand is cut, put a pad inside the hand, close the fingers, and tie the bandage round the clenched fist.

If the wound is in the forearm, put a pad in the bend of the elbow, and tie the forearm firmly up on the arm. If the wound is above the elbow stop the main artery in the way above indicated. This artery runs pretty well under the inner seam of the sleeve of a man's coat. Diagram I. shows how this artery may be stopped by direct pressure of the hand; Diagram II. how a tourniquet may be applied.

For bleeding in the arm-pit, press in a pad and tie the arm down to the side. It may be necessary here to compress the artery with the thumb. The artery here lies behind the inner bend of the collar bone lying on the first rib.

In case of arterial bleeding about the head apply the bandage as in Diagram III. The pressure is here applied right over the wound, as the skull is always behind on which to press the artery.

A wound in the leg should be treated in a similar way to a wound in the arm. Diagram V. shows the stopping of bleeding above the knee.

Do not remove the pressure until the arrival of a medical man.

Wounds, Ill-Smelling.--For all such wounds, the best method is frequent cleansing with vinegar or dilute ACETIC ACID (see) by means of a small glass syringe, such as may be got at any druggist's (see Abscess; Wounds, Syringing). We know one case where the patient was expelled from a curative home because of the evil smell of his wounds, three careful cleanings out with dilute acid so removed all odour that the patient was at once readmitted. Where the wound is very tender, soak soft cloths or lint in the dilute acid, and lay them on the wound three or four ply thick. Remove and renew them every quarter-of-an-hour till the smell is gone. Of course the cloths should be immediately washed or, better, burned. In using the syringe, care should be taken to suck out the ill matter, as well as to send the dilute acid well down into the sore. Careful cleaning of the syringe with boiling water before use is necessary.

Wounds, Soothing.--During the process of healing, wounds often give a great deal of pain, even when all is going well. It is this pain we here show how to relieve. After an operation under chloroform, itself painless, the process of healing is often very painful. We are sure this pain need not be endured, but to prevent or cure it we need to see what is its cause. Two causes are specially notable--pressure and cold. By skilful handling and bandaging, undue pressure may be avoided by the surgeon. But a great deal can be done by any one to keep cold from the seat of injury. Have a bag of soft flannel, as fine as possible, made so as to surround the wounded part. This bag is filled with dry bran, heated in an oven or otherwise, without being wet. Of course the heat must not be great enough to cause any discomfort, but sufficient to give a fine sense of relief. This application is for a wound which has not become inflamed, but is doing well.

When inflammation has set in, and the patient is fevered, the opposite treatment is applied. Over the dressing apply three or four folds of dry cotton cloth, and over this again apply cold towels (see Towels, Cold Wet) until the pain is relieved. Good sense must regulate this treatment, of course, and excess of cold be avoided. But with ordinary care this need never cause anxiety.

Wounds, Syringing.--Very great good can often be done by a little careful syringing of internal wounds. Take, as an illustration, a case of a kind we have often seen. It is that of a young patient with a wound on the lower part of the leg, a good long way below the knee. This wound will run in spite of all that has been done to dry it up. The opening in it is very small, and one would think it ought to be easily cured, but it is not so. The truth is that this wound is from two to three inches distant from where the real sore is situated in the limb. The wound is well down towards the ankle; the real sore is well up towards the knee. There is a corroding matter generated in the internal sore, and that runs down under the skin, and keeps cutting its way out at the wound. Until this is rectified, there will be no successful healing. Ointments that might do well enough on a small external sore have no effect in this case. The real sore, however, is easily reached and cured by the right use of a small pointed syringe. The kind most easily procured is made of glass, and costs about sixpence. Choose one that has a small smooth point, which can be easily inserted into the hole in the wound. This should be done without causing any pain. The point of the syringe should be dipped in hot water till it is as near as possible to blood heat: that is, it should neither be hotter nor colder than the skin it has to touch. If you are sufficiently careful on this point, all else will be comparatively easy.

Before you actually try to insert the syringe, observe in what direction the wound is likely to be extended under the skin. It will probably be upwards--almost certainly it will be so, as the waste matter, by its weight, tends to fall down. The sore at the top insertion of a muscle near the knee will send its matter down the leg, perhaps near to the ankle. Fill the syringe with warm water only, as near blood heat as you can have it. When you have got the point of the syringe even a very little way into the wound, you can inject a little water, and in doing this you will probably learn more nearly where the actual sore is to be found. The water will probably come out as fast as you send it in, but it may not come till a good quantity has gone in. Now, as you fill your syringe a second time with water at the same degree of heat, you will add a single drop of strong acetic acid, or twelve drops of white vinegar to a teacupful. You must be careful that this is not exceeded at this stage, or you will cause great pain. Moreover, you do no good to the sore by making the acid so strong as to cause suffering. If it is only just so strong as to cause a comfortable feeling of warmth, it will be all right for its curative purpose. Even very weak acid combines with the irritating waste matter that is keeping the sore diseased, and produces the desired healing effect. You have only to add one drop after another of the acid to your full teacupful of warm water, till the feeling produced by the syringing is all that could be desired. In the case of the limb that we refer to, a sensible mother used the syringe and the acid so skilfully as to heal the internal sore in a very short time, and thus the external wound quickly disappeared. Of course, if the wound is so very deep that the acid cannot be got up to cleanse it thoroughly, surgical aid should be sought.

It may be well, however, to take another case or two for further illustration. Here, then, is a decayed tooth extracted, but the part from which it is taken does not heal, as is usual. The hole in the gum does not close, and a discharge of offensive humour flows from it constantly. The bone of the upper jaw is evidently wasting, and the decay has extended somehow considerably up the side of the nose. The hole, however, is so small, that the usual glass syringe cannot enter it. We got an exceedingly small instrument, used for the injection of morphia under the skin. The point of this syringe is a needle with a point that is hollow nearly to the very end. When this point was broken off, the hollow part was so small that it entered the hole in the gum, and so it was easy to inject the weak acid up to the bottom of the sore, which had come to be only a little under the eye. About an inch and a half of hollow had to be washed out with the acid. But in a very short time all discharge ceased, and the cure was perfect. Both of these cases are comparatively simple, but they show clearly the great value of this use of acetic acid.

Carbolic acid is much more commonly used for such a purpose. It has the drawback of being liable itself to melt away the healthy tissue, and to make a wound larger. Acetic acid never does this, and so heals more quickly and certainly.

We might take a much more difficult case. It was that of an abscess and bad sore in the lower bowels. It was supposed to be necessary to perform a very dangerous operation in order to try to cure this--not much hope was held out of its being possible really to cure. It was, however, quite possible to reach the sore by the injection of acetic acid. The sufferer was directed to have this done regularly. In a very short time there was a complete cure. In such a case all that is wanted is an ordinary india-rubber enema. A much larger quantity of water is required, but about the same strength of acid. First of all, as much acidulated water as can be taken up with comfort is injected: after a minute or so this is passed off. Then another is used in the same way, and passed off also. A third syringing may be employed, when about half-a-teacupful is taken and retained. If the acid gives no comfortable feeling of warmth it needs to be strengthened till it does so, but not so that it produces any pain. The operation really well done is not in the least painful, but, on the contrary, rather comfortable.

There is still one syringing which we may notice--that of suppurating ears. If an ear is discharging from some internal sore, nothing is more important than syringing with acetic acid, but it must be done with very peculiar care. The water used should be as nearly as possible of exact blood heat, and the acetic acid of the exact strength at which it will give a fine comfortable feeling in the ear. It must neither feel as if it were a mere wetting of the ear, nor that it gives the least pain. The syringe, too, must be used gently, so as not to force the water strongly against the internal parts that are so tender. It is a soaking operation rather than a forcible urging of the water into the ear which is wanted. If this is nicely done, say twice a day, the acid will reach the sore, and we may confidently look for a cure. Even when the bones are wasting, as we have seen in the case of the upper jaw, if this acid can be really brought to bear upon the sore, it will be cleansed and healed. In this simple way we have seen many, both old and young, delivered from sore trial, and made to enjoy life and health again.

PHYSICAL CULTURE.

Much weakness might be prevented and often cured by light gymnastic exercises practised twice a day, say on rising and at bedtime, giving tone to the muscles and bringing into regular use many which in ordinary daily life are seldom or never used. The various vital organs of the body owe much of their health to the proper exercise of the surrounding muscles; it will be seen then how necessary a system of regular exercise must be. The best way to learn this is to take a course of Swedish Drill or other good system at one of the gymnasiums which are now so common in Britain and America. But as many of our readers live in places where such cannot be had, we shall try to indicate by diagrams some simple movements which can be practised by anyone.

A few general rules should be borne in mind:--

Begin with a short time, say five minutes; omit at first the more fatiguing movements and gradually increase as the strength improves.

The time spent need never be long; fifteen or twenty minutes is long enough at any one time.