Part 6

Take, then, a case in which the ankle bone has first become painful, perhaps without any perceptible cause, or it may be as the result of an injury to the part. It then swells and becomes inflamed. At this stage two or three fomentations (see) well applied may very likely cure it entirely. But if neglected, or leeched, blistered, and the skin spoiled with iodine, what is called disease of the bone may set in, accompanied with discharge of matter at one or more places on the ankle. This discharge, where it is evidently lodging in the limb, may be assisted to escape by careful lancing by a good surgeon. For such a case, fomentation of as much of the limb as possible is the treatment. Let a bath be procured, in which the limb may be immersed in hot water as deeply as possible, even up to the very thigh. Let the water at first be comfortably warm. Increase its temperature gradually until as hot as can be borne without pain. Keep the limb in this bath for an hour, or for such shorter period as the patient may be able to bear it. Gently dry, and rub all over with warm olive oil. Wipe this gently off, and cover the limb with clothing. Then syringe any sores with weak acid (see Acetic Acid; Wounds), and dress with bandage (see Ankle, Twisted). Do this twice each day, and persevere.

If it cannot well be bathed, let it be fomented by a large piece of flannel soaked with boiling water, and placed round the diseased part. We have seen a wasting bone healed entirely in a few weeks by this means. We have seen a man with the bones of both his legs splintering off and coming through the skin perfectly healed in a few months. It stands to reason that it should be so. The bathing in his case, like the fomenting in others, were so effectually done that the bones themselves were heated, and strong healing action set in at once. We saw lately a piece of dead bone above four inches long come out of a young man's arm as the result of nothing else but fomentation. The arm was soon as whole and as useful as could be desired, though it had been to all appearance only fit to be taken off at the elbow. The steady supply of moist heat does wonders in this way.

We have seen some most remarkable specimens of what was erroneously thought sufficient fomentation. One was a case of diseased thigh-bone. A bit of old flannel, about a quarter of a yard square, had been wrung out of water slightly tepid and laid on the skin, covered by a little cloth scarcely equal in size. The application would not have conveyed activity to the skin on which it was laid, though it required to convey it to the heart of a large mass of bone. The helpless complaint of the operator was that it did no good. How in the world could it do good? Not less than six or seven or even eight yards of a blanket are required. That is to be folded and rolled up so that a good quantity of boiling water may be poured first into one end of it and then into the other. It has to be squeezed and kneaded till the heated water and steam are fairly soaking the inside of the blanket. When this is opened up, it is far too hot to put to the skin, but a double flannel or strong towel may be put on first, so that the heat shall go gradually through to the body, and by-and-by into the bone. This may be done at least once a day--if agreeable, it may be done twice. But it must be so well done that the heat shall effect the bone, or you cannot look for any result of importance.

If under the bathing the skin becomes irritated, as it will often do, cover it with cloths soaked in weak vinegar till the bathing is over. If the skin suffers from the fomentation, do the same thing, and if this does not cure, dress it, before putting on the fomentation flannels, with SOAP (see) lather as if for shaving, spread like butter on a cloth, and made to shelter the skin from irritation till the fomenting is done. This is of great importance in many cases; the skin is often so sensitive that it cannot well be bathed without being protected.

In the case of hip-joint disease, the ARMCHAIR FOMENTATION (see) is the best form of fomenting. For other parts, common sense will guide how to produce an extensive and thorough heating of the diseased part and its neighbourhood by some similar means (see Bathing the Feet; Pains, etc.). It is only heating the failed tissues, only keeping on such heating, and all the elements of perfect cure are supplied. Even limbs which have shrunk and become shorter, grow out to their natural size under this patient heating.

Get "steel drops" and all such-like sent down the sewer. The rats may have them if they are disposed. Give wheaten or oatmeal porridge, bread or Saltcoats biscuits, with good buttermilk, and the poor creature, half dead with poisonous "drops," begins ere long to have red on his lips and on his cheeks, some fresh vigour in his muscles, and healthy bone in the course of formation, where bone was only wasting before. How is this explained? On the simple principle that the bodily system can turn wheaten meal into all the elements wanted for good bodily health. Beef tea, soups, "fine things" of all descriptions, never on earth gave human beings solid strength, but in myriads of cases they have been successfully employed to take it away. Above all, they fail to give healthy bone.

Get the patient to take wheaten or oaten meal porridge twice a day at least. We are not so stern as some in forbidding all else, though in this we may fall short; but by all means let eating and drinking be considered in the light of what we have been writing (see Food in Health).

Good air is important in this, as in all cases of ill-health.

Much depends, in this treatment, on cheerfulness of mind. Let the patient feel that he is going to be cured. Avoid opium, tobacco, alcoholic drinks, and all worry. This will actually increase the vital exchange in the body and very much help the cure.

Bone, Soft.--Often, in the young, the bones are so soft that they bend more or less, and the beginning of a distressing deformity appears.

In such a case plaster jackets and steel bands are of little use, and often very painful. It is better to use bandages, applied so as to support where that is necessary. Also avoid all long sitting, such as is found at school. It is best sometimes not to permit the child to walk at all. Better far to lose two years of schooling than to be deformed for life. Parents should see to it, with all weakly children, that school does not become a means of trouble. Continuous education is not nearly so important as is sometimes supposed.

For positive treatment, let the parts be well and carefully rubbed (see Massage) every day with olive oil, in such a way as to direct a flow of blood to the feeble bone. It must largely be left to the healer's common sense how this is to be done, but a little thought will show how. At many Hydropathic Establishments it may be learned.

This careful rubbing, with good diet and proper bandaging, will gradually effect a cure in most cases. But here, as elsewhere, patience must rule. Plenty of good porridge and milk, with abundance of fresh air, work wonders in this disease.

Bowels, Glands of.--Symptoms of glandular trouble in the bowels are--weariness and pallor, lack of appetite, softness and shrinking of limbs, with swelling of the belly. In its earlier stages, before consumption sets in, this trouble may be perfectly cured. We have seen even apparently hopeless cases recover under proper treatment. In its essence the trouble is a failure of power in the nervous centres upon which health of the bowels depends. To supply this needed power, take a small bag of cotton cloth, like a little pillow-slip, of just the size to cover the patient's whole back. Fill this with bran, prepared as for poultice (see Bran Poultice). Oil the back before applying this, and place, if needed, four ply or so of cloth on the back to moderate the heat to the skin. After half-an-hour, if the patient feels desirous, renew for another hour; do this each day at bedtime for a week at least. Rub the body all over with warm olive oil when this is taken off; then place a bandage with only a gentle tightness in such a way as just to help the relaxed bowels, but only just so much--not by any means to try and force them into what might be thought proper dimensions. Give a teaspoonful of liquorice mixture (see Constipation) thrice a day before meals in a little hot water. Feed on wheaten porridge and generally light diet, being careful to regulate it so as to make the bowels work easily and naturally. If not too bad a case, this treatment will soon tell favourably. Enemas (see) of either cold or warm water, as required, will also greatly help.

Bowels, Inflammation of.--This (called medically Peritonitis) is an inflammation of the membrane covering the bowels. It results from chill or strain, and sometimes, in the case of child-birth, from dirt introduced into the parts by handling with unwashed hands. In such cases, the utmost care must be taken to ensure cleanliness, which will secure against one fertile cause of the disease. The hands should be always fresh and clean, and all cloths, etc., should be either most carefully washed or burnt. Where the trouble arises from strain, or chill, these lower the vitality, and the membrane becomes gorged with blood at fever heat. To regulate this heat, then, and free the membrane from the blood which over-fills it, is to lead to a cure. Rub the back with warm olive oil, place on it a large BRAN POULTICE (see), or an india-rubber bag of hot water covered with moist flannel; this must in either case be large enough to cover the entire lower back. Anything may be used, if these cannot be had, which will powerfully stimulate the back with moist heat. Wring a small thin towel out of cold water, and place it over the bowels. At first this must be very gently laid on. After a little, and when several times freshly applied, this cold cloth may be very gently pressed all over the bowels. Relief will almost certainly come ere this has been done for an hour. Then a rest may be given for two hours, and after that a large fomentation applied to feet and legs (see Fomentation). While this is on, the cold cloths may be changed over the bowels again, and over the chest as well. After an hour of this, great relief should be felt. If there is great thirst a small bit of ice may be sucked, or a few drops of vinegar in water may be taken; but the outside cooling will probably render this unnecessary. Avoid all alcoholic drinks.

Shivering and a feeling of cold is often the earliest symptom, and as it is of immense importance that warming measures should be promptly applied. Hot bricks, or bottles, placed merely to the soles of the feet, are but poor helps: it would be vastly better to pack the feet and legs in a hot blanket fomentation at once, and, if pain at all shows itself, to apply a large fomentation to the lower part of the back. The sooner this is done the better; besides, there is the consolation that the treatment can never do any harm even if applied in a case in which there has occurred a harmless chill. The dread which some medical men have of cold applications is wonderful, but we know that the front-rank men have no such fear. When care is taken to have the hot application on first, there is, and can be, no possible danger in any case in cooling down the burning circulation. One or two applications have sufficed in many cases we have seen.

Bowels, Lax.--A teaspoonful of lemon juice (freshly expressed), along with hot water and sugar, will often relieve where the bowels are acting excessively. For infants in diarrhoea a mixture of honey and lemon juice is an excellent cure, and has been most successful in our experience. Avoid brandy and alcohol generally.

Bowels, Locking of.--Sometimes when one part of the bowels is much more active than another, it passes into that other, and they become locked, like a stocking half turned inside out. This causes dreadful pain, and if not soon relieved is fatal. Purgatives are of no use, and usually make matters worse. A surgical operation in very skilful hands will relieve, and must be quickly performed when necessary.

In cases in which the one part of the bowels has not yet gone far into the other, nothing more is required than a cold cloth gently pressed over the parts. We have seen relief set in on the fifth or sixth change of such a cloth, when nothing else was used whatever. When a hot bag, or bran poultice, has been put on the back, and cold cloths persistently changed over the bowels, the whole matter has been put to rights, and natural motion of the bowels has been had within an hour after the applications have been begun.

There is, however, a stronger measure than merely heating the back and cooling the front in this way. The patient may be put at once into a sitting bath or small tub, and a panful of cold water poured or dashed on to the bowels; they then contract so powerfully, and shorten themselves so much, that all invagination, as it is called, is made to cease instantly. We should be disposed to try the mildest method in the first instance, unless the case is one in which the lock in the bowels had just taken place. Then it might be well to dash the pailful of water on so as to put all right at once, and afterwards simply to apply such remedies as would tend to prevent a recurrence of the evil.

It is, however, usually the case that the distress has lasted some time before an opportunity of doing anything occurs, inflammation, more or less, has set in, weeks may have passed, and blundering treatment may have done great mischief. Then it is safe to use the heat at the back, and frequently changed cold cloths in front, so as to reduce the inflammation, and contract the bowels more slowly, so as to remove the obstruction. When these have been used for some time, if the obstruction is not removed it will be well to resort to the stronger measures. Nothing is more beautifully simple than the ordinary action of the bowels. The healthful movement is like that by which an earth-worm moves along the ground: so long as the tube is thus moving its contents onward, by contraction and expansion, no part can pass inside or outside that which is before it; but when one part loses nervous tension, and expands without contracting quickly enough, the part behind it tends to worm itself into it, and a "knot," as it is sometimes called, is formed. No possible instrument can reach it except by cutting the body outright, but the action of cold is so powerful in contracting the tube that the "loop," as it is also called, is drawn out, and the right state of things is produced. It is important to remark that there are glands near the lower bowel that swell and form tumours. The cold applications reduce these very speedily to their usual size, and if their swelling is an obstruction, it is soon removed. But it is the lock in the tube itself that is the real malady of which so many die, and with which so many more narrowly escape.

The trouble is best avoided by attention to the regular action of the bowels. It arises from great irregularity in that action.

Bowels, Reversed.--See Bowels, Locking of, above.

Brain Exercise.--Proper exercise for the brain is most important. But this is not to be found in that kind of severe mental labour which is sometimes mistaken for it. Children at play have genuine brain exercise. So has a man at what is called a "hobby," such as photography, golf, or cycling. The child at school, the man in his office, are not at exercise, but at wearing work. This distinction is most important. Exercise, again, is not found in careless dreaming, but in some form of "play" which calls for steady, but almost unconscious, and altogether enjoyable thinking. Books sometimes furnish this, when they lift the mind as far as possible out of its usual track, and produce only pleasant thoughts. Tragedies, novels which end miserably, or which are pessimistic, should all be avoided. Perhaps some easy science or art is the best exercise of all, when the brain is suffering from overstrain. But taste will guide in this. The great matter is to have pleasurable, easy, and natural employment for the brain. This and not work is strengthening "exercise," whether in child or man. So far as we can we should see that the weary get it. For he who procures this for his fellow works immense good.

We have seen, for instance, a student attacked with dysentery while in the hardest part of the session at the university. His whole system became prostrate, and muscular activity to a very small degree would have killed him; so would the continued mental toil necessary to go on with his studies. Yet his brain was in need of exercise almost from the first appearance of his disease. He must have this or be miserable, and not likely soon to recover. An intensely interesting book fell into his hands, altogether away from his track of toil. He read day after day at this book. This was his "exercise"--that is, it was the activity of that one only part of his physical system which needed such exercise for the time. That exercise allowed all the other organs to recuperate.

Brain, Inflammation of.--This arises often from over-schooling of young boys and girls. Care should ever be taken to avoid this. Obstinate constipation in the bowels, chills and exposure, are also fruitful sources. Much worry and anxiety also bring on this serious illness. All sometimes combine to produce a bad case. Pain in the head sets in, followed by convulsive attacks; yet the trouble may be cured in many cases with comparative ease. Leeches, opium, and blistering are to be avoided as most injurious. For treatment it is well to begin at the feet; if these are clammy and cold, wrap in hot fomentation up over the knees (see Fomentation). Proceed to give a pretty warm injection of water into the lower bowel (see Enemas). This should be repeated several times, allowing it to pass off each time. If this increases the pain, try an injection of cold water. This treatment of feet and bowels is most important, and should never be neglected; it renders the treatment of the head tenfold more effective. Cold cloths may now be gently pressed for some time over the head. If the pulse is violent and feverish, let several towels be well wrung out of cold or even iced water, fold one so as to cover the entire head and back of the neck, and have the others ready, similarly folded. Press the first on gently, especially at the back of the head, so that the cooling cloth covers the head all over and soothes the violently heated brain. As soon as one towel grows warm, take a fresh cold one. Relief should come in an hour at least, but longer may be required. During the cooling see that the heat of the fomentation on the legs is well kept up; change if necessary. When the more painful symptoms abate, oil the lower part of the back, and place on it a bran poultice (as recommended in Bowels, Inflammation of). This will go far to prevent any relapse. If the symptoms recur, use the treatment again. See Brow, Weary; Eyes, Failing Sight. See also, for other brain troubles: Restlessness; Sleeplessness.

Brain Rest.--The need for this is often indicated by irritability of temper. This coming on is generally a warning that a period of rest must be taken. An overheated brow is also another indication. If this shows itself in a child during or after school, together with listlessness and excitability, all idea of lessons should at once be laid aside for a time. It is nothing less than cruelty to work an overheated brain in such a case. Let the child go free from school till all the head trouble is removed. Also let the head be soaped (see Head, Soaping).

Sometimes pain in the head sets in from overwork. Even in the young, fainting may show itself. Rest is essential, and will prove a perfect cure, together with a little brain exercise of the kind described in article Brain Exercise, always avoiding fatigue. Let all readers remember that it is better to lose six months in rest than become permanently incapable, therefore let old and young take rest in time.