THE LIBRARY
OF
THE UNIVERSITY
OF CALIFORNIA
PRESENTED BY
PROF. CHARLES A. KOFOID AND
MRS. PRUDENCE W. KOFOID
HOME HYGIENE AND
PREVENTION OF DISEASE
HOME HYGIENE AND
PREVENTION OF DISEASE
BY
NORMAN E. DITMAN, M.D.
NEW YORK
DUFFIELD & COMPANY
1912
Copyright 1912, by
DUFFIELD & COMPANY
INTRODUCTION
One of the most important developments of modern medi-
cine has been the fact that it is now realized that it is far
better to avoid than to contract illness, even if the modern
methods of treatment have robbed disease of many of its
old-time terrors. A consequence of this has been that the
modern physician takes every opportunity to instruct his
clientele how to avoid contracting disease.
It is with a belief that this part of the physician's in-
structions can be advantageously supplemented with infor-
mation which the average person can have constantly at
hand that has made the publishing of this book seem dis-
tinctly called for. Simple as a physician 's advice may seem
for the avoidance of any disease, it is often necessary to
have this advice in a form where it can be more carefully
studied and digested if we are to develop a "hygienic
sense" which will enable us more or less instinctively to
avoid the paths which lead to disease.
The public as a class has been saved much suffering and
avoidance of future inconvenience by the knowledge which
it has assimilated on first aid to the injured. Similar bene-
fit should result from popular appreciation of the methods
of first aid to the sick. For often, in the case of illness * ' a
stitch in time saves nine. ' '
One justification of a popular work of this kind is that
not only can its readers render the best aid to the incipient
or slight invalid; but they should be enabled to better
appreciate when an ailment has become serious enough to
require expert medical attendance, or when a disease is
from the outset beyond the aid of unskilled hands.
There are few in our modern era of civilization who do
not understand the workings and failings of automobiles,
engines, phonographs, sewing machines and household ap-
pliances. It would seem the part of discretion therefore
if we knew at least as much about a few of the commoner
workings and failings of the human body — a machine of
INTRODUCTION
far more importance to all of us than all the mechanical
appliances in the world.
It is with this purpose in view that the author of this
work ventures to place it in the hands of the public, ex-
pressing, at the same time, the hope that some of the more
technical of the information imparted will be employed
with discretion. To those living in rural districts where
the service of physicians is difficultly obtainable it is hoped
that the information herein contained will be a means of
saving life and avoiding unnecessary suffering. To those
living less far from the trodden highways it is hoped this
work will prove to be an aid to the physician — educating
the human kind to a more intelligent appreciation of his
efforts, lessening the numberless irritations and infinite
inconvenience resulting from the human gad-fly "minor
ailments"; and materially lightening the load of long-
suffering humanity from preventable sickness.
In many cases it is difficult to judge from a patient's
symptoms the precise character of the disease from which
he is suffering, and it is obvious that except in the simplest
cases no one but a medical man can form a reliable opinion.
It must be made clear that the object of this book is not to
displace the family doctor, but to furnish the reader with
general information regarding medical subjects; and that
while pains have been taken to ensure accuracy, the author
and publishers can accept no responsibility for errors.
Nearly all the medicines mentioned in the text (except
those marked POISON) may be obtained from licensed drug-
gists without the prescription or signature of a medical
man, but persons who treat themselves in accordance with
the directions contained in the book must realize that they
do so on their own responsibility.
N. E. D.
HOME HYGIENE AND
PREVENTION OF DISEASE
HOME HYGIENE AND PEEVENTION
OF DISEASE
Abscess, — When some part of the body is damaged by
injury or poisoned by a germ, inflammation is set up, and
the symptoms of heat, redness, swelling, and pain, begin to
appear. If the supply of good blood is sufficient to over-
come the poison or to repair the damage done, then the
inflammation grows less and less until at last the mischief
is as far repaired as ever it can be. But if the poison is
too strong, or the damage too severe, then the inflammation
increases in intensity, until there is formed a swelling which
has in the middle of it an isolated collection of dead blood-
cells, constituting what we call "matter," or "pus," sur-
rounded by a red ring of inflammation. The results of the
struggle between the blood and the poison are thus walled
in so that they cannot do much more damage, and this
state of the part is called an abscess.
If possible we try to avoid the formation of an abscess,
either by destroying the bacteria causing the trouble, by
helping the inflammation or by relieving the process by
cutting into it and washing out the poison.
The first may be accomplished by applying wet dressings
composed of sterile gauze saturated with a solution of bi-
chloride of mercury (1-2000) or aluminium acetate.
The inflammation may sometimes be helped by causing
an increased flow of blood to * he part by applying a vacuum
cup. Warm applications may hasten the formation of an
abscess, but when an abscess has once formed the sooner it
is opened the better. If, on looking at an inflamed swell-
ing, you can see a yellowish spot anywhere, then the
swelling has become an abscess, and ought to be opened at
once, and the pus let out.
Nowadays the fear of the surgeon's knife is unnecessary.
A doctor will always save the patient pain by using some
2 ACNE
anaesthetic to deaden the feeling in the part. (See "Anaes-
thetics.) And the sooner the cutting is done the smaller
will be the scar, and the sooner the whole trouble will be
over.
Acidity (Sour Stomach, Heartburn). — This is not a disease
in itself, but merely one of the symptoms of indigestion or
dyspepsia. It is a sign that either too much food is being
taken, more than can be thoroughly digested, or that there
is something radically wrong with the digestive process —
that is, with the kind of food taken. A change is needed.
Not that you must go away to the seaside, but that you
must alter your mode of living, eating, and drinking. The
sour taste in your mouth, the feeling of weariness after a
night's rest, the dream-harassed slumber — all these may be
removed by simple means. First, get your teeth attended
to, so that the food may be properly chewed. Then, have
your meals at stated intervals punctually. Avoid all
spirituous liquors, drink only at the end of a meal, avoid
too much meat, and pastry, and cheese, and pickles; and
take a teaspoonful of bicarbonate of soda and a teaspoonful
of carbonate of magnesia in a tumbler of water every night
at bedtime. In addition, go to bed early, rise early, take
plenty of exercise, and your "sour stomach" will soon be
only a memory of a disagreeable past. (See also "Indi-
gestion/')
(1) For acidity and sour-smelling diarrhea in children
under 10: — Sodium bicarbonate, 2 grains; mercury and
chalk, 2 grains ; magnesium carbonate, 5 grains. (Mix and
make a powder to be taken every other night. )
(2) For acidity, heartburn and painful digestion: —
Liquor of bismuth, 1 drachm ; infusion of quassia, 1 ounce.
(This draught to be taken three times every day.)
(3) Powders for acidity and heartburn : — "White bismuth,
10 grains; magnesium carbonate, 10 grains. (Make a
powder to be taken in half a bottle of soda water twice a
day.)
Acne.— (See "Blackheads.") The little pores and fol-
licles in the skin sometimes get blocked up by dirt, and as
described under "Blackheads," there remain little tiny
pouches of fatty matter, which can be squeezed out by
pressure with a key, or by the finger-nails. Sometimes the
dirt which blocks the entrance to the pores remains fixed
in the tubes, and then the blackheads become red and in-
ADENOIDS 3
flamed and are called acne spots. These pustules, or small
abscesses, presently come to a head, and then burst, dis-
charging matter. This matter — pus — is poisonous, and if
carried by scratching finger-nails to another part of the
skin, causes fresh acne spots there. Acne spots leave un-
sightly scars. In older people a variety of "acne" is apt
to appear on the nose, especially on the red shiny nose of
the alcoholic drunkard.
Treatment. — In young people too much smoking, and in-
digestion due to bolting the food are the general causes of
the complaint. The first and last of the treatment is
summed up in the word cleanliness. The skin must be kept
very clean indeed, not only by frequent washing, but by
rubbing violently with rough towels after the washing.
The rubbing makes the skin red, and that is what is wanted,
for the increase of blood improves the nourishment of the
skin and helps it to fight against the evil effects of dirt and
germs.
Thin people with acne ought to take cod-liver oil, and fat
ones should drink a purgative mineral water, or take a
Seidlitz powder every morning. When the acne pustules
are already formed, steam the skin, and clean it well with
friction and soap, and then, using a new needle, prick the
yellow point in each spot and squeeze out the pus, and wipe
it away with a cloth dipped in peroxide of hydrogen.
Then bathe the skin well, and rub in white lotion. This
may be reapplied several times during the day.
All the cotton-wool, gauze or lint which has been used
is to be burnt, and the needle also. And the hands should
be washed, and the nails scrubbed, with carbolic soap.
Adenoids. — Adenoids, or, properly speaking, "adenoid
vegetations, ' ' are overgrowths of the glandular tissue which
is found in the back of the upper part of the throat, just
where the nasal cavity opens behind. They are allied to
the enlarged glands which are so common about the angles
of the jaws in children and in their necks ; and their pres-
ence causes a great susceptibility to catching cold. The
adenoids, if plentiful, block up part of the passage through
which breathing takes place and prevent the proper de-
velopment of the lungs. Not only that, but they cause
deafness. About ninety per cent, of all the cases of deaf-
ness among children are due to adenoids. Children with
adenoids generally look stupid, keep the mouth open, and
4 AGE AND WEIGHT
breathe through it, and are listless and lack concentration.
Lastly, such children are often nervous and irritable and
are prone to bed-wetting and to have nightmares.
Treatment. — If the child cannot sleep with its mouth
shut, or play without getting out of breath, the adenoids
ought to be removed by operation. There is nothing else
of any use.
Age and Weight. — The proper relations between age and
weight are shown in the following tables ; which, however,
are not to be taken as representing an invariable standard.
Many persons of less weight than is here shown enjoy ex-
cellent health.
I.— CHILDREN.
Years of
age
Boys
Girls
Ibs.
Ibs.
5
50
40
6
54
43
7
57
48
8
60
52
9
64
57
10
69
62
11
73
69
12
79
78
13
84
89
14
92
98
15
103
106
II.— ADULTS.
Male
Female
Height
Weight
Height
Weight
ft. in.
Ibs.
ft. in.
Ibs.
5 2
126
4 10
98
5 3
133
4 11
102
5 4
139
5 0
105
5 5
142
5 1
110
5 6
145
5 2
114
5 7
148
5 3
121
5 8
155
5 4
128
5 9
162
5 5
135
5 10
169
5 6
139
5 11
174
5 7
148
6 0
178
5 8
158
ALCOHOLIC DRINKS 5
Alcohol, Acute Poisoning by.— When spirits are given to
children, or when adults go in for a debauch and drink
excessive quantities of alcoholic liquors, the alcohol acts
as a deadly poison and sometimes kills on the spot.
If death does not occur, the drinker to excess becomes
more or less collapsed, his muscles are relaxed and he lies
helpless and perhaps insensible. If left in this state he
may sink and die, or he may perhaps sleep it off, or he
may catch inflammation of the lungs and die of that in a
very short time. The treatment is to empty the stomach
first ; give a drink of warm mustard and water. When the
doctor comes he will probably give a stronger emetic, if
the mustard- water has not yet acted, and then will ad-
minister hot, strong coffee injections into the rectum (or
back passage) with a Higginson syringe, and rouse the
patient by every possible means. Later on the sick man
will require a long rest and plenty of liquid nourishment.
The delirium, which sometimes comes on at the end of a
long spell of drinking, and which is known as "D.T.'s" or
Delirium Tremens, may be fatal after a few hours of horri-
ble suffering and mental agony. Careful and constant
nursing is required, sleep and plenty of food. These cases
should be treated by a doctor.
Alcoholic Drinks, Moderation in. — The writer pleads for
moderation in the drinking of alcohol, as in all things else
— for conscience sake, for the stomach's sake and for the
sake of society, the comfort and well-being of which all
are bound to consider.
Probably never, throughout the world's history, has been
seen so widespread and drastic a movement against the
use of alcoholic drinks as the modern so-called Temperance
Movement ; so-called because the most of the reformers aim,
not at "temperance," which means moderation, but at
total-abstinence. It cannot be denied that there is much
that is admirable in this movement in a time of excessive
drinking, and that the motives of the promoters are lofty
and command respect. Seeing around them the millions
who are being made unhappy, unhealthy, criminal, or mad,
by excess of alcohol, the total abstainers are teaching that
even the moderate use of alcohol is full of danger, and that
everyone owes it to himself to give up every form of it.
The last word of science up-to-date is definitely on the side
of the reformers, and against alcohol even in moderation.
6 ALCOHOLIC DRINKS
"Even the smallest doses," says the scientist, "lessen
energy and efficiency to some extent, and have the in-
evitable reaction of depression." These truths are pretty
generally known by this time, and if, in consequence, all
who dearly value their health do not at once become total
abstainers, it is probably because they realize that most
people have funds of health and energy within them, far
greater than are required in the mere daily routine of life ;
and they are of opinion, too, that with that superfluity of
energy they ought to be allowed to do as they please. To
be a lifelong total abstainer means to be quite safe from a
host of diseases — to be on the safe side entirely as regards
the diseases due to alcohol. It means never to be brain-
fuddled, never to be sentimentally maudlin ; easily to avoid
being grossly impure or vicious; or at any time entirely
at the mercy of ruffianly men or scheming and evil women ;
and lastly, it means to save much money which would
otherwise be spent on the vices which seem to be insepara-
ble from excessive indulgence. And the really healthy
youth, starting in life with an equable commonplace tem-
perament, a fair knowledge of the possible evils of drunken-
ness, and no drinking companions to prompt him, would
almost certainly prefer to do without alcohol altogether,
and would go on his way rejoicing, healthy, happy and
sober-minded — even if a bit of a prig.
The moderate drinker, on the other hand, desirous of an
occasional emotional excitement in the dull routine of life,
lives in a different set of circumstances. He knows, or
may know, of loftier flights of imagination (as well as
deeper depths of depression) than the teetotaler; he has
generally more sympathy with the poor, the afflicted, and
the tempted, than the total abstainer, who is too apt to be
self-righteous. Among the moderate drinkers have been
some of the world's greatest men and most honored names.
All the serious disadvantages of alcohol are connected
with its abuse; it would be ignorant and foolish to deny the
advantages of its use. Just as a tired horse at the sound
or touch of the whip makes a grand effort to complete its
task, despite fatigue, so will a man or woman sometimes
overcome a serious difficulty by the help of the stimulus
supplied by alcohol.
The great majority of mankind in every land have al-
ways used alcohol, more or less in moderation; the general
ALCOHOLIC DRINKS 7
feeling everywhere has been always against the abuse of
it. Hence arises the question, so very difficult for the
individual to solve — "What is moderation?"
We have all of us seen plenty of examples of men and
women of advanced age, who are in good health, and who
are known to have drunk beer, cider, wine or spirits all
their lives ; so that there can be no doubt that it is possible,
for some of us at any rate, to enjoy the benefits of alcohol
in moderation, and to reach a healthy old age.
Now all alcoholic beverages produce, in moderate doses
and well diluted, a certain pleasurable effect called stimu-
lation. If the majority of alcoholic drinks were not as
shamefully adulterated as they undoubtedly are, people
would find that the stimulant effect came sooner and with
smaller quantities, and that the after-effects are less dis-
agreeable. It is the cheap adulterated rubbish that nearly
every publican sells so much of to the poor which does
harm to those who honestly desire moderation. The drink
manufacturer makes large profits, and almost in every case
adds something to the liquor he sells to increase the thirsti-
ness of the customer. No wonder moderation is difficult
to maintain.
By a " stimulant " effect we mean a sense of well being,
an elation, a hopefulness, warmth, and good humor. The
same small dose gives appetite, increases the rate of the
pulse, and supplies, sometimes, fresh energy for a disagree-
able task.
Now, every stimulant effect has a corresponding period
of depression. This will be noticed, perhaps, an hour after-
wards, and may last an hour or two ; or the period may be
spent in sleep, when the depression passes unnoticed and
recuperation takes place as well.
When a hard task has to be long continued, even a small
dose of alcohol does more harm than good, and to repeat
the dose will do even more harm. After a long task is
completed a dose of alcohol is comforting, sedative and
refreshing and promotes the sleep that is so greatly needed.
One thing is certain, namely, that alcohol does not confer
any additional working power. It may give a temporary
stimulus to body work or brain work, but reaction succeeds,
and leaves the body and mind less active than before.
We come then, to this conclusion, that the greatest diffi-
culty, as regards moderate drinking, lies in the fact that
8 ANAEMIA
just as no two persons are alike in size, weight, constitution
or appetite, so the quantity of alcoholic liquor which will
help one man and do him no harm, repeated daily for years,
may entirely ruin a man who has weak organs or some dis-
ease of the heart, liver, or kidneys. What may be modera-
tion in you may lead to my early death. How then is a
person to judge whether he may take any alcohol or not,
and how much, and how often?
The answers are, after all, fairly definite. Drink none
at all if you desire perfect safety, and especially if any
relations or ancestors of yours were of drunken habits. If
you will drink, drink as little as you can, especially if your
life is sedentary and you cannot get much exercise. Drink,
in any case, only at meal times, and you will not go far
wrong. Set your face against the senseless parrot cry,
''Come and have a drink," and the foolishness of creating
an artificial thirst, which leads to the benefit of one person
only — the drink-seller. It is natural and proper for young
people to like convivial society, but the society of the public-
house bar has nothing to recommend it. Young women do
not find it necessary to be continually taking nips of alcohol
to bring out their wit and gayety, and young men would do
well to bear the fact in mind. There is nothing "manly"
in the silly sleepiness, or the bubbling frothy gayety in-
duced by too many drinks. Directly you feel the stimulus
of the first drink, alcohol has done^ all the good in its power,
and more alcohol does harm. It is when the stimulation is
felt, of course, that there is the greatest temptation to
secure some more, and then begins the poisoning of the
system and the overworking of the liver and kidneys.
Actual experiment has shown that from 1 ounce to 1%
ounces of absolute alcohol represents the quantity of alco-
hol which a healthy man may daily consume without ill
effects. (See also "Beverages.")
Anaemia. — Ancemia means bloodlessness, but nobody is
bloodless, and so the word is used to mean any state of
health in which the blood is not of as good a quality as it
should be. The pink color of the lips and other "mucous
membranes" is due to the red color of the blood which
circulates under the surface of them. A person may be
anemic (or poor blooded) because he has lost a quantity
of blood by accident, or because he is badly nourished, or
because he is poisoned by some disease, or chemical poison
ANAEMIA 9
such as lead. Or he may be anaemic because his blood-
making powers are not up to the mark. We shall describe
only the more common forms of anaemia, such as is not
caused by loss of blood.
1. — CHLOROSIS or Green Sickness. This is the anaemia
so common in young girls about 13 or 14 years of age. In
a bad case of this kind of anaemia, the girl looks pale, or
yellowish and sallow-tinted, her lips pale pink, her cheeks
a little flushed. On the backs of the hands the veins show
pink through the whitish skin instead of purplish through
a pink skin. She is languid, weak and tired, and is liable
to headaches, giddiness, fainting-fits, shortness of breath
on going upstairs, and swollen ankles at bedtime. Her
appetite is poor and she complains of a feeling of a heavy
weight on the chest after meals. At the same time, she
may be fat, or at any rate plump. Such girls are very
often emotional and hysterical (see "Hysteria") and full
of sentimental sickly fancies. They nearly always have
some disturbance of the female functions; very often in
anaemia the courses stop altogether, and the girl grows
irritable and apt to shut herself up or moon about alone.
Treatment. — This may be summed up in a sentence.
Take iron and keep the bowels freely open. Iron, in some
form or another, will have to be taken continuously for
three months or more. Iron, if given in large doses and
often enough, will cure nearly all cases. But even iron
is useless unless the bowels are kept freely open. This is
Sir Andrew Clark's medicine for chlorosis, and it will be
found suitable for a large number of cases, though not for
all:-
Sulphate of magnesium, 6 drachms ; sulphate of iron, 24
grains; aromatic sulphuric acid, 1 drachm; tincture of
ginger, 2 drachms; compound infusion of gentian, to
8 ounces — a sixth part to be taken twice a day.
2. — ANAEMIA in Adults. The treatment of this must de-
pend upon the cause of it. Lead-poisoning (see "Lead-
Poisoning"), gout, syphilis, kidney-disease, malaria, severe
bleeding piles, discharges, stomach inflammations — all these
may be causes of anaemia.
Iron, given in some form which will not upset digestion,
is the real cure for anaemia. To begin treatment the pa-
tient must take a smart purge of Epsom salts, then continue
10 ANEURISM
with iron and a bitter tonic like quinine. Thus — Tincture
of perchloride of iron, 10 fluid drachms; sulphate of qui-
nine, 1 drachm, 20 grains; glycerine, 2 fluid ounces; water
to 8 fluid ounces. Take two teaspoonfuls of this mixture
in a wineglassful of water thrice daily after meals.
Persons who are very weak as well as anaemic may find
the following pill very useful : — To make one pill — Arseni-
ate of iron, a quarter of a grain; reduced iron, 5 grains.
Take one pill morning and evening after meals.
One of the most widely used of all iron preparations in
the treatment of anaemia is Blaud's pill in combination
with cascara or some other laxative. There is another
form of anaemia known as pernicious anaemia which is diffi-
cultly curable and which may terminate in death. There-
fore in the case of any anaemia which does not respond
readily and quickly to the ordinary modes of treatment
for anaemia, a good physician should be quickly consulted.
Anaesthetics. — This is the word which means all the
different medicines used to send people to sleep — the arti-
ficial sleep and insensibility to pain, called anaesthesia.
The art of using anaesthetics is now so well understood that
no one need be afraid of them. A very few deaths occur
every year from anaesthetics in the case of people with
unsuspected bad heart disease or broken-down constitu-
tions.
The chief drugs used are ether, chloroform and nitrous
oxide gas for producing artificial sleep, and cocaine, eu-
caine and ethyl chloride to produce insensibility of the
skin. The choice of anaesthetic must, of course, be left
entirely to the judgment of an expert, but as a matter of
fact there are almost no cases of illness (in which an opera-
tion is really required), for which a suitable anaesthetic can-
not be found.
Aneurism. — Inside the blood vessels, of course, there is
always a great pressure of blood, caused every moment by
the beating of the heart, which pumps blood round the
whole body. The pressure is great, and the blood vessels
(arteries and veins) have to bear it without giving way.
This they could not do unless they were elastic, as in fact
they are. The arteries are elastic tubes, dilating when
more blood rushes through them, and contracting when
there is less blood. An artery never ruptures, even
when the heart is beating furiously, so long as it retains its
ANTISEPTICS 11
elasticity. But in old age the arteries become less elastic,
less able to cope with sudden alterations of pressure, and
the same thing happens even in youth in the presence of
such diseases as gout, syphilis, and alcoholism. The weak-
ening of the arteries in these diseases may affect all the
blood vessels of the body, or only certain of them, or some-
times only small patches on a very few of them. This
disease of the arteries is called atheroma, and everyone
with atheromatous arteries who is subjected to physical
strain or hard manual labor, is liable to have an aneurism.
An aneurism is a blood-tumor connected with an artery
and caused by the weakened inner wall of the artery di-
lating and giving way before suddenly-increased pressure
of blood. Once an aneurism is formed, it has a slight
tendency to self-cure, and will get well spontaneously if
suitable medical treatment and nursing can be obtained.
Of course, the signs and symptoms of an aneurism depend
altogether on the position of it — it may be behind the knee,
in the chest, in the lungs, in the abdomen, or almost any-
where else. The symptoms are always pain, more or less,
and the results of the pressure on other organs. Nothing
more can be said here about aneurisms ; they are in no way
suited for home-doctoring, and, in fact, often tax the in-
genuity and skill of the cleverest and most experienced
medical man.
Angina Pectoris, or BREAST PANG, is a sudden cramp of
the heart itself. The first attack often proves fatal, but
some people have several attacks before they die. The pain
is intense, like no other pain on earth, and accompanied
by a fear of impending death. It lasts about a minute.
The cause of the condition is almost unknown.
Persons who have had one attack must regard themselves
as likely to have another, and they should always carry
about with them small glass capsules of amyl nitrite, the
vapor of which, released by breaking the tube, is to be
inhaled by the patient. Recurrence of the attacks may,
perhaps, be prevented by avoidance of excitement.
Antiseptics are substances, mostly of a chemical or min-
eral nature, which possess the property of arresting or
preventing the growth of bacterial organisms which are
capable of producing poisonous substances in animal tis-
sues with death or decay of the body cells. The changes
which take place in a wound or ulcer or sore when germs
12 APOPLEXY
get into it are called septic processes, sepsis, or putrefac-
tion. (See also "Abscesses" and "Inflammation.")
The choice of an antiseptic must depend upon the pur-
pose for which it is to be used.
The following is a list of the better known antiseptics.
Bichloride of Mercury or Corrosive Sublimate. Pre-
pared in tablets. Used in strengths of 1 in 1000 or in 1 in
2000 parts of water, for inflammatory processes of bacterial
origin.
Peroxide of Hydrogen. Used in full or % strength to
cleanse dirty and infected wounds.
Boracic Acid. Saturated or yz saturated solution. For
mild inflammations of mucous membranes.
lAsterine, borolyptol, eucalyptol, borine, alkalol and
glycothymoline. For toilet antiseptic purposes, as mouth
washes, etc.
Alcohol, and Tincture o/ Iodine. Both are good, in full
or % strength, as skin antiseptics when the skin surface is
not broken.
Potassium permanganate. One in 250 parts of water.
An active oxidizing agent with antiseptic and deodorizing
properties.
Carbolic acid is little used nowadays on account of the
danger resulting trom strong solutions or when it is in-
completely dissolved.
Among the best known antiseptic powders are iodoform,
dermatol and aristol.
Apoplexy. — This is the medical name for a "stroke."
The person affected falls down as if struck, unconscious,
breathing heavily and snoring. Before the attack there
are generally some warnings, such as headache and sudden
giddiness on stooping, noises in the ears, temporary deaf-
ness or blindness, squinting, nose-bleeding, vomiting, de-
pression, sleepiness, thick speech. Certain persons are
more liable than others to have a stroke. Such are the
sedentary, the high livers, with fat stomachs, large heads,
florid cheeks, and short thick necks, and persons over fifty.
Intemperance and its resulting kidney disease make people
very liable to apoplexy.
A stroke may have various results — complete recovery
occasionally occurs; some paralysis of the hand, arm, or
leg may remain, with or without loss of the faculty of
speech; or death may occur. An attack of apoplexy may
APPENDICITIS 13
come on in one of three ways. (1) The patient falls down
unconscious, with red face, snoring, and convulsions; or
(2) he has a violent pain in the head, is pale, sick and
faint and gradually becomes unconscious; or (3) he sud-
denly becomes paralyzed, but does not lose his senses. He
may recover or get worse. Sometimes you see a man in
the street "in a fit," and the fit may be epileptic or apo-
plectic, or perhaps only drunken. It is sometimes ex-
tremely difficult even for a doctor to decide whether a man
is drunk or ill, and whether he ought to be left to the police
or carefully looked after. Such a man in a fit may be
both drunk and ill, or might have become ill and taken some
alcohol to cure himself in vain. These "fits" are quite
beyond the power of the ordinary layman to deal with.
He ought on no account to administer brandy or any strong
alcoholic drink, unless he chooses to run the risk of being
censured by a coroner, and the sick man's death attributed
by the doctor to his interference. All he can do is to give
the sufferer as much air as possible, to loosen belts, bands
and collar, and prevent his damaging himself in his strug-
gles, and to await the doctor's arrival.
Appendicitis. — As most people know, the abdomen con-
tains, coiled up in it, a very long tube (about 26 feet, in
fact), called the intestine, or gut, or bowel. In this tube
the food after leaving the stomach is mixed with various
digestive juices, such as the bile, and when ready, is ab-
sorbed into the blood vessels of the gut, and thence into
the general circulation, to be made into blood fit to nourish
the body. Now, the tube which extends from the stomach
onwards for 20 feet, is a narrow tube, called the small gut ;
then begins a much larger tube which goes on to the back
passage. This larger tube, the large intestine, begins at
a spot just beneath the skin of the belly, on the right side,
close to the bony prominence of the hip. At a few inches
from the beginning of the large bowel, there is, in most
people, a little blind tube hanging from it. This little bit
of a tube is only about as big as a goosequill, from two to
five inches long, and is of no use whatever. It is called
the appendix, and sometimes the food or foreign bodies as
they pass along through the large intestine, set up irrita-
tion and inflammation in it. For instance, a cherry-stone,
swallowed, may irritate the appendix and so cause it to
inflame, and bring on appendicitis itself. The abscess
14 APPETITE
which forms as the result of all this bursts at last into the
belly cavity, or is opened by the surgeon. But not all
cases of appendicitis get as far as that.
The causes of appendicitis are many and various. While
nobody knows how to avoid getting the disease it is be-
lieved that of any one cause constipation is the most potent.
The symptoms of appendicitis are these: — (1) Sudden
pain all over the belly, getting worse and worse, and finally
settling down to the right side of the lower part. The sick
man lies on his back and draws his right leg up. (2) Loss
of appetite, sickness, constipation. (3) Tenderness to
the touch, especially at a point two-and-half inches from the
bony prominence of the hip-bone in the direction of the
navel. (Dr. McBurney's "Spot.") (4) Feverishness.
(5) Swelling in the part referred to.
In an ordinary case these symptoms increase for a few
days, then gradually subside and the disease gets well.
Treatment. — Very light milk diet, and rest in bed.
Poultices or an ice-bag to the painful region. Do not give
purgative medicines.
All cases must be seen by a doctor, who alone can tell
whether they are going to be serious or not and whether
an operation will be necessary or not.
Appetite, Good, Bad and Indifferent. — By appetite the
medical man means the desire for food which every person
possesses when in good health.
I. — A loss of appetite is one of the earliest signs of ill-
ness, and it usually continues so long as the patient is in
any way seriously ill.
It is so pleasant a state to have a good appetite that
patients will come to a doctor about a loss of appetite, with-
out being in any other way ill. When this is the case the
fact is generally that the person has been eating too often
and too much, or, at any rate, more than his stomach can
manage to make good use of. When too much food is
taken, and too little work done, the whole system becomes
overloaded with waste products, in excess of the quantity
which the bowels can carry off, and the liver and kidneys
become affected, and their whole work disorganized, and
so the blood becomes impure. Loss of appetite is an ad-
vantage under such circumstances. Many people boost of
a large appetite who would live longer and feel better if
they ate less. Rich people, with good cooks, who eat heavy
APPETITE 15
late dinners, are rarely very robust for any long time to-
gether, and large numbers of them have to go abroad once
a year to undergo a course of abstinence and mineral
waters at some Spa or health resort.
Many old people are in perpetual suffering from nothing
more irrational than having indulged a good appetite while
they were young and reckless.
The old physicians knew this, and used to say that he
who wants good health should care little about eating, and
should leave the table before he feels quite satisfied.
Among the poor, however, and in our towns, a loss of ap-
petite is generally a sign of disease, which may be acute
or chronic.
II.— All fevers and states of inflammation are ushered in
by want of appetite, and most chronic states of ill-health pro-
duce the same state before they have existed for long. For
example, phthisis, or consumption of the lungs, scrofula,
and cancer. Serious acute illnesses often leave behind
them a state of debility or weakness, which lasts for several
weeks, and in this state also the appetite is often fastidious,
and needs to be tempted.
III. — While loss of appetite is one of the most common
symptoms of illness, doctors are also consulted by sick peo-
ple who want to eat too much, and for some who do eat
enormously.
An excessive appetite is a sign of disease in most cases,
but we do also find it present in some persons who are not
ill in any way. Some badly-managed children are very
large eaters, and occasionally we see an adult man or woman
gorging food ; such persons are often weak in mind. Chil-
dren with intestinal worms will sometimes be found to have
an unnatural craving for food. In olden times doctors
used to say that if a man had a tapeworm within him, he
had to eat more than usual to feed the worm; but at the
present day we should say that the tapeworm sets up an
irritation in the coats of the intestine, which shows itself
in a false sense of hunger.
Imbecile children will eat at all times, and will eat any-
thing ; even chalk, cinders, coal, and pencils in some cases.
The disease called diabetes, not uncommon in people at
or beyond middle life, often gives rise to a voracious ap-
petite. This disease is marked by the production of an
enormous quantity of water from the kidneys, and this
16 ASTHMA
urine is peculiar because it contains sugar dissolved in it.
Many a diabetic person will consume one or even two
pounds of rump steak at a meal without suffering from
any indigestion. Navvies, coal miners, and others who
work long hours at very laborious work, and get high
wages, often have voracious appetites, and eat very large
quantities of food, generally of a wholesome sort, however ;
but they eat more than they need, for it is a mistake to
suppose that even the hardest laborer requires all the food
a man can eat. The excess of food must be got rid of some-
how, so the liver and kidneys are called upon to work in
a dangerous, overloaded condition, and they frequently get
damaged in consequence even before such men reach the
age of 40, and in many cases these organs break down com-
pletely from over-strain, passing into states of disease which
lead to an early death. The over-feeding of children is
often the result of undue encouragement by the parents.
A child is, perhaps, rather thin, and is, therefore, prompted
to stuff, and so gets into the habit of over-eating. In many
such cases we have observed the child to get no plumper,
and this is because it had not needed more food, but better
powers of digestion, and over-feeding led to further dis-
orders rather than to improved nutrition.
Ascites. — Sometimes patients see this word on their hos-
pital tickets. It means dropsy of the belly. The abdomen
is full of, or contains, fluid, and may have to be tapped.
It may be caused by disease of the liver, heart or kidneys.
(See "Dropsy.")
Asthma. — This word is often used loosely to mean any
kind of shortness of breath. It should only be used to
refer to a spasmodic disorder of the air passages, neither
acute nor chronic, but paroxysmal (occasional). It is
liable to complicate chronic bronchitis, but it is an error
to believe that all extra severe attacks of that complaint
are connected with real asthma.
Shortness of the breath which is not spasmodic is usually
caused by some organic disease of the lungs, heart, or kid-
neys and is best cared for by the sufferers' placing them-
selves, at the earliest possible moment, in the hands of a com-
petent physician, who can determine the cause and direct the
proper treatment.
A patient who is subject to asthma seems perfectly well
before the attack and then is suddenly seized, often dur-
ASTHMA 17
ing sleep, with the most violent breathlessness ; feeling a
tightness at the chest, he gasps for breath and grasps at
near objects such as the bedpost to help him to breathe.
The attack may last a few hours or a few days, and then
suddenly pass off. One of the curious features of people
who suffer from asthma is their tendency to skin eruptions.
The real and exact cause of the attacks is a spasmodic
narrowing of the air-passages of the lungs, but what causes
the spasm is very often not known. A nerve-troubled
family history is generally found in people who have these
attacks, and sometimes instead of an attack of asthma they
will have one of gout, or neuralgia, or madness.
No doubt every lung disease predisposes a little to attacks
of asthma, especially in gouty people. Some climates
cause attacks, while others seem to do them good. But no
doctor can safely prophesy what sort of climate will cer-
tainly suit a given case of asthma. If you have attacks
where there are trees, go where there are none ; if by the
sea, then go inland.
It is pretty certain that attacks of indigestion cause
attacks of asthma in those subject to them. So all asth-
matics ought to avoid cheese, pickles, celery, sardines,
pastry, porter, pork, and nuts. No late suppers should be
taken on any account.
Between the attacks one can only try and live quietly and
without much excitement. As to climate, the sick per-
son, whether a child or an adult, should live, if possible,
away from fogs, dust, and smoke. More than that cannot
be said about the climate. Solid food should not be taken
after four o'clock in the afternoon. Children are often
asthmatic and do not "grow out" of the disease.
Iodide of sodium may be taken with advantage by most
asthmatic people twice daily, in five-grain doses.
Before an attack, the sufferer may take lobelia or
pyridine, but both drugs must be taken only under medi-
cal supervision. Milk is the only diet allowed during the
attacks. As for inhaling the smoke of asthma-powders, it
is a useful proceeding. White blotting paper, soaked in
a saturated solution of nitrate of potash, and two or three
strips of it burnt, and the vapor inhaled, is a simple
remedy. Many people find instant relief by smoking
stramonium or cubeb cigarettes.
The disease itself does not shorten life. People do not
18 BABIES LOST BY OVERLAYING IN BED
die in attacks of asthma. But if they occur too frequently,
they increase the bronchitis which they too often accom-
pany. Once in a while, a child grows out of the complaint,
but adults never lose it altogether.
Babies Lost by Overlaying in Bed. — Is it not a very serious
state of affairs that hundreds of babies are overlain in
London and New York every year? And can nothing be
done to make infant life more safe ? The root of the matter
lies in the old custom of the country — that of having an
infant to sleep in the mother's arms, or at any rate, in her
own bed, and with the father. Overlaying is practically
unknown on the Continent of Europe, the reason being that
it is a recognized custom for parents to obtain a cot as soon
as a baby comes. The old-fashioned wooden box, cot, or
cradle used to be handed down from one generation to
another, and used for every baby as it came along. In
Germany and some other countries, there was a strict law
that no mother or nurse should have an infant under two
years of age in bed with her, under a heavy penalty, and,
if the law being broken resulted in a child's death, and
an infant got suffocated in bed with a grown-up person,
there was a conviction for manslaughter, and a long im-
prisonment followed.
In this country there are, of course, many cradles in
use, especially in country districts, but in our cities and
among the poor it is an almost invariable rule to find
young infants in bed with both parents. We want to
teach parents that the life of an infant under one year of
age is never safe in bed with a mother; it is too feeble to
breathe easily under any covering, and suffocation is bound
to follow when an infant's mouth and nose get squeezed
against a mother's breast, or if her arm rest upon or over
them, or even if heavy bedclothes get pulled up over a
child's head. Until baby is a year or more old it is sel-
dom strong enough to rouse up a mother when it is dying ;
its struggles for fresh air are too feeble to awake a woman
who sleeps soundly. In our towns women work hard and
go to bed late; sleep like logs, many of them, for hours,
in utter ignorance that the baby whom they love is dying
beneath them. There is no medicine which can make
mothers sleep lightly, and there are no means of avoiding
overlain babies except by insisting on the use of a cradle.
It is only reasonable to urge that the clergy should do their
BALDNESS 19
best to get this reform carried out. There are, of course,
numbers of babies overlaid because their mothers drink
too much, but we feel quite sure that the number of such
is small compared with the total number of babies who die
suffocated in bed, overlaid by parents tired with the day's
work.
There is no reason for the non-possession of a cot for the
baby.
Backache. — Pain in the back is a very common ailment
indeed, especially that form of it called by women " bear-
ing-down pain." It is very often a sign of nothing more
than tiredness of the muscles of the back ; but, on the other
hand, it may be a symptom of disease in some internal
organ.
Under "LUMBAGO" you will find a full account of the
pain due to rheumatic trouble in the back muscles, as well as
several valuable ways of dealing with all kinds of back-
aching. Backache in young growing persons may be due
to general debility, and then keep an eye open for curva-
tures and weakness of the spine. Actual disease of the
spine itself more often causes what is called "referred"
pain in the front of the belly. Some kinds of kidney di-
seases (see "Kidney Diseases") cause backache. Gall-
stones cause backache especially on the right side and in
the right shoulder. Ulcer of the stomach (see "Stomach
Diseases") will often cause local pain in the back at the
level of the last rib. But the commonest causes of women 's
backache are menstrual disorders, catarrhs of the womb,
falling of the womb (due to getting up too soon after mis-
carriage or childbirth), inflammation of the womb, and
tumors of every kind, connected with womb or ovaries.
Very little can be done towards curing the backache un-
til we know what causes it. If a young man or woman
has severe backache, that is not due to "growing pains,"
or general weakness, or curvature of the spine, let him or
her save a sample of the urine which he or she passes first
in the morning, and submit it to the doctor for analysis.
Under "LUMBAGO" will be found plenty of "cures" for
those whose backache is due to something that cannot be dis-
covered, or cannot be treated, and we refer all sufferers
to that article.
Baldness. — This may be permanent, as in old age, or
temporary as after fevers, in debility, syphilis, and con-
20 BANTING
sumption. Even those who are bald with increasing age
need not despair, however, for so long as any hair-growing
follicles are left in the skin they may be stimulated into
activity. The hair requires plenty of brushing and wash-
ing about once a fortnight, or three weeks. The washing
should be done in hot water, with a little household am-
monia in it, and then some ordinary yellow soap should be
used, or, better still, egg julep as a lather. When the
scalp is clean, dry it and the hair by rubbing with rough
towel.
A good hair-wash for the baldness following an illness
is — Castor oil, 20 parts; tincture cinchona, 10 parts; tinc-
ture rosemary, 10 parts; tincture jaborandi, 10 parts; bay
rum, 100 parts. Shake well and rub into scalp frequently.
Women who are weak and anaemic should try this lotion
to prevent hair shedding: — Salicylic acid, 3 drachms;
liquefied carbolic acid, 1 drachm; castor oil, 3 drachms;
alcohol, q. s. to 6 ounces. Make a lotion. To be rubbed into
scalp.
When the hair falls off because of scurfmess of the scalp,
use this lotion: — Resorcin, 1 drachm; ether and castor oil,
of each, 1 drachm; eau de cologne, one ounce; rectified
spirits, 6 ounces. Mix.
If the scurf is very thick and very greasy, and the hair
comes out by the roots, try this lotion : — Resorcin, 40 grains,
ether and castor oil, 2 drachms; eau de cologne, half-an-
ounce ; bay rum, four ounces. Rub into the roots night and
morning on clean rag, which is to be burnt immediately
after use. (See also "Skin Diseases" IV.)
Banting. — "Doing Banting" means dieting one's self in
a special way in order to get thin. Banting was the in-
ventor of this particular method of reducing weight. In
one year, Banting reduced his weight from 196 to 154
pounds.
The Banting diet is very scanty, but many very fat
people adopt it with good results. Here is the dietary: —
Breakfast. — Six ounces of meat, any meat except pork
or veal; one ounce of dry toast, or dry biscuit; 10 ounces
(half-a-pint) of coffee or tea, without sugar. Dinner (five
hours later). — Six ounces of meat (except pork, veal, eels,
salmon or herring), or of any kind of poultry or game;
six or eight ounces of any vegetable except potato, beetroot,
turnip, carrot or parsnip ; one ounce of dry toast ; a plate
BARRENNESS 21
of cooked fruit, unsweetened ; 10 ounces of claret and water.
Tea (four hours later). — Three ounces of cooked fruit, un-
sweetened, with plain rusks; eight ounces of tea without
milk or sugar. Supper (three hours later). — Four ounces
of meat or fish, or game, or poultry, as at dinner; six
ounces of claret, or claret and water.
This method of treating extreme fatness is deservedly
popular, but for some people it may not be enough to keep
up the strength. Such people should not try and eat
more, but should adopt the Oertel method, which is similar,
but has a higher proportion of fat and starchy foods, and
is combined with regulated hill-climbing.
Barbers' Itch. — Hairdressers generally know enough
about skin diseases to be aware that they sometimes help
to spread contagious skin diseases by insufficient attention
to the cleanliness of brushes and other utensils which they
make use of in the ordinary course of business. One of
these is called "barbers' itch." It may affect the eye-
brows, eyelashes, mustache, beard, and armpits and
groins. There are little tender pimples which form around
the hairs, and develop into tiny abscesses (pustules), and
the hairs come out easily. When the hairs are out the
matter comes out too, and perhaps at once affects the next
hair-sheath. The disease is most obstinate to cure. The
hairs have to be pulled out and the matter has to be gently
squeezed out of the follicles; after that you must rub in
some antiseptic ointment, such as yellow oxide of mercury
ointment, or 2 per cent, resorcin in vaseline or cacao butter.
Under the heading of ' ' Hairdressers ' ' we give some hints
as to the prevention of such diseases.
Barley Water for Invalids. — DIRECTIONS. — Mix one
dessert-spoonful of Robinson's Patent or Prepared Barley
with a wineglassful of cold water into a smooth paste.
Pour this into a stewpan containing one quart of boiling
water, and stir over the fire for five minutes. Flavor with
lemon and sugar, either or both, according to taste, allow
the mixture to cool, and strain off the barley sediment.
For invalids requiring nutriment, a large quantity of
barley should be used and the straining of sediment omitted,
or not, as directed by the doctor.
Barrenness. — The treatment of barrenness must obviously
depend on the cause of it, and only a doctor can decide
this point.
22 BATHING
Bathing, The Importance of. — In order to maintain good
health, it is of the utmost importance to keep the skin of
the whole body clean. "We may notice among persons whose
habits we know of, that those who take daily baths are not-
able for health and for having a good color and clear com-
plexion. We are constantly getting rid of used-up mate-
rial through our skins by perspiration and by evaporation.
The pores of the skin tend to become blocked up unless
often washed, and when the pores are obstructed more work
is thrown on the kidneys. Persons in robust health are all
the better for having a daily bath of cold water ; those who
are less strong are wise to have a morning bath of warmed
water. Such a practice is well worth the trouble of the
process and the loss of time, and it should be followed in
houses with conveniences for it. When a daily bath is
not practicable, a warm bath should be taken once a week
at bedtime, and during pleasant weather a bath in the
sea, or in a river, or in a town swimming-bath, is very
desirable. It is not desirable to remain in any bath very
long, and on getting out the whole body should be rubbed
with rough towels until the skin is all pink and glowing
with warmth. When a person does not feel a hot glow after
a cold bath, he should not bathe in quite cold water. It
is only foolhardiness to risk taking cold baths in the open
air during winter weather. Medical men describe and ad-
vise several sorts of baths. For instance, the cold bath
generally means the use of water just at the temperature
it happens to be according to the weather. Baths of
warmed water require the use of a thermometer to regulate
the heat to the degree ordered. In general domestic use,
of course, it is customary to test the heat of the water by
the hand; this, however, is an uncertain guide. Delicate
children may easily be scalded by hot water which does not
feel painful to a nurse's hand. A bath called by a doc-
tor "tepid" means of heat between 84 and 92 degrees
Fahrenheit scale. A warm bath is from 92 to 98 degrees;
the latter is blood-heat. This feels hot to the whole body,
and is most suitable for a general washing with soap. A
hot bath is of a heat from 98 to 105 ; this is only to be used
as a form of medical treatment. A mustard foot-bath is
made with a half-teacupful of mustard powder to a gallon
of hot water. An alkaline bath, used in skin disease, is
made by adding carbonate of soda to warm water. A
BEDSORE 23
sulphur bath, to cure itch, is made by adding two drachms
of sulphurated potash to each gallon of water. Soak the
affected hands and arms in it.
Bed Case. — This is an old-fashioned name for cases of
hysteria of a certain kind. Instead of being up and about,
doing their share of work in the world, the subjects of this
pitiable condition prefer to be regarded as interesting in-
valids. They dislike being told that they look well. They
like to believe, or to make their friends believe, that they
have a mysterious internal complaint, and that their doctor
considers them very interesting and obscure cases. They
often are tranquil and cheerful, and have good digestions
for dainty food. They always have some speciality in the
way of a disease — always obscure and invisible. Either it
is * ' something wrong with the spine, ' ' or with the * ' womb, ' '
or ' ' the nerves, ' ' and they say, in order to attract the sym-
pathy which is as bread and cheese to their vain and little-
minded selves, that they have ''horrible pains/' If these
patients can be brought into a healthier state of mind by
cheerful companions, or nurses who will stand no non-
sense, they may be cured. But, unfortunately, too many
of them are quite comfortable in their selfishness and do
not in the least desire to be made like other people, or
deprived of their friends ' sympathy. (See l ' Neurasthenia"
and "Hysteria.")
Bedsore. — A bedsore is a sore or ulcer which forms on
some part of a bed-ridden invalid, and it is due to pressure
and moisture combined. The chief places are the heel,
the buttocks and the bottom of the spine. A nurse should
regard the formation of such a sore on her patient as a
disgrace, generally, and due to her own carelessness or
want of watchfulness. The sick person must be kept quite
dry and unsoiled by sweat, discharges or urine. Look out
for redness over parts which are lain upon, and rub them
a little daily with methylated spirits, dry thoroughly and
dust with some clean powder. If the skin once gives way,
the ulcer is very difficult to heal, and the doctor's atten-
tion must be called to it. Otherwise the sick person will
have an additional trouble which ought to have been
avoided. Bedsores occasionally occur in very old, para-
lyzed, and dying folks, but in most cases can be avoided
by proper attention.
Beef Tea, How to Make. — (1) Cut up a pound of lean
24 BEVERAGES
gravy beef into small pieces, put them into a covered jar
with two pints of cold water and a pinch of salt; put the
jar on the hob, let it warm and simmer gradually for two
hours, taking care it never reaches boiling point. An-
other method is: — (2) Chop fine a pound of lean beef, add
a pint of cold water and leave for two hours. Then let
it simmer on stove for three hours, but never let it get
much hotter than 160° F. A thermometer will be wanted
in nurseries where this method is made use of. Make
up for the water lost by evaporation by adding cold water,
so that a pint of beef tea shall represent a pound of beef.
Strain, and carefully squeeze all fluid from the beef. —
(Bartholow.) (3) Beef tea and oatmeal — a very nourish-
ing meal: — Mix thoroughly a tablespoonful of groats with
two tablespoonfuls of cold water and add to a pint of hot
beef tea made as in (1). Heat up again for ten minutes,
stirring all the time, and strain through a coarse sieve.
Beverages. — All "drinks" contain a large proportion of
water, and, in fact, the daily drinking of a large amount
of water is a necessity for health. An average adult needs
water, in one form or another, to the extent of from 2%
to 4 pints a day. It should be filtered or boiled, or both.
We shall now consider the principal beverages from a
medical point of view: —
Tea and Coffee are much alike both in their composition
and in their effects. They stimulate the system and are
quite harmless, in moderation. Cocoa, on the other hand,
is a true food.
Tea ought to be made with boiling water, and water as
"soft" as possible. If your tap-water is hard, boil it for
fifteen minutes with a pinch of carbonate of soda before
you make the tea. Everybody knows the effects of tea-
drinking. We need only say that green tea has much
stronger effects than black. If tea gives rise to any sort
of indigestion or palpitation of the heart, it may be be-
cause it has "stood too long." In any case, tea ought to
be drunk after a meal, and not with a meal, and a little
carbonate of soda should be added to the pot. "High tea"
—the meal consisting of tea and meat — is a fruitful cause
of indigestion.
Coffee ought to be freshly roasted, and freshly ground
in order to be at its best as a drink. Coffee in moderation
stimulates the heart and lessens the sense of fatigue. Too
BIRTHMARKS 25
much coffee may depress the heart and make it irregular,
and cause an uncomfortable feeling in the cardiac region;
it may also cause heartburn and flushing of the face, es-
pecially when strong black coffee is drunk after a meal.
It then delays digestion of the food. Strong coffee is a
splendid antidote to poisoning by alcohol or opium. (See
"Poisoning.")
Cocoa is a very nutritious food. It contains both body-
building and energy-giving foods, and should be used in-
stead of tea by the poor especially.
Chocolate is a very excellent and agreeable drink, con-
taining a deal of fat and starchy material, and plenty of
sugar. Bilious people should not drink it. It is a food
rather than a beverage.
Alcohol is a useful food in very small quantities, an
agreeable stimulant in larger quantities, and in excess is
a powerful narcotic poison. A great authority says that
one fluid ounce or one-and-a-half ounces of absolute alcohol
in twenty-four hours is the most that any healthy adult
can take with probable impunity. One ounce of pure
alcohol is contained in about: —
2% fluid ozs. of whisky. Half-a-pint of claret.
2 fluid ozs. of brandy. Two pints of bitter beer.
2 fluid ozs. of gin. One-and-a-half pints of porter.
1% fluid ozs. of rum. Two-and-a-half pints of lager
beer.
6 fluid ozs. of sherry. Two pints of cider (varies very
much) .
NOTE — See also "Drachms" and "Ounces".)
Birthmarks. — Blemishes at birth are of various kinds.
The commonest, perhaps, are "port- wine stains" on the
skin. These are purplish patches of fantastic shape, due
to dilated blood vessels. Sometimes they increase in size
as time goes on; more often they only increase slowly for
a few months and then remain quite stationary. They can
sometimes be improved by electrolysis, but more often not.
Old wives tell tales about "strawberry-marks," and
"mouse-marks," and say that they are the results of some
of the mother's experiences during pregnancy; these no-
tions are but silly superstitions. Other " mother 's-marks "
are hairy moles and colored moles, all called by doctors
26 BITES OF DOGS
ncevi (ncevus is the Latin for mole). These are more
likely to be removable by electrolysis.
Bites and Stings of insects may be bathed with tincture
of arnica, onion juice, thymol ointment, or dabbed with a
piece of rag or cotton-wool soaked in ammonia solution.
Cloudy household ammonia will do nicely. An insect bite
must not be scratched or a sore may result from poisoning
by dirty nails.
Bites of Dogs. — If an ordinary healthy dog bite a per-
son, there is no need to fear hydrophobia. Not all dogs
which bite are ''mad dogs." In fact, "madness" in dogs
means the rare disease called rabies. There is a very cur-
ious, but entirely nonsensical, superstition that if a mad
dog which has bitten someone is shot afterwards the suf-
ferer will be saved. Rabies in the later stages is easy
to recognize; the poor animal who suffers from it lies ill,
curled up in a corner, with foamy mouth and hanging
tongue, and is more or less paralyzed. In the earlier
stages of this "madness," the dog is sulky, suspicious, and
snappish, and may, perhaps, run after anyone who annoys
it, and bite him. But even when bitten by a "mad dog"
a person need not develop hydrophobia. The poison in
the dog's saliva will probably have been wiped off in the
clothes through which it bites.
For the same reason mad-dog bites of the hands are
dangerous and those of the face especially so on account
of the great blood supply.
As hydrophobia, once developed, is almost always fatal,
the first thing to do is to cauterize the bite. Only a sur-
geon can do it properly, but anyone with the necessary
hardy courage could burn out the wound with a cautery,
such as is used for fancy poker-work, or a red hot poker,
or a pair of lady's curling-irons.
The disease is comparatively rare. Still, every bite of
a dog ought to be seen to by a medical man.
Hydrophobia may develop a few days after the bite,
but in many cases there is an interval of weeks or months.
When bitten by a dog it is most important to establish
the fact whether the animal is rabid or not. This may
be done by one of two methods. 1st — Keep the dog alive,
under observation. 2nd — Kill the dog, cut its head off and
forward, as quickly as possible, packed in ice to some
health department laboratory where a diagnosis can im-
BLACKHEADS 27
mediately be made by a microscopical examination of the
brain. By no means let the dog escape, or be killed and
lost sight of.
If, in either case, the dog is proved to have rabies, the
subject bitten must begin immediately the Pasteur treat-
ment:— either at a department of health, a Pasteur In-
stitute, or as can now be done, by his own physician at
his own home.
All public spirited citizens should appreciate the fact
that rabies, which is becoming very common in this coun-
try, can never be blotted out until widespread muzzling
of dogs is carried out — at least for a limited period fol-
lowed by a permanent national quarantine — such as en-
forced in England, where rabies is now an unknown disease.
Black-Eye. — A purple discoloration of the skin of the
eyelids, cheek, and perhaps forehead, due to a blow, or
fall; the color results from blood being effused under
the skin from veins bruised by the violence. Very severe
blows may have injured the bone deeper still. The whites
of the eyes may also be stained crimson or purple. A
black-eye will gradually get well if left alone, but it is
a good plan to apply cold lotions of spirit and water, or
vinegar and water, or a piece of raw steak, if attended
to at once; if the case be found painful at a later stage
apply warm poultices, or fomentations of poppyheads.
The dark color will fade away, becoming red and then
yellow before the skin becomes white again. In the final
stage rub the part gently with white vaseline, lanolin
or cold cream. If the skin is broken as well as bruised,
treat the case with fomentations of boric lotion, followed
by zinc ointment.
Blackheads. — There are comparatively few young peo-
ple whose skins are entirely free from "blackheads."
They show as little black pimples on the skin of the nose
or forehead or chin; but also on the shoulders, back, and
chest. They look a little like grains of gunpowder em-
bedded in the skin. If they are squeezed out between the
finger nails, or with the barrel of a small key, they look
like little white curly maggots with black heads. Some-
times the little plugs are more like tiny orange pips. They
are quite harmless, but they disfigure the face very much,
and they may, and often do, become acne spots (see
"Acne"). They ought to be squeezed out, but gently,
28 BLEEDING FROM VARICOSE VEINS
because if it is roughly done, there is sure to be an acne
spot formed there, and then the skin must be washed
vigorously with soft soap and hot water and dried with
a rough towel. This ought to be done at bedtime, and
then the following paste must be rubbed in : — Glycerine, six
drachms; kaolin, one ounce; and vinegar, half-an-ounce.
Bladder, Diseases of. — There are two ''bladders" in the
human body — the gall bladder in the liver, and the urinary
bladder, to which the urine passes as it comes from the
kidneys until the bladder gets uncomfortably full. In-
flammation of the urinary bladder is called cystitis.
1. — The signs of cystitis are: — Pain in center of lowest
part of the belly; too great frequency in passing water;
bad smell, turbidity, and whitish sediment in the urine;
f everishness ; shivering fits.
Treatment of acute cystitis. — Rest in bed, hot hip baths,
milk diet, plenty of water to drink, and urotropin (5
grains) to be taken three times a day. This is the treat-
ment of an attack of cystitis caused by catching cold.
But cystitis, and pain and bloody urine, may be due to
a stone in the bladder, or to other things, and then the
disease requires very skilled treatment. Other diseases
of the bladder are irritability, tumors, and rupture (noth-
ing to do with " hernia").
II. — Irritability of the bladder (with very frequent de-
sire to pass water) may be caused by cystitis, stone,
stricture, enlarged prostate gland, gouty acidity of the
urine, piles, too tight foreskin, etc. The treatment, of
course, depends on the cause, which only a doctor can
decide.
Bleeding from Varicose Veins. — In persons who suffer
from varicose veins the skin of the parts affected at length
becomes brownish, shiny, and so badly nourished that the
very slightest injury may give rise to a troublesome sore.
The sore does not heal because the parts are so badly sup-
plied with blood, and the ulcer (see under "Ulcers" — 6)
may penetrate to one of the swollen veins under it and give
rise to a sudden copious loss of blood. In a few seconds
the sufferer may lose blood enough to cause a serious faint-
ing fit, which arrests the bleeding for a short time. If
you ever see anyone bleeding furiously from a sore on
the leg where there are knotted and swollen veins, make
him lie down on his back, raise the leg, and apply pressure
BLISTERS 29
with a handkerchief rolled into a pad, directly on to the
Heeding spot and bandage it tightly there, or bandage both
above and below the wound. Then send for a doctor.
BLEEDING from the back passage, or rectum, generally
shows the presence of piles, or ulceration, or inflammation
of the bowels. A small occasional loss of blood in a full-
blooded person is rather a good thing, but in all cases
a doctor should be told about it, as it may be curable, or
it may be the sign of a disease elsewhere which ought to
be medically treated.
BLEEDING from the nose. (See "Nose-bleeding.")
BLEEDING WOUNDS. — When a cut is received on fingers or
arms the wound should first be thoroughly cleaned with
water and peroxide of hydrogen or bichloride of mercury
solution (1-1000). Then pressure should be applied — pref-
erably with sterile gauze and a firm bandage applied. If
the cut has been a severe one this may have to be followed
by attention from a physician to tie off the bleeding
points and perhaps sew up the wound. All wounds of
the face, when small ones, should be sewed up by a physi-
cian, otherwise the numerous muscles of that part of the
body will cause the wound to gape and leave an ugly
scar.
If the bleeding from a wound can not be controlled by
direct pressure a tourniquet should be applied with pres-
sure over the main artery of the extremity some place on
the heart side of the wound.
Blisters. — A blister is a watery bleb of the skin. It may
be caused on the hands by rowing, or other exercise, and
on the feet by too much walking. A burn may cause a
blister, so may a bruise, or a scald, or an attack of ery-
sipelas.
For feet inclined to blister, bathe daily with a lotion
of alum and 10 per cent, chromic acid (poison), or smear
the inside of the socks with dry soap. For actual blisters,
prick them with a clean needle, let the fluid out, and put on
a piece of soap-plaster or other clean dressing. For small
blisters, leave them alone ; if inflamed, apply zinc ointment
or show them to the doctor. If the blister has not been
caused by any ordinary event, it may be a symptom of
a skin disease, and skilled advice must be obtained.
Blistering may be produced artificially by certain plasters,
or by blistering fluid, for the purpose of curing pain or
30 BOILS
bringing down inflammation. A blister should never be
put on without medical advice.
Blood-Spitting. — This means coughing up blood, and blood
can only be ' ' coughed ' ' up from the windpipe or the lungs.
Sometimes an aneurism (see "Aneurism") bursts into the
air passages, but in all other cases blood from the lungs
means lung disease more or less serious. The coughing up
of blood is accompanied by a tickling sensation in the
throat, and the patient goes on coughing up blood for
some little time; the blood is generally scarlet, and mixed
with air-bubbles. The commonest cause of blood-spitting
is tuberculous disease of the lung; then comes congestion
of the lung from chronic heart disease; then acute pneu-
monia and bronchitis ; then disease of the voice box ; then
an aneurism; and the most unusual cause is from con-
stitutional disorders, such as scurvy.
When a patient begins to spit blood in small quantity
put him to bed and give him pieces of ice to suck, or sips
of cold water. If he spits or coughs up a large quantity,
keep him lying down with his head on a low pillow, and
try to keep your own presence of mind, and cheer him up
until the doctor comes. It is all that you can do.
Blood-Vomiting. — The first thing to find out is whether
the blood that is vomited comes from the stomach or not.
A man may bleed from his lung, or from the back of his
nose, and the blood may be swallowed and afterwards
vomited. So be sure to notice particularly all the charac-
ters of the blood and of the vomiting. Tell the doctor if the
blood is bright red, or dark red, if it comes into the hand-
kerchief when the nose is blown, and whether the gums
are sore or not. Blood is dark red and clotted if it comes
from the stomach, and light red and frothy if it comes
from the lungs. The more accurately you can describe
to the doctor all the details of vomiting, and its relation
to food and drink, the more accurate is his advice likely to
be, and the more speedily he will be able to begin the neces-
sary treatment. Until the doctor comes, keep the patient
in a lying-down position and let him suck small lumps of ice.
Boils. — The appearance of boils usually indicates a "run
down" condition. Under these conditions the tendency to
the occurrence of boils is increased by excessive use of
tobacco and alcoholic drinks or constipation. They are
BREAST, ABSCESS OF 31
exceedingly common in people suffering from diabetes.
A boil is an abscess of the skin — a red, painful, in-
flamed lump, which when "ripe" is full of matter called
pus, and contains a "core," which is made of dead tissue,
and must be got rid of before the inflammation will heal.
A boil may sometimes be aborted by the following pro-
cedures:— Take a cathartic (calomel followed by laxative
salts), scrub the inflamed area with soap and hot water,
pull out any hairs near the central area and apply gauze
soaked in bichloride of mercury (1-000 in 50% alcohol).
Stop smoking and drinking. Further aid may be ob-
tained by the inoculation of a vaccine (against suppuration)
by a physician.
If the boil comes to a head it must be opened by a
physician, cleaned out and drained. Afterward it may
be necessary to take sulphide of calcium (gr. 1/10) and a
tonic of iron and arsenic with a course of vaccine treat-
ment.
Brandy and Egg Mixture (EGG-NoGG). — Mix together the
yolks of two eggs, half-an-ounce of refined sugar, two
ounces of good cognac and four ounces of cinnamon water.
Breast, Abscess of ("MILK- ABSCESS"). — Causes. — Ab-
scess of the breast rarely occurs except during suckling.
A cracked nipple is generally the path through which the
germs of inflammation get into the breast itself; and they
are able to set up inflammation there because the breast is
neglected and gets too full of milk, owing to the fact, that
the nipple being sore, the baby is put too much to the other
breast. This is very bad for the baby, who is drawing his
very life from the other breast.
Treatment. — Whenever, because of cracked nipple, or
for any other reason, a baby does not make use of one
breast, it must be regularly emptied by a breast pump,
such as all druggists sell. If inflammation is beginning and
some part of the breast is getting hard and tender, let the
woman purge herself well, foment the breast every two or
three hours, and support the breast with bandages or a
sling passed round the neck and under the gland. But if
an abscess seems to be forming, let the doctor see it with-
out delay, for an early incision will often save weeks of
pain and illness and avoid the formation of a foul and
troublesome ulcer.
32 BBOKEN BONES
Breath, Unpleasant or Foul. — This may be the result of un-
healthiness of the stomach or of the mouth and teeth. The
breath of a person whose digestion is good, and who keeps
the teeth clean is quite free from anything objectionable.
It is useless to try and cure unpleasant breath with cachous
or scented lozenges, so long as the food is not masticated
properly ; or if too much alcohol is drunk, too much smoking
or snuff-taking is indulged in, and the teeth are not brushed
regularly every night at bedtime. (See the article on " In-
digestion" and " Teeth.")
BREATH, SHORTNESS OF. — This may occur only after exer-
tion, such as climbing the stairs, or it may be always present.
Shortness of breath may be spasmodic (see "Asthma,")
or continuous, which would be a sign of heart disease or
advanced lung disease, or chronic bronchitis. Shortness of
breath on exertion in young girls is generally due to
ancemia (which see), or to heart disease caused by rheu-
matism. In older people, shortness of breath on exertion
is more likely to be due to a "fatty heart" (perhaps one
of the results of tippling), or to a weak flabby heart (after
Influenza), or to chronic bronchitis. In the last case, sul-
phuric ether taken internally in small doses will give re-
lief.
The reader will understand that there is no royal cure
for shortness of breath itself. We must first discover what
it is caused by, and treat that condition appropriately.
But there are very few cases of shortness of breath which
a doctor cannot greatly relieve. The shortness of breath
which occurs in young girls is very amenable to treatment
and such cases should never be neglected.
Bright's Disease. — Acute Bright 's disease is an ailment
in which the kidneys are inflamed, the urine scanty, the
eyelids swollen, and albumin is passed in the water. It
must be treated by a doctor. (See "Kidney Disease.")
Broken Bones. — If, after any injury, a bone is thought
to be broken, a doctor can not be seen too quickly. It is
much easier to replace broken bones soon after the accident
than later. When a bone is broken there is pain at the
site of the fracture with swelling, tenderness on pressure,
and inability to use the part. If only on-e bone of the
lower arm or leg is broken the other bone, acting as a splint,
may prevent complete loss of use.
After a simple fracture, a splint of a thin piece of board,
BRONCHITIS 33
covered with cotton, should be applied and bound firmly
with a bandage.
If the broken end of the bone protrudes through the
skin (compound fracture) do not try to put it back in
place before the doctor arrives as it has been infected and
unusual precautions are required to prevent the forma-
tion of suppuration and an abscess.
Diagnosis of broken bones is nowadays practically al-
ways confirmed by the X-rays.
By this means also it can be determined whether the
broken ends have been replaced in the proper position.
If there is one form of illness for which Christian Science
is not fitted to treat it is broken bones.
Broken bones require from three to six weeks to heal,
depending upon the size of the bone and the age of the
subject. Some fractures in old people, as that of the neck
of the femur at the hip, heal only with the greatest diffi-
culty.
Voluntary motion of the muscles of a fractured part must
be begun as soon as possible, otherwise they rapidly shrink
from disuse and it may take a long time to recover the use
of the part.
Bronchitis. — This means inflammation of the air tubes in
the lungs (see also ''Lung Diseases"). It is a catarrh of
the air tubes just as a cold in the head is a catarrh of the
nose and throat (see also "Cold in the Head"). It affects
persons of all ages, from infancy to old age. Its chief
symptom is a cough (see also "Coughs"). When the
disease is acute, the sufferer has much fever and general
illness, but the cough is the chief feature. At first it is
hard, and no phlegm is coughed up, but later it becomes
easier and the patient spits up a lot of yellowish thick
phlegm, sometimes tinged with blood.
Acute bronchitis may be fatal, and must be treated by
a doctor. Chronic bronchitis, in its various forms, such as
a "winter cough," is more or less easy to relieve, but very
difficult, and often impossible, to cure. The patient ought
to live in a dry climate, or failing that, a warm one. He
must dress warmly and keep his skin active with frequent
baths, and his bowels always well open. There are three
different types (among others) of persons with chronic
bronchitis.
(1) — One type has a dry catarrh, a painful difficult
34 BUBO
cough and thick, sticky phlegm, which is very hard to get
rid of. For such a case as this we recommend: — Sodium
iodide, one drachm; sodium bi-carbonate, four drachms;
chloride of ammonium, two drachms; solution of mor-
phine, one drachm; chloroform water, eight ounces. Take
a teaspoonful three times a day.
(2) — A second type is one in whom there is a lot of
coughing, not painful, but noisy, and plenty of watery
phlegm. Such persons would be benefited by: — Tar water
(1 in 10), a wineglassful of half-a-pint, twice or three times
a day. Sulphur lozenges and Cod-liver oil are also useful
in such cases.
(3) — The third type is the bronchitic aged person — old
and feeble, and wheezy. A good remedy consists of syrup
of tolu, half ounce; ammoniacal mixture 2 ounces; com-
pound tincture of camphor 3 drachms; and water up to 6
ounces. A tablespoonful may be given thrice daily, or
every four hours. Petroleum Emulsion is also an excellent
remedy given after meals.
It must always be borne in mind that a long continued
cough which is difficult to cure is one of the first signs of
tuberculosis or consumption. Therefore, if a cough has
been impossible to cure after three or four weeks, a physi-
cian should be consulted to make sure that tuberculosis is
not developing. The greatest hope for cures in consump-
tives lies with those who recognize their condition the earli-
est.
Prevention. — Much can now be done to prevent the oc-
currence of bronchitis and colds and consequently tubercu-
losis in the following way : —
Avoid the inhalation of dust. Keep up the resistance
of the body to germ invasion by cold morning baths, out
of door exercise, nutritious diet without excess of alcohol
and tobacco and avoidance of undue fatigue.
Bruises. — If a bruise is accompanied by breaking of the
skin it should be cleaned with peroxide of hydrogen and
dressed aseptically until the skin has healed.
If the skin is not broken it may be rubbed with any
healing, soothing lotion — such as belladonna liniment — the
most efficacious thing being the massage which removes
the extravasated blood and lymph and thus diminishes the
swelling and consequent pain.
Bubo.— (See "Glands.") A bubo is a swollen gland.
BURNS 35
The word is generally applied to the glands in the groin,
swollen as a complication of venereal disease. The treat-
ment is surgical, and requires skill and a careful use of dis-
infectants.
Bunion. — This is the inflammatory swelling which takes
place on the ball of the great toe of a person who wears
ill-shaped boots. Good boots are straight on the inner
edge and not cut to a point. The remedy lies in buying
better-made boots. A bad bunion may require a little op-
eration called ' ' excision of the joint. ' '
Burns. — It is quite evident that burns of the body may
be of every possible variety as regards extent and depth,
If a hot cinder falls on one '& flesh it may burn a deep hole ;
if one's clothes catch fire, there may result a very exten-
sive burning of the skin only, and the fat and muscles be-
neath may not be damaged. There is always a certain
amount of " shock" to the nervous system after a burn,
and the greater the surface burned the greater will be the
shock. A hot coal burning a hole in the flesh will not
shock the patient so greatly as a surface burn of any part
of the body.
In the case of a small burn, we have only to think about
the burn, and how to get it well. We shall consider this
first. There are two things necessary to know: — First,
how to keep the burned part clean and free from germs of
disease, which are generally floating about in the air, and
are on the hands and clothes of everybody in cities and
towns; and, second, how to relieve the dreadful pain and
smarting, and to keep the raw place free from all mechan-
ical irritation.
First, then, remember, that flesh or skin which has just
been burned is already probably quite free from " germs,"
or, as doctors say, ''aseptic," because fire is the destroyer
of disease germs. So that it is our duty to see that noth-
ing that can possibly be contaminated goes anywhere near
the burn. Rags, oil, flour, etc., are all very well, but they
may not be "clean" in a medicinal sense. Every house-
hold ought to have a little packet of pure boric acid powder
in the cupboard, and this should be dusted over the burn.
Blisters should be pricked with a darning needle, whose
point has been held in a flame for half a minute, and the
fluid allowed to trickle away or mopped up with medi-
cated cotton-wool. Then over the powdered place you may
36 BUST DEVELOPMENT
put a layer of medicated cotton-wool or a piece of boric
lint. In any case, if you are going to treat the burn your-
self, wash your hands and brush the nails with 5 per cent,
carbolic soap before you begin. Then, even if the burn
does not heal properly and there is a lot of scarring, you
feel that you have done your best. With regard to scar-
ring, do not forget that a burn on the face or hands, or
neck, may result in contraction of the skin, which may
disfigure the patient and spoil his looks for life.
For anything but a trivial burn, a doctor must be called
in. No one else can apply really suitable treatment in any
given case, especially if medicines are required in addition.
Some like oily applications for burns, and use carron oil,
composed of equal parts of linseed oil and lime water.
The alkali which the carron oil contains neutralizes the
acid from the burn and thus prevents the pain which re-
sults when acid is applied to exposed nerves.
Some physicians, instead of using oil, prefer to expose
burns to the air, neutralizing the acid with a solution of
sodium bicarbonate. This is undoubtedly preferable for
large surface burns where the oxidizing function of the
skin must be aided — not interfered with.
Bust Development. — Doctors are constantly being asked
by their lady patients for some unobjectionable method of
developing their figures. That being so, and seeing that
there are numbers of expensive preparations advertised
for this purpose on the market, we give our readers a few
hints. Undeveloped figures are generally a sign of poor
nourishment, and the first thing to do is to eat only the
most nourishing food and attend to the digestion and the
state of the teeth. Eat porridge, plenty of bread and
cheese, and eggs, and milk, and puddings, and avoid pic-
kles and nuts, and too much meat. Breathing exercises are
of the first importance. Every morning, before breakfast,
throw open the window, have no tight bands or belts, or
braces on, stand erect with heels together and shoulders
thrown back, and fill the lungs with fresh air, slowly, to
their utmost extent. When full of air, hold it in as long as
you can, and then breathe it slowly out again. At first it
will tire you, but persevere. Do it fifteen times, then lie
down quite still and rest; then fifteen times again, then
continue dressing. After three weeks your lung capacity
will be much improved and then you may begin to fatten
CANCER 37
and nourish the skin of the neck, shoulder and breasts.
This is done by rubbing in the following preparation for
five minutes night and morning; rub gently and firmly,
and in a circular direction, with the palm of the hand: —
Elderflower water, half-a-pint; simple tincture of benzoin,
half-an-ounce ; tincture of myrrh, a few drops ; mix well and
add best linseed oil, half-a-pint.
The intelligent reader will understand that all such
methods as the above are, though often highly satisfactory,
of much less real value than courses of suitable gymnastics
would be. It is better to be in good muscular condition on
the chest and elsewhere, than to be merely fat, because fat-
ness varies with the time of the year and state of the
health; and a woman with suitably-developed muscles sel-
dom lacks a comely natural covering of fat and a healthy
and rosy skin in addition.
Cancer. — It seems to be a fact that there is an ever in-
creasing mortality from cancer in every part of the civi-
lized world. The word "cancer" is used in a very vague
way, almost as if it could be considered interchangeable or
synonymous with "tumor." Every cancer is a tumor,
but very few tumors are cancers. " Tumor" means a
swelling, and nothing more than that. There are at few-
est ten different kinds of cancer, and they vary in course,
in origin, and in causation. One of the commonest kinds
of cancer, especially in males, is Epithelioma, which is al-
ways caused by mechanical friction of a part in a predis-
posed person, and is nearly always preceded by an ulcer
of that part, caused very often by excess of alcohol or to-
bacco. Scirrhous cancer is the form which women gener-
ally have, and most often in the breast, as the indirect
result of a blow or anything else which may hinder the
proper performance of the functions of that organ. Only
10 or 11 per cent, of women affected can really trace the
tumor from a blow, or some other mechanical violence.
And then there is a group of fatal tumors called cancers
by the public, but which are called Sarcomas by the doc-
tors. Sarcomas are different from cancers in some im-
portant ways, but resemble cancers in that, if not removed
in time, they will kill the patient. A malignant growth,
whether Epithelioma, Carcinoma, Scirrhous, Sarcoma, or
any other kind, kills the patient by exhausting his strength,
and the only treatment is to have it removed by operation,
38 CARBUNCLE
or burnt away by strong caustics. Even then it may come
back again in another place, and if the other place is one
which we cannot get at by the knife, of course we cannot re-
move the tumor, and the patient must die. It is now believed
that cancer cells, in small collections, exist in many people
from birth; and that the tendency for them to grow into
tumors is hereditary. Not everybody who has a few can-
cer cells in his body has cancer, however — a tumor may
never develop. As to the real immediate causes of cancer
we know almost nothing. In a predisposed person, long-
continued mechanical friction, or any other kind of me-
chanical injury will, perhaps, make a cancer form; and
any old lump, or tumor, or sore, may become cancerous, if
it is irritated long enough. If there is cancer in your
family, you should guard against neglecting bruises, blows,
sores, or inflammations of every kind; and you should, to
be quite on the safe side, drink no alcohol and sn.oke no
tobacco. It cannot be shown conclusively that cancer has
anything to do with food, soil, or climate.
Prevention: — A large proportion of the deaths by can-
cer could be avoided if the cancerous condition were rec-
ognized early enough and removed soon enough. There-
fore the moment a suspicious lump is observed in the
breast, a sore on the lip which will not heal, indigestion
which will not improve, or if there are evidences of blood
from the uterus which cannot be explained by normal
processes lose no time in seeking medical advice to get a
diagnosis.
Pain is one of the most common symptoms in cancer,
but do not rely on this symptom alone in making a diogno-
sis of cancer for it is sometimes absent.
Do not try to temporize with X-ray and blue light cures.
You may be losing invaluable time. See a doctor as soon
as possible.
Carbuncle. — This is a large boil, affecting several glands
in a group. (See also " Glands. ") The inflammation is
more severe, the pain is greater, and there is more general
illness than with ordinary boils. The seat of the trouble
— the skin of the affected part — is raised, firm, bright, red
and hot. In most cases the inflammation does not im-
prove but gets worse for about ten days, and becomes a
brawny red painful swelling, on the back of the neck, or
elsewhere. Then it softens, becomes dotted with " heads"
CATHETER 39
or yellow points, and at each point the skin gives way and
yellow blood-stained pus comes out. The carbuncle may
even then continue to get larger. The skin between the
holes dies and sloughs, so that there is a "core," and a
ragged foul ulcer. The nearest glands are swollen and
tender also, and the patient has shivering, aching, fever,
and general illness. Death may occur from blood poison-
ing.
It occurs sometimes in persons of robust health, because
it is due to poisoning by germs, but weakly people are more
liable to be attacked. Many cases end in death from ex-
haustion, especially if they have diabetes as well.
The treatment of a small carbuncle is the same as for a
boil. (See "Boils.") Paint the surface of the skin with
glycerin of belladonna, and apply hot compresses. The
surgeon must be called in, and he will make a cross-shaped
opening with his knife, and let out as much of the poison
as possible. The cavity will have to be scraped and mopped
out with strong germicides.
But besides the local treatment, the patient himself — it
is generally a man — will require treatment. He must have,
if he is to recover, a liberal diet, and a strong tonic, suited
to his age and state of health. Until after the slough has
been cleared out, he ought to avoid stimulants, but port
wine or champagne may be required in the after-treatment.
Afterwards a change of air and a rest are most neces-
sary.
Cataract.— (See "Eye Diseases.") If you read the first
paragraph on eye diseases you will know what the lens is.
A cataract is an opaque spot on the lens of the eye. It is
commonest in persons over fifty as one of the forms of the
decay of age. Cataracts in young persons are generally
the result of injuries to the eye.
Many cataracts can be removed by skillful eye surgeons,
with restoration of sight.
Catarrh.— (See "Cold in the Head.")
Catheter. — A catheter is a tube for passing into the blad-
der to draw off the urine. No one but a doctor can use
the instrument properly, but sometimes patients have to
be taught to pass it on themselves, because they are unable
to pass their water in the natural way. We give here full
medical directions as to how to treat a catheter, which has
to be used daily by the patient himself. We may remark
40 CHANCRE
that a few persons regularly use a catheter without taking
any precautions whatever, but sooner or later such behavior
is always disastrous. An unclean catheter takes germs
from the outside air into the bladder, and sets up inflam-
mation there, which may be fatal.
A man who has to use a catheter regularly should use a
red rubber one generally, and a gum-elastic one only when
absolutely necessary. The smallest roughness or fraying of
the catheter should cause it to be discarded. Have a bottle
of a pint of 1 in 2,000 corrosive sublimate lotion ; it is quite
cheap and the drug is sold in tabloid form. Wash the
hands with carbolic soap before handling the catheter, and
the privates also, whenever practicable, before pushing the
catheter into the bladder. Let the catheter lie in the lotion
for five minutes before use, and then lubricate it with 1 in
40 carbolic oil. It is a good plan to squirt some lotion
through the catheter (with a glass syringe kept for the pur-
pose) before introducing it.
After use, the catheter ought to be washed with soap and
water, and lotion run through it. Then roll it in a piece
of boric lint and keep it in clean paper until wanted again.
If these precautions are taken, a man may go on using the
catheter daily for years without risk. If such precautions
are neglected, the patient may at any time contract a ca-
tarrh of the bladder or something even more serious.
Chancre. — This word means a sore, caused by the poison
of a venereal disease. There are two types of chancre, the
soft and the hard. The soft sore is a local disease, it de-
velops from a pimple which appears within a few hours
and gets well, if properly treated, in a few weeks. But
the glands in the groin may enlarge and become an abscess
called a bubo. This disease is curable, and no ill-effects
are transmitted to the children. But it is intensely con-
tagious. The hard sore, on the other hand, is nothing more
nor less than the first stage of the dreadful disease called
syphilis (which see). This sore develops in from two to
three weeks. The disease lasts for two years at least, and
can be transmitted to the innocent children of marriage,
as well as to the wife.
Upon the development of such a chancre the man or
woman must immediately place him- or herself under
good medical advice. They not only owe it to themselves
to get well, but it should be their greatest concern that they
CHANGE OF AIR 41
do not further spread the disease. This might be done by
direct contact of the parts or later, through other disease
conditions in the mouth, through common drinking cups
and eating utensils.
The best way to avoid the inconvenience and agony of
this disease is by not contracting it; and the best way to
avoid contracting it is by leading a clean moral life.
To try to treat a disease like chancre or syphilis by
Christian Science is one of the greatest crimes of modern
times.
Change of Air. — Nowadays we all say we want a change
of air and a holiday occasionally, but our grandfathers
tell us that they did not want, and did not get, trips to the
seaside, nor holidays from Saturday to Monday, nor any
long autumn vacation, but they kept on at the same work
year after year. What is the reason for this change?
Are we less vigorous than our forefathers? Or do we
work harder and have more worries than they did?
There are reformers who tell us that we are a degenerate
race, and there seems much evidence in favor of that view ;
and there is an easy explanation offered for our accept-
ance. Modern improvements in medicine and surgery have
saved thousands of invalid lives during the last fifty years,
and these thousands of unhealthy persons have had fam-
ilies, and their children are more or less tainted by hered-
ity of scrofula, tubercle, or some other form of blood-
poisoning. Whatever may be the cause, we moderns do
really need rest and change very frequently, and it is wise
to consider how to get the best effect out of our oppor-
tunities. It is quite certain that persons of ample means
who can go away for a month to a health resort or to a
seaside village, or who can go for a sea voyage under com-
fortable circumstances, will derive great benefit there-
from. It is, however, quite a different matter for the poor
worker, who has to stint himself in his ordinary mode of
life in order to get away from his home at all. Most of us
love pleasure and change for their own sake, and we are
apt to take them without much concern as to whether we
shall really benefit in health. The average man is very
apt to overdo his pleasures when he gets out of harness,
and may certainly drink too much when on a holiday. Our
railways offer us very tempting short excursions, but we
are apt to find ourselves tired and exhausted after a long
42 CHANGE OF AIR
railway journey in a crowded railway train. Persons who
do not travel often in trains frequently catch severe colds
when the weather is unfavorable ; and the seaside lodgings
to which the middle class and poor traveler have to go are
often small, poky, dirty, and badly ventilated, and land-
ladies frequently prepare meals less carefully than the
housewife does for her family at home. The unfortunate
result is that a holiday away from home does not always do
all the good that is expected of it.
Change of Air as a Remedy. — Apart from drugs, there is
no remedy of greater service to the invalid, the convales-
cent, and delicate person, than change of air. Change of
scene and occupation are also valuable in the treatment of
many minor ailments. For almost all complaints a change
to the seaside is likely to produce improvement, if adopted
after the disappearance of all acute symptoms. Sea air is
more full of ozone, and is slightly saline, and is notable
for improving the appetite and for giving tone to the
nervous system. To the town dweller, and especially to
those who have to work long days in factories and close
rooms, the fresh sea air is life-giving; and even a few
hours of life on the seacoast blows all impure air out of
the lungs, and so does much to purify the blood. The
pure air of the countryside inland, far from towns and
factories, is often of almost equal value as a tonic remedy
to one who is recovering from an exhausting illness.
There are also thousands of persons who are of a scrofulous
or tuberculous constitution, and children with rickets,
who are hardly able to survive in towns. These will often
grow up stronger, and even hardy, if removed to country
villages or to the seaside. Country-born and bred persons
are always superior in vitality to town dwellers, and this
is one reason why it is such a national misfortune that the
present-day tendency is for the young to desert country
life and open-air occupations in favor of the town employ-
ments, which are never so healthy or free from risk.
Town dwellers, accustomed to narrow streets and courts,
often have a notion that they would be more liable to ill-
nesses from catching cold; but this is a mistaken idea, for
open-air life for a month renders persons much less liable
to catch chills than they ever were before. The winds
from open fields are much less dangerous than the draughts
of air met with at street corners in towns. Persons who
CHANGE OF LIFE 43
in London catch a cold if they, for an exception, ride out-
side an omnibus, will not be made ill by a long ride on
a coach among the Welsh or Scotch hills, because the air
is purer and freer from germs. Delicate children should
always be sent away from town for a long visit to country
relatives, whenever it is possible, and quick recoveries will
often be found to occur after whooping cough, diphtheria,
enlarged glands and rickets, if treated by a three to six
months' country residence.
Change of Life. — (MENOPAUSE, CLIMACTERIC, THE
CHANGE.) — This is the time of life in a woman when she
ceases to menstruate (see "Menstruation"), and, as a rule,
becomes incapable of bearing children. This change oc-
curs between the ages of 45 and 50, and sometimes comes
on abruptly and suddenly, but in other women it is more
gradual and sometimes accompanied by great loss of
blood.
This change of life is a very critical period in the life
of every woman. Every part of her seems to share in the
general disturbance. Her bodily organs are all more likely
than ever to become disordered, and hardly any woman
escapes some ill-health at this time. Headaches, flushings,
giddiness, and loss of blood are common. Great irritabil-
ity of temper, over-sensitiveness, fancifulness, wrong-
headed suspiciousness, unseemly behavior and coarse con-
versation, all these are characteristic of even the most ami-
able and respected women at their change of life.
If any germs of disease exist in a woman, they will often
develop at a fearful rate at "the change," and women
ought not to neglect to take medical advice at that time.
It is impossible to map out any line of treatment for a con-
dition which varies so greatly in different women, but it is
always a safe rule to keep the bowels and skin acting very
freely and to avoid excitement and late hours, and especially
to avoid alcoholic drinks.
It should be borne in mind by all husbands, and, in fact,
by all adults, that a woman, heretofore reasonable, amiable,
lovable, and just, may, at the change of life, become tem-
porarily ill-tempered, unreasonable, wildly and absurdly
jealous, and unjust; these things are to some extent beyond
her control, and she must be treated with the patience and
forbearance which are shown to invalids and children. A
"sweet reasonableness" must not be expected of her,
44 CHEST, DEFORMITIES OF
though she is unable, in many cases, to see that there is
anything unusual in herself.
Chest, Deformities of. — A healthy chest is well-rounded
in every way; it is covered with a fair layer of skin fat
and no bony points project; the shoulder blades lie against
the back of it and are covered with firm muscle. The
grooves between the ribs can hardly be seen. In section
such a chest is oval, slightly flattened behind. Such is the
healthy chest containing healthy lungs and a strong heart.
If the chest has a shape different to that, it may, perhaps,
still contain healthy lungs, but those lungs are very liable
to disease. The different kinds of deformed chests are
these : —
Flat Chest. — This is either due to undevelopment or to
lung disease. The chest is flat instead of rounded, the
ribs are too straight and there is not much room inside for
the lungs to expand. Such a chest may be greatly im-
proved by the regular use of a "developer."
Pigeon-breast. — The cross-section of such a chest is tri-
angular, the breast bone forming a sort of keel in front,
as it does in the breast of a pigeon. The ribs are flattened
to the sides. The cause of this deformity is some obstruc-
tion to breathing in infancy, so that the lungs have not
been properly filled with air. Such obstruction may be
adenoids or enlarged tonsils. (See "Adenoids.")
Bulging of one side of the Chest is caused by lateral
curvature or twisting of the spine on its axis.
Rickety Chest. — This is very characteristic, and is one of
the effects of rickets in childhood. The ribs are too soft
while the lungs are developing, and so they yield at the
weakest parts and form two grooves down each side of the
body; and there is a row of knobs down each side of the
breastbone where the ribs join it, knobs which are caused
by rickety enlargements of the ends of the bones. The
lower part of the chest is apt to bulge from lying over the
liver. Such a chest, though ugly and misshapen, is not es-
pecially prone to disease.
Barrel Chest— (see "Strong, How to Become.")— This
deformity consists of an undue roundness of the chest, the
result of blown-out and inelastic lungs. The chest is too
short, the ribs too horizontal, and the shoulders raised.
Long Chest. — This is the opposite of barrel-shaped. The
ribs slope down, the neck is long, the throat prominent,
CHILBLAINS 45
and the shoulder blades stand out behind like wings. The
lungs inside such a chest never are, and never have been
properly expanded, and are very prone to become tuber-
culous— "consumptive." The deformity is curable by the
correct use of a "developer."
Chicken-pox. — The medical name is Varicella. It is quite
distinct from smallpox, which, however, it resembles some-
what. Chicken-pox develops about a fortnight after ex-
posure to infection. It is not very contagious. There is a
rash which comes out on the first day of illness, in succes-
sive crops of small pimples, on the chest, mostly, but also
on the face. There may be a little fever. Death almost
never results from chicken-pox.
The rash is characteristic; it consists of pink pimples,
which become blebs containing watery fluid in about twelve
hours. In a few hours more the fluid becomes milky in
appearance and then the spots begin to dry up, and the
pink ring round them gradually fades. A few of the pocks
leave small whitish scars.
Treatment. — Light diet, isolation, and attention to the
bowels are all that are necessary. The child must be pre-
vented from scratching the spots. The itching may be re-
lieved with a weak lotion of camphor water and carbolic
acid, which any good druggist will supply.
Chilblains. — Nearly everyone is familiar with the ap-
pearance of chilblains, and a very large number of people
whose circulation is weak suffer from them every winter.
The skin affected with a chilblain is tender, and itches
abominably as soon as it gets warm. As the inflammation
goes down there is generally some shedding of the skin.
In underfed and scrofulous children the skin of a chil-
blain sometimes breaks into a painful ulcer or sore, which
is very difficult to heal. A further stage in the same
process is frostbite, in which the part gets at last swollen
and almost violet in color and little blebs form.
We must not forget that though chilblain is a local dis-
order, it is due to bad circulation of the blood, and this is
often accompanied by poorness of the blood, which is what
doctors call anaemia ; so that it may be necessary to get the
doctor to prescribe tonics and blood-forming foods, par-
ticularly cod oil and malt, as well as to treat the chilblain
locally.
The chief thing is to stimulate the circulation of the
46 CHOKING
blood in the affected parts. For this purpose the parts
must be kept warm. If the hands are affected, mittens or
knitted woolen gloves must be worn continually, and, un-
less the feet are disabled by pain and swelling, plenty of
walking must be done, and the feet and legs must be kept
warm with woolen worsted stockings. After washing it is
important to dry the parts as thoroughly as possible and
to rub the chilblain with a rough towel. Friction is al-
ways useful if it can be borne. For painting on the chil-
blain there are three useful remedies — tincture of iodine,
spirits of camphor and friar's balsam — all homely med-
icines.
If the skin breaks the ulcer must be treated as any
other ulcer, but it is better to let a doctor treat it, because
chilblain ulcers do not heal at all easily.
If the chilblain ever becomes a real frostbite, the only
way is to rub it with snow until the circulation is restored.
If you warm it rapidly at a fire you may lose a finger or
nose from mortification. And all persons who are subject
to chilblains are likely to be benefited by taking ichthyol as
a medicine. (See also "Skin Diseases" II.)
Child Crowing. — The other common name for this is spas-
modic croup ; the medical name is Laryngismus. The
symptoms of the ailment are — twitching of hands and face
(which may occur even during sleep), and a sudden great
difficulty of breathing, so that the child gets terrified and
runs to its mother. The spasm ends as suddenly as it be-
gan, with a loud crowing noise. Sometimes children die
in the attack without having uttered a sound, though this
is rare.
Treatment. — It is especially rickety children, and those
with worms, who get these spasmodic attacks. The doctor
ought to be asked for advice as soon as the first one occurs.
If a bad attack comes on, put the child into a warm bath,
or if none is ready, dash cold water on its face and head,
and tickle the back of the throat with a finger, to make it
sick. Further treatment must be by medicine ordered by
the doctor. (See also "Croup.")
Choking. — This may be caused by something which ob-
structs the air passages, a piece of food, a * ' plate ' ' of false
teeth, a marble, or a toy; or by a sudden swelling of the
passages themselves, as happens after swallowing certain
poisons, in diphtheria, and occasionally in chronic Bright 's
CHOLERA 47
disease. Or the throat muscles may be paralyzed and
lumps of food may get into the windpipe instead of slip-
ping easily down the gullet.
Everyone recognizes choking, there is no need to describe
it. If a child chokes, and coughs vigorously, let him alone,
but put a cup of water or tea in his reach, so that when he
is ready he can wash the lump down. If the coughing is
feeble and the face is getting dusky, slap him on the back,
giving him a slap in time with each effort of coughing.
Do not get excited, however. But if he really seems to be
suffocating (and this takes a little time to happen), force
his teeth open, hold them open with the knife handle, and
sweep the finger along the back of the mouth from side to
side. If the child is very small, turning it upside down
and holding it up by the feet is very good practice.
If suffocation seems to have taken place already and the
child is livid and seems dead — if the doctor has not yet ar-
rived— the child's only chance is to open the windpipe
and let the air in through a hole. Take a sharp-pointed
penknife, or one blade of a pair of scissors, feel for
''Adam's apple" in the throat, and then push the knife in
just below it, and keeping exactly in the middle line, and
having opened the windpipe enlarge the wound downwards
a little. Air will rush into the windpipe and lungs, if you
have been quick enough, and you have saved his life. You
may need to hold open the windpipe wound with the scis-
sors blades. But more likely the obstructing lump of food
will be coughed up then and all will be well.
In cases of choking, where the throat is swollen, the same
opening of the windpipe may be necessary. A person who
swallows boiling tea or soup by mistake may get an in-
tensely swollen throat and may choke. Nothing can be
done without a doctor's advice.
Cholera. — This term is used to describe three entirely
different conditions, namely, cholera infantum, cholera
morbus and Asiatic cholera. The last is the epidemic form.
Cholera infantum. — Is an acute disease of childhood
characterized by high fever, vomiting, purging and col-
lapse, caused largely by hot weather, faulty feeding, denti-
tion and bad hygiene.
This is a very serious condition and calls for prompt
treatment, preferably by a physician.
Treatment consists of fresh air, coolness, laudanum in
48 CLEANING
very small doses to arrest diarrhea, brandy to counteract
collapse, with bowel irrigations.
Barley water and beef juice are relied on for nourish-
ment as soon as the stomach can retain food.
Prevention. — During the hot summer months give the
child only breast or pasteurized milk and meats and fruits
of undoubted freshness.
Cholera Mor~bus. — An acute disease resembling true chol-
era but rarely ending fatally, usually caused by eating
partially decayed meat or fruit.
It is characterized by intense cramps in the stomach,
vomiting, purging, fever and great prostration.
Give a dose of castor oil if it can be retained, brandy for
the prostration, morphine by hypodermic injection, hot ap-
plications to the abdomen and ice for the thirst.
Asiatic Cholera. — True Asiatic cholera, which is always
more or less prevalent in India, China and Arabia, has
lately reached our thresholds. Prevention is the most im-
portant measure for us to observe. Preventive measures
consist in having efficient quarantine officers, with quaran-
tine of suspicious cases. As cholera is a water-borne dis-
ease freedom from contracting it is usually assured by
using only boiled and filtered water and eating no uncooked
food. Discharges from suspicious cases should be disin-
fected.
An attack of cholera is marked by the sudden onset of
pain and spasms in the bowels, vomiting and diarrhea of
thin rice-water-looking stools followed by great collapse
and death in 50 per cent, of the cases.
In any suspicious case a physician should be called at the
earliest possible moment.
Circumcision. — This means the removal of the foreskin
of the male. The little operation is performed on every
Jewish and Mohammedan male child as a religious rite.
It certainly promotes local cleanliness and lessens the risk
of local disease. Every qualified medical practitioner is
competent to perform circumcision. The parts will be
healed in about a week, but will take longer in the case of
an adult. The operation is often performed to cure bed-
wetting.
Cleaning. — A large number of the infectious or germ dis-
eases are contracted by inhaling the germs in the dust. It
CLEANING 49
is of the greatest importance therefore that in homes, and
places where people gather in large numbers this source
of disease should be reduced to the smallest possible pro-
portions.
As the weekly body bath of our ancestors has given way
to the daily bath of our time, so has the dreaded cataclasm
known as ''spring house cleaning" given way to our daily
or weekly cleaning. This has been rendered possible
largely by the use of the modern vacuum cleaner, by the
use of which carpets, floors, mattresses, furniture and cur-
tains can be thoroughly cleaned without removing them
from their regular positions.
Almost worse than no cleaning or dusting is the use of
the feather duster, which simply stirs up the dust, making
it easier to inhale, and never doing more than moving it
from one place to another. If the vacuum method of
cleaning is not available, the feather duster may be re-
placed by moist cloths, or moist saw dust on the floors,
which will prevent 'dust from flying about during the
process of sweeping.
Rooms containing the least number of dust-catchers are
the most sanitary and healthiest, and hard wood floors
with rugs are preferable to carpets.
In cleaning parquet flooring care should be taken to
clean the floor first with "paille de fer" which can be
bought for a few cents. This can be rubbed on the floor
with the foot to take out all grease and other stains before
applying floor wax. Butchers floor wax polish is the most
satisfactory as it leaves no oil.
In cleaning furniture or any wood with polished surface,
the best article is that known as "The Japanese Furniture
Polish."
White painted surfaces, if soiled or greasy, should be
wiped over lightly with a cloth dampened with turpentine
and wiped with the grain of the wood.
For the floors of public buildings the use of such sub-
stances as Standard Floor Dressing is recommended to
allay dust and promote cleanliness.
For ordinary flooring no better initial form of cleaning
has ever been devised than the occasional old-fashioned
scrubbing with soap, water and scrubbing brush with use
of a mop, provided that these articles are subsequently
50 CLIMATE FOR INVALIDS
properly disposed of or cleaned, so that the germs they have
collected cannot again become free and escape into the air.
Climate for Invalids. — There is no model or perfect
climate in the world; none which will suit every kind of
invalid. The dry ones have wind and dust; the moist,
warm ones have malaria, and are relaxing; the cold, dry
ones are not thus all the year round. If you want luxuri-
ant vegetation and scenic beauty of that kind, then you
find that the climate must be hot and damp, a very bad
climate for nearly all consumptives. Sea air is excellent
for many people, but does some asthmatic people much
harm, and neuralgic people are very liable to be in pain at
the seaside.
People with shattered constitutions ought to avoid warm,
relaxing climates like the Florida Coast Resorts and choose
places like Redlands and Riverside ( Cal. ) , Aiken, Asheville,
Virginia Hot Springs, Lakewood, St. Lawrence River,
Bermuda or the Hawaiian Islands.
Nervous, excitable people should avoid such climates as
those of Colorado, Idaho, and Wyoming.
A choice of climates for a few of the common diseases
follows : —
Pulmonary Tuberculosis. — Arizona, New Mexico, Sierra
Madre (Cal.), Colorado Springs, Adirondacks, Asheville,
San Moritz (Switzerland).
Nervous, Excitable People. — Bermuda, Jamaica, Cuba,
Florida Coast Resorts, Hawaii, Southern California, Ashe-
ville, Aiken, Old Point Comfort, Atlantic City, Lakewood.
Neurasthenia. — Yellowstone, Yosemite, Grand Canyon of
the Colorado, Niagara, Great Lakes, Canadian Rockies,
White Mountains, Maine Woods, St. Lawrence River, Mex-
ico, Bermuda, and foreign travel.
Heart Disease. — Watkins Glen Springs.
Rheumatism. — Virginia Hot Springs, Mt. Clemens
(Mich.), Watkins Glen Springs, Saratoga Springs, Paso
Robles and Glenwood ( Col. ) , Richfield, and Poland Springs.
Convalesence. — Lakewood, Atlantic City, Aiken, Vir-
ginia Hot Springs, Southern California, Bermuda.
Liver, Skin and Digestive Disturbances. — Saratoga, Rich-
field, Arkansas Hot, French Lick and Poland Springs.
HEALTH RESORTS 51
HEALTH RESORTS.
Adirondacks. — General elevation, 1,500 to 2,000 feet.
Climate cool. Large number of cloudy days with high
humidity. Soil — light and sandy. Tree growth — pine, bal-
sam, spruce, and hemlock.
Popular for the treatment of pulmonary diseases of tu-
bercular origin.
Best known resorts are Saranac, Ampersand, Paul
Smiths, Lake Placid, Blue Mountain Lake, Raquette Lake,
Keene Valley, and Adirondack Lodge.
Aiken. — Near the Georgia line in South Carolina. Ele-
vation, 500 feet. Pine country with sandy soil. Few
rainy days and comfortable winter climate. Desirable for
convalescence relaxation.
Arkansas Hot Springs. — Light alkaline-calic thermal
springs used in the treatment of syphilis, gout, rheuma-
tism, neuralgia, and skin diseases. Numerous fine hotels
and baths.
Asheville. — Near the Blue Ridge Mountains, North Caro-
lina, on a plateau of 2,250 feet elevation. One of the most
popular of the southern health resorts — utilized especially
in the treatment of pulmonary tuberculosis and diseases of
the lungs. It is also a desirable climate for convalescence
and rest after nervous strains.
Atlantic City. — On the Jersey Coast. The best known
of the northern coast resorts. Abundantly supplied with
fine hotels and sanitoria. Chief health features are de-
rived from comforts available at the hotels, the baths, and
the boardwalk near the ocean, — broad and of great length.
The climate, though somewhat milder, is not greatly dif-
ferent from neighboring places. It is of most use medi-
cally to convalescents and to those needing rest and re-
laxation.
Bermuda. — A beautiful island 36 hours from New York
by comfortable steamer. Patronized to the greatest extent
by Americans about Easter-time. Delightful climate most
of the year, many diversions and a restful atmosphere.
Chief towns are St. Georges and Hamilton — the latter
place having two good hotels. Ideal spot for convales-
cents, nervous irritability, cardiac and renal conditions,
and for a rest cure. Best accommodations for invalids
52 HEALTH RESORTS
in the Bermuda Sanitarium on Ferry Reach in West St.
Georges.
Colorado Springs. — Attractive health resort at the foot
of the Rocky Mountains near Pike's Peak, altitude, 6,000
feet. Abundance of sunshine, cool climate, low humidity,
dry porous soil, beautiful scenery and beautiful residences,
with pleasant social life.
This climate is admirably suited to pulmonary tubercu-
losis— especially the incipient forms.
Eastern Health Resorts. — Maine, Moosehead and
Rangely Lakes. Cool, clear air. Fine fishing and camp
life.
Poland Springs and Rockland — fine hotels and good
climate.
Mt. Desert and the Maine coast. Cool refreshing climate.
Frequent fogs. Attractive social life.
Florida Coast Resorts. — Jacksonville, St. Augustine,
Palm Beach, Ormond and Tampa. Well supplied with
magnificent hotels. Climate equable, temperate, warm and
humid. Good for physical and mental relaxation but poor
for pulmonary troubles.
French Lick Springs. — Orange County, Indiana. Sul-
phated saline waters.
Glenwood Springs. — Glenwood Springs, Colorado. Alti-
tude, 5,200 feet. Fine accommodations. Cool, bracing
air.
Hot saline sulphur springs with fine pool and baths, and
natural sulphur vapor cave.
Of value in chronic rheumatism, gout, cutaneous and
renal diseases.
Hawaiian Islands. — Twenty-one hundred miles south-
west from San Francisco — 6% days by steamer.
Volcanic origin. Beautiful scenery. Tropical vegeta-
tion. Equable, comfortable climate, occasionally warm and
moist.
Lakewood. — Ten miles inland from the Jersey Coast.
Sixty miles south of New York — easily accessible and well
supplied with fine hotels. In the heart of the Jersey pine
belt where the soil is dry and sandy. Temperature usually
10° warmer than New York.
Well deserved reputation for curing protracted colds,
catarrh, influenza, and all forms of convalescence.
Mt. Clemens, Mich. — Strong saline springs with good ac-
HEALTH RESORTS 53
commodations. Useful in chronic rheumatism with stiffened
joints, and neuralgia, scrofulous disorders of skin, bones and
joints.
Old Point Comfort. — North of Hampton Roads, Va,, near
Fortress Monroe. Temperature variation from 40°
(Winter) to 80° (Summer). Bathing, boating and attrac-
tive social life. Of benefit to people suffering from catarrh,
bronchitis and nervous troubles.
Poland Springs. — South Poland, Maine. Superb hotel.
Mild alkaline-calic water, used in treatment of rheumatism,
gout, dyspepsia, renal and hepatic disorders.
Richfield Springs. — Lake Canandaigua, N. Y., altitude
1,750 ft. Beautiful country. Attractive hotel life. White
Sulphur Springs — of value in insomnia from overwork,
nervousness or anxiety, stomach disorders, gout, rheumatism
and some disorders of the liver and kidneys.
Saratoga Springs. — The most famous watering place in
the United States, with many large hotels. Most of the
waters may be described as muriated alkaline-calic car-
bonated waters. The best known are the Congress, Geyser,
Hathorn, Kissingen, Seltzer, United States, Vichy, Carlsbad
and Champion Springs. As these waters are quite potent
they should be taken under medical supervision.
They are most used in dyspepsia, engorgement of the
liver and portal system and chronic constipation.
St. Lawrence River. — The Thousand Islands offer a de-
lightful region for rest and recreation with cool, equable
medium-moist climate. Fine hotels, or rough camps are
available.
Southern California. — Coronado. — Attractive coast resort
with fine hotel and equable marine climate.
Los Angeles. — Enterprising city 14 miles from the ocean
and also from the mountains. Mild climate — many fogs.
Monterey. One hundred and twenty-five miles south
of San Francisco on the Pacific Coast. Fine hotel — Del
Monte — and beautiful country-gardens and drives. Climate
mild, equable but humid.
Pasadena. Nine miles from Los Angeles — altitude 900 ft.
Twenty miles from the sea and five from the mountains.
Charming city of attractive homes and fine hotels. Rest-
ful climate.
Santa Barbara. — Climate mild and equable — like the
Riviera. Many foggy days. Good hotel.
54 HEALTH RESORTS
Adapted for cases of nervous exhaustion and con-
valescents.
San Diego. One of the most equable climates in the
United States, with maximum number of sunny days, al-
though the humidity is not low. Nights are cool. Adapted
to cases of nervous exhaustion.
Sierra Madre. — Twelve miles north of Los Angeles. Alti-
tude 1,700 ft. Most desirable climate in Southern Califor-
nia for consumptives.
Paso Robles. — El Paso de Robles, California. Altitude
800 ft. Climate mild and luxurious, atmosphere pure,
balmy, and invigorating, equable and dry. Hot springs
are sulphurous and alkaline. Good bathing accommoda-
tions. Beneficial to sub-acute and chronic rheumatism,
scrofula, blood, glandular and cutaneous affections.
Redlands. Elevation 1,350 ft. at foot of San Bernardino
Mountains. Fertile country, climate warm but not hot,
and equable. Comfortable for invalids.
Riverside. Elevation 850 ft. Sixty miles east of Los
Angeles, eight miles from Redlands. Many fine residences
and hotels. Fertile orange country. Comfortably warm
and dry climate. Delightful for invalids and convalescents.
Strong Medicine. — In Large Doses for Those Whose
Enthusiasm is Failing.
Yellowstone National Park (Wyoming). A museum of
nature containing geysers, boiling springs, terrace and
crater formations, cliffs of obsidian, deeply cleft canyons,
petrified trees, sulphur hills and pine forests. Situated
on a plateau of 8,000 ft. elevation surrounded on all sides
by mountains.
The Grand Canyon of the Yellowstone is a magnificent
canyon 20 miles long, 600 to 1,200 ft. deep, with walls of
gorgeous colors. Climate bracing. Nights cold.
Grand Canyon of the Colorado (Arizona.) One of the
most stupendous natural wonders of the world. 3,000-
5,000 ft. deep, 217 miles long, 10-13 miles mide. The
walls are terraced and carved into a myriad of pin-
nacles and towers and are tinted with various brilliant
colors.
To the south are the cliff dwellings, the petrified forest
and the land of "silence, sunshine and adobe." Elevation
of the rim of the canyon about 7,000 ft. Climate dry and
bracing, with cool nights.
HEALTH RESORTS 55
Yosemite Valley (National Park). On the west slope
of the Sierra Nevada Mountains in California. A valley
with level floor 8 miles long with enclosing walls 3,000-
5,000 ft. in height — almost vertical. The chief features
are the Yosemite Falls (2,500 ft), Bridal Veil Fall, El
Capitan peak (7,042 ft.), and Half or South Dome (8,852
ft.).
Niagara Falls, New York. On the Niagara River.
One of America's greatest natural wonders. American
Falls 167 ft. high, 1,000 ft. wide. Canadian Falls 158 ft.
high, 2,550 ft. wide. Volume of water 12 million cubic ft.
a minute.
The Great Lakes. — "In all the world no trip like this."
A delightful steamer trip of several days on fine steamers
from Buffalo via Mackinaw to Duluth or Chicago, through
Lake Erie, the Detroit River, Lake St. Clair, Lake Huron,
Lake Michigan or Lake Superior through the Sault St.
Marie. Pure bracing air, pure water, at times out of sight
of land, at times running close to picturesque and refresh-
ing land scenery.
Canadian Rockies. — Banff — 4,520 ft. elevation. The head-
quarters of the Canadian National Rocky Mountain Park.
Fine hotels here and at Laggan (5,040 ft.) Glacier (4,095
ft.) and Field (4,064 ft.)— the last near the famed Yoho
Valley. The magnificent mountain peaks of this region are
almost innumerable — averaging 10,000 to 12,000 ft, in height
and of a rugged nature. Ideal camping and fine hunting,
with cool bracing air.
Virginia Hot Springs. — Large modern hotel and elabo-
rate baths. Popular health resort in Spring and Fall.
Alkaline-calic springs resembling those of Aix-les-Bains,
used in rheumatism, gout, sciatica, neuralgia, etc. Com-
petent physicians.
Watkins Glen Springs. — Watkins, N. Y. on Seneca Lake.
A modern, well-equipped sanitarium with beautiful sur-
roundings. Salinic-calic waters charged with carbonic acid
gas used in the treatment of glandular and rheumatic
troubles, gout, lumbago, sciatica and chronic diseases of
the heart. For the last the Schott method is employed as
at Nauheim.
White Mountains. — The air of the White Mountains is
cool, pure and clear. Popular resorts are Bethlehem, 1,459
ft., Jefferson, 1,440 ft., Dublin, 1,500 ft., Franconia, 1,100
56 COLD IN THE HEAD
ft. and Bretton "Woods, where is located the magnificent
Mt. Washington hotel.
Cold in the Head (Nasal Catarrh) . — What is the meaning
of that very common kind of catarrh called a cold in the
head? It is probably this — that the catarrh (with all its
sneezing, shivering, nose-running) is an effort on the part
of nature to get rid of some germs which we, in a minute
of depression (due, e. g., to cold, fatigue, or worry, or lack
of food), breathed into our mouth or nose and allowed to
settle and breed there. Do what you will with a cold in the
head, you cannot "cure" it, and if you hasten nature's
three day process too much, then the system may fail to
throw off the poison, and the cold "gets down into the
chest" as we say, and we get, perhaps, bronchitis. The
present writer is sure that all colds are first local to the nose
or throat, and that local treatment, aiming both at easing
the symptoms and encouraging the natural process, is most
likely to be serviceable. A cold, then, takes three days,
more or less, to run its course, and the sensible way of
dealing with it — since we cannot "cure" it, is to help it
along and give the system every chance of throwing it off.
This "throwing-off" the poison is done by the kidneys,
lungs and skin, but chiefly by the two former, for the skin 's
nervous apparatus has been rather out of order since the
"cold "was "caught."
So the best "cure" is to make the blood as pure as we
can. As soon as ever you know that you have got a cold,
start right away to treat it. This is done (1) by keeping
indoors from the moment that the cold is caught, in a well-
ventilated (not stuffy) but warm room — say 60°-65° F. —
by wrapping up, as long as any feeling of chilliness or f ever-
ishness lasts ; and by sleeping a little more warmly at night
than usual. (2) As you are to rest and stay indoors, even
if not in bed, for three days, you require very little food,
and no meat food. Your object is to clear the blood of all
impurities. Drinks of hot lemon water should be taken
often, to wash out the stomach and bowels and flush out
the kidneys.
Now as to medicines. Take two grains of calomel fol-
lowed by aperient salts. Take — frequently repeated —
coryza tablets containing aconite and belladonna, and
douch out the naso-pharyngeal passages frequently with
dilute borolyptol, listerine, glycothymoline or alkalol.
COLIC 57
But your cold is, perhaps, a more serious infection than
you thought; you are feverish and wretched, and cough a
little. Have a hot mustard foot bath at bedtime, then ; and
when in bed, a basin of hot gruel. Get as much rest and
sleep as you can. For the cough, take ipecacuanha wine,
10 drops, and paregoric, 20 drops, in some water every
three hours (smaller doses for children).
On the fourth day, if much better, you may go out, if
warmly wrapped; don't overweight yourself with clothes,
however. Then begin a tonic medicine — quinine and iron
mixture twice a day. (See also "Cough" and "Sore
Throat")
Cold-on-the-Lip. — This is a little skin eruption which oc-
curs on the lips, or in the nostrils sometimes, when one
has a "cold in the head." Its proper name is herpes,
and it is described under that heading. The same eruption
is apt to occur on the private parts, and in some people,
round the waist, where it is called shingles. (See
"Herpes.") It is contagious to some extent and may be
communicated by kissing. It is not dangerous.
Once formed these herpetic vessels are very difficult
to control, but they may sometimes be aborted, in the earliest
stages, by peroxide of hydrogen and camphor cream locally,
in connection with a calomel cathartic.
Colic. — A violent sudden pain in the abdomen.
(1) Flatulent colic is often very sudden and very pain-
ful, but it is caused by nothing more serious than "gas"
in the bowels, which makes them swell out, and which is
caused by decomposition of food, the indigestion being due
to something wrong with the bile or other of the digestive
juices. Such colic is especially common in weak and in
hysterical people, also in artificially-fed infants.
(2) Wind colic in small infants must, of course, be treated
by attending to the feeding, and to more cleanliness in the
bottles and teats used. This griping in children is some-
times cured by a smart purge (say two teaspoonfuls of
castor oil) ; but when a child is continually having griping
attacks (as shown by it making grimaces and drawing up
its legs), there can be no doubt that the food disagrees with
it. Oil of anise, one or two drops on a small lump of
sugar, may be given every hour and Dill water is a favorite
remedy in teaspoonful doses every hour. In adults the
colic is generally due to some irritating article of food which
58 CONCUSSION OF THE BEAIN
may be purged out with an ounce of castor oil. A hot-
water bottle applied to the belly gives much relief.
(2) Lead colic. (See "Lead-Poisoning.")
(3) Renal colic. (See "Stone in the Kidney.")
(2) Liver colic (See "Gall- Stones.")
(4) Liver colic. (See "Gallstones.")
(6) Intussusception or telescoping of the gut.
(5) Volvulus, or twisting of the gut.
The last two are rare. Intussusception of the gut is
similar to what takes place in the fingers of a tightly-fitting
glove as they are turned outside in when the glove is drawn
off a warm hand. The intense pain, bowel obstruction, pas-
sage of blood from the rectum and collapse of the patient
show what has happened and very soon there is a big
tumor to be felt in the belly and the patient begins to
v omit the contents of the bowels. Nearly all the cases are
in children who have been too severely purged. It is use-
less for a layman to attempt to treat that.
Collapse. — By this word is meant the state of utter pros-
tration which may follow a serious accident, a great loss
of blood, an acute fever, or a blow in the pit of the stomach.
Very great grief may have a similar effect. In all cases
of collapse or shock, keep the sufferer warm, elevate the
extremities, loosen the collar and all constricting bands
and stimulate with sal volatile, smelling salts, aromatic
spirits of ammonia, whisky or brandy.
Coma. — By this term is meant insensibility, unconscious-
ness, in which the patient cannot be roused, and touching
the naked eyeball with the finger tip produces no effect.
The breathing is deep and slow and noisy. The chief causes
of coma are apoplexy (which see) and diabetes (which see).
Sometimes the comatose person dies without regaining con-
sciousness; sometimes he recovers. In diabetic coma, how-
ever, his chances of recovery are very small.
Concussion of the Brain (Stun). — A blow on the head or
a fall may so shake up the brain as to cause the patient
to be stunned. This is shown by pallor of face, and a
state of faintness and unconsciousness, which may last
only for a few minutes, or may continue for hours. Re-
covery may soon occur with vomiting, if there be no severe
internal injury to the head, but if the concussion has led
to bleeding in or upon the brain great danger to life will
CONSUMPTION 59
ensue. Put patient in bed and keep head high and send
for doctor.
Confinement. — To calculate when a baby will be born,
take the date of the last day of the last menstruation, add
seven days and go back three months. For instance, if
the last day of the last menstrual period was January 7th,
add seven days — January 14th, and go back three months,
to October 14th, which will be the date of the birth of the
child.
Constipation. — (See ''Costive Bowels.")
Consumption. — This disease causes more deaths in this
country than any other form of illness. In infancy it at-
tacks the brain, in childhood chiefly the bowels, and in early
manhood the lungs suffer most often. In former days the
disease used to be called a decline. To be "in a decline"
meant that the lungs were diseased, and that an early death
by gradual wasting was possible.
Until quite recently consumption, the medical name for
which is phthisis, was considered to be essentially an in-
herited disease; but of late years medical opinion has
changed, and all doctors now consider that phthisis is
capable of being caught by infection, which arises from
germs breathed in from the air having escaped from con-
sumptive lungs, or from those contained in tubercular milk
and tubercular meat.
To-day we do not believe in the inheritance of consump-
tion from parents. Each case of consumption is viewed as
a case of infection by the germ of the disease. What may
be inherited, is a weakly state of body, favoring infection.
The alteration in modern medical opinion has been due
to the great improvement effected in microscopes in recent
years, by which it has been possible to discover the pres-
ence of extremely minute organisms, called bacteria or
bacilli, in the phlegm coughed up by consumptives, and even
in their saliva, their urine, and blood. By experiments on
animals it has been shown that inoculation with these bacilli
will cause the disease to break out in them.
These bacilli, however they may enter the human body,
whether in our food, or in milk, or by being inhaled in the
air we breathe, will set up the state of disease now called
tuberculosis; and the part first attacked, although most
often the lungs, may be the bowels, kidneys, or skin.
II. — Cattle also may die naturally from tuberculous dis-
60 CONSUMPTION
eases set up by infection with bacilli, and it is an accepted
opinion that children may get infected from milk taken
from cows already diseased. Even grown-up persons may
become infected with tuberculosis by eating the meat ob-
tained from diseased cows. It is for this reason that so
much attention is now given to the examination of
slaughtered animals in butchers' shops.
Cattle are certainly liable to tuberculosis of the internal
organs, and may die of it. The slaughter houses of our
cities are now under inspection, so that diseased meat may
be discovered and destroyed; but until recently the Jews
alone were particular about refusing the meat of diseased
cows, and it is certain that the Jews have always had a
lower death rate from consumption than Christians. With
the Jews it is a matter of religion to have their butchers'
meat passed by a Hebrew official, and it is then marked
as Kosher.
The principal contagion from consumption of the lungs
is found in the phlegm coughed up and expectorated. In
this phlegm the bacilli are to be found in millions. When
the phlegm dries up and is powdered under foot, the wind
blows the germs about, and women's long skirts spread
them from room to room. This dust is inhaled, and falls
into our drink and food, and so the disease is spread.
If there is one point more important than all others, it
is that all consumptives should spit into basins or bottles
containing antiseptic liquids, or else into paper handker-
chiefs, which can be burned. These are now procurable
very cheaply.
Consumptive patients, although they feel great debility,
have a bad digestion, frequent cough, and often suffer
from diarrhea and night sweats, yet they are generally
of a hopeful turn of mind. They grow gradually weaker
and thinner month after month, and yet are always look-
ing forward to a recovery, which is unlikely.
III. — In cases of consumption or tuberculous disease of
the lungs, it is usual to find one lung affected before the
other, or one lung much more affected than the other ; and
the upper lobes, under the collar bone are generally the
first to suffer. The disease at first causes patches of con-
solidation, which may either dry up and become chalky
nodules, or else, if the general health be bad, the patches
soften down, and abscesses form. The lung structure gets
CHRONIC CONSUMPTION 61
eaten out into holes by ulceration; these are called cavi-
ties, and matter, with phlegm, collects in them, especially
at night ; hence it is that consumptives so often have a severe
cough in the morning, the cough being for the purpose of
getting rid of the accumulation. Phthisis is not usually a
painful disease, the only pain in the chest being usually
due to attacks of pleurisy in the dry stage. Much dis-
comfort is, however, often felt from the disordered, shallow,
and rapid breathing.
Yty. — ' ' GALLOPING CONSUMPTION. ' ' — Although consump-
tion is most common in its chronic form there is an acute
variety, most commonly seen in young adults, in which the
first symptoms are fever, shortness of breath, and weakness,
and these lead on to death in a few weeks. In such cases the
lungs are found after death studded with numerous quite
small points of disease, which have abolished the use of
the lungs for breathing purposes, and death is from the
impurity of the blood.
V. — "CHRONIC CONSUMPTION." — Chronic phthisis or
tuberculous consumption of the lungs seldom causes death
the first year, and it may last for many years, and even
after a long course there may be an almost complete re-
covery. This slow recovery is more common of late years
than formerly; this good result is from the modern plan
of open-air treatment and good feeding.
The ordinary consumptive patient is a pale, round-
shouldered, thin person, with a chronic cough, who suffers
from loss of appetite, indigestion, and occasional diarrhea;
his heart is feeble, and he is short of breath, and is liable
to night sweats.
A long continuing cough, spitting of a little blood, and
a very slow gradual loss of weight and fat, with weakness
are the most frequent signs of the onset of consumption,
and should always alarm a patient's friends, and this occurs
before any notable lung diseases can be found by examina-
tion. As the beginning of the disease is so faintly marked,
there being no violent or urgent symptoms, it very often
happens that the ailment is well established before any
curative measures have been undertaken. This is a great
misfortune, because consumption of the lungs is especially
a disease which is curable at the beginning but incurable
when the structure of the lung has been destroyed, and
the lung is full of cavities.
62 TREATMENT OF CONSUMPTION
The diagnosis of the disease, although still imperfect, is
much more easy than in olden times ; the modern physician
examines the chest by observing its state of expansion by
the breathing; he feels its expansion with the hands; by
tapping the chest all over he discovers any loss of the natural
elasticity, and by the use of the stethoscope he hears the
sounds made by the air entering and leaving the lungs,
and can discover whether the air tubes are too dry,
or if they contain liquids, such as phlegm, blood or mat-
ter; and can discover whether or not the lung is already
eaten out into hollow places, called cavities.
Cases of serious lung disease vary widely as to symp-
toms, and especially as to the presence or absence of bleed-
ing. The coughing up of blood is a very alarming symp-
tom, and one which in rare cases may cause sudden death
from fainting or suffocation. In most patients, however,
blood-spitting, or haemoptysis, is only slight, but it may be
frequent. When it occurs quite early in the case, and is
only trifling in amount, it does no harm, and, indeed, serves
the useful purpose of calling attention to the nature of
the illness, and it leads to prompt and serious treatment
of the patient. When it is profuse, it causes weakness, for
a consumptive patient cannot afford to lose blood, and is
generally already pale, and his blood of poor quality.
Haemoptysis is a serious matter when it occurs from the
rupture of a large blood vessel in a cavity in the lung, and
immediate medical aid must be summoned, and until a
doctor arrives the patient must be put to bed, with head and
shoulders raised, and must be cautioned not to talk or use
any exertion. Ice may be given him to suck in small quan-
tities.
VI. — Treatment of Consumption. (1) — The treatment
consists of every effort to improve the general health of
the patient by sanitary methods, by good feeding, by open-
air life, and gentle exercises, and by the treatment and
cure of all painful and exhausting symptoms as soon as
they arise.
It must be admitted that although science has been at
the work of searching for an antidote to the poison of
tuberculosis for hundreds of years, the constant result has
been failure.
Mercury, iodine, and arsenic have each had a short repu-
tation as a cure for phthisis; and so have creosote, car-
TREATMENT OF CONSUMPTION 63
bolic acid, guaiacol, and sulphur. Dozens of substances
have been tried as vapors and inhalations in hopes of kill-
ing the germs in the air tubes of the lungs, such as turpen-
tine, terebene, eucalyptus oil, prussic acid, iodine, naphtha,
tar vapor, and oxygen gas ; but they have all failed to check
the disease. Then, again, local applications to the chest
have often been vaunted as cures, such as applications of
iodine liniment, and turpentine, mustard plasters, and
blisters of cantharides ; also the use of issues and of cup-
ping.
There are many clever physicians in different parts of
the world at work on the treatment of consumption by vac-
cines and serum. Marmorek, F. von Behring, Wright,
Trudeau and others, are those to whom we look for further
knowledge on this subject, but though they are all success-
ful in some of the cases, they do not succeed often enough
to enable them to pin their faith to any one method. There
is no doubt, however, that the use of some vaccines in the
form of certain tuberculins is of appreciable assistance
to the other methods of treatment in the early cases of con-
sumption with slight involvement of the lung.
VII. — Treatment of consumption. (2) — After mention-
ing so many medicines which do so little good to persons
who are suffering from phthisis, or tuberculous consump-
tion of the lungs, we may fitly advise as to the treatment
which may be expected to lengthen life, and so give nature
a chance to cure the disease, for that seems the utmost which
present knowledge can do.
Reliance must be placed more on general principles than
upon drugs, and most important are the open-air life,
plenty of good food, and the addition of the preparations
of cod-liver oil and malt. It is of great importance, on
the other hand, to avoid unhealthy, close bedrooms, gas-
lit workshops, and the too close associations with other per-
sons. Cases of consumption, early taken to fresh air
sanatoria and there treated, almost invariably recover.
The main point is to detect the disease in its early stages.
The utmost importance must be given to rules to avoid
self-contagion, by cleanliness, changes of clothing and bed-
linen ; and remember that these patients must never swallow
the phlegm they cough up, but must use a pocket spittoon
or a paper handkerchief, which can be burnt.
The most certain way for a consumptive to infect other
64 TREATMENT OF CONSUMPTION
people is to cough or sneeze without protecting the mouth
with a piece of cloth. As a result of the coughing the
saliva is expelled in a fine spray which may float about in
the air and be inhaled by someone else at a distance of
several feet.
The next most certain way for a consumptive to infect
other people is to spit on the floor anywhere around him;
and the reason is that when the phlegm dries it becomes
ground into the dust by the feet, and the dust floats up into
the air which others breathe, gets into the air tubes of their
lungs, and thus starts the disease in a new place.
The consumptive needs to be treated as an invalid,
and should be made to take regulated exercise and
regular rest, and regular meals. The appetite may be en-
couraged by mixtures containing vegetable and acid tonics,
and the digestion may be assisted by doses of pepsin, and
pancreatin, or by food partly digested by chemical proc-
esses.
Much milk and milk foods are necessary, and well-
cooked dishes, but the cookery is better plain and good than
of the fancy sort; avoid giving shellfish, pastries, cheese
and vinegar ; but give more than usual of fresh fruits, dried
fruits, jellies, fresh fish and fresh, boiled vegetables. Dried
fish, bacon, ham, and tinned foods are less digestible, and
are unsafe. Emulsion of cod-liver or olive oil, or sardines
with oil, are all valuable, and so are malt extract, maltine,
meat extract, preparations of blood and bone marrow.
Sedative medicines are needed for the cough, with astringent
mixtures for diarrhea, also special drugs to check night
sweats and losses of blood.
Night sweats are a serious symptom, which must be
checked by medicines, as far as possible, because they cause
great prostration, and are also a source of danger by caus-
ing the sufferer to lie in wet linen, in which state he may
fall asleep and lie uncovered, and so catch fresh cold. In
these cases patients should wear flannel clothing and lie be-
tween blankets.
Diarrhea of a particularly intractable sort often occurs
in the latest stage of consumption, and may resist all medi-
cines. It is believed to be due to ulcerated spots within
the bowels. The aromatic confection powder is often use-
ful, given with paregoric, or chalk and opium mixture. In
TREATMENT OF CONSUMPTION 65
severe cases doctors may give dilute sulphuric acid and
opium; or 10 grains of camphoric acid thrice daily.
The cough of consumptives varies very much in charac-
ter. If dry and barking, it may be due to pleurisy ; a very
frequent cough is often due to slight attacks of congestion
of the lungs. A continuous cough, with profuse expectora-
tion, is a sign that patches of the lungs are softening and
breaking down into cavities. A cough with clear, frothy
phlegm shows the occurrence of a little passing attack of
bronchitis.
We append a few "recipes" which may be useful — al-
ways remembering that doctoring without a doctor is not
without risk.
VIII. — Treatment of Consumption. (3) —
(a) For daily fever and night sweats. — Quinine
4 hydrochlorate, 30 grains; calcium hypophosphite,
64 grains; tincture of nux vomica, 160 minims;
tincture of orange, 1 fluid ounce; glycerin, two
ounces; water, to eight ounces. Take one table-
spoonful of this mixture half an hour before
meals thrice daily.
(b) For night sweats. — Atropine sulphate — gr. 1/100
taken at bedtime.
(c) For a cough of irritation, without much phlegm
— a dry hard cough. — Codeine, 2 grains; syrup
of orange flowers, 1 ounce; distilled water, 1
ounce. Take a teaspoonful occasionally, holding
it in the mouth a minute before swallowing.
(d) For a cough with much phlegm. — Pure creosote,
% drachm ; spirit of cinnamon, 4 drachms ; tincture
of orange, 2 ounces; glycerin, to 4 ounces. Take
a teaspoonful in a wineglassful of water three
times a day.
(e) Vomiting — Take a hot drink of milk and a tea-
spoonful of brandy half an hour before meals ; and
5 grains of pepsin, and a few drops of lemon juice
after the meal.
(f) Loss of appetite tonic. — Tincture of nux vomica,
5 minims; sodium bicarbonate, 5 grains; spirit
of chloroform, 20 minims; infusion of calumba,
1 ounce. Take this dose an hour before each meal.
66 CORPULENCE
(g) Diarrhea — (1) If without pain — castor oil, 1
teaspoonful; hot milk, 2 tablespoonfuls ; brandy,
1 teaspoonful. Take this draught first thing in
morning. (2) If with much "wind" in stomach
—Liquor calcis saccharatus, 1 drachm. Thrice
daily. (3) If with pain — Give an enema into
the rectum of 10 drops of laudanum and five grains
of tannin in 2 ounces of mucilage of starch, twice
a day.
Corns and Bunions. — Nothing much can be written about
corns or bunions that will be of real service. They are
thickenings of the skin caused by pressure or irritation of
badly-fitting boots. When the bones of the toe and the
joint also become involved we call the trouble a bunion.
The first requisite is a well-fitting pair of boots, roomy
enough, and straight along the inner side. Hard corns
ought to be shelled out neatly by a competent chiropodist.
Amateur chiropody is generally foolishness. A soft corn,
which is one that has become sodden and soft through neg-
lect and perspiration, needs ordinary cleanly surgical treat-
ment. If a bunion is forming, a boot made with a toe post
inside should be worn; but later on nothing but a little
operation on the joint will be of any use. A great many
corns have a tiny drop of pus right in the inside of them,
and that causes an irritation which makes the skin hard
over them. A good chiropodist will know how to deal with
it. Of course, there are corn solvents, which aim at soft-
ening the skin so that you can peel it off; and there are
corn plasters which relieve the pressure of the badly-fitting
boots. But the really sensible way to deal with a corn is
to have it removed by a chiropodist, and to wear more suit-
able broad-toed boots in future. Solvents (so-called) are
of little use in bad cases.
Corpulence or Obesity (Too FAT). — Obesity is very
greatly a question of heredity and no amount of dieting
will make a difference to some people. It may be said
that when proper dieting cannot reduce corpulency, along
with exercise and attention to skin and bowels, no drugs can
possibly influence this condition of body.
There are a few well-recognized causes of being too fat.
One is over-indulgence in alcohol, another is a too indulgent,
selfish and luxurious life, and another is a too sedentary
CORPULENCE 67
life. Women very often get very fat at the time of the
change of life (see " Change of Life."). Idiots are very
often too fat, and so are many anaemic girls.
With regard to dieting, there are two main causes of get-
ting obese — the eating of too much fat-forming food, and
the inability of the body to deal with the food properly.
Of course, these two causes may act together. A person
who is too fat may be eating too much every day, and may
also be too feeble to make use of the food he eats, so that
it gets stored up in his body as fat, and he has to carry it
about with him. Speaking generally, to begin to get too
fat is to begin to grow old, and that is why people should
and do avoid it. That is why the old gentleman who has
left business takes to gardening, to keep down his fat;
and why the middle-aged maiden lady, with a small cozy
income used to go bicycling for exercise. If you are too
fat and want to reduce it, first consult a doctor. Let him
examine your heart, liver and lungs, because they may be
hampered by the fat, and any sudden exercise may cause
faintness and even death, if the heart be fatty. If there
is no serious mischief yet in any organ, you may prepare
to take down the fat. There are four ordinary ways of
doing this: — (1) To "do Banting," i. e., to go without
all fats, sugars and starchy foods, and eat only lean
meat and green vegetables (see "Banting") ; (2) To eat
less sugars or starchy food such as puddings, bread, etc. ;
(3) To drink almost no liquids with meals and none at all
between meals; (4) The most complete and thorough
method is that of Oertel. It consists in (a) climbing hills
for hours every day ; ( b ) meals in small quantities, at long
intervals; (c) only one or one-and-a-half pints of fluid is
allowed to be drunk in every twenty-four hours. Of course,
all these plans require a little effort of will, and perse-
verance, and so many fat people are also lazy that they
seldom can get up enough energy to carry out any plan
thoroughly. An excellent plan is to eat every day only one
pound of raw, or nearly raw, gravy beef, minced up, and
divided into four meals, accompanied by the drinking of
as much very hot water as possible (see "Salisbury Treat-
ment").
Note that certain persons are by habit of body and in-
heritance inclined to develop undue stoutness. In such
cases it is dangerous to attempt to reduce body weight be-
68 COSTIVE BOWELS
yond a certain point. Interference with the natural bodily
constitution always results in disaster, and therefore the
family history must be taken into account in all cases of
treatment of obesity.
Diet for persons who are too fat. — FORBIDDEN. — All fat
and fatty meats such as goose, duck, pork. All fatty fish,
salmon and eels. All light farinaceous puddings. Po-
tatoes, peas, beans, and such vegetables. Butter, cream.
All sweet jams; sugar with fruit or tea. It is starchy and
sugary foods which tend to make fat.
ALLOWED. — Lean meat and lean poultry in strict modera-
tion. Lean ham and tongue. Fish without rich sauces,
and with lemon or vinegar. Green vegetables, cress, let-
tuce, French beans, etc. Fresh fruit in small quantity.
Dry oaten biscuits and gluten bread. A tablespoonful of
good whisky, in water, after lunch. Tea or black coffee
without sugar, at breakfast or tea-time.
Costive Bowels. — An enormous number of people suffer
from costiveness or CONSTIPATION ; and it is quite com-
mon to find people taking medicines that other people have
told them are "good for costiveness," instead of trying to
find out what their own costiveness is caused by, and seek-
ing to remedy that particular cause. We shall say nothing
here about the costiveness which is merely a symptom of
some disease, such as fever, anaemia, Bright 's disease, and
so on. The commonest causes of constipation in otherwise
healthy people are : —
1. Sedentary habits, so that the muscles of the bowels
are lax and weak, like all the other muscles.
2. Unsuitable diet and habits of eating.
3. Nervousness, because of pain in the back passage,
due to piles, or ulcers, etc.
4. Something wrong with the liver, so that there is not
enough bile secreted, though there may be too
much in the blood, causing jaundice.
5. Occupations which cause continual free perspira-
tion ; and diseases like diabetes. In such cases the
bowels are costive because there is not enough
water left in them.
(1) — Women are generally more sedentary than men,
especially milliners and shop girls; but men clerks and
those confined to the house also are very apt to be costive.
COUGH 69
Young women too often have a false delicacy in these
matters, which leads them to postpone relief of the bowels.
All such sedentary persons should make a habit of attempt-
ing relief of the bowels at a fixed hour every day, until
success is attained. This rule is much more important than
it appears at first sight.
Secondly, regular bodily exercise must be taken. Time
must be found for it somehow. Walking is best.
Thirdly, a laxative should be taken regularly for a time
until the habit has become "second nature" to the bowels.
A purge is too strong; a laxative such as one of these is
best : —
Cascara pill, Triplex pill, aloe belladonna and strych-
nine pill, Lady Webster pill, compound licorice powder, Sal
Hepatica, Hunyadi Janos, apenta water, sodium phosphate,
or citrate of magnesia.
(2) — As to diet in costiveness or constipation, many
people eat too much meat, and many others take too little
fluid. An excellent plan is to take half-a-pint or more of
pure cold water before breakfast and again before going
to bed ; or else to drink a free draught of water after every
meal. Some prefer to drink hot water. The following
foods are liable to cause constipation : — Eggs, milk, tapioca,
sago, rice. And these are "good for constipation": —
Green vegetables, stewed fruits, wholemeal brrad, maize,
prunes, Turkey figs, honey, treacle, gingerbread (excel-
lent), Spanish onions. The bad habits of eating are, to eat
too fast, to bolt the food without chewing it, to drink too
much alcohol, to drink tea with meat foods.
(3) — Nervous people with piles or fistula dread a motion
of the bowels. They should use a glycerin suppository
every other day, and apply cocaine and bismuth ointment
locally.
(4) — Liverishness is generally accompanied by costive
bowels. Regular exercise must be taken and a blue pill to
affect the liver, may be taken at night, and a little apenta
water in the morning.
(5) — Persons who sweat a great deal ought to drink
plenty also.
Cough, — Let it be clearly understood that a cough is not
a disease in itself, but only a sign of some disease. A
cough may show the presence of indigestion, for example,
being caused by irritating food in the stomach ; or of bron-
70 COUGH
chitis (inflammation of the air tubes in the lungs) ; or of
tuberculous disease of the lungs (see " Consumption") ; or
of a relaxed throat; or of inflammation of the voice box;
or of a tumor, such as an aneurism, in the chest.
The first thing to discover then is, what causes the cough?
To stop the cough is not to cure the disease, and sometimes
it may be even dangerous to stop a cough.
If the cough is hard and short and frequent, it is prob-
ably due to indigestion, and no phlegm is coughed up, or
"raised," as country people say. If it is hard, painful,
brassy in sound, and later on accompanied by much phlegm,
it may be due to bronchitis.
Children with short, hacking coughs, often have worms
in the bowels. Many infants cough during teething. A
sudden cough coming on at night, hoarse, harsh, noisy,
clanging, and panting for breath, will mean the disease
called croup.
It is impossible, in the limits of such a book as this, to
do more than give the intelligent reader a general idea
about the meaning of coughs. As to treatment, it ought,
of course, to be left to the skill of a medical man. Yet
there are cases in which some of the following formulas
may be useful: —
1. For a croupy cough. — Ipecacuanha wine, antimonial
wine, syrup of squills — of each, 2 drachms; dis-
tilled water, to 3 ounces. For a child of about a
year old. A teaspoonful to be given every quarter
of an hour until vomiting occurs ; then half a tea-
spoonful every three hours, until cured.
2. For winter cough in adults. — A few drops of tere-
bene (pure) on a piece of sugar dissolved in mouth
thrice daily; or a teaspoonful of glyco-heroin in
water every 4 hours or so.
3. Routine mixture for chronic bronchitis in middle-
aged people. — Carbonate of ammonia, 24 grains;
tincture of squills, 2 drachms ; compound camphor
tincture, 3 drachms ; infusion of senega, 8 ounces ;
iodine of potash, 24 grains. A tablespoonful of
this mixture may be taken twice a day and two
tablespoonfuls at bedtime, additional.
4. For chronic cough in a rheumatic person. — Salicylate
of soda, 6 drachms ; glycerin, % ounce ; colchicum
CEEMATION 71
root wine, 6 drachms ; compound syrup of squills,
iy2 ounces; camphorated tincture of opium, 2
ounces. Take a teaspoonful in some water every
four hours.
Some chronic coughs, even if not of a tuberculous nature,
are benefited by cod-liver oil and malt and some require a
change of climate. It must always be borne in mind that
a chronic cough may mean the beginning of consumption.
Therefore a cough should never be allowed to continue for
more than two weeks without consulting a physician to
find out what the cause of its continuance is. Remember
that an early diagnosis in pulmonary tuberculosis or con-
sumption is half the battle won.
Cracked Nipples. — Many women who suckle children suf-
fer from painful cracks and sores of the teats of the breasts.
They ought to be wiped quite dry after suckling, and
glycerin of tannic acid painted on with a brush into the
cracks. Alcohol, in the form of methylated spirit, or
spirits of wine, may be used to bathe them if they are soft
and tender. Slight cracks may be painted with flexible col-
lodion. (See also "Pregnancy, Hygiene of.")
Cramp in the Calf of the Leg. — Many people are occasion-
ally seized with painful cramps of the calf muscles when in
bed at night. The causes of such cramps are over fatigue,
nervous exhaustion and ' l goutiness, " by which we mean
that the body is not able to throw off waste matters through
skin and kidneys, as well as usual.
Treatment. — (1) Sometimes smart rubbing of the
affected muscles will relieve the spasm.
(2) At other times, applying tight elastic bandage
round the thigh relieves the cramp at once.
(3) The calf muscles are used to draw up the heel;
those which push down the heel and raise the foot are
' ' antagonistic ' ' to the calf muscles. It is often a good
plan, then, to forcibly raise the foot by muscular action.
(4) Massage of the legs will cure bad cases.
(5) Five grains of salicylate of soda swallowed
thrice daily, between meals, may do good.
Cremation. — The number of persons who agree with the
principle of cremating the dead grows greater every year.
72 CROUP
Instead of consigning every corpse to the ground, there to
lie and decompose in a wooden coffin, and perhaps to con-
taminate the underground watercourses and spread disease
among the living, many thoughtful people to-day prefer to
destroy the lifeless clay by fire, and thus to purify it and
render it harmless to the living. Every dead body sooner
or later becomes dust ; cremation only brings about the same
process in a quick, cleanly way, and the furnace destroys
at the same time the teeming myriads of disease germs
which exist in nearly every corpse. Cremation is done, too,
without the smallest sacrifice of sentiment or decency, and
we may well hope that in coming years the public at large
will become so educated, so intolerant of the foulness of
disease and putrefaction, that they will gladly submit the
bodies of their loved ones to purification by fire, and leave
instructions in their wills that their own bodies may also
be thus cleansed and rendered harmless.
Cretinism is a medical word which is applied to a state
of stunted growth, both mental and physical, due to the
absence of a soft gland called the thyroid gland, which is
situated under the skin and muscles, across the lower part
of the neck and windpipe, and which does lie there in every-
body except cretins. Cretinism is common in certain dis-
tricts. The cretin may live to be a good age, and is often
good-tempered, quiet and fat. The skin is dry and rough,
the face is vacant looking, the hair stubbly, the hands short
and spade-shaped, and there are bosses of fat just over the
collar bones. These poor creatures often improve under
medical treatment.
If the thyroid gland wastes away in an adult, the adult
will generally become cretinoid, but his state is called
myxo3dema; and he also is susceptible of being improved
up to a certain point by giving him extract of thyroid
gland. But though in both these conditions it is not diffi-
cult to improve the body, it is very hard to restore or
improve the mind.
Croup. — This word, unfortunately in common use among
the poor, ought not to ~be used, because it has been made to
mean so many different ailments. Child crowing (which
see) has been also called false croup. The name "false"
ought to be reserved for spasmodic inflammatory laryn-
gitis, or inflammation of the voice box, which is accom-
panied by noisy breathing. The word croup itself means
DEAFNESS 73
"a noise in the windpipe." The right use of these names
is as follows : —
False croup is an inflammation of the larynx, accom-
panied by a hoarse noisy cough and difficulty of breathing ;
such indrawing of the breath being accompanied by a coo-
ing or crowing noise. If the child is left alone the spasm
will probably pass off, and on waking the child seems
almost well, but hoarse. Attacks may occur again on sub-
sequent nights. The medical names are spasmodic laryn-
gitis and inflammatory croup.
Membranous croup is probably always genuine diph-
theria of the larynx and the disease only resembles the
other kinds of croup in the shortness of breath and a noisy
cough. This is also called true croup.
Spasmodic croup is described under the heading of
"Child Crowing" (which see). It is purely a nervous dis-
ease and there is no inflammation about it. Mothers some-
times call the attacks "passion fits" and "holding the
breath." It is apt to occur during teething. Its medical
name is laryngismus stridulus.
If there is the slightest suspicion that an attack of croup
is true croup or diphtheria a physician should be called
immediately, for in these cases if diphtheria antitoxin can
be administered early death rarely occurs. If the admin-
istration of antitoxin is delayed several days the chances
of death are about one in ten, while if no antitoxin is ad-
ministered the chances of death are much greater.
In any case of suspected croup look for a white diph-
theritic membrane on the tonsils, pharynx or in the nose.
Sometimes the membrane is in the larynx and is then in-
visible to the unaided eye.
Cut throat. — A throat may be cut by a murderer or by a
suicide. Death may follow from loss of blood if the large
blood vessels in the neck are severed; but a wound of the
windpipe is not necessarily fatal. If a case is seen when
no skilled assistance is at hand, it is probably best to leave
the case alone and the fainting which follows is the best
thing that can happen to check the flow of blood. Send
for a doctor and a policeman at once.
Deafness. — Do not be misled into seeking temporary rem-
edies for deafness. Remember that it is a sign, a symptom,
and not a disease. You must first try to discover which
part of the hearing apparatus is in fault, and then direct
74 DEAFNESS
your attention to remedying the fault if possible (see also
"Ear Diseases"). In most cases, at the outset, and in an
early stage of deafness without pain, you may syringe out
the ear with a glass syringe (or, better still, an india rubber
enema syringe), and a lotion made of a teaspoonful of
baking soda in half a pint of warm water. Continue until
all "wax" and dirt and dried discharge have been washed
away. Dry with a towel, and not by poking in a piece of
cotton-wool on the end of a hairpin ! If there be still some
wax, leave a bit of cotton-wool soaked in a very strong soda
solution, in the ear for a few hours; then squirt again.
If the ear is too tender to allow this to be done properly,
put a poultice on the side of the head; or, better still, a
hot onion (see "Poultices"). If now the deafness is not
gone, it must be caused by catarrh, which makes the mucous
membrane lining the whole hearing apparatus swollen and
hot, and interferes in several ways with hearing. There is
no "certain cure" for this catarrh; there is no "cure" at
all, really. You cannot learn too soon that a catarrh is
only the local sign of a general constitutional weakness.
You may apply douches, ointments, gargles, drops, etc., as
much as you like, and they are all useful to relieve the
discomfort; but they will not cure. A nasal catarrh, like
every other catarrh, must be cured by improving the bodily
health, and specially by change of air. You must call the
doctor in to prescribe lotions, douches and drops that may
be necessary to your special case; but you, yourself, must
see to the cure. You must live in a well-ventilated house ;
must have the window open at night; must dress lightly
but warmly and use no such unwholesome clothes as eider-
downs and the furs of dead animals. You must eat all
you are able to, chewing the food well. You must rest in
bed enough; you must indulge in no bad habits (see "Hy-
gienic Misdemeanors"), and take no unnecessary stimu-
lants. Little by little, as time goes on, your general health
will improve and your liability to catarrhs will be con-
quered, and you need spend no more on deaf-curing insti-
tutes or medicines. If your weakness is hereditary so much
the worse for you, and the harder you must fight, and the
less dissipation you can afford. But catarrhal deafness is
not to be cured by medicines (though, of course, good medi-
cal advice and treatment are necessary to help you on your
way), but by living hygienically and wholesomely.
DEATH, SUDDEN 75
Death, Sudden. — We are not going to say anything about
death which occurs suddenly as the result of an injury or
an accident. We are referring only to sudden, unforeseen
death occurring in a person whom we had supposed to be
in no immediate danger of dying at all.
No one dies suddenly, apart from the effects of violence,
as long as all his organs are sound. But there are diseases
which develop slowly and secretly, without letting the pa-
tient know of their existence by pain or feeling of illness.
Not absolutely without signs, we mean; but without signs
enough to alarm the patient, though his doctor may know
at a glance that he is liable to die suddenly. For example,
a man with advanced disease of his blood vessels may only
complain occasionally of a little indigestion, or flushing, or
shortness of breath. A man with diabetes eats heartily,
sleeps well, and is cheerful, but he may die to-morrow all
the same. One cause of sudden, unforeseen death is fatty
heart, probably caused by the patient's own faulty mode
of life, or indulgence in alcohol. Another cause is valvular
heart disease which may exist for years, and only kill when
the poor overworked heart is suddenly overtaxed. Another
cause is the dreadful angina pectoris, or breast pang — a
sudden, terrific pain at the heart, a sense of impending
death — and then sudden death, or absolute recovery. Some
people have three or four attacks of real angina before
one carries them off. This is not the same as the acute
attacks of heart pain that so many hysterical females com-
plain of. Those are often due to wind in the stomach, and
do not cause death ! The bursting of an aneurism, or blood
tumor, occasionally causes death — unforeseen, because an-
eurisms occasionally exist quite unsuspected, especially in
robust and hard-working mechanical laborers.
Another set of causes is connected with the brain, and
are such as tumors of the brain, and bleeding into the head,
between the brain and the skull. People with epilepsy
sometimes die suddenly in a fit. In the Reign of Terror,
and doubtless occasionally since also, death has occurred
from emotion — terror, rage, or despair, and even joy.
Tight-lacing has caused sudden death. Then there are
deaths from sunstroke ; a great many people die every year
in New York from that cause. Some even die of heat
stroke in the depths of a shady wood, or while watching a
great house on fire. In Russia cold kills about 700 people
76 DELIRIUM TREMENS
every year. A few children die every year, with sudden-
ness, as the result of tobacco smoking. Very stout people
are apt to die of sudden heart failure, especially during
exercise after over-eating, or while walking up a hill.
Anaemic girls, who are so often the victims of the indiges-
tion due to ulcer of the stomach, sometimes die suddenly.
This is due to the shock caused by the ulcer perforating
through the stomach wall and the food escaping into the
cavity of the belly ; where it soon sets up peritonitis. Per-
sons with gastric ulcer go about in hourly danger of this
peritonitis, and this complaint ought, therefore, never to be
neglected.
Delirium Tremens. — DRINK MADNESS. — In the career of
the moderate drinker there is sometimes an occasional de-
bauch. The excess is taken, the intoxication is passed
through, the long sleep that follows allows nature to recover
somewhat, and only a little indigestion remains, or perhaps
not even that. This is melancholy enough, seen as a spec-
tacle of human weakness; but we are accustomed to think
that "there is not much harm done." In the case of an
habitual drinker to excess things are different. A tem-
porary excess in his case is very likely to bring on what is
called drink madness, or delirium tremens. Any accident,
fall, shock, or an acute inflammation may bring on this
serious condition. The man is restless, irritable, and can-
not sleep ; so he flies to alcohol to calm him — in pain. He
begins to talk incessantly, and to fidget about, or rush
violently from place to place. His talking becomes mutter-
ing, his muttering grows incoherent. He has horrid vi-
sions— rats, snakes, and crawling reptiles glide about his
bed, and he hears the roars of devouring beasts, and the
voices of enemies conspiring to kill him. He attempts to
jump out of the window. He cannot sleep, he trembles,
cries, groans and raves, and will not eat or drink.
On the third or fourth day he dies of exhaustion, unless
he has been properly treated, in which case the restlessness
abates, sleep at last comes to his rescue, and he improves
until he is cured. For a time he has been thoroughly
frightened. He realizes his weakness and sin, and per-
haps rushes to sign the pledge. Unfortunately, the drink-
ing habit, once fully established, is rarely abandoned. But
every man must decide for himself. If he cannot drink
DENTAL HYGIENE 77
moderately, without occasional excess, let Mm be manly
enough to abstain altogether. The golden mean is only for
the strong and self-respecting.
Treatment. — Even in the mildest case the patient must
be treated as insane for the time being, and the doctor will
consider it his duty to impress upon the friends that the
sick man cannot be trusted out of sight for a moment.
He has horrid delusions, and at any moment he may commit
suicide, or murder. His room ought to be in darkness, and
he in bed. To nurse him will require great courage and
great tact, so as not to increase the struggles. It is a good
plan to put a sheet across him and tie down the corners
and tuck in the ends. Strong soups, jellies, beef essences,
and plenty of milk must be administered as often as the
patient will take them. It may be necessary to feed him
forcibly through a tube.
We shall advise no drugs. Sometimes drug after drug
is given to produce sleep and no sleep comes, and after-
wards the drugs, which have been lying undigested in the
body, suddenly take effect and poison the patient afresh.
Only a doctor can know whether or not to give drugs and
when to do so.
Dental Hygiene , — The importance of taking care of the
teeth and preventing their decay is appreciated when we
realize that in a recent survey of school children 97 per
cent, of the boys and girls were found to have teeth in a
diseased condition. This means that all through their lives
— unless their teeth are filled or replaced by false ones —
they will be unable to chew their food properly, will suffer
from indigestion and malnutrition, and every time they
swallow they will swallow disease germs which lurk in the
(Jirty cavities of diseased teeth. The result will be a con-
stant low grade poisoning which will do much to impair
their health efficiency and happiness in after life.
This being the case what precautionary measures can be
taken to avoid having the teeth become diseased?
The teeth ought to be brushed after every meal. If this
cannot always be done we should at least take great care
to clean them just before bedtime and before breakfast.
The teeth should be brushed up and down as well as
crossways. The backs should be brushed as well as the
fronts. It is well after cleaning to draw a silk thread in
78 DIABETES
and out between the teeth to take away any bits of food
which may have caught there and which will ferment if
allowed to remain.
Tooth powder is of service in keeping the teeth clean;
but none but alkaline tooth powders should ever be used,
as acids spoil the teeth.
Every morning and evening an alkaline mouth wash
should be used. A good example of such a mouth wash is
alkalol, or the official Liquor Antisepticus Alkalinus.
Once every six months the teeth should be cleaned by a
dentist in order that tartar which collects about the bases
of the teeth can be removed.
Offensive breath usually comes from decaying food par-
ticles which are allowed to remain between and about the
teeth.
A good inexpensive tooth powder may be made up by
your druggist as follows: —
Bicarbonate of soda, y2 ounce ; precipitated chalk, 2
ounces; pulverized orris root, 1 ounce; pulverized
Castile soap, 1 ounce. Flavor with peppermint or
wintergreen.
A dirty mouth full of disease germs is not only dan-
gerous to the owner, but to his associates as well, for every
spray from such a mouth in coughing, sneezing, or even
talking or reading, is laden with microbes which vitiate
the air to be breathed by others.
Do not forget that nature 's method of brushing the teeth
is by chewing foods having considerable firmness of con-
sistency.
This is the reason why the teeth of dogs and bears are
usually in such good condition.
Therefore it is well to include in one's dietary foods
which must be chewed to be swallowed, and then to be sure
to chew them sufficiently before they are passed on to the
stomach for digestion.
Diabetes. — There are two forms of diabetes, distinct dis-
eases, but both characterized by the daily passage of too
large a quantity of urine. Diabetes insipidus is a nervous
disease, chiefly of children, who suffer from intense thirst
and an excessive amount of urine, which, however, contains
nothing unusual.
DIABETES 79
Diabetes Mellitus is much more common. The symptoms
of it are these : —
(1) Loss of weight and increase of weakness.
(2) Continual thirst.
(3) Frequent desire to pass water and the passage
of large quantities of it every day. The normal person
passes about 3 pints a day (see ll Urine Troubles ")»
but the diabetic passes as much as 20 or 30 pints a day
sometimes.
(4) The urine is sweet (it contains grape-sugar),
very pale in color, is irritating to the private parts,
and often causes itching and skin eruptions.
(5) The appetite is sometimes enormous.
(6) The breath often smells sweet, as of apples.
(7) Skin eruptions of all kinds, especially eczemas,
are common.
(8) Indigestion, decay of the teeth, dry harsh skin,
are common signs.
Causes. — Disease of the pancreas (sweetbread) is con-
sidered to be one cause of the symptoms. The liver is evi-
dently at fault, too, for the liver is the organ which deals
with the starches and sugars taken in the food, and which
ought to store them up (as sugar) for future use, instead of
letting them escape by the urine. The immediate causes
are not known either; too much brain work, too much
worry, too much business strain may all cause an attack.
Engine drivers suffer particularly from the nerve strain
they experience.
There are three more or less definite types of cases of
diabetes: —
(1) Young patient, with much sugar in the urine,
with chest complications and general debility. The
escape of sugar cannot be controlled much by the use
of drugs or dieting, and the disease is fatal in a few
months.
(2) Middle-aged patient, with sugar leakage, which
can be controlled to a large extent by suitable treat-
ment and drugs, and which may last for from two to
four years.
(3) Elderly patient, in whom all the symptoms are
not very severe, and who gets great benefit from medi-
80 DIET FOR DIABETES
cines and dieting, but who dies at last from consump-
tion of the lungs or coma after many years.
The complications of diabetes may be : —
Neuritis and paralysis, various skin diseases, kidney
diseases, cataract, carbuncles, collapse or coma (in-
sensibility), gangrene (of lung, or of toes or fingers).
Coma, in diabetes, accounts for the deaths of about half
the total number of patients. It may come on quite sud-
denly as the result of an injury, or merely of fatigue. The
patient becomes collapsed, his breathing is slow, then very
slow, and his breath smells sweet (as of hay or apples),
and he quietly becomes unconscious and insensible and dies
at last without moving. Nothing can be done when coma
comes on.
Note about diabetes. — Persons who suffer from boils,
eczema, carbuncles, itching of the privates, too much ap-
petite, continual thirst, loss of sexual power or desire,
ought to take a specimen of their urine to a doctor and
ask him to examine it for sugar. They may have early
diabetes.
Treatment of diabetes. — This consists almost entirely in
suitable dieting and the use of opium as a medicine. As
to the dieting we are obliged to say that no two cases of
the disease do well on the same dietary. So that no dia-
betic patient can possibly do without a doctor. The great
point about the diet is that it must contain as little as
possible of either sugar or starch.
Every week of his life the patient ought to weigh him-
self, estimate the amount of sugar in his urine (which he
can learn to do for himself), and adjust both diet and
medicine from time to time in accordance with what he
notices about the sugar and his own comfort in life. We
can lay down no hard and fast rules ; but here are two lists
which may help some diabetic patient to diet himself: —
He must not eat — Potatoes, turnips, carrots, cauliflower,
peas, beans, seakale, apples, pears, oranges, gooseberries,
currants, plums, peaches; cornflour, bread, rice, sago, tapi-
oca, confectionery, pastry, liver ; sugar of any kind.
He may eat — Any kind of meat, game, poultry, or fish;
all green vegetables ; cheese, butter, eggs, saccharin or saxin
in place of sugar; nuts. The only real difficulty is in the
DIARRHEA 81
matter of bread. Bran bread, gluten bread, toasted thin
slices of baker's bread, almond cakes, cocoanut cakes, may
be eaten.
The question of drinks must be left to the doctor ; and so
must that of medicine. Codeine (from opium) still re-
mains the best drug to use in most cases.
Diarrhea. — Diarrhea is of frequent occurrence, and it
arises from very different causes, and exists from the pres-
ence of many different diseased states. In infancy it is
commonly due to improper feeding, to over-feeding with
milk, or too early use of starchy foods with the milk, or
to the use of bottles, tubes, and teats insufficiently cleansed,
or to the use of milk food which has turned sour from
staleness, or hot close weather, or from being kept in rooms
with foul air. If an infant has frequent diarrhea, in the
absence of all these causes, there is a danger that the child
has tuberculous or consumptive disease of the bowels, which
is a most dangerous ailment. In older children diarrhea
is almost always set up by errors of diet, especially by
unsound fruit, and unwholesome foods. In adults occa-
sional attacks of diarrhea are also generally due to im-
proper food, or to some gross excess in some article of diet
or of drink. Impure drinking water from public courses,
or from private wells, or drunk from dirty cisterns, may
also produce diarrhea. The presence of many decayed
teeth, causing faulty digestion, is also a fertile cause of
upset bowels, with colic pains and frequent loose stools.
In addition to these various reasons for the presence of diar-
rhea, it must be remembered that it may be due to the pres-
ence of serious organic disease or to typhoid fever. Chronic
intemperance, which has partly destroyed the liver, is often
accompanied by a form of diarrhea, which rapidly reduces
the strength of the sufferer. Phthisis, or consumption of
the lungs, in its later stages, is in many instances ac-
celerated by very persistent and exhausting diarrhea,
which is due to tuberculous ulceration in the intestines.
In typhoid or enteric fever also the looseness of the bowels
results from a peculiar form of ulceration in the coats
of the large intestine. Acute attacks of severe diarrhea
also occur, generally in autumn in this country, in an
epidemic form; these are sometimes called cholera morbus.
Treatment. — When diarrhea is set up by offending mat-
ters in the bowels, it is first necessary to effect complete
82 DIARRHEA IN BABIES
removal by some simple non-irritating purgative dose, such
as castor oil, or compound senna mixture, or by Epsom
salts, with peppermint or ginger ; and then, later, to ad-
minister sedatives and astringents, such as chalk mixture,
aromatic confection, or paregoric. But if the diarrhea
be due to ulcerations in the bowels the highest medical skill
may be needed to keep it under control by means of more
powerful medicines and special care in diet.
Here follow some formulas which if used with discretion
and intelligence may be found useful : —
For Summer Diarrhea,. — Bicarbonate of soda, 4 grains ;
rhubarb powder, 1% grains; cinnamon powder, 1
grain; — for one powder. A child of one year old
may take this powder twice a day. A dose of castor
oil with 10 drops of laudanum in it will often check
diarrhea.
For Alcoholic Diarrhea. — Take a two-grain pill of
capsicum every four hours.
Chronic Diarrhea. — Take a two-grain pill of acetate
of lead every four hours. (See also " Diarrhea in
Babies.")
Diarrhea in Babies. — Diarrhea in babies is generally a
sign of inflammation of the intestines (enteritis) caused in
the first place by unsuitable food, and kept up by the want
of nourishment, which follows as a matter of course. ( This
disease is often spoken of among the poor as "consumption
of the bowels, ' ' but need not be connected with tuberculous
disease). If the mother looks at the child's "motions" in
the napkins she will see that they consist generally of masses
of lumpy curd (undigested cow's milk), rather like clots
of putty in appearance, smelling badly and greenish in
color. Along with the curdy mess is a little acrid greenish
discharge, which the nurse is apt to suppose to be urine,
but which comes really from the intestine. If opiates,
soothing syrups, or vegetable astringents (such as aro-
matic powders) are given, the baby will probably get worse
and perhaps die. The child vomits, and sinks into an
exhausted state, due simply to lack of nourishment. The
greatest mistake is to continue to administer cow's milk,
which the child cannot digest. Dr. Lennox Wainwright
recommends in these cases a diet mainly of albumen water.
This is made of the white of a raw egg, beaten up with
DIPHTHERIA
half-a-pint of water, and sweetened with sugar and milk.
Alternate feeds may consist of whey (made with rennet
and milk and cream). No ordinary cow's milk may be
given. The only medicine required is gray powder in
doses of half-a-grain or so, according to the baby's age.
Digestibility of various kinds of food. An ordinary
dinner of soup, meat, vegetables, bread, pudding and
cheese, is digested in from four to five hours. Some of
the ingredients are more digestible than others. The fol-
lowing table gives approximately the hours required for
the digestion in the stomach of some of the principal
foods : —
HOURS
Beef, boiled 3
" roast 3—4
" grilled 4—5
Cheese 3 — 4
Cabbage 3| — 4
Carrots 3 — 3i
Eggs, raw 2
" fried or boiled 3— 3J
" _ hard-boiled 3|— 4
Goost, roast 4 — 5
Fish, boiled 1 \ — 2J
Ham, boiled 2 — 3
Lamb 2J
Apples
HOURS
Mutton, boiled 3
roast 3— 3i
Milk 2
Oysters, raw 2
Potatoes, boiled 2£ — 31
Pork roast 5
Poultry 2£— 4
Tripe 1
Turnips 3| — 4
Rice 1—2
Sago 1 — 2
Tapioca 1 — 2
Wheat Bread 3 — 4
3 — 4 hours.
Diphtheria. — This is a disease in which there is inflam-
mation of the throat chiefly, but also, sometimes, of the
lining of the nose and air passages. What is called a
''false membrane" is formed on the parts affected. This
is a whitish, tough substance, which covers a red, inflamed
and tender place. The disease does not begin, as a rule,
suddenly, but the sufferer complains of a bad sore throat,
and tenderness and swelling at the angle of the jaw, head-
ache, and sickness. He is feverish and ill, and so power-
ful is the poison of the disease, caused by a germ called
the bacillus of diphtheria, that the sick child (it is very
often a child under twelve years) becomes rapidly ex-
hausted, and may die suddenly of heart failure, or of
suffocation. This disease is contagious, especially if one
comes in contact with the sneezes or coughed-up phlegm
of the child.
A child with diphtheria gets rapidly worse, coughs,
84 DIPSOMANIA
tosses restlessly in bed, gasps and wheezes. A doctor must
be called at once. If he is called as soon as there is a sore
throat, he will inject a substance called antitoxin, which
will soon cure the disease. Diphtheria is too serious a
matter for any amateur doctoring, and so we shall say
nothing about the treatment of it. But it is important
that the reader should know how serious may be the com-
plications and sequels of the disease.
First of all, a child with diphtheria of the throat and
air tubes may be suffocated at any moment, and a doctor
must be on the alert ready at any time to perform trache-
otomy, that is, to make an opening in the windpipe for
the patient to breathe through. Secondly, the child's pulse
must be carefully watched by the doctor in order to stave
off exhaustion, or else he may die suddenly. Thirdly,
pleurisy or pneumonia may develop. Fourthly, a few days,
or even weeks, after apparent recovery, the child may be-
gin to talk through his nose, and to choke over his food.
These signs are caused by paralysis of the palate of the
mouth, due to the diphtheritic poison. He may also squint,
or become weak in the legs. He may even die of paralysis
of the heart. Generally, however, he recovers in a few
weeks.
The chief things to remember in these cases are, to be
careful not to catch the breath of the patient ; to nurse him
in a room empty of everything except really necessary
furniture; to hang a sheet wetted with carbolic acid over
the room door; to use plenty of disinfectants; to give the
child no toys or books that cannot be burnt afterwards ; and
to keep everyone out of the room except the nurse and
the doctor.
Dipsomania. — This is a form of drunkenness in which
the drunkard drinks to excess in bouts, or paroxysms, and
then goes for some time without drinking at 'all. Dur-
ing the attack the dipsomaniac drinks because he has a
craving to do so, which he has no strength to resist (and,
perhaps, in some cases, no desire either) ; and in the in-
tervals he does not drink because he suffers from remorse,
and has been made thoroughly ill besides; and, perhaps,
because the craving is absent, and he has lost for the time
all desire for alcohol. When the end of the period of
abstinence is over the craving comes back again, and, if
DISINFECTION 85
he has any moral courage left, he will fight against the de-
sire until either he or the demon is conquered. But in-
dulgence in alcohol weakens everyone's moral nature, and,
by-and-bye, he cannot resist drinking, even though he may
wish to do so with all his unhappy soul. This is one of
the laws of the disease of drunkenness — the fact that the
craving is periodical. It is easy for people to fancy that
if a dipsomaniac can stop for six weeks he could easily
stop during the seventh also, if he liked. It is not the
case. Just as in ague or malaria, the attacks come on more
or less regularly, and leave the patient fairly well between
times, so in dipsomania, when the craving comes he falls
into the slavery — he becomes again a victim to the poison-
ous drug habit, and is no more free than the sufferer from
ague is.
Now, from what has been said, it will be seen that to
cure drunkenness, two things are necessary — one, to stop
the supply of alcoholic poison, which weakens the moral
and physical resistance against itself; and the other, to
break up the rhythmic regularity of the attacks, to in-
terfere with their periodicity. These things are what
honest systems of cure aim at doing. In the intervals the
drunkard is fed up and rested and encouraged, so that
the ravages of the poison may be met by as strong a body
as possible ; and then, when the attack comes on, he is put
under restraint, so that he cannot possibly obtain the poison
which will ruin him, body and soul.
Disinfection. — After every case of contagious disease and
advisedly after every case of infectious disease the room
and fabrics in contact with the case should be disinfected.
A disinfectant is an agent capable of destroying the in-
fective power of infectious material.
The most effective disinfectants are fire, steam and heat.
These will kill anything. The most useful disinfectant
for room purposes is formaldehyde gas.
After closing all cracks and crevices in a room by cotton,
adhesive plaster or paper, one pound of unslaked lime may
be put in a tin basin resting on bricks and on this is poured
y2 pint of 40% formalin. This is sufficient for 1000 cu.
ft. of space. The room should remain sealed for 6-8
hours.
Formaldehyde gas may be made for this purpose.
86 DOSAGE
Sulphur is frequently used, but is not as good as for-
maldehyde although it will destroy vermin, which for-
maldehyde will not do. For each 1000 cu. ft. to be disin-
fected 3 Ibs. of sulphur are to be burned. The heat gen-
erated by burning sulphur is so great that the pan con-
taining it should rest on bricks — not on a wooden floor
directly.
These gases do not penetrate fabrics very far.
Chloride of Lime, and trikresol are good disinfectants
for discharges from patients.
Bichloride of mercury (1-500) is useful in the disin-
fection of bed clothing.
Lime in the form of whitewash is a capital form of cheap
disinfectant for country buildings and outhouses.
Among the proprietary disinfectants may be mentioned
Platt's Chlorides, C. N. Disinfectant and the English
Sanitas Fluid.
Dislocation generally means that the bones of a joint
are displaced, and this has been done by violence of some
kind. Every joint in the body is liable to be the seat of
dislocation, but dislocations of the collar bone, elbow, ankle,
and jaw, are most common.
The non-medical person cannot generally distinguish be-
tween a dislocation of a joint and a fracture, or break-
age, of the bone. Sometimes the bone is broken and dis-
placed also. The notable thing about most simple dis-
locations is that a joint which usually moves freely has
become fixed. Of course a dislocated collar bone is an ex-
ception to this, but it may be known by a lump in an un-
usual situation. No one, who is not a doctor, can possibly
hope to "reduce the dislocation" or put back the bone into
its place without a serious risk of doing more damage to
the joint. In the case of a dislocation of the jaw the pa-
tient's mouth is open, and he cannot close it. It may be
out of joint on one or on both sides at the same time. It
may occur during yawning. Nearly every dislocation is
accompanied by a sprain and a bruise; so refer to the
articles on those subjects.
Dosage. — When the dose of a medicine is mentioned in
this book, it is a dose which would suit an adult. To find
out what dose to give a child or infant, consult the fol-
lowing table : —
DRACHMS AND OUNCES
87
For example, if t
he Adult Dose:
For a Child of
Give
Be One Drachm;
(or 60 grains, or
If One Ounce;
(or two table-
60 minims).
spoonfuls).
Less than 1 year old
y1^ of adult
give 5 grains
40 minims
dose
« « 2 "
i of full dose
7J «
1 drachm
" " 3 «
ft
10 "
80 minims
f( (I £ «
I
15 "
2 drachms
Between 4 & 7 yrs. old
I
20 "
160 minims
7 & 14 "
I
30 "
\ fluid oz.
14&20 "
§
40 "
5 drs. 20 ms.
Above 21 years old
Full dose
Drachms and Ounces. — All through this book, prescrip-
tions for medicine will be found written in drachms and
ounces. When referring to a liquid medicine the words
drachm and ounce really mean fluid drachm and fluid
ounce.
There are 60 grains to a drachm, 8 drachms to an ounce ;
and there are 60 minims to a fluid drachm and 8 fluid
drachms to a fluid ounce. A minim is a measured drop.
Now, in domestic life, these measures correspond nearly to
certain familiar measures as follows :
A fluid drachm is about 1 tea-spoonful.
A fluid ounce is about 2 tablespoonfuls.
A tablespoon holds about . . half a (fluid) ounce.
A dessertspoon ' '
A claret glass ' '
A sherry glass
A port wine glass
A tumbler ' '
two drachms,
four ounces,
two ounces,
two and half ounces.
10 fluid ounces, or half-
a-pint.
It will be easily understood that teaspoons and table-
spoons and glasses vary in size, so that they are not ac-
curate measures for medicines. It is always advisable to
have a properly marked medicine glass in the house and
to measure all medicines before giving them. Most modern
teaspoons will hold as much as 85 instead of only 60
minims.
88 DRINKING CUP
Dreams. — Dreaming is not quite a healthy condition.
No one ought to dream, pleasantly or otherwise. Sleep,
in fact, ought to be quite dreamless, and always is, if we
live hygienically. The meaning of dreaming is this —
only a part of the brain is asleep ; in the remainder of
it, or in certain parts of it, thoughts run riot uncontrolled
by the higher centers of judgment and reason. Every
mental picture seems real; probability counts for nothing;
nothing is too absurd and nothing seems impossible, in
dreamland. When we realize the necessary truth of these
facts we see how ignorant and absurd it is to be influenced
or terrified by dreams, in our waking moments. A dream
is an uncontrolled fanciful riot of the lower mental facul-
ties, and the causes of this too-light sleep may be too much
mental worry, the bad habit of "thinking things out" in
bed, too heavy bed clothing, excessive blood supply to the
brain due to heart disease, excessive use of tobacco, which
depresses the heart, tight-lacing, costiveness of the bowels,
indigestion, and so on. The treatment of dreaming is the
removal, as far as possible, of the cause, and not the taking
of composing draughts or ' ' night caps. ' ' (See also ' ' Night-
mare.")
Many young men find that they are troubled with
dreams only when they sleep on the back. Such should
tie an empty cotton reel on the back over the spine by
a string round the waist, so that it will wake them and
make them turn to sleep on the side. Dreamers should
also avoid cigarette smoking and late suppers, and es-
pecially alcoholic drinks in the evening.
Drinking Cup. — Reliable bacteriologists who have made
examinations of common drinking cups have found on
them the germs of diphtheria, tuberculosis, syphilis, in-
fluenza, meningitis, pneumonia and ordinary colds.
It is now known that infantile paralysis, measles and
scarlet fever can also be spread in this way, although the
germs of these diseases are so small they never have been
seen.
When a public drinking cup has been used by hun-
dreds of people it is not only probable that the germs
of one or more of these diseases remain on the cup, but
an absolute certainty.
For this reason the use of the common drinking cup in
public places is being rapidly abolished by law.
DROWNING 89
In its place one of two devices may be used: — The
bubble fountain without a cup; or the individual cup
which, as a folding pocket cup, may be carried about, or
the paper cup which, after having once been used, can be
thrown away or destroyed.
Dropsy. — This is not a disease but a symptom of many
different diseases. There are several different kinds of
dropsy, too, though the word is generally used by the
public to refer only to swollen legs or to fluid in the ab-
domen. Dropsy is a collection of liquid somewhere in the
body as the result of a disease. Thus when there is dropsy
everywhere under the skin, it is called anasarca. The skin
is swollen and doughy to the feel. If you press your finger
into it, a dimple remains, which takes a certain time to
disappear. This sign is called by doctors ''pitting on
pressure. ' ' You can see anasarca round the ankles at bed-
time, in persons who have anaemia, or heart disease, or
merely a fatty weak heart, or Bright 's disease. In the
morning, after a rest, the swelling is gone. Dropsy of the
belly is called ascites. The fluid collects there as a result
of some disease of the liver or gall bladder.
Dropsy of the chest is called hydrothorax, and occurs
in heart and kidney diseases. Dropsy of the head or brain
is called hydrocephalus, or water on the brain. Very local
limited dropsical swelling, such as occurs near poisoned
wounds or injured joints or ''black-eyes," is called cedema.
Treatment. — You have to treat the disease which caused
the dropsy, and that, of course, requires the skill of a
doctor.
But you have also to deal with the dropsical part.
JEdema of the legs, for instance, must be treated by rest-
ing the leg in a horizontal position. In some cases the fluid
has to be drawn off, or tapped, by the doctor, before relief
can be obtained.
Drowning. — If any one of our readers should rescue a man
from death by drowning, or should come across a person
who is lying, apparently drowned and dead, on the shore
or bank of a river, let him send at once for a doctor, but
while the messenger is gone, there are many things that
he can do.
In drowning death may be caused by suffocation, or by
the shock produced by striking the head on a rock or on
the bottom of the pond. The appearance of the patient
90 DROWNING
will vary accordingly. A person who has been suffocated
by the water will be ' ' black in the face, ' ' the veins of neck
and arms will be swollen; and the heart beats cannot be
felt. In death from shock the skin is pale, the face calm,
and no water has been sucked into the lungs because no
attempt at breathing has taken place. If the face and
mouth of a drowning person have been under the water
two minutes or more, there is probably no chance of his
being brought back to life. In the struggles of a drown-
ing man he draws water into his lungs and this water suf-
focates him. Now, there are four possible ways of deal-
ing with a person who is apparently drowned. They all
aim at "artificial respiration." The written descriptions
of these methods are of little use, however, in our opinion.
They can be learnt only in practical ambulance classes
where "first-aid" is taught. We shall, therefore, give only
a sketch of treatment, so that while the messenger is gone
for the doctor the man on the spot need not be wasting
valuable time.
(1) Turn the body on its face, with a rolled-up jacket
under the chest, and kneel on or press the chest with
the hands to force out water from the lungs. Open the
mouth and put the finger in to hook out any mud or
weeds that may block up the throat. Pull out the
tongue by grasping it with a handkerchief, so that it
cannot fall back and stop up the entrance to the wind-
pipe. Loosen all tight clothing.
(2) Then put the body on its back, with the roll under
the shoulder blades, and try to make the patient begin
breathing again. This requires much patience and pres-
ence of mind; above all, don't hurry. A person can
only breathe about 15 times in a minute, that is once
every four seconds. If you hurry, you do no good. Be
deliberate and steady and firm.
(3) Kneel down at the top of the patient's head.
Lean over him and seize his arms just above the el-
bows. Draw the arm slowly and steadily upwards until
you make them meet over the head. (This imitates the
first act of taking a breath, raising the ribs, and suck-
ing air into the lungs.) Keep the arms up while you
count "one two three" and then turn them down again
pressing them firmly and gently against the sides of the
DUST 91
chest while you count three. (This imitates the act of
expiration, forcing the air out of the lungs again.)
Then repeat the process, slowly, deliberately, and
firmly, until you see that the patient is beginning to
breathe for himself.
(4) Then turn your attention to warming him. If
there is someone there to help you, let him attend to
that part of the business while you are doing the ' * arti-
ficial respiration." If blankets are obtainable, wrap the
patient up in them and commence rubbing the limbs up-
wards in the most energetic way. Take the boots and
stockings off and chafe the feet, if you have no hot-water
bottle.
(5) As soon as you can get the now recovering man
into a house or room, put hot bottles or hot bricks to
the abdomen, feet, under the armpits and between the
thighs. As soon as the patient begins to swallow his
saliva, make him swallow warm brandy and water, hot
coffee, or mulled wine.
Note. — Artificial respiration must be persevered with
for at least an hour, even in apparently hopeless cases.
Once recovered and really alive, if the patient seems
to want to sleep, let him. It will aid his recovery very
much.
Dust. — The subject of dust became of the greatest im-
portance to us when we came to realize what a vast amount
of disease was directly attributable to it. For example
in some of the dusty trades — such as grinders, 49% of
all the deaths occur from consumption — largely caused by
inhaled dust.
For our purposes consideration of the subject of dust
is best divided into inert and living dust (bacteria) ; and
in reference to its location, into that in the street, the
home, the workshop and the public building or convey-
ance.
Inert dust is chiefly dangerous on account of its irri-
tating character to the lungs, — causing an increased
vulnerability to tuberculosis and other germ diseases. In
New York City 305 tons of iron and steel dust are pro-
duced monthly.
Dangerous disease germs may be the sole constituent of
finer dust or they may cling to the coarser inert particles.
92 DUST
This is the reason why exposure to dust on streets so often
produces colds, catarrh, influenza, hay fever, tonsilitis,
pneumonia and tuberculosis.
Solid dust particles and bacteria which we breathe in
the air do not come out with the expired air, but are re-
tained on the moist surfaces of the mucous membranes of
the respiratory tract. The body ultimately finds a way to
dispose of much of this, but in this process it is liable to
sustain much harm.
Dust particles on the street come largely from small
fragments of sand, broken fibers of plants, pollen, fine hairs,
the pulverized excreta of domestic animals, ashes, fibers of
clothing and other fabrics, particles of lime or plaster or
soot, masses and clusters of micro-organisms.
So dirty is the air of the New York street that while in
a given quantity of air there were only 34 bacteria in a
private house, on the street there were 5,810.
For the removal of this street dust we are in the hands
of the city street-cleaning department. (Heaven help us.)
All we as individuals can do is to breathe through our noses
and our handkerchiefs and put our trust in the Lord and
our ballots in the box for the other political party at the
next election.
Home dust may be diminished by filtering all incoming
air through cheese cloth (if there is a proper ventilating
system), and by controlling the expectoration of invalids.
To avoid the collection of dust have hard floors, with
rugs which may be cleaned out of doors, few hangings,
and furniture upholstered with smooth surfaced fabrics.
It must be remembered that when air enters a room the
germs on dust settle.
The air passes out of the room purer but the germs remain
and keep constantly collecting in larger numbers.
In cleaning, anything which stirs up this dust is un-
desirable. (See Cleaning.) The best methods are the use
of the vacuum cleaner and the moist cloth, — avoiding the
feather duster and the dry broom.
In the workshop the dust most to be feared is that
which is produced in the course of manufacture. The
dusty trades produce the greatest mortality from consump-
tion. The remedy is to have the dust removed at its point
of origin by a suction ventilator.
In factories and public places dust should be filtered out
EAR DISEASES 93
of the air employed for ventilation. Special precautions
should be taken against the scattering of bacterial dust
from people by discouraging unprotected sneezing, cough-
ing and spitting.
Floors and furnishings should be such as to gather as
little dust as possible. Cleaning should be frequently done
(at such times as when the dust has well settled) by means
of vacuum cleaners, moist cloths, etc. (See Cleaning.)
Sunlight is one of the best agencies to take the sting out
of living (bacterial) dust.
Dyspepsia (see Indigestion).
Ear Diseases. — Doctors speak of the " external ear,"
which is the ear you see at each side of a person's head,
the "middle ear," which is inside the head and consists
of the delicate machinery of the hearing apparatus, and
of the "internal ear," which is the auditory (or hearing)
nerve. The commonest disease of the external ear is
eczema, which generally requires only very slight treat-
ment (see "Eczema").
Of the hearing apparatus inside the head the only dis-
eases we need mention here are polypus and catarrh. The
former requires the skill of an aural surgeon for its re-
moval.
Catarrh of the middle ear is very common. When acute,
it is a part of a bad cold in the head, which has affected
the ear as well as the nose and throat. The ear-ache is
intense, because behind the drum of the ear there is a little
collection of matter which cannot get out. If the ear-
ache is treated by poulticing, the matter bursts through
the ear-drum, and comes out, and the relief is immediate.
Afterwards the little hole in the ear-drum heals up and
the hearing may then be as good as ever. Do not poke
anything into the ear, or you may injure the drum. In a
very severe case of ear-ache it is better to call the doctor.
He will very likely order leeches to be put on over the
skin at the back of the ear, and bleeding should be en-
couraged. Then with a fine-pointed delicate knife, he will
just prick the ear-drum, and let the matter out. If the
matter is allowed to break through the ear-drum by itself
there is a risk that the little hole or "perforation," will not
heal and that the catarrh will become chronic.
Chronic catarrh of the ear is very difficult to get rid of.
When any ear discharge appears, go to an ear surgeon at
94 ECZEMA
once. Constant syringing may be tried, using a Higgin-
son syringe and warm boric acid solution. If the dis-
charge smells badly, drops of this lotion may be put into
the ear at bedtime: — Sulphate of zinc and carbolic acid,
of each, 5 grains, and distilled water, one ounce. Much
ill-smelling discharge may mean that there is a polypus
there. But all such means often fail to cure, and syring-
ing does not reach the seat of the trouble. Wearing cotten-
wool in the ears only pens up the foul discharge.
Some wax in the ear is quite natural, but when there is
too much of it the patient gets noises and singing in the
ears, deafness and sometimes giddiness. Gentle syringing
with warm water is enough to dislodge the wax, but if this
is unsuccessful, go to a doctor about it without delay. (See
also "Deafness.")
Eczema. — Eczema is one of the commonest of all skin
diseases and the name has been used so loosely that there
is the utmost confusion in the public mind as to what is
eczema and what is not, and as to what is "good for
eczema ' ' and what is not. It is a disease which has several
different stages and which requires different treatment in
each stage. It is a disease in which the three stages may
be present at one and the same time, in the same person.
The different stages can only be properly recognized by
a doctor, and the right treatment can only be applied by a
doctor. Not only that, but there are many cases of eczema
which are incurable. All things considered, therefore, the
layman who is going to treat eczema on his own respon-
sibility and knowledge has a hard task before him ; and the
person who goes about asking his friends or consulting the
newspapers for a "certain cure" is doomed to disappoint-
ment, because there is no such thing as a "certain cure"
for eczema.
However, a little elementary knowledge of the disease
will greatly help the intelligent reader and patient to give
intelligent assistance to the doctor in his difficult task, so
that we have decided to give a short account of this disease
and its treatment, and a few medical recipes.
Eczema is a catarrh of the skin just as a cold in the head
is a catarrh of the mucous lining of the nose and throat.
And just as the nose "runs" with fluid discharge and has
scabs when the cold is "drying up," so does the skin dis-
charge and scab over in eczema. This more or less con-
ECZEMA 95
tinual "weeping" of the skin under the dried scabs is
characteristic of eczema.
Eczema seems to arise spontaneously, and instead of run-
ning a course, it smoulders on, sometimes better, sometimes
worse. There are very many varieties of eczema, but really
they are all different stages of the same process, though
no two cases of eczema are exactly alike.
An attack of eczema generally begins with sensations of
burning and itching; then the part gets covered with a
more or less deep red blush, then little blebs form on it
and you see all the signs of the catarrh of the skin — swell-
ing, heat, redness, and pain. Then the blebs burst or are
torn open by the patient's scratching, and the skin "weeps"
a fluid which stiffens linen as if it were starch. After a
few days the patches dry up and heal, and then probably
another patch or two breaks out, until they may spread
all over the body.
We have described a mild case. In worse cases the skin
may become thickened and inflamed and cracked terribly;
the itching may cause weeks of sleeplessness and ill-health.
We have seen strong men crying with worry and irrita-
tion and want of sleep when the eczema did not look very
bad; and we have seen them scratch madly at the itching
skin until blood came, and until they became tired out with
pain and nervous exhaustion, and sink to sleep for a while.
Added to such terrors as these, there are sometimes extra
sores and boils produced by scratching and contact with
infected things. No wonder then that the doctor sometimes
feels in despair about a case of eczema.
There is no part of the skin which may not be attacked
by eczema. We shall refer especially only to a few of the
commoner varieties of the disease.
Scalp eczema is generally red and dry and covered with
crusts, and complicated with other kinds of skin disease.
Wash head with soft soap and apply weak sulphur oint-
ment.
Eczema of the ear is common and sometimes spreads right
into the ear hole. Cold cream should be applied. The
druggist can sell you some cheaper than you can make it.
Eczema of the palms leads to much cracking and swelling
and pain and soreness of the hands ; the nails often become
pitted and split and discolored. Soak the hands in a
calamine lotion bath for a half-hour occasionally. Keep
96 ECZEMA
the parts always covered with weak sulphur ointment
spread on lint.
Eczema of the bathing-drawers area. — This name ex-
plains itself. The eruption is confined to the parts which
would be covered by short bathing-drawers. The crusts
and swollen inflamed skin, so tender that the patient can
hardly sit down, make life almost unbearable. The parts
should be swathed in linen, soaked in calamine lotion, and
later on dredged lightly with a powder made up of talc,
87 parts ; starch, 10 parts ; and salicylic acid, 3 parts.
Eczema is sometimes associated with piles, which must
be treated by themselves (see ''Piles").
Now, the causes of eczema are not well understood. Cer-
tain types of people, such as gouty people, are very liable
to it; but there is no real gouty eczema, and in Germany,
where there is very little gout, there is plenty of eczema.
The disease is just as common among the well-fed chil-
dren of the rich as among those of the poor. Breast-fed
children are not less liable to it than bottle-fed.
Eczema itself is not contagions. It can nearly always
be cured if a proper kind of treatment is adopted, and
stuck to perseveringly for a long time; but the home-
physicker has little or no chance of curing it with house-
hold remedies.
Treatment of eczema. — We know that there are certain
individuals who believe that in every case of disease, es-
pecially skin disease, the "blood must be out of order,"
therefore, they argue, you must give a medicine to * ' purify
the blood"; and the disease will cure itself then. Well,
there is a certain small amount of truth in the idea, and
it is worthy of a little of our consideration. A few cases
of eczema may be improved by blood-purifying medicines,
but in most cases the less drugging the better. No known
medicine will benefit every acute case of eczema. Arsenic
and antimony and opium are all useful in acute and pain-
ful cases, but these medicines being also poison must be
prescribed by the doctor himself. The following items of
treatment can be attended to by the patient himself: —
A very simple diet, a free action of the bowels (castor
oil), no stimulants, rest in bed with light coverings, and
two-grain doses of quinine every four hours. This is the
way to treat an acute inflamed attack of eczema. The doc-
tor will add the other necessary medicines.
ECZEMA 97
Now the local treatment of eczema is much more im-
portant. In applying local ointments and remedies, you
must keep two rules:
i-
(1) The strength of the remedy must be in propor-
tion to the degree of intensity of the disease. It
is hopeless to apply a strong ointment to a mild
attack of eczema.
(2) The remedies must be kept continuously applied.
It is useless to smear a little ointment on occa-
sionally.
Then, as regards the treatment itself: —
Remove all crusts and scales, after softening them
with olive oil, with a piece of clean lint. Other-
wise the remedies cannot get down to the mis-
chief. The parts must never be washed with
ordinary water, and soap must never go near
the disease. The weeping surfaces may then be
bathed with a lotion made of a soloid of boric acid
dissolved in rain water, or water which has been
boiled, and dried by the use of muslin bags, con-
taining starch and boric acid powder in equal
parts. Then smear some of this cold cream on
a clean rag and keep it applied to the raw sur-
faces:— Zinc oxide powder, 6 drachms; lanolin
ointment, 2 drachms ; olive oil, 1 ounce ; lime water,
1 ounce.
As to other ointments and preparations, you have to
"feel your way" in using them. The plastermulls in-
vented by Professor Unna are most useful to eczema pa-
tients. They are to be cut out to the exact size of the patch
of eczema. They are made of various medicinal materials.
For the terrible itching, dab on the following lotion with a
clean plug of cotton-wool: — Carbolic acid, 1 drachm;
glycerin, 2 drachms; water, to 8 ounces. If that does not
relieve the itching, perhaps the following will be better: —
Lunar caustic, 15 grains; sweet spirit of niter, 1 ounce;
detergent tar solution, 2 ounces. To be dabbed on with
cotton-wool (never with a sponge).
For the old hard chronic patches of eczema, which will
not heal or yield at all to other plastermulls or ointments,
98 ENEMA
try sulphur plastermull ; and lastly the following: —
Chrysarobin, 10 grains; lanolin, 1 ounce.
Lastly, do not forget that eczema is a catarrh of the skin,
and so the dryer the climate the better will the patient
get on.
Emetics. — An emetic is a medicine which causes vomit-
ing. Here is a list of those most commonly in use : —
(1) Give 30 grains (about half a small teaspoonful)
of sulphate of zinc in a tumblerful of tepid water.
(2) Or, give 10 grains of sulphate of copper dis-
solved in warm water.
(3) Or, give a dessertspoonful of mustard stirred
up in a tumblerful of warm water.
(4) Or, copious draughts of warmed sea water.
(5) To produce vomiting in cases of bad cough,
with sticky phlegm, which cannot be got rid of and
makes the patient retch: — Give (to a child) a tea-
spoonful, and (to an adult) a tablespoonful or more,
of ipecacuanha wine.
(6) When the heart is feeble and an emetic is neces-
sary, a tablespoonful of sal volatile in a tumbler of
water may be very useful.
(7) If far from medical aid tickle the throat with
a feather.
Emetics are given (1) to children, especially those with
whooping cough, to help them to get rid of the phlegm;
(2) to drunkards who have "mixed drinks," and are be-
ing poisoned with alcohol; (3) to persons who have taken
poison.
(8) The stomach pump. The proper use of the
regular stomach pump cannot be taught here. But in
the absence of a doctor, a child who has taken poison,
or who has been fed upon poisoned food, may have
his stomach emptied through an india rubber male
catheter attached to an ordinary glass ear syringe.
Eub the catheter with a little oil before you slip it
down the child's throat.
Enema. — A doctor will sometimes tell you to administer
an enema in his absence. An enema is an injection made
with an india rubber syringe into the back passage. An
EPILEPSY 99
enema is generally given for the purpose of making the
bowels act freely; but it may be given for other pur-
poses, such as to apply a lotion to a sore or ulcerated
surface in the rectum, such as occurs in dysentery; or to
nourish the patient when he cannot take food by the mouth,
because of a cancer for instance; or to stop diarrhea. An
enema for making the bowels act is made of a pint of warm
water and soapsuds. Another excellent way of making the
bowels act is to use a little enema syringe made of vulcanite,
and inject about two teaspoonfuls of glycerine. The com-
mon form of syringe used for ordinary enemas is called a
"Higginson syringe." The patient ought to lie on his or
her left side, with a towel or mackintosh beneath him to
catch any drippings. The bone nozzle then, well oiled,
should follow a well-oiled forefinger into the bowel, and be
pushed upwards for one inch. Then withdraw the finger
and push the nozzle backwards and upwards for another
inch and a half. Then use the ball of the syringe. Many
patients like to put in the nozzle for themselves. It gives
no pain, and relief of the bowels is speedy.
Epilepsy. — (I.) In olden times this disease used to be
called the Falling Sickness, because it consists of a series
of sudden fits in which the sufferer almost always falls
down, wherever he may be. A fit of epilepsy must not be
confused with other attacks, such as syncope or fainting,
nor with apoplexy, also called a fit. An epileptic fit or
attack consists of a sudden loss of power and sense, causing
a fall down, and convulsive twitchings of the muscles of
the arms and legs, of the face and jaws. Every fit of con-
vulsions is not epilepsy, for children are liable to have fits
from teething, from indigestion, or when sickening for
some fever or inflammation ; they also have fits from spasms
in the throat and windpipe. Any severe attack of convul-
sions occurring in a previously healthy child, man, or
woman, may be of epileptic origin, but no one could be sure
of this. This disease varies very much in severity, both
as to the frequency of the attacks, and as to the importance
of each fit. Some sufferers have several fits in a day, others
may have only one fit in a month or in a year. A fit may
come on suddenly, and last only a moment, or it may cause
a sudden fall, deep insensibility, general convulsions,
gnashing of the teeth, biting of the tongue, and foam at
the mouth, and may last for hours. Severe fits are fol-
100 EPILEPSY
lowed generally by heavy sleep and then by headache and
exhaustion. In some exceptional cases the patient has
some warning of the coming fit, but in most persons the
attack is immediate, and the sufferer drops whatever he
may be holding, and falls without any power to save
himself from injury or from death. Epileptics are often
burnt, drowned, and suffocated in accidental manners ;
therefore, never leave an epileptic alone after a fit has
occurred. The great mystery about the disease is that
although from the symptoms we know that the brain and
spinal cord must be affected, yet after death sometimes no
fault can be found in them ; and at other times faults are
seen which may or may not account for the fits during life.
Sometimes surgeons discover neither brain injury, nor
tumor, nor bleeding, nor abscess. When there have been
several epileptic fits the disease is rarely cured, or recov-
ered from. Slight fits often lead to more serious mind
failure than severe convulsions, and often end in madness.
Epileptics should not marry, nor have families, for their
disease is very apt to reappear in their offspring.
(II.) What to do with epileptics is a very difficult prob-
lem, for being never safe from attacks of the disease they
are dangerous to have as servants in private houses, and
are not safe as workers in factories, nor in the Army or
Navy. Farm colonies have been instituted, and perhaps
such sufferers are more safe in the fields than anywhere else.
Epileptics have often bad tempers, and are passionate
and revengeful, while many are almost imbecile. A con-
siderable number of murders are done every year by epi-
leptics, after recovering from a seizure, their mad violence
being a sudden short outbreak, which soon passes off, and
may leave them quiet and reasonable, and sometimes quite
forgetful and unconscious of what they have done. Hered-
ity seems to be the most frequent origin of this ailment,
and the next most frequent cause is intemperance or mad-
ness in the parent. True epilepsy is not started by in-
juries, nor by the drunken habits of the person himself.
When anyone has had a series of fits, he or she rarely loses
them entirely, however treated by medicines, food, or diet.
Almost every known drug, vegetable, mineral, or animal,
has been given for this disease, and more than a hundred
have at some time or other gained some reputation as cura-
tives; but it is sad to have to say that there is but one
EPILEPSY 101
which produces any definite improvement by making the
fits less severe, and the intervals between them of longer
duration. This drug is bromine, which, however, cannot
be given with advantage in its pure state; it is a deep
reddish-brown pungent liquid, obtainable from seaweed.
In medicine it is used combined with alkalies, and its most
usual preparations are bromide of potassium, bromide of
sodium, and of ammonium. A fourth form is a clear, color-
less, sour liquid, named hydrobromic acid. Bromide of
potassium has been most used, beginning with doses of five
grains for adults, and afterwards much increased. It is a
drug with a calmative effect, but taken continually it is
very depressing, and it is not wise to take it except under
medical care. Arsenic was once a common remedy, and
so was nitrate of silver ; solutions of salts of gold have been
tried, and now disused. Epilepsy is eminently a disease
for being periodically seen by a doctor, who will watch the
course of the treatment, and decide as to its success.
(III.) As to the treatment of these fits of epilepsy, apart
from medicines, we must say that neither a purely flesh
nor an entirely vegetable diet will remove the tendency to
these fits, nor will total abstinence. The use of tobacco
does not seem to have any curative effect, nor does it seem
to make the disease any worse. Epileptic fits are attacks
of convulsive spasms of the voluntary muscles. These
muscles are governed by impulses sent from the brain and
spinal cord through the nerves, and these spasmodic jerk-
ings are involuntary in onset, and cannot at all be checked
by the strongest effort of will. In severe fits, there being
temporary loss of the senses, of course the human will has
no chance of controlling the spasms. The disease called
hysteria, which occurs chiefly in nervous and delicate young
women, will sometimes give rise to fits which imitate an
epileptic seizure; but the history of the case, and the fact
that there is an absolute insensibility, serve to distinguish
the two ailments. An epileptic never gives more than one
cry in a fit at the onset, whereas the hysterical girl will
keep up a noisy disturbance of mixed crying, screaming,
and often laughter of a mad sort. In the hysterical fit
also the tongue is not bitten, nor is there foaming at the
mouth. The actual epileptic fit cannot be stopped until it
has run its course, except by means of chloroform or ether,
and this administration would, under the circumstances,
102 ERYSIPELAS
be almost as dangerous as the fit itself. The most impor-
tant thing to be done for a fit is to prevent the patient
from self-injury, and from wounds and bruises from knock-
ing himself on the floor or against furniture. In any case
where there is gnashing of the teeth, it is a good plan to
put a firm, but soft plug of cork, or some similar material
between the jaws ; otherwise the tongue may be sadly bitten.
Persons who live in the same dwelling with an epileptic
should run to his assistance when any cry or moan is
heard, and the patient should be laid, if possible, on the
floor on a rug; or if put on a bed or sofa, he must be
prevented from falling. In general, no medicine can be
given during a fit, but in some very severe and long attacks
an anaesthetic, such as ether, chloroform, or nitrous gas,
may be administered by a doctor.
Erysipelas. — This disease is less common than it used to
be, and the reason is that our sanitary arrangements are
much more perfect than they were.
Where there are defects of drainage, broken sewers, cess-
pits near houses, or worse still near wells, or where sewer
gas enters dwelling houses, there erysipelas used to be rife.
It was also a common disease in the surgical wards of our
hospitals before that famous surgeon, Lord Lister, intro-
duced the antiseptic mode of treating wounds.
Erysipelas may attack patients suffering from wounds, or
it may appear in a person who is otherwise out of health,
sickly, or of broken-down constitution. In either case the
true cause appears to be a special disease germ floating
about the air of a place. It used to be called a miasmatic
disorder, and by miasm was meant impure air — air poi-
soned by exhalations from diseased persons, or from many
wounds, or from decaying animal matter. This was before
the time when the microscope became powerful enough to
discover very minute bacilli, bacteria, and microbes. This
disease is sometimes epidemic — that is, affecting a great
number of persons at once ; or it may be sporadic — that is
to say, occurring in solitary cases.
Erysipelas is always contagious, and although medical
men and nurses but rarely catch it when attending cases,
yet sickly people, or persons with open wounds, or with
ulcerated throats, often take the disease.
Erysipelas is an inflammatory fever of a severe type,
associated with painful redness and swelling of some part
EXERCISE AND RECREATION 103
of the skin, and often of the face and head. The affected
skin becomes pink, then more and more red, and livid in
tint; it is puffy and tender, and the patch tends to spread.
It may attack the edges of an unhealthy wound, or any
old ulcer. The first symptoms are believed to appear about
six days after taking the infection; then there are chilli-
ness, shivering, and fever, headache, dryness of tongue,
much discomfort, and then the inflammation is found com-
ing out on some patch of skin, with pain and redness. If
the face is attacked, the swelling may be so great that the
features are hidden. Nausea, vomiting, and diarrhea are
common. Death may follow from exhaustion, from blood
poisoning, or from the disease attacking the windpipe, or
from its spreading inward to the brain.
As soon as the disease is discovered, the patient must be
put to bed and have a sharp purgative, and should have
no solid food. Some doctors apply poultices to the red
patches, while others prefer only dry applications, such as
starch, flour, or rice powder.
The perchloride of iron is generally prescribed by the
doctor in these cases. It is almost a "certain cure." Fif-
teen-drop doses of the liquor are taken with advantage by
some adults. French surgeons rub in a lotion of per-
chloride of iron, 30 per cent., with a lint swab, locally.
But most cases get well if the part is merely covered with
a mixture of equal parts of boric acid and flour, and the
strength of the patient kept up with iron tonics and stimu-
lants.
Exercise and Recreation. — The most important factors in
the maintenance of health are the avoidance of infection, —
the use by the body of pure fuel (food, drink, and air)
— and the maintenance by the body of a high degree of
resistance to disease. Among the last means of health
preservation few are more important than exercise.
The main effect of exercise on the body is to increase
oxidation. It increases the rapidity of the circulation
everywhere and therefore causes in all organs a quicker
renewal of plasma, and a more effective removal of the
waste products of tissue combustion.
No man can continue healthy without exercise in some
form. Physical health requires bodily exercise. Mental
health requires recreation.
Though, as is the case with food and drink, some people
104 EXERCISE AND RECREATION
require more exercise than others, yet the complete avoid-
ance of it results in digestive and nervous disturbances,
loss of vigor, and, if continued, in organic degeneration and
disease.
The form of exercise must vary with the habits, time,
strength, means and requirements of the individual.
The best form of exercise is that which is at the same
time recreation.
This is especially the case with children. Boys must
find amusement in their exercise and it is preferable if
obtained in the form of games with other boys. For
this reason the best exercise for boys is that obtained
by playing such games as the following: — baseball, foot-
ball, tennis, cricket, lacrosse, hockey, handball and bad-
minton.
For girls: basket ball, skipping the rope, tennis, golf,
prisoner's base, head-on and the folk-dances and games are
good.
For adults the following are recommended: — Walking,
which is an exercise available to all, is of little benefit un-
less the walk is fast and far. Running is good exercise
if not carried to the point of exhaustion.
Horseback riding is one of the best forms of exercise,
calling into play all the muscles of the body, shaking up
the organs and maintaining the interest of the rider. Polo
is the king of exercises, but available to few on account of
its expense.
The games baseball, football, cricket and lacrosse are
good games for the young adult.
Bicycling, rowing, boxing, wrestling, and fencing are
good sports and capital exercise.
There are few better forms of exercise for the nimble
adult than hockey, squash and handball. For the man of
middle age the best exercises are bicycling, horseback rid-
ing, tennis, golf, swimming and badminton. All exercise
should be taken in the open air if possible. If this is im-
possible recourse may be had to chest-weights, dumb-bells,
Indian clubs and the army setting-up exercises.
For those who are unable to indulge in such active ex-
ercise, or those who require a little more of the intellectual
element in their exercise, the following are healthy forms
of recreation: — Gardening, camping, yachting and boat-
ing, botanizing, collecting of animals, birds, fish, butter-
EYE DISEASES 105
flies, insects, etc. — field work in archeology, ethnology,
paleontology, etc.
Intellectual stimulation on one hand, enjoyment of the
beauties of nature on the other hand ought to fill out
the time of recreation of every cultured person.
Those whose calling compels them to undergo bodily
exertion and exercise in the open air should rest the body
during their leisure hours, and should seek recreation par-
ticularly in intellectual stimulation, viz., in enlightened
discussion, in reading useful books, in contemplation of
works of art or in the enjoyment of good music. On the
other hand, he who is mentally occupied, and must spend
his hours of work standing or sitting in closed rooms,
should seek action for his body in his leisure hours by
suitable bodily exercise.
Social intercourse also affords congenial recreation not
injurious to health when confined within proper limits.
The exchange of thoughts with other people stimulates
the mind advantageously; the communication of our feel-
ings and experiences is a necessity for most people and
requires social conversation as well as proper interest in
the pursuits of our fellow-men.
There is a tendency to mental atrophy nowadays through
taking our intellectual amusements in a predigested form
— as in the case of many of the present day theatrical
performances of little merit. A brain should be very tired
before it should be asked to be content with diversions of
such doubtful benefit.
Eye Diseases. — Before learning anything about the dis-
eases of the eye, it is desirable for you to know the proper
names of some of the parts of the eye. The "white" of
the eye is properly called the conjunctiva; the colored part
is the iris, and the dark center of the eye is the pupil. The
pupil is really an opening in the eyeball, which allows rays
of light to pass into the eye in order to reach the back of
the eyeball where the optic nerve (the nerve you see with)
is spread out in a delicate layer called the retina. If you
look at your own eye in the looking glass, with a strong
light, you will see that the pupil is very small. This is
because the rays of light are strong and you don't need
many of them to see with. If you look at your eye in the
glass in a bad light, you will see that the pupil is much
larger — it has dilated, in fact. So you see that the iris
106 DISEASES OF THE EYE
is really a movable circular curtain, which can open and
close in order to allow as much light to pass into the eye
at any moment as is necessary for sight. The pupil is the
entrance for all rays of light, and it is protected from the
air by a transparent covering called the cornea. The
cornea is the glass window of the pupil, so to speak, and
just behind it, and behind the iris, is the lens which collects
the rays of light and focuses them on the retina.
Diseases of the Eye. — (1) The cornea is very liable to
ulcer ation and inflammation. An inflamed eye cannot bear
the light. Such trouble as this is fairly common in chil-
dren after measles. All the forms of inflammation are
roughly classed together under the heading ophthalmia
(see below), and the signs are redness, wateriness, pain,
and dislike of light. Make the child wear a green shade
over the eyes. Put a little yellow oxide of mercury oint-
ment between the eyelids twice a day. Feed the child up.
(2) A more serious form of ophthalmia is the ulceration
of the cornea, caused by tuberculous disease. A doctor
must be called in.
(3) An ulcer or sore on the eyeball coming from a slight
injury such as the scratch of a twig or a person's fingers
may be very serious indeed. A doctor must be called in to
treat it.
(4) Children with inherited syphilis are very liable to
cloudiness of the cornea. (See also " Syphilis/') The
front of the eye in these cases gets to look like ground
glass and then seldom improves.
(5) "Catarrhal Ophthalmia. "—This is a very bad "cold
in the eye. ' ' The eyes feel as if they had ' ' grit ' ' in them ;
the conjunctivas are bloodshot, the eyelids are stuck to-
gether in the morning; work is unbearable, because the
eyes cannot bear light. This ophthalmia is sometimes epi-
demic, generally in the springtime, and affects people of
all ages and both sexes. The attack lasts about a fortnight.
Treatment. — Use zinc sulphate lotion, two grains to the
ounce, several times a day. Apply yellow oxide of mer-
cury ointment, four grains to the ounce of vaseline, be-
tween the lids at bedtime ; wear a green eye shade.
(6) "Gonorrheal Ophthalmia." — This disease is caused
by bringing the pus of the venereal disease called Gonor-
rhea to the eye by the finger. It is a terrible disease and
often ends in blindness. Thousands of children are blind
ERRORS OF VISION 107
or have defective vision because their mothers have suffered
from Gonorrhea. The treatment cannot be carried out
without a doctor.
(7) "Granular Lids." — This name speaks for itself.
Among the poor it is very common to see eyelids which
are sore at the edges and seem to have been dusted over
with fine granules of sand. This disease, whether treated
or not, as a rule drags on its course for months or even
years, and the lids may become scarred and contracted,
and the eyelashes may grow inwards. Ulcers of the con-
junctiva are common then, and the sight is damaged.
(8) "Watery Eyes." — All day long, whenever you blink,
a tear comes out of the little tear gland lying at the outer
corner of the eye, and is washed across the eyeball, and
escapes down a little tube, the opening of which you can
see at the inner corner of the eye next the nose. This
little tube is called the tear-duct and leads down into the
nose. If the eye were not washed continually like that, it
would suffer from the grit and dust which are always float-
ing about in the air. Sometimes people get a "cold" or
"catarrh" in the tear-duct, and it gets more or less stopped
up for a time. So the tears cannot escape, and remain
and make the eyes "watery," especially in windy weather.
If this does not get better in a few days, a sort of stricture
of the tear-duct may develop, and then a little operation
will be necessary.
(9) "Errors of Vision." — If you cannot see as well as
other people, and if you value your sight, do not go to the
ordinary jeweler's shop, or even to the ordinary optician's,
or spectacle-seller's shop, but have your eyes properly ex-
amined by an oculist, and he will tell you not only whether
you require glasses but exactly what glasses are necessary
to correct your sight. It is a little more expensive, per-
haps, to consult an oculist than an optician, but the advice
and recipe for glasses once given, you will probably not
need to consult him again; and the eyesight is really far
too precious to trust to the tender mercies of a man who
merely wants to sell glasses, and knows nothing of eye
diseases. (The spectacle makers are, we believe, to be in-
structed in the future in the elements of the treatment of
errors of vision by means of spectacles. This will be a
real advantage to a large section of the public.) In
middle-aged persons the power of the eyes, to accommodate
108 FEVER
themselves to all kinds of vision, sizes of print, distances,
etc., etc., is gradually growing less. At from forty to
forty-five years, even persons with ordinary sight begin to
require glasses. At forty-five a person with ordinary good
sight will require glasses, called plus-one-dioptre in order
to see to read; at fifty he will require two-dioptre glasses;
at fifty-five, three-dioptre glasses, and so on for every five
years up to sixty or sixty-five. A person who has always
been ''long-sighted" will need glasses for near vision
sooner than others. Short-sighted people will not need
glasses for near vision until they are quite old.
Fainting.— When a person faints lay him on his back,
loosen the clothes round the neck and round the waist, and,
if the person be a tight-laced woman, cut her stay-laces.
Then, if in a moment or two the patient does not recover,
throw cold water on the face or put smelling-salts to the
nostrils.
Fever. — Fever is an abnormal condition of the body char-
acterized by elevated temperature, quickened respiration
and circulation, faulty secretions and increased tissue
waste ; and dependent upon a perversion of the physiological
processes which usually so balance the generation and loss
of heat that a uniform normal temperature is maintained
(98.6° F.).
Fever is caused by — (1) Local inflammations excited by
external causes, or the products of faulty metabolism (gout,
rheumatism) .
(2) The presence in the body of microorganisms, or of
toxines produced by them, as in typhoid fever, pyaemia,
diphtheria, malaria, etc. (3) Paralysis of heat-center, as
in thermic fever.
The only exact way of determining the degree of fever
is by the use of the clinical thermometer. This may be
inserted in the mouth under the tongue, under the arm-
pit, or in the rectum (the last method being the one always
employed with babies). A fever between normal or 98.6°
and 101° is considered slight; 101° to 104° moderately to
decidedly high, 104° to 106° very high; and above 106°
hyperpyretic and exceedingly dangerous.
Before beginning to treat a fever it is best, if possible, to
understand the cause. Then the specific treatment for that
special form of fever can be employed if there is one.
In addition to the specific treatment there is a general
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110 FEVER
form of treatment of fevers, which is rarely contra-indi-
cated, which is especially to be recommended in the early
stages of all febrile diseases.
This consists of rest in bed, a cool, well-ventilated room,
liquid or semi-liquid diet, a mercurial purgative such as
calomel (1 or 2 grains) or blue mass, followed by a saline
cathartic such as Epsom or Rochelle salts.
The elimination of the poisons causing the fever may
be increased by drinking an abundance of water; by in-
creasing perspiration and the fluid excretions by Dover's
powders, ammonium acetate or sweet spirits of niter.
Sponging the surface of the body with cool water, or water
and alcohol, helps to diminish body temperature through
evaporation. Among the drugs capable of reducing tem-
perature may be mentioned quinine, aconite, antipyrin,
phenacetin and acetanelid, but as the last three are coal-
tar products, which are somewhat depressing to the heat,
they should be used with caution.
As soon as a specific cause has been discovered, that cause
should be removed or the specific drug called for should
be administered. For example, if the cause of fever is an
abscess it should be opened, cleaned and drained. If the
fever is malarial, quinine should be administered ; if gouty,
colchicum ; and if rheumatic, salicylates.
Many of the infectious fevers are characterized by a
rash which develops after a more or less definite incuba-
tion period. Many of these diseases are contagious; there-
fore to prevent their spread they should be quarantined
until all danger of their transmission has passed. The
preceding table gives the duration of such a quarantine,
the incubation period of the disease, the character, time of
appearance and duration of the rash and the duration of
the illness.
Diphtheria is usually quarantined four weeks, if con-
valescence be complete, and no sore throat, albuminuria
or discharges remain; and bacteriological examination of
the throat is on two consecutive occasions negative.
Whooping Cough is quarantined five weeks from the
commencement of the whooping, if the characteristic spas-
modic cough and whooping have ceased. Earlier if all
cough be gone.
Mumps are quarantined three weeks, if all swelling has
subsided.
FITS AND "INWARD FITS" 111
Fits, and "Inward Fits." — Infants are specially liable to
have what mothers call fits; some uneducated mothers say
that besides real fits, babies have inward fits. By this
latter name they generally mean the grimaces seen on
babies' faces when they are suffering from indigestion, and
have stomach-ache and wind in the stomach and bowels.
Real fits are attacks of convulsions, and the presence of
convulsions is shown by violent, sudden, and involuntary
twitching of the limbs, clenching of the jaws, and rolling
of the eyeballs. In some cases all the muscles are affected,
while in others the face only is convulsed, or the limbs
only. In full-grown persons the only fits of convulsions
are those due to epilepsy — a well-recognized, chronic dis-
ease, which renders a sufferer liable to convulsive attacks
at uncertain intervals; and fits occurring at the close of
blood poisoning from kidney disease, or resulting from an
apoplexy due to bleeding on the brain. (See ''Apoplexy.")
In childhood, however, fits of convulsions are quite com-
mon, and may be fatal, without showing an epileptic consti-
tution.
Causes: — Such fits may be started by the onset of fevers,
or of inflammations of the lungs or kidneys, or by any
irritation within the body, or on the skin; for example,
curdled milk in the stomach, a biscuit food if given at too
early an age, colic, diarrhea, ulcers, coughs, and skin dis-
eases may all set up a series of fits; and so many slight
operations, such as vaccination, or the application of caustic
to a wart, or tying a thread around a birthmark, or circum-
cision. Convulsions or fits are dangerous to life by affect-
ing the windpipe and so causing suffocation by spasm;
convulsions of the muscles around the chest may so hinder
the breathing as to cause death; and spasm of the heart
leads to fainting and instant death. The occurrence of a
fit may point out the presence of disordered digestion, and
so lead to prompt treatment of the stomach and bowels,
which, under artificial feeding by the bottle or teaspoon
with cow's or goat's milk, or with condensed milk, is much
more common than when an infant is suckled. When
starchy foods, such as arrowroot, maizena, cornflour, baked
wheat flour, or biscuit are given with milk to infants, there
is always a risk of the occurrence of convulsions until a
baby is six months old or older, because until that age is
reached the juices of the stomach are unable to digest
112 FLIES
starch, and the food gets into hard lumps, which do not
dissolve. The cutting of teeth in infancy is the other most
common cause of fits, and, because it causes so much pain
and disorder to the nervous system, it is always wise to
take special care of children when teething; but in any
case of convulsive fits, send at once for a doctor.
Flies. — Housekeepers have for a long time considered flies
as a necessary nuisance. More or less attempt has been
made by many to keep them out of the house by screens
or to kill them by means of fly paper, but this was done
principally because they soiled the picture frames or the
chandelier, or because they were annoying when they set-
tled on the hands or face. Physicians and health officers,
however, have come to the conclusion that the common,
ordinary domestic fly that we have tolerated for so long,
is not only one of the most disgusting and filthy things
imaginable, but, what is worse, is probably the cause of
much sickness and many deaths.
The fly is usually born in a 'manure pile. Garbage, dead
animals, and refuse of all kinds is selected by the female
fly as a suitable place for breeding.
The fly is not at all particular as to his food; he likes
milk and cake and most all the kinds of food people eat,
but he can also be seen enjoying a hearty meal off the
contents of a privy vault, off the expectoration from a con-
sumptive, the discharges from sores on animals and men,
and many other equally repulsive substances.
The dirty habits of the fly ought to be enough to disgust
anyone and make him a determined enemy of the pest;
but, to make matters worse, the fly's liking for these re-
pulsive things makes him a positive source of danger. The
food of a fly is not served on a diminutive plate, but he
steps right into it ; and he not only eats all that he wants,
but he gets his legs and body and wings more or less
covered with whatever filth he is eating. And the filth
he so often chooses contains myriads of germs of disease.
By use of the microscope it has been shown that on a
single fly there may be as many as 6,500,000 bacteria or
germs; the average number is probably about 1,250,000.
These are not all disease germs, for there are bacteria that
are harmless ; but a few typhoid germs from a privy vault,
or tubercle bacilli from a cuspidor or from an expectora-
tion on the ground, or a small number of germs of diar-
FIIES 113
rheal disease from the sewage-soiled bank of a stream are
enough to cause fatal illness.
And some of the filth and germs on the legs of the fly
are going to be deposited on the very next thing he settles
on; it may be milk in the pitcher or pail, it may be the
fruit or vegetables exposed for sale, it may be the bread
or cake, it may be the nipple of the baby's bottle, or it
may be the lips or face of the child as it lies asleep.
The many cases of typhoid fever that occurred among
the American soldiers in the various camps at the time of
the Spanish war were mainly due to the flies which had
access both to the bowel and bladder discharge of the sol-
diers and to their food.
Other diseases which may be transmitted by the flies are
summer diarrhea, infantile paralysis, cerebro-spinal men-
ingitis, tuberculosis, trachoma, septicaemia, erysipelas,
cholera, plague, anthrax and the intestinal parasites such
as tapeworms (through contamination of food by the eggs).
The fly is more, then, than a mere nuisance; it is a
positive enemy to life and health and must be exterminated.
And everyone must join in and do his share in this work.
We must all try to stop the breeding of flies, and we must
all do all we can to kill those that are born and to prevent
them from carrying disease.
The life cycle of the fly. — The eggs of the fly are de-
posited upon putrefactive animal or vegetable matter.
From the eggs emerge the larvae or maggots, which feed
upon the decaying material. After a variable number of
days, they shut themselves into their skin, forming a hard
case (puparium) around themselves, from which they
emerge, by a marvelous transformation, as winged insects.
A single fly lays 120 to 140 eggs; the larvae or maggots
leave the eggs at the earliest eight hours after laying;
they mature in five to eight days, then pupate; the pupae
mature in five to seven days, the cycle from egg to fly
requiring at least ten days.
All stable manure and filth should be kept in a vault or
pit from which flies are shut out by screens, and lime
should be sprinkled freely and frequently over the contents
of the pit. This will not injure the value of the manure
as fertilizer, but it will stop the breeding of flies. As
ninety-eight flies out of every hundred are born in a ma-
nure pile, this ought to do away with a vast number of
114 FOMENTATIONS
flies, and it is the most important measure in the war of
extermination. It is well to bear in mind, too, that it
takes ten days for the fly to develop from the egg; so if
manure is removed about once a week and spaded into the
ground, flies in process of development will be destroyed
before they reach maturity.
The other places in which flies breed must also be looked
after. Garbage should be kept in a covered receptacle,
and no refuse should be allowed to collect where flies can
get at it. Dead animals should be promptly removed and
buried or burned.
Privy vaults should be so constructed as to exclude flies.
Openings for ventilation, etc., should be screened with
wire or mosquito netting, and all cracks in the walls or
openings under the bottom should be closed.
Doors and windows of houses should be screened, espe-
cially in the kitchen and dining-room, and any room in
which there is a case of sickness. And care should be
taken to see that the screens fit accurately, and that they
are always in place, and that screen doors are not left
ajar or held open. If wire screens cannot be afforded flies
can be kept out by cotton mosquito netting tacked over the
windows. A piece of netting containing sixteen square
yards can be bought for half-a-dollar.
Flies that do get into the house should be chased and
killed, or should be caught by fly paper, etc. All dead flies
should be promptly burned.
Don't ~buy food exposed for sale in places where flies can
get to it.
Our houses are not the only places where fly screens
should be used. Slaughterhouses, butcher shops, markets,
candy stores, grocery stores, bakeries, and the wagons of
food peddlers of all kinds — every place where any kind of
food is handled or sold — should be screened. Flies should
never be allowed to come in contact with anything that is
to be eaten.
Fomentations are, on the whole, better than poultices.
They are made with flannel or lint, or boric lint — best of
all. The lint is wrung out of boiling water in which poppy
heads have been soaking. To wring out warm cloths with
the hands is quite impossible, if the fomentation is to be
as hot as it ought to be, and in the process of wringing
much heat is lost. So in every household there ought to
FOODSTUFFS EXPOSED TO DIRT 115
be a wringer, which is thus made: — Take a towel, or a
piece of coarse towelling, or a piece of bed ticking, twelve
inches wide and thirty inches long. Make a hem at each
end wide enough to form a channel for a stick of about
eighteen inches long. Two pieces of broomstick will do
nicely. To use the wringer, put it, with the fomentation
lint folded into a pad on it, in boiling water, or else pour
boiling water on to it, and then seize the sticks, twist them
in opposite directions so as to squeeze all superfluous water •
out of the fomentation. Untwist it again rapidly, seize the
fomentation, smooth it out, place it on the body, cover it
with a bit of oil-silk, and then a pad of cotton-wool and a
bandage. Apply another fomentation before the first gets
cold.
Foodstuffs Exposed to Street Dust and Dirt. — Foodstuffs
exposed on the streets may become contaminated by dust
(see "Dust") and flies (see "Flies") and consequently a
source of disease when eaten in the uncooked state.
Regulations such as the following are now enforced by
many boards of health and should do much to ensure the
safety of our food supply.
A. The following are prohibited from being displayed
for sale outside any premises or in any street or public
place unless covered so as to be protected from dirt, flies
and other contamination.
1. Pastry — bread, pies, rolls, cake.
2. Sliced fresh fruit, such as watermelon and oranges
when cut open.
3. Dried or preserved fruits — dates and figs.
4. Candies or confectionery (does not include candy
exposed for sale when wrapped in paper).
5. Perishable food products which are not pared, peeled
or cooked before consumption, which includes : (a) Plums ;
(b) Berries; (c) Grapes.
B. The following shall not be hung or exposed for sale
in any street or outside of any shop or store or in any
open windows or doorways thereof:
1. Meat.
2. Poultry.
3. Game (except rabbits).
4. Fish.
C. The body of any animal, or any part thereof, used
for human food shall not be carted or carried through the
116 GAIT AND APPEARANCE
streets unless covered so as to be protected from dust and
dirt.
Gait and Appearance. — Every doctor cultivates as much,
as possible the faculty of observation. He is called in
to a patient and has patiently to listen to a long rigmarole
of complaints and description of illness, and he has to ar-
range what he has learned in a methodical way, asking
questions to fill up the blanks in the information given,
and at last he makes up his mind what is wrong with the
patient and decides what treatment will do him good.
But the clever doctor has more to do than that. He has to
notice that, very often in the case of women patients, the
account given is not quite truthful. Willfully or igno-
rantly the sick person has misrepresented or exaggerated
something. So, all the time that the talking is going on,
the doctor observes little details, and draws his conclusions
far more from what he sees than from what he hears. When
a patient approaches a doctor in his consulting room, he
walks towards him, and from his very gait and appearance
there may be a great deal to be learned. Sometimes it is
possible to "diagnose" a disease at the first sight of a
patient, just as you can diagnose a cold in the head from
seeing a person with watery eyes using his handkerchief
to blow his nose ! Note the elastic confident tread of a man
in good health; the shambling gait of the public-house
loafer; the dragging of the feet in people who are tired.
If a child cannot walk when it is a year and six months
old, you can safely diagnose stupidity, paralysis, or rickets.
A child with St. Vitus' dance walks jerkily and oddly, and
perhaps twitches with hands and face at the same time.
In paralysis agitans, the trembling palsy seen sometimes in
old age, the person totters along, getting quicker as he goes,
and at last is unable to stop himself except by running
against a chair or wall. His steps are all very short.
In locomotor ataxia the patient looks to see where he is
putting his feet; he lifts his foot high in the air in order
to be sure to clear the ground, and brings it down on the
pavement again with force. When he tries to turn sud-
denly, he nearly falls down; he cannot walk unless he can
see his feet. In alcoholic paralysis the foot is "dropped"
and it has to be lifted high in order to clear the ground
and the knee is much bent. In flat foot the person walks
with his toes turned out. The person with hip-joint dis-
GENERAL PARALYSIS 117
ease takes a long step with the sound leg and swings round
the other one, thus walking lopsided.
Gallstones. — A gallstone is a little dried-up mass of
bile-materials which forms in the gall bladder. When the
stone is pressed through the gall tube into the intestine,
it is sometimes too large to pass easily, and causes violent
colic in the belly, which continues until it gets out of the
narrow tube into the gut. The main symptom is intense
pain on the right side, occurring in spasms.
It must be carefully differentiated from appendicitis,
which occurs lower down on the right side.
The most common causes are sedentary habits, a rich
diet, and diseases of the liver and bile ducts — and not
infrequently following typhoid fever. The pain is fre-
quently accompanied by a well-marked jaundice.
Hot fomentations may sometimes relieve the pain., but
morphine may be necessary.
An attack of gallstone colic may terminate at any time
in a surgical condition demanding operation, therefore a
physician should always be summoned during such an
attack.
The medical treatment consists of a regulated diet,
largely vegetable, and systematic exercise between attacks.
Mineral waters, sodium phosphate, calomel or podophyllin,
and salol or urotropin are useful drugs.
Gangrene, or Mortification. — This name is given to the
death of a part, as of a finger, or of a foot, or of a portion
of flesh in a wound. It follows very severe local injuries,
when the blood supply is stopped by the tearing or wound-
ing of arteries and veins ; the same results occur when the
blood vessels are blocked by firm clots, as sometimes occurs
in weakly, aged persons. Gangrene may be of the dry
form in which the parts wither up, or "slough," or of the
moist form, in which the parts become a sodden decaying
mass. The gangrene may lead to blood poisoning and
death, but there may be a chance of prolonging life if the
part affected can be removed by the knife — (amputation).
General Paralysis. — This disease is nowadays treated in
asylums, and the sooner the afflicted person gets off to
where he can be suitably looked after the better for every-
body. The disease begins generally in the thirties. The
average age of death is forty. It affects all classes, espe-
cially of townspeople, men oftener than women. The most
118 GIDDINESS
important cause is "Syphilis" (which see), and other
causes are mental worry, overwork, alcoholism, and head
injury. It would be useless in a book like this, to give a
long account of the disease, and, as it is incurable, nothing
need be said about treatment. The earlier signs by which
the disease may be known are : —
(1) Changed mental condition — jealousy, bad temper,
fancies, illusions, delusions, loss of memory, ex-
travagance of ideas, filthy and degrading habits.
The patient sometimes shows the first sign of
the disease when he goes to a shop and orders
quantities of things he does not want and cannot
pay for. Also, when he brags about his mil-
lions of money and watches and jewels when he
is really poor.
(2) Later, the pupils of the eyes are seen to be un-
equal, he loses the power to write, etc., and at
last becomes helpless and bedridden.
Giddiness. — The medical name for this ailment is vertigo,
it is derived from a Latin word meaning to turn round,
and the principal feature of giddiness is a sensation that
the room and objects around are turning round you, not
that you yourself are turning round.
Giddiness may be only occasionally felt, and it may come
on quite suddenly, and may as quickly disappear, or it may
occur and not be got rid of for hours or days. It may
occur as the only symptom of ill-health, or it may be asso-
ciated with headache, and nausea, or sickness.
Giddiness is certainly a symptom due to a momentary
fault in the circulation in the brain, and may, of course,
be due to actual brain disease, but in general the cause
of giddiness is to be found in disturbances of the digestive
organs, and particularly from biliousness and other liver
troubles.
One form of giddiness can be brought on intentionally
by many persons, by turning round quickly while standing
upon one heel, or by waltzing ; many others feel giddy when
on the moving deck of a vessel at sea; others, again, feel
giddy when looking down from a high place, or over a
precipice.
Nervous persons who have had one real attack are apt
GLANDS, SWOLLEN 119
to fancy they feel it coming on again; in severe cases of
nervous debility patients may feel giddy whenever they
get up from their beds or from their seats ; others are afraid
to cross open spaces for fear of falling.
Giddiness is commonly felt by patients who have lost
much blood, or who are exhausted by fever or any wasting
illness. Anaemic girls, pale from want of sufficient healthy
blood, are subject to attacks of giddiness.
This ailment is also related to epilepsy, for when such
sufferers have passed through an attack or epileptic fit,
they tell you it began by a giddy feeling.
Persons who are very robust, who eat much more than
they need, and are too full-blooded, are subject to giddiness.
Certain peculiar defects of eyesight lead to this unpleasant
symptom, and there is a disease of the internal ear, called
Meniere's Disease, in which giddiness is associated with
deafness.
The poisonous principles of tobacco produce a giddy
feeling in persons who are attempting to smoke for the
first few times, and, of course, everyone knows that alco-
holic drinks taken to excess, cause such giddiness as to
make men stagger and fall down.
In general we may say that if a person in good ordinary
health becomes giddy, the safest remedy to employ is a
thorough good purgative dose of sulphate of magnesia in
water.
Glands, Swollen. — When an enlarged gland is formed on
a person who is in good health, we may be fairly sure that
the swelling is curable, because its cause is not, as a rule,
far to seek, and can be removed. Enlarged glands occur
in certain situations. These are chiefly, the neck below the
jaw, and just below the ear, the groins, the armpits and
just above the elbows.
Now in each of these situations there are groups of
" glands" which are called "lymphatic glands" in which
the blood circulates, and in which the blood undergoes
certain changes, fitting it for recirculation. If you cut
or scratch your finger or foot with a dirty instrument or
pin, the poison enters the skin through the wound, goes
into the blood, and is carried upwards towards the body.
If the poison could get into the body (or, when it does)
you become ill for a time. But if you are in good health
the set of glands which lie between the cut or wound and
120 GOITER, OR DERBYSHIRE NECK
the heart try their best to stop the poison, and to destroy
it there. But if the poison is too much for them, then the
glands begin to swell from the irritation of the poison,
and get red, hot, and inflamed. As a fact the inflammation
is Nature's way of getting rid of the poison. Ear disease,
decayed teeth, enlarged tonsils, and vermin may all cause
the neck glands to be swollen. The cause must, of course,
be dealt with in every case.
Enlarged glands in the groin are produced by gonor-
rhea, syphilis, and by the poison from a sore place on the
leg or foot.
A swollen gland or ' ' bubo ' ' will very often get better by
itself, especially if poulticed. But often it becomes an ab-
scess, and then the matter or pus must be let out by a cut
with a surgeon's knife. It must not be forgotten that
persons with consumptive tendencies are most liable to
enlarged glands and these must be dealt with according to
the case. Sometimes it is wise to leave them alone and
they will gradually disappear. At other times they will
have to be dissected out, or scraped out, according to their
condition. In all cases cleanliness must be observed, sores
must be healed, and decayed teeth must be attended to.
(See also " Abscess.")
Goiter, or Derbyshire Neck (See also " Cretinism").—
By goiter is meant a swelling in the thyroid gland, an
organ lying on the front of the neck ; in health it is neither
seen nor felt, being very small and soft, but in goiter it
may swell up to a very large size, making a huge, bulging
tumor (on one or both sides of the middle line), which is
not painful, nor hot, nor inflamed. It grows gradually
and has but little tendency to go away, unless it is con-
tinuously treated; it is apt to appear first in childhood
from 7 to 12 years old, and may last a lifetime without
causing serious illness. It is most common in people who
live in valleys among mountains, and may be due to habit-
ual drinking of very hard water.
In treatment, the first requisite is to remove the patient
from the locality where the goiter has started, if it be one
where cases are of frequent occurrence; in all cases, how-
ever, change of air, scene, climate, and food are desirable.
Put the patient under the most healthy conditions, and
with plenty of open-air exercise and good food. The most
successful remedy is iodine given internally in many forms,
GONORRHEA 121
such as iodide of sodium, iodide of potassium, or iodide of
iron, together with the external application of iodine oint-
ment or a mercurial ointment. Of recent years it has been
found that many cases improve when treated by doses of
the extract of the thyroid gland of the sheep ; this can now
be obtained in many forms, as a liquid medicine, or as a
powder or pills or tabloids.
Another form of goiter is that commonly called Grave's
disease, and in this case the disease has no relation to
climate, soil or water, and is accompanied by a peculiar
state of the heart and great blood vessels. The swollen
neck is associated with protruding eyeballs which give a
most notable appearance to the face, and yet the eyeballs
are in no way diseased; there are also present a highly
nervous state, shortness of breath and palpitation of the
heart with throbbing in the blood vessels. This disease
is also called "Exophthalmic goiter." It can be in no
way treated by domestic remedies with any hope of giving
relief.
Gonorrhea. — Gonorrhea is a disease which one is ex-
ceedingly liable to contract upon departing from the moral
mode of living. It is readily transmitted from one sex
to the other and among married people may thus be trans-
mitted from the guilty to the innocent. It is a cause of a
large part of the pelvic inflammatory conditions for which
women require surgical operations and is the cause of a
great deal of misery in the world.
The most important thing to remember about gonorrhea
is that until it is entirely cured it can be readily trans-
mitted.
In this disease, in the male, there is an inflammation of
the urethra (the pipe for the passing of the urine), which
gives rise to severe pain and smarting, especially on pass-
ing water, and very often to much general illness as well;
fever, loss of appetite and weakness, in addition to the
continual discharge of pus from the pipe. The disease is
often the starting point of months or years of severe ill-
ness and pain. Most cases are curable by the surgeon,
especially if the treatment be conscientiously carried out,
but many half-cured cases get tired of being doctored,
return to their immoral ways and are a real menace to
society, to themselves, and to future generations.
The disease, in man, has dozens of possible complications.
122 GOUT
Among the more serious ones are stricture, bladder disease,
abscess of the kidney, ophthalmia which may lead to blind-
ness, and gonorrhea! rheumatism. This last disease, which
occasionally affects women also, is in many cases incurable,
and in all cases very difficult to treat.
Gout. — This is a very large subject, and it is difficult to
know where to begin to discuss it. It is pretty certain
that the word ought to be used to mean a very large group
of symptoms, such as are referred to under such loose
expressions as "goutiness," " gouty tendency," and the
like. We are obliged to say that, notwithstanding the
immense amount of research and study which have been
devoted to gout, we are not much nearer a thorough under-
standing of how it is caused. We know more about how
to guard against it, and how to treat it. But it is so mixed
up, in many cases, with something of a rheumatic nature,
that it is hard to cure, and sometimes even very hard to
relieve. The word gout comes from the French word
goutee (a drop), and from the Latin word gutta (a drop) ;
and we are still obliged to say (as the old Romans and
Greeks did) that gout is the result of the gradual deposits
of drops of some material in the joints and elsewhere. We
now know that the material is called bi-urate of sodium
(a chemical substance derived from uric acid), and we
know that it is deposited as a result of some defect in the
kidneys which prevents their getting rid of some of the
waste matters in the blood. But this defect is also con-
sidered to be a result of something wrong with the nervous
apparatus of the body. Gout, in fact, is a nervous disease
(in one sense), characterized by defective action of the
kidneys and hence in storing-up of waste matters in the
body.
Causes. — The people who have gout are mostly those who
— in the first place — have what doctors call a neurotic
family history (see " Neurosis"), and, in the second place,
those whose kidneys are not equal to the strain of getting
rid of waste matters from the food. Men are more liable
to gout than women ; but, perhaps, women are more apt to
have "rheumatic gout."
Note that the heredity of this disease is so strong that
many persons who are and always have been strictly tem-
perate and moral and careful, yet suffer from gout. But
no doubt, a steady life in a gouty subject makes it unlikely
GOUT 123
that he will be troubled much with gouty attacks. Paint-
ers and plumbers are liable to be gouty, because lead
poisoning is apt to cause the disease.
The two chief varieties of acute gout are — regular gout,
which is gouty swelling of a joint, and irregular gout, which
is gouty pain and inflammation of some other part of the
body.
Signs of an attack of gout in a joint. — Many people get
a warning that there is going to be an attack, a day or two
before. Such warning may be — wind in the stomach, numb-
ness of fingers and toes, irritability of temper; sometimes
patients feel livelier than usual. The patient goes to bed
all right, and wakes up in the night, shivering and fever-
ish, just before an attack, with violent pain in a joint —
generally the big-toe joint.
The gouty joint is so tender and so painful that the
patient cannot bear the weight of the bedclothes, and hates
to be touched. The skin over the joint is red, tight, and
shiny. After a few hours the pain abates, and is better
during the daytime; but comes on again next night; thus
continuing for about ten days. Then the skin over the joint
gets paler and peels off. While the attack is going on the
patient is very bad-tempered, thirsty and dyspeptic. After
it is over he feels better than he has done for years. Then,
sooner or later, another attack comes.
Treatment for an attack : —
(1) Send for the doctor.
(2) Don't use arnica, or poultices, or ice for a gouty
joint.
(3) If the pain is bearable, wrap up the joint in
plenty of cotton-wool, covered with oil-silk, and lightly
bandaged.
(4) Otherwise, put the feet in a hot foot bath of
water in which are several poppy heads (obtainable
from the chemist). Or apply Baume Analgesique
Bengue to the joint and wrap it up in gauze or flannel.
Keep the part elevated.
(5) Let the sufferer send out for an ounce of colchi-
cum wine and let him take 40 drops of it at once in a
wineglassful of water. He will have to go on taking
colchicum in some form or other for some time; but
colchicum has a certain depressing effect on the heart,
124 GROG BLOSSOMS
and no sensible man will take it without being super-
vised by his doctor. We only recommend him to take
those 40 minims in case the doctor might be delayed.
(6) Diet to be very light — do not give concentrated
meat essences.
Signs of Chronic Gout. — Dyspepsia, stone in the kidney,
swollen and knobby finger and toe joints with lumps of
chalkstones, skin eruptions, irritable heart, muscular pains,
etc.
Treatment of a gouty tendency. — In young men gout is
avoidable and curable, especially if they become teetotalers.
There must be no greediness, nor gormandizing, and, in
fact, the less meat and pastry gouty people eat, the better
for them. Indolent habits are to be given up. Lots of ex-
ercise must be taken. Everybody who fears gout should
take a heaped-up teaspoonful of phosphate of soda, and
wash it down with a pint of clean water, every morning of
his life, before breakfast. When a person has all sorts of
pains and aches due to goutiness, he must be more careful
with his diet, and he may take the following medicine : —
Bicarbonate of potassium, 6 drachms; iodide of potassium,
2 drachms; colchicum wine, 2 fluid drachms; camphor
water, to 12 ounces (mix). Take a tablespoonful of this
mixture, thrice daily, in a wineglassful of water, after meals.
Grog Blossoms. — We should be very careful how we use
this vulgar and unscientific name of the disease which doc-
tors call "Rosacea," for though drink is often the cause
of it, or at least, the circumstance which keeps it up, yet
"grog blossoms" are occasionally seen on the faces of per-
sons who claim to be quite temperate and even teetotal.
At first the red flush comes on just after eating or after
exposure to the cold. Many women get red noses in the
open air on a cold day. If it gets worse the whole of the
middle part of the face, cheeks and nose, get permanently
red and the little blood vessels of the surface of the skin
get enlarged and visible. After a time this too-great nour-
ishment of the skin of the nose causes the skin glands to
overwork themselves, and so the skin gets shiny and greasy
and scaly as well as red. Then the skin, if at all coarse in
texture, gets covered with holes and pimples, and this con-
dition has given rise to the vulgar word "grog blossoms."
In cabmen and men who are prone to drink raw spirits
HAIRDRESSERS 125
after much exposure to the open air, the skin now begins
to thicken, and perhaps to sprout into little lobules and
bulbs and knobs of fat. But there are unfortunate people
who never touch alcohol at all who get rosacea as a result
of chronic indigestion, or again it may be a personal pe-
culiarity, inherited from the parents. Even well-brought
up women get rosacea from exposure to the air and feeble-
ness of circulation.
The treatment is not hopeless if the patient will go with-
out alcohol for always, and give up tea and coffee until
cured. The doctor must be consulted to put the patient's
stomach in good order. After that, the sufferer from a red
nose is to take a 5-grain tabloid of ichthyol before breakfast
and before retiring to bed. After a fortnight the dose is
to be increased to eight grains, and after three weeks to ten
grains, until the case is cured. This is to be combined with
the local application of alkaline spirits of soap to the nose
and cheeks at bedtime, or by using ichthyol ointment.
Gumboil. — A spot of inflammation, leading on to the for-
mation of an abscess, and commencing near the fang of a
decayed tooth. The gum is a very dense, hard structure,
and the growth of the abscess causes great pain; it forms
a red, tender swelling on the gum and may burst alongside
the tooth, or through the gum, or in the cheek. Give a
brisk purgative such as a dose of salts and senna, and get
a dentist to open up the hollow tooth or to lance the gum;
if this is not desired, some slight relief may be gained from
holding hot water in the mouth, or applying a few drops
of laudanum and spirit of camphor on cotton-wool to the
gum, or by hot poultices to the cheek. Gumboils often
recur and when this happens removal of the tooth is the
only remedy.
Hairdressers, Hints to. — In some parts of Europe the
government authorities compel all hairdressers and barbers
thoroughly to disinfect all instruments and brushes imme-
diately after use.
If such excellent regulations were in force in this coun-
try we should soon hear no more of diseases contracted by
people in hairdressers' shops. Among the diseases spread,
partly in ignorance, partly by lack of thoroughness in
cleanly precautions, by hairdressers and barbers among
their customers, are Barbers' Itch (which see), different
forms of ringworm, boils, acne, itch, impetigo and others.
126 HAIRDRESSERS
Of course, the self-respecting barber in this country also
uses disinfectants, and is as thorough in his cleanliness as
he knows how to be ; but sometimes, from ignorance of the
diseases in question, he does not know how properly to
guard against them. We have therefore drawn up a few
rules for the guidance of hairdressers in this matter of
the hygiene of the toilet.
(1) Everything in the shop ought to be thoroughly
cleaned at the beginning of the working day. Not only
must the rooms be swept out with a broom (that only re-
distributes some of the small dust and hair on the floor) ;
but a mop ought to be used after the broom, and the mop
ought to be kept in a bucket containing a lotion made
thus: — Dissolve one-eighth grain soloid of corrosive subli-
mate in a quart of water. Renew this lotion twice a week
at least, and use it on the mop for disinfecting the dust
on the floor everywhere. In addition to this, all seats and
chairs and chair-backs should be sponged thoroughly with
this powerful germicide lotion, and all basins, tubes, and
taps also.
(2) All the barber's assistants should wear white cotton
washable jackets with short sleeves, and no frayed cuffs
beneath. All assistants should be required to wash their
hands and arms in carbolic soap 5 per cent., and to keep
the nails short and polished and clean. Nails should never
be cleaned with a knife or steel pick, but with a nailbrush
which is kept always in a little tray of lotion.
(3) Shaving brushes are peculiarly liable to convey con-
tagious diseases unless kept quite clean. They ought to be
washed in a corrosive sublimate lotion after every using.
Trays, like those used by photographers for developing
plates, should stand on the sideboard, half-full of boric
lotion, and all scissors, clippers, and razors ought to lie in
the lotion until just before use. Boric lotion does not
rust steel instruments. It is made by dissolving a boric
acid carton in a pint of boiling water. Some hairdressers
dip the razor into hot water just before use, but the
water must be boiling if it is to be of any special antiseptic
use.
(4) The soap used is important, but the choice of it must
be left to the individual barber. Be careful only not to
use the same cake of soap for a spotty chin and a healthy
skin in succession. The most hygienic way is to use one of
HAIR, CARE OF 127
the soap-powder preparations, so as to have absolutely fresh
soap for each customer.
(5) After shaving, the razor should be wiped on a wash-
able india-rubber slab or tray, as is already done in many
places. A spotty chin should then be sprayed with the
weak corrosive sublimate lotion above mentioned, with a
few drops of scent in it, and a small square serviette may
be used to wipe dry. The powder afterwards applied
should be made of equal parts of talc, zinc oxide, and
starch.
(6) Combs used after hair-cutting should be disinfected,
and brushes should be washed with 5 per cent, carbolic soap.
(7) Hairdressers who adopt these thorough measures
should take care to advertise the fact in their windows.
Hair, How to take Care of. — (1) Use little grease or po-
matum on your hair, unless your health is not good and
the hair is brittle and splits at the ends. Then you can
use a little pure olive oil which is to be rubbed on to the
scalp and not just smeared over the hair.
(2) No animal fat or lard or lamb's- wool ointment should
be used on the scalp. It only irritates the skin as it be-
comes rancid, and causes scurf.
(3) Don't wash the head with frequent irrigations of
cold water. Nothing so soon makes the hair gray and
scanty.
(4) To wash the head, make a lotion of a teaspoonful of
ammonia to a quart of hot rain water, and add two table-
spoonfuls of soft soap. A lump of carbonate of soda will
do instead of the soft soap if you prefer it. After washing
the hair, dry it very thoroughly on a rough towel — not a
Turkish bath towel, full of fluff. If your hair is fair, that
method will suit it well. But if your hair is dark, use the
yolk of an egg beaten up with borax and rain water.
(5) For thin, scanty hair. — Quinine sulphate, 1 drachm;
dilute sulphuric acid, 15 minims ; rectified spirit, 2 ounces ;
rose water, 8 ounces — mix, and add glycerin, 2 drachms;
— mix and shake well. Use this lotion, rubbed in the scalp,
twice a day.
(6) For thin, scanty dark hair. — Take of good black tea-
leaves, 1 ounce; add boiling water, 1 pint. Infi se in a
teapot. Leave to cool. Strain off the infusion, <md add
to it, Jamaica rum, 3 fluid ounces. Rub some into the roots
of the hair with a piece of rag, morning and evening.
128 HAIR, CAKE OF
(7) The color of hair is due to mineral pigments. Very
fair hair contains magnesia, and fair hair often remains
unchanged, even in old age. Brown and chestnut locks
contain sulphur, and a little iron; black hair pigment is
rich in iron. Gray and white hair have no iron and very
little sulphur. Therefore, most hair restorers and dyes
contain iron and sulphur. But all ordinary shop-sold dyes
are apt to be unsafe, and may have poisonous minerals in
them which will at last make the hair and scalp decay.
There is, in fact, no really satisfactory hair dye, as far
as we know.
(8) Greasy lank hair may be made somewhat dryer and
curlier by the use of such lotion as this: — Bicarbonate of
soda powder, 2 drachms; borax powder, 2 drachms; eau-
de-cologne, 1 fluid ounce ; rectified spirit, 2 ounces ; tincture
of cochineal, 4 fluid drachms; distilled water, 16 ounces.
(Mix and shake.)
(9) For dry, stubby hair, instead of grease or pomade,
use: — Eau-de-cologne, 8 ounces; tincture of cantharides, 1
ounce; oil of English lavender, 15 drops; oil of rosemary,
20 drops. (Make a lotion to be rubbed well into both hair
and scalp.)
(10) After an illness your hair may come out in hand-
fuls. To remedy this, cut it quite short and keep it so for
a year, using the lotion given above in paragraph (5).
This plan enables both air and light to get down to the
scalp and enables you to employ friction of the scalp with
a wire brush. Use no grease.
(11) Shampoo, for scurfy heads : — Yolk of an egg, a pint
of rain water, an ounce of spirit of rosemary. (Mix and
warm before using.)
(12) "Silver hairs among the gold." — A few gray hairs
appearing in a youth show that the scalp is badly nourished.
Get the doctor to prescribe you an iron tonic, and use cheap
claret as a weekly head wash.
(13) To make the hair curly. — All shop-sold prepara-
tions for this purpose are risky to use. The following
"curling fluid" is free from objections: — Carbonate of
potassium, 12 grains; warm water, made soapy, one pint.
(Disso]ve. — Stir up into a froth, damp the hair brush with
it and brush the hair thoroughly at bedtime, with the wet
brush. Then curl up the hair on rollers of wire and kid
[such as all first-rate hairdressers keep for sale]. In the
HANGING 129
morning the curliness of the hair will outlast even rainy
weather to some extent.)
Never use crimping-irons, they only destroy the hair at
last.
Hair, Loss of.— (See "Baldness.")
Hairs, Superfluous. — Superfluous hairs on the faces of
women are a fruitful source of profit to skin doctors,
beauty doctors (so called), chemists, and hairdressers.
Electrolysis (or the removal of hairs by electricity) can
only be done by specialists. Perhaps as many as twenty
hairs may be removed at one sitting. There is only one
class of chemicals which may help in the matter — caustic
alkalies, in combination with sulphides, and these are dan-
gerous. A paste is made thus: — Quicklime, 16 oz. ; pearl-
ash, 2 oz. ; liver of sulphur, 2 oz. These are mixed and
finely powdered, and enough water is added, as required,
to make a paste. The paste is spread thickly on the skin
for three minutes, then it is scraped off with a bone paper
knife, and cold cream is applied instead. The lip or chin
thus treated will, perhaps, itch, grow red, and smart. The
epidermis is removed. The hairy, downy growth is all gone.
But the hair bulbs, deep down in the skin, remain, and later
on a fresh crop of hair comes up, as if nothing had been
done. A German physician has made a liquid depilatory.
Here it is: — Tincture of iodine (1 in 10), half a drachm;
Venice turpentine, 1 drachm ; castor oil, 1% drachms ; recti-
fied spirit, 1% oz. ; collodion, 6 oz. — Mix. This is painted on
the part at night, and next morning the film is peeled off;
and the hairs if they behave themselves properly, come up
by the roots. But sores may be left, and they are difficult
to heal. No one should try such experiments except under
skilled advice.
Hanging. — If ever you come across a person who has
hanged himself or herself, or who has been hanged by
someone else — that is, if ever you see a body hanging by
the neck — get a knife or scissors and cut the body down.
Don't lose your presence of mind; don't be foolish enough
to stand horror-stricken, or to rush away and whisper the
awful fact to somebody else. This kind of foolishness is,
unfortunately, common enough in cases of hanging, but let
the reader of this book be more sensible.
Cut the body down. — (Many a criminal or highwayman
in the old days was cut down by his friends and brought
130 HAY FEVER
back to life again, even after half-an-hour 's suspension.)
When you have cut it down, loosen the noose round the
neck and perform "artificial respiration," as described
under "Drowning." (See "Drowning.")
If the neck is not broken you can probably restore the
patient back to life again.
Hangnail. — This means a sore finger from irritation set
up by a little tag of skin peeling off near one of the nails.
When one is in a weak, unhealthy condition the skin of
the fingers becomes liable to fester whenever any little
scratch occurs; any little raw spots get infected with dirt
and become acutely painful. To obtain a cure clean the
part very thoroughly with soap and hot water, and then
with clean water, dry it, and paint the spot with flexile
collodion, or the liquid called "new skin"; under this coat-
ing the little ulcer will soon heal up ; after this rub vase-
line into the skin of the fingers every night for a week.
Harelip. — This is a notch or cleft in the upper lip on one
side of the middle line, caused by a lack of proper develop-
ment of the face. Sometimes there is a notch on the other
side of the middle line as well, leaving a central flap of
lip (double harelip). There may be, in the same person, an
incomplete development of the palate as well, called cleft
palate.
Treatment. — A very slight notch in the lip may be op-
erated on a few weeks after birth. Of course, there is no
cure for the deformity, except a plastic operation. Cleft
palate, if complete, can also be cured by operation, and
this ought to be done when the child is about 18 months
old. The deformity will interfere with learning to speak,
and until harelip is cured the child cannot suck properly.
Hay Fever. — This refers to a peculiar catarrh of the nose
and eyes affecting some people from May or June to the
latter part of July (rose cold) or from the latter part of
August to the first frost (autumnal catarrh).
It runs in families, especially gouty families, and affects
chiefly men of high intellectual powers. It is, in fact, a
neurosis or functional nervous disease.
Signs. — The eyes and nose water, the patient sneezes, has
a hard cough, and attacks of shortness of breath. But
there is no f everishness. The attack 'may last for several
weeks, though a change of air and scene, especially to a
barren and non-fertile district, will often effect a cure.
HEADACHE 131
Treatment. — In the first place, a person liable to hay
fever must avoid the fields during the summer. A seaside
place is generally the best to go to, provided it is bare
and there are no forests near.
The only medicine of much service is Dunbar's pollantin,
a few drops of which are to be instilled into the eyes every
morning during the attack. Lately, supra-renal-extract
spray, 5 per cent., has been used to spray nose and throat
with a good deal of success in these cases. A solution of
quinine used as a nose spray is also useful.
Headache (Varieties of). — Headaches may be due to
dozens of different causes. No doubt the reader cares very
little about that — what he or she wants is to know how to
cure a headache! But there is no royal road to anything
in life, and certainly not to the curing of a complaint.
That is why doctors are real necessities, in spite of the
quacks and their cure-alls. The man who analyzes, and
studies and builds up personal experience of disease, is the
only man whose opinion is worth anything in these matters ;
and every doctor will tell you that there is no royal road
to a cure. But he who studies the possible causes of head-
ache, and then applies his remedy, has some chance of cur-
ing the complaint. A dyspeptic headache may be known
by the pain being worse after food, and by its being accom-
panied by costiveness, acidity, and a feeling of sickness.
The headache of the ancemic girl occurs in girls who are
pale or yellow, and have pale lips, and suffer from palpi-
tation of the heart. Hysterical headaches are usually
worse at certain times, and are generally confined to one
special part of the head. Such headaches are said to be
like nails driven into the temples. Rheumatic or neuralgic
headaches are generally diffused over the whole head; the
scalp is tender, and there are rheumatic pains in other parts
or joints. Sick headaches are ushered in by flashes of light
in the eyes, dizziness, or temporary blindness. After the
headache, which is generally quite local, comes a feeling
of nausea or sickness. The headache of the person who
suffers from neurasthenia, or nerve exhaustion, is generally
a feeling of weight on Jthe top of the head, and is attended
with a good deal of confusion of thought. The temper is
irritable, and the patient is sleepless. There are many
other varieties of headache, some connected with actual
brain disease. But it is impossible to go into those in this
132 HEADACHE
article. As to cures, they must obviously depend upon the
cause of the complaint. Anaemic and hysterical people
will always be subject to headaches, until the anaemia is
cured by large and continued doses of iron; and the hys-
teria is improved by marriage or by a little severe treat-
ment (see also "Hysteria").
This subject seems so important that we shall give a
more detailed account of a few of the different kinds of
headache, and some prescriptions. We have already
warned the reader that he must study to find out the cause
of the headaches before taking remedies; and we may add
that many of the " headache powders" of the patent medi-
cine market are either dangerous or useless.
I. — Migraine or Sick Headache. — These headaches occur
periodically. They come on regularly at certain intervals,
or else occur quite unexpectedly without traceable cause.
The attacks may begin at any period of life and affect one
side of the head only. Some patients feel chilly and irrita-
ble and depressed before an attack ; then come disturbances
of vision — spots and flashes of light, zigzag figures and
blurring of sight, even blindness for a time, especially
blindness of one half of the field of vision. The patient
seeks a dark room and a warm corner. Then comes a vio-
lent headache, which lasts about an hour or more, and is
followed by sickness and nausea and yawning. When he
has vomited several times, and a sour liquid has come up,
the headache ceases and the sufferer falls asleep. Severe
forms may last two days. The disease is frequently in-
herited, especially from gouty parents.
The treatment by diet is unsatisfactory; the most ab-
stemious sometimes have migraine. Between the attacks,
especially if they are regular, it is a good plan to take
five grains of butyl-chloral and twenty grains of sodium
bromide thrice daily for three days before the attack is
expected. Many people keep tabloids of antipyrin at home,
and swallow one when they feel headachy. But this is to
be condemned, because the drug lowers the heart. Phen-
acetin is better; and caffeine is better still; during attacks
take one grain with a little sugar of. milk every hour until
recovered.
II. — Ancemia, Headache due to. — The pain in this type
of headache is generally more or less continuous, and affects
sometimes the forehead, sometimes the back of the head, and
HEAKT DISEASE 133
sometimes the top. Bodily and mental exertion make it
worse. The patient is generally costive, drowsy, listless,
and sleeps badly. Of course the anaemia itself must be
dealt with by the doctor. Tea and coffee are useful reme-
dies, but alcohol does harm. If the patient is hysterical
as well as angemic, let her take a one-grain pill of valerianate
of zinc and one-sixtieth grain of phosphorus twice a day,
for a month at a time, and ten to twenty grains of sodium
bromide at bedtime, occasionally, to produce sleep.
III. — Congestive Headaches are due to over-indulgence
in food or drink; sluggish liver; the change of life (which
see), and heart disease. The blood vessels throb, the face
flushes, the pain gets worse when lying down, and there is
giddiness. These headaches cannot be cured by drugs,
except those drugs which relieve the causes of the condition.
But until the doctor comes, and until the general state of
health is improved, purgative medicines will always give
relief.
Health Resorts.— (See "Climate for Invalids.")
Heartburn is a burning sensation, sometimes amounting
to pain, passing up along the food pipe or gullet from the
stomach to the back of the throat. Sometimes mouthfuls
of an acid fluid are brought up at the same time. It is
caused by Acidity (which see), and the return of acidified
food from the stomach. (See "Indigestion.")
Heart Disease. — The heart, which is situated in the chest,
between the lungs, a little to the left of the middle, is the
most important organ of the body. It is formed of red
flesh or muscle, and contains four cavities, through which
the blood is constantly flowing from the veins, and on into
the arteries, to nourish the whole of the tissues of the body.
The heart is in a constant state of contraction and relaxa-
tion, which continues as long as life lasts; even its mo-
mentary stoppage causes a partial death, called fainting.
In order to maintain health, the heart must be in good
order, and whenever any part of the heart is injured by
disease, there are sure to be some symptoms of ill-health,
as well as some defect in the circulation of the blood.
Diseases of the heart may be considered in two groups —
functional and organic; the first including all cases of
wrong action of the heart without disease or deformity of
the structural anatomy of the heart; the second includes
all defects of the walls of the heart, all faults in the
134 HEART DISEASE
muscular texture, and all imperfections of the many valves
within the heart. All actual organic faults are incurable,
but some relief may often be given by suitable treatment.
On the other hand, functional heart diseases are often tem-
porary; they may come and go with variations in the
constitution.
The most common cause of functional heart symptoms
is the state called Anaemia, or bloodlessness, which means
that the blood is too weak and watery. It is shown by
pallor of the cheeks, and lips, and ears, palpitation on
slight exertion, a state of breathlessness, and a tendency to
fainting. Hysterical women also suffer from this form of
heart disease, and it is often seen in women past middle
age. Drunkards are liable to it, and an excessive use of
tobacco may cause a feeling of weakness, giddiness, trem-
bling, and faintness due to an unsteady cardiac action.
Patients who are weak after a serious illness, or after an
accident, have almost always a temporary loss of the strong,
regular action of the heart which is so necessary to per-
sonal comfort. Persons with feeble anaamic hearts often
have puffy ankles at night and swollen eyelids in the morn-
ing. The pulse is generally too quick, but too small,
thready and feeble ; there may be a dull pain in the chest,
and very often there is an inability to sleep lying on the
left side; in some cases there are headaches, giddiness,
noises in the ears, and flushings of the face. In these cases
a doctor must try simple remedies, in the hope that there
may be no organic disease, for the sounds heard by the
stethoscope much resemble those of real valvular disease.
I. — Organic heart disease. — The several forms of or-
ganic cardiac disease are due to actual faults in the heart's
muscles, and the valves within the heart. In some cases
these faults are present at birth, and continue during life,
but in other cases the mischief arises from over-strain, or
from rheumatic fever, or from fatty degeneration of the
muscles. A wasting or atrophy of the heart is also known,
and an over-growth or chronic enlargement of the heart is
often present as a secondary result of obstructions to the
circulation of the blood, as, for example, from chronic
alcoholic hardening of the kidney. Still another and very
fatal form of heart disease is called dilatation, in which
the heart is larger, but not heavier; and this is due to a
dilating, bulging, or enlargement of the cavities, while the
HEART DISEASE 135
walls get thinner and weaker. This disease often leads to
sudden death from a faint, or from spasm of the heart.
There are four valves within the heart, through which the
circulating blood is constantly passing, and these have to
open and close about 70 times in each minute of our lives.
Whenever the valves are out of order, or deformed by such
inflammation of them as occurs with rheumatism, there is
more or less disturbance of circulation, leading to various
symptoms, such as pain, breathlessness, cough, palpitation,
fainting and dropsical swellings of the legs and face, all
due to the effects of the valve disease on the heart walls.
II. Valvular diseases, which are mostly due to attacks
of inflammation, caused by rheumatic poison, of the deli-
cate membrane lining the cavities within the heart, are of
two sorts — first, those which obstruct and delay the blood-
flow through the valves, and, secondly, those which prevent
the correct closing of the valves at each contraction of the
heart. These valvular troubles due to inflamed membranes
are most commonly found to originate during the course of
acute rheumatism, during which the large joints of the
limbs are most affected. Another form of valvular mischief
arises in late middle life from the deposit of chalky flakes
and bony layers in the structures forming the valves; the
result is that the valves, which in youth and health are
delicately soft and elastic, become hard and brittle, and
are liable to lead to sudden fain tings and unexpected death.
The form of heart disease in any patient is partly judged
from the symptoms, and partly from the sounds arising
from the heart's action, which can be heard outside the
chest by means of the stethoscope in the hands of a skilled
physician. Skill in this process is not easy to acquire, and
when gained it needs constant use, for the ordinary person
hears nothing but confused and very slight sounds when he
applies the stethoscope to a chest.
III. The doctor's examination of the heart. — The in-
troduction of the use of the stethoscope, which is a wooden
or metallic tubing, having at one end an ear piece and at
the other a chest piece, has very much increased the power
of the physician to diagnose or discover the nature of a
case of heart disease. This instrument is now also made
of india-rubber tubes, for use with either one or both ears.
By its means the sounds made in the lungs by the breathing
are also heard, and when listening to a chest in certain
136 HEATING
positions both lung and heart sounds are heard at once, so
that experience and skill are needed to come to correct
conclusions as to the origin and meaning of chest sounds.
Diseases of the valves of the heart give rise to sounds called
murmurs. The study of these murmurs is by no means
easy, and it is, unfortunately, true that some forms of a
very serious heart disease do not produce any of these curi-
ous noises. Another mode of discovering heart diseases is
by the process called percussion, or rapping the chest sur-
face and noting the clearness or dullness of the musical note
produced. By this means a physician can tell how large a
heart is, and whether or not it is displaced from its correct
position between the two lungs. A doctor also gains a
knowledge of the heart's action by merely looking at and
gently feeling the chest surface. By these means he notices
the place and force of the heart's beat. The apex, or
pointed lower end of the heart, should tap against the chest
on the left side of the breastbone, about three inches from
it, and between the fifth and sixth ribs; its action should
be regular as to intervals, and regular also as to force.
Nervous people, however, will be found for a few minutes
to have an irregular throbbing action of the heart, called
palpitation, when a doctor tries to examine it. This alone
is no proof of heart disease, but only of nervousness. At-
tacks of palpitation, or heart-throbbing, are a frequent
symptom of heart disease, possibly only due to a weak, or
fatty, or nervous state of that organ, and are not a proof
of actual structural disease, nor of valvular mischief.
Shortness of breath and panting on exertion are also signs
that the heart is not in good order. The pulse, as it is
felt conveniently at the wrist, gives valuable indications
of the rate of the heart's action and its strength. When it
is irregular, and especially when it occasionally misses a
beat, medical advice should be sought.
Heating. — There is perhaps no department of domestic
economy about which greater ignorance is displayed than
the warming of houses. Among the poorer classes more
especially, this ignorance, combined with more or less care-
lessness, leads to the most reckless waste in the consump-
tion of coal, even when poverty necessitates its being pur-
chased at the cost of considerable deprivation in other di-
rections. Poorly constructed fireplaces have been to blame
for this. In recent years some improvement has been ap-
HEATING 137
parent, but even now we have not seen the last of the hide-
ous, hollow-backed iron grates.
Closely associated with the comfort, efficiency and
economy of heating is the subject of humidity of the air.
Humidity is harmful not only if too high but also if too
low. Room temperature should be maintained at 65 to 70°
F. When heated air is maintained at a temperature of
72° F. the humidity is usually about 24%.
If now the humidity is artificially increased to 50% the
body feels the same sense of comfortable warmth if the
temperature is only 65° F. ; and in this reduction of tempera-
ture there is not only a saving in fuel cost of 12%%, but
the occupants of the rooms have increased freedom from
influenza, catarrh, coughs, and colds.
Overheated air which lacks moisture subtracts it from
any surface in the room — the skin, hair, and mucous mem-
branes of a person — hence the discomfort. The faults of
most heating apparatus are mainly due to their super-
heating the air, and to their lack of any provision for
ventilation.
The principal methods of heating are — open fires, closed
fires and stoves, hot air and pipes containing hot water
or steam. One of the best methods is that known as the
"plenum" system.
Open fires carry off large volumes of air besides their
own products of combustion, stoves only a little ; hot pipes
not at all; while fender stoves not only do not ventilate
but add to the impurity of the air.
Grates or Open Fireplaces: —
These are excellent aids to ventilation, extracting from
10,000 to 20,000 cubic feet of air per hour through the
chimney. If, however, pure air is not provided to meet
the demand the air of halls, kitchens, cellar or water-closet
is drawn upon with the result that good ventilation is not
accomplished. The ordinary fireplace is also extremely
wasteful of fuel, as only 12 per cent, to 14 per cent, of
the heat generated is utilized in a room, the remainder
escaping up the chimney. The common experience in a
room so heated is that the person near the fire is very hot,
while at any distance from the fire the room is cold.
Gas stoves are economical and cleanly in use, create no
smoke and can be lighted, extinguished or regulated in
a moment.
138 HEATING
A gas stove burns from ten to twenty or more cubic feet
per hour, therefore the amount of air consumed, which must
be renewed, is considerable.
Stoves have their advantages and disadvantages.
There is less loss of heat than with open fireplaces or
grates, and the room is more uniformly warmed. The dis-
advantages are, — poor ventilation, air which passes over
a stove becomes too dry, the burnt organic particles of
air may give a disagreeable odor and carbonic oxide gas
may escape, giving rise to headache and a feeling of dis-
comfort.
Hot Air is advocated by some authorities as the best
mode of warming houses, as well as public buildings.
This may be done by a basement furnace and conveying
the warmed air to all parts of the house by special channels.
The essentials for this form of heating are: a brick-lined
fire chamber, an exhaust flue for foul air and a supply of
fresh air from out-of-doors — not from the cellar.
Hot Water and Steam Pipes are frequently employed for
warming houses as well as offices and public buildings.
This system, if properly applied, is an excellent one, but
one usually finds, in cases in which it is in operation, that
all principles of ventilation have been completely disre-
garded. The wholesome influence of the ordinary fire-
place in changing the air of the room is lost, with the
result that the same foul air, which has been breathed for
hours on end, is circulating in warm currents round the
room in question.
No system of warming by hot water or steam pipes is
admissible, unless both inlets and outlets are provided for
ventilation. The best method of introducing air into a
room warmed in this manner, is by so arranging the open-
ings that the incoming air must first circulate over the
hot pipes. These are known as ventilating radiators. A
very convenient form of such a device is the electric radia-
tor which possesses the advantage of yielding no products
of combustion and producing heat which is available im-
mediately the current is turned on.
The form of heating device which is by all means the
most preferable for public and semi-public places, theaters,
apartment houses, museums and private houses, if the ex-
pense is not a drawback, is the "plenum" system, or the
indirect system of radiation.
HEATSTROKE (STINSTKOKE) 139
The out-door air is sucked in from near the roof-level
through a large shaft into a cold-air room, where it is
moistened and washed by a spray or water curtain, and
whence it passes through a dust-fitter, consisting of a
double layer of fine wire gauze or cloth. Thence it passes
through tempering radiators and humidifier into the re-
volving fan whence part passes through a second radiator
to be further warmed, — the other part not further warmed
being mixed with this warmed air and the mixture carried
through flues to the rooms.
By this method the temperature and humidity of the
air can be controlled by thermostats and humidostats in
any room, the air is pure and clean, and circulation of air
is assured as it is not unusual to supply a million cubic
feet of air an hour by this method.
By introducing into this circuit a cooling plant operated
by expansion of air, evaporation of liquids or the Carre
ammonia process, rooms can be cooled in summer as well
as they can be heated in winter.
Heatstroke (Sunstroke) , — When a person is exposed to
a broiling sun, or to intense moist heat, the body is apt to
become overheated and to suffer from the results. Those
who drink alcohol and those who are depressed by worry
and anxiety are the ones most liable to be made ill by
exposure to great heat. Among women, laundresses,
bakers, and sempstresses, in ill-ventilated, crowded rooms,
and tight-lacers are those who are most liable to heat-
stroke.
There are three different ways in which intense heat
may affect an individual: — (1) The first is called Heat-
stroke. The person feels suddenly sick and giddy, then
drowsy. The skin is pale and clammy, the pulse is quick
and intermittent, the breathing is gasping and sighing.
The sufferer may die of heart failure (syncope). To cure
him, let him lie down flat, give him sal volatile (a tea-
spoonful in a wineglassful of water), or brandy, and rub
the hands and feet.
(2) Heat apoplexy. — This looks just like an attack of
apoplexy (which see), occurring in a very hot place. There
is unconsciousness and there may be fits. Pump cold water
over head and back, rub the body with ice and give a rectal
injection of cold water. The body is intensely hot in this
form of heatstroke. If the patient doesn't recover his
140 HERNIA
senses as his body gets cooler, shave his scalp and put a large
blister on.
(3) The most serious form of sunstroke is called
Thermic Fever. The heat of the body runs up to about
108° Fahrenheit or more, and the patient simply burns
rapidly away, if you cannot save him, in a day or two. He
has great thirst, quick bounding pulse, pains all over,
headache, vomiting and gasping for breath. The body may
be swathed in a sheet wrung out of cold water.
Hernia, or Rupture. — This word means the protruding
of an organ into or through the wall of the cavity to which
it belongs. Thus, a hernia of the lung is said to be present
when there is a wound of the chest wall and the lung sticks
out or escapes through it. But the word hernia is at the
present day almost exclusively used to mean a rupture or
tear of some part of the belly watt, which allows a " knuckle"
of bowel to slip through it and appear as a tumor (or
swelling) beneath the skin. The rupture does not affect
the skin but the layers of muscles and membrane, which are
less tough.
The anatomy and contents of hernial protrusions are
difficult to understand, and we shall not attempt a popular
description.
The important thing for the sufferer and for the general
reader is to understand something about the different types
of rupture and the risks attending the neglect of a rupture.
Rupture at the navel (umbilical hernia) occurs in in-
fants sometimes, and is seen as a lump pushing the navel
an inch or two out of the belly, especially prominent when
the child strains or cries. A concave circular pad and
bandage will have to be worn. Some doctors make a pad
out of a cut beer-bottle cork and apply it with adhesive
plaster.
Inguinal hernia. — This is a rupture at the groin. The
swelling may be either very slight, or considerable, and in
men the lump escapes down into the purse or scrotum, and
lies alongside of the testicle there. This is the commonest
form of rupture.
Femoral hernia is the variety which is most common in
women. There is a lump under the skin at the upper and
inner part of the thigh.
Double hernia. — Any person may have a rupture on both
sides, and they may be of different varieties.
HERNIA 141
Ventral hernia is the name given to a protrusion of the
bowel through some artificially-made opening, such as the
weak scar of an old abdominal operation.
Congenital hernia is one which exists at birth.
Acquired hernia is one which is developed later in life
through a strain or accident.
Reducible hernia is a rupture in which it is possible at
any time to return the tumor into the place where it be-
longs by gentle pressure with the fingers in the right direc-
tion.
An irreducible hernia is one which cannot be returned to
where it belongs, either because it sticks to its new sur-
roundings because of inflammation ; or because it has grown
too fat since it escaped through the rupture, or for some
similar reason.
A strangulated hernia is one in which a large knuckle of
bowel has been forced (by coughing or straining) through
a very narrow orifice, and the tightness of the opening in-
terferes with the proper circulation of the blood in the
bowel. By-and-bye the bowel tumor swells up, and unless
a surgeon can succeed in " reducing the swelling" or in
cutting through the band of constriction, the bowel will
mortify, and the patient will die of shock and blood poison-
ing. Any hernia may become strangulated.
Causes. — Many hernias are produced suddenly by strain-
ing. The patient feels something give way and finds a
lump there. More often the hernia develops gradually, in
a person who is always lifting heavy weights or doing work
that is too much for him. In coughing or straining in the
w.c. the hernia "comes down," and the patient feels in-
secure and presses his hand over the rupture. Even a small
rupture is apt to produce constipation (costive bowels).
Symptoms of strangulation. — If in a person, known or
not known to have a rupture, there occurs a sudden ab-
dominal pain at the seat of the rupture, stoppage of the
bowels, and vomiting, the probability is that he has a
strangulated hernia, and a doctor must be sent for at once.
Every minute of delay is dangerous. An operation will
probably have to be done in any case, but the longer the
delay the more severe will be the operation. Old persons
who may have had ruptures for many years without much
trouble from them may be taken with serious sudden vomit-
ing, pain, and costiveness; and such cases ought always to
142 HERNIA
be examined to see if they have a strangulated hernia or
not.
Treatment. — There are two ways of dealing with a rup-
ture. The person must either wear a truss or he must un-
dergo an operation for a radical cure of the hernia, and
in most cases the operation is by far the better way.
Of trusses, we may say that if a truss fits comfortably,
keeps back the hernia entirely and produces no pain nor
chafing of the skin, it may be considered in every way a
suitable instrument.
"In the case of infants, the constant application of a
truss day and night will effect a complete cure within a
year in the majority of instances of inguinal hernia,"
writes Dr. Whitla. No baby is too young for a truss, but
it ought to be made waterproof and easily cleanable. The
truss may be left off six months after the rupture is con-
sidered cured. Adults must see that their trusses fit accu-
rately, which cheap trusses seldom do. A badly-fitting truss
causes a great risk of strangulation. Patients must have
two trusses in case of accidents, while one is undergoing re-
pairs.
The skin under the truss pad should be kept dusted with
zinc oxide. See that growing young people with ruptures
are kept supplied with powder, and with new trusses when
they grow out of old ones.
In young people with recent ruptures, well-fitting trusses,
worn night and day, may be regarded as curative in many
cases, after a year or two.
If a hernia be irreducible, either a special kind of truss
must be worn, or the hernia must be cured by an opera-
tion.
The operation for the radical cure of herina is not in itself
a dangerous one, and necessitates lying up for about three
weeks. Only an operating surgeon can decide whether the
operation ought to be done in any given case. Even old
people with old ruptures may be cured.
The operation involves no risk to the testicle or to any
other organ.
The ailments which may complicate, or be mistaken for
hernia, are: — Varicocele, hydrocele (a collection of watery
fluid in the purse, alongside of the testicle) ; retained
testicle (that is, one which has not descended from the ab-
dominal cavity, where both testicles are before birth) ;
HEKPES 143
hematocele (an effusion of blood in the purse) ; and
others.
Never pay heed to quacks who advertise "cure" of rup-
ture by means of lotions or plasters.
Herpes (Pronounced Her-peez). — "Shingles" is the old-
fashioned popular name of the disease which medical men
called Herpes Zoster. It is one form of Herpes, which is
a skin disease marked by patches of inflamed skin, upon
which a group of little raised, red, tender pimples spring
up. These pimples grow for one or two days, and then
each one is found to contain a little drop of yellowish
liquid; at length they burst, or else the heads get rubbed
off, and a little sore discharging surface remains for several
days, and may dry up into one or more little scabs. If the
scabs are not disturbed the skin heals under them, and
when the scabs fall off there is only a little reddened patch,
and in a few days more the natural appearance is re-
stored, except for a pale-brown stain which lasts a few days
longer. Shingles appear generally on the ribs ; it may effect
one side only of the chest, or both at once, or one after the
other.
Shingles is generally accompanied by some constitutional
disturbance, and begins with a chill and shivering. Pain
is felt in the side, and the skin is tender, before any spots
appear; this pain is sometimes quite severe, and resembles
neuralgia. In children the rash is found to give rise to
intense itching, while in old people there is more pain and
tenderness than irritation. In some cases the pain ceases
when the rash breaks out, and is replaced by a sense of
constriction — a tight feeling, with smarting.
The eruption often comes out, not all at once, but in suc-
cessive crops, until there may be perhaps a dozen little
patches, extending half-way round the chest. These run
the course already described.
It is very important that these pimples and vesicles should
not be torn by scratching, because if so injured there may
be several ulcers, which are difficult to heal, and will leave
ugly scars. In delicate and unhealthy persons the glands
in the armpit may become a little tender and enlarged for
a few hours.
This is a somewhat serious disease, especially in aged
persons; it seems to be generally set up by the effect of a
chill to the skin. The disease runs a course of a fortnight,
144 HIP-JOINT DISEASES
but may last three or four weeks. In the beginning of the
attack it is well to go to bed and stay there for a week.
Salines and purgatives should be taken, and when the pain
is severe opium or morphine may be needed. Locally, zinc
ointment does good, or the rash may be dusted with dry
powder of starch with bismuth, or boric acid, and a little
dry morphine may be needed.
Mild cases, especially those which are relapses, may be
treated without a doctor, but if the pain and neuralgia
which accompany and follow the attack are bad enough
to require morphine, a doctor's prescription must be ob-
tained, or the chemist will not supply the medicine.
The special treatment of Herpes when it affects the lip
(see "Cold in the Lip") is to bathe it with water, as hot as
can be borne, in which some bicarbonate of soda has been
dissolved. Bathe it several times a day. When there are
scabs, do not pick them off but apply resin ointment at bed-
time.
Hiccough is a spasmodic indrawing of the breath, which
needs no special description as it is familiar to everybody.
Most cases of it are caused by mere indigestion ; but when
it occurs in such serious diseases as chronic Bright 's dis-
ease and typhoid fever, and lasts a long time, it is a sign
of grave importance.
Treatment. — Generally none is needed. A teaspoonful
of compound spirit of ether, if swallowed, will generally stop
the hiccough. When continuous and excessive, the doctor
ought to be asked to treat it.
Hip-Joint Diseases. — These are nearly always of a tuber-
culous nature, that is, are caused by the same germ which
causes "consumption of the lungs." The disease is com-
monest in children and young people. At the very first the
disease of the joint gives no pain in the hip joint itself,
but the child will complain of pain in the knee and down
the inner side of the thigh. Then the symptoms of the hip
mischief begin.
(1) Slight stiffness at the hip and wasting of the mus-
cles and flesh of the thigh on that side. The joint soon
gets "tired."
(2) If the child be put on his back in bed, you see
that he bends his hip a little, bends his knee a little, and
HOMEOPATHY 145
turns the whole leg outwards, separating it from the
other.
(3) When the child walks during this stage, he walks
lame, and the diseased leg appears to be longer than the
one on the healthy side.
(4) Later, there are starting-pains in the joint at night,
and if you put the child on its back in bed now, or watch
it standing up, you will see that the leg of the diseased
side is turned inwards, nearer to the other and with that
knee over the sound knee. See him walk, and you will
notice that now the healthy leg seems to be longer than
the other one.
(5) If untreated by prolonged rest and splints, an
abscess will form in the diseased joint and the matter
may burst through the skin somewhere or go into the back
passage. If it all escapes and the child is pretty ro-
bust the joint may now get well, but it will remain stiff
and fixed.
It is useless to say more about treatment here. These
cases cannot be dealt with except by a surgeon.
Homeopathy. — This system was the invention of a Ger-
man doctor, named Hahnemann. It is based on the theory
that ''like cures like"; for instance, vomiting ought to be
curable by an emetic! Keal Homeopathy has proved an
utter failure, both in practice and in theory, and the mod-
ern homeopathist is a faddist, and, if a successful healer,
cannot be true to his principles. The fundamental rules
of homeopathy are these : — (1) Ascertain the effects of medi-
cine on persons in health; (2) choose the remedy whose ac-
tion corresponds with the symptoms of the patient; (3) give
the remedy by itself alone; (4) give a very small dose of
it. Hahnemann, himself, pretended that only infinitesimal
doses were necessary; that 1-100,000 grain of belladonna,
for example, is enough for each dose in the treatment of
scarlet fever. But, although the whole theory and practice
of homeopathy are unworthy of serious notice to-day, yet
the movement has had its uses in discouraging the over-
use of drugs, and in encouraging reliance on fresh air,
rest, and good nursing. Seeing that most cases of illness
tend to get well with suitable dieting, rest, and fresh air,
there can be no doubt that the addition of microscopic
146 HYDROCELE
doses of drugs is, in the way of treatment, preferable to
the continual and indiscriminate tabloid-swallowing, which
is so common at the present day.
Housemaid's Knee. — Over the kneecap, and below it, we
find a little flattened bag of liquid, intended by Nature
to act as a "buffer," and protect the joint from injuries
or bruises, such as might be produced by kneeling. In a
housemaid, who kneels often for long periods, while scrub-
bing and polishing, the little bag (called a bursa) at the
lower edge of the kneecap is apt to become inflamed and
enlarged, and at last to form a sort of tumor below the
knee, covered with a tough and reddened skin.
Treatment. — Strong iodine liniment should be painted on
all over the bursa daily until it blisters. Then dress the
blister with clean rag or lint, smeared with boric ointment,
and a bandage. If this plan fails the doctor will "tap"
the swelling, let the fluid out, and inject a small syringe-
full of iodine tincture and water (equal parts). The io-
dine is squeezed out again after a few minutes, but it sets
up an inflammation in the little bag, which results in its
being obliterated.
Hydrocele. — This is a collection of fluid in the scrotum
or purse of the male. It is a sort of dropsy of the bag
which holds the testicles. It may be either single or double
— that is, on one side only or on both. The two sides of
the purse are quite distinct from one another, and each
testicle lies in a pouch of its own.
Causes. — A hydrocele may be congenital — that is, a child
may be born with it — or acquired. Sometimes it seems
to come from a bruise, or to follow inflammation of the
testicles (orchitis), whether due to an injury or gonorrhea.
But very often the cause is quite unknown.
Signs. — A hydrocele must not be confounded with hernia
or varicocele, or enlargement of the testicles, or hematocele
(blood tumor), but it is quite impossible to teach the or-
dinary reader how to distinguish between these various dis-
orders, because he probably has no knowledge of anatomy.
A hydrocele may be quite small, or it may swell to the size
of a pumpkin. It is not painful, or tender, or red, though
it may feel heavy. It is, when large, a pear-shaped swell-
ing with the pointed end towards the groin. In congenital
hydrocele the bag of liquid can be gradually emptied
through the neck of it into the abdomen, and fills up again
HYPOCHONDKIASIS 147
when the patient stands up. The testicle is not interfered
with and can be felt at the back part of the lower end of
the swelling.
Treatment. — In hydroceles in children a truss must be
worn to encourage the closing of the opening between the
purse and the belly. Some surgeons then irritate the skin
over it with iodine, and this makes the fluid absorb. Others
tap the little tumor and withdraw the liquid. After that
the hydrocele generally gets well of itself. But in adults
a truss is of no use, and either the hydrocele must be tapped
regularly as soon as it is too full to be comfortable, or else
an operation must be done which just removes the ''wall"
of the bag of fluid and then there can be no more dropsical
swelling for there is no place for it to collect in. Hydrocele
is not dangerous, nor is the operation for it a dangerous
one.
Hypochondriasis or Neurasthenia. — This long scientific
and medical word is the name of a complaint which is very
common amongst us, though you may never have heard this
long word before. It is a condition of the mind in which
the sufferer is always fancying that he is in some way out
of health, and he makes himself miserable about it.
Most hypochondriacs are in the possession of very fair
health indeed ; in fact, there is seldom very much the mat-
ter with them except a disordered fancy. But they are so
selfishly wrapped up in their fancied ailments that they
hardly enjoy life at all. They really do suffer, from —
nothing in particular ! But their sufferings are real enough
to them, and we should pity them because they have not
the strength of purpose to throw off their morbid fancies.
There are plenty of hypochondriacs among middle-aged
men, especially such as have got on in business, and have
not very much hard work to do. There are plenty of young
men also in the same category. They look at their tongues
in the glass every morning; they dose themselves con-
tinually ; they read the long accounts in the advertisements
of patent medicines, and they believe every word they read.
If a cold bath is advised, they take a cold bath; if a cold
bath is said to be injurious, they cease taking a cold bath.
They study all their insignificant little sensations, and read
up medical books, to try and find out what is wrong with
them. They suffer agonies of worry and trouble because
of the little knowledge which is to them so dangerous a
148 HYSTERIA
thing. Some of them fancy they have this complaint, some
that ; and every little sensation makes them believe they are
in for some serious disease. They buy a clinical thermome-
ter, and tabloids, and tonics, and take everything and any-
thing— except what a doctor advises. They never stick to
one doctor ; they go from place to place looking for a doctor
or a patent medicine advertisement which will understand
their terribly complicated case! There are many women
in the same condition, especially those who have no work
to do and plenty of time to do nothing in. Some few of-
them are curable. They want plenty of beef steak, bitter
beer, and wholesome stale bread and cheese; they should
avoid pickles and indigestibles, and they should take long
walks or get a muscle developer and use it. But their
minds really require more treatment than their bodies, and
they should work hard at anything which will give them no
time to think of Number One! Carlyle's advice to all
such people is excellent: — "If you are not miserable, be
happy" — there ought to be no half-way conditions.
Hysteria. — This is a large subject, and it is impossible
for us to do more than give an outline of it. By Hys-
teria we mean a curable nervous disorder which leads to
various disturbances in health, such as numbness, pain,
paralysis, flushings, palpitations, and others too numerous
to mention. A person who is subject to these more or less
avoidable and self-caused symptoms is said to be hysterical
and to have hysteria; every attack of such symptoms is
called an hysterical attack or fit of hysterics. Clearly un-
derstand that hysteria is real disorder of the controlling
centers of the brain; it is not shamming, though an hys-
terical girl generally shams as well.
Most hysterical people are girls in their teens, but some
women are hysterical all their lives. Boys occasionally have
hysterical attacks, and even men are sometimes subject to
them. The tendency to hysteria is increased by bad or
weak moral training, especially by mothers who " cosset "
their children and lead them to expect undue sympathy in
every little trouble. The hysterical patient has no "back-
bone," no "grit," as we say: she is "namby-pamby" and
silly. We have to consider, then, what are the signs of
hysteria and what are the characters of an hysterical fit.
Hysteria. — The girl or woman with hysteria is emotional
and perhaps very sentimental. She laughs or cries without
HYSTERIA 149
sufficient reason. She wants to be taken notice of all the
time. Without sympathy she is miserable, and the result
is that she will (in bad cases) do or say anything which
will procure sympathy and fussing. She may even produce
illness in herself, swallow stones or needles, or make erup-
tions on her skin with acids or poisons in order to deceive
her doctor, and excite his and others' interest and sym-
pathy. In worse cases, she begins to fancy that she cannot
move an arm or a leg, and at last, having made herself be-
lieve that she can 't move it, she finds that she is really para-
lyzed. Or she may become voiceless, or rigid, or go to
sleep for weeks, or go without food for weeks, with or with-
out a religious motive. Sometimes the senses of an hys-
terical woman get so acute and sensitive that she cannot
bear the light of day and complains of the least touch or
noise. Her spine is very likely tender, and she has tender
spots in various places — especially (1) at the top of the
head, (2) below the breasts, and (3) on each side of the
abdomen.
Sometimes the symptoms vary from day to day, for the
hysterical woman will soon find a new complaint if sym-
pathy seems to be on the wane. She cannot bear to be
forgotten and she loves to be pitied, though she will often
say that she wants no sympathy !
The causes of hysteria are many; among them are: —
bad moral and emotional training of the young, mastur-
bation, sexual excesses, impure literature, lack of physical
exercise and fresh air, ancemia, disappointment in love, loss
of social position, emotional shocks, grief, and so on.
An hysterical fit is something like this: — the girl or
woman begins by laughing or crying, or doing both at once,
and complains of a feeling as if a ball were rising into
the throat and making a choking sensation. Then she falls
down * ' in a fit, ' ' and seems to be quite unconscious, but may
recover quite suddenly, especially if no notice whatever is
taken of her, or if someone says aloud that he is going to
drench her with cold water. But the forms of hysterical
fits are very numerous, and we cannot say more about
them here.
Treatment. — Slight cases of hysteria can be treated at
home, hysterical girls who fast, sleep for days or weeks, are
paralyzed, erotic, or subject to trances, must be treated in
a suitable institution. The home treatment of hysteria is
150 IDIOSYNCRASY,
not difficult if the parents and friends are sensible and not
sentimentally foolish. The girl needs plenty of rest, good
food, moderate exercise, laxatives for the bowels, iron tonics
for the blood — but no fussing or sympathy. Special symp-
toms, such as pain, need medical advice.
As to the fits — in slight attacks no treatment is needed.
The girl or woman must be encouraged at other times to
exert self-control, but when the fit comes leave her in a room
quite alone. Or watch her, if you are anxious, but only if
you can do it without her knowledge. She is very sharp,
and if she finds out you are watching, her fit will get worse
and worse. Yet she is not shamming, she is suffering from
a mental disorder. The mere mention of a jug of cold
water will generally cure her, because dislike of a cold
douche or the application of strong smelling salts to her
nose forces her to exert self-control. But if the name
"cold water" does not cure her, pour it over her, or dash
the water in her face without hesitation. The essential
thing, between the fits, is to make her understand that you
are sorry for her, but that she shall have no sympathy un-
less she tries to control herself.
Idiosyncrasy. — This word implies nothing more than
"personal peculiarity," and is used by doctors with refer-
ence chiefly to the effect of medicines. Some people can-
not, for example, take even five grains of iodide of potas-
sium without getting watery eyes and all the signs of a cold
in the head! Others can take twenty grains of the same
drug, three times a day, with benefit. The same pecul-
iarities apply, of course, in the case of alcohol, arsenic,
shellfish, eggs, porridge; some people like these things and
some cannot take them without feeling ill. Many people
get singing in the ears and giddiness from even small doses
of quinine ; others take quinine to cure noises in their ears !
' ' One man 's meat may be another man 's poison, ' ' says the
old proverb, and it is a very true one. This makes it diffi-
cult to find a good definition for poison. Powdered glass if
swallowed, will probably cause death, and so might boil-
ing water, but one cannot call these things poison. One
man can take a quarter of a grain of morphine with noth-
ing but a feeling of drowsiness, whereas the same dose
would be fatal to many women and most children.
The moral to be drawn from all this is to avoid buying
and swallowing tabloid medicines without a doctor's pre-
INDIGESTION 151
scrip tion and advice, just because someone (non-medical,
like yourself) has said that they are "good for" your com-
plaint. In health, certain medicines (like morphine,
atrophine and aconite) are actually poisonous; in some
forms of disease, and with some idiosyncrasies, they are
beneficial, and may even save life !
Imperial Drink. — For persons with feverishness or any
acute feverish disease, and for those with Bright 's disease,
who suffer much from thirst. Pour a pint of boiling water
on a large teaspoonful of cream of tartar, a little sugar,
and a few bits of lemon peel. Strain when quite cold and
serve.
Impotence. — Let no one hesitate to consult a doctor. A
young man may imagine that other young men are not
troubled with these matters, but really they are very com-
mon, and the doctor has heard the whole story before, many
a time, and is quite well able to tell you how to deal with it.
Indigestion. — So very many persons are always suffering
from chronic indigestion, that we feel obliged to refer to
this subject at length. Some have dyspepsia, or indiges-
tion, because the digestive organs — the stomach, bowels, or
liver — are diseased ; others suffer because they eat either too
much, or eat unwholesome food; while a third group of
patients suffer indigestion because they drink to excess.
Habits of chronic intemperance are sure to ruin the coats
of the stomach, and to harden the liver, sooner or later, and
very often injure the kidneys as well. In the early days
of free drinking a change to total abstinence is often quickly
followed by a complete recovery; but when alcoholism has
destroyed the liver cells there can be no recovery of good
digestion. Apart, however, from alcoholic drink, the con-
sumption of too large a quantity of food, and especially
the habit of taking meals too close together, may render
a state of healthy digestion impossible. The stomach needs
rest as much as the mind, or the body in general ; it ought
to empty itself into the intestines, and remain empty for
one or two hours between each meal. Almost all of us eat
too much; that is, we eat more than is needed to supply
energy and to keep up the body weight. Persons in poverty
who cannot get enough to eat rarely suffer from indigestion.
Most people are all the better for an occasional day of fast-
ing, say, once every month. The Roman Catholic Church
was wise in making all Catholics fast on one day every
152 WATERBRASH
week, and also live sparingly for forty days every year in
Lent, which, happens in the springtime. When indigestion
is the result of organic disease of the stomach or liver, or
when it is an accompaniment of consumption, there will be
great difficulty in curing it. Medicines may have to be
taken for months together, and seem to have very little
effect in giving relief. The usual symptoms are deficient
appetite, unpleasant taste in the mouth, oppression felt in
the chest after food, and this may last for hours (see also
"Acidity") ; pains in the chest, flatulence, and belching
upward of wind or gases. Some persons also have water-
brash and heartburn, also occasional nausea and vomiting;
the action of the bowels may be either relaxed or too con-
stipated, and there may be piles. The treatment of indi-
gestion must vary with the peculiarities of the patient and
with its cause. (See also "Salisbury Treatment.")
Very few people will take the trouble carefully to study
even a popular work on Indigestion, and so they go on
suffering for years, and only learning by bitter experience
how to avoid the chief troubles of dyspepsia by avoiding
the foods (sometimes) that they most enjoy! We have de-
cided that our best plan is not to describe the types of
indigestion but to resort to the method of giving a list of
the principal symptoms and hints as to how to deal with
them. Of one thing be certain — the cure must be by means
of proper diet, not by drugs.
Heartburn (see article on "Acidity").
Flatulence (Wind in the Stomach, Belching, Fullness
after Food). — It is a mistake to belch, or to try and "raise"
the wind; more air is swallowed and the distress only in-
creases. A little dried Poplar Charcoal (say 5 grains, with
5 grains of bismuth subnitrate) swallowed in a cachet just
before each meal is very useful. A few drops of essence
of ginger, of peppermint, of cloves, or of cajuput at meal-
times are often serviceable. Pepsin and papain in large
doses are also good for flatulence. Soups, eggs, starches,
fruits, vegetables, should be eaten sparingly. A dry meat
diet is often best.
Waterbrash. — This is a gush of acid fluid (chiefly saliva)
which comes into the mouth after an attack of pain in the
stomach.
Try the following mixture: — Sodium bicarbonate, 15
grains; magnesium carbonate, 10 grains; compound carda-
INFANT FEEDING
153
moms tincture, 1 drachm; aromatic spirit of ammonia, ^
drachm; caraway water to one ounce. The draught to be
taken occasionally.
Flushing after meals. — Take a one-grain pill of creosote
made with soap, after food, thrice daily. Or, a half minim
creosote pill.
Vomiting. — The cachets of bismuth and charcoal above
mentioned are useful.
Foul breath. — Sodium bicarbonate, 10 grains; carbonate
of bismuth, 5 grains; tincture of chiretta, 10 minims; in-
fusion of quassia, % ounce. Take this draught half an
hour before each meal, and look well to the state of mouth
and teeth.
Infant Feeding. — No other one factor in the health of an
infant compares for a moment in importance with the man-
ner in which it is fed. Breast feeding may be more diffi-
cult to carry out than bottle feeding ; but according to Holt
the mortality of bottle-fed infants during the first year is
fully three times as great as that of those who are breast
fed.
Dr. Winter says that while very few breast-fed infants
die, the mortality of bottle-fed infants in tenements and
institutions may be as great as 59 to 93 per cent.
These figures apply to those cases where our modern
knowledge of artificial infant feeding is not applied. With
care these percentages can be much reduced ; but no matter
how perfect our methods of artificial feeding are they can
never equal, in their results, the effects of breast feeding.
Breast Feeding. — During the first day the infant need
have nothing but water.
Little milk is secreted by the mother until the third day.
The number of daily nursings and the intervals are shown
by the following table (from Holt).
Period
Nursings in
24 hours
Interval by day
hours
Night nursing
(10 P.M. to 6 A.M.)
1st & 2nd day
4
6
1
3 days to 6 weeks . . .
6 weeks to 3 months .
3 to 5 months
5 to 12 months ....
10
8
7
6
2
2y2
3
3
2
2
1
0
154
ARTIFICIAL FEEDING
The mother should have a simple but generous diet with
plenty of fluids. Eggs, cereals, soups, vegetables, meat
once a day, gruel, milk, or cocoa at bedtime.
She should avoid worry, anxiety, fatigue, social dissipa-
tion, grief, excitement, fright and passion.
There is no objection, after the first few months, to sub-
stituting bottle feeding for some of the breast feedings.
Weaning should be begun gradually at nine or ten months
and completed at one year.
Artificial Feeding. — Milk for artificial feeding should
come from healthy cows and be clean and fresh.
It is preferable if it is "certified," pasteurized, or both.
In making up the following formulas (according to Holt)
7 per cent, milk is used. This is obtained by removing
the upper half from a quart bottle of milk which has stood
at least four hours. It can also be obtained by mixing
three parts of milk and one part of ordinary (16 per cent.)
cream.
Nine formulas are employed for different periods of the
child's development.
They are made as follows : —
1
II
III
IV
V
VI
VII
VIII
IX
oz.
oz.
oz.
oz.
oz.
oz.
oz.
oz.
oz.
7-per cent, milk
2
3
4
5
6
7
8
9
10
Milk sugar ....
1
1
1
1
1
1
1
1
1
Lime water ....
1
1
1
1
1
1
1
1
1
Boiled water . .
17
16
15
14
13
12
11
10
9
Totals
20
20
20
20
20
20
20
20
20
Formula I is begun on the second day; II on the fourth
day; III at ten to fourteen days; but after that the in-
crease is made more slowly. A healthy infant with good
digestion will be able to take formula V by the time it is
three or four weeks old.
Formulas from 7 per cent, milk can be continued until
the child is six or seven months old. Then a change should
gradually be made — using whole milk. Instead of remov-
ing the upper 16 ounces, one may for two weeks remove the
upper 18 ounces.
For the next two weeks remove the upper 20 ounces and
for the next two weeks remove the upper 24 ounces.
FEEDING
155
After this the bottle may be shaken up and the whole
milk used (Holt).
For artificial feeding of infants during the first year the
following table will be of service.
Age
Interval
between
meals by
Night
feedings
10 p. m.
No. of
feed-
ings
in 24
Quantity
for
one feeding
Quantity
for
24 hours
day
to 7 a. m.
hours
Hours
Ounces
Ounces
2nd to 7th day ...
2
2
10
l-ll/2
10-15
2nd & 3rd weeks . .
2
2
10
li/8-3
15-30
4th & 5th weeks . .
2
1
10
2y2-3i/2
25-35
6th to 9th weeks . .
2ya
1
8
3-5
24-40
9th week to 5th mo. .
3
1
1
4-6
28-42
5th to 9th month .
3
0
6
5-7y2
30-45
9th to 12th month .
4
0
5
7-9
35-45
The entire amount for the 24 hours should be made up at
one time, placed in bottles containing the exact amount for
a single feeding and pasteurized.
At the end of six months a little farinaceous food may
be added to the diet — also a little beef juice, the white of
an egg and orange juice.
For vomiting the amount of milk must be reduced, or
the fat content of milk should be reduced and the lime
water increased.
For colic or constipation strengthen the formula, sub-
stitute milk of magnesia for lime water or replace milk
sugar by maltose.
For diarrhea diminish the fat content of the milk, boil
it and dilute it if undigested milk appears in the stools.
The best forms of pasteurizers are the Freeman and the
Walker-Gordon.
As soon as the bottles are emptied they should be rinsed
with cold water and allowed to stand filled with water to
which a little bicarbonate of soda has been added. Before
the milk is put into them they should be thoroughly washed
with a bottle brush and hot soap-suds and then placed for
twenty minutes in boiling water.
Feeding during the Second Year : —
Five feedings a day should be given with milk at 10
p. M. if the child is awake, from the bottle.
The following are given until the fourteenth month —
156 INFANTILE PARALYSIS
milk with gruel, orange juice, beef juice, white of egg and
mutton or chicken broth.
From the fourteenth to the eighteenth month the follow-
ing are given: — milk (warmed), fruit juice, oatmeal or
hominy with cream, dry toast, beef juice, egg, rice, broth
and scraped beef.
After this, until the end of the second year, may be
added beefsteak, mutton chop or roast beef, prune pulp or
baked apple.
Feeding during the Third Year : —
The night feeding at 10 p. M. should be omitted. The
midday meal should be increased. Three regular meals
should be given and milk once besides.
To the second-year diet may be added baked white po-
tato, boiled rice or spaghetti, asparagus tips, string beans,
peas and spinach — all cooked until soft and mashed.
Condensed milk and proprietary foods. — If these foods
are used to correct symptoms of indigestion they should
be used for a few weeks only.
Most of them are low in fat and proteids and high in
sugar.
Children fed upon them for too long a time are liable to
develop rickets and sometimes scurvy.
Infantile Paralysis (Acute Anterior Poliomyelitis).—
This is an acute disease characterized by the rapid onset
of paralysis with fever. While it is usually confined to
infants and children, adults may also contract it. It is
most prevalent in summer and has recently been occurring
in epidemic form. The paralysis is most common in one
or both legs, but the arms may be affected. After a mild
attack the paralysis may disappear entirely. In all cases
some of the paralysis disappears, but as a rule the paralysis
which remains is sufficient to cause considerable deformity
and disability. In addition to the paralysis and fever,
there may be pain and tenderness, headache, restlessness
and muscular twitching. Few cases die.
Infantile paralysis is a disease due to a germ so small
that it has never been seen, which attacks the spinal cord
and produces local injury there.
Early treatment consists of rest in bed, counter-irritation
over the spine and local antisepsis of the mucous membranes
of the mouth and nose. Later the services of an expert
physician are most necessary to prevent deformity by means
INFLUENZA 157
of electricity, massage and the use of mechanical appli-
ances.
Since 1907 when the first large epidemic occurred in this
country in and near New York City the disease has been
spreading rapidly until during the past year there have
been epidemics in 31 states.
Prevention. — As the disease is communicable and to some
extent contagious, all cases should be isolated for at least
a month — as the disease germ has been found in the secre-
tions from several weeks to several months.
While the exact modes of transmission are not yet known
there is a suspicion that it may be caused by flies, fleas or
street dust. It may be carried by a person who has been
exposed even if not a sufferer. As the most common point
of entry of the germ into the body is the mucous membrane
of the nose, not only should all nasal and oral discharges of
the sufferers be disinfected and destroyed, but those ex-
posed (and we are all constantly exposed) should cleanse
their nasal cavities and mouths several times daily with
some mild antiseptic solution such as Liquor Antisepticus
Alkalinus.
While monkeys have been immunized, it has not yet be-
come practicable to immunize human beings. One attack
protects from subsequent ones.
Inflammation. — (See "Abscess.")
Influenza is an epidemic fever, accompanied always by
catarrh of some part of the body or other. It begins about
a week after infection, and it begins suddenly, with a rapid
rise of temperature, which it needs no clinical thermom-
eter to prove. The feverishness lasts nearly a week in
ordinary cases, and ends suddenly in an attack of perspira-
tion. There are at least four quite different types of in-
fluenza, and the same poison, whatever it may be, seems
to cause them all. Everybody who catches influenza has
three symptoms — feverishness; "cold" in the head, nose,
eyes, throat or chest; and extreme prostration. But some
people have other things added to these : for example, bron-
chitis and pneumonia; or palpitations, flushing, fainting,
sweating and gasping; or diarrhea, vomiting, jaundice; or
skin eruptions; or mental troubles. Everything depends
upon which part of the body is attacked. There is very
seldom a rash, but there may be a rose-rash which soon
fades. Nearly every case of influenza which is going to
158 INSANITY
be serious is accompanied by dreadful pains in the head,
back and limbs.
Influenza is infectious and epidemic, and it is due to
a germ, which is coughed into the air and is inhaled by
sufferers. You may have numerous attacks; one attack
does not protect you from a second. Old and young, poor
and rich, all stand a good chance of being attacked during
an epidemic.
The first thing to do when you are seized with influenza
is to send for the doctor. He will know how to nip the
mischief in the bud, if it ever can be thus nipped, and the
earlier treatment is begun the better chance you will have
of escaping lightly. Only about one person in a hundred
cases dies of influenza, but many, very many, are left pros-
trate for weeks, if not months, afterwards, and many are
never the same again after an attack. So do not waste
precious hours in self-doctoring, or you may regret it all
your life. In middle-aged and elderly folks the attack is
only too likely to be complicated by pneumonia (inflamma-
tion of the lungs). In younger people, an attack of in-
fluenza is often trivial and recovery occurs in a few days.
But it will not do to presume too much on one's former
health and strength ; and relapses are quite common.
You must keep the patient in bed during the attack ; and
until the doctor comes you may give a teaspoonful of am-
moniated tincture of quinine every two hours, and some
strong beef tea and good cognac brandy in it. Do not let
him take antipyrin or any such strong medicine without
medical advice, lest you damage his heart, which will re-
quire all the power it possesses if complications should arise.
Afterwards, a tonic will be required. If possible a change
of air and a thorough rest should be undertaken.
Insanity. — Not very many years ago a madman or mad-
woman got very little sympathy, and was locked up in an
insanitary madhouse, looked after by ignorant and often
brutal attendants, and hastened to death, or worse forms of
madness, by neglect, cruelty, starvation, or accident. If
the mad person were raving, noisy, and destructive, he was
tied down, confined in a dark room, or half -smothered with
clothes. If he believed himself persecuted by poisoners,
he would refuse all food, and then would probably be left
to starve. If he were depressed and melancholic, he would
be left alone, and shunned and neglected. If he were in-
INSANITY 159
clined to commit suicide very little trouble was taken to
prevent his doing so, and sooner or later he generally suc-
ceeded. If he were homicidal, he would be chained up,
and, if he were a person of no importance, would probably
be utterly neglected, and die of some disease caused by
unhealthy surroundings. A great many cunning lunatics
were able to conceal their disorder, and keep out of asylum,
because of the ignorance of doctors, as well as of the public,
on the subject of mental disease.
In this way anyone who became so insane as to require to
be locked up, became at once a disgrace to the family — a
skeleton in the cupboard whose existence was concealed at
any cost, and a stigma on all the relations. If a man had
cancer, or was a drunkard, he was pitied or despised; but
if his mind gave way, he was shunned, and ran the risk of
dying of neglect. He was thought by the ignorant pious
to be possessed of a devil, or to be a wizard or a witch. A
madman rarely recovered, for his unmerited sufferings in-
creased his madness, and to the tortures of mental pain
were added the unkindness (often ignorant rather than in-
tentional) of those sane and well.
At the present day the lot of the insane is very greatly
improved, and mental disease is a department of the study
of medicine in which very great progress is being made.
It is probably true that at no period of the world's history
have the needs of the mad been so well understood and
catered for as at the present day. Of late years the study
of madness has been recognized as the province of the
physician, and not of the lawyer, or clergyman, or mad-
house keeper. There are a great many things connected
with lunacy which are still in the hands of lawyers, and
plenty of instances where the attitude of the Law towards
criminals who are mad, rather than bad, or who are both
mad and bad, is manifestly unjust and wrong. Still, things
are improving, and it is the medical expert who generally
decides as to the alleged insanity of a criminal, though it
is the judge still who apportions the responsibility.
Just as in all other branches of the art of medicine, so in
the science of mental disease — people who are quite igno-
rant of the subject are apt to express opinions about pa-
tients who are said to be mad. And the reason of this is
that madmen do not necessarily act on all occasions in a
different manner to the sane. You might easily pass
160 INSANITY
through an asylum without chancing to see anyone at all
whom you would consider insane, and yet every one of the
patients there is mad. And there are a great many vari-
eties of the disorder, each with special signs, which you can
only recognize when you have been taught to do so. This
will explain how it is that madness requires special study,
and why it is that madmen must be kept for care and kind
treatment in a suitably-appointed asylum, and submitted
to the wholesome routine that is there carried out. Those
who have had absolutely no experience of either asylums
or the insane are very apt to think that it is terrible to
"lock up" an insane person in an asylum; but no kinder
thing can be done to a madman than that. And for these
reasons :
Nowadays asylums are all visited by officials of the
Government of the very highest standing, and it is their
duty to report on what they see in asylums for all the
world to know. At the head of every asylum is a physician
of special knowledge in the treatment of insanity. Under
him are other physicians, who assist him and train the
attendants, so that the patients shall not be in the care of
ignorant, and possibly unkind, men and women.
The utmost care is taken of the mad people, and the
physicians report on their condition regularly to the Govern-
ment. As soon as a madman recovers, and he is well
enough to be at large, he is discharged — a free man. The
rooms and corridors are warmed, the food is excellent, and
the management of the patients is in skilled hands. So
you see that everything is done to alleviate the sadness of
madness. Entertainments are provided, and in some places
recovery is accelerated by giving all the patients suitable
work to do ; for work is the grandest thing to keep you in
good mental health. The lot of the insane person at the
present day is made as comfortable as possible; formerly,
as I have shown, the mad were ill-treated, as if they were
evil or criminal, and the treatment soon made them both.
But while we may congratulate ourselves on our growing
knowledge, wisdom and kindness towards the unfortunate,
we are possibly too lenient and forbearing — not towards
poor suffering mad people, but towards the sane as well.
For a lunatic is not as other people are, even if he recovers ;
he is always liable to relapses, and yet when free of the
asylum he may marry and have children, and there is
INSANITY 161
always a risk that he will transmit to them some taint or
other — madness, alcoholism, or some other dread disease.
The Varieties of Madness. — Insanity, or the state of mad-
ness, is the condition of unsoundness of mind which is the
opposite to sanity, which means that state of mind which
makes men and women able to carry out their duties to
their fellows, and to behave properly in their own interest.
There are cases of insanity of very different forms, and
they may be classed and considered in many ways. Infants
may be born mad, and are then called idiots; or insanity
may come on at every period of life, even in extreme old
age. Indeed, old age has a special form of madness, called
Dementia, or a return to a childish state of mind. Insanity
may be inherited or acquired. Madness certainly runs in
some families, and sometimes comes on about the same age
and in similar form in one generation after another. It
can be acquired by head injuries, by drunkenness, by de-
bauchery, by shocks to the mind, from extreme grief, and
from horror. Long-continued, severe pain and starvation
will also send people mad. A long series of epileptic -fits
may end in insanity. The usual forms of insanity which
occur in middle-life to persons who have been in good health
are three — Mania, Melancholia, and Monomania. Mania
means madness in which violence predominates, or, at any
rate, the form in which patients have attacks of violence.
It is called raving madness. It is marked by loss of com-
mon sense and memory, with delirium, restlessness, and
sleeplessness, self -neglect, senseless anger, distrust of others,
shouting and howling for hours together. The maniac is
mischievous and destructive, and may attack others or kill
himself. Melancholia comes on gradually, with depression
of spirits, fear, and a sullen, morose state of mind. Such
patients seem unwilling to say or do anything, and sit for
hours vacant-minded or in mental agony. They sometimes
refuse food, and try to starve themselves, and may attempt
suicide in many ways. Melancholic persons may also de-
velop murderous tendencies, and sometimes try to set fire
to furniture and buildings. The worst cases of melan-
cholia are those which begin from extreme religious devo-
tion. Monomania is the name given to those forms of
madness in which the patient has some settled delusion or
mental crank, and may yet be able to speak and act sensibly
in ordinary matters. For example, monomaniacs may think
162 PREVENTION OF INSANITY
themselves kings, or made of glass, or that they have some
divine work set them to do.
That form of insanity in which the sufferer has constant
fixed delusions is called paranoia. This is one of the com-
monest forms of insanity in this country.
Treatment. — To conceal a person's insanity is to commit
an action which is both unkind to the patient and a crime
on the whole public. The earliest possible removal to an
asylum is of the utmost importance, and every day's delay
may diminish to some extent the chance of his restoration
to health. There is not much to be ashamed of in having
a mad person in the family as a drunkard, for instance ;
but, in any case, asylum treatment is his only chance of
recovery.
Prevention of Insanity. — The importance of preventing
insanity is appreciated when it is realized how rapidly in-
sanity is increasing — (104 per cent, during the last decade
in New York State, where one-sixth of the total expenditure
of the State is for the insane.)
Insanity is due, in a majority of cases, to causes which
are known and preventable. The 32,000 persons now in
hospitals for the insane in New York State might have
remained sane and lived useful and happy lives if they
had known certain facts and acted accordingly.
Of the preventable causes the following are the most
important : —
Immoral living, alcohol and other poisons, certain physi-
cal diseases, bad mental habits and heredity.
Immoral living is extremely liable to result in the con-
traction of syphilis, which may produce, among other dis-
eases, softening of the brain — the cause of 25 per cent, of
all insanity. Every man and boy should know that by
yielding to the temptation to go with immoral women he is
exposing himself to the probability of getting this disease,
which may result, years after, in incurable insanity.
Alcohol. — Forty per cent, of all insane cases are due
directly or indirectly to alcohol even in ' ' moderate ' ' quanti-
ties not producing intoxication.
Other poisons capable of producing insanity are opium,
morphine and cocaine.
Physical diseases which may be followed by insanity are
typhoid fever, influenza, diphtheria, tuberculosis, and dis-
eases of the arteries, heart and kidneys. A person suffer-
PREVENTION OF INSANITY 163
ing from these diseases should have good nursing, skilled
medical treatment, pleasant surroundings and freedom
from anxiety. Physical diseases may be prevented or con-
trolled by protection of food and water, temperance, health-
ful homes and factories.
Hard work alone rarely causes a nervous breakdown.
It only becomes a menace to health when associated with
worry, loss of sleep, etc.
Bad Mental Habits. — The healthy state of mind is one
of satisfaction with life. This does not depend so much
upon our surroundings or how much money we have, as
upon the way in which we train ourselves to deal with
difficulties and troubles. " Stone walls do not a prison
make, nor iron bars a cage."
Anyone who departs too far from this state of satisfac-
tion must be regarded as tending towards an unhealthy
condition.
The average person little realizes the danger of brooding
over slights, injuries, disappointments, or misfortunes, or
of lack of frankness, or of an unnatural attitude towards
his fellowmen, shown by unusual sensitiveness or marked
suspicion. Yet all these unwholesome and painful trains
of thought may, if persisted in and unrelieved by healthy
interests and activities, tend toward insanity. Wholesome
work relieved by periods of rest and simple pleasures, and
an interest in the affairs of others, are important pre-
ventives of unwholesome ways of thinking.
We should train ourselves not to brood, but to honestly
face personal difficulties. We may not like even to admit
the existence of these difficulties, but they are often the
real cause of the brooding. To start doing something, to
change the situations about which we fret, is the healthiest
way to avoid aimless fretting. We should not hanker after
the impossible, but learn to get satisfaction from what is
at hand. We should not give ourselves up to day dreaming,
but try to do something, no matter how small it is.
Heredity. — We cannot choose our parents, but we can
do much to insure the health of our offspring. On the
other hand we can accomplish much by not worrying un-
duly about insanity in our ancestors. Insanity is not di-
rectly inherited. One may inherit a greater or less tend-
ency toward insanity. Mental instability may be inherited
just as weak constitutions may be inherited.
164 INSOMNIA
Those who have reason to believe that there was mental
disease in their ancestry should not be unduly alarmed.
The fact that some of their ancestors suffered from mental
trouble does not make it certain that they will suffer like-
wise. These tendencies towards insanity may lie dormant
during the whole lives of the individuals. But such per-
sons should take the proper precaution to prevent the
development of this tendency. As a weak constitution may
be built up by healthful habits, so may mental instability
be made stable by good mental and physical habits. The
individual whose family has bad mental trouble may often
escape the disease by proper surroundings, healthful and
temperate activities, and proper mental and physical habits.
The most important fact in heredity is that the vast ma-
jority of ancestors of every individual were normal.
Heredity tends, therefor, rather more strongly toward
health than toward disease.
The fact that heredity plays a part in the causation of
insanity, should create a public conscience regarding mar-
riage. Marriages should not be contracted by two persons
who have insanity or feeble-mindedness in their immediate
families, without first seeking the advice of a competent
physician.
Insomnia. — (SLEEPLESSNESS.) — No one can remain many
days without sleep, but many persons do not sleep so long
as they would like to, and many persons do not sleep as
much as their health needs. The doctors describe a special
form of disease named insomnia, which means wakefulness
occurring when sleep ought to be present. It may be due
to disease of the mind, or of the brain, or of the body, and
may itself give rise to other diseases. Absence of sleep
is very rarely complete even for twenty-four hours, but
want of quiet, restful, continuous sleep is a state from
which most people suffer at some time or other. It is very
well known that there are drugs which will produce sleep,
or, at any rate, will bring on insensibility, or a form of
sleep, and these drugs are called sedatives or narcotics.
It is, however, very bad policy to give any doses of such
medicines until you have tried the removal of all possible
causes for the wakeful state, because in most patients there
is some definite cause for it, and when the cause is taken
away the patient sleeps well. Sedative doses strong enough
to compel sleep should be avoided also because they dis-
INSOMNIA 165
order the stomach, disturb the digestion, make the tongue
dry and coated, and cause an unnatural thirst ; the appetite
is also lost. Sleeplessness may show the presence of fever;
it may be due to pain, to shortness of 'breath, to palpitation
of the heart, or to delirium, especially the delirium of
drunkards. Simple sleeplessness does sometimes occur in
the absence of any of these serious causes; it may be due
to a state of worry or irritability of the mind, pointing to
a congestion of the brain. Some forms of indigestion will
cause it, and in this matter people vary very much, for some
cannot sleep after a heavy supper, while others lie awake
if they have an empty stomach. Persons who lead lives of
bodily work carried on in the open air generally sleep very
soundly, while persons who work in the close, unhealthy
rooms in factories often have restless nights. Over-fatigue
may cause restlessness, and so anxiety of mind can destroy
all chances of sleeping. Literary workers, and also persons
who lead useless, frivolous lives, often sleep very lightly,
and go to doctors for sedatives.
But all attempts at classifying the causes of sleeplessness
are very unsatisfactory, and the subject might be dealt
with adequately only in a couple of thick volumes. We
have mentioned above eight of the commonest causes of
sleeping badly. Others are cold feet, tea-drinking at bed-
time, lack of food, heart disease. The first thing to do,
then, if you sleep badly, is to find out why. Have your
room dark and quiet, and see that your feet are warmed.
(See also "Sleep, Hints on Obtaining," in this volume.)
When we come to consider drugs we tread on dangerous
ground. The people who suffer most from sleeplessness
are not those who do some work in life, and fill their hours
in some profitable way, but they are those who idle and
lounge, or live frivolously, and those who drink and eat
too much. These people are already self-indulgent, and to
tell them to drink a little alcohol, or to take a little narcotic
at bedtime, is only to give them an excuse for another bad
habit. Chloral, morphine, alcohol, and the rest, spoil a
good many lives from over-indulgence. The most harmless
sedatives are the bromides, which may be taken, if neces-
sary, for years. Thirty grains of bromide of ammonium
should be taken an hour before bedtime in mild cases of
sleeplessness, and until this plan has been given a good
trial, no other sedatives should be used. A very safe drug
166 ITCHING
is bromural in a dose of 10 grains, taken in a little hot
water and sugar at bedtime.
Itch is a skin disease caused by the presence of a species
of mite which lives, male and female, on the skin, and
burrows into it. The female itch-insect leaves her eggs in
the burrows and they set up an intolerable itching and
irritation. The commonest places for these burrows are
the webs between the fingers and toes, the front of the
wrists, and women's breasts; and never are they seen on
the face, except sometimes on children in arms. There is
generally a little tiny pimple which marks the mouth of
each burrow, and a little track can generally be traced by
the thin line of dirt which fills it. So that almost anyone
can discover the signs of the presence of the insect. If you
rub weak sulphur ointment into the burrows so thoroughly
as to get into every cranny and nook, for a few days, the
insects will die, and the disease will be cured. But in
cases where the itch occurs on parts of the body which are
covered up, disinfection of the clothes must be undertaken,
and the patient must take baths, and use soaps and lotions
which must be ordered by the doctor according to the merits
of the particular case. So far, so good. But many people
who contract the itch scratch the skin wildly, and as the
finger-nails are not always clean, the scratched skin soon
has a number of sore places on it, all more or less "poi-
soned" by the patient himself, who very likely spreads the
disease all over his body by mere scratching. With regard
to the cure we must say that mere smearing of the ointment
on the place is of no use ; on the other hand, you need not
be so vigorous as to inflame the skin with it. If there is
only itch, you may cure it with stavesacre ointment, or weak
sulphur ointment, after a hot bath, in which use soft soap.
For the itching a lather of menthol soap is the best thing.
But where the skin has been rudely scratched, and is a mass
of tender places and sores and scabs, it is a case for the
personal attention of a doctor.
Itching of the Skin of Various Parts. — There are two dis-
tinct ailments in which the sufferer complains of itching of
the skin. One is prurigo, a non-contagious skin-eruption
of small pimples, causing intense suffering, and very diffi-
cult to relieve. It has nothing to do with the disease called
the itch, and is really a disease of old age and caused in
some mysterious way by the slow * ' decay ' ' of the skin itself.
ITCHING 167
This ailment we shall say no more about. The other ail-
ment, which must not be mixed up with prurigo, is called
pruritus, and means "an itching."
Pruritus is not a disease, nor is it a skin-eruption, but
only a sign or irritation of the skin caused by something
which it is the doctor's duty to find out before he can set
to work to relieve it. The causes of the itchiness of the
skin which we call pruritus are : —
(a) Local causes —
(1) Dirty habits; lack of washing.
(2) Lousiness (see "Lice").
(3) Ringworm.
(4) Eczema.
(5) Irritating woolen underclothing.
(6) "Prickly heat" (a sweat eruption which some
people get in very hot weather) .
(b) General causes —
(1) Diabetes (which see).
(2) Jaundice.
(3) Piles, which cause much itching at the anus.
(4) Diseases of the womb often cause itching due to
the irritating discharges.
(5) Pregnancy. Many women have terrible itching
towards the end of child-bearing.
(6) The change of life in women (see "Change of
Life").
(7) Worms in the intestines.
Now, whatever be the cause of the itchiness, it gets worse
when the patient gets warm in bed.
Treatment. — First, insist on thorough cleanliness and
bathing. Eczema, if present, wants special treatment (see
"Eczema"). Diabetic itching is relieved by sponging the
parts daily with Goulard lotion. Or the following may be
painted on with a brush — menthol, 1 part ; olive oil, 5 parts.
Baths are especially comforting to itchy skins. — The co-
nium and starch bath — Extract of conium, 120 grains;
starch powder, lib.; hot water, 30 gallons. (After this
bath, sprinkle the skin with starch powder.)
The Sulphuret bath — Sulphuret of potash, 4 ounces ; hot
water, 30 gallons.
168 KIDNEY DISEASES
Caution. — Not to be taken if there be sore places from
scratching.
Kidney Diseases. — The kidneys are two organs lying in
the lower part of the back (the loins), and their duty is
to get rid of the waste matters in the blood. The water
which the kidneys secrete passes down two little tubes into
the bladder and remains in the bladder until that vessel
is uncomfortably full when it is passed away through the
urethra or pipe.
A healthy person passes about fifty ounces (two and a
half pints) of urine every day. In cold weather, more ; in
hot weather, less, because the skin gets rid of a lot of water
by perspiration. Healthy urine is pale amber-colored and
has no deposit. But let none of our readers pay too much
attention to the urine. It varies very much in color and
in quantity even in good health. A pinkish sediment in
urine that has been standing and has got cool in the cham-
ber, is very common, and is of no importance. It probably
means that you have a slight cold, or that you are eating
too much meat. Many medicines color the urine; rhubarb
makes it very yellow, asparagus makes it smell aromatic-
ally; and so on. If the state of your urine troubles you,
take a little bottle of it to a doctor and ask his opinion.
Don't take " kidney pills," or other self -prescribed medi-
cines. And don't run away with the idea that a pain in
the back necessarily means kidney disease, as certain ad-
vertisements try to make you believe. The pain may be
kidney trouble, but probably is not. (See also "Lum-
bago.")
The kidneys are subject to inflammations of various kinds.
The acute inflammations are serious acute illnesses, and
must be treated by the doctor. Nothing is to be gained by
a long description of these diseases.
Inflammation of the kidneys ( Bright 's disease) produces
certain signs and symptoms which the reader ought to know
something about.
(1) Smoky urine. — When the urine looks as if it had
been mixed with smoke, it probably contains blood. Take
some of it to the doctor at once.
(2) Dropsy. — The eyelids are puffy when the patient
rises from bed in the morning. The ankles are puffy at
bedtime. If the finger is pushed into this puffy swelling
it leaves a pit ; the flesh seems to be " boggy, ' ' and is water-
KIDNEY DISEASES 169
logged, as the saying is. These signs, seen in a person who
has had scarlatina, means kidney trouble. In middle-aged
persons who have damaged their kidneys by drunkenness,
this dropsy is common.
(3) In kidney disease the heart and pulse beat hard and
strong, and the patient is liable to giddiness and vomit-
ing.
Chronic Bright 's Disease. — This is of two chief varieties.
Persons who have had syphilis, or malaria or gout, and
those who work in lead, are especially liable to these forms
of kidney decay. But the chiefest cause of all chronic
kidney disease is intemperance. The early signs of chronic
kidney disease are anemia, loss of appetite, headaches,
sickness, general weakness, passing too much urine (es-
pecially having to get up in the night to pass it), and
dropsy, as before described. The disease generally pro-
gresses until the patient gets an attack of paralysis, or
several attacks, and then heart disease, and then death.
But much may be done by a doctor's careful treatment,
warm clothing, and especially by total abstinence from
alcohol. Alcohol, in fact, is a powerful poison when the
kidneys are diseased. Meat must be given up as far as
possible, and the diet be confined to milk and farinaceous
foods.
The treatment of some of the symptoms of chronic
Bright 's disease, or chronic nephritis (degeneration or de-
cay of the kidney tissues), is here given: —
For sleeplessness —
(1) Sulphonal, 20 grains, in cachet. (To be swal-
lowed at bedtime, and washed down with a half-pint of
hot water.) Or,
(2) Paraldehyde, 1 drachm; water, a wineglassful.
(At bedtime.) Or,
(3) Trional, 5 grains in cachet. (To be swallowed an
hour before retiring.)
Note. — Chloral, opium and morphine must not be
taken.
For headache —
(1) Caffeine, 5 grains; antipyrin, 2 grains. (To be
taken whenever the headache is violent.)
170 LEAD POISONING
For smoky urine —
(1) Nitrate of pilocarpine, 4 grains; vaseline, 12
ounces. (To make an ointment, about 3 ounces of which
are to be daily rubbed well into the skin and covered
with cotton wool, and bandage.)
For dropsy —
General measures — massage, hot-air baths, purgatives.
For vomiting —
(1) Real buttermilk, 1 ounce; potash water, 7 ounces.
(To be taken as a draught occasionally.)
(2) Iced champagne.
Koumiss, Home-made. — A stimulating, nourishing, and
refreshing food and drink for persons with diabetes, and
others with indigestion. // buttermilk can be got, mix two
pints of it thoroughly with three pints of milk, and add
five lumps of white sugar. Put the milk in a bowl, covered
with a clean towel, and let it stand in a warm corner for
24 hours. Then pour it into small bottles, cork them, and
tie down with corks. Leave the bottles in the kitchen three
days lying on their sides and shake them occasionally.
After this the koumiss is ready for use.
// buttermilk cannot be got. — Boil enough fresh milk to
fill a few quart bottles when cold, not filling the bottles
completely, but leaving room to shake. Add to each bottle
half -ounce of castor sugar, and 20 grains of Vienna yeast ;
cork the bottles up with sound corks and tie down. Lay
the bottles horizontally on the floor in a warm corner,
and shake twice a day. The koumiss will be ready to
drink on the sixth day (sooner in hot weather and later
in cold.) Can be made thinner by using skimmed milk.
— (Yeo.)
Lead Poisoning. — This occurs chiefly among painters,
plumbers, compositors, type-founders, and factory-hands
in white lead factories and potteries. Those who drink
beer to excess are more liable than others.
Poisoning by lead may be known by attacks of colic,
ancemia, gouty attacks, a blue line on the gums, paralysis,
and headaches, and cramps and numbness, and, in women,
abortions. The colic attacks are very severe; the pain is
LICE 171
relieved a little by pressure and a tight belt. The patient
is constipated, and often vomits before the colic begins.
The anaemia is often the first sign (see also "Anaemia").
The "blue line" is not to be seen in persons who brush
the teeth regularly. The paralysis is in the form of wrist
drop — the patient's hands hang down and he cannot raise
them.
The poisoning is curable, but will come on again if the
patient does not give up his unhealthy occupation. The
colic yields to opium, but a doctor must be consulted about
that. All the signs of poisoning will disappear at last if
the patient, having changed his employment, will take, for
three months, or more, as the case may be, some such medi-
cine as the following: — Iodide of sodium, 40 grains; sul-
phate of magnesia, one ounce ; tincture of nux vomica, two
drachms ; cinnamon water to eight ounces. Take two table-
spoonfuls, on rising and at bedtime, for three months.
Lice (VERMIN) are not uncommon on the bodies or
among the hairs of persons who are not of cleanly habits.
A louse is a tiny insect looking a little like a tiny crab,
and, in fact, the word ' ' crab ' ' is often used to refer to such
lice. The louse lives on the skin and feeds on the blood of
the dirty person who harbors it. The presence of several
lice causes itching, and as the person scratches with dirty
finger-nails, he infects the little louse wounds with dirt, and
thus he gets a sort of skin disease. The whole business is
all the more disgusting because it could be entirely avoided
by keeping the skin clean. In a bad case, a neglected child 's
skin or scalp becomes covered with dirty sores and crusted
scabs; on the hairs near will be found "nits," tiny eggs,
which are glued to the hairs, and cannot be got off by or-
dinary washing. Later on the glands in the neighborhood
become swollen and form painful lumps, which may become
abscesses.
Whenever a child's head is always itching, and there
are scabs on it, and a few little lumps on the neck, the child
probably has lice, and we ought to look for the nits, which
are gummed to the hairs. First cut the hair short, and
burn it. Burn also the cap or hat that he has been wear-
ing, and send his towel and pillow-case to the wash. Then
rub into the scalp white precipitate ointment.
Vinegar and water will destroy nits, used as a lotion
after washing the head thoroughly. A good lotion for lice
172 ARTIFICIAL LIGHTING
consists of 1 grain perchloride of mercury, 1 drachm spirits
of rosemary, and dilute acetic acid up to 1 ounce.
Elderly people of dirty habits often complain of an itch-
ing skin, and if the folds of the shirt or chemise near the
neck be closely examined, lice may be found. In such a
case the clothes must be disinfected as well as washed, and
that may be done by baking them.
Lighting. — The illumination of a room is a matter greatly
affecting the comfort and, indirectly, the health of the
occupants, and is of especial importance to eyesight in
the case of factories, workshops and schools, where the
eyes are concentrated on small objects for many hours at
a time.
The difference between good lighting and darkness is
the difference between cheerfulness and gloom. It vastly
increases the efficiency of the worker; it obviates eyestrain
and the development of myopia. Good natural lighting
aids cleanliness, destroys germs and their dangerous prod-
ucts and influences directly the health of the body. Just
how light acts in this way is not definitely known but it
is a well-proven fact. Some direct evidence comes from
the recognized effect of ultra-violet rays and the Finsen
light on certain disease processes on the surface of the
body.
The best illuminant is sunlight. The best artificial illum-
inants are those which most closely resemble sunlight.
All sources of light should be shaded and the best form
of illumination is that known as the * ' indirect ' ' where light
is reflected from a broad light surface.
An important aid to the illumination of dark interiors by
natural light has been the recent introduction of panes or
plates of glass with a series of ridges or prisms, which re-
fract and diffuse throughout a room light which would
otherwise illuminate it but partially or not at all.
ARTIFICIAL LIGHTING— of all the systems of arti-
ficial lighting in common use at the present time the in-
candescent electric light should be placed in the first rank,
followed next by the incandescent gas-light (Welsbach).
The Incandescent electric light presents the following
advantages over coal gas, oil and candles. There is no
consumption of oxygen, there are no products of com-
bustion to pollute the air, and the heat produced is rela-
tively slight. The light of the arc light is not yellow, but
ARTIFICIAL LIGHTING
173
white. It precisely resembles solar light in being rich in
the violet and the ultra-violet rays. Plants grow and flower,
and fruit ripens, when exposed to this light, just as they
do in the sunlight; whilst photographs can be taken as
easily by the arc electric light as by daylight.
The arc light, while well adapted for lighting streets,
large halls and buildings, is extremely dazzling, and is
productive of injurious effects on the eyes of those who are
much exposed to its influence unless it is extremely well
shaded.
The incandescent lamps are best suited for domestic use.
The light is steady and agreeable, but should always be
shaded or used as a diffused indirect light.
Modern economical forms of electric lighting for work
rooms and halls are the mercury vapor tubes used in the
Cooper-Hewitt and the Moore systems. In the Cooper-
Hewitt light the red rays are absent and human beings
have the complexion of death. The light is a very good
one to work by, however. The Moore light has a more
agreeable yellow or pink rose color.
The Welsbach light is less productive of carbon dioxide
than the average oil lamp and consumes not quite one-half
less gas than the ordinary gas burners, giving rise, there-
fore, to the evolution of half the heat and half the amount
of carbon dioxide, while its illuminating power expressed
in candles is more than three times as great as the best
ordinary gas burners or incandescent electric light.
The important attributes of an illuminant, from the
health standpoint, are the following: — amount of ogygen
removed from the air, the amount of carbon dioxide pro-
duced, the amount of heat produced and the degree of
vitiation of the atmosphere.
The following table shows these points for the com-
moner forms of illuminations : —
Candle
power
Oxygen
removed
Carbon
dioxide
produced
Heat
calories
produced
Vitiation
equal to
adults
Tallow candle ....
Kerosene oil lamp .
Coal-gas burner . .
Welsbach burner ..
Electric incandes-
cent light
16
16
16
50
16
cu. ft.
10.7
5.9
6.5
4.1
0.0
cu. ft.
7.3
4.1
2.8
1.8
0.0
1400
1030
1194
763
37
12
7
5
3
0.0
174 LIVER, DISEASES OF THE
Acetylene gas, generated by the action of carbide on
water, furnishes a powerful white light; but its use is not
unattended with danger, unless great care is exercised.
Coal gas gives a yellow or orange flame which is usually
steady and agreeable although there are certain drawbacks
connected with its use. It consumes much oxygen, pro-
duces carbon dioxide, produces much heat and vitiates the
atmosphere considerably. Leaky gas pipes are dangerous.
The products of combustion are injurious to health. The
combustion dries the air and the humidity is much lowered.
Each cubic foot of gas burnt per hour from ordinary
burners vitiates as much air as would be rendered impure
by the respiration of an individual.
Kerosene oil lamps are well fitted for use in rural com-
munities. The fuel is cheap and the light a steady one,
and agreeable if properly shaded. They vitiate the air
greatly and produce a great deal of heat, as well as consume
much oxygen and produce much carbon dioxide. Their use
is sometimes attended with danger from explosion and fire,
but modern lamps are made in which explosions are im-
possible, and there are lamps which become extinguished
automatically when they are upset.
Tallow candles are the poorest of the common forms
of illuminants. The light is flickering, weak, too yellow
and sooty. Much gas and heat are produced, the vitiation
of the air is great, much oxygen is consumed and the amount
of carbon dioxide produced is large.
Liver, Diseases of the. — The liver, which is a very large
gland, lying chiefly on the right side, below the lung, and
beneath the lower ribs, has for its principal duty the for-
mation of a digestive fluid called bile or gall, which is stored
up in the gall-bladder on the under surface of the liver,
and is poured out drop by drop into the gut or bowel so
that it may mix with the food and digest it. To digest
food means to prepare it for absorption into the blood.
The liver has other work to do also, but the making of the
all-important bile is its chief industry. Now bile not only
helps in the digestion of the food, but it is a natural dis-
infectant, and a natural purgative, helping the lowest parts
of the bowel to get rid" of the waste matters. It is now
easy to see why a stoppage in the formation of bile leads
to costive bowels, and to indigestion.
Like every other part of the body, the liver is subject
CIRRHOSIS OF THE LIVER 175
to congestion and inflammation. Acute inflammation of
the liver is caused by excess of alcoholic drinking, indis-
cretions in diet, etc., and requires rest in bed. The patient
is a little feverish, the liver is tender, the whites of the
eyes are yellowish, the motions are pale colored, the urine
high-colored, and he has a headache and languid feeling.
A light milk diet will be needed, and a three-grain dose
of calomel; and a hot linseed and mustard poultice must
be put on over the liver and replaced when cold by a thick
layer of cotton-wool. The attack generally lasts about a
week.
Chronic inflammation of the liver results from heart-
disease of certain kinds, and this is the patient's sad mis-
fortune; the chronic enlargement of the liver due to al-
coholic excess is more common and is the patient's fault.
Its cure depends very largely on the patient himself. The
chronic enlargement is called cirrhosis (pronounced sir-
rosis) of the liver. The symptoms of it are also those
of chronic indigestion caused by alcohol, because it is al-
ways accompanied by inflammation of the stomach. The
chief signs are trembling and coated tongue, shakiness of
the hands, enlarged veins over nose and cheeks, sickness on
rising in the morning, loss of appetite, a dry taste in the
mouth, sleeplessness. Later on, piles and blood-vomiting
(which see ) ; watery eyes, muddy complexion, fat body,
thin legs and arms.
Most of these drunkards, suffering thus from years of
folly and self-indulgence, are weakened from long absti-
nence from food, and a slight nutritious slop diet is one
of the first necessities. But Nature will recover herself
largely without much treatment if only the alcohol is given
up absolutely and at once. Change of occupation is of
vital importance for waiters, publicans, and barmaids who
have developed the disease. Outdoor labor should be
tried.
Cirrhosis of the Liver has very, very numerous, pain-
ful and distressing symptoms. We cannot here attempt
a thorough exposition of the treatment necessary. When
the disease is definitely developed the patient will require
continuous medical aid as well as his own efforts at keep-
ing sober. The following medicine will help him to resist
the craving for drink and will do his indigestion good:—
Taraxacum juice, 2 ounces; dilute nitre-hydrochloric acid,
176 LOCOMOTOR ATAXY
% ounce; tincture of mix vomica, 6 drachms; liquid ex-
tract of Cinchona bark, 4 drachms; water to 12 ounces.
Take a tablespoonful in a wineglassful of water before
meals.
Cancer of the Liver. — This generally occurs in the in-
temperate, but a secondary growth in the liver may happen
to anybody with a cancer. (See "Cancer.")
Liver Colic. — This is the pain caused by the passage of
a gallstone which is forced from the gall-bladder where it
was formed, through a narrow tube too small for it, into
the gut. The pain is sudden and intense and is felt in
the lower part of the chest, the right shoulder and back.
It is often so severe that the wretched man (or more often
woman) is bent double in agony and writhes about on the
floor, shivering, sweating and miserable. After a time the
pain becomes less, and dull and aching until it all sub-
sides— or a fresh attack occurs.
Very often the patient gets yellow all over, jaundiced.
The whites of the eyes are the first to show the yellowness
and the last to lose it. If the gallstone passes into the
gut, the pain all goes away, the jaundice gets better and
the little stone is passed away in the motions. But the
stone may remain in the little tube, unable to get out.
The actual attack of pain must be treated by a medical
man. Afterwards the patient must take precautions against
the formation of another stone. The diet must be spare,
plenty of exercise must be taken and alkaline drinks must
be taken in large quantities always. Also the patient must
take a heaped-up teaspoonful of phosphate of soda in hot
water every morning.
Hot baths or hot poultices are useful for the attacks of
pain, until medical advice can be obtained.
Lockjaw. (See "Tetanus.")
Locomotor Ataxy. — A nervous disease, chronic, progres-
sive, ending in death in a few years. Most common in
middle-aged men, especially fast men, who have had
syphilis, and who, in addition, are given to drinking alcohol
in excess.
There are three stages to the disease: —
(1) The Pre-ataxic stage. (Ataxy means inability to
control muscular movements.) — Some of the signs and
symptoms in this stage are: — "lightning-pains" (acute,
severe and violent sudden pains lasting a few seconds) ;
LUMBAGO 177
"girdle-pain," a sensation as if bound tight with a belt
or iron band.
(2) Ataxic stage. — The first sign is often the tumbling
forward into the basin on closing the eyes during washing
in the morning, another is the difficulty in buttoning up
the collar.
The patient soon feels as if he were walking on wool
instead of on the pavement, and cannot turn round sud-
denly, or stand with his eyes shut. He has to look at his
feet when he walks. He is no weaker, however. Then he
may have vomiting, acidity, shortness of breath, inability
to pass his urine or to hold it sometimes. The skin is
dry; the nails crack, perhaps. The pupils of the eyes
are small.
(3) Paralytic stage. — The patient becomes bed-ridden,
and sooner or later dies of pneumonia or some other serious
disease. The disease is probably always incurable, but some
cases caused by syphilis have recovered under treatment.
Lumbago. — Rheumatic pains in the muscles of the loins
— backache. This often comes on quite suddenly as a
violent pain in the back, like a stab with a dagger in the
loin muscles. It comes on again every time the sufferer
rises from lying down to the erect position, and also some-
times when he coughs or sneezes or laughs.
He is apt to imagine that he has some terrible kidney
disease but he probably has not. There are no signs of
illness, except the pain ; and it is not like the pain of either
kidney or liver colic.
When it is better, the back feels stiff and sore for a
long time.
Treatment. — As in the treatment of all other pains, we
must try to relieve lumbago not only by local applications,
but must get at the root of the mischief by giving medicine
internally.
Local applications —
(1) Hot fomentations, sprinkled with laudanum or
turpentine.
(2) Put a piece of brown paper over the loins and
then iron them with a heated flat-iron.
(3) Hot-air baths.
(4) "Baths" of warm medicated mud, such as
"fango," are very useful and comforting.
178 LUNGS, DISEASES OF THE
(5) Rub in compound camphor liniment four times
a day, and let the patient wear a warm, wide, woolen
belt next his skin, around the loins and abdomen.
(6) Dry -cupping of the loins is very likely to give
relief to lumbago in robust and full-blooded persons.
This is a treatment which ought to be done by a doctor
or nurse, but as there are always a few people who like
to do things on their own responsibility, we describe the
process here. To dry-cup, take a thick glass tumbler,
and put into it a bit of blotting-paper sprinkled with
methylated spirit. Set fire to the paper, and just before
it has quite burnt out, clap the mouth of the glass on
to the loins of the patient. The heating of the air in
the glass has "rarified" it, and a vacuum is produced so
that the skin is sucked up into the glass and the blood
rushes to it, thus being drawn from the seat of the pain.
The glass is left on for 15 minutes. This can be re-
peated in several places. Wet-cupping is even more ef-
fectual, but it cannot be done by non-medical persons.
(7) If the patient with lumbago wants to move about,
he should wear a plaster made from equal parts of
belladonna plaster and opium plaster and spread on
leather.
(8) Many doctors get good results from puncture.
They rapidly insert a stout needle into the loins and
pull it out again, and repeat this in several places. It
is a somewhat painful proceeding at the time, but gives
relief directly afterwards.
(9) It may be necessary, if none of these methods give
relief, for the doctor to inject some medicine into the
loin with a syringe, through a fine, hollow needle.
(10) Very chronic cases of lumbago are relieved by
blistering freely.
(11) Electricity is used in some hospitals to relieve
pain. Internal remedies are such as these : —
Aspirin, sodium salicylate or salicylate of colchicum.
Lungs, Diseases of the. — The lungs are two elastic organs,
occupying the chest and sharing it with the heart, which lies
in a closed membranous bag between them. The chief
duties of the lungs are: — to enable the blood which cir-
culates in the spongelike tissue, to come into contact with
the oxygen of the air ; and to give off carbonic acid gas in
MADNESS, SYMPTOMS OF 179
the breath. The oxygen is required to purify the blood
which gets filled with carbonic acid gas in doing its work
of nourishing the tissues of the body. It will be seen that
the lungs are most important organs. Thus: —
(1) If they are undeveloped, then the blood does not get
aerated and purified as well as it should; also it does not
give up its carbonic acid gas properly. So the whole nour-
ishment of the body suffers and the body remains stunted.
(2) If they are inflamed or diseased, then the blood
which is continually circulating through them carries im-
pure and used-up blood to the rest of the body, instead
of pure fresh blood. We shall refer again to this condition.
(3) If the lungs are too much developed — blown-out,
as in many athletes, and asthmatics and bronchitic persons,
and glass-blowers, and wind-instrument players, then they
cannot expand and contract properly, and the blood never
gets properly aerated. The results are shortness of breath,
blueness or coldness of the hands and feet, and so on.
(See "Chest Deformities.")
(4) In people who suffer from Bright 's disease, and
heart disease, the lungs are apt to get dropsical or * ' water-
logged," and hence the blood cannot be properly aerated.
The disease which is most important of all those which
affect the lungs themselves is one known as "Pneumonia."
This is also called "inflammation of the lungs," but as it
is in reality a disease of the whole body, involving the whole
of the respiratory organs and the digestive and other or-
gans as well (though the chief mischief is in the lungs),
we shall devote a separate article to it. (See "Pneu-
monia.")
The next most important lung disease is Broncho-Pneu-
monia, in which there is Bronchitis as well as Pneumonia.
It is commonest in children under five years of age, and is
very often fatal. Other lung diseases are Abscess of the
Lung, Gangrene of the Lung, and Tuberculous Disease of
the Lung, which is another name for our old enemy, Con-
sumption. Lastly, the lung may be affected with Cancer.
Madness, Symptoms of. — The mental symptoms and signs
of unsoundness of mind are mainly three. Every insane
person has one or more of these symptoms, though it is
quite possible for anybody to have one or more of them
in a very slight degree, without being considered or treated
as insane. A very large number of persons are subject
180 HALLUCINATION
to delusions; and as long as they are harmless delusions,
and as long as the patients know that they are probably
delusions, and do not act upon them, there is no need to
put them under care and restraint in an asylum or home.
These are the symptoms : —
An hallucination is a disorder of one of the special senses
(seeing, hearing, smelling, tasting or feeling). That is to
say, the patient fancies that he hears voices, when there
are really no voices ; or that he has a bad taste in his mouth,
when there is nothing in his mouth and it is quite healthy
and clean; or that he sees persons, who are not there; or
that he smell onions, when there are no onions near. Cer-
tain very saintly people in the middle ages, particularly
half-fed and badly-treated nuns and monks, used to fancy
that they heard voices — whether from heaven or hell — tell-
ing them to do certain actions. So long as they kept com-
mon sense enough not to act upon the fancied voices, they
were sane; but as soon as they began to act upon the sug-
gestions (which, after all, came from their own brains)
then they were really insane. Unfortunately, no one in
those times had any really scientific knowledge about in-
sanity; and the result was that if these poor, half -starved
creatures acted piously as the result of the "heavenly''
voices which they thought they heard, all went well with
them, and after death they were regarded as saints. But
if the voices made them act wrongly and commit crimes
instead, they were said to be "possessed of the devil," and
treated accordingly. Many a poor wretch, even at the
present day, commits crimes at the instigation of "voices"
which do not exist except in his own ears, and come from
his poor diseased brain. No one who confesses that he
hears "voices" talking to him, or about him, and saying
rude or slanderous things about him, is quite fit to be
trusted; at any time he or she may become quite insane
and irresponsible. The golden rule in all such cases is that
of securing medical advice as early in the development of
the ailment as may be possible. This practice, in fact, con-
stitutes the only hope of cure.
An illusion is a false perception of the senses — that is to
say, the senses misinterpret what is seen or heard. A per-
son who has illusions, for example, sees an empty dressing-
gown hanging behind the door and believes it to be a
burglar concealing himself. Some persons have illusions
MALARIA 181
too, but they do not act upon them, or at any rate, act
sensibly. A man who, seeing his beloved wife in the night
standing in the bedroom, believes her to be the devil, and
beats the life out with a poker is acting insanely, and is
certainly, if only temporarily, insane. We are all very
often obliged to doubt the evidence of our senses ; especially
in watching conjuring and sleight-of-hand tricks. But no
sane man would knock a conjurer down because he pounded
up his gold watch before his eyes; the man would know
quite well that he was under an illusion and would applaud
the cleverness of the conjurer.
The third mental sign of insanity is delusion. A delu-
sion is a disorder of consciousness. It is a false belief in
some fact (which nearly always concerns the patient per-
sonally) of the falsity of which he cannot be persuaded,
either by his own senses, knowledge or experience, or even
by the declarations of others whom he trusts. A man, for
instance, may believe that his legs are made of glass, and
that he cannot sit down without a risk of breaking them.
If he is insane, it is perfectly hopeless to prove to him
that his legs are flesh and blood and that they bleed when
pricked; it is a waste of time to argue with him. He is
insane, and he not only believes that his legs are of glass,
but he is terrified lest they should be broken. Of course,
he is not always quite consistent in his actions, but then
none of us are quite consistent, even when we are sane.
There are plenty of well-educated people who are under
delusions on certain subjects, such as table-turning, etc.
These are "sane delusions," or, more properly, erroneous
judgments. A perfectly logical and consistent sane man
would argue, if invisible spirits could be got to rap on
tables, and make them turn round in the dark, that they
might fairly be expected to do something useful and serv-
iceable also, such as dusting the furniture or cooking the
dinner! But no one with the "table-rapping" delusion
ever seems to expect a spirit to use his energy in a reason-
able and useful way !
Malaria. — This is the general term for diseases that have
been known for years as marsh-fever, coast-fever, ague, jun-
gle-fever. The whole subject of the study of malarial dis-
eases forms one of the most triumphant and interesting of
all those connected with the science of medicine.
Malaria consists of a series of periodical attacks of fever
182 MALARIA
which come on regularly and almost exactly just when they
are expected. There are several types. Thus you may get
daily malarial fevers (quotidian), or an attack every other
day (tertian), or an attack every third day (quartan).
Cause. — The cause is the presence in the blood of one of
three parasites, all very much alike and microscopically tiny.
The parasite is injected into the blood by mosquitoes which
have first chanced to bite someone else ill with malaria, and
have themselves become infected. It is believed that it is
impossible to catch malaria without being stung by a cer-
tain kind of mosquito, called the anopheles. The parasites
of malaria, thus injected into the body by an infected
mosquito, multiply rapidly in the blood, and it is the poison
generated by their presence which causes the feverish at-
tacks.
Before an attack of malarial fever, or ''ague fit" comes
on, the patient gets headaches and shiverings, but he may
be quite well.
The ague fit itself consists of about an hour of shivering
(when the patient gets to bed and piles clothes on him-
self, even in the hottest weather) ; then several hours of in-
tense heat and high fever (when he throws off the clothes
and vomits and has violent headache), and then a period of
sweating, which continues till he has gradually recovered
and feels quite well. The whole attack happens again next
day, or in two days, or in three days, and again and again,
unless he is properly treated.
Occasionally persons die in these attacks.
Now, even if the fever is neglected (and it often is),
sooner or later, if the person leaves the malarious country
and gets no more mosquito bites, the disease wears itself
out and gives no more trouble. But if it is more severe,
malaria becomes a chronic disease and leads to a chronic
state of ill-health, consisting of ancemia, yellow wasted skin,
enlarged liver and enlarged spleen. This is called by doc-
tors the "malarial cachexia."
The cure of malaria is accomplished by the use of quinine,
but every case needs special care ; and the same form or
preparation of quinine does not suit everybody. Moreover,
no two people thrive on exactly the same dosage. Overdoses
of quinine upset the digestion and cause giddiness and ring-
ing in the ears.
As a rule five grains of quinine taken three times a day,
MASSAGE 183
in capsule or pill form, is sufficient to cure an acute attack
of malaria in an adult. The dosage must be continued
for several weeks, however, or the malarial attack may
return.
Prevention of Malaria. — (See also "Mosquitoes.") — As
the only method by which malaria can be contracted is
through the bite of a mosquito infected with malaria the
most rational way to prevent it is by destroying all mos-
quitoes in the neighborhood of one's residence. Details of
the methods for the destruction of mosquitoes are given
under the heading "Mosquitoes."
As mosquitoes can only obtain the malarial parasite from
a person suffering from malaria it stands to reason that
the best way is to keep mosquitoes away from the malarial
case by careful screening.
When living in a malarial country in which the develop-
ment of mosquitoes cannot be controlled, some protection
may be secured by taking quinine from time to time in
doses of ten or fifteen grains a day.
Malignant. — This word is used by doctors to refer to any
form of disease which is more serious than the usual type
and almost certain to be fatal. Thus, we speak of malignant
smallpox, malignant typhoid, etc. The word is applied also
to the set of tumors called cancers, which include every form
of tumor which, if left alone, will ulcerate and kill the
patient by exhaustion, and which, even if removed, will
probably come back again, growing in another part of the
body.
Massage. — This is the general term for the work done by
nurses who are skilled and certificated masseurs, or mas-
seuses (for both men and women do this work) . Their Eng-
lish name is "rubbers." Massage, or scientific medical
rubbing, can be learned from a book, by those who know
physiology; but no masseur is of any use until he under-
stands the meaning of the rubbing which he learns to do.
The movements included in Massage are called stabile and
labile. The stabile movements are pressing, pinching,
hacking, thrusting and tapping the skin and muscles, to
improve the circulation and stimulate the tissues. The
labile movements are stroking, rubbing and kneading.
Massage is useful in the following complaints : — stiff joints
(unless they are "strumous" or "tuberculous," when they
must not be rubbed), inflammatory tough thickening,
184 MEASLES
rheumatic stiff joints, and fractures, or broken bones, and
a few cases of slight paralysis and sprains.
Measles. — A majority of us suffer from measles in child-
hood. But let it be remarked here that the ideas held by
many of the ignorant poor, that every child must have
measles, and that a child therefore might as well be put
in the same bed with a brother or sister who has the dis-
ease, are absolutely wrong, if, indeed, not criminal. Dr.
Alexander Gordon quotes the following experience: — "A
boy of 14 had measles, and his mother, feeling sure that
the other children would catch the disease in any case,
took no precautions. Her six-months old baby died after
two days of measles, and her little girl of two years lost
the sight of both eyes. So much for the wickedness of the
superstition. ' '
The disease is contagious, and infects the air round the
patient and the clothes which he wears, though to a less
degree than scarlet fever does. It is even more contagious
before the rash comes out than afterwards. Between the
day of catching the disease and the first signs of it, about
ten days elapse. It begins with feverishness, loss of appe-
tite, drowsiness, and chills, and in some children with
vomiting or fits. Then the eyes get red and watery, the
nose runs, and there is a cough because the air-tubes in
the lungs are also affected. On the fourth day of this
"bad cold" the rash comes out. (See "Rashes on the
Skin.") There are pink spots, round, and afterwards ir-
regular in shape, patches of redness with scalloped edges.
Only a doctor can distinguish between it and the rash of
scarlet fever. The rash is mostly on the face which gets
red and blotchy, but there are some patches on the body
and limbs, too. In three days it has reached its height and
then it begins to fade, leaving mottled, brownish patches
from which the skin is shed in tiny bran-like fragments.
This "peeling" is often hardly noticeable. The feverish-
ness is worse when the rash breaks out, and then begins to
subside. After about a week the patient begins to get well
again.
This is an ordinary mild case of measles without compli-
cations. But there are many possible complications.
Thus, the catarrh of the air-tubes may become a real severe
bronchitis, or the lung itself may share the inflammation
which then develops into a pneumonia. Then the voice-
MEASLES 185
box or larynx may become inflamed too, and laryngitis
comes on, with a croupy cough and hoarseness. Other com-
plications are, inflammation of the eyes (ophthalmia), of
the mouth, of the bowels (causing diarrhea), and of the
ears. Enlarged tonsils, swollen glands and tuberculosis
and pleurisy are all apt to occur.
Treatment. — When a child is 1 1 sickening " in the way
above described, the disease may turn out to be measles,
or German measles, or scarlet fever. It is wise to have the
child under medical supervision from the first — in order
to name the disease correctly, to treat it correctly, and to
guard against complications.
No one can possibly cut short or ''cure" the disease all
at once. But a good doctor can point out how best to
guide and support the patient until the course of the dis-
ease is run, and how so avoid the terrible possible complica-
tions. Briefly, this is what to do — (1) Isolate the child if
possible in a room with not a single piece of unnecessary
furniture. (2) Let the temperature of the sick-room be
not less than 60° and not more than 70°. (3) Moisten
the air by boiling a kettle in the room and have plenty of
steam. It helps the patient to breathe. (4) Have two
beds in the room, one for day and one for night. Ventilate
it well with open window or door, using screens round the
bed itself. Plenty of fresh air, but no draughts. (5)
Have a subdued light in the room. (6) Disinfect freely.
Use a good disinfectant, and be sure to put some of it into
the bed-pan before and after use, and to rinse all vessels
in it which have been used by the patient. (7) Milk diet
is necessary, milk alone, or with lime water or soda water.
Barley-water and lemon juice or home-made lemonade may
be freely given. (8) If the fever is high the doctor may
direct you to sponge the body with tepid water. The cough
in ordinary cases needs no special medicine. (9) To ease
the feverishness at first, you may give a teaspoonful of this
mixture to any child with measles from 2 to 5 years of
age: — Solution of acetate of ammonia, 2 ounces; spirit of
nitrous ether, 2 drachms; sirup, 1 ounce; distilled water
to 4 ounces: mix. Dose — One teaspoonful every two or
three hours. (10) After a week, in ordinary cases the
child may get up from bed but not leave the room. In the
poorer classes children are generally allowed out too soon;
hundreds of cases of consumption and deafness and chest
186 MEDICINE CHEST
troubles are due to this serious mistake. In the winter no
child ought to be allowed to run about in the open-air for
at least a month after the attack. "Serious complications
are more common after measles than after any other dis-
ease/' wrote Dr. Whitla. (11) During convalescence
tonics will be wanted, such as quinine and iron, to improve
the appetite. Whooping cough is very common after
measles. No case of either of these diseases should be
treated without medical advice.
Medicine Chest. — Here follow a few suggestions for the
home medicine-chest. Bottles ought to be labeled with
large white labels, well written, and perfectly clear.
Poisons must have red as well as white labels, and they
ought to be in green or blue fluted bottles, so that they can
be picked out when the light is bad. On every bottle
there ought to be written the dose of the medicine, and, in
case of poisons, their uses.
A well-stocked home medicine chest should contain: —
A pair of scales and drachm and grain weights.
A clinical thermometer (see notes below).
A glass measure, marked in drachms and ounces.
A minim measure, for small doses.
A medicine glass, marked in teaspoonfuls and table-
spoonfuls.
A feeding-cup.
A glass eye-bath.
Brushes for painting out the throat (no two persons
to use the same brush).
A piece of oiled silk, say a square yard, or a piece of
jaconet.
A roll of surgeon's lint.
A bottle of pastils (or tabloids or soloids) of corrosive
sublimate, for making lotions, for washing ulcers,
etc.
A cake of carbolic soap, 10 per cent.
A waterproof sheet, for confinements, etc.
A roll of adhesive plaster.
A glass ear-syringe: A Higginson syringe.
A bottle of household ammonia, for bites of insects,
stings, etc.
Bandages, assorted. A "wringer" (see "Fomenta-
tions," pp. 86-7).
MEDICINE CHEST 187
For external application, in bottles marked POISON : —
Liniment of iodine, two ounces (see notes below).
Glycerin of the subacetate of lead, four ounces.
Creosote, pure, two drachms.
Zinc sulphate, four ounces (see notes).
Carbolic acid lotion, 1 in 60, two pints.
Friar's balsam, four ounces.
A bottle of smelling salts.
Boric acid powder, one ounce.
Zinc ointment (one ounce).
Sulphur ointment (for the itch).
Hamamelis ointment (for piles).
For internal use — (1) as purgatives:—
Sirup of senna, two ounces. (Dose for children, one
drachm. )
Epsom salts, half-a-pound. (Dose 30 grains to half-
ounce.)
Compound rhubarb pills, four grains in each.
Calomel, a bottle of tablets of a grain each.
Castor oil, four ounces. (Dose, about one ounce.)
(2) To relieve pain: —
Laudanum, half a fluid ounce. (Dose, up to 30
minims. )
Paregoric, two ounces. (Dose half to one drachm
[adult].)
Phenacetin and caffeine tablets, 25.
(3) To stop bleeding:—
Alum powder, two ounces (see also notes below).
(4) To stop diarrhea:—
Aromatic chalk powder. (Dose 10 grains to one
drachm. )
Salol (five grain tablets), 25.
Gray powder (for children), an ounce. (Dose, %
grain. )
(5) For coughs, etc.: —
Ipecacuanha wine, two ounces. (Dose, 10 to 30 min-
ims.)
Sal volatile, two ounces. (Dose, one drachm in water.)
Pil. Ipecac, et Scillae.
188 MEDICINES
(6) For feverish colds: —
Quinine tablets of two grains each, 25.
Dover's powder tablets, five grains in each, 25.
Smelling salts.
NOTES ON THE FOREGOING MEDICINES, ETC. : —
A clinical thermometer is marked from 95° to 107°
Fahrenheit. It is used by placing the mercury bulb under
the tongue, closing the mouth, and leaving the thermometer
there for three minutes or less, according to the make of
the thermometer. A person in health varies from 96° to
98.4°. Above 99° he is said to be feverish, and below 96°
he is said to be subnormal, and may be in " collapse."
Some people prefer to "take the temperature" in the arm-
pit, which must be wiped dry before the bulb of the ther-
mometer is put there, and it must be left there about 15
minutes. After use, the mercury column is to be taken
down again by jerking.
The throat-brush must, of course, be used for nothing
else, and thoroughly washed every time. Each brush
should have a label gummed onto it, bearing the name of
the person who has used it. The brush must be dipped into
the glycerin of tannic acid (used for painting the throat)
in a saucer and not in the bottle.
Corrosive sublimate lotions. — One part in 2,000 of water
is a strong enough antiseptic lotion for most purposes.
Carbolic soap. — The hands ought to be washed with this
before any cuts, ulcers, or burns are attended to.
Bandages. — A three-inch unbleached calico bandage can
be cut into two in its new rolled-up condition, by a sharp
knife, if finger bandages are wanted.
Liniment of iodine is good for painting on chilblains, and
for painting on the skin of the whole of the chest, back and
front, in cases of irritable and frequent cough.
Subacetate of Lead with glycerin is useful in eczemas,
especially if mixed with four parts of fresh milk and ap-
plied on lint. Goulard water is the name given to the
diluted solution of subacetate of lead, and it is used as a
lotion for sprains and bruises. Mixed with one-eighth of
its volume of laudanum, it becomes "lead and opium lo-
tion," and is useful for painful bruises and itchiness of the
skin.
CASTOR OIL 189
Creosote is useful in toothache. One drop on a tiny piece
of cotton-wool, put into a hollow aching tooth will relieve
the pain. Oil of cloves would do as well. Two to five
drops swallowed in a bread pill will often stop seasickness.
Zinc sulphate. — Externally, this is very useful. Ked lo-
tion, used for ulcers (see "Ulcers") is made of zinc sul-
phate, 20 grains; compound tincture of lavender, 150
minims; and water to half-a-pint. As an eye lotion for
inflamed eyes, use 30 grains to 10 ounces of pure water.
But zinc sulphate is an internal medicine also. Taken
internally in doses of from one to three grains (for an
adult) it is a good tonic, and in doses of from 10 to 30
grains it acts as an emetic and produces vomiting. It is
useful to have this drug, therefore, always in the house.
Friar's balsam (compound tincture of benzoin). — This is
one of the most useful things in the chest. Externally it
is an excellent antiseptic soothing and healing application
for all cuts and wounds. A cut finger may be wrapped
round with a bit of clean lint dipped in balsam, and covered
with a piece of jaconet, and the dressing need not be re-
moved until the cut is healed. Of course, before applying
the balsam you must hold the cut under the tap for a time
to get the wound quite clean.
Internally, a good cough mixture may be made for a
hard, painful cough by putting an ounce of balsam into an
eight-ounce bottle and filling up with water. Dose, a table-
spoonful three or four times a day. Again, a teaspoonful
of the balsam in a jug of boiling water gives off a healing
vapor very useful in hoarseness and sore throat.
Boric acid powder, a clean, non-irritating antiseptic dust-
ing powder for all sorts of purposes.
Compound rhubarb pills are to be taken, say, one every
evening, by persons with costive bowels and furred tongue.
Calomel is a splendid liver stimulant. Bilious people,
who suffer from specks before the eyes and headaches,
should take a dose of calomel in the evening, occasionally,
and follow it up by a dose of Epsom salts next morning.
Calomel powder should be dusted on those ulcers on the
lower third of the leg occasionally, and on those mucous
red patches on the face, and on the privates of persons with
syphilis.
Castor oil. — Besides being a purgative it is useful for the
eyes. One drop of castor oil when you have "grit in the
190 MEDICINES
eye" gives almost instant relief. Every case of summer
diarrhea ought to be given a dose of castor oil first, to clear
the bowels out.
Laudanum is tincture of opium and poisonous. It is use-
ful in all cases of mysterious colic or pain of any kind if
the doctor cannot be had. It is useful as a local applica-
tion, too, especially for toothache, or to increase the action
of poultices.
Paregoric is compound tincture of camphor. It is useful
for children's coughs and restlessness and sleeplessness,
especially when combined with ipecacuanha wine.
Phenacetin with caffeine is very useful for migraine or
sick headache due to fatigue or too much reading; also for
feverish attacks.
Alum is an astringent, and useful for gargles in cases of
relaxed sore throat, especially if combined with an equal
quantity of chlorate of potash. A teaspoonful of each to
half-a-pint of water will make a strong gargle.
Alum will also stop bleeding from razor cuts. All bar-
bers keep blocks of it on their shelves. A teaspoonful of
alum in a very little water will often act as an emetic.
With four grains to the ounce of water may be made an
eye lotion for bloodshot eyes. A lotion of twice that
strength, as a vaginal douche, is useful for women who
suffer from ' ' whites. ' '
Salol will not stop diarrhea of itself ; but it disinfects the
bowels and thus removes the irritating matters which are
causing the diarrhea.
Ipecacuanha wine is an emetic in doses of four to six
drachms, but in doses of 10 to 30 drops (adult) it is a
splendid expectorant, and makes a cough easier.
Quinine as well as phenacetin is "good for" feverishness,
but it is no use trying to knock down fever until the bowels
are acting freely.
Dover's powder (compound ipecacuanha powder, con-
taining also opium). It increases the action of the skin,
causing a healthy free perspiration in acute catarrhs; and
it checks diarrhea. For children it is almost the only safe
preparation of opium ; the dose is one grain for every year
of the child 's life.
Gray powder. — This is mercury with chalk. It is of the
utmost use for children with diarrhea in doses of half-a-
grain, twice a day, especially for those puny, miserable
MENSTRUATION 191
children who are of unhealthy parents and badly fed, and
are always having diarrhea with foul fetid motions.
Meningitis. — This disease may be of tubercular origin,
occurring as a primary disease in children or in adults
secondary to tubercular infection elsewhere in the body.
Epidemic Cerebro-spinal Meningitis is an acute germ
disease caused by the meningocoecus, occurring most fre-
quently in the young, but not confined to any age. The
disease usually begins abruptly with a chill followed by
vomiting, excruciating pain in the head, back and limbs.
The head is bent back.
There is high fever and sensitiveness to light, sound and
touch.
Untreated or improperly treated, this disease usually
results in death; or if recovery takes place is very liable
to be followed by blindness, deafness, paralysis or imbecility.
A physician should be called at the earliest possible mo-
ment, for if antimeningococcus serum can be administered
early enough complete recovery takes place in the great
majority of cases.
Prevention. — All cases should be promptly isolated. As
most cases occur in the presence of unhygienic conditions,
care should be taken to improve the sanitary conditions
where danger of infection threatens.
As infection is probably contracted through the mucous
membranes of the nose and mouth the hygiene of these
cavities should be carefully seen to by the use several times
a day of a mild antiseptic solution such as the official Liquor
Antisepticus Alkalinus.
For this purpose a nasal douche, such as may be had at
any drug store, is of service.
Menstruation. — This is a natural function in every fe-
male. The discharge, which occurs about every twenty-
eight days and lasts from three to eight days, is accom-
panied, in many women, by feelings of tiredness, headache
and irritability ; and in some cases by severe pain and sick-
ness. In a few women the whole phenomenon is painless
and gives no trouble at all. This function of menstruation
begins, in temperate climates, between the ages of 14 and
16, and as soon as it has become established the girl is said
to have reached the ' ' age of puberty. ' '
During pregnancy the process does not occur, and in
fact the sudden cessation of the flow is often the first sign
192 MIDDLE-AGE
that a woman is about to bear a child. While suckling her
baby, the flow is still suspended, and, among the poor,
women often continue to suckle a child far beyond the
proper length of time (about six months) because they
wrongly suppose that a new pregnancy is impossible as
long as suckling is continued.
Disorders of Menstruation. — (1) It occasionally happens
that menstruation ceases in a woman who is neither married
nor about to be a mother. This should not, in itself, cause
alarm. The reason is probably that she is anaemic, or poor-
blooded, and that Nature is trying to set matters right in
her own way. At the same time, the doctor ou^ht to be
consulted.
(2) In some women menstruation is accompanied by
much pain, headache, backache and languid feelings. This
may be due to neuralgia, inflammation, or some other cause.
For a woman who has never borne children or suffered from
any internal complaint requiring a medical examination,
the following medicine will be found useful : — antipyrin,
30 grains; tincture of castoreum, 90 minims; liquor mor-
phine, 20 minims; spirit of chloroform, 40 minims; water
to 6 ounces. A fourth part to be taken every two hours
while the pain continues, but not more than four doses are
to be taken altogether, except by express medical advice,
because this medicine contains poison. Very often these
cases are benefited by surgical treatment in a hospital.
(3) In the few cases in which very large quantities of
blood are lost at each period, no home treatment ought to
be attempted, but medical advice obtained before severe
anaemia sets in. (See also "Change of Life/')
Middle-aged Man, The. — " After the age of 50, the less a
man eats and drinks, the more healthy he is likely to be."
Let us see how and why this statement is true. In the
first place we all, or nearly all, eat a good deal more than
we need. We could almost certainly do all the work re-
quired of us on a very much smaller consumption of food,
and we could generally do it better without stimulants,
such as spirits. Now, of course, all food contains only
a certain amount of nourishment; the remainder of it is
waste matter, and has to be got rid of somehow, by kidneys,
and bowels, and skin, and breath. These are facts of very
elementary physiology, such as every child ought to be
MIDDLE-AGE 193
taught at school; but, unfortunately, the majority are still
ignorant of them, and thoughtless about them.
While one is still young, the body will answer to almost
any strain that is put upon it, for a time ; and that is how
it is that excesses and unsuitable foods do not hurt as much
as might be expected. If one eats too much meat, or drinks
too much of that very unnecessary alcohol, the youthful
body strains a few points and gets over the trouble by
drawing on the reserve powers. In middle-age there is
less reserve power, and, especially in those who have been
careless or dissipated in youth, the body finds it difficult or
impossible to get rid of the waste matters in the food.
Again, in middle-age we are too ready to take less exer-
cise, to ride instead of walk, and, worst of all, to find our
chief pleasure in eating and drinking. We are apt to get
stout, and, as we grow more and more self-indulgent, we
get fatter still. This is so common that it is, unfortu-
nately, looked upon as quite "natural" to get fat in middle-
age. The French have a proverb which means, ' * To get fat
is to grow old," and it is often true. But the getting fat
is not the worst thing that may happen; and, as a fact,
many people admire fleshiness in middle-aged people. The
storage of waste matters, due to eating too much, in middle-
age — especially the eating of much animal food, and the
drinking of sweetened alcoholic drinks — leads to about half
the headaches, backaches, rheumatics, and gout of the
middle-aged.
By the time one reaches middle-age one ought to have
stored up a supply of energy enough to carry one on
through life. After 50, the only food taken ought to be
just enough to keep one going, and not so much as to leave
waste matters in the system, to produce headaches, and
rheumatism, and gout. Much meat and alcohol are the
two chief offenders. The middle-aged man or woman can-
not only do well with very little of them, but will actually
enjoy life better in every way with as little as possible of
them. He will have a clearer mind and more active body
if he takes only what he requires to keep up a fair weight.
Let those of our middle-aged readers who have tried this
plan bear witness to our truthfulness.
In conclusion, we warmly recommend all middle-aged
people, married or single, male or female, to read the valu-
194 MILK
able book by Sir Henry Thompson, entitled, Diet in Rela-
tion to Age and Activity.
Milk, — Of any one factor in the maintenance of the health
of a family, the milk supply is without doubt the most
important. It may be very good and an important fac-
tor in the growth of a healthy family. It may be very poor
and responsible for much disease and ill-health.
Cow's milk, containing all elements of nutrition, is an
ideal food. It is therefore destined to be almost univer-
sally consumed in vast quantities by man whatever his
environment or mode of living. But unfortunately milk
is also an unusually favorable soil for the growth of bac-
teria, the pathogenic varieties of which are man's most
insidious enemies, to be feared and fought as were the wild
beasts of the forest by our primeval ancestors.
In the various processes of handling and transportation
which milk for city supply undergoes between its produc-
tion and consumption there lurks the danger of contamina-
tion at every step, even assuming that the milk was free
from disease germs when drawn from the cow. Great as
is the danger under ordinary conditions, it has been enor-
mously increased by the progressive lengthening of the
time that elapses between production and consumption.
As our modern cities grew, the source of milk supply,
as of all food supply, was pushed out into wider and wider
encircling areas until now the inhabitants of a large urban
community must frequently wait a day and a half, or two
days after the milk is produced before it reaches their
tables. For it must be realized that the 2,000,000 quarts of
milk which New York City, for example, consumes a day,
comes from 44,000 farms situated in seven different States,
and some of this milk travels 400 miles before it reaches
the consumer.
The commoner diseases which may be transmitted by
milk are typhoid and scarlet fever, tuberculosis, diphtheria
and summer diarrhea.
The methods of avoiding diseases transmitted in this
way are by cleanliness and precautions at the dairy to pre-
vent the milk being contaminated; and destruction of the
germs in the milk a short time before it is consumed.
If a choice can be exercised in the source of a milk sup-
ply, procure milk from a dairy which is inspected properly
and kept in a sanitary condition. Milk should only be used
MILK 195
from cow's proved to be free from tuberculosis by the
tuberculin test. Of milk from dairy supplies not so con-
trolled 10 per cent, is found to contain tubercle bacilli and
can produce tuberculosis in children.
Milk should be kept cooled from the time it is produced
until it is consumed, except during the few minutes when
it is being pasteurized. This is one of the most important
factors in preventing the growth of bacteria. Milk which
has been collected and handled under the best conditions
may have only 5,000 bacteria per cubic centimeter when
sold.
A bacterial count of 10,000 per cubic centimeter is very
good for bottled milk — the average being from 10,000 to
100,000. The bacterial count for milk in cans runs from
100,000 to 40,000,000 per cubic centimeter.
The advantage of using bottled milk is therefore seen at
a glance.
When so many bacteria constantly occur in milk, and as
the danger is so great that among these numerous bacteria
some will be disease-producing ones, the only way to make
milk safe to drink is by pasteurizing it. Many large deal-
ers are now doing this by exposing milk in bulk to a tem-
perature of 140° F. for twenty minutes and bottling it
immediately in sterile bottles. All milk not thus treated
should be pasteurized at home. This can be done conven-
iently by the use of the Freeman pasteurizer — by which
milk is maintained at a temperature of 75° C. for 30 min-
utes. This does not render the milk absolutely sterile or
kill all the spores, but it kills practically all the disease
germs and is sufficiently effective to check fermentation.
Pasteurized milk should not be kept more than 24 hours.
In the home milk should constantly be kept cool and in
sealed bottles to prevent the access of flies — a most danger-
ous source of contamination.
Shun as you would poison milk which has been obtained
in small quantities from a can in a dirty retail grocery
store where little or no attempt has been made to keep the
milk iced or to prevent the access of flies.
Milk, Artificial Human.— (See also "Infant Feeding.")—
Every child ought to be breast-fed for the first six or eight
months of its life. For the first three days the milk is not
very good, but the child ought to be put to the breast both
because that stimulates the breast into action and because
196 MIND FAILURE
the milk purges the child a little. No other food is neces-
sary or ought to be given. When the flow of milk is well
set up the baby ought to be put to the breast at regular
intervals of from two to three hours during the day, for
ten minutes at a time, and less frequently during the night.
No crying on baby 's part ought to make a difference in this.
But if the mother cannot suckle, the child must have a wet-
nurse, or artificial food. The milk of mares and asses most
nearly resemble the milk of women. Cow's milk pure
needs the addition of water, cream and sugar to make it
anything like human milk in digestibility.
The shape and make of baby's bottle are important. Two
bottles ought to be in use, and the one not in use ought to
be lying in concentrated boric acid solution, to "sterilize"
it free from all germs. The boat-shaped bottles are the
best; there must be no india rubber tube. The Ballin
baby's bottle is to be warmly recommended. It can be
obtained through any chemist.
Even if there is no epidemic of any sort about, milk,
even if obtained with the greatest precautions, may con-
tain some disease germs such as the typhoid or diphtheria
bacilli, the germs of tuberculosis, summer diarrhea or of
septicaemia.
Danger from all these sources is obviated if the milk
is pasteurized before it is given to the infant. It should
be pasteurized in small bottles sealed with cotton and served
in these same bottles as soon afterward as possible.
The Freeman pasteurizer is one of the simplest and most
practical. Many milk companies are now selling pasteur-
ized milk.
Mind Failure. — All diseases of the mind and failures of
the intellect are becoming more common every year, and
although our present day medical men know more accu-
rately how to treat insane persons, yet our asylums become
more and more crowded, and extra asylums for lunatics
are built every year. There are two chief reasons given
for this increase of lunacy — one is the high pressure at
which we now live (see "Simple Life"), and the other is
the widespread prevalence of intemperance. Nearly three-
quarters of all mad persons who have not inherited insanity
have drunk to excess.
A man may be said to be insane when his conduct con-
tinues to be markedly out of touch with his surroundings
MISCARRIAGE, CAUSES OF 197
and with his neighbors' ways. Physicians are often able
to detect the signs of a coming attack of madness before
they are noticeable by other persons. It is not usual for
madness to appear quite suddenly, except when persons
mad with drink get delirium tremens, and then pass on
into the state of mania. Neglect of suitable treatment in
the early stages of insanity defers the time of recovery
in a very marked manner. Epileptic persons, after a long
course of fits, are very apt to drift into madness.
Insane persons fall into several classes, as, for example : —
(1) Maniacs characterized by excitement, violence, and
passions, want of sleep, causeless attacks of anger, neglect
of duties, and distrust of relatives and friends ; disordered
reason and confusion of ideas. Such patients are often
mischievous, and will injure their friends and attendants.
(2) Melancholies. These are in a state of sadness and
gloom ; they despair of all things, often refuse food, will
not talk to others, and sit alone in solitude. (3) Demented
persons. These have lost whatever intellect and mental
power they may have had ; they are weak-minded, like chil-
dren ; have dirty habits, and cannot understand the common
decencies of life. Memory is lost, not so much of the great
events of their lives, but of the happenings of the last few
hours. (4) Monomaniacs, who have peculiar ideas, de-
sires and actions in some special direction. For example,
some think of nothing but religion, others only of love-
making; others, again, are possessed with the wish to set
fire to buildings ; others seek to kill men and women around
them; and a last class are suicidal. (5) The fifth class are
sufferers from paralytic insanity — a disease which runs a
short course, and is shown by a gradual onset of palsy,
accompanied by insane thoughts and actions. In these
cases the sufferers are often full of self-esteem, and think
themselves gods, and kings, or millionaires; they lose the
power of speech, and in a gradual manner paralysis spreads
all over their limbs; they become mere animals, and sink
into death. (See also ''Madness.")
Miscarriage, Causes of. — By miscarriage is popularly
meant the birth of a child long before its time, and before
the pregnancy is seven months old.
About 37 per cent, of child-bearing women miscarry be-
fore they are thirty ; and it is commonest before the fourth
month. The causes may be classified : —
198 MOSQUITOES
(1) Causes due to the father — syphilis, malaria, etc.;
advanced age.
(2) Causes existing in the mother — syphilis and fevers,
jaundice, albumin in urine (kidney disease),
severe morning sickness; too long suckling of
previous child ; severe rheumatism ; mental shock
or worry; diseases of the womb; heart or liver
disease ; direct violence.
(3) Causes in the unborn child — its death ; its strangu-
lation in the womb.
Abortion. — To "procure an abortion" is to cause a child
to be born before its due time ; and this is a serious crime,
whether committed by the mother who bears the child or
by any other person except the doctor. A properly quali-
fied medical man may induce premature labor, if, after
consultation with another medical man, he decides that to
allow pregnancy to continue until full term would prob-
ably or certainly prove fatal to the mother. But in any
case the proceeding is a violation of nature, and is very
often followed by chronic ill-health. There are certain
drugs sold by unscrupulous herbalists to women for the
purpose of abortion. Not only do they fail in their in-
tended effect, but they invariably produce local disturbance,
and sometimes even lifelong illness. The advertisements of
such unscrupulous and heartless quack medicine vendors
are easily recognized, as they generally profess to "remove
obstructions. ' '
Mortification. — (See ' ' Gangrene. ")
Mosquitoes. — It has recently been discovered that certain
kinds of mosquitoes are the sole means of the transmission
of malaria.
Other diseases which they are capable of transmuting in
southern climates are yellow fever, break-bone fever, and
filariasis — the cause of elephantiasis.
When we reflect how simple are the precautions necessary
to annihilate this pest, and how effective when carried out
properly, we realize that there is no excuse for anyone get-
ting malaria or these other diseases.
They may be gotten rid of by three methods — drainage,
kerosene, or fish which devour their larvae.
Mosquitoes cannot breed except in water. Therefore, if
stagnant water is done away with there can be no mos-
MUMPS 199
quitoes. The eggs are laid on the surface of the water
and hatch out as little black wrigglers which live in the
water for several weeks until they finally become trans-
formed into mosquitoes.
The following are the methods used to prevent their
breeding : —
Ditching — to drain stagnant pools, puddles or marshes.
Clear away old cans, pans which collect water, and repair
gutters in which water collects. Screen barrels, tanks
and cisterns. Weeds and shrubbery in which the mos-
quitoes can find a dark, cool place to hide during the hot
part of the day, or when the wind blows, should be cut
down.
When pools of water cannot be drained, it is an easy
matter to kill all young mosquitoes in them by pouring a
little kerosene on the water. If the kerosene is washed
away by rains it must be renewed in ten days, before any
mosquito eggs have been developed into adult mosquitoes.
Minnows, goldfish and other fish feed on the mosquito
larva?, so by introducing these into a pond the number of
mosquitoes that breed there may be greatly lessened.
Whenever a person is suffering from malaria or yellow
fever he should be screened so that he cannot be bitten by
mosquitoes which may become infected and later, by biting
other people, convey the disease to them.
Mothers5 Marks.— (See "Birthmarks.")
Mucous Membranes. — The mucous membrane is practi-
cally to the inside of the body what the skin is to the
outside. It is the thin lining of the inside of the body,
of the inside of the mouth and lips and nostrils, and of
the rectum and of the urethra, and of the womb. It is
always moist, because it is lubricated with mucus; and
pink, because it is so thin that you can see the color of
the blood through it. (See "Polypus.")
Mumps. — This is a very contagious ailment, occurring
only once in the same individual, as a rule about two or
three weeks after exposure to the infection. The patient
first feels "out of sorts," and has a rather sore throat.
Then comes swelling of the gland round and below the
lobe of the ear, and then of the glands beneath the jaw
on each side. There are feverishness and faceache too,
and the patient cannot chew or swallow properly. These
symptoms subside in about a week and then convalescence
200 NERVOUS DEBILITY
begins ; but in some cases this stage is unpleasantly marked
by swelling of the testicles (in males), or of the breasts
and ovaries (in females), and — rarely — these temporary
swellings may result in atrophy (wasting away) of one of
the organs affected.
Patients with mumps ought to be isolated so that other
children do not catch the disease, and they must not be
allowed to mix with their companions again till after four
weeks have elapsed from the beginning of the disease. No
special treatment is required, except that dictated by
commonsense. Poultices may be needed to relieve the face-
ache, and a doctor should be called in if the testicles or
breasts become swollen.
Mussels. — Unwholesome mussels may cause nausea, vom-
iting, and severe purging, leading to rapid exhaustion.
These poisonous effects may arise either from the mussels
being stale and decaying, or from their having been col-
lected out of water rendered impure by sewage contamina-
tion, or because they have grown upon timber containing
copper nails, or sheathed with copper as often occurs in
docks and locks. The poisonous material needs to be re-
moved by vomiting, so give emetics (see list) of ipecac-
uanha, zinc sulphate, mustard and water, and also a brisk
purgative dose when the sickness is over, such as castor oil
(two tablespoonfuls), or black draught of Epsom salts and
senna; if there is much collapse, brandy (a tablespoonful
in a little water, repeated in 15 minutes) will be needed.
Nervous Debility. — A great number of people are always
complaining of being weak and nervous; indeed, the state
of nervous debility seems to be the most common of all
ailments nowadays, and the young, who ought to be strong,
seem to suffer more often than those who are past middle
life and might reasonably be expected to be feeling the
weakness of old age gradually coming on.
There are hundreds of quack medicines which are war-
ranted to cure this state of ill-health; but we fear that
they are not very successful. The symptoms of this nerv-
ous weakness as recounted in advertisements are general
weakness, and loss of appetite, headaches, and sleeplessness;
indigestion, flushings of heat in the face, and coldness of
the feet and hands; nervous tremblings, and a feeling
of timidity and bashfulness before strangers. This is a
long catalogue of very indefinite symptoms, and if you
NETTLERASH 201
really are weak and nervous and have some of these symp-
toms, you can readily fancy all the others. Nervous per-
sons can fancy almost anything they hear spoken of, and
many people of that sort fancy they have heart disease
all their lives without having anything at all the matter
with their hearts. Such people generally have "wind in
the stomach, ' ' and they fancy that the pain comes from the
heart. Nervous debility can generally be cured more read-
ily by leading a simpler life, with a proper share of whole-
some food, ample open-air exercise, and cold baths than
by any tonic or medicine, however much advertised, pro-
vided the patient will avoid the pleasant dangers of drink-
ing and over-much smoking. Sensible people who have no
actual disease of any organs can be their own doctors, but
when there is actual organic disease sensible persons will
not attempt to treat themselves. If you feel nervous de-
bility, examine yourself, and consider what kind of life
you have led, and what has caused your weak state. Is it
from any excesses, or late hours, or want of fresh air?
Or is it from irregular meals, or from cigarette-smoking,
or from an unhealthy home ? Or is your weak state heredi-
tary— has it come down to you from your parents? In
any case, remove the cause, if you can find it. Women
are often weak and ailing from drinking too much tea, or
from drinking tea habitually which has been made too long
before use, for in that case the hot water has soaked much
tannin out of the leaves, and tannin injures the coats of
the stomach, and lessens the appetite. There are occasions,
no doubt, when a short course of tonic medicines, such as
quassia, gentian, cinchona bark, and quinine, will do much
good; but do not rely on them too much, nor continue to
take them too long. Live as simply and naturally as pos-
sible, and avoid drugs as much as you can, and do not take
to drops of wine and spirits to keep you up, because they
will gradually make you worse than ever. Rest when you
can, and get a change of air and scene whenever possible,
and spend as much time as possible in the open air and
sunshine (see also "Neurasthenia").
Nettlerash. — The medical name for this form of skin
affection is Urticaria, from the Latin name for nettle, and
is so called because this peculiar skin rash resembles the
white marks which are caused on a person's skin by being
stung with the leaves of the nettle plant.
202 NEURALGIA
Nettlerash may occur in healthy persons as well as in
invalids, and is generally found to have been caused by
some errors in diet, or by some unwholesome food, or by
chills.
The characteristic signs are the appearance of bright red
patches or wheals on the skin; these are slightly raised,
but smooth and flat, and have no pimples nor vesicles on
them, no sores, no discharge, and no scurfiness.
The wheals are red at first, and then change a little, be-
coming pale and white in the middle, with a ring of pink-
ness around them; and as the wheal subsides the edges
grow pale, and are pink in the center. They vary in shape,
and may be seen any size, from a threepenny piece to the
size of the palm. A patch may last only an hour, or per-
haps for a day, or even longer. The wheals burst out
quite suddenly, and are accompanied by a feeling of heat
and by itching. Scratching gives only momentary relief,
and in some cases fresh wheals show up wherever the skin
is scratched.
The attack may be quite local, or it may be accompanied
by feverishness. The rash may last for days, fresh crops
coming out every few hours. Chronic cases are sometimes
seen, in which there may be occasional crops of skin rash
every few days for months or years.
This disease occurs chiefly in persons of a nervous tem-
perament, and is often found to accompany asthmatic at-
tacks. Persons who are habitually intemperate frequently
suffer from it, and so do gouty persons. It is very com-
mon among infants. Violent emotions of the mind, pas-
sions, and terror may bring on an attack, especially in
children. Unwholesome food is, however, the usual cause;
tainted meat, high game, shellfish, such as mussels and
oysters, crabs and lobsters, and mushrooms, are among the
commonest irritants which disorder the stomach and in-
testines, and bring out a nettlerash; and, lastly, children
with worms often suffer. As to treatment, of course the
first necessity is to find out and remove the cause; if it
comes out directly after suspicious food, give an emetic;
if later, give a sharp purge of black draught. For some
days take low diet, and a rhubarb and soda mixture, and
apply eau-de-cologne as a lotion, or zinc ointment.
Neuralgia. — "Neuralgia," said a wise physician, "is the
prayer of a nerve for healthy blood." From this we learn
NEURALGIA 203
that the real cure for neuralgia lies in the improvement
of the general health of the body, and not in rubbing in
something to ease the pain — though that is necessary-
enough sometimes. Neuralgia is not a disease, but a sign
of disease, of some organ or nerve. Every doctor does his
best to discover the cause of the neuralgia first. In the
meantime, until he has found it he relieves the pain as
much as he can.
Ancemia is a great cause of neuralgia. If a woman is
anemic, let her try the following medicine for her neuralgic
pains : — Reduced iron, 4 grains ; arseniate of iron, y8 grain ;
sulphate of quinine, 1% grains; ingredients for one pill.
Take one of these pills after each meal (thrice daily) and
two at bedtime. Continue this for a month or more. But
the bowels must be kept freely open every day all the time ;
otherwise the pills will be useless.
Gout, Rheumatism and Syphilis are very common causes
of neuralgia. Of course, they must be dealt with accord-
ing to their nature in each case. Lead poisoning is another
frequent cause.
The local treatment of neuralgia is important. We shall
give here several useful formulae, reminding the patient
once again that it is wise to consult a doctor first of all,
and find out from him what is likely to be the cause of the
neuralgia, and what steps ought to be taken. These re-
marks apply specially to the dentist as well.
The fact that there are hundreds of recognized medicines
in daily use (in treating neuralgia), as well as hundreds
of quack remedies which are all said to "cure" without
delay, will prove to the reader that the treatment of neu-
ralgia is difficult in very many cases. We hope that some-
thing in the following list may be useful to sufferers who
have failed to obtain relief from either doctors or quacks,
and who are willing to take the risks which must always
fall to the lot of those who "pour medicines, of which they
know little, into bodies of which they know less. ' '
For Neuralgia of the face and brow. — Morphine hydro-
chlorate, y$ grain; sulphate of quinine, 5 grains; chloride
of ammonium, 15 grains (contains poison). Mix, and
make a powder, to be swallowed in a cachet twice a day.
(Requires a doctor's prescription.)
For Neuralgia of the gums and jaws. Tincture of gel-
semium, 15 minims; water to one ounce. Make four such
204 NEURASTHENIA
doses. Take two tablespoonfuls of the medicine every six
hours. (Should not be taken without a doctor's advice.)
For General Neuralgic or Rheumatic Pains. — Fellowes'
sirup of the hypophosphites. Liniments to be rubbed into
the painful spot: — Linimentum Aconiti (poisons if taken
internally) ; or, Menthol 3, chloroform 3, olive oil enough,
to 16 parts; or, compound camphor liniment (poison) ; or,
Baume Analgesique Bengue.
If all medicines fail, recourse may be had to (1) Elec-
tricity, the results are generally disappointing; or, (2)
Operation. The various operations which have been done
to relieve neuralgia include nerve-stretching, nerve-cutting
in different ways, nerve-tearing, and nerve-ligature (ty-
ing). Lastly, (3) Hypnotism.
Neurasthenia is a very common complaint nowadays.
It is the medical word for nerve exhaustion, and it is
caused in different ways. The tendency of the age is to-
wards brain work, and brain workers therefore have to
contend against enormous competition. The weak-nerved
among them therefore break down sometimes. Then comes
the abuse of stimulants — alcohol and tobacco, which are
taken to whip up the tired brain — and then comes nervous
breakdown. The neurasthenic man or woman has usually
been a hard, honest worker, and when the breakdown comes
he tries to hide it and does not ask for sympathy. Even
if the breakdown is due to excesses and debauchery instead
of to hard work he tries to hide it, and to overcome it.
With hysteria, it is different. She (it is generally, but not
always, a woman) is idle and probably plump and well-
nourished, and craves for sympathy ; in fact, she will stoop
to almost any deception to get the pity and sympathy she
craves. Her aches and pains and sleepless nights are
mostly imaginary, though she at last begins to deceive
even herself, and she pities and loves herself sincerely.
The neurasthenic man or woman suffers from a feeling of
oppression at the top of the head, a poor memory, sleep-
lessness, irritability, fear of being in open spaces in the
streets, and melancholy. He may be wasted in body. The
two diseases, neurasthenia and hysteria, are generally quite
distinct, but in women both may be present together.
When they are distinct they differ, as we have said, in the
attitude of the patients towards sympathizers ; and in this
— that hysterical women are very difficult to cure because
NEURITIS, ALCOHOLIC 205
they often do not really desire to be cured, whereas neuras-
thenic people wish with all their hearts to be cured so that
they may be able to resume their work.
The proper treatment of neurasthenia requires time.
First, there ought to be a complete change — a change of
scene, of air, of occupation and of faces. This partly ful-
fills the second requirement, which is rest, which ought to
be absolute. There ought to be absolutely no business
worries, no business letters and nothing to do but idle the
time away. The third requirement is plenty of food and
fresh air. And this method of treatment which is so good
for the neurasthenic is the worst possible for the hysterical
person. (See ''Hysteria.")
Neuritis, Alcoholic. — This is fairly common, especially in
women who drink spirits to excess in secret. It begins with
pains or cramps and tenderness of the muscles, especially
those of the calves of the legs; and the patients, who love
their pet vice, prefer to believe that the pain is rheumatism ;
and that it is not alcohol which is making them ill. In
fact, they drink more alcohol to relieve the pains! Then
come tingling and numbness, or burning pains in feet and
hands, and some weakness, which may or may not become
actual paralysis. If the patient will leave off drinking
she may recover completely, but otherwise the trouble will
increase; and she will become suspicious and disagreeable
and fretful, and believe ill of everybody, and fancy that
people are persecuting her. It often happens that in these
cases the relations and friends cannot imagine what is hap-
pening to the patient or what makes her so ill and disagree-
able. A doctor will often suspect a woman of secret drink-
ing for months or years before he is able to find her out.
He may feel sure all the time that her illness is caused by
the spirit-drinking, and yet be unable to make her confess
to it. A woman who drinks to excess is the worst of liars,
and there is hardly a depth of meanness or deception to
which she will not stoop to obtain and conceal the drink
which is poisoning her blood.
Treatment. — The first thing to do is to deprive the pa-
tient at once of all alcoholic liquor. This is sound treat-
ment, though if terrible depression follows, or vomiting or
delirium takes place, the patient and her friends will very
likely attribute the new trouble to the sudden deprivation
of alcohol instead of to its real cause, the alcohol itself.
206 NIGHTMARE
But even though the patient protests that she will die if
she doesn't get more drink it must be withheld or she will
not recover.
There are exceptions to this rule, however, which the
experience of a doctor only can decide. To allay the crav-
ing for drink which now begins with great fury, food must
be given by a firm nurse every hour, or thereabouts — a
little liquid food of some kind in small quantities at short
intervals. Then a teaspoonful of the following medicine
should be given in soda-water every hour while the craving
is intense : — Spirit aromatic of ammonia, 4 ounces ; tincture
of cinchona, 2 ounces; solution of hydrochloride of strych-
nine, 1 drachm; tincture of capsicum, 1 ounce. (Poison.)
Then, as to the local treatment of the neuritis, rest in
bed is necessary, and cocaine injections under the skin very
often give much relief. In bad cases the sufferer must lie
on a water-bed. Twice a day hot fomentations ought to be
applied to the most painful parts of the limb, and after
being dried well, the limb must be wrapped in cottonwool
or woodwool tissue. Warm baths are often comforting.
When the pain is better the wasted muscles need electrical
treatment or massage. Note. — Neuritis is not caused only
by alcoholic excess, though that is by far the most common
cause ; nor does it occur only in women. Men are liable
to it also, and especially those whose work brings them in
contact with certain chemical poisons, such as arsenic, lead,
mercury, silver, etc., and those who are afflicted with gout,
gonorrhea, syphilis, influenza, beri-beri, diabetes. (See
also ' ' Lead-poisoning. ' ' )
Neurosis. — This word means a ' ' nervous ' ' condition which
is not caused by any discoverable alteration in the brain,
spinal cord, or nerves. Such diseases are hysteria, asthma,
neurasthenia. A family is said to be neurotic when there
is a family history of one of the neuroses. Madness in some
forms is a neurosis.
Nightmare. — Horrible dreams, as of falling over a preci-
pice, being strangled, being crushed, and so on, are gen-
erally due, in adults, to too much supper or to such items
of diet as cucumber, pastry, mayonnaise, pickles and cheese.
We all remember how Scrooge, in that wonderful old story
of Dickens', believed that Marley's Ghost was nothing but
a nightmare, and told him that he (the Ghost) might be
nothing more than an undigested bit of beef. Some adults
NOISES IN THE EARS 207
have these dreams only when they sleep on their backs,
and they should tie an empty cotton-reel around the waist
to prevent their being comfortable on their backs.
Night-Terrors. — These occur in nervous and excitable
children, especially those of precocious intelligence, whose
active little brains give them vivid dreams. The doctor
must be consulted in every case of these "terrors" in chil-
dren. The cause must be looked for. It may be nothing
more serious than the irritation of the nervous system
caused by teething ; or by worms in the bowels ; or by indi-
gestion. But the terrors may be due to some foolhardy
and ignorant nurse-girl who tells the children ghost stories
or threatens absurd punishments for naughtiness. Chil-
dren who are very sensitive should not be put to bed in a
quite dark room — there should always be a night-light.
Adenoid growths seem to "predispose" to night-terrors.
No medicine should be given in these cases without the ex-
press orders of the family doctor.
Night Sweats. — Children with rickets often perspire very
much at nights, especially about the head and neck. The
treatment is the general treatment for rickets.
Persons with consumption of the lungs sometimes wake
up drenched with perspiration. This is very weakening if
it continues long. The following pill, given at bedtime,
will stop the sweating in many cases: — Oxide of zinc, 2
grains ; extract of belladonna, %6 grain ; extract of hyoscya-
mus, 1 grain. To make 12 pills.
If this fails, however, try picro toxin (see "Consump-
tion") or give five grains of sulphonal at bedtime instead.
If there is diarrhea as well as sweating the patient will
improve on 10 grain doses of calcium phosphate.
Noises in the Ears. — The treatment of these must depend
upon the cause, which may be wax in the ear, a polypus,
catarrh, decayed teeth or some other unexpected condition.
We can only give a prescription or two in the hope of
relieving some who suffer from this distressing symptom.
First, however, let the sufferer get the ear well cleaned out
by syringing with boric acid lotion. (Also see "Ear Dis-
eases.")
(1) Apply a blister behind the ear; or, (2) rub veratrine
ointment into the skin round the ear; or, (3) take ten
minims of the tincture of digitalis in water every four
hours; or, (4) take fifteen grains each of ammonium bro-
208 OYSTERS, RISK OF EATING
mide twice a day. (5) Fowler's solution, 1 drachm;
bromide of sodium, 2 ounces ; aromatic spirits of ammonia,
2 ounces; camphor water to 12 ounces. Take one table-
spoonful of the mixture thrice daily after meals. Of
course, before beginning with any of these medicines the
sufferer will make sure by getting the advice of an aurist
that there is no local curable condition.
Nose-Bleeding may occur from knocks or blows, or from
over-fullness of the blood vessels. In moderate quantity
it rarely does any harm, and is checked by bathing the
face with cold water, while the patient sits down quietly;
loosen the collar, and calm him, if alarmed. The sudden
application of cold, such as of a cold laundry iron, to the
bare back between the shoulder blades, often stops the
bleeding by giving a shock to the nervous system. Nose-
bleeding may occur in women instead of some other usual
loss of blood, and even in pregnancy, in a similar way.
Some persons are born with a special liability to bleed,
especially at the nose. After middle-age, nose-bleeding
often shows a dangerous state of internal congestion and
averts an attack of apoplexy.
Never allow a person with nose-bleeding to hang his head
over a basin. Keep the head high and apply cold to the
nape of the neck. When simple treatment fails to check
nose-bleeding, it is necessary to spray the inside of the
nostrils with an astringent lotion, such as alum in water
— a teaspoonful to a tumbler. In cases of violent bleeding,
which you cannot stop, you may paint the inside of the
bleeding nostril with glycerine of tannin, by a long, fine,
soft brush, or blow powdered alum or tannin into the
nostrils from an india-rubber bag, or insert a cone of cotton-
wool, dipped in some alum or tannin solution, into the
nostrils with a probe. These modes of treatment, however,
require skilled hands and special apparatus, so a doctor
should be sent for. If all these fail, the surgeon will have
to plug the nostrils behind as well as in front by means
of a special instrument called a nasal sound.
Overlaying. — (See "Babies Lost.")
Oysters, Eisk of Eating. — Oysters are a very nutritious
food, and when eaten raw are very digestible, but when
cooked are not suitable for invalid diet. Oysters are grown
in shallow sea water at certain sandy places along our
coasts, and there is always the risk that they may have been
PAIN 209
tainted with sewage. All sea-coast towns drain into the
sea and very often there are currents which carry foul
matters along the coasts instead of more directly into the
ocean. Contaminated oysters cannot be distinguished
either by sight or smell, but when eaten may give rise to
attacks of typhoid fever, which may end fatally; such at-
tacks may not show themselves for a week or two after
taking the poisoned oysters.
Pain. — Students of human nature will probably agree
with almost complete unanimity that since the world began
mankind's greatest curse has been pain; yet, paradoxical
as it may seem, very casual consideration will prove con-
vincingly that this same specter pain is, in reality, the
greatest blessing ever bestowed upon mankind.
The power of pain to emphasize the appreciation of
pleasure (a dictum frequently dwelt upon by the old phi-
losophers) may be put aside for the present, for the impor-
tance of pain has a much more direct bearing upon the
subject here at hand.
It is pain which calls the attention of the human being,
no matter how low in the social order, to the fact that he
is experiencing some abnormal condition which if not
heeded and corrected may result in the cessation of his
earthly existence. Not infrequently it is pain alone which
stands between him and physical annihilation if this in-
dicator is not heeded. For without this symptom, in many
inflammatory conditions of vital organs, relief would not
be sought until the time had long passed when hope of
relief from medical or surgical agencies would be of avail.
The importance of pain as a symptom, then, having been
established, it becomes of the greatest importance to the
average human being to be able to appreciate what forms
of pain may be trivial and capable of relief by home meth-
ods, and what forms are serious and demand the quickest
possible relief by expert agencies.
On general principles it may be stated that pains in the
extremities rarely immediately threaten life and may be
temporized with ; while pains in the trunk or head may
indicate the involvement of a vital organ, and any tem-
porizing may have fatal consequences. Therefore, in at-
tempting relief of such pains, the average human being
should feel very sure of his ground before attempting to
relieve such pains without expert opinion as to its cause.
210 PARALYSIS
Pains may be roughly divided into the following
forms : —
Inflammatory, neuralgic, tumors, foreign bodies such as
stones, pressure pains (as e. g. aneurism), chemical poisons
and functional pains.
Functional and neuralgic pains should only be diagnosed
after a process of exclusion of other forms, and rarely
prove fatal. Any one of the other forms, however, may
indicate a condition capable of resulting fatally.
The causes and treatment of the various forms of pain
are best considered under the various disease headings.
The interpretation of many pains is so complex that only
a trained diagnostician is competent to adjudge them cor-
rectly. This is emphasized by the fact that many pains
are "referred pains" caused by a condition remote from
the apparent site of the pain. Moreover, the most serious
conditions are not always announced by the most severe
pain.
Therefore, unless a pain is thoroughly understood, do
not delay in having its cause determined by a competent
medical authority, and do not belittle this — "God's great-
est gift to man. ' '
Paralysis. — The old-fashioned English name for paralysis
was palsy, but this word has gone very much out of use
of late years. It will be found in Bible stories. The word
means a state of disease in which there is a loss of muscular
action, a loss of power to move some part. Thus, for
example, there are facial palsies, in which the face muscles
have lost their uses, and the face on one side, or both, is
expressionless. Another variety is seen in painters and
others who have lead colic; in such patients we may find
a partly useless hand or a dropped wrist. The most com-
mon cases of paralysis are, first, those cases called Hemi-
plegia, in which one side of the body, one arm and leg, are
palsied, and, secondly, Paraplegia, in which both legs are
palsied, but not the arms. The first is due to brain mis-
chief, either softening of the brain or bleeding into the
brain; the second is caused by disease or injury to the
spine. Either of these diseases may be recovered from in
some cases, but in others a fatal result ensues. Simple
palsy of one side may last for years, and never improve;
some such cases remain bedridden all a lifetime. We can-
not say that any medicines have power to cure palsies, ex-
PERSONAL HYGIENE 211
cept those caused by syphilis, and when cases recover it is
"Nature" which effects the cure.
Hemiplegia, or paralysis of one side, is generally of sud-
den onset, coming on with an apoplexy, commonly called
a fit, or a paralytic stroke. (See "Apoplexy.") In such
cases a blood vessel has burst in the brain. If of slow
onset, it is due to the "softening" or decay of some spot
in the brain. A sudden loss of the senses occurs often ac-
companied by a fall; the patient cannot be roused, as he
can from a faint ; also, instead of the pale face, seen in one
who has fainted, there is often a purple tint of face, with
difficult noisy breathing. One cheek hangs loose, and the
other cheek is drawn aside ; there may be a squint, and one
eyelid may drop uselessly. The patient is unable to speak,
from part of the tongue having lost its power ; saliva often
dribbles away. When the insensibility passes off it is
found that the arm and leg of one side cannot be volun-
tarily moved; they may be flabby or stiff. Some cases die
even in the moment of the fit ; others live for hours or days,
and die without regaining consciousness ; the result depends
upon the situation and amount of the brain mischief.
When this is slight the signs of recovery may come on very
soon, and complete disappearance of all the symptoms may
ensue in a few days or weeks. But in the majority of cases
some weakness (called Paresis) is left, even if there is no
definite palsy, and the patient is an invalid who has to
take great care of himself for the rest of his life. Elec-
tricity and massage may be necessary, but not very much
good is to be hoped from electrical treatment. Massage of
a paralyzed limb is always grateful to the sufferer. The
possibility of a second attack has to be borne always in
mind, and the patient should particularly avoid excess of
alcohol and should live on a very light diet.
Paraplegia is commonly the result of spinal disease, espe-
cially in children. And there is another type of paraplegia
(paralysis of the legs) with spasm added to it. Nothing
can be gained from dealing more fully with these subjects
in this book. (See also "General Paralysis.")
Pathology. — This is the science which treats of the
changes produced in the body by disease.
Personal Hygiene. — Man's health is maintained by car-
ing for the condition of his body and his environment.
To the latter the term sanitation is usually applied.
212 PERSONAL HYGIENE
Hygiene implies a somewhat closer association with the
body, and by personal hygiene is meant care of the body
which will improve its physical condition and prevent the
contraction of disease.
Personal hygiene is a large subject and can be dealt with
fully only at great length; but there are a few rules of
right living which may be conveniently mentioned in brief
—the observance of which would do much to diminish the
amount of sickness and ill health.
Skin. — This is a protective against the entrance of germs
into the body and assists in the purification of the blood
and the regulation of the loss of heat from the body, mainly
by perspiration.
It is important to keep the skin clean because dirt in-
terferes with perspiration and the other skin functions,
favors skin blemishes, boils and abscesses, and the harbor-
ing of parasites and germs of disease.
To this end a daily cleansing bath of hot water with
soap is advised — preferably at night.
Mouth. — The mouth harbors many of the germs of dis-
ease— even when the person feels perfectly well. If any-
thing occurs, however, to lower this person's resistance to
disease — as e. g., chilling — these germs may obtain a foot-
hold and cause disease. Therefore efforts should be made
to keep the mouth as germ free as possible by the use sev-
eral times daily of some pleasant mouth wash or antiseptic
such as listerine, glycothymoline, borine, alkalol, borolyptol
or alkaline antiseptic fluid of the pharmacopeia.
Lungs and Nose. — The air of cities is full of germ-laden
dust. To prevent the entrance of this dust into the lungs
breathing should be done entirely through the nose where
there is a filtering apparatus capable of removing dust im-
purities from the inspired air.
The air thus inspired is also warmed before it reaches
the lungs.
Dust which is removed from the air by the nasal filter
should be removed from the nose at least twice a day by
the use of a nasal douche containing a weak antiseptic
solution such as dilute glycothymoline, alkalol or boracic
acid.
If the nasal passage is obstructed, the obstructions should
be removed. The commonest form of obstruction in the
naso-pharynx is lymphoid tissue or adenoids.
PERSONAL HYGIENE 213
Signs of obstruction are — open mouth, a vacant, unin-
telligent expression, snoring, frequent colds and nasal dis-
charge, mental dullness, deafness and cough.
For the proper development of the chest and lungs deep
breathing is strongly recommended.
Stomach and Intestines. — The first great rule of diges-
tion is not to eat too much. The simple articles of diet
are the best. Temperance in the use of alcoholic drinks is
highly recommended.
The intestines should be emptied every day or two.
Laxatives may be necessary, but the natural means are
preferable. These consist in the use of articles of diet
which have a coarse residue and in exercising the abdom-
inal muscles. Enemas may prove a useful adjunct.
Digestive ferments to aid digestion are not recommended
for continuous use. Healthy out-of-door exercise is the
best appetizer.
Hair and Nails. — Disease germs are readily harbored
beneath the nails. They should be kept short and cleaned
daily with a small sharpened piece of wood which is to be
immediately destroyed.
The hair is a prolific gatherer of germs. It should be
washed at least once a week and the scalp rubbed at the
same time.
Ringworm and lice are the two most common parasitic
diseases of the scalp and hair. The former requires treat-
ment by a physician.
To remove lice cut the hair short and apply a mixture
of equal parts of olive oil and kerosene twice a day for
several days.
Hearing. — The most common causes of defective hearing
are adenoids, wax in the ears and inflammation or abscess
in the middle ear from inflammation or disease of the nose
or throat. Wax and adenoids should be removed.
Early attention to diseased throat and nose conditions
will often prevent permanent deafness.
Eyes and Vision. — The eye conditions requiring atten-
tion are ophthalmia, trachoma, conjunctivitis, and func-
tional diseases from eye-strain.
Most ophthalmias occur at the time of birth and can be
prevented by dropping a drop of 1 per cent, solution of
silver nitrate into the eyes of the new-born child.
Trachoma is a contagious disease requiring medical
214 BATHS
treatment. It can be avoided by avoiding people who are
suffering from it.
Conjunctivitis usually occurs from over-strain or from
dust which gets into the eyes.
Daily use of a % per cent, solution of boracic acid will
relieve it.
Eye-strain can be avoided by avoiding too continuous
eye work, fine and indistinct work, faulty lighting of the
room, and bad posture in reading or writing.
Nervous system. — Hygiene of the nervous system is more
or less complex. It consists largely of avoiding worry and
strain and maintaining a good reserve force of the body.
The latter is accomplished by proper food, sufficient sleep,
exercise and daily baths, with occasional vacations.
Cheerfulness, happiness and avoidance of irritation are
great aids in the maintenance of a healthy nervous system.
Sleep and Rest. — The amount of sleep required varies
with the person and his work. The child usually requires
from 10 to 12 hours of sleep ; the young adult about 9 ;
the adult of middle life usually finds 7 to 8 sufficient, while
old people can usually do with less.
Sound, refreshing sleep is favored by a well-ventilated
room (all the windows should be open), absolute quiet,
darkness and a warm bed.
Baths. — Warm baths cleanse the skin and thus promote
its healthy functions. They may be taken weekly, bi-
weekly, or even once a day — preferably always at night.
Warm baths have a temperature of 85° to 100° F. Hot
baths range from 100° to 110° F., and should usually be
followed by cold sponging or a cold shower.
Cold baths are not cleansing, but have a stimulating and
tonic effect and reduce the liability to catch colds. They
should be taken every morning. Cold shower baths are
more invigorating than cold tub baths.
Swimming baths provide physical exercise and promote
health. Salt water baths are usually more invigorating
than fresh water baths.
Turkish, Russian and hydro-therapeutic douches are ad-
mirable tonics — though to be classed as luxuries.
Baths should not be taken too soon after meals, because
digestion may be lessened or entirely stopped by the blood
being called from the stomach to the skin and muscles.
In cold baths the head should be immersed first to avoid
TEMPERANCE 215
increasing the blood pressure in the brain too greatly,
which might result if the body were gradually immersed
from the feet upward.
Clothing. — The best rules for clothing are those which
ordinary intelligence dictates. Simple general rules are to
keep the head cool and the extremities warm; avoid tight
constricting bands; and wear cool clothing in summer and
warm clothing in winter.
For summer wear the light colors are preferable, and
cotton and linen fabrics will generally be found the coolest.
For winter wear wool, silk and fur are the warmest.
Underclothes of wool are the warmest and those introduced
by Jaeger are the most comfortable and serviceable.
The much condemned corset of women's wear is un-
doubtedly harmful — if for no other reason than that it
interferes with free respiration as well as exerting pressure
on the abdominal viscera and producing constipation.
The most important sanitary precaution to preserve in
reference to clothing is that of cleanliness. While dark
clothing does not show dirt as well as light it accumulates
just as much, and should be cleaned just as often. The
greatest precautions in regard to cleanliness are required
in the case of those articles of clothing worn next to the
skin.
Exercise. — (See "Exercise and Recreation.")
Temperance. — The long-continued, immoderate use of
alcohol leads to degenerative changes, primarily in the
stomach and liver, and at a later period in the kidneys,
lungs, brain and blood vessels. The degeneration is char-
acterized by increased growth of interstitial fibrous tissue,
which in course of time shrinks and causes atrophy of
gland cells and loss of function. Chronic catarrh and
cirrhosis of the stomach with cirrhosis of the liver, followed
by dropsy and hemorrhage, are the well-recognized results
of alcoholic intemperance.
The effect of such intemperance in shortening life is now
universally recognized. Statistics bear overwhelming evi-
dence on this point. It may be stated generally that the
mortality of the intemperate is from four to five times
greater than that of the strictly temperate of the same
age and in the same class of life.
All evidence points to the fact that alcohol, except in
strict moderation, is injurious to men who are exposed to
216 SEX HYGIENE
extremes of climate (great heat and great cold), or who
have to undergo great bodily or mental labor. Its effect
on the circulation is distinctly injurious to those engaged
in hard bodily work, for it causes the heart to do more
work without conferring any counterbalancing advantage.
In strictly moderate doses alcohol has not been proved
to do any harm; and, taken in the form of beer or wine,
many of the inhabitants of our large towns find it a useful
aid to digestion and assimilation. But it must be remem-
bered that there are idiosyncrasies as regards alcohol, and
that what is harmless to one individual may be injurious
to another. For thoroughly healthy people, alcohol in any
form presents no advantages, and for children and young
people it is decidedly injurious.
Worse than all other dangers from alcohol is the danger
of the alcohol habit. This invariably leads to loss of effi-
ciency, dependence, insanity or even worse.
Sex Hygiene. — The defective or degenerate of the human
race should not be allowed to propagate.
To produce healthy children and ones not prone to dis-
ease, both parents should possess good constitutions, and
they should take great care not to weaken these by excess
of any kind, physical or mental. In this climate the proper
age for marriage is considered to be about twenty-four or
twenty-five for the man, and nineteen or twenty for the
woman.
A disease may be hereditary — as syphilis — or only a pre-
disposition may be hereditary, as in the case of tuberculosis.
Marriage between relatives is reprehensible — the danger
increasing with the nearness of the relationship.
Before a marriage is contracted it should be a certainty
that neither party is suffering from syphilis or gonorrhea.
Other diseases which are very liable to reappear in the
offspring, especially if present in both parents, are scrofula,
gout, hysteria, epilepsy, insanity, some physical deformi-
ties and skin diseases and criminal tendencies of various
kinds.
Unhygienic Habits. — There are certain unhygienic habits
which need but to be once called to the attention to be
discontinued.
Such are the following : —
Putting articles into the mouth — such as pencils, coins,
PILES 217
candy, chewing gum or any other object that has been in
the mouth of another person.
Allowing the unwashed fingers to touch the face, eyes or
lips.
Spitting, or coughing and sneezing without protecting
the mouth with a handkerchief.
Washing the teeth in a wash basin which is used by
other people for washing purposes.
Allowing children to play in the dirt.
Careless disposal of excreta.
The use of a common drinking cup and the drinking of
impure water.
Kissing babies on the mouth.
Perspiration. — (1) Offensive (sweating feet). The feet
of dyspeptic people often smell offensively, especially if
they have to stand a great deal. In these persons the arm-
pits also are apt to be very offensive. The digestion must
be attended to first; and the armpits and feet are to be
washed daily in a lotion made of carbolic acid 1 part and
water 39 parts. After drying well, dust the feet with
boric acid powder and starch, equal parts, or with talc
powder. The socks or stockings are to be wrung out of
a corrosive sublimate lotion, 1 in 2,000, and then dried,
before being worn. And, as the bacilli, or germs, which
cause the evil smell, flourish in the damp leather of boots,
the insides of the boots ought to be wiped out with a wet
rag dipped in the same lotion, occasionally.
(2) Excessive sweating. — This is a sign of general de-
bility, and must be treated with tonics. (See "Night
Sweats of Consumption.")
Physiology. — This is the science which deals with the
duties and functions of all the parts and organs of the
(human) body, when it is in a state of health.
Piles (called by doctors, "HEMORRHOIDS"). — Piles are
varicose veins of the rectum or lower bowel. It is usual
to speak of external and internal piles. An internal pile
is a swollen vein in the inside of the bowel, just inside the
anus; and an external pile is one which, perhaps, was once
internal, but which has come out through the opening dur-
ing straining at the water-closet, and which has been
squeezed and bruised by the muscle which closes the open-
ing until it has become inflamed and bleeds. External
218 PILES
piles tend to get well, and to leave behind ridges and tags
of hard skin hanging just outside the anus.
Causes. — A sedentary life, constipation, sluggish liver,
overeating, alcoholic disease of stomach or liver, pregnancy.
Signs. — A person may have external piles for years with-
out caring anything about them, though suffering much
discomfort when the bowels are costive. But when they
get inflamed, there is a feeling of weight and great soreness
at the anus, pain during the passage of motions, itching
and throbbing, and perhaps irritability of the bladder and
a frequent desire to pass water. When piles get really
inflamed and swollen the patient cannot even sit down in
comfort. Then the piles will suppurate and discharge pus.
This process is often Nature's way of bringing about a
cure ; the piles get filled up with blood clot and shrivel up.
Internal piles show their presence by bleeding, which, if
copious and too frequent, may be a danger to health. But,
generally, the loss of an ounce or two of blood by piles is a
good thing for the patient, and may save him headaches,
apoplectic strokes and attacks of illness.
Treatment. — (1) Palliative. — A spare diet, especially
avoiding alcoholic drinks, much meat, and spiced foods.
The bowels must be kept always a little loose, not with
strong purges, but with gentle laxatives like magnesia, con-
fection of senna, brimstone and treacle, castor oil, phenol
phthalein tablets, licorice powder — and not calomel, aloes,
colocynth, jalap.
When piles are acutely inflamed. — Take two grains of
calomel at bedtime and a dose of castor oil (half-an-ounce)
in the morning. Take hot hip baths or use hot fomenta-
tions. If an external pile, with a blood clot inside, is in-
flamed and tender, send for a doctor, who will probably
puncture it.
If you have internal piles, especially bleeding ones, which
come out every time you go to the closet, you must gently
press them back again, and use a collapsube of ointment
of galls and opium, or of hamamelis and cocaine, or of
ferric perchloride. Regular exercise is essential in all
these cases. Conium ointment is also an excellent soothing
application.
(2) Operative. — The operations for piles are called " ex-
cision" and "ligature." Of course, they are entirely out-
side the province of home-doctoring. But it is quite
PLEURISY 219
certain that many a man and woman whose piles are a
lifelong nuisance to them would be immensely relieved
by the simple and safe operation for the removal of their
piles. Such an operation would lay a patient up only for
about a week and the relief would be immediate.
Pleurisy. — This is an inflammatory disease within the
chest. It is accompanied by fever in the acute form, but
may become chronic, and may last for weeks without any
fever being present. It is an inflammation of the pleura,
or serous membrane, which lines the inside of the chest,
and also covers the surface of the lungs, so that the two
surfaces of the membrane glide over each other with every
breath that is taken. These movements are quite unfelt in
a state of health, but when pleurisy has come on each
breath taken and every movement of the chest causes pain,
which in acute inflammation may be of a very acute nature.
In health the pleural surfaces are smooth and moist, but
when inflamed there is at first dryness, then roughness and
tenderness. After some hours of the disease a change oc-
curs and some fluid is poured out, and some flaky, white,
solid material is deposited. The fluid which is formed col-
lects in the chest cavity around the lung, and if the quan-
tity becomes great it compresses the lung more and more
and renders it unable to expand. At first this pleuric ef-
fusion is a clear, pale yellow, watery liquid, but if the
inflammation continues the clear effusion becomes opaque
and purulent, like the contents of a boil or an abscess.
This is called by doctors empyema. This is a very serious
state of disease and very often leads to early death.
Pleurisy is generally set up by catching cold from exposure
to cold and damp; in healthy persons attacks are usually
short and easily cured, but if pleurisy attacks a consump-
tive child or young person it is always a serious matter.
On the other hand, in a person who has consumption of
the lungs, local pleurisy is one of Nature's methods of try-
ing to localize and heal the mischief.
An attack of pleurisy begins with a feeling of chilliness
and a shivering fit, followed by flushes of heat and thirst,
headache and a burning skin ; there is acute pain somewhere
in the chest, most often in the side, and a dry cough, which
much increases the pain. Either one or both sides may be
affected. The pulse is hard and quick, and the breathing
is rapid ; there is restlessness, and a feeling of anxiety, and
220 PNEUMONIA
the urine is scanty and high colored. As soon as these
symptoms are observed, the patient must give up and go
to bed, have a hot bath, and then lie between blankets,
take a sharp purgative, and put a hot linseed jacket
poultice, with a little mustard, on the painful part of the
chest. A doctor must take charge of the case at once.
(See "Poultices.")
Pneumonia. — (See also "Lung Diseases.") — Men, women
and children are all liable to pneumonia, in which the chief
trouble is inflammation of the lungs. The persons who
run most risk of it, and who are most liable to die of it,
are drunkards. It is slightly contagious. The disease be-
gins quite suddenly: the patient has a shivering fit, his
temperature runs up to 103° or 104° (the usual healthy
temperature is 98% ° and anything higher than that is
called "fever") ; his tongue is coated, his appetite is lost,
and he has a bad headache and shivering. Then he coughs
in a painful way, and spits up phlegm tinged with blood.
In a few hours more, he is propped up in bed with flushed
forehead and cheeks, bright eyes, and panting, gasping for
breath. He is very feverish, and his skin is dry. At night
he cannot sleep, but wanders in his mind and talks non-
sense. He gets worse and worse (and perhaps dies).
But suddenly, when he has been ill about eight days,
and is very bad indeed, he falls asleep ; his fever abates,
his pulse rate goes down, his breathing becomes easy, his
dry, brown tongue grows moist — and he wakes up feeling
almost well ! From that time forward he slowly but surely
improves until he is all right again. Nearly all the cases
of pneumonia that recover end in this way.
Here, then, is a disease which is caused by a germ, which
runs its course, and which cannot be cut short. It is a
dangerous disease and its treatment demands much skill.
No sensible person without a medical training would care
to undertake the treatment of pneumonia on his own re-
sponsibility. The doctor will order a diet of milk, beef
tea or mutton broth given in small quantities, frequently;
and the patient may have a liberal amount of water to
drink. Large hot linseed-meal poultices may be wanted
(see "Poultices"). Leeches may be required. An ice bag
(a gutta-percha bag to hold fragments of ice) may be called
for. Alcoholic stimulants may be the only thing which
will keep life in the patient in the later stage before the
POISONING 221
crisis — as much as 8 to 12 or more ounces of good whisky
or brandy daily may have to be taken. (See "Drachms"
and "Ounces.") The sleeplessness requires special treat-
ment; the ice bag to the head is recommended by many
doctors, but chloral must not be given even if the patient
is accustomed to its use.
In recent years great emphasis has been laid upon the
importance of fresh air in the treatment of pneumonia.
Many cases are treated out of doors. Oxygen is freely
given in many cases. Serums seem to be of assistance in
some cases, but no specific has yet been discovered. The
chief danger in pneumonia is heart failure during the at-
tack and thrombosis and embolism, causing instant death,
during convalescence. Therefore a patient must be kept
absolutely quiet until all danger is past.
During convalescence a tonic will be required, followed
later, if possible, by a change of air to a temperate sunny
climate for a few weeks.
Prevention, — As pneumonia is an exceedingly common
disease during winter and spring and as it so often results
fatally, it is important that all possible care be taken to
avoid contracting the disease. This is done first by in-
creasing the body resistance, and second by avoiding con-
tact with the infectious cause, or pneumococcus germ.
The body resistance is maintained by the following
means :
Exercise, cold morning bath, good nourishment, little
worry, little alcohol to drink and little tobacco smoking.
Avoidance of exposure to cold, draught, sudden changes
of temperature and wet feet.
Pneumococcus vaccine will increase the body resistance
to infection.
The infective agent is avoided by careful household
cleaning, avoiding close proximity to people who are cough-
ing, sneezing, or spitting in public places, or breathing
through the nose while in their presence. Frequent careful
cleaning of the mouth with antiseptic solution — especially
in the morning, evening and after meals.
Poisoning. — When a person has taken poison you must
send for the doctor at once. In the meantime, if you know
what poison he has taken, you may be able to save him;
if you do not know, you must await the doctor, but in the
meanwhile you need not be idle.
222 POISONING
FIRST CASE. — You know what poison has been taken. If
it is Prussic Acid or Cyanide of Potash the patient will
almost certainly die at once. There is no time to save him.
But if he is not yet dead, and lies insensible, pale, and
rigid : —
(1) Give him a tablespoonful of mustard in a tumbler-
ful of warm water. If he vomits, it is well; if
not, put your finger to the back of his throat.
(2) When he has been sick, give him brandy or strong
beef tea or strong coffee.
(3) Pour cold water over his head, holding him over a
basin.
These two poisons are very powerful. They are used in
photography and are too easily obtained.
If the poison is Laudanum, the patient is first excited,
then depressed, then insensible. At first you can rouse
him, afterwards he becomes like one dead, with noisy
breathing, blue lips, and pale, ghastly face.
(1) Give him a tablespoonful of mustard in a tumbler-
ful of water.
(2) March him about, stimulate him, douche him, keep
him alive by worrying him in every way. If
you let him alone he will die, probably.
(3) Give him a pint of very hot strong black coffee,
injected into the rectum, or back passage, with
a glass or Higginson syringe.
If the poison is Oxalic Acid, make him swallow chalk,
lime or whiting, or plaster scraped from the wall, in large
quantities, washed down with water. Don't give an emetic.
Give him stimulants and castor oil. But the acid is irritant
and you cannot do much for a person whose whole mouth
and food tube are inflamed and corroded.
If the poison is White Arsenic, there will be very little
time. Give spoonful of magnesia and white of egg and
salad oil until the doctor comes.
If the poison is Carbolic Acid, give him : —
(1) A tablespoonful of mustard in a tumblerful of
warm water.
POLYPUS 223
(2) When he has been sick, give him half-an-ounce of
Epsom salts in a half -pint of cold water.
(3) Keep him warm, and give him stimulants.
Sometimes people take overdoses of sleeping draughts.
For an overdose of Chloral: —
(1) Make him sick by tickling the back of the throat.
(2) Rouse him, stimulate him, flick him with wet
towels, force him to walk about, worry him.
(3) Inject a pint of hot coffee into the rectum.
SECOND CASE. — You do not know what poison has been
taken. In this case you must use your wits and notice
what symptoms he has.
If he has Vomiting, Diarrhea, and Colic — he may have
taken sugar of lead, phosphorus, arsenic, spirits of salts,
corrosive sublimate, sulphuric acid, Prussian blue, salts of
sorrel, or other irritant poison.
(1) Do NOT give an emetic, because you may injure
stomach by the vomiting.
(2) Give plenty of lime water, or milk, or magnesia,
or wall-plaster, or whitewash, or whiting, or
chalk, and plenty of milk and water to wash
them down. If he vomits them up, give him
more.
(3) When he becomes exhausted, give a tablespoonful
of brandy or whisky in milk or water, and put
hot-water bottle to his feet, until the doctor
comes.
Smell his breath. If he has taken carbolic acid or prussic
acid or laudanum or alcohol, you will know it by the smell.
Phosphorus (rat paste) smells of garlic. If he is quite
insensible, he may have taken opium, morphine, bella-
donna, laudanum, chloral, chloroform ; or he may be suffer-
ing from coal gas which has escaped into the room where
he slept. In all these cases stimulation of every kind is
desirable, though no special treatment can be undertaken
without medical advice.
Polypus. — This is an old-fashioned Latin word, used to
mean a little tumor (or swelling) with a stalk, short or
224 POLYPUS IN THE EAR
long, by which it is attached to the mucous membrane
somewhere — in the nose, the throat, the ear, the rectum or
the womb. It is impossible to understand what a polypus
really is without knowing what a mucous membrane is, and
so you must first read the article on * * Mucous Membrane. ' '
Now, when a mucous membrane is afflicted with catarrh
and inflammation (see "Abscess") for a long period, dur-
ing which pus, or matter, is always trickling over it, the
membrane gets into an irritable state and a polypus is
formed, which tends to drop off by its own weight, but may
remain attached by a stalk.
A nasal polypus is a red, soft, gelatinous, mucous tumor,
like a hanging pear-drop. If it gets big enough it blocks
up the nostril, and then it must be removed by a surgeon.
He passes a silver wire noose over it and twists it off. If the
catarrh continues, of course, there may be another there
very soon, growing on to the stalk of the old one. A nasal
polypus generally causes deafness.
Polypus in the ear is often one of the results of years
of the very common middle-ear disease, with its chronic
discharge. It must be removed, by an aural surgeon, with
a "snare."
These fibroid tumors, and fibroid polypi of the womb,
are very common among women in the middle period of
life — so common that they are the real reason for the un-
fortunate stoutness of so many middle-aged women. When
a woman has dull, aching, throbbing pain in the abdomen,
with feelings of weight and * ' bearing down, ' ' piles, costive-
ness, and frequent attacks of bleeding, she very likely has,
in her womb, a fibroid tumor, which may or may not have
become a polypus already. By that time the surgeon will
be able to feel the tumor and will advise as to its removal.
Short of operation, the patient may control bleeding by
douches of hot water, and by taking this medicine in-
ternally:— Ammonia sulphate of iron, 30-36 grains; dis-
tilled water, 8 ounces; mix. Take a sixth part every six
hours. Very hot water douches will generally stop the
bleeding, and give a sense of great comfort. But, if very
profuse, a solution of hemisine, or adrenalin, or supra-
renalin (liquid extract, 1 part, hot water, 10 parts) will
be necessary to check the hemorrhage. These three drugs,
which closely resemble each other, are the very latest and
POULTICES 225
best agents for checking every kind of bleeding. Cheaper
drugs for the same purpose are — turpentine, perchloride
or iron and alum.
The reader will now understand that when a patient
says that he or she has "a polypus," and wants a "cure"
for it, we can give no help. A polypus may occur any-
where where there is a mucous membrane, and its only
treatment is local, and requires skill.
Polypus of the Womb. — The commonest sort of tumor
of the womb is a little hard, fibrous knob, which grows and
develops witjiin the substance of the womb itself. Most of
our readers know that the womb is the muscular bag in
which the unborn child lives and develops until it is ready
to be born. The little knob, growing in the muscular
substance (the "flesh") of the womb is gradually squeezed
out of it, and bulges either into the hollow inside of the
womb, or on the outside, among the coils of gut. In either
case, it drags the mucous membrane along with it and
when it is squeezed right out of the womb substance, it
remains hanging as a tumor with a stalk of mucous mem-
brane, either inside or outside the womb. The tumors,
which happen to be squeezed outside, and lie among the
coils of intestine, are not very dangerous, however large
they may grow; but those inside the womb (called polypi)
cause much pain and bleeding, and may have to be re-
moved by operation.
Poultices are rather old-fashioned applications for ap-
plying heat and moisture to inflamed parts. They are not
so cleanly as fomentations, and ought not to be used for
sores or anywhere where the skin is broken, because they
are not antiseptic and may even themselves contain the
germs of disease.
A poultice must only just be big enough to cover the
inflamed part; if it is bigger it makes the surrounding
parts sodden and helps to spread the inflammation. When
an abscess has discharged itself no more poultices must be
used; their time of usefulness is over. Before applying
a poultice to the chest of a young child or old person a
piece of warm flannel must be placed there first, and grad-
ually withdrawn after the hot poultice is in its place.
Thus the great heat of the poultice is brought gradually
and not suddenly to the child's notice. This is a little
226 TO MAKE A POULTICE
nursing "tip" which few trained nurses know. After re-
moving a poultice, dry the skin and cover it with a layer of
cotton wool.
To make a poultice. — Have everything quite ready before
beginning to make it, so that when it is made it may be ap-
plied without delay, as hot as possible ; test its heat by apply-
ing it first to your own cheek. A linseed poultice is thus
made. ' ' Into a basin, previously scalded, place the ground
linseed meal, enough for the size of poultice required. Pour
scalding water on it gradually, stirring with a table knife
or ivory paper knife. Spread the poultice on linen, old
flannel, or tow; the tow is then folded over the edge of the
meal and the poultice is ready. It is a better plan to pour
the water on the meal than to sprinkle the meal on the
water, unless a very large poultice is required. A bread
poultice is thus made: — Stale white bread crumbs are
dropped into boiling water and the cup in which the poul-
tice is being made is then covered with a saucer and stood
upon the hob. The water is then drained away and the
pulp applied upon a piece of linen. A starch poultice is
soothing and retains the heat a long time, and is suitable
for inflamed skin eruptions. The starch is first mixed
with cold water and then boiling water is added until the
mess becomes of a proper consistence. A charcoal poultice
is a good antiseptic one. Finely-powdered vegetable char-
coal is mixed with bread or linseed meal and a little more
charcoal is sprinkled over the surface just before apply-
ing it. A mustard poultice is thus made: — The mustard
powder is made into a thin paste with hot or tepid water
and spread in a thin layer on brown paper, and covered
over with a layer of muslin. It is kept on as long as
necessary, or as long as it can be borne, say fifteen minutes,
unless blistering of the skin is aimed at. An eau-de-
cologne poultice consists of an ordinary pocket handker-
chief saturated with eau-de-cologne, and applied to the
skin with a layer of oil silk over it. This is quite enough
to produce the redness of counterirritation on some skins
and the redness quickly disappears."
A hot boiled Spanish onion is a splendid poultice for
earache, as its pointed end fits into the ear, keeps the
heat a long time, and the juice is an antiseptic. Put a
large pad of cotton wool over it and bandage on it. (See
also * ' Fomentations. ' '
PREGNANCY, SIGNS OF 227
Pregnancy, Hygiene of. — Pregnant women must have
plenty of fresh air and only moderate exercise. Walking
is better than riding. All fatigue to be avoided, also
crowded entertainments. Dress. — Tight stays, garters and
collars are not to be worn. If the enlargement of the
abdomen is excessive, an obstetric belt must be worn.
Flannel drawers are advisable.
The bowels must be kept well open, with cascara or saline
purges if necessary. A warm bath ought to be taken
once weekly. If the breasts are painful they must be
bandaged or supported; the nipples must be hardened by
bathing with equal parts of whisky and water, or alum
lotion, night and morning. The nipples, if not prominent,
must be drawn out and kept out for a few minutes daily
by an elastic .ring placed round the bases of them. This
is most important, as also is this — that in every pregnant
woman the urine ought to be analyzed at least twice during
the carrying of the child.
Lastly, at the periods which correspond to the courses
which would otherwise be in progress, great care and
caution is to be observed, as miscarriage is more apt to
occur then.
Pregnancy, Signs of. — Wives are frequently doubtful as
to whether they are ' ' in the family way ' ' or not. In many
cases the skill and experience of a medical man are neces-
sary to decide the question, but very often there is no
difficulty in being sure, one way or the other, at an early
date. The ordinary signs of the pregnant condition are
here given, with comments: —
(1) A woman, on becoming pregnant, at once ceases
her menstrual periods (see "Menstruation"). This is the
first sign, and is relied upon by most women for calculat-
ing when the baby will be born. Precise calculation is
impossible, as a rule, but the confinement may be expected
about 280 days from the first day of the last menstrual
period.
Fallacies. — But the periods may cease, in any girl or
woman, because of anaemia, which must be treated by a
doctor. And, very often the fear of becoming pregnant
may cause the periods to cease for some weeks, and the
desire to become pregnant may stop them. In fact, any
nervous condition is enough to upset some women in this
way. Secondly, a woman may continue to menstruate for
228 PSOEIASIS
three or four months, even though she is pregnant, be-
cause of a polypus or other disease of the womb.
(2) The breasts of a woman feel full and hard at a
very early stage of pregnancy.
(3) In the second month comes "morning sickness."
The expectant mother feels sick on getting up in the morn-
ing. This is a very common sign, but is occasionally quite
absent. Sometimes, however, the vomiting is a very serious
matter. Fallacy. — Women who drink overnight, or who
tipple in secret, are often sick in the morning from catarrh
of the stomach.
(4) After the third month the dark circles round the
nipples of the breast become very dark red instead of a
rosy pink, and a drop of milk may sometimes be squeezed
out of the breast. But many blonde women show no sign
of this kind.
All the other signs are such as only a doctor can under-
stand or seek for.
Psoriasis. — This has been called "the skin disease of the
healthy man," and it is true that most of those who have
this disease are otherwise quite healthy. Psoriasis con-
sists in a chronic inflammation of the skin, with raised
red patches, covered with silvery or yellowish-white dry
scales. No one knows the true cause of psoriasis.
Psoriasis often appears first in childhood and then goes
away again, and reappears occasionally. It occurs espe-
cially in gouty, rheumatic, and syphilitic families, and is
particularly noticeable in the spring of each year. It is
not infectious or contagious. The true psoriasis has silvery
scales, and when it occurs in a person who has had syphilis
the scales are much yellower. It can hardly be said, how-
ever, that syphilis has much to do with the causation of
the disease.
Psoriasis first appears on the back of the forearms and
•elbows, and on the front of the knees. There are, in
the earliest stage, small pimples each capped with a little
dry scale, and the pimples grow or unite with others until
they form patches of two or three inches wide. Then
other parts of the body become affected. There is no pain
or itching.
Treatment. — Of course, the first thing to do is to guess
at the probable cause of the disease and to deal with any
rheumatic or gouty taint that the person may have, A£
PSORIASIS 229
to diet, it is of very little real service, as a rule, to adopt
any special diet. But the writer has seen cases in which
a month or two's severely vegetarian diet worked wonders
in the cure for psoriasis.
The one medicine of all others which seeme to have in all
cases a certain amount of beneficial effect, is arsenic. But
arsenic, though a valuable medicine in the hands of a medi-
cal man, is yet a very powerful poison. The dose of it is
to be increased right up to the limit of toleration of the
patient; until, in fact, he gets redness round the eyes.
Then it is to be continued until the eruption has disap-
peared, and for three months after that, in gradually
diminishing doses. But at the very beginning of a first
attack of psoriasis arsenic is not to be given ; in that stage,
thyroid extract tablets may be given with advantage.
Psoriasis, then, is a disease which is not suitable in any
way for amateur treatment. Both arsenic and thyroid are
powerful medicines and require a doctor's prescription.
A celebrated physician recommends the patient with
psoriasis to swallow a 10-minim capsule of turpentine
three times a day; and he increases the dose up to 30-
minim doses.
Local treatment. — This is much more important and more
easily manageable at home than the constitutional treat-
ment. The best application of all is chrysarobin ointment,
which must be rubbed well into the patches of the disease
but must not be allowed to touch the healthy skin round
about. The strength of the ointment may be, say, 15
grains to an ounce of vaseline. The ointment stains the
skin and bedclothes, and if applied to the face may make
the eyelids dropsical. But if it is rubbed into patches on
the body, some of it gets absorbed and does good at last
to the patches on the face.
In dealing with a patch of psoriasis it is of no use to
rub any ointment on it until you have rubbed off the
scales. Tar ointment is not so messy as chrysarobin, and
the detergent tar solution may be thought even more con-
venient. This solution acts well if applied to the patches
undiluted and allowed to dry on.
Hutchinson's excellent ointment for psoriasis is as fol-
lows:— White precipitate, 10 grains; chrysarobin, 10
grains; creosote, 20 minims; detergent solution of tar, 10
minims; benzoated lard, 1 ounce (mix).
230 PURGATIVES
If a patient finds it difficult to get off the scaliness, let
him apply to the patches for several hours, pads of lint
soaked in weak carbonate of soda solution and bandaged
on over a piece of oiled silk.
Purgatives. — Medicines which act upon the bowels. The
following list of purges will be found to contain some-
thing in the way of medicine suitable for the relief of all
kinds of costiveness, sluggish liver, congestive headaches,
dropsy and blood poisoning. (See also "Dosage.")
(1) Laxatives. — Medicines which cause Very gentle
purging, without griping, and with soft semi-fluid mo-
tions:— Honey, figs (especially green figs), tamarinds,
prunes, brimstone and treacle, citrate of magnesia.
(2) Aperients produce more liquid motions and cause a
little griping: — Black draught (compound senna draught),
white mixture (at all hospitals), extract of cascara sagrada
(adult dose, 2 to 4 grains), castor oil (adult dose, 1 fluid
ounce).
(3) Saline purgatives are especially good for gouty and
rheumatic people, and those with Bright 's disease, or liver
disease, or who suffer from headaches (see also "Head-
ache") : — Phosphate of soda (dose, 2 drachms), Epsom
salts (y±.to 1/2 an ounce), Seidlitz powders, cream of tar-
tar (1 to 3 drachms).
(4) Cholagogues especially stimulate the liver and move
the bowels: — Blue pill, calomel, podophyllin. (Require a
medical man's prescription.)
(5) Drastic purgatives cause a violent and very watery
action of the bowels. They are required in cases of drunk-
enness, dropsy (unless the heart is feeble) : — Colocynth,
jalap (compound jalap powder, 1 drachm), croton oil (dose,
1 to 3 drops, given rolled up in a bread pill).
A few additional purgative medicines for special cases
are now given: — (1) For habitual costiveness and "wind
in the stomach": — Sulphate of sodium, 2 drachms; dilute
sulphuric acid, 1 drachm; compound infusion of gentian,
to 6 ounces. (Take a small wineglassful of this mixture
after the two principal meals every day. ) (2) As a purga-
tive for persons with rheumatic gout: — Sulphate of soda,
l!/2 ounces; flowers of sulphur, 2 ounces; (One teaspoon-
ful in a tumbler of milk on rising from bed every morn-
ing). (3) For anaemic women, with headaches, costive-
ness, and stoppage of the monthly flow: — Granulated
RASHES OF THE SKIN, ARTIFICIAL 231
sulphate of iron, 2 grains ; pill of aloes and myrrh, 3 grains.
(To make one pill. Let the patient take one such pill
thrice daily, after meals.) (4) To relieve the fullness of
dropsy: — Podophyllin resin, 6 grains; ginger powder, 20
grains; extract of hyoscyamus, 24 grains. (Divide the
mass into 12 pills, and let the patient take 2 every other
night, at bedtime.) (5) A laxative for children with
costive bowels. A stock of this medicine to be kept in
cupboard at home: — Rhubarb powder, 45 grains; mag-
nesium carbonate, 3 drachms ; dill water, 4% fluid ounces.
(Mix well and give the infant a teaspoonful every two
hours until the bowels are freely moved.) (6) Another
purge for persons with dropsy in any part of the body: —
Elaterium, 1 grain; extract of gentian, 12 grains. (For
four pills. Let the patient take one every night.)
Quinsy. — This means the abscess which forms in the back
of the throat sometimes as a result of inflammation of the
tonsils. It ought to be opened by the surgeon; if left to
itself, it will burst in time, but it may burst during sleep
and suffocate the patient. It ought not to be left un-
treated. (See also "Sore-Throat.")
Rashes on the Skin, Artificial. — These eruptions are those
which are not due to some internal disease, such as scarlet
fever, but which are mostly caused by some substance ap-
plied to the skin. Soldiers and sailors, and others, such as
professional beggars and tramps, sometimes make them-
selves ill in this way in order to escape service or duty,
or to prey upon the sympathy and charity of the kind-
hearted. These sham eruptions come under two main
headings : —
A. — (1) Eruptions caused by external agents, (a)
Animals — such as lice, fleas, bugs, jellyfish, gnats, mos-
quitoes, wasps, and the irritating discharge of ulcers,
carbuncles, and the urine in diabetes. (6) Vegetable —
such as germs of some kinds, orange-peel juice, arnica,
poison-oak, poison-ivy, mustard. Most of these produce a
rash like that of eczema.
(2) Trade eruptions, among those who handle paraffin,
tar, sugar (grocer's itch), salt, lime, cotton oil, etc., and
such people as chemists, dyers, tanners, paperhangers,
bakers.
(3) The eruptions of beggars and tramps are often pro-
duced purposely by the patients themselves to excite pity.
232 RASHES OF THE SKIN
The chief offenders are hysterical girls, who cannot get as
much attention paid to them as they desire; prisoners;
deserting soldiers and sailors; and lunatics. The sub-
stances used are such as croton oil, acids, turpentine,
iodine, mustard, Spanish fly, urine. A few of these
malingerers are very clever, but not quite clever enough
to deceive a doctor for very long, because they produce
rashes which are not seen in disease, and suggest ''art"
rather than "nature." In the French army the soldiers
use thapsia root, and sometimes get erysipelas from it.
Rogues of this kind will often inflict much pain on them-
selves.
B. — The other type of artificial eruptions is produced
by drugs taken internally. The rash caused by too much
antipyrin, for example, is often like that of a certain dis-
ease, but there are generally ways of distinguishing it, and
doctors are generally on the alert for these drug rashes.
Bromides (given for sleeplessness or epilepsy) produce an
artificial eruption (in some people) like acne. So may
iodides, arsenic, chloral, mercury, belladonna, quinine,
opium and others.
RASHES ON THE SKIN. — (1) A rash coming out in crops,
first on chest, stomach and neck, then on wrists and the
rest of the limbs, and accompanied by a sore throat and
feverishness which has lasted one day only, is likely to be
the rash of scarlet fever (scarlatina). Send for the doctor
at once.
(2) A rash appearing at the beginning of an illness or
without any feeling of illness, coming out in crops, on
the face, shoulders, back, and scalp, with tiny red pimples
which very soon become blebs — is probably chicken-pox.
Send for the doctor at once.
(3) A rash, first seen on the face, of hard red pimples
which feel like shot embedded in the skin, and accom-
panied by pain in the bottom of the back, and fever and
headache and vomiting of three days' duration — is the
rash of smallpox. Send for the doctor at once, or go to
the nearest vaccination station and get vaccinated.
(4) A rash of red patches with round scooped-out edges,
which appears on the fourth day of illness, and is seen
first on the face, then on the body, and then on the limbs,
and is accompanied by the signs of a bad cold in the head,
cough and feverishness — is the rash of measles. Send for
RED GTJM 233
the doctor and see that no other children go anywhere near
the diseased one.
(5) The rash of German measles is variable.
(6) Small red spots with deep-purple points in the cen-
ter of them are generally due to flea ~bites. Old flea bites
might be mistaken for a skin disease, but marks on the
linen and clothes will perhaps show what the spots are
caused by.
(7) Wheals on the skin with whitish middle parts and
a central blueish spot, are caused by bug bites. Bugs in-
ject a poison into the skin which makes it swell so that
the bug may have a better supply of blood to feed upon.
Toilet vinegar and lead lotion are both good for bug bites.
(8) See also "Lice.';
(9) Sometimes a patient taking medicine by the doctor's
orders gets a skin eruption or rash, which ought to be re-
ported at once to the doctor. Some people are too sus-
ceptible to some medicines and the dose will require to be
regulated by him.
The commoner medicines which sometimes cause rashes
are ether, bromides, iodides, chloral, quinine, antipyrin
and belladonna.
(10) A rash of tiny blebs like drops of dew on the skin
is probably a rash due to too much perspiration. It should
be dusted with violet powder or fuller's earth.
(11) A rash which consists of wheals, flattened, and
feeling hard and firm ; at first red, then white and blood-
less with a bright pink edge; and surrounded by a red
halo — is the rash of nettlerash. In bad cases the whole
skin is red and the wheals stand out in white patches
upon it.
It comes on quite suddenly and itches and burns, but
wherever the scratching is done fresh wheals appear. (See
"Nettlerash.")
(12) Rashes may be caused by various irritants, such
as the stings of wasps, jellyfish, and stinging nettles; of
gnats and mosquitoes, and of hairy caterpillars. (See
"Rashes, Artificial.")
Red Gum. — This is a skin disease, seen only in babies,
and is associated with the cutting of the first teeth. It
is shown by pink pimples on the skin of face, body or
limbs, sometimes in patches, at other times in single
pimples. They do not last many days, often come and
234 RHEUMATISM
go, and do not ulcerate; they may alternate with a loose-
ness of the bowels. Pay strict attention to diet, and avoid
all chills to the skin. Give a dose of rhubarb and soda,
in amount according to the age of the infant, and smear
a little zinc ointment over the spots.
Refuse Disposal. — Refuse may be divided into three chief
classes — house sweepings and ashes; garbage; and sewage
(see i l Sewage Disposal ") . The substances composing tho&e
three classes should be disposed of separately.
Ashes may be disposed of by the producer in the coun-
try for paths, roads or filling-in, or they may be collected
by municipal or town authorities to be disposed of as they
see fit.
Garbage should be collected in covered galvanized cans
which are emptied frequently (daily).
In the country garbage may be consumed by pigs, or
dumped on a garbage heap, which is disposed of at longer
intervals. Both garbage heap and pigpen should be
screened to prevent the access of flies, which find garbage
an ideal breeding ground.
The most sanitary method of garbage disposal for both
city and country is by the use of garbage destroyers or
incinerators. Small ones are now manufactured which
can be placed in kitchens, and garbage can thus be de-
stroyed as soon as it collects.
Garbage and refuse are collected in settled districts by
the municipalities or towns and are then best disposed of
by garbage crematories, furnaces or destructors.
Rheumatism. — This disease occurs in several forms. The
most serious cases are those of acute rheumatism, also
called rheumatic fever (see " Acute"). Chronic rheu-
matism may be left behind in the joints when the acute
form passes off, and the" same name is also given to a similar
affection of the muscles. Rheumatism of the loins is com-
monly called lumbago, and when the pain goes down the
back of the thigh it is called sciatica. It may here be
remarked that all these terms are very inaccurately and
carelessly used. As a fact the pains in these cases are very
little understood even by doctors themselves. Hence much
difference of opinion. The muscles of the shoulders, ribs
and arms may also suffer. There is also a form of this
disease called rheumatic arthritis, in which the toes and
fingers become swollen, painful, and gradually so deformed
RHEUMATIC FEVER 235
until they are useless. The chronic forms of rheumatism
are associated with great pain, but an absence of fever.
Rheumatic fever is a formidable disease, lasting some-
times for weeks. In it there are severe pains in several of
the large joints, high fever, great weakness, and an ex-
treme liability to have inflammation attacking the valves
inside the heart. It has been supposed that the disease
depends on the formation of a peculiar chemical compound
called lactic acid in the blood, and that this acid attacks
the fibrous structures of the joints, causing them to in-
flame, swell, and contain an excess of watery fluid. For
a long period it has been supposed that the immediate and
only cause of attacks were chills, exposure to cold and
damp, when the person is in a weak or unhealthy state.
But more recent arguments and researches seem to show
that rheumatism is, like most others, a germ disease.
The symptoms are shivering, malaise, nausea, and head-
ache, with restlessness, passing on into a state of fever;
next day there is an onset of painful stiffness in one or
more joints, often the knees or elbows, the hips or the
wrists; the fingers and toes rarely suffer. The patient
feeling great heat, with violent pain, is soon rendered a
pitiable spectacle of helpless suffering. He dare not move,
because each movement increases the pain, which becomes
agonizing, even the weight of the bedclothes can hardly be
borne, the skin becomes bathed in sweat of a peculiarly
offensive, sour smell ; the pulse is full and bounding ; there
may be constipation or diarrhea, the tongue is furred, and
the water is scanty and high-colored; the disease passes
from one joint to another, and relapses are common.
Treatment. — Absolute rest in bed is necessary, lying be-
tween blankets on a hard hair mattress with the affected
joints wrapped in wool, or covered with warm fomenta-
tions. The most reliable modes of treatment are by the
salicylate of soda, aspirin, salicin, bicarbonate of potash,
and similar medicines.
The three different types of the medicinal treatment of
an acutely inflamed rheumatic joint (whether the case is
severe enough to call "rheumatic fever" or not) are: —
(1) The salicylate treatment, (2) the opium and salicylate
treatment, (3) the alkaline treatment. The first is the
best, generally speaking, though some patients cannot take
enough salicylates, because of the humming noises they pro-
236 RHEUMATISM, CHRONIC
duce in the head. It is certain that this medicine relieves
the pain in the joints, whether it cuts short the attack
or not. We give below two useful prescriptions: —
Salicylate of soda, 3 drachms; syrup of ginger, 1 ounce;
water, 6 ounces. A tablespoonful to be taken every three
hours while the joints are hot and painful (for an adult).
Tincture of opium, 1 ounce ; potassium carbonate, % ounce ;
glycerin, 2 ounces; water, 12 ounces. To make a lotion;
to be applied on lint to the painful joint. (Poison — not
to be taken.)
Diet in Acute Rheumatism. —
FORBIDDEN ARTICLES OF FOOD. — Beef tea, meat extracts,
pastry, sweets, sugar in all forms, alcoholic drinks of
every kind.
ALLOWED. — While the joints are red and tender and
there is inflammation — milk, milk and soda, peptonized
milk; fruit jellies, oatmeal gruel, barley water, home-
made lemonade, weak tea, malt extract.
When the fever has abated — light clear soups and broths,
vegetables, chicken, light puddings, bread and milk, ar-
rowroot.
After a fortnight without fever — Bread and butter,
eggs, white fish, chicken, pounded lean beef or mutton or
veal, stewed celery, spinach, potatoes, seakale, asparagus,
grapes.
Rheumatism, Chronic. — Kheumatism in its chronic forms
and stages manifests itself in numerous ways; it is an ail-
ment that varies perhaps more than any other, both in
the parts affected and the severity of the pains. (See
" Acute.")
The disease may appear as lumbago, or pain, with stiff-
ness, may affect the neck, or any one of the joints; or it
may specially attack muscles, such as those between the
ribs, or over the shoulder, or the scalp of the head.
All these forms of rheumatism are worst in cold
weather, especially after exposure to wet and cold com-
bined; they are also often related to certain forms of in-
digestion, and in most rheumatic persons they can be
brought on by indulgence in beer.
Every attack which occurs renders the sufferer more
liable to further attacks, and many persons suffer from
rheumatism every few weeks from middle life to old age.
Repeated attacks are liable to lead to further changes,
RHEUMATISM 237
for the muscles may waste and lose power, and the bones
of the joints may grow out — that is, become enlarged and
deformed.
All rheumatic patients should pay great attention to
three points — diet, warmth, and excretions (i. e., bowels
and urine) and perspiration. By these means attacks
may be seldom felt, while errors as to these points may
lead to much suffering at any time. It is wise to take a
saline purgative, such as a mixture of sulphate of mag-
nesia with bicarbonate of potash, in water, more or less
regularly, without waiting for symptoms of illness. The
skin also should be kept thoroughly and frequently
cleansed with warm baths. The action of the kidneys
should be sustained by an occasional dose of weak warm
gin and water at bedtime.
Chills must be avoided by wearing woolen clothing,
thick socks, and by the removal of wet boots at the earliest
possible moment.
The diet should be very simple, with only a small quan-
tity of meat; salted dry meats are especially to be
avoided. Very little sugar should be taken. All starchy
foods are likely to be harmless, as is milk, and also eggs,
so that a very excellent diet consists of boiled and baked
puddings of arrowfat, maizena, sago, tapioca, and
macaroni, made with good cow's milk and eggs. All
cooked vegetables will help to maintain the purity of the
blood, and many varieties of fruit, such as oranges,
lemons, bananas, pomegranates, cooked apples, and prunes,
may be taken with advantage.
As already said, beer almost always does harm, while
the French and German light wines, being of an acid
nature, are unsuitable. The safest drinks are soda or
potash water, to which a little malt whisky or good brandy
may be added, and these should be taken only with meals.
Medicines. — (1) Powdered guaiacum resin, 1 drachm;
potassium iodide, 1 drachm; tincture of colchicum seeds,
3 drachms; syrup, 2 ounces; cinnamon water to 6 ounces.
A dessertspoonful of this mixture to be taken twice a day.
An excellent medicine for old chronic rheumatism of the
large joints. (2) Veratrine, 1 drachm; protoiodide of
mercury, 1 drachm ; vaselin, 1 ounce ; an ointment to be
gently rubbed into the joints. (3) Guaiacum powder, 1%
drachm; capsicum powder, 15 grains; pill aloes et asa-
238 RHEUMATIC GOUT
foetida, 1% drachm. Divide mass into 60 pills. Take one
three times a day, if preferred to liquid medicine.
Rheumatic Gout (Rheumatic Arthritis), — This is a name
applied to many cases of chronic, painful joint disease,
which differ from gout as much as from simple rheu-
matism. Rheumatic gout affects persons of middle age,
or old people, and is not seen in children. It is essentially
a chronic disease, and it tends to grow gradually worse
and worse, to last for years, and until death occurs from
some other disease. Both sexes suffer about equally. It
is essentially a disease of the joints, and it is not related
to rheumatism of the muscles so common in old age. Its
onset is generally slow and gradual, but in some cases
there are occasional feverish attacks. A man or woman
begins to feel unwell and weaker than before, easily
fatigued, loses appetite, and has vague pains in the head,
back, and limbs. The digestion is disordered, and the
bowels are irregular, and the urine often high-colored;
the sufferer is restless, uneasy, and sleeps badly. Soon
afterwards some of the joints become affected; pain is
present more or less continuously, and the joints are puffy
and enlarged, but not hot and burning with acute inflam-
mation. The joints are stiff, and can only be moved with
some difficulty and increase of pain; and so if the hip,
knee, or ankle is affected, the patient is rendered lame.
In some cases a peculiar sort of crackling or creaking
noise can be made by handling and rubbing the joint,
which, nevertheless, often seems to contain too great a
supply of oil within it. One joint becomes affected after
another, and this is often seen in the several joints of the
fingers and thumb. After causing mild suffering for
months or years, the joints become really enlarged with
hard, bony outgrowths, and the gristle part of the joint
becomes destroyed. In this way a joint becomes too large,
too hard, deformed and useless. Following this destruction
of the tissues forming the joint, the nerves of the parts
around become irritated, which gives rise to spasms and
cramps of the affected limb. All these troubles leading
to weary days and disturbed nights, break down the gen-
eral health gradually, and the patient becomes melan-
choly, and, on account of the debility, always feels chilled
and depressed; he catches cold easily, and so often suffers
from bronchitis; and such cases often end with conges-
RICKETS 239
tion of the lungs. This is a very intractable disorder, for
while gout is more or less controlled by colchicum and
iodide of potassium, and rheumatism by the salicylate of
soda and bicarbonate of potash, this form of disease is
not checked by any drug known to medical science, and
the only hope of cure lies in the possibility of building up
the constitution with fresh air, change of climate, regular
exercise, with carefully-arranged diet.
Rickets. — This is a disease which affects children, and
may be observed soon after birth, or not until the child
is several years of age. It is a form of weakness caused
by unsuitable and insufficient food, and the tendency to it
may be inherited from one or both parents who were af-
fected by rickets in their childhood, or it may be the
result of birth from parents who were delicate in health
from overwork or from scanty food at the time of the in-
fant's development and suckling.
Poverty of the suckling mother is the most certain
cause, as this is generally associated with unhealthy homes,
and often with overwork. It is most apt to occur in the
latter children of a family when the mother has had too
many children for her strength, or has had children too
fast, especially when the means of the father have not
improved with the passing years.
There can be no doubt that children with congenital
syphilis often develop rickets (see "Syphilis"). Some-
times it has seemed that a lack of lime salts in the food
has caused the onset of rickets, and so the cod-liver-oil
emulsion and the hypophosphite of lime mixtures sold by
chemists often do good. But not every case is cured by
lime salts. There is hardly a tissue in the body which is
not affected in the disease called rickets.
The bones are soft and bendable, because they are want-
ing in lime salts, and they do not develop in the usual
way. The chest of a rickety child is badly shaped, and
perhaps "pigeon-breasted." The ends of the ribs in front
are enlarged and feel like knobs under the skin. The
elbows, wrists, knees and ankles are too large and knobby,
and the legs get bow-legged because they are too weak to
bear the child's weight. The spine sometimes gives way
under the child's weight and may be bent forwards or
sideways. The skull is too big and bulgy, and so the face
looks too small; and the two soft places that you always
240 SALISBURY TREATMENT
find on a child's head, and which generally "close up" in
a few months still remain "open" beneath the skin, and
soft for a year or two. A rickety baby often grows into
a deformed child, and dies of rheumatism, St. Vitus'
Dance, or some similar disease before reaching adult age.
The bony girdle at the hips may grow much out of shape
and give much trouble, if the child is a girl, when the time
comes for her to give birth to a baby.
The blood is poor in quality in rickets. The spleen and
liver are often too big. The results of the disease of the
tissues are to produce tenderness of the body of the child, so
that it cries when it is played with or rubbed. It throws
off the bedclothes at night. Its head is hot and perspir-
ing. Its stools (or motions) are green, pasty, watery, and
smell very badly. The child is very liable to spasms, fits,
convulsions, squinting.
No case of disease deserves more careful treatment, but
it is almost useless to lay down a routine of treatment, as
cases vary so much. The efforts of the child's parents
must be directed towards the improvement of the general
health, by fresh air, sunlight, and a life in the country,
or by the seaside. Plenty of milk, cream, and eggs are
wanted, and plenty of fresh fruit and vegetables. The
most useful medicines are cod-liver oil, saccharated solution
of lime, phosphates, quinine, iron, iodide of iron, and so on.
Ringworm. — (See "Skin Diseases" V.)
Rupture.— (See "Hernia.")
Salisbury Treatment, The. — This is a system of treatment
chiefly useful for persons who are much too fat and who
are at the same time not in any way gouty. Gout and
Bright 's disease must not be treated by this system. The
Salisbury method is to feed the patient on an entirely meat
diet, giving him about three pounds of lean beef every
day and almost nothing else except plenty of hot water
to drink. After one week of treatment the patient goes
back to his ordinary diet for a time. The scientific value
of this method, according to the inventor of it, is that it
gets rid of all "fermentative" foods and that the large
quantity of hot water drunk acts beneficially by carrying
away the excess of uric acid which there is sure to be in
such a purely animal diet, and forces the kidneys, skin
and bowels to act most freely. The plan of treatment is
given in case any of our readers would like to try
SALISBURY TREATMENT 241
this method at home. Persons with chronic indigestion,
dry red pointed tongue, and pain after food will very likely
derive benefit from the Salisbury method. Very fat people
may give it a trial too. Clearly understand that the Salis-
bury diet is not intended as a permanent diet. It is to be
continued "only while the necessity for it lasts/'
The Salisbury dietary is as follows : —
(1) There are to be three meals a day.
(2) An hour and a half before each meal the patient
is to drink one pint of hot water about 100° F. or a little
hotter. It is to be sipped slowly. It may be flavored
with lemon juice, or a little tea or salt, according to taste.
(3) Mealtimes are to be 8 A. M., 1 p. M., and 6.30 P. M.
(4) The minced beef may be flavored with pepper,
or mustard, or Chutney, and the only vegetables allowed
are lettuce, watercress and celery (raw or cooked). The
least amount of mince taken with each meal is to be two
ounces, and the largest amount allowed at any one meal
is 16 ounces (one pound). If the patient is still hungry
then, he must take the whites of one or two eggs lightly
poached, between meals. He must not exceed six eggs
a day. The feeling of weakness that this diet produces
for a day or two will pass off.
(5) A little aperient medicine, such as cascara, may
be necessary occasionally.
(6) If after a long course of treatment the patient
is sick of beef-mince and beef cakes, he may have
(minced before being cooked) mutton, lamb, poultry,
well-boiled rice or macaroni, as additional food, but these
are not to replace the beef altogether.
(7) Instructions for making beef-mince. — Cut slices
from the top side of a round of beef. Cut the meat into
strips and scrape away all fat and gristle. Put the meat
twice through the mincing-machine. Beat up the pulp
in a roomy saucepan with cold water, in the proportion
of one teaspoonful of water to one ounce of pulp. Add
black pepper and salt to taste.
Cook the mince slowly, stirring all the time, until the
red color disappears. This will take about twenty
minutes.
When finished, the mince should be a smooth, soft,
jpasty mass, without any lumps in it, aixd is .to be served
242 SCARLET FEVER
in a hot basin and eaten from a teaspoon. The patient
may have a stick or two of raw celery if he wants some-
thing to chew with it.
(8) Instructions for making Salisbury beef cakes. —
Take minced beef pulp prepared as already described
above, season it to taste, and turn it with two forks into
several flat round cakes, about half an inch thick, and
grill them over a clear moderate fire for about six minutes
each.
Scarlet Fever (Scarlatina) . — This serious disease, to which
all are liable, though young children are most often attacked,
is a contagious fever, of which the most important charac-
ters are sore throat and a bright red rash on the skin ; and
the most important complication is inflammation of the
kidneys. (See also "Infection.") The poison of it clings
to clothing and articles that have been used for the sick,
sometimes for months, and often lying harmless for a long
time may suddenly start the disease again if it finds a per-
son who is weakly or susceptible.
As a rule, a person who has "caught" scarlet fever falls
ill within two days. He shivers, vomits, and complains of
headache and backache, and cannot eat or sleep. Then
comes a bad sore throat. On the second day appears a red
rash (see "Bashes on the Skin," No. 1). This rash begins
to fade about the sixth day of illness, and then begins
"peeling." The skin shreds off in tiny flakes, or even in
large flakes, and these little scales are very contagious.
This goes on sometimes for six weeks or more. As to the
throat, it is red, swollen, and painful and tender. The
tongue is bright red. The fever is high. In most cases
the disease is at its height about the sixth day of illness, and
after that the patient slowly gets better. In fatal cases
the patient dies from exhaustion after about five days of
severe illness.
The complications of scarlet fever may be terrible. The
tonsils and the palate may ulcerate; the glands under the
jaw may enlarge into a brawny hard swelling and undergo
mortification. This generally kills the patient. The mid-
dle ear (see "Ear Diseases") may become attacked, and
the patient will probably then be deaf and have a discharge
from the ears for the rest of his life. But the most seri-
ous of all are inflammation of the kidneys — which may
SCIATICA 243
come on during convalescence and lead to dropsy, etc., —
and scarlatinal rheumatism, which may leave the patient
with heart disease.
Treatment. — The general measures to be taken as to iso-
lation are described under the treatment of measles (which
see). A sheet dipped in and kept always wet with 1 in 100
carbolic acid lotion must be hung up to cut off the sick room
from the rest of the house. From the very first it is a good
plan to anoint the patient's body daily with 1 in 50 carbolic
oil. Washing the body daily with weak disinfectant lotions
is only to be done during convalescence. The medicines
must, of course, be left to the doctor in attendance. A
throat spray should always be used ; it lessens the risk of ear
complications. Such a spray is the following: — Glycerin
of carbolic acid, 3 drachms ; glycerin of borax, 3 drachms ;
rose water to half-a-pint. Isolation must be kept up for at
least six weeks. It is of the very highest importance to
guard against chills during the convalescence.
Sciatica, — This word means neuralgia (nerve pain) or
actual neuritis (nerve inflammation) of the sciatic nerve,
which lies under the muscles at the back of the thigh from
the buttocks to the heel. It is generally caused, in the first
place, by exposure to wet and cold, as by sitting on cold
stone, or lying on wet grass; and, once contracted, sciatica
is often very difficult to get rid of. Persons with sciatica
have pain more or less along the whole length of the nerve,
even down into the heel, and tender spots at various points
on the back of the thigh. If it goes on for a long time,
there is generally some wasting of the muscles and flesh of
the thigh.
Occasionally, sciatica is a sign of some spinal disease.
Acute sciatica, coming on suddenly after some indiscre-
tion, like sitting on a cold stone, should be treated thus: —
Get the sufferer to bed, wrap him up warmly, and give him
two or three grains of calomel, followed by two Seidlitz
powders next morning. About the same time as the dose
of calomel, let him take 15 grains of Dover's powder.
(This is a pharmacopoeial, and not a patent medicine.)
Very chronic sciatica ought to be treated by a long rest
in bed and dry cupping over the course of the nerve, along
the thigh. Both acute and chronic sciatica will need spe-
cial medicines for the relief of pain, and morphine or co-
caine may have to be injected under the skin; of course,
244 SCROFULA
these drugs can only be safely administered by a doctor.
Moreover, in most cases of sciatica, the patient is already
tainted with gout, or rheumatism, or alcoholism, or syphilis,
and the treatment proper to these diseases must also be
administered. Sufferers from sciatica might like to try one
of the following formulas : —
(1) Phenacetin, 50 grains; salol, 50 grains; caffeine, 5
grains. Divide into 10 cachets, and take from two
to four cachets daily, in recent case of sciatica; or
(2) Spirit of turpentine, % ounce; pure honey, 1^2
ounce. Make a confection, and take a teaspoonful
night and morning; or
(3) Salophen, 10 to 40 grains, in cachets. Three or
more cachets to be taken daily in cases of sciatica
in rheumatic person. Aspirin has also had its ad-
vocates in 10 grain doses, thrice daily.
(4) Several liniments are in common use, but let the
sufferer remember that most cases of sciatica are
neuritis and not neuralgia alone. Hence the re-
lief obtained by rubbing liniments in is only tem-
porary. Good liniments for this purpose are
chloroform, belladonna, aconite of turpentine or
camphor liniments.
(5) Many cases of sciatica get relief from the injection
under the skin of pure water ; others like injections
of cocaine; others of chloroform.
(6) Leeches put on over the painful spot often give
much relief.
(7) Great heat, locally applied, as in the Sprague sys-
tem, often cures the neuritis altogether.
(8) Alcohol, one of the chief causes of neuritis, does
harm in all cases, and ought never to be taken.
Scrofula. — A child or person is said to be scrofulous when
he or she suffers from a special liability to diseases caused
by the germ of tuberculosis or consumption — ' ' the tubercle
bacillus." The word is dropping out of use nowadays.
There used to be an idea that there were only two types
of body which were especially liable to be attacked by
tubercle. But it is quite certain that there is no type of
individual which cannot become infected, though some
types are still recognized as being more prone than others
SCURF 245
to the disease. The two "scrofulous" types are — (1)
Those persons with coarse hair, coarse features and greasy
skins, of poor muscular development and long, flat chests,
and (2) those of somewhat delicate beauty, with pink and
white delicate skins, large eyes, soft dimpled flesh, downy
hair over the face, neck and arms, keen perceptions, lovable
dispositions, and bright intellect. The word struma means
much the same as scrofula. Old country doctors still
sometimes call only tuberculous disease of the lungs "con-
sumption"; tuberculous disease of a joint "scrofulous
joint"; and tuberculous infection of the glands "strumous
glands ' ' ; although as a fact the disease is the same in all
these cases — caused by a deposit of "tuberculous matter"
in the part affected. (See "Tubercle.")
Scurf. — This is a very different thing from scurvy, which
is a blood disease. Scurf is a disorder of the skin of the
head and hairy scalp. There are two chief varieties of
scurf — (1) a greasy, oily scurfiness of the skin, with flakes
of reddish-brown scurf skin and red blotches, which may
spread from the scalp down on to the face; and (2) a dry-
ness of the scalp, with itching, and dry scales, which accu-
mulate on the collar of the coat during the day, and fall
in a shower when the hair is brushed. The first variety is
generally called scurf, and the second is named dandruff.
In the one case the skin glands are too active and too much
oil is made, so that the skin becomes sodden and sticky, and
in dandruff the hair, eyebrows, mustache and beard get
thin because there is not oil enough in the scalp. In both
cases the hair glands are in fault. Constipated persons
seem to be very liable to scurf on the head. Seeing that
people of all ages and of all classes, and of every way of
life, and under the most various circumstances of health
and quality of skin, suffer from scurf, we are sure to be
pretty right if we conclude that scurfiness is caused by the
presence of some parasite or other. But although animal-
culas of many different varieties have been found in the
scales from scurfy heads, no one can be sure yet what par-
ticular organism does the mischief. The importance of
all this to a non-medical reader is this — that no one ought
to wear the cap or hat, or use the hair brushes or combs of
another person, and that brushes and combs ought to be
washed in disinfectants as well as with soap. In the house-
hold of the intelligent woman of the present day, disin-
246 SCURVY
fectant solutions ought to be frequently in use for the pre-
vention of disease ; for prevention is better than cure. As
to what disinfectant to use, one may employ Sanitas Fluid .
or boric acid, or boroglyceride, or carbolic acid, or corrosive
sublimate. The last two are very powerful, and they are
also poisonous. But little bottles of tablets may easily be
obtained, and lotions of various strengths (according to the
purpose required, and prepared from the instructions on
the labels), may be made in a few minutes.
There is no doubt but that scurfiness prepares the way
for eczema in some persons and that it is sometimes diffi-
cult to decide where scurf leaves off and eczema begins.
All the more reason for keeping brushes and combs clean
and disinfected, and for not using other people's clothes
and for frequent washing of the scalp.
Now scurf is a local disease, and does not require "medi-
cines for the blood." The scaly masses ought to be got
away by gentle rubbing with a clean rag, dipped in spirit.
Then, at bedtime, in the case of dandruff, or dry scurf, rub
into the scalp (NOT the hair, but the skin) an ointment made
of precipitated sulphur, 1 part in 10 parts of cold cream.
Another good pomade is made of 5 grains of precipitated
sulphur to an ounce of lanolin.
In the other cases of scurf, where there is already too
much oiliness, first remove all greasy crusts and scabs and
scales, but gently, and without one of those abominable
little fine-tooth combs, which injure the skin and do harm.
Wash the scalp daily with Spiritus alkalinus saponis in
warm water for a week or so. Then when the scurfiness is
less, wash only once a week, and then use a new lotion made
of 20 grains of corrosive sublimate in 6 ounces of spirit and
2 pints of water. This is a poisonous preparation, and it
must be labeled poison and not left about. And, at last,
when there is no more scurf, to promote the growth of the
hair, use the following elegant pomade whenever necessary :
— Precipitated sulphur, 2 drachms; castor oil, 4 drachms;
tincture of cantharides, 1 fluid drachm ; balsam of Peru, 10
drops or more ; cocoanut oil, 3 drachms. This will be found
a delightful preparation and may be continued throughout
life. (For other methods of treating Scurf, see "Skin Dis-
eases" IV.)
Scurvy. — This is a blood disease caused by the absence of
sufficient vegetables in the diet. It is not to be confounded
SELF-DOCTORING 247
with scurfiness or scurf, which is merely an unhealthy condi-
tion of the scalp of the head. The signs of scurvy are —
weakness of gradual onset, sallowness, sunken eyes, pains all
over the body, tenderness of the gums, and foul breath.
Later, the gums bleed, the teeth fall out and bleeding takes
place from nose, rectum or vagina and even under the skin
(bruises) and in the whites of the eyes. The disease may
cause death at last.
Treatment. — Scurvy can always be avoided by a sufficient
supply of fresh vegetables or fresh meat ; and the same rem-
edy will cure all but the very worst cases.
Seasickness. — There are some people who, expecting to
be seasick when they go down to the quay, generally man-
age to feel so before they actually go on board by merely
watching the ship riding at her anchor. Others, expecting
to be sick, spoil the whole pleasure and interest by mere
apprehension. Some require no more than the gentle
plunging of a vessel at anchor ; some need a thorough shak-
ing-up in order to produce retching. As soon as a suscep-
tible patient gets on board a ship he should lie down flat on
his back and keep his eyes closed, and try to get a nap.
But, then, the susceptible man or woman ought never to at-
tempt a sea voyage without preparing themselves. The
nervous system of such a person requires soothing for a few
days before embarkation. Twenty grains of bromide of
sodium ought to be taken thrice daily for four days before
going on board. A light meal must then be taken three
hours before the ship starts. Some people only want a
little courage to help them fight against seasickness, and
iced champagne may very often supply the stimulus re-
quired to make Dutch courage. Chlorobrom is one of the
favorite remedies. It contains bromide of potash and other
things, and should be taken in the same way. Some people
like to suck extra strong peppermints all the time, and
there is no objection to them if the people near at hand do
not object. Before going on board attend well to the gen-
eral health. Eat nothing in the least bit indigestible, such
as pickles, cheese, nuts, rich soups, highly seasoned dishes,
and such-like. And, above all things, keep the bowels freely
open.
Self-Doctoring. — This is only mentioned to be condemned.
No sensible man or woman will doctor himself or herself in
anything more than a passing ailment. Even a doctor will
248 SEWAGE DISPOSAL
not doctor himself, because he knows how misleading sen-
sations can be. If you are ill, send for the best doctor
you can afford, and respect him, and put full faith in him.
Tell him everything, carry out his full directions and work
with him in every way. Even at the worst, his advice,
founded on skill and experience, must be better than your
unskilled guesswork; and this plan will be found to be
more economical in the end.
Sewage Disposal. — There are few more common methods
for the transmission of disease than the improper disposal
of sewage. This comes about as a rule through the con-
tamination, through sewage, of water and milk supplies,
of baths, and of food supplies, largely through the agencies
of flies. Diseases transmitted in such ways are typhoid and
scarlet fever, cholera, diphtheria, tuberculosis, summer
diarrheas, and many others, including those due to the in-
testinal parasites. One of the gravest and most familiar
example of the last is the transmission of hook-worm
through sewage-contaminated soil.
This is a foot or skin infection and is prevented by wear-
ing shoes.
There are two main systems of sewage disposal — the wet
and the dry systems. The wet system is only applicable
where there is a plentiful water supply, as in cities, or towns
and is therefore confined to thickly settled districts.
The methods most in use in the dry system are the pail
system, the earth closet and the privy vault.
The last method is usually objectionable as the contained
sewage is very liable to contaminate soil and water.
If used it should be lined with impervious material like
concrete or brick and emptied every week or two. It should
always be carefully screened from flies and the openings
should have hinged coverings.
In the pail system a pail is used of about two cubic feet
capacity.
These pails are removed as often as necessary — neigh-
boring farmers being willing to remove them free of charge
on account of the value of this material as fertilizer.
In the earth-closet system about a pound and a half of
dry sifted loam or clay are immediately thrown upon the
dejecta, which are thus rendered inodorous and inoffensive.
Owing to the action of certain bacteria in the earth, all
trace of the peculiar nature of the organic compound is
SEWAGE DISPOSAL 249
quickly destroyed, and the mixture soon becomes practi-
cally nothing but humus and is of some value as a fer-
tilizer.
The closet should not be on ground higher than the house ;
it should be tightly closed in and the openings in the seat
covered to keep out the flies. It should not be too far from
the house (about 150 feet) and not nearer to a well than 200
feet. Lime should be freely used, or even better are wood
ashes. Closets should be frequently cleaned and the matter
in them (if not used for fertilizing purposes) completely
buried or spread out on soil at some distance from the house
so that it will dry quickly.
Horse manure is best handled by placing immediately in
barrels which are covered or screened from flies (98 per
cent, of which breed in horse manure).
In the wet system of sewage disposal the chief points of
interest are the collection or plumbing and the disposal of
the sewage material.
The essentials of good plumbing are: —
Enough water to flush and clean pipes.
A ventilation system to dilute and carry off gases.
Open plumbing — to facilitate examination and repairs.
Traps — to prevent entrance of sewer gas and micro-
organisms into the dwelling.
The following are the commoner methods of sewage dis-
posal, which concern not so much the householder as the
engineer planning city works: —
Emptying into the sea at a distance from the shore.
Land irrigation, in which the sewage is distributed over
farms for fertilizing purposes.
Purification by chemical precipitation with subsequent
disposal of the sludge.
Biological purification by means of the septic tank or
contact beds.
Filtration. — This is often combined with the previous
method. The filtrate contains very few bacteria after the
last three processes and may safely be emptied into a large
stream.
To empty untreated sewage into a stream is criminal, as
inhabitants on the banks lower down are certain to con-
tract such diseases as typhoid fever, diphtheria or cholera
if this water is drunk.
Cesspools, which are frequently used in the country to
250 SIMPLE LIFE
temporarily collect and store large amounts of sewage, are
dangerous unless properly built.
They should be at least 50 feet away from a dwelling and
60 to 80 feet distant from a well, spring or stream. Their
walls and floors must be constructed of good brickwork in
cement, rendered inside with cement, and with a backing
of at least 9 inches of well-puddled clay around and beneath
the brickwork. The top of the cesspools must be arched
over and means of ventilation provided, which, at the same
time, are carefully screened from flies and insects.
The best method of emptying cesspools is by the pneu-
matic pressure method such as is commonly used in Paris
with the fosse permanente.
Simple Life, The. — The papers, a short while ago, were
full of this expression: "Live the Simple Life!" What
does it mean? "The Simple Life" is the title of a won-
derful book by a German pastor named Wagner, in which
he finds just fault with all the artificiality of our present
empty civilization. He shows that most of the so-called
comforts we enjoy are not necessaries, but luxuries which
we should be happier without. Who can doubt it? The
arguments in this book chiefly hit the foolish expenses of a
certain rich class; but the working man is not exempted,
for does he not drink to the hurt and damage of his health
and happiness, the emptying of his purse, and the impov-
erishment of his family? What would life be, with all its
disappointments, without some of its convivial drinking, its
smoking, its cups of tea? — the reader may ask. Well, as
life is at present in our towns, and with the fearful com-
petition, life would be dull indeed without some "dissipa-
tion," we are forced to admit. But, all the same, the Sim-
ple Life has its claims upon us. It does not mean that
to be happy and well we ought to forego all alcohol, all tea,
all tobacco, all gorgeous hats, smart boots and shoes,
feathers and luxuries.
It only means that the man, woman, or child is happy
and rich in proportion to the things he or she can do with-
out! The more simply we live, the happier and healthier
we shall be. The real Gospel of the Happy Life is to learn
to do without. We do need pictures, and travel, and books,
and clothes, and stimulants, in moderation. They help us
to develop the best that is in us. But we can and ought to
see pictures in the galleries, and they are better than most
SINS AGAINST HEALTH 251
of us can buy; we can spend our savings on bicycles and
traveling tours ; we can dress suitably to our stations, and
for comfort rather than show ; and we only need stimulants
when we are not strong enough for the work we have to do.
The Simple Life saves our pocket money, and increases our
health and enjoyment. We are better citizens, better sons
and daughters, better sweethearts, better married folk, bet-
ter fathers and mothers, better old people, for having
learned to do without what we really do not need. It is in
the hands of women, to a great extent, to bring into effect
the advantages to be gained by the simpler way of living.
Let them scorn to keep company with the man who drinks
to excess, and let them refuse to marry — as they are doing
more and more — with men who are dissipated or selfish and
luxurious. And they themselves may set a good example
by dressing plainly, and discouraging extravagance. They
are very anxious to please and be pleasing ; so let the men,
in their turn, discourage over-fine dressing, excessive tea-
drinking, and encourage, as far as possible, the "Simple
Life" in their families.
Sins against Health — Hygienic Misdemeanors. — Under
these rather stern titles we refer to all those faults
which people commit, knowingly or unknowingly, against
their physical bodies or their minds. How is it that to-day
there is a mighty host of doctors trying to grapple with a
mass of disease and ill health; that there are hundreds of
patent medicines, all guaranteed to cure; that there is an
ever-increasing number of asylums for the unfortunate in-
sane; and that every year the hospitals are crying out for
funds, that they may enlarge the scope of their necessary
labors? Is not medical science wonderfully advanced?
Have we not sanitary boards, health officers, splendid san-
itation, and isolation of infectious disease? How many
families, reader, do you know of in which there is no one
sick, no one ever ailing? Has nearly every family, then, a
sick member? And this in America — the most advanced,
civilized, and enlightened country in the wide world (ac-
cording to the American) ! The fact is, that we — advanced,
wealthy, sensible, sturdy, plucky, enlightened and civilized,
as we are — are living to-day an artificial, unwholesome,
and wearing life ; and it is the artificiality of our lives that
prevents so many of us from enjoying the birthright of
every living creature — sound health. As long as an indi-
252 SKIN DISEASES
vidual follows that inward voice which tells him what to
do and what not to do, he remains healthy in body and
mind. As soon as he begins to hear and do what others tell
him to do, he begins to find life complex, and to ail some-
thing. A young man is led to suppose something manly
in drinking and smoking; of himself, unless he be ill, he
would never drink except when thirsty; and of himself he
probably would never smoke. Why should he? He only
smokes in imitation of his fellows. The young girl is told:
that to tight-lace, wear high heels, or otherwise deform her-
self is to excite admiration in men. Of herself she would
probably prefer to breathe freely, and to live without adorn-
ment other than the roses of good health. Thus you see
what we mean by a hygienic misdemeanor — it is really a sin
against health. You must realize that Nature is pitiless
and inevitable ; that as you sow, so must you reap. Every
excess must be followed by a reaction, a depression; every
sin brings its own punishment, sooner or later — but sure as
death. No one can escape this law. And, in the same wayr
it is possible to live righteously, from a hygienic point of
view — to be moderate, temperate in eating, as well as in
drinking, and the result is just as certain, just as inevitable.
Years of drinking to excess, whether in the bar or in the
privacy of your bedroom, with the bottle hidden beneath
the mattress or up the chimney — will tell upon you, ruin
your nerve, and spoil your health. And years of moderate
living, of hard work, of early hours, and of exercise in
fresh air, will have their due effect. Without accidents
or excesses many a man and woman lives to a hale and.
hearty hundred. Why not you?
Skin Diseases. — I. — This is a subject which does not lend
itself to easy comprehension by the non-medical person.
More, perhaps, than in any other branch of medicine is it
necessary to know the anatomy and physiology of the parts
under consideration, and to have experience of hundreds
of cases. We have, therefore, merely written a sketch of
the subject here, while for a few only of the commonest skin
diseases and their remedies, details are given under sepa-
rate headings (which see).
Almost all persons have some form of skin disease at one
time or another, and these affections often give rise to muck
discomfort and often to disfigurement. Some forms cause
SKIN DISEASES ?53
great irritation, others are painful, and some give rise to
unpleasant discharges.
It must be remembered that many skin ailments are con-
tagious, especially those that are due to parasites or insects.
Some are attended by fever, and these are acutely infec-
tious, such as measles and scarlatina.
Some of these diseases are only observed in infancy, others
in childhood, while others again are only seen in middle life
or in aged persons.
Constitutional diseases of the nature of blood-poisoning
are often shown to exist by skin eruptions. The diseases
of the skin are shown by about nine different peculiarities
of the surface ; these may occur singly or may be observed
grouped together. These forms are smooth reddened
blushes, pimples, vesicles, blebs, pustules, wheals, stains,
scaliness, or scabs.
For example, erysipelas is shown by a blush only, but
smallpox goes through the stages of pimple, vesicle, pustule,
and scab ; while psoriasis is scaly only, as is one form of
ringworm or tetter. The red blush is seen in measles or
scarlatina. By pimple is meant a small, round, raised spot,
somewhat hard and solid. A vesicle is a similar spot, which
contains a drop of clear liquid. A pustule is a similar
raised spot, containing a drop of pus, or matter — a
thick yellow liquid. Blebs are large vesicles like a blister
caused by a scald or burn. Wheals are temporary raised
pink patches; they rarely last many hours; they are seen
after nettle stings.
Scales of dry scurf are commonly seen on the scalp, but
some skin diseases cause large patches of scaly soreness on
the hands and arms. Stains of color, which are often hairy,
are generally formed before birth, but some patches of yel-
low or brown color may be due to parasites in the skin, or
some are caused by constitutional disease.
Scabs are the late stage of vesicles, blebs, and pustules,
after they have been broken, and arise from the surface dry-
ing into a hardened crust; but when a scab is pulled off
a raw sore place is found underneath.
Scabs being a dried, dead layer, it is not of the slightest
use to apply any ointment or lotion to them; the scabs
must be removed, and any curative treatment must be ap-
plied to the raw surface. Much disappointment is often
254 CHILBLAINS
felt by a neglect of this precaution. To remove scabs it is
often necessary to apply one or more poultices of bread,
linseed meal, or mashed boiled turnip.
II. — Chilblains, Cracks and Chaps. — One of the most
common forms of skin disease in the cold weather is the
chilblain; this is caused by exposure to cold air, and is
often due to imperfect drying of the hands after washing
them ; it also attacks the feet, and in some persons the ears
suffer from exposure to cold winds. What are called chaps
are also caused by cold. Persons afflicted with a weak con-
stitution and a defective circulation of the blood suffer
most often.
Chilblains commence with a red blush on the skin, which
is very irritable, and becomes tender from rubbing. If
they are not soon cured they are apt to become broken in
small patches; that is to say, the inflamed surfaces become
raw, and require to be treated as an ulcer with healing
applications, such as zinc ointment. While unbroken they
need to be protected from the air, and require stimulating
liniments or spirituous paints, such as the tincture of
iodine. An excellent application is made by mixing
turpentine 12 parts, castor oil 6 parts, and collodion 30
parts ; this is painted on the chilblains with a brush. Com-
pound soap liniment or camphor liniment will cure many
cases. A favorite old domestic remedy was to take an
onion, cut it in half, dip it in salt, and rub the salted cut
surface on the chilblains. None of these applications must
be put on a broken chilblain. Inasmuch as this ailment
shows a state of feeble health, it is always wise to give
cod-liver oil for two or three weeks after meals and also
to take a mixture of quinine and iron half an hour before
the two principal meals each day.
Chaps and small cracks on the skin of the fingers may
be well treated by collodion, or by the above-described col-
lodion paint. Chafes are red patches of skin due to rub-
bing, and are also frequently found on the legs of infants,
where they are set up by their being kept tied up in wet
napkins, especially if they are not changed often enough.
These can be avoided by frequent bathing with warm water
and soap, and the parts carefully dried with a warm, soft
towel. When they have occurred they must be carefully
attended to in the same manner, and then dusted over with
a mixture of dry oxide of zinc and starch powder. If
NETTLERASH 255
actual soreness has arisen, then apply zinc ointment twice
a day, and put a layer of clean lint smoothly over the part.
Fuller's earth is often applied by the poor to these tender,
sore patches on infants, but it often does harm, because
it is not ground sufficiently fine and smooth. Another
excellent dusting powder is named oleate of zinc; it is
extremely soft, and very soothing to inflamed skin.
III. — Nettlerash, Freckles, Babies' Pimples, Erythema.
— The ailment called nettlerash is not uncommon; it is al-
most always due to indigestion set up by excess of food,
or by unwholesome food, and attacks are particularly com-
mon after eating shellfish, crabs, lobsters, cockles, oysters,
or periwinkles. Eating cold pickles with hot meat is an-
other cause. A sudden chill on a perspiring skin may
bring it on. Persons who have had one attack often have
others subsequently. Nettlerash is a red blush, upon which
a paler patch soon appears; it does not last many hours,
but leads to much itching and irritation. Scratching and
rubbing this part should be avoided, and the irritation can
be subdued by lead lotion, zinc ointment, or by a lotion
of equal parts of sanitas and water. Epsom salts, taken
in water, is the best remedy for internal use.
Freckles are a form of skin disease, shown by small yel-
low or brown spots on the white skin of the face, arms and
hands. Most persons object to them, but there are a few
people who do not think them unbecoming. There are
hundreds of advertised quack remedies for freckles, but we
do not consider that there is any means of cure. They
often come out after exposure to bright, hot sunlight, and
may disappear of themselves. The cucumber ointment im-
ported from Paris is, perhaps, the most likely means of
cure. Or the following lotion may be tried : — Fresh lemon-
juice, rose-water, rectified spirit — equal parts. (Mix.)
Leave for 24 hours. Strain through muslin. Bathe the
face night and morning with the lotion after washing, and
dry lightly.
Red-gum and white-gum are the names of minute red
or white pimples seen on the skin of infants ; they appear
after free perspiration under their clothing; they are not
of much importance and do not last many days. A little
laxative medicine may be given, and lead lotion or zinc
ointment may be applied to the skin.
The group of pink, red, and purple skin rashes, which
256 SCALP DISEASES
are accompanied by fever — we refer to measles, scarlatina,
and erysipelas — are serious diseases, and need medical care.
There is one other which may not be of much importance ;
this is called Erythema. In this disease there may be no
fever, and it is shown by the appearance of roundish pink
patches on the white skin, and these are often seen on the
front of the legs. They may be a little raised above the
skin around them; they may become more dusky in color
as they fade away; they last a few days. These patches
are also seen on the face and chest. The treatment is by
aperient medicines, such as sulphate of soda or sulphate of
magnesia, citrate of magnesia, or the tartarated soda; rhu-
barb, with bicarbonate of soda, is suitable for children and
infants. The diet for a few days must be light, consisting
of broths and farinaceous puddings, and fruit; lemonade
is the best drink to be taken. This skin rash is not con-
tagious.
IV. — Scalp Diseases. — The skin of the head is a part
which often gives rise to trouble. In health it should be
pale, smooth, free from scurf, and not too greasy, and the
hairs should stick firmly in it.
In disease it loses all these natural characters. The hair
may fall out generally, or in patches, and leave baldness.
There may be any variety of pimples, and pustules with
scabs, and the scalp may become scurfy, with either dry-
scales or a matted greasiness. Some forms are acutely
contagious; others cannot be caught by one persons from
another.
Loss of the hair may be due to ill health, and may result
from the violence of a fever, and the hair does become
gradually thinner during consumption and chronic ill-
nesses. In such cases, when recovery follows, the hair
generally takes on new growth. Loss of hair early in life
is very often an inherited peculiarity, and in such persons
neither medicines nor local applications will effect a cure.
When the loss of hair occurs in patches it becomes neces-
sary to decide whether the baldness is due to the growth
of a microscopic vegetable mold, or fungus, or to some fault
in the nerves of the spot. To decide this a physician is
necessary; he must scrape the surface, and examine the
scurf under powerful glasses ; if there is any mold growth,
the treatment is by applications which kill such fungi; if
not, the cure is by stimulating liniments and general tonics.
RINGWORM 257
Scurfiness of the scalp is often a great annoyance; it
generally comes on from neglect of regular washing of the
scalp and brushing of the hair. Local treatment is neces-
sary. The scalp must be thoroughly washed with warm
water, with a nailbrush and a cake of 10 per cent, carbolic
soap, which a chemist can supply. Do this every other
night, three times. After this treatment, rub in every
night the following lotion, with a piece of flannel : — Mix the
yolk of a small, fresh egg with half an ounce of spirit of
rosemary, and a half-pint of clean rain water. "When the
scurf is greasy, rub in this lotion instead: — Take one
drachm each of powdered bicarbonate of soda, and borax,
half an ounce of eau-de-cologne, one ounce of rectified
spirit, and water half a pint ; mix and bottle.
Until lately it was considered very good practice to rub
pomatums, scented ointments, into the scalp almost daily,
but of late years doctors have considered that this custom
chokes up the pores of the skin, and does not nourish the
hair. The present plan is to stimulate the growth of the
hair by constant brushing of the hair and scalp.
V. — A note on Ringworm. — We come now to that most
persistent and troublesome ailment which is commonly
called tetter, or ringworm. It is a contagious disease, due
to the growth of a minute vegetable mold or fungus on the
skin, and in the roots of the hairs. It makes the hairs
brittle, and they break off, and makes them loose, and they
fall out. The disease may commence in one spot only, or
in many patches, almost at once. It causes irritation, and
so the sufferer scratches it, and so makes the skin red and
inflamed, and he infects one place after another. Patches
may begin anywhere among the hair on the scalp, or on
the neck where there is only a fine down growing. There
is a variety of ringworm which occurs on the skin of the
face, neck, arms, or body where there is no hair; this also
is parasitic, but it is much less troublesome and is gen-
erally easily cured by the ointment of ammoniated mer-
cury. The difficulty with children is to prevent them
scratching the spots, and so spreading the disease.
To return to ringworm of the scalp, if you see a patch
of about a week old which has not been treated there will
be a bare place, with a scurfy pink surface, the stumps
of the hairs visible; a few hairs not yet lost will be found
to be easily broken off by rubbing them; such a patch be-
258 RINGWORM
comes red with scratching, and may soon be covered with
vesicles and little scabs ; ointments and paints which cause
irritation will produce the same result. The patch may
spread continuously, or other separate patches may appear,
and any or all of them may spread, until almost all the
hair of the head has been destroyed.
If a child be very healthy, and if the first patch be at
once treated in a scientific manner, there may be a chance
of cure in a month if there be no infection of other spots.
But in the majority of cases the disease spreads from its
first center and may run a course of many months, and
even years.
In order to effect a cure it is necessary to improve the
general health, to keep the spots free from dried scabs,
to apply paints or ointments which will kill the growth,
and then, with zinc or lead ointments, to heal up the in-
jured surfaces. The most difficult part is to find out when
the disease is killed, and the powerful applications may be
safely discontinued. If they are applied too long, they set
up unnecessary inflammation, ulceration, and scabbing; if
they are left off too soon, the work of killing the fungus
growth has to be begun again. Skilled medical attention
is necessary throughout the whole course of treatment.
Amateur doctoring is practically useless. "We give a few
good prescriptions for those who care to try them.
(1) For ringworm of the body. — Ointment of the
iodide of sulphur, y± drachm to 1 ounce of benzoated
lard. (For delicate skins.)
(2) For ringworm of the body — (for farm laborers,
etc.). — Ointment of the iodide of sulphur, 1 part; lard,
8 parts. (Should be made up a few days before re-
quired.)
(3) For scalp ringworm — delicate skins. — Oleate of
mercury ointment, 10 per cent.
(4) Pomade for the heads of children in a school or
home where ringworm has broken out. — Boric acid
ointment, 2 ounces; eucalyptus ointment, 1 ounce;
cocoanut oil, 2 ounces ; oil of cloves, % drachm.
(5) Hutcliinson's plan. — Cut off all the hair and
shave it close, where possible. Wash the scalp twice
a week with a lotion made of tar water, 1 drachm;
rain water, 1 pint; and rub in this ointment: —
SLEEP 259
Chrysarobin, 1 drachm ; ammon. hyd. chlor., 25 grains ;
lanolin, 1 drachm; benzoated lard, 6 drachms; tar
water, 10 drops.
The secret of success often lies in the patient con-
tinuance of the same remedy.
Sleep, Hints on Obtaining. — (1) Let the room be well-
ventilated and cool.
(2) Let the feet be warm. Those who suffer from cold
feet should first try holding them in a basin of cold water
by the bedside, just before getting into bed, for about
two minutes or less, and then rubbing them fairly dry
with a rough towel. In persons with poor circulation, this
plan may fail ; then a hot-water bottle must be kept at the
end of the bed. Anything rather than cold feet.
(3) If hot when coming to bed, sit undressed long
enough to get moderately cool, and then get quietly into
bed.
(4) Have nothing to eat or drink for at least two hours
before bedtime.
(5) Once in bed, resolve to have done with thinking and
calculating. Once the bad habit of reviewing the day's
actions and events in bed is formed, it is very hard to
break.
(6) Get a dark blue globe for a night light or electric
light in the bedroom. Many persons can go to sleep better
in blue light than in any other, or in darkness.
(7) Try drinking half a pint or more clean cold water
on retiring. With some people this clears the blood, washes
irritating food out of the stomach, and promotes a feeling
of quietude which helps sleep.
(8) Brush the teeth, and wash out the mouth before
retiring.
(9) The following method, suggested by Mr. Martyn
Westcott, may prove as useful as it is interesting. "Lie
on the back, in an attitude of complete muscular relaxa-
tion. Let the feet be warm or make them so with a hot-
water bottle. Let the covering be of blankets only, and
not too many either; it is the lower half of the body which
especially needs to be kept warm at night. Now take a
long slow breath, without great effort and without hurry.
At the same time slowly and gradually open the eyes to
the full extent. At the end of the long breath the eyes
260 SLEEPLESSNESS
ought to be widely open and the eyeballs looking upwards.
During these breaths the mind must be concentrated on
what you are doing; that is essential. Five such breaths
are to be taken — leisurely, easily — and the opening and
shutting of the eyes must keep time with them. Then take
ten such breaths with the eyes closed. Then five more
with the 'eye accompaniment'; then ten more without it.
Gradually you feel more and more sleepy, you lose count,
you do the eye-opening at last only in imagination, and
you drop off to sleep. A very little practice is required
to perfect this method, which is really one of auto-sugges-
tion."
Sleeplessness. — It is during natural sleep that the waste
and wear and tear of the mind and body are replaced and
remedied. The brain it is which controls the whole organ-
ism, and it is the brain which knows when fatigue has
arrived and when the various parts of the body have done
as much work as they are fit for. It is the activity of the
brain which requires rest and renewal, and if that activity
is obliged to continue, if we are kept awake too long, the
whole body suffers. Whereas, as soon as the activity of
the brain ceases for a time during sleep, all the rest of the
body is able to repair and renew itself. Thus we see
the importance of sleep. When we dream it means that
only part of the brain is asleep, and that is why dreamy
sleep is so unrefreshing. That is the reason also why
dreams are so unreasonable, so unhappy, or so absurd ; only
a small part of the brain is at work, and there is no control
over the ideas as they dart in and out of the half -conscious
mind.
Want of sleep for long periods is often the cause of mad-
ness; or in many cases it would be true to say that the
cause of madness is also the cause of the sleeplessness, and
that if we cannot relieve the latter the patient may go mad
at last.
It follows that we should make sure of our due allowance
of sleep, and a small allowance will do for many people;
too much sleep makes one drowsy and dull-witted. We
should never take sleeping draughts if there is any other
way of dealing with the trouble. The principal causes of
want of sleep are worry, grief, exciting passions, indiges-
tion, heart disease, pain, cold feet, lack of nourishment.
We are often asked how much sleep should be taken.
SLEEPLESSNESS 261
But we cannot answer the question. Every person must
find out for himself how much sleep he needs, and see that
he gets it, even if it means curtailing hours of pleasure
spent in dancing or amusement. "Six for a man," they
say, ''seven for a woman, and eight for a child." But
most men want more than six hours.
Sleep is produced by withdrawing blood from the head.
We mean, for instance, by putting hot-water bottles to the
feet. Many people cannot sleep because their feet are cold
and bloodless.
If you eat a hearty meal you will probably feel drowsy
after it, and that is because the stomach requires all the
blood it can get to help to deal with the food. You cannot
do brain work after a hearty meal because of this, and if
you attempt it you will get indigestion.
If you suffer from sleeplessness, then, the first thing to
do is to see if you are transgressing any of the ordinary
laws of health and hygiene. Attend to the ventilation of
your bedroom; do not eat heavy suppers, with pickles and
cheese; take enough exercise and try and put aside all
business worries as soon as you enter the bedroom.
A hard bed is always better than a soft one; a spring
mattress is the best of all for health; perfect quiet is not
always desirable ; some people cannot get off to sleep with-
out a clock ticking in their neighborhood; but habit is all-
important. Reading in bed is not to be encouraged; it
promotes slovenly habits of mind, though many sleepless
people read in bed to prevent their too active brains from
thinking and worrying. It would be better to get out of
bed and read at a table until too tired to sit up any longer.
A copious drink just before retiring will sometimes pro-
mote sleep ; with some people a hot drink, and with others
a cold one.
Many people go to sleep at once on retiring, and then,
after an hour or two, wake up and lie tossing and restless
until nearly morning. This is very often due to an un-
suitable or indigestible supper, and will come right of itself
as soon as the dieting is set right; but it may be due to
a lack of nourishment, and then a few biscuits and a glass
of milk taken in the night on waking will lead to a refresh-
ing sleep. As to the drugs and medicines which counter-
act sleeplessness, in each case which will not yield to simple
measures medical advice must be sought. The fear of ere-
262 SMALLPOX
ating a habit which will enslave the sleepless one for the
rest of his life will be enough to deter unskilled persons
from recommending drugs for want of sleep. (See also
"Insomnia.")
Smallpox. — This disease is always and only caused by
contagion; it is impossible for anyone to contract small-
pox without coming into personal contact with someone
who has the disease already, or with clothes, bedding, or
books which have been in the sick room.
It is most important to know that patients are contagious,
even before the rash comes out, and that the poison is given
off into the air even from the bodies of those who have died
of the disease. People of both sexes and at all ages are
liable to it; even the unborn child within the womb may
suffer from smallpox, and be born marked with the results.
At the present time smallpox is not common, and the num-
ber and severity of the epidemics have been reduced by
improved sanitary measures, by greater cleanliness, and,
above all, by efficient vaccination. Generally, the disease
occurs only once in the same person.
The disease begins suddenly, twelve days after catching
it, with a severe pain at the bottom of the back, shivering,
and fever; headache and vomiting. On the third day the
rash comes out. (See "Rashes on the Skin," number 3.)
There are several varieties of smallpox, named according to
the type which the rash assumes. When it occurs in those
who have been vaccinated years before, it is very mild,
and is called varioloid.
Treatment. — Nowadays, when a case of smallpox occurs,
the patient is generally taken off to the nearest fever hos-
pital, where the treatment is, as a rule, excellent, and where
the patient will probably recover. Smallpox is apt to leave
behind some very disagreeable complications — abscesses,
conjunctival inflammation (see "Eye Diseases"), middle-
ear disease (see "Ear Diseases"), bronchitis or paralysis.
Cases of varioloid generally make a good recovery. Cases
in which the spots (or pocks) run together, are more seri-
ous. These are called confluent smallpox. The general
principles of treatment are the same as for measles (see
"Measles"), namely, isolation, disinfection, and rest.
There is no method known which will, in every case, pre-
vent the scarring and pitting of the skin. (See also "Vac-
cination.")
SORE THROAT 263
Sore Throat. — There are very many forms of disease
which may affect the throat, and so we very often hear
persons say that the throat is sore or relaxed. Sore throats
may be considered in three groups. The first and most
common forms are those ailments due to catching cold from
exposure to cold and wet. The second group are those
cases of sore throat which accompany acute fevers, such as
scarlet fever and diphtheria; these are terribly infectious,
and are of a more serious nature. And the third sort are
truly ulcerated conditions of the throat, due to the ravages
of venereal disease. Cases of this last variety come in the
secondary stage after infection. (See "Syphilis.") The
soreness may last for months. The second group, those of
the infectious fevers and sewer-gas poisoning, are acutely
painful, and are accompanied by high fever. In scarlet
fever, unless very severe, the throat gets well in a week.
In diphtheria, which mostly affects the throat, nostrils and
windpipe, soreness is less painful, but even more danger-
ous, because there is a growth of false membranes in these
parts which may cause suffocation. There remains the
class of sore throats which arise from chills ; there is hardly
any more common accompaniment of a cold, or catarrh,
as doctors call it, and some persons have several attacks
each year; but they rarely last more than a week or ten
days. Three varieties may be mentioned — first, a simple
relaxed throat, in which the mucous membrane is seen to
be red and somewhat swollen, wuh a long, puffy uvula (the
little ball which hangs in the center of the throat), and an
increased amount of secretion. The next form is more
violent ; there is a bright redness of the parts, with swelling
of the tonsils, pain and difficulty in swallowing, accom-
panied by thirst, heat of skin, and general f everishness ;
this sort of attack may pass off in three or four days. The
most severe form of sore throat is seen when the attack
beginning as last described ends in a definite inflammation
of one or both tonsils, passing on in the course of a week
into quinsy (see "Quinsy") ; and in such cases an abscess
forms on one or both sides of the throat, and then there is
no comfort until the abscess bursts or is opened by the
knife of the surgeon.
Treatment. — In simple relaxed throat, where there is no
fever or inflammation, astringents are needed locally, either
as lozenges, or pastils, or jujubes, medicated with tannin,
264 SPECIALISTS
rhatany, or catechu. Formamint lozenges are an excellent
remedy, because they disinfect the throat. Or gargles may
be used, containing alum, or sulphate of zinc. The chem-
ist will adjust the strength according to the age of the
patient. Some prefer to have the parts painted by a soft
brush dipped in glycerin of tannin, or a weak solution of
the chloride of zinc. All these remedies must be got prop-
erly made by a chemist of suitable strengths. Quinine and
iron tonic medicines will also be required to tone up the
system.
Tonsilitis. — In acute inflammatory sore throat the pa-
tient would do well to knock off work as soon as the symp-
toms are developed, and to take to bed until the fever and
inflammation have passed away. Let him go to bed after
a hot bath — if there be a convenient bath indoors — and
take a good strong dose of saline purgative, with something
warm added to check pain ; such a dose as compound senna
mixture, or Epsom salts with essence of ginger. Put on
ample bedclothes, and try to produce a profuse perspira-
tion. Steaming the throat will give much relief, and put
on a warm poultice round the neck ; it may be made of hot
water with bread, or linseed meal, or boiled turnip. Dur-
ing the next two or three days the patient must take only
liquid nourishment — gruel and broth — no alcohol, and must
not smoke. When the acute illness has passed off the case
will need treating as for relaxed throat as already de-
scribed. In the more severe cases, when there is quinsy
(abscess), poultices on the neck will be much needed, and,
in addition to simple steaming of the throat, inhalations
medicated with compound tincture of benzoin (teaspoonful
to half-a-pint of hot water, repeated), and other drugs will
hasten the cure. Additional internal medicines, such as
aconite, antimony, or antipyrin, are commonly adminis-
tered every two or three hours, to combat the intensity of
the inflammation. These require a doctor's prescription.
Cases of quinsy require careful treatment by tonics and
local astringents for several weeks after the disease in the
tonsils has subsided.
Specialists. — A specialist, in the medical sense, is a medi-
cal man who, having gone through the course of study
necessary for the training of every registered doctor, has
given up " general practice" in order to study and treat
special diseases or the diseases peculiar to one special or-
SPECTACLES AND FAILING SIGHT 265
gan. There is no specialist who makes a profession of
dealing with only one disease — such a man would not be
worth his salt. He is not necessarily better educated or
more highly trained than the family doctor, and in very
many instances he is not as skillful as the family doctor,
because he (the specialist) in studying his own specialty
is very apt to become narrow in his judgment, and to
tinker unnecessarily at the diseases or organs which he
knows most about. There are several recognized "special-
isms" in medicine and surgery. Such are diseases of
women, diseases of the nose, ear and throat; diseases of
the skin; diseases of the eyes; venereal diseases. It is
quite certain that as time goes on specialists will become
more and more numerous; but persons who can afford it
are too ready to run away to a specialist with diseases
which the family doctor is perfectly competent to treat.
Pew people are superior to the curious vanity of supposing
that their illness is unusual, rare, difficult to treat, and
requiring the special services of a specially-skilled person!
There are no such doctors as "specialists in rupture," vari-
cocele, asthma, bone diseases and so on.
Spectacles and Failing Sight. — We refer in this article
to the failing sight of those persons of full age or advancing
old age, who have enjoyed good sight all their lives. Much
of this, however, will also be applicable to those who are
habitually short-sighted or too long-sighted. These two
faults depend upon a naturally badly-shaped eyeball, and
the vision is apt to fail earlier in life than it does in people
with well-formed eyes. The most common reasons for fail-
ing sight in adults are cataract, glaucoma, and amaurosis,
to which may be added opacities, clouds on the cornea —
that is, the window front of the eye. These last arise from
injuries, or from ophthalmia, which means inflammation
of the eye surface, generally arising from injuries due to
irritating dust or other substances. (See also "Eye Dis-
eases.")
By cataract is meant slowly-growing opacity, or want of
transparency, affecting the lens within the eyeball. The
effect of this is to hinder the rays of light from passing
into and across the interior of the eyeball. A similar effect
is seen when a clear plate of glass is breathed upon, or is
dusted over with some fine powder; one can no longer see
clearly through it. Cataract is due to a slow deterioration
266 SPINAL CURVATURE
of the structure of the lens — a process of decay. No defi-
nite cause is known; all our organs may wear out, each in
its own peculiar way. Either one or both eyes may be
affected at once, or one may first suffer and then the other.
No curative medical treatment is known of, and the usual
practice is to await the stage of blindness, and then to
remove the offending lens by a surgical operation; if this
succeeds the patient will be able to see very well again,
with proper glasses.
Glaucoma is the second serious cause of blindness, and
is often a painful disease, which cataract is not. This is
a state due to obscure inflammation within the eyeball, by
which it becomes tense and hard from undue internal pres-
sure. It is more common in a chronic form, but it may
suddenly appear, with violent pain, as an acute disease,
which may very soon result in blindness. In some cases,
a greenish color is seen when looking into the eyeball, and
another symptom is the sudden onset of a state of long-
sightedness.
Amaurosis, the third form of disease is a slowly pro-
gressing failure of sight, due to disease to the nerve struc-
tures of the internal parts of the eye ; it is a sort of palsy
of the nerves of sight, and may result from diseases of the
brain, and may follow apoplexy.
Our sight is one of the most valuable gifts, and any dis-
order of vision should send a sufferer in all haste to an
ophthalmic surgeon, who makes diseases of the eye a special
study.
Spinal Curvature — Deformed Back. — There are several
varieties of deformity affecting the spinal column, and
these may be curable or incurable. They may be due to
.general debility and muscular weakness, or to bone disease.
The spine should be straight up and down when seen
from behind; but when seen from the side, it has special
curves in health. The natural curves may be lost, and
improper curves appear in delicate persons, from bad habits
of sitting, lounging, or working. Children at school often
sit very badly at their desks, and, of course, many trades
cause deformity from the continued necessity for occupy-
ing a constrained position, as in cobblers and tailors.
Near-sighted persons often have a bent neck and stooping
gait from the need to lower their eyes to their work.
Nurses may get a bent spine from long carrying of heavy
SPINAL CURVATURE 267
babies. Blacksmiths, who use the right arm so much more
than the left, often get the spine somewhat curved. At-
tacks of pleurisy, by injuring one lung, often deform the
chest and back. Hip-joint disease and other ailments of
the leg and foot, by causing shortening of one leg, are
often followed by a spinal curvature.
All these deformed conditions are of gradual onset, and
of slow progress ; but once developed they are very difficult
to cure.
Persons who are most likely to suffer are those who are
born with a scrofulous constitution. (See "Scrofula" and
"Chest, Shape of.") They are generally thin, pale, sal-
low people, flabby of skin and muscles, and they have a
tendency to enlarged glands in the neck, large tonsils,
large bodies and thick lips.
Lateral curvatures are mostly from debility, and are
seen in girls and young women who have outgrown their
strength. One shoulder becomes higher than the other,
and the shoulder blades bulge out behind ; one hip projects
too much, and the other looks too small. The spine about
the middle of the ribs projects too much either right or
left. This deformity injures the lungs more or less and
displaces the heart, and so there may be pains in the chest
or back, or in the sides, and the breathing may be oppressed
and the digestion disordered. The opposite sort of curva-
ture from before back may arise from an injury or from
disease of the bones called vertebrae, which compose the
spine. In this form tuberculous or consumptive disease
may cause decay of one of the bones, so that instead of
its being firm and hard it will soften down into pus and
matter, and so form an abscess ; the body weight then bends
the spine at the spot thus destroyed by disease. The result
is an angular curvature, leading to hump-back. This dis-
ease is often fatal, although many cases recover health to
some extent, and even become robust, though always de-
formed.
In childhood bent backs can be treated with some hope
of success by means of mechanical appliances, but those
occurring in later life can rarely be treated successfully.
The great object is to improve the general health over a
period of years by means of good feeding, suitable exer-
cises, frequent changes of air, and by giving cod-liver oil,
maltine, and syrups of lime and iron.
268 SQUINTING
Sprains. — When a joint is sprained, there is at first a
little pain and much weakness. Then the patient lies down
and the pain grows worse, and, either at once, or very soon,
the joint begins to swell. The structures in the interior
of the joints have been violently treated and they soon
begin to bleed under the skin. That is called at home
' ' black-and-blue " and is the result of a bruise. The very
first thing to do with a freshly-sprained joint is to hold it
under a stream of cold water from a tap for about ten
minutes. Then let the patient lie down and rest, and, if
the doctor has not yet arrived, put the sprained joint in a
thoroughly comfortable position, and wrap it in plenty of
cotton wool, and bandage it firmly and rather tightly. If
there is enough cotton wool, it will equalize the pressure
after a few minutes. It is not a good plan to poultice the
limb, even to relieve the pain, because the swelling is in-
creased in that way.
The greater part of the pain and loss of function after
a sprain results from the swelling, which is caused by the
escape of blood and serum into the tissues. Recently two
methods have been employed to prevent this, either to
"strap" the part with adhesive plaster, or to employ mas-
sage from the beginning. The latter is becoming the more
popular for small sprains.
In sprains of gouty and rheumatic and consumptive peo-
ple, constitutional medical treatment by a doctor must be
undertaken, or there is a serious risk that the joint may
become damaged for life.
Sometimes after a sprain there remains a good deal of
chronic thickening of the skin and structures of the joint.
In such cases people sometimes neglect them until it is
too late. Massage and the application of hot and cold
water douches alternately, are useful measures.
Squinting. — This well-known deformity generally begins
in very early childhood, but in a few cases children are
actually born, if not with a squint, at all events with the
paralysis of one of the eye muscles which cause a squint
as soon as the eyes begin to see things. Squinting is
caused, then, by paralysis or weakness of one of the mus-
cles which turn the eyeball from side to side, or up and
down. The patient tries to look at the same point with
both eyes, but one eye cannot be brought to bear on the
right spot, and the patient then is said to squint. If one
STAMMERING 269
eye, looking straight ahead, sees an object, and the other
eye looks in another direction, away from the sound eye,
then the second eye is partly paralyzed, and squints. This
is called divergent squint, because the lines of sight diverge
from one another. If, on the other hand, one eye looks
straight at an object, and the other eye looks across the
path of vision, then the squint is called a convergent
squint, because the lines of vision converge and cross each
other. Such a person is called cross-eyed. Sometimes the
squint is permanent; sometimes it happens only when the
eyes are tired; sometimes only one eye is paralyzed, and in
other cases both eyes squint. When the sight of both eyes
is good, and when the squinting is not caused by paralysis,
it is generally curable by operation. The causes of squint
are many and various. A baby may squint as the result
of irritation caused by worms in the bowels, or by irritation
of the nerves caused by teething; and the disease known
as "water on the brain," of which the proper name is
hydrocephalus. In the great majority of cases, however,
the optic nerves and eyeballs themselves are badly devel-
oped second-rate organs, generally smaller than they should
be, and badly shaped. The operation that is done is to cut
through the muscle which pulls the eyeball out of position,
and the muscle is left to attach itself to a more suitable
part of the eyeball. It may be necessary to operate twice,
or even thrice. The operation is often successful, but
sometimes is not. It can do no harm, if skillfully done,
even if it does no good. Squint caused by paralysis can-
not be cured in the majority of cases.
Stammering. — We are frequently asked what to do with
a child who stammers. There are a few well-known meth-
ods of dealing with stammering, and some specialists claim
to be able always to cure the complaint. Boys at an ordi-
nary school who stammer are very heavily handicapped,
and their lives made almost unbearable by the thoughtless
teasing and wanton mischief of the other boys. In itself,
stammering is not caused by general debility; but stam-
mering often causes general debility, spoiled tempers, and
ruined dispositions. Boys who stammer are generally
backward in their education, because they cannot say their
lessons, even if they know them; and if they are lazy,
they shirk their work because they think their stammering
will cause it to be passed over. Masters cannot be blamed
270 STOMACH DISEASES
for passing them over, either, as their time, and the time
of the whole class, cannot be wasted in waiting for a stam-
mering boy. Some masters, out of kindness, try and help
the boys; but the advice is often misguided, and makes
things worse. All this leads to the conclusion that a boy
who stammers ought to be taught only at a special school
for stammerers. The question of what to do with a boy
or girl who stammers is really a serious one, as we have
seen, if the stammerer is to earn a living in these days of
keen competition. There is no doubt that stammering is
a spasmodic nervous disorder, and the first need is for
medical treatment, directed towards quieting down a too
sensitive nervous system. It will be noticed that nobody
stammers when he sings; and so the best way for a stam-
merer to begin to cure himself is to say everything in a
sing-song way, and only very gradually to come to one
note, and then to ordinary speech. The stammerer finds
his greatest difficulty in the use of consonants as "f" and
"v" which entirely supersede the passage of air through
the nose, and where the necessity arises for firm contrac-
tion of parts of the mouth. But the real cure of stammer-
ing must be left to the specialists, only one or two of whom
are medical men.
Stomach Diseases. — It is often a difficult matter to dis-
cover whether the stomach is diseased or not, because symp-
toms arising from upset stomach and disordered digestion
accompany almost all fevers and many other diseases as
well. True stomach pain is not very common, but stomach-
ache is the most usual name for all pains in the body lower
than the fifth ribs, so that the name has lost all accurate
meaning. Stomach-ache, in most cases, means a pain in
the intestines or bowels, due to either colic or the irritation
accompanying diarrhea. Most people speak of "stomach"
when they mean "belly" or "abdomen." Now, the stom-
ach itself is a hollow bag, with thin coats; its sides fall
together when empty; but when food and drink are taken
it will dilate so as to hold one or two quarts ; then it gradu-
ally shrinks as it empties itself during digestion, into the
bowels. Diseases of the stomach itself are of two kinds —
organic, in which the coats of the stomach are diseased by
inflammation, ulceration, or cancer; and functional, in
which the action of the stomach as a digestive organ is
DILATED STOMACH 271
alone impaired. The healthy stomach when it receives
food, pours out a liquid called gastric juice, which digests
the food, especially meat foods. During digestion the
stomach is in constant motion, though we are quite un-
conscious of it, churning up the chewed food and gastric
juice together. This process should be painless. It will be
obvious, when thought about, that if the internal coats of
the stomach are tender, sore, or inflamed, the movements
of the stomach will be painful ; and if the patient be in bad
health, the gastric juice will not be in a good condition,
and so the food is delayed in the stomach, imperfectly
digested. The results are that the food ferments, turns
sour, and causes nausea and sickness. Diarrhea often fol-
lows this state of indigestion, which doctors often call dys-
pepsia. The liver often " sympathizes" with an upset
stomach, and then the bile also becomes unhealthy, and
unable to perform its special duty of digesting fats in the
intestines.
Gastritis. — Gastritis is the name for inflamed stomach.
Acute gastritis is not usual; it is due to poisons, caustics,
swallowing hot liquids, and violent spirit-drinking bouts.
Chronic gastritis is often associated with liver disease, im-
proper diet, free drinking, and especially with consumption
of the lungs. It is shown by nausea and sickness, pain
under the left ribs in front and side, some tenderness there,
water brash, heartburn, and disordered action of the
bowels.
Bilious Attacks. — Gastric catarrh may come on as part
of a general cold or catarrh, or it may come on periodically,
especially in feeble persons, who generally call this ailment
by the common title of bilious attack.
Dilated Stomach. — In some unfortunate persons the
stomach dilates with each meal, but fails to shrink back to
its naturally small, empty state; and after some months
of dilating, a state of chronic indigestion arises, because
the stomach is never quite emptied between meals, as it
should be. In this condition there are nausea and occa-
sional sickness, with loss of appetite and cramp-like pains
in the stomach; constipation is common, with much flatu-
lence. Vomited matters will be found dark, undigested,
and sour-smelling from having been delayed so long as to
have fermented.
272 STONE IN THE BLADDER
Cancer of the stomach. — Cancer of the stomach is most
often seen in men past middle age ; it is a very painful dis-
ease, and proceeds to a fatal issue.
Ulcer of Stomach. — Ulcer of the coats of the stomach is
an ailment very common in young women, and this also
may be fatal, from accidental rupture of diseased blood
vessels. If a young woman complaining of want of appe-
tite, pain after eating, and general indigestion, is found
to become daily more pale and weak, the presence of an
ulcer in the stomach must be suspected. The ulcer is round
or oval, and on the inner aspect of the stomach coats, but
may be on the front or the back of the organ; according
to its position, the place where the pain is felt will vary.
The pain is worst after food for an hour or more; sour
liquids rise up in the throat, and slight vomitings are com-
mon. There is most danger when such an ulcer eats so
deeply into the coats of the stomach as to cause bleedings.
There may be only smears of blood on what is brought up
by vomiting, or there may be a tablespoonful or more of
blood, generally dark and clotted, and not frothy, as it is
when coughed up from the lungs. Of course, if an ulcer
eats into a large vein, the bleeding will be profuse, so great
even as to cause fainting; but the hemorrhage may be all
internal and give no sign of its occurrence.
Perforated Ulcer. — An even more dangerous accident is
when the ulcer eats quite through the thin stomach walls,
and then the blood, liquid food, and gastric juice escape
into the general space within the body. Such an event
causes instant collapse, intense pain, and very often a sud-
den death. In that case the only chance of recovery is an
immediate surgical operation to sew up the perforation.
From these facts it will be obvious that cases of severe
indigestion should be watched by a doctor. In mild cases
of dyspepsia, domestic treatment should endeavor to regu-
late the bowels to one or two daily actions by means
of rhubarb, senna, or cascara. A dose of rhubarb, soda,
and ginger will often relieve stomach discomfort. Indiges-
tion should not be treated by giving spirits, because it is
easy to begin a habit of having recourse to strong drinks
to cure small ailments. (See "Indigestion.")
Stone in the Bladder.— (See "Bladder Diseases.") The
signs of a stone in the bladder are — pain in the region of
tjie, bladder, and in the bottom of the back, too frequent.
STRONG, HOW TO BECOME 273
desire to pass water; the water passed often containing
blood (and looking "smoky") ; the passage sometimes of
pure blood; shivering fits. The pain is generally most
violent immediately after passing the last few drops of
water.
Strong, How to Become. — (A warning!) — This is too wide
a subject to deal with in much detail within the limits of
the short articles in this book.
Everyone nowadays realizes that to become physically
strong it is necessary to live steadily, purely, cleanly, and
to take sufficient and suitable exercise. The leisured man
gets his cricket, his football, his tennis, his golf, and his
hockey. The man of small means and small leisure time
must needs take his exercise in walking or in gymnastics.
The home-gymnastics method is now very largely catered
for. There is an ever-increasing crowd of "professors"
and "strong men" and "culture teachers" of more or less
ability. They nearly all have one serious fault. They
advertise that they can make anybody and everybody
"strong." They show photos and pictures of men of
enormous and unnatural muscular development, and they
try to make you believe, first, that it is desirable to have
such an excessive development, and secondly, that, whoever
you are, you can be made equally big and strong by their
particular method. Now, it is an undoubted fact that
thousands of people are lamentably undeveloped in every
way; that girls grow up flat-chested and narrow-hipped
all over the country. Hence the frequent advertisements
of bust developers, which aim only at increasing the fat
over the neck and breasts and at enabling a woman to
present a good appearance. Young men are to be seen in
plenty, round-shouldered and flabby in muscle. No one
will wish to deny that all these young people could be im-
proved by systematic development, and, if only the gym-
nastics employed are suitable to the individuals, all will go
well. With gradual muscle development comes renewed
health.
But the " let-me-make-you-strong " professor teaches that
anyone can attain a fine physical and muscular develop-
ment. This is not true. Doctors will tell you that very
numerous cases of damage done by injudicious muscular
exercise come to their notice every year. The physical
culture cranks, keep very quiet about the overstrained,
274 SUMMER HOLIDAYS
hearts, and the muscular debility and the mental im-
poverishment produced in some of their customers. It is
so easy to go to excess in the ambition to become a Hercules
— so easy to overtax a heart that would have been quite
adequate for all ordinary purposes. Not everyone has a
heart and vessels which will bear the strain of daily con-
centrated muscular exercise. Only the very few can ever
attain to the dimensions of a Samson. Once a person has
had rheumatism, for instance, his heart is forever unfit to
do much more than the ordinary routine demands. (See
"Exercise and Recreation.")
Struma.— (See "Scrofula.")
Stun, — (See "Concussion of Brain.")
Styes. — A stye is inflammation, and, at last, abscess
round the root of an eyelash. The whole eyelash gets
red and swollen, and just as one stye is quieting down and
getting well another one begins. Styes are practically
boils of the eyelid.
Treatment. — As soon as you see a stye, look at the eye-
lid through a magnifying glass, and with a fine pair of
forceps pull out the eyelash which is in the very center
of the reddest part of the inflammation. A tiny drop of
matter may come out then, and when it has been wiped
away with a clean bit of cotton wool, touch the place with
the blunt end of a needle which has been dipped in pure
carbolic acid. In those cases where styes are always com-
ing, owing to the weak state of health of the patient, it is
a good plan to apply weak yellow oxide of mercury oint-
ment along the edge of the eyelid twice a day. The
patient ought to ask his doctor to prescribe a tonic for him
also.
Summer Holidays. — Now is the time to sound a note of
warning for those who are going to take a holiday — the
one holiday, perhaps, of the whole year. What are the
benefits that we expect to derive from this yearly cessa-
tion from work? It is, firstly, a change of occupation for
the mind, and change of occupation means rest, and rest
means recuperation and refreshment. Secondly, it is a
change of habits, diet, and air for the body. The change
brings fresh zest to life, fresh enjoyment to mere eating,
drinking, and sleeping; and if a holiday is properly used,
the whole system is invigorated. But, just as there is a
right way and a wrong way in everything else, in holiday
SYPHILIS 275
making it is possible to be foolish and thoughtless, and to
return from the annual outing in worse condition than
before. The artisan's wife and children go down to Ocean
Grove for a fortnight. The children (unless they are al-
lowed to paddle beneath a broiling sun and get sunstroke,
or else overeat themselves with fruit or ices and get
choleraic diarrhea) will very likely benefit greatly by the
change of air, by the exercise, the lack of restraint, and
the country food. But for the wife and mother herself the
holiday is too often but a period of extra anxiety and wor-
ries. The bother of getting suitable lodgings, of packing
for the family, of procuring and preparing victuals in un-
familiar and often unsuitable places, and the worry of
keeping an eye on the children, to see that they don't fall
into the sea, off the end of the pier, or over the side of
the Skylark, or get lost on the crowded sands — all these
matters deprive the poor woman's holiday of a good deal
of its restfulness. Poorer and less fortunate people still
(and there are hosts of them in our great cities and else-
where) get, perhaps, only a few days, or a week, of holi-
days. It is no real holiday to scamper off to Ocean Grove
by the steamer for one day only. Thousands do it, and,
perhaps, the change does some of them good. But the
weakly ones only get tired out, and we have seen children
and adults in these crowds, at the end of the day,
thoroughly exhausted with unwonted excitement and
bustle. Holidays should be arranged with a view of rest-
fulness. If your holiday time be very short, don't go a
long way from home to a crowded place. Go into a quiet
country or seaside place ; sit about in the open air and
sunshine; don't "live" every minute of the time in the
silly, nervous, modern way, but just "exist," quietly
enjoying the calm beauty of the landscape, or the sea, or
whatever scenery there may be, and the inspiriting music
of the bands. Then, when you return to the busy hum of
city life, with its unending toil, you will feel that the
"holy calm," and perfect quiet and rest, have done you
some real good. (See also "Change of Air.")
Sunstroke.— (See "Heatstroke.")
Sweating. — ( See ' ' Perspiration. ' ' )
Syphilis (The "Bad Disorder"). — This is the most impor-
tant of the venereal diseases. Syphilis spoils the lives of
thousands every year. It is contagious, not only through
276 CONGENITAL SYPHILIS
sexual congress, but even through kissing, or using the
pipe or cup of a contagious person. The disease is indeed
a dread one, and those who suffer from it may infect a
great many during the two or more years that the con-
tagiousness lasts. The man who contracts it, if untreated
or improperly treated, may suffer from it, or its complica-
tions, all his life; and symptoms may crop up as many as
thirty or more years after it was caught. Thousands of
wives suffer chronic ill health all their married life from
having caught syphilis from their husbands. Hundreds of
doctors suffer from blood-poisoning caught from patients
with syphilis which they have been treating and trying to
cure. And, worst of all, the sins of the parents are visited
on the children, even to the third and fourth generation;
for syphilis is the cause of a large proportion of all mis-
carriages, and hundreds of innocent children are born every
year, alive, but with ' ' hereditary " or ' ' congenital ' ' syphilis
in their bodies.
There are, then, two kinds of Syphilis — the Congenital
and the Acquired.
(1) CONGENITAL SYPHILIS. — Children born of parents
in the secondary stage will almost certainly in every case
be the victims of congenital syphilis. As a rule, when the
parents have arrived at the tertiary stage (see next section
— " Acquired Syphilis") their child escapes the disease.
One attack of syphilis protects against a second; no one
gets syphilis twice. In a large majority of cases the
syphilitic child is born apparently quite healthy and looks
plump and well for about three or four weeks. Then it
gets "snuffles," a bad cold in the nose with a discharge
of pus and dirty crusts. Then comes a RASH on the skin,
on the thighs, back, buttocks, and belly. This eruption is
the color of raw lean ham, but it must not be confused with
another skin disease called intertrigo. Only a doctor can
distinguish them.
Then there may be pimples, blotches, sores all over the
poor little body, and the face of the child gets wrinkled
and like the face of a little old man or woman.
It must be borne in mind by parents that this disease is
very tractable if it is dealt with early enough, and the
careful treatment of a family physician will do much
towards converting a miserable, puny, diseased baby into
a crowing, laughing, healthy little person!
ACQUIRED SYPHILIS 277
(2) ACQUIRED SYPHILIS. — We shall follow a case of
syphilis through all its stages.
Firstly, inoculation. — The poison is transferred by sexual
connection, or by kissing or other contact, to the healthy
skin, and enters it through a minute crack or scratch,
which is perhaps too small to be noticed.
Nothing happens for a period of from two to three weeks.
Then there comes at the infected spot, a red pimple, like
a hard, flat, dry button, called a "hard chancre." This
occurs on the skin. But if the mucous membrane be in-
fected instead, there is a sore instead of a button or pimple,
which, only after about ten days, seems to be situated on
a little disk of parchment slipped under the skin. This,
then, is the hard chancre, the "primary stage" of this
disease.
The writer imagines that no one with any such sore
would be foolish enough not to consult a doctor at once
about it. And it may be said at once, that if the doctor
decides that the sore is a " hard chancre, ' ' then the patient
has the disease called syphilis; he will be contagious, and
must at once start treatment for eighteen months or two
years under medical supervision.
The PRIMARY STAGE OP SYPHILIS, then, consists in the
presence of a sore at the place of inoculation. The nearest
lymphatic glands (generally in the groin) become hard
and lumpy and tender. In some cases, this stage is the
whole of the disease, and the victim is never troubled with
it again if he carefully carries out the whole two years'
treatment. In the majority of cases, however, four to six
weeks after the hardening of the chancre the second stage
begins.
SECONDARY STAGE. — Note carefully that these "stages"
are only so called for convenience' sake. Nature does not
always arrange the disease exactly as here described. The
chief signs of secondary syphilis are as follow, but some of
them may be absent, and others may be present: —
(1) Eruptions of the skin. These are raw ham or
coppery colored ; occur on both sides of the body ; do not
itch; do not leave scars; and are sometimes of every
possible variety — pimples, blotches, blebs, abscesses,
patches, scales, wheals, nodules, scabs, etc.
(2) Moist patches — very contagious indeed — about the
mouth, nostrils, and back passage.
278 TERTIARY SYPHILIS
(3) Sore throat, which often gets ulcerated, and if not
treated well may lead to scars which deform the throat
and spoil the voice of the sufferer.
(4) Enlarged glands in various parts.
(5) The hair comes out, and sometimes the nails are
shed also.
(6) Sometimes paralysis occurs.
Then comes a period of rest. The disease appears to be
gone for ever — cured, and sometimes there is no more of
it. But in some people there comes an intermediate stage,
called "Reminders" stage.
"REMINDERS" of Syphilis. — These may take dozens of
forms. Among them are scaly patches on the hands (called
psoriasis of the palms), and various eye troubles.
TERTIARY SYPHILIS. — At last, at the end of about
eighteen months to two years after the chancre, the third
stage of the disease begins. There is no hard and fast line
between the secondary and tertiary stages, but when the
secondary symptoms have quite disappeared, and two years
have elapsed since the chancre, the tertiary stage is said
to have begun. As said above, not everyone gets any
symptoms in the third stage; but once the last secondary
symptom has gone, the disease is no longer contagious, and
though the patient may have to suffer himself, at any rate
he (generally) cannot make his wife suffer or give the
disease to his children. The symptoms of the tertiary stage
may be : —
(1) Skin eruptions, scattered, affecting only one side
of the face or body, forming sores (ulcers), and leaving
deep scars.
(2) Lumps in any part of the body (called nodes),
on the surface, or in the bones, or in the organs.
(3) Tumors in any part of the body, such as the liver
or brain ; these are called gummata.
(4) Destruction of the testicles in men and ovaries in
women.
(5) Fits, convulsions, paralysis.
Now, the reader who has acquired syphilis and who has
read carefully all the foregoing is by this time probably
much alarmed at the prospect and severity of the disease.
He will ask, at this point, three questions : —
SYPHILIS 279
(1) How can any one be sure that he has contracted
syphilis ?
(2) How long, and in what manner, is a syphilitic
person dangerous to society?
(3) Can the disease be cured?
The answers are as follow: —
There is only one way of deciding the presence or absence
of syphilis, and that is to consult a surgeon of repute, and
be guided in this very serious matter wholly by his ad-
vice. No one can keep the thing secret and get well. The
doctor must be taken into your confidence, and, cost what
it may, he must be consulted from time to time for the
next two years at least.
The answer to the question as to whether syphilis can
be quite cured turns on the meaning which is given to the
word cure. Some people seem to get " cured" very soon,
and are little the worse for the experience. Yet, if even
they decide to neglect the treatment, they will almost cer-
tainly suffer in later life. The disease becomes quiescent,
but no one can be sure that it will not break out again later
on. Whereas the man who continues treatment for about
two years is as safe as medicine can make him.
The drug which, by universal consent, is allowed to
have most influence in the cure of syphilis is mercury. If
given regularly — and suitably — from the first it modifies
and at last demolishes the disease. Mercury must be taken;
but as to how it is to be taken we can only say that this
must be decided by the doctor, according to the age, sex,
and habits of the patient, and the severity of the attack.
It is worse than useless to expect to get one prescription
which will suit all cases, or all stages of the same case. To
neglect medical advice in this matter is to run into danger
which may affect one's whole life. Syphilis is curable —
in many cases, entirely so; in many others, the patient
must be content if he gets rid of all symptoms, and must
put up with, as inevitable, the weakness which, to some
extent, always remains.
In short, though signs of syphilis may be got rid of,
and a cure, in that sense, obtained, yet the patient is never
quite the same person again, but has been subjected to
a poison which may (or may not) give him trouble for the
rest of his life. His best chance of escaping the effects of
280 TATTOO MARKS
the disease is to live a quiet life, and especially to avoid
alcoholic excess. Alcohol especially renders him liable to,
and aggravates, all the symptoms of the tertiary stage.
Recently a new preparation has been discovered, known
as "606," for the treatment of syphilis. This has been
found efficacious in a large number of cases, especially the
old resistant ones; but the technique of administration is
difficult and it can only be given by an experienced
physician.
Taller, How to Grow. — Let it be noted that Nature seems
to have fixed an average height for the Anglo-Saxon —
about 5 feet 8 inches — and that she maintains it with con-
siderable persistency. If one's father and mother are
above the average height, one is most probably an inch or
so shorter than one's parents; if the parents are under-
sized the child is generally an inch or so taller. If the
mother is too short the sons tend to be too tall, and if the
father is undersized the daughters are probably taller than
the average. There are ways of increasing the height of
individuals, nevertheless.
Firstly, we nearly all stoop, and do not appear as tall
as we really are. This is the first thing to attend to, then,
to stand and sit upright, even at the office desk. The back
muscles need to be strengthened to bring about this re-
sult, and that can be done by using one of the "developers"
on the market — all are equally good if intelligently used
— or with dumb-bells. Indian-club exercise is an excel-
lent means of increasing the height. After thirty it is
well-nigh impossible to get taller, except by straighten-
ing out the back ; or to look taller, except by wearing eleva-
tors in the shoes and boots.
Secondly, there is a method used by the American
cavalrymen and others — stand upright with back to a wall
until quite erect. Then take two paces forward away
from the wall. Eaise the arms slowly with the palms for-
ward, up, up, until the forefingers meet over the head.
Keep the arms unbent. Do this slowly, thirty times on
first rising in the morning, and thirty times, when un-
dressed, before going to bed at night. Thus can you add
about an inch to your stature, if you are not yet thirty
years of age.
Tattoo Marks. — Let us urge the reader, whoever he or
she may be, not to submit to the wiles of the tattooer,
TEETH, CARE OF 281
even for the sake of having the flag or a sweetheart's
name or initials tattooed on his arm or chest. In later
life everyone regrets these marks, for if tattooing is prop-
erly done, the marks never can be removed. Glycerin of
papain has been used to destroy tattoo marks, but in any
case a skin surgeon should be consulted if removal is de-
sired.
Teeth, Care of. — Our teeth give us trouble from the
cradle to the grave. As infants, the growing and cutting
of our teeth of the first set cause pain, feverishness, and
often convulsions. No sooner are they all cut but they
begin to get loose and fall out, and very often they suffer
from decay as well. In some states of constitution these
teeth may be decayed even before they are cut.
Before all the first set of teeth is got rid of, the first
double teeth of the second set appear at five or six years
of age, followed by the front teeth, then the side ones,
and lastly the double ones behind the first great grinders.
This process may be finished at 12 years of age. The four
wisdom still remain, and they may not be fully through
the gums until 24 years of age, and sometimes they never
appear at all.
The cutting of the teeth of the second set may be fairly
painless, but the cutting of the final four wisdom teeth
may give rise to persistent neuralgia.
A man or woman is blest if born with a good constitu-
tion and a perfect set of strong, regularly placed teeth;
they escape hours of face-ache, and much indigestion,
which is sure to result from improperly masticated food.
There are some few people fortunate enough to preserve
all their teeth until they reach the age of three score and
ten, but they are very few; in olden days they were more
numerous, and among savages, uncontaminated by our
civilized habits of feeding, they are common still.
Very few of us have no decayed teeth, and many of us
lose some teeth almost every year from the time we get
them. This is no new ailment, for we know that the ancient
Egyptians suffered to some extent from decay of the
teeth, and we know that they had some priest dentists, for
teeth containing gold stoppings have been found in mum-
mies in Egypt. Some diseases, such as rickets, scrofula, and
tubercle, cause early decay of the teeth. But, apart from
these diseases, there is no doubt that cookery is largely
282 TEETH, CARE OF
responsible for decay of the teeth; the more simple the
national diet the healthier are the teeth. Very hot drinks,
such as hot tea, and very cold food, like confectioners'
ices, play havoc with the teeth and crack the enamel.
Long ago, when races ate only vegetables, fruits, and nuts,
we believe decayed teeth were unknown ; even in the times
of the Old Testament food was much simpler than it is
now, and the word toothache does not occur in it.
It Has been said that wherever you find a toothbrush
you will find decayed teeth; and this is no doubt true;
but it would be silly to say the former caused the latter.
When a race becomes developed enough to indulge in
cookery, hot and cold foods, vinegar, etc., toothache be-
gins to be common, and doctors become common, and den-
tists, too, later on. Under these circumstances, it is wise
to adopt the use of the toothbrush, and also certain soft
powders and disinfectant liquids may be suitably used
with the brush. There is reason to fear, however, that
much of the tooth powder, consisting mainly of chalk,
which has been retailed the last fifty years, has been much
too gritty, and that although it may have made teeth look
clean, it may have worn away the enamel of the teeth in
places, and may have started spots of decay.
Liquid teeth washes, containing an antiseptic, such as
the preparations of carbolic acid, are the most safe.
Dental hospitals for the poor exist now in England, and
parish doctors will always look at decayed teeth, remove
them, or advise what is best to be done. Decayed teeth are
always liable to ache, and are a source of danger to health.
For instance, sickly children with decayed teeth rarely eat
freely, and do not eat enough, because the mouth is so
tender.
It is the fermentation of particles of food lying in the
spaces between the teeth which gives rise to acid juices,
which corrode the enamel surfaces of teeth, and lead to
spots of decay. Careful and frequent brushing removes
the source of mischief. An excellent plan is as follows:
— At bedtime, put a teaspoonful of bicarbonate of soda in
the bedroom tumbler full of warm water. Soak some
pieces of white silk in it. Draw the strands of silk be-
tween the teeth, backwards and forwards until the dis-
colored patches are gone. Then brush the teeth with car-
bolic tooth powder. If a tooth is healthy when it is
TETANUS 283
cut it does not decay from within, but from without in-
wards, because of the decay of the particles of food which
are caught in the cracks of the enamel.
The early stage is painless, but at last in each case there
comes a day when the erosion by decay opens into the
natural space within the tooth, exposes the delicate, sensi-
tive nerve, and toothache begins, and will continue to be
felt either continuously or at intervals until the whole of
the sensitive pulp is dead.
Even then the danger of toothache still exists, because
little abscesses may form at the deep-seated ends of the
fangs of the tooth, and it is then that the sufferers rush
at last to the doctor or the dentist for immediate relief by
extraction.
The teeth, then, are of so much value to health that
everyone should pay the utmost attention to them.
There is always an early stage, when the affected tooth
may be saved for a time, if carefully stopped by a dentist;
but this stage is easily passed by, and then there only re-
mains the cure of the pain by having the tooth taken out.
(See also "Dental Hygiene.'7)
Tetanus (Lock-jaw). — Tetanus is a disease which occurs
most commonly from Fourth of July accidents, and as a
result of wounds made with dirty or rusty instruments or
nails.
It is nhie to a germ found most commonly in the soil
and about stables, which enters the body through wounds
which may sometimes be so small they are hardly noticed.
The most dangerous wounds are the small deep ones, such
as those made by nails, and the wounds from firecrackers
and toy pistols.
The toxin manufactured by the tetanus germ is three
hundred times as strong as strychnine. It poisons the
nervous system and causes all the muscles to be thrown
into contraction. One of the first symptoms of tetanus is
a stiffness of the muscles of the jaw and neck.
When a wound is made by a dirty instrument — a nail,
a firecracker or a toy pistol — extraordinary precautions
should be taken to disinfect the wound, using peroxide
of hydrogen, potassium permanganate solution, followed
by bichloride of mercury solution. Copious bleeding of
a wound helps to wash out the poisonous products.
An antitoxin for tetanus has been prepared, but it is
284 TOBACCO
of more use in preventing the disease than curing it. As
a result of the use of this antitoxin the deaths from tetanus,
following an almost equal number of Fourth of July in-
juries (about 4500), were reduced from 406 in 1903, to
62 in 1907. Observance of the "safe and sane" Fourth
in recent years has still further reduced the amount of
death and injury resulting at this time of the year.
Tobacco; Ought we to Smoke it? — Let us say in answer
to our own question — Yes. So long as we smoke in
moderation, and, at suitable times, and do not annoy other
people by our smoking, there seems no good reason why
we should not smoke. Given as a drug, tobacco does
weaken the heart and depress the nervous system. In
smaller doses it only quiets the heart and soothes the
nerves. So it has its uses, as everybody knows. No one
wishes to defend its abuse. If a young man finds he has
flabby, cold hands, he is very likely smoking too much;
but what may be excess for him may be only moderation
for somebody else. A smoke often makes one feel more
comfortable in mind and body, but the feeling of well-
being is not accompanied by a desire for activity (except
in a few people who write), but by a desire to stay as
long in the easy-chair as possible! So we ought to smoke
only when work is done. Many people who suffer from
''sick headache," or migraine, as doctors call it, find that
tobacco is a wonderful means of getting relief; but others
do not get sick headache until they have smoked too much.
"What is one man's meat is another man's poison," says
the old proverb. People will certainly keep on smoking in
spite of cranks of all kinds, and in spite, even, of certain
scientific investigations which go to prove that it does no
one any particular good, and many people much harm.
The pipe is the best way of smoking tobacco, and the sea-
soned clay pipe is the sweetest smoke of all. Yet the
stem of the clay is hot, and, in certain people, leads to
ulcers and sores of the lips and tongue. The stronger the
man the stronger the tobacco he can stand; but, also, the
more he is likely to go to excess. After all, men will do
something or other to excess, and excess of smoking does
far less social damage than excess of alcohol. Cigarette
smoking is generally rather prejudicial, and all smoking is
likely to be harmful when inhaling is indulged in. Egypt-
TOE-NAIL INGROWING 285
ian and Turkish cigarettes are apt to contain niter, to make
them taste strong. They often cause headaches. Cigars
of good quality are free from much objection, but few
can afford a good cigar. In tobacco-growing countries one
can get a good weed for about 2 cents, but here no cheap
cigar is worth smoking. Many cigars are innocent of to-
bacco, and are made of dock leaves, or rhubarb leaves, or
dandelion; and are flavored with tobacco juice. Such
cigars are smoked only for effect. They taste like what
they are — imitation tobacco; and the buyer does not gen-
erally want to buy any more of them, if he can procure
tobacco in some other form.
Toe-Nail Ingrowing. — This is a very painful and rather
troublesome affection, caused by wearing boots too narrow
across the toes. The soft flesh and skin at the side of
the big-toe nail is pressed upon by the boot and made to
overlap the edge of the nail. The nail does not grow into
the flesh, however, but causes a sore place where the flesh
is pressed against a sharp edge of the nail. The ulcer
formed is often troublesome when the feet have not been
kept clean.
In mild cases, a good plan is to scrape the nail down the
middle with a knife or piece of broken glass, until it is
hardly thicker than a sheet of paper. Then, all dirt or
horny skin should be removed from under the nail. Then,
a notch should be cut in the middle of the free edge. These
measures help the edges to curl up somewhat and take them
away from the flesh. But if tight boots are not worn, and
if the edge of the nail is not cut square, the toe-nail
trouble will never arise. The first essential, then, is to
wear roomy boots with squarish toes.
In very bad cases of ingrowing toe nails, there is only
one really satisfactory treatment, and that is removal of
the whole nail. This can be done by a surgeon, or at a
hospital. Short of this radical cure there are several modes
of treatment, of which we give two. One comes from Ger-
many. The plan is to put a fragment of cork under the
edge of the nail where it appears to be growing into the
flesh. Then pour ten drops of strong solution of ferric
chloride on to the ulcer and edge of the nail, let it dry
on, and repeat the process every day for five days. A
blackish crust forms and the nail becomes so brittle that it
286 TONGUE, DISEASES OF
can be scraped away easily. Then the sore may be healed
up with a little iodoform ointment, and wider boots must
be worn.
The other plan is quicker and rather cleaner. Get a 50
per cent, solution of caustic potash (or caustic soda), warm
some of it, and moisten the nail with it. This softens the
nail and the soft part may be scraped away with a piece
of clean broken glass. Then drop a little more caustic
on to it and scrape away until the nail is as thin as paper.
Then the offending part of the nail may be easily removed
with nail scissors. This is a very good method when deal-
ing with old horny tough nails such as are found on the
feet of old men and women of the laboring class.
Tongue, Diseases of. — The tongue has its own special dis-
eases, such as inflammation, ulceration, and cancer, and
may, of course, suffer from injuries, such as scalding, or
it may be bitten during fits, especially epileptic fits.
The tongue has its minor ailments also, and its appear-
ance varies so greatly from day to day during the course
of general diseases that it has been looked on from time
immemorial as the guide to a person's state of health.
Medical knowledge has made immense strides during the
last 50 years, but the state of the tongue still remains one
of the most important guides to the progress of a disease.
The tongue of a healthy person is pink, soft, moist, and
clean; that is to say, it is not covered with any "fur,"
or deposit of a white, gray, or brown color. It is ex-
tremely important that the tongue should be moist, for
if it be dry it causes much discomfort, and sense of taste
is lost.
The tongue is discolored and covered with fur whenever
there is any form of indigestion, and also during all states
of fever.
Another tongue symptom is that of being in a state of
tremor; it trembles when it is put out, and the patient is
quite unable to hold it steady. This is one of the symptoms
of delirium tremens, and is the result of poisoning by
alcoholic drinks. The absinthe so much drunk in Paris is
especially liable to cause this ailment.
Palsy may also affect one-half or the whole of the
tongue, and this is usually one of the results of a severe
apoplectic attack, which brings on paralysis of either the
right, or left limbs.
TOOTHACHE 287
Pallor of the tongue — a loss of its rosy pink tint — is
seen in the course of anaemia, so common in young women ;
and in debility the tongue becomes swollen, soft and flabby,
so that at its side you may see the marks where it lies
against the teeth.
White furred tongue is seen in rheumatic and other
fevers, also dyspepsia and congestion of the liver, and all
stomach ailments. All who drink too freely are liable to
have the tongue furred, and smokers generally have a
dirty white tongue.
A bright red tongue is seen in scarlatina, and red dry
tongue marks the end of fatal diseases, such as phthisis
and pyaemia. A dry brown tongue is a sign of great ex-
haustion, such as seen in typhoid and typhus fevers and in
cases of blood-poisoning. When patients are recovering,
the tongue gradually loses its fur, and regains its proper
color and moisture, much to the relief of the sufferer.
We may mention that in many illnesses in which the
tongue is furred it may be "cleaned" for a time, with bi-
carbonate of soda solution and a clean towel. This often
gives a great sense of comfort to the sick man. Lemon
juice may be used if soda fails to clean it.
Too Fat.— (See "Corpulence.")
Toothache. — This is a sign of some local trouble in one
or more of the teeth, or in the jaw, and must be dis-
tinguished from neuralgia of the face, though neuralgia
is often caused at first by the irritation of decayed teeth.
If the pain is made worse by hot or by cold water in the
mouth, probably the tooth is decayed and the nerve pulp is
exposed. The proper thing to do then is to syringe the hol-
low tooth out carefully and gently with warm water and
to put into it afterwards, without any pressure, a little
plug of cotton wool steeped in creosote, or oil of cloves, or
cocaine dissolved in oil of cloves. If the pain is due to
inflammation in the pulp cavity (i.e., inside a tooth) no
relief will be obtained till the pus can get out, and a visit
to the dentist should be made.
If all the gums around are swollen and tender, the neces-
sity of a dental surgeon's advice is all the greater. What-
ever you do, do not be beguiled into trying to "cure"
your toothache with any of the so-called "neuralgia cures."
They will be useless while the local state of things in the
mouth is unattended to. It would be difficult to overrate
288 TRADE DISEASES
the importance of keeping the teeth in order. Decayed
teeth are really little nests of disease germs and may cause
consumption, enlarged glands, indigestion, ear disease, fits,
&c., &c.
Trade Diseases. — There are certain trades and occupa-
tions which have important relations to certain diseases,
which are therefore grouped together here under the above
heading.
I. — Lead poisoning. — All workers in lead, such as fac-
tory hands in lead works, painters, compositors, plumbers,
glass and pottery polishers, and white lead makers, are
liable to suffer from a group of symptoms caused by the
absorption of lead into their systems. Lead may also be
taken into the body in poisonous quantities in drinking
water contaminated by lead pipes, in cider, or in tinned
fruits.
It is the lead glazers who chiefly are liable to lead poison-
ing, as they inhale dry lead salts.
Symptoms. — Early signs are muscular weakness, debility,
and pallor of the skin. Then follow some or all of these
symptoms: — A blue line along the gums, absent where the
teeth have fallen out and often absent in those who clean
the teeth regularly. Colic and constipation, generally very
painful indeed, and lasting, sometimes, several days.
Wrist-drop and foot-drop — the muscles which should hold
up the wrist and foot respectively become paralyzed. Con-
vulsions and violent headaches may occur. Anosmia, and
all its consequences. Kidney disease, with scanty urine.
Treatment. — In lead works the foremen generally know
what to do when there are signs of lead poisoning in any
of the workers. Colic is to be dealt with by hot fomenta-
tions and morphine injections, which the doctor will give
with his hypodermic syringe. (See also "Lead poison-
ing.")
II. — Arsenic poisoning. — Those who work at arsenic ore
smelting, and in factories of wall paper, and elsewhere,
all are liable to suffer from arsenic poisoning. The
symptoms are those of multiple neuritis — vague pains and
tingling in the limbs, weakness and wasting away of the
calves and thighs, wrist-drop, and * ' dropped foot, ' ' hoarse-
ness, squinting, and tenderness of the calf muscles. In
addition to these there may be cough, diarrhea, eczema,
headache and trembling.
TRAINING 289
If the patient gets away from the source of all the mis-
chief, namely, the arsenic, he will get well. Otherwise, he
will not.
III. — Phosphorus poisoning. — The fumes of phosphorus
are apt to affect those who work in match factories where
the yellow form of phosphorus is in use.
These workers are liable to have "phossy jaw," which
is a local disease of the jawbone due to the irritation of
phosphorus which has got in through a hollow decayed
tooth. All factory hands should take special care of their
teeth. Special medical treatment is necessary.
IV. — Mercurial poisoning occasionally occurs in felt-hat
makers in which occupation mercury nitrate is often used.
Sometimes a man gets an inflamed mouth while dosing
himself with mercury for syphilis. The treatment for
this is to stop the mercury for a time and suck chlorate of
potash lozenges continually.
V. — Among other diseases caused by occupations are —
aneurism, to which laborers and porters are liable; 'bron-
chitis, emphysema and deafness, from which glass blowers
often suffer; sore throat of a special type, common among
the clergy; fibroid consumption of the lungs, set up by
irritating particles of metal, is common among flax-workers,
iron-workers, steel grinders and millers.
VI. — Special forms of nervous cramps and paralysis
occur among typewriters, clerks, and telegraphists. Miners
are liable to suffer from jerkiness of the eyeballs, and
shoemakers and tailors and leather-workers sometimes get
wry-neck of a spasmodic kind from sitting too long in one
attitude.
Training. — As our object in this book is to be of use to
as many of our readers as we possibly can, we feel it our
duty to say something on the subject of athletic training.
The object of training is to bring about the development
of the highest degree of activity and endurance and
strength possible to the human body. Some loss of stored-
up material (principally fat) always takes place in this
process; and so, if it be carried too far, the athlete is at
last weakened and is then said to be overtrained.
Training consists in a combination of dieting and ex-
ercise, and takes about six weeks to accomplish. The
muscles get harder, the whole skin improves in appear-
ance and the athlete feels more and more "fit" every
290 TRAINING
day. The change from ordinary feeding to a training diet
should be gradual and not sudden. A diet consisting
largely of lean meat is necessary, but this reminds us
that no one ought to be allowed to undertake "training"
on these lines, or to enter for feats of endurance or
strength, if he is over 35 years of age, or if he is gouty
in tendency. But no really sensible man begins training
without having had himself "overhauled" first by the
family doctor.
The diet then is to be roast or grilled underdone beef
and mutton, with a moderate allowance of vegetables and
bread. All entrees and pastry and puddings and sweets
are absolutely forbidden. So are all sauces, condiments,
and pickles, for their only use is to increase artificial
appetite.
The drink allowance is to be limited, and there is to be
no allowance of spirits; occasionally, a very light dry
Rhenish wine may be taken. Toast-and-water, barley
water, cocoa, tea and coffee are to be the beverages. There
are to be three meals a day. We append below the schemes
of training which are adopted at Oxford and Cambridge
Universities for the inter-university boat race every sum-
mer. As to exercises, we can say little; no one will be
able to train quite satisfactorily without personal advice
from a trainer; we can only suggest the dietary.
A day's training for the boat races. (Summer.) — (By
Dr. Maclaren) : —
CAMBRIDGE—
A run of 100 or 200 yards, as fast as possible.
Breakfast. — Underdone meat, dry toast, two cups of
tea, watercress occasionally.
2 P. M. — Meat as at breakfast, bread, potatoes, greens.
One pint of beer. Dessert, oranges, or biscuits
and figs, 1 vo glasses of wine.
"Rowing exercise during late afternoon.
8 :30 P. M. — Cold meat, bread, lettuce or watercress,
one pint of beer.
10 P. M. — Retire to bed.
OXFORD—
7 A. M. — Rise. A short walk or run.
8:30 — Breakfast. — Underdone meat, crust of bread or
dry toast, tea (as little to be drunk as possible).
TUBERCLE 291
2 P. M. — Dinner. — Meat, bread, no vegetables (not
strictly adhered to), one pint of beer.
5 :30 — Rowing exercise.
8:30 — Supper. — Cold meat, bread, sometimes water-
cress, one pint of beer.
10 P. M. — Retire to bed.
It will be observed that at both the universities the un-
dergraduates take two pints of beer daily during train-
ing. Professional trainers and professional athletes are
mostly teetotal; and it yet remains to be proved whether,
even for young fellows, undergoing training for special
events like the boat race, it would not be much better if
they adopted a training diet which excluded alcohol alto-
gether.
Tubercle. — A tubercle is a little tiny granule (in some
organ such as the lung), made of a collection of cells which
have gathered together to try and limit the poisonous
effects of one or more tubercle bacilli, or germs, which oc-
cupy the center of the tubercle. The bacilli are breathed
into the lungs (for example), find that there is a suitable
place for them to grow in, and begin to multiply as fast
as they can. From that moment the person becomes
"tuberculous." But his resisting power may be so great
that the germs are surrounded by cells which soon cut
them off from all nourishment, and then they die ; and the
place where they had found a temporary lodging turns
into a sort of cheesy mass which is harmless. Then the
person is said to be cured of his tuberculous disease. Too
frequently, however, there are some bacilli left, which only
await their opportunity to start a fresh patch of disease,
whenever the person gets run down. There are hundreds
and thousands of people who are exposed to the tubercle
bacilli in the air every day of their lives. Hundreds of
them become infected over and over again, and get rid
of it by a natural cure. Many a person with a bad cough
has a small infection of tubercle, which he will presently
get cured of. Every person with even bad tuberculous
disease may hope that he will get into a stage of quiescence,
which is about the best that can be hoped for. If a case
of tuberculous disease is taken early and treated well, there
may be a complete cure; but, too often, the damage done
to the organ affected only admits of "quieting" and not
curing the disease.
292 TYPHOID FEVER
Tumor. — The word tumor means a swelling, and nothing
more than that. But the word is applied not so much to
diffuse and generalized swelling (such as occurs on a
shoulder after a severe bruising, for instance), but to
"lumps" or "knobs" of any sort caused by inflammation
or by the growth of "new tissue," such as cancer. A
tumor which, if it were removed, would not be replaced by
another of the same type, is called a benign tumor. Such
are fatty tumors, birth-marks or naevi, bony knobs, cysts
(wens), and fibrous growths, like warts.
A tumor which, if removed, would only be replaced by
another of the same type, and which, if left alone, would
ulcerate and cause the patient's death, is called a malignant
tumor. Such are all the forms of cancerous, and sarcoma-
tous growths.
Typhoid Fever. — Although this disease is less often found
in an epidemic form than it used to be, before the drain-
age of our towns was carried out so efficiently, yet it is
still a very common ailment in solitary cases. It is gen-
erally spread through the contamination of drinking water,
or milk, or oysters, or by the rise of sewer gases from
drains or sinks into our dwelling houses. It is but very
slightly infectious in ordinary ways, and cannot be caught
from the breath of a patient, and only from touching a
sufferer when the skin has been soiled by discharges. Even
those who nurse cases of this disease very rarely become
infected.
Cases of typhoid fever vary very much in severity; a
few persons are able to keep up most of the time, but the
majority of those who have it need to remain in bed for
four or more weeks. Children seem to suffer less severely
than adults; both sexes are affected, and young adults
generally have the most severe attacks. It attacks rich
and poor almost equally, and it may so lower the vitality
that although a patient may recover from it, he often,
soon after, goes off into consumption. On the other
hand, many people, on recovering from typhoid fever, get
better and stronger than they ever were before; and some
consumptives get quite cured of their consumption by an
attack of typhoid fever. This disease is sometimes called
enteric fever, because it causes local affections in the bowels.
It is in our times the great scourge of armies, especially
in war-time. In this country it is most prevalent in the
TYPHOID FEVER 293
autumn of the year and wet seasons. When one case is
caught from another, a period of 10 to 14 days elapses be-
fore the onset of symptoms. This is called the incubation
period of the disease. It is slow in developing, unseen
and generally unsuspected. It is a disease attended by a
form of fever, continuous, but generally not of a violent
type.
The ailment begins with a period of debility and languor,
with loss of appetite and nausea, then follow headache, chills,
thirst, and pains in the back and limbs, with a tendency to
diarrhea without much colic pain; about two degrees of
fever in the mornings and three to four degrees in the
evenings. The patient is restless, and often sleepless. This
fever may continue for three weeks, and in such cases the
weakness becomes extreme, the tongue dry and brown, and
there may be extreme diarrhea, and even blood may be
passed, which comes from ulcerations of the bowels. In
a considerable number of cases there is a slight rash of
pink dots on the skin of the chest and body. These rosy
spots are most noticeable on the belly, and come out in
crops, some fading while others are appearing. These
symptoms may gradually pass off, and recovery will follow,
but in severe cases they lead on to fatal exhaustion, ac-
companied by delirium, insensibility, and convulsions. No
drug has any power to cure the disease, and the doctor can
only give medicines to relieve serious symptoms as they
arise.
But it is useless to attempt to treat the disease without
medical aid. It has been well studied and is well under-
stood. A large proportion of all cases recover. The chief
hope of the patient is in the excellence of the nursing.
The nurse must daily examine the "stools" (the matter
passed by the bowels), and must be on the look-out for un-
digested lumps of curdled milk. The diet must be milk
(if it agrees), chicken broth, barley water, and so on.
Beef tea is not much use, especially as it tends to bring
on diarrhea. Alcohol may be needed in the later stages
when the heart is weak.
The disease, as we have said, requires real skill and
medical treatment; the nurse must have, always ready,
broken ice, hot water, castor oil, a water-bed for the patient
to lie on; and she must be on the look-out for bedsores,
which are very apt to form. (See ' ' Bedsores. ' ' ) Lastly and
294 ULCERS
most important, she must keep a plentiful supply of dis-
infectants and put some into every stool and every vessel
used by the patient. (See "Infection.")
Note that no solid food must be given to any typhoid
patient till the temperature of the body has been normal
for at least a week or ten days. To give solid food other-
wise is to kill the patient.
Prevention of Typhoid Fever. — Typhoid fever can be pre-
vented in one of three ways (the three combined are prefer-
able) :—
1st. Destroy the infectious agent at its source.
2nd. Destroy the means of transmission.
3rd. Avoid infection.
(1)^ The infectious agent always proceeds from a case of
typhoid fever. Therefore disinfect all secretions and ex-
cretions from a typhoid case by the use of freshly slaked
lime or chloride of lime. Dispose of these in such a way
that they cannot contaminate a water or milk supply. Do
not allow utensils or furnishings in a typhoid case's room
to be used by anyone else until they have been thoroughly
sterilized or disinfected.
Remember there is danger of a "typhoid carrier's" trans-
mitting the disease through excretions a long time after
recovery from the disease. Absence of the germ from the
excretions can only be determined by a bacteriological ex-
amination.
(2) Pasteurize all milk drunk and filter or boil all water.
Destroy flies or prevent their breeding. Do not empty raw
sewage into water supplies used for drinking or bathing.
(3) Avoid infection by having yourself immunized
against typhoid by preventive inoculation. Any first class
physician can do this.
Do not drink any but pasteurized milk unless you know
its source to be free from danger of typhoid. (Very few
are.)
Do not eat any but deep-sea oysters, unless cooked.
Prevent the access of flies to your food.
Do not bathe in sewage-polluted water.
Keep your body in robust condition.
Ulcers. — The common word for ulcer is "sore," and, of
course, there are a very great many varieties of sore. (For
ulcer of stomach and perforated ulcer, see "Stomach Dis-
eases"; ulcer of back, see "Bedsores"; ulcerated throat,
ULCERS 295
see "Sore Throat"; syphilitic ulcer, see " Syphilis"; scrofu-
lous ulcer, see "Tubercle" and "Consumption"; eczema-
tous ulcer, see "Eczema.") The treatment of every
different type of ulcer is different, and this fact makes it
necessary for us to describe each of the more common kinds
of ulcer, so that the reader may know what sort of ulcer he
has before he begins to treat it. We hope that these re-
marks will be of the highest value to our poorer readers
who suffer so much from ulcerated legs, who grudge the
money that the advice of a good medical man naturally
costs, and who are too apt to waste their money in buying
ointments which are said to cure all ulcerated legs! No
one ointment can possibly be good for all the different
kinds of ulcers, and some ulcers want no ointment at all.
(1) The Healthy ulcer. — The skin round it is not swollen
or boggy, or discolored; there is no change in it beyond a
ring of pinkness immediately round the sore. The edges
of the sore are rounded, shelving gently down to the sore,
and are opaque white at the very margin, bluish nearer to
the middle and dark red at the center of the sore. The dis-
charge, if any, is like white of egg in appearance. There
is no pain, no tenderness. It is the object of our treatment
to bring all ulcers to this condition.
Treatment. — Rest, and any cleanly dressing are all that
are needed. The ulcer will heal of itself in good time.
Now with regard to REST, we must say that it is the most
important thing of all in the treatment of every kind of
ulcer. Few people will take to bed for the sake of healing
a small sore which is giving little trouble, but many a
woman's whole life's misery would have been saved if she
had only treated her ulcerated leg with rest in bed while
it was not a serious matter! By those who can afford a
proper surgical dressing for the ulcer, the following in-
structions may be followed: — A piece of perfectly clean
lint, exactly the size of the sore, is moistened with a con-
centrated solution of boric acid and laid on the ulcer. It
is covered with a piece of oiled silk which overlaps the lint
all round; uniform pressure is applied by a bandage and
the dressing is changed once a day.
Whatever mode of treatment be adopted for an ulcer on
the leg, rest in bed, with the limb raised, has more influence
than any other condition in hastening the cure.
Sometimes, even in a healthy ulcer, there is so much loss
296 ULCERS
of tissue, that if we are to wait " until it skins over" we
shall have to wait a very long time. In these cases sur-
geons graft some flakes of skin from other parts of the body,
and the transplanted skin grows well in its new situation.
(2) The weak ulcer. — This is often the result of too much
watery poulticing. The edges are not definite and the ulcer
has no opalescent blue ring like the healing ulcer has. The
granulations (the pinkish granular flesh of the sore) are
pale, flabby and exuberant, and have a watery discharge.
Old nurses call the ulcer " proud flesh."
Treatment. — This is, in one word, stimulation. The pa-
tient wants nourishing food, rest in bed, pure air, and a
tonic. The ulcer has to be dressed often, washed with red
wash, and a little piece of lint the same size as the ulcer
is to be dipped in the wash and always kept on the ulcer.
The flabby, pale little granules are to be lightly touched
with a stick of lunar caustic from time to time.
(3) The callous or indolent ulcer. — The edges of this
ulcer are raised, irregular and hard. The surrounding skin
is hard, discolored, and brownish-red and brawny. The
surface of the sore is smooth and yellowish, and there are
no granulations because there is no healing going on. Such
ulcers are seen mostly on the outer side of the leg, between
the ankle and the calf, in persons of middle age. They are
painless, and callous, and not tender to the touch.
Treatment. — First, of all, try the pressure method. Ap-
ply a Martin's india-rubber bandage to the ulcer, without
any dressing, every morning before getting out of bed;
keep it on all day, wearing it not too tightly. At bedtime,
wash the ulcer with warm water (using a piece of cotton
wool or rag — never use a sponge in surgery!) and put over
the ulcer a pad of lint soaked in rectified spirit, and apply
an ordinary calico bandage. The india-rubber bandage
ought to be dipped or kept in some disinfectant during the
night.
If this plan of treatment does not bring the ulcer into a
healthy condition a surgeon must be called, to strap it, or
to incise it. There remains, however, one of Unna's meth-
ods of treating these ulcers; it is this: — Paint the ulcer
itself and all the surrounding skin with Unna zinc-ichthyol
gelatin, cover the whole with clean lint, bandage it and
leave it three days, and then renew the treatment.
(4) The irritable ulcer. — This is commonest in elderly
VARICOSE ULCER 297
people and is generally situated behind the ankle. The
surrounding skin is often purplish, hard, and discolored.
The edges of the ulcer are raised and irregular. The sore
itself is dark red or covered with a "slough," and a thin
scanty discharge issues from it. The pain of it is terrible
and keeps the patient awake at night, bringing him to a
severe condition of exhaustion. The sore is acutely tender
to the touch. Absolute rest in bed is the first essential.
The bowels must be moved occasionally with half-a-drop of
croton oil swallowed in a bread-crumb pill. During the day,
if the ulcer is very painful, let the sufferer take five grains
of antipyrin and thirty grains of bicarbonate of soda, four-
hourly. At night, to procure sleep, some form of opium
will probably be necessary, but it must be prescribed to suit
the special case by a doctor.
The treatment of the ulcer itself is not easy. A good
plan is to paint it over with a 10 per cent, solution of
cocaine; ten minutes later, to rub it gently all over with
lunar caustic so as to form a slough; and then to dress it
with boric acid ointment on lint. After a day or two the
slough separates and comes away, and a healthy sore ought
to remain, which is treated as under (1). If the ulcer does
not look healthy yet, this plan may be repeated.
(5) The inflamed ulcer. — This is the sort of ulcer that
drunkards are especially liable to have. The surrounding
skin is red, swollen, hot and tender. Note, that any ulcer
may become an "inflamed" one, if neglected. The edges
are sharply cut. The sore itself is generally covered with
a slough, and there is a blood-stained discharge from it.
Or it may be quite dry and covered with a scab.
Treatment. — The patient will be all the better for a good
purging, and he may have to be treated for gout. After
two grains of calomel at bedtime, the patient should take,
next day, three times during the day, a drachm of Epsom
salts in an ounce of infusion of quassia. Very hot fomenta-
tions made with boric lint and sprinkled with a few drops
of laudanum, make very good local applications to the sore.
But the important things in the treatment of these ulcers
are rest in bed, abstinence from alcohol, and purging.
(6) Varicose ulcer. — These are very common among
middle-aged and elderly women of the poorer class. The
patient has varicose veins, and as a result of them, the skin
of the leg, somewhere between the calf and the ankle, be-
298 URINARY TROUBLES
comes badly nourished, purplish in color, and shiny in ap-
pearance. Such shiny, discolored skin is very easily dam-
aged by very slight injuries and a sore is very liable to
form. This sore as it spreads is all too likely to eat into
one of the dilated twisting varicose veins ; and at any time,
in a few seconds, the patient may lose as much as a pint
of blood (see " Bleeding from Varicose Veins").
Treatment. — No local treatment will be of much good
until the pressure of the column of blood in the dilated
veins is taken off the part where the ulcer is. This must
be done by wearing an elastic stocking or elastic bandage
during the daytime. At night, hazeline ointment may be
applied on lint to the sore. But the only radical treatment
is by operation on the varicose veins which are causing the
trouble.
Urinary Troubles. — The troubles connected with the pass-
ing of water from the body may be described under two
main headings : —
A. — Incontinence of urine. — Inability to hold water in
the bladder —
(1) True incontinence is caused by paralysis of the
muscle, called the sphincter, which lies at the entrance
to the bladder. This paralysis is probably caused by
spinal cord disease or injury and may or may not be
curable.
(2) Incontinence occurs in men sometimes as the
result of sexual excesses. Rest and tonics raid whole-
some living will cure it.
(3) Hysterical incontinence occurs in young girls
sometimes.
(4) Nocturnal or night incontinence, or bed- wetting,
occurs in children of all ages; it may be due to a long
foreskin, which requires circumcision, or to a stone in
the bladder, or to bad bringing up. (See No. 7.)
(5) False incontinence is the word used to express
the overflow from an over-full bladder in a paralyzed
patient.
(6) Women after childbirth sometimes cannot hold
their water because of the bruising of the parts during
the delivery of the child.
(7) Epileptic attacks are often accompanied by the
dribbling away of urine. Many epileptic children wet
DEPOSITS IN URINE 299
the bed without knowing it, and ought to be treated
for epilepsy.
(8) Fright sometimes causes a child to wet the bed.
B. — Retention of urine. — This means a condition in which
the patient cannot pass his water though the bladder is
quite full. It is a very painful affection. It may be due
either to some obstruction or to paralysis of the bladder —
(1) In old men the obstruction may be an enlarged
prostate gland. This is often relievable, but hardly
curable.
(2) In adult men, the obstruction may be a stric-
ture; congestion, due to gout; a little stone lodged in
the passage.
(3) In children, the foreskin may be too tight to
allow the water to pass freely.
(4) In women, a tumor in the abdomen, or the head
of a yet unborn child may press upon the passage and
prevent the passing of the urine.
C. — Frequent desire to pass water. — This may occur in
one of two different sets of circumstances. Some people
are always wanting to urinate because their bladder seems
to be always full, and in fact, does fill up very quickly.
This occurs with —
(1) Diabetes.
(2) Chronic B right's disease.
(3) Hysteria in women.
(4) Chronic drunkards.
Other people are continually wanting to pass water be-
cause the bladder is so irritable that it will not tolerate the
presence of even a few drops of water in it. This occurs
in —
(1) Inflammation of the bladder.
(2) Inflamed prostate gland.
(3) Enlarged prostate gland (in old men chiefly).
(4) A stone in kidney or bladder.
D. — Deposits in urine. — The man who worries himself
about his health so much as to look at his tongue in the
300 VACCINATION
glass every morning, and to examine the color of his urine,
often frightens himself quite unnecessarily. The deposits
which may be seen in the urine are very numerous, and
most of them indicate something seriously wrong with the
individual. But there are other deposits which are less
important, or unimportant and far more common. Quite
normal, healthy urine is clear and amber-colored when
passed. But urine may be turbid when passed, and that
turbidity is generally caused by eating too much meat, or
by a little catarrh of the bladder caused by catching cold.
After a heavy meal there is sometimes a brick-dust sort of
deposit, reddish-yellow, pink, or red. It is of no impor-
tance, but suggests that you have been eating too much
meat, or that you have a bad cold, or that you are feverish.
In short, a little knowledge of the urine is really a dan-
gerous thing to all who are unduly nervous. The only good
reason for examining the urine passed is to enable you to
report it truly to the doctor, and not to enable you to
doctor yourself without understanding the subject.
Vaccination. — We of to-day little realize how enormous
the destruction of life from smallpox was up to a hundred
years ago when control was obtained over it by means of
the process known as vaccination.
During the 18th century 60,000,000 of the inhabitants
of Europe died from smallpox and there were few who
escaped having the disease some time during their life.
Since the introduction of vaccination the reduction of the
amount of smallpox has been so great that there can be no
doubt of its infinite value.
The death rate in Sweden per million has been reduced
from 2,050 before the vaccination era to 2 in 1894. In
1897 there were only 5 deaths from smallpox in the entire
German Empire of 54,000,000 people. In Russia, where
vaccination is neglected, there are still over 50,000 cases a
year.
If a person is vaccinated in infancy and again at the
end of childhood he is practically safe from smallpox. He
is absolutely safe if he is revaccinated every ten years.
There is no danger from vaccination. The vaccine is
now manufactured in an absolutely pure condition and
there is no possibility of contracting any disease through
vaccination. The reaction is slight and never lasts more
than a day or two.
VARJCOCELE 301
Every child should be compelled to be vaccinated before
one year of age and again when a pupil of a private or
public school at 9 or 10 years of age.
We should not be lulled into a sense of false security by
the practical absence of smallpox in this country at the
present time. If we should relax our precautions and dis-
continue vaccination smallpox would soon become almost
as common now as it was 100 years ago.
The disfigurement of the face from smallpox known as
pock marking or pitting is permanent. Without vaccina-
tion you can never feel that you are free from this danger.
Vaccination is a very simple procedure; but should be
done by a physician.
Varicella. — This is the medical name of chickenpox
(which see). Chickenpox and smallpox (variola) are
quite distinct diseases, because chickenpox occurs in chil-
dren whether vaccinated or not, and an attack of it does
not protect from smallpox.
Varicocele. — A varicocele is a little bunch of dilated and
knotted veins in the "purse" or scrotum of a man. It is
the result and not the cause of that ' ' loss of manly vigor, ' '
that "diminished sexual power," and that "debility,"
which figure so largely in the advertisements relating to the
cure of varicocele. We beg to remind our readers that no
registered doctor, surgeon, or physician in America is al-
lowed to advertise, and that if he does so, he runs a risk
of losing his position as a member of the honorable faculty
of medicine.
The youth, then, who, as the result of fast living or bad
habits, begins to wonder why he is weak and wretched is
only too apt to believe advertisements when they tell him
that varicocele is at the root of all his trouble, and that
the cure or removal of the varicocele will restore all his
power. That is not true. Restoration of virility and man-
liness will take place at once (though slowly), on the re-
sumption of a clean mode of life — early hours, hard work,
and not too much food. The varicocele may or may not be
cured. It is not half as dangerous, even when it is large,
as a varicose vein of the leg, which may ulcerate and bleed
you to death !
We now come to the surgery of this subject.
A varicocele is a little bunch of twisted and knotted veins
inside the scrotum, or fleshy bag which contains the testi-
302 VARICOCELE
cles. The swelling may be very small, or so large as to be
a nuisance. It is greater when the man stands up, and
gets smaller when he lies down. It increases for a time
after coughing or exertion. Sometimes it may be compli-
cated by a " rupture" or hernia, and for that reason no
young man ought to bother himself about his varicocele or
buy bandages for its treatment until he has consulted a
surgeon, who will tell him exactly what is wrong. If only
young men would go to respectable family doctors and ask
about all private natural matters which they don't under-
stand, how much heart-burning might be saved! Some-
times a varicocele is attended with a sensation of weight and
aching, especially if it is large and unsupported by a ban-
dage. Sometimes the neuralgic pain of it is very great.
Occasionally, but rarely, a vein " bursts," and the scrotum
fills up with blood.
Treatment. — There are two ways of treating a varicocele,
if, indeed, it is large enough to cause any annoyance. One
is the palliative treatment. This consists in attending to
the general health by tonics and exercise and by living a
cleaner and more moral life, and by wearing a suspensory
bandage which supports the varicocele and soon relieves
the pains, and by bathing the parts with cold water night
and morning. The other way of treating a varicocele
is the radical method. This consists of a little surgical
operation for the tying, or tying and removal of the whole
bunch of enlarged veins. The little operation is free from
danger and is done quite painlessly. The testicle is not
touched or in any way damaged, and it does not waste
away afterwards, except in a few cases when it was already
wasting from a poor blood supply. But even if the testicle
of the left side (and varicocele is nearly always on the left
side) does waste away, there is still one left; and a man is
just as well able to procreate children with one as with
two. These remarks will be appreciated by all those who
are continually sending letters to the medical editors of
papers asking for information on these subjects.
The circumstances for which radical cure of a varicocele
is generally undertaken are these : —
1. When the existence of a varicocele disqualifies a man
for admission to the public services.
2. Great discomfort and neuralgic pain from a very large
varieocele.
VARICOSE VEINS 303
3. Those cases of young, well-educated and sedentary
men, who worry about themselves, fidget about the local
condition which they can see and feel for themselves, and
suffer from amorous dreams and uncomfortable sensa-
tions.
Varicose Ulcer. — Many people have varicose veins of the
legs, especially women who have borne many children.
Sometimes a vein, if unsupported by an elastic stocking,
gives way and bleeds. When the bleeding has been stopped,
a little sore remains which is all too apt to become a regular
chronic ulcer of the leg. Rest in bed is the first essential.
(See "Ulcers.")
Varicose Veins. — This name is applied to a dilated and
tortuous condition of the veins, most common in the legs,
and usually due to long standing, severe muscular exertion,
pressure from a tumor or some intra-abdominal condition,
or an organic affection of the heart. Hereditary disease
such as gout may predispose to this condition by a weaken-
ing of the walls of the veins.
The appearance of the tortuous vein meandering up the
leg cannot be mistaken.
It is usually accompanied by a feeling of fatigue and a
sense of fullness of the limb after exercise or long standing.
The circulation may become so poor that the tissues be-
come poorly nourished, congested, inflamed (varicose ec-
zema), or may die, producing a varicose ulcer. These com-
plications are usually intractable and require the help of
a physician to heal.
The palliative treatment of a varicose vein consists in
supporting it by an elastic stocking and reducing the hours
of standing.
The radical treatment consists in the excision of a greater
or less portion of the dilated vein with ligation — to force
the blood back through the deeper veins of the leg. The
radical method is recommended in aggravated cases or
cases with intractable ulcers or eczema.
Vegetarianism. — Real vegetarian diet consists only of
fruits, nuts and vegetable produce of every kind. There
are few real vegetarians because they very soon discover
that to take enough vegetarian diet to work upon, they need
absurdly large quantities of it. Moreover, vegetables all
contain a very high percentage of water in their composi-
tion, and sooner or later the bowels get out of order.
304 VEGETARIANISM
A rational and altogether satisfactory diet (from the
health point of view) is the modified vegetarian diet — that
is, one which admits eggs, milk and cheese in moderation.
This fleshless diet is, of course, not a purely vegetarian one ;
for eggs and milk are highly concentrated animal foods.
But there is no doubt that thousands of us would be all the
better if we ate no flesh. The man who eats no meat or
very little meat, soon gets to care very little for alcoholic
drinks, and soon finds that his pocket benefits, and that his
health is better. It is the " fumes" of a flesh diet which
give rise to thirst; and the large amount of waste matter
in flesh food and the difficulty of getting rid of it by the
kidneys are the causes of the craving for stimulants. It is
not to be expected that people will give up their joints of
roast beef ; and perhaps the nation would lose much of its
fighting propensity if they did. But, nevertheless, the
middle-aged man who wants to feel young still, who wants
to avoid rheumatic pains and gouty attacks, and who
doesn't want to be a soldier, or to take part in any amuse-
ments which depend upon brute strength and animal
powers, may do much worse than restrict his animal diet,
or do without flesh altogether. The acid properties of a
half-pound of fillet of beef, washed down with a pint of
beer, make a man feel at peace with the world and send
him (where possible) to the armchair for a smoke and an-
other glass of stimulant. But if he is middle-aged, and
especially if he has no manual labor to do, he has eaten a
meal far in excess of his requirements, and of a nature dif-
ferent from that which he needs for brain work. It is
lucky for him if years of this kind of ''solid feeding" don't
provide a future for him of gout, rheumatism or apoplexy !
This doctrine is not as "cranky" as some may suppose.
We do not find fault with the hearty meals of the youth
who has to work and play hard. But we strenuously main-
tain that brain-workers and business men would drink less,
work harder, and be more clear-headed on a fleshless diet
than on either a full-flesh or a vegetarian diet. The experi-
ment, in any case, would not only cost a man nothing, but
would save money for him, for meat is an expensive item;
and the experimenter would find himself fresh and brisk
in the mornings, indifferent to continual and stupid
' * liquoring-up, ' ' and free from most of the aches and pains
that we call rheumatic. Age, sex and occupation, of course,
VENEREAL DISEASES 305
produce great variations in our food requirements. Per-
sons much exposed to the weather require fats and sugars
and starches. Children require much meat, or, rather,
milk, eggs and cheese ; whereas old people, if they want to
live long, will have to eat sparingly, especially of animal
foods. In conclusion, we recommend to the notice of all
our middle-aged and elderly readers the wise little book of
Sir Henry Thompson, entitled Diet in Relation to Age and
Activity, which can be ordered through any bookseller. It
is not a work on vegetarianism, however.
Venereal Diseases. — (See also "Syphilis" and "Gonor-
rhea.")— Until very recently it has not been realized what
a vast amount of venereal disease there is in this country.
One reason has been because these diseases, syphilis and
gonorrhea, rarely appear in our mortality statistics and
because we have never taken the trouble to tabulate the
simple cases. But many of these cases produce more seri-
ous conditions and it is by determining the results of these
diseases that we know how abundant they must be and what
enormous damage they are doing.
Syphilis is a cause of a large part of the following fatal
diseases: — General paralysis, locomotor ataxia, paraplegia,
softening of the brain, arteriosclerosis, aneurism and still
births.
Gonorrhea is responsible for 80 per cent, of the deaths
due to inflammatory diseases peculiar to women. It is the
cause of many of the cases of rheumatism and most of the
cases of blindness in infancy.
These diseases are sometimes contracted innocently — as,
e. g., an innocent wife from a "fast" husband; but most
of them come as the direct result of immorality.
It is doubtful whether laws will ever aid much in con-
trolling this evil.
It is certain, however, that moral teaching can do much
— especially when backed up by the facts of what suffer-
ing, sorrow, and disease may result from a departure from
moral methods of living. It is a question how old children
should be before they are educated on the "social evil";
but such education should certainly be given before a child
is sent off to school or college, or freed from home re-
straints.
If syphilis or gonorrhea should ever be contracted by any-
one they should place themselves at the earliest possible
306 VENTILATION
moment under the care of a physician and absolutely avoid
all possibility of transmitting the disease until they have
been pronounced cured and free from infection.
Ventilation. — The idea of human beings living steeped in
their own excretions is not a pleasant one to dwell upon;
yet this is just what countless people in shops and houses
are doing when they breathe air not sufficiently renewed
by ventilation.
When we realize that there are many buildings in New
York City where several thousand people spend their days
on a ground area of 100 x 100 feet; that the streets be-
tween are narrow and dark and the spaces between are
cistern-like and filled with stagnant, lifeless air we can
understand the headache, depression, anaemia and impaired
health which many of the " sky-scraper" denizens feel.
Of the importance of ventilation we as a nation are as
yet almost totally ignorant. We appreciate how much bet-
ter we all feel out-of-doors, but we don't seem to realize
that the reason we feel less well in-doors is because we
breathe air which is shut up in rooms inadequately circu-
lated and inadequately renewed.
Ventilation is required to rid the air of its gaseous im-
purities and the watery vapor which result from the respi-
ration and transpiration of human beings, and to reduce
these to such an extent that the air of inhabited rooms shall
not be detrimental to health. Solids, as dust, microorgan-
isms, etc., are not removed by the ordinary means used for
ventilation, and the circulation of fresh air through an
apartment cannot, therefore, take the place of methods of
cleaning.
The amount of fresh air required for each person per
hour is 3,000 cubic feet. As air cannot be changed com-
fortably, without producing some feeling of draught, more
than three times an hour, each person in a house should
have at least 1,000 cubic feet of air space. The legal mini-
mum for shops and factories in most states is 250 cubic
feet by day and 400 cubic feet by night. Each gas burner
consumes 4 cubic feet of gas per hour and requires 4,800
cubic feet of fresh air an hour. This must be added to the
air required by people in a room. Electric lights do not
consume any air.
The ideal scheme of ventilation is one in which the air
is derived from a pure source some feet above the ground,
VENTILATION 307
washed and filtered free of dust and impurities, given a
proper degree of humidity and temperature, forced into
each individual room, sucked out through a pipe and ex-
pelled out of doors.
This is known as the artificial method of ventilation.
The natural method depends upon diffusion, wind, and tem-
perature to cause a circulation of air and is largely a mat-
ter of luck. Wind and temperature cause warmed air to
go up the chimney and it is hoped that fresh air to replace
this will get in somehow.
Diffusion stirs up the air and dilutes the impure air with
air not yet used.
The advantages of the artificial over the natural methods
are its constancy under all conditions and the facilities
which it affords for regulating the source and amount of
fresh air, and the preparatory treatment as to temperature,
moisture and purification.
In any scheme of ventilation regard must be had to the
following practical points : —
1. When air is heated it expands and tends to rise; when
air is cooled it contracts and tends to fall.
2. The inlet provision for fresh air should average 24
square inches for each individual; the provision of inlet
areas somewhat larger than those of exit tends to immunize
draughts.
3. Inlets should be low in the room and incoming air
should be directed upwards if cold and downwards if warm.
4. There is a tendency for fresh air to take a direct
course to the outlets, and this must be counterbalanced by
a judicious selection of the relative positions of inlets and
outlets.
5. With less than 250 cubic feet of space per head, no
ventilation can be satisfactory which is not aided by me-
chanical force.
6. The source of the incoming air should be considered.
It should not be borrowed from adjoining rooms, but taken
direct from the outside.
7. If warmed air is forced into a room, it should only
be raised to a temperature sufficient to prevent a feeling of
cold (about 60° F.). More highly heated air is often felt
to be overdry and unpleasant.
8. Mechanical methods of ventilation are essential in
all office and public buildings, factories and theaters. It
308 WAETS
is advisable in all apartment houses and homes unless the
expense of installation and maintenance is prohibitory.
Warts. — Everybody knows what a wart is, but everybody
does not know that a wart is something between a mere
thickening of the skin and a cancerous tumor. A cancer
growing from the skin (called an epithelioma) is practically
a wart of a certain type — a wart which, if left alone, will
at last ulcerate, cause swollen cancerous glands in the arm-
pit and perhaps, also, cancerous growths in internal organs
such as the womb or liver. Of course, most warts are, and
probably will always remain harmless; but as no one can
tell exactly whether a wart is going to become cancerous or
not, it is always worth while to get it removed.
Children's warts are found chiefly on the fingers or
knuckles, and are tough, flat, circular knobs of hardened
skin, ingrained with brownish dirt, and apt to bleed if the
topmost layer of skin is knocked off. They may come in
crops whenever the child is a little out of health. They can
be destroyed by caustics such as ethylate of soda, lunar
caustic, nitric acid pure, or caustic potash. A little of the
caustic is applied daily, from the end of a wooden match,
care being taken to touch only the wart and not the skin
surrounding, and to let it dry on. Little by little the tough
hard skin shreds off and the wart is gone. A little lime
water taken after food daily is said to assist in causing
warts to disappear. Sea water has also been used.
Pigmented warts. — Colored warts are the ones which
should certainly be removed, for they are always apt to
grow into malignant tumors as the person gets on in years.
Tuberculous warts are common on the hands of students,
post-mortem room porters and funeral officials. They must
be cut out by a surgeon.
Cancer developing from a wart is of very rare occurrence
before middle age. About that time (say 45) and after,
the continual smoking of a hot-stemmed clay pipe is apt
to cause cancer of the lip. Chimney sweeps are liable to
cancerous warts of the skin on the scrotum, caused by the
irritation of soot, and by lack of cleanliness. The continual
drinking of bad spirits certainly makes a man more liable
to cancer of the stomach.
Note. — Neither warts nor cancers are easily caught by one
person from another. But there is something in the idea
that the blood of a wart will sometimes produce another
WATER 309
wart if rubbed on healthy skin. And as to cancers, it is
undeniable that there are houses in which person after
person, for generations, gets the disease from merely living
in them. Such are called "cancer houses," and ought to
be avoided. It has also been noticed that the husband of
a wife with cancer of the womb, or the breasts, frequently
develops cancer himself later on.
Water, — There is no greater necessity of life than an
ample supply of pure water, especially for drinking pur-
poses. But the amount we drink is very small compared
to the amount which must be provided per head for the
inhabitants of a town. Allowance has to be made for ordi-
nary washing and personal cleanliness, for the baths and
domestic washing, for closets and for cooking, and for street
cleansing and for use in gardens.
In some towns sea water is used in the streets and for
the sewers, and in many places rain water is used for wash-
ing. In solitary cottages and small villages water is gen-
erally obtained from shallow wells, and this supply may
be pure enough for use when the population is small and
scattered. Shallow wells are, however, very liable to pollu-
tion from surface drainage, and from this reason the water
may be seriously contaminated. As villages grow into
towns a supply of drinking water has to be fetched from
hills at a distance, and conveyed through canals or under-
ground pipes. In some districts it is found possible to
obtain a supply of water by boring very deeply with iron
pipes in short lengths until a water-bearing stratum is
reached; these are called artesian wells. Such water is
generally very pure, but may be too hard. A water is said
to be hard when it has dissolved in it too much lime ab-
sorbed from the soil. Sea water is useless for drinking or
for domestic use, being too salt.
Rain water, although very pure, if collected away among
mountains or very far from dwellings, is both dirty and
impure when collected in towns. The air of towns is con-
taminated with carbonic acid and sulphur, dust of a thou-
sand sorts, emanations from the skin and germs of infection,
and rain in falling through it becomes dirty, impure, and
unfit to drink.
All towns now have a public water supply. This may be
of two sorts — one in which the pipes supplying each street
and house are kept constantly full of water, under full
310 WATER
pressure, at all hours; and on the other mode of supply
each house has to have a tank for storing water, because
the supply under pressure is only turned on for an hour
or two each day. This latter plan is more common than
the first, which is better. Under the constant supply more
water runs to waste, but with the occasional system there
is always a risk to health from cisterns which may be kept
in a dirty state or may get rubbish thrown into them.
Unless a person has seen a drop of dirty water exhibited
under a microscope, it is difficult to believe what a collec-
tion of very minute living beings may be contained in it.
Many of these are, no doubt, harmless, but, on the other
hand, many are germs of different diseases. These micro-
scopic germs, bacteria, and bacilli multiply with amazing
rapidity, especially in water which lies stagnant.
They get into the water from the rain, or from the soil
through which the water has run, and may fall into the
water in our cisterns if not well covered. Many diseases
are known to be spread by water containing the special
germs of the disease, and this is especially the case with
typhoid fever. Slops may be thrown away in gardens, or
sewage from infected houses may soak through the ground
and find its way into the water of shallow wells, and so
one case may lead to the occurrence of many other cases.
In this way typhoid fever is always common among soldiers
in camps, especially during war time, when it is so difficult
to secure sanitary conditions. In a war typhoid fever al-
ways kills more men than the guns of the enemy. Drinking
water kept in tanks may be wholesome enough if great
care is taken to keep tanks clean and covered, and if a full
supply is added daily, while a certain amount is drawn
away every day for use. But in poor districts it is always
found to be very difficult for landlords to keep the cisterns
clean. Of course, many landlords are very careless, and
pay but little attention to the needs of poor tenants; and
when a landlord does his best, poor tenants are apt to be
grossly careless and dirty in their habits. They leave cov-
ers off, or let children play in the tanks, and but rarely
watch that the water in them is clean. Cisterns are often
badly situated in dwelling houses; they should be as far
as possible from the closets, and should be placed so as to
be frequently inspected; they should be scrubbed out at
least every three months. Pure, wholesome water should
WATER PURIFICATION 311
be clear, sparkling, and colorless, without the faintest smell
or taste, and should not be too hard with dissolved lime.
Impure water sets up diarrheal colic, sore throat, nausea,
and loss of appetite. Life is never safe without a pure
water supply.
Water Purification. — So many of the infectious diseases
may be contracted through a polluted water supply that it
is advisable as a routine measure to avoid all chance of
contracting disease in this way by drinking only water
which has been purified.
Some city water supplies are filtered before being dis-
tributed.
Others are not. Whether the city water is filtered or not,
home measures for purification are advisable.
The chief measures for purification are — boiling, filtra-
tion, distillation and chemical treatment.
Boiling destroys bacteria and removes temporary hard-
ness. This is one of the safest ways of purifying water,
but it may taste flat unless the air which has been removed
by boiling is replaced by aeration.
Distillation is the most universally applicable mode of
purification, and even sea water can be utilized in this way.
The process of distillation is a slow one, however, and the
water may taste flat from want of natural salts and air.
Filtration is a very good method of home water purifi-
cation provided good filters are used and kept in good order.
The best filters are the Berkefeld and the Pasteur-Cham-
berland, which can be applied to the water tap.
Every few days the filter-candle should be removed from
these filters, and thoroughly scrubbed and boiled before
being replaced.
Chemical processes are used, for the most part, in the
removal of inorganic impurities — especially lime. This is
best done in connection with filtration, and many large
filters are provided with an arrangement by which the lime
is precipitated out of the water as it passes through the
filter by means of alum.
The purest water supplies are those which come origi-
nally from mountain springs, deep-driven wells and prop-
erly-filtered city water.
Water Brash is a clear alkaline fluid, much like saliva (or
spittle) in appearance, which comes into the mouth in
gushes, and has to be spat out, generally in the early morn-
312 WHITE LEG
ing. Sometimes it comes up without any trouble, some-
times it is vomited up with painful retching. It is actually
spittle, from the mouth, which has been swallowed during
the night and comes up again in the morning. It is a sign
of chronic inflammation of the stomach, and is probably
caused by over-indulgence in alcoholic liquors. (See also
"Indigestion.")
Watercress AND ITS DANGERS. — If watercress is grown in
a stream of clear water it is a most valuable salad, and is
well suited for eating with bread and butter at meals when
tea is drunk. It is very purifying to the blood, containing
potash with vegetable acids. There is, however, a risk of
being infected with typhoid fever, and, perhaps, also, of
swallowing the eggs of worms which may breed in the
bowels, if the water is foul, stagnant or has become soiled
with sewage materials draining from the fields or gutters.
All watercress should be pulled to pieces and thoroughly
washed by water running from a tap, or with several lots
of water in a bowl.
Water-on-the-Brain. — This is the popular name for menin-
gitis, or inflammation of the membranes of the brain, called
in novels, "brain-fever." It is generally due to tubercu-
lous disease. Children are sometimes born with water-on-
the-brain, which has swelled up their heads, and which
crushes their brains and makes them more or less idiotic.
Weir-Mitchell Treatment. — This is an expensive treatment
for neurasthenia (which see). It consists of complete rest
in bed, without letters or newspapers, or worrying visitors ;
overfeeding and massage to take the place of muscular
exercise. The patient is allowed to see no one except the
doctor and the nurse. It is a splendid treatment for ex-
haustion and brain-fag.
Wens. — A wen is a cyst of the skin caused by blockage
of the mouth of a little gland; it is full of a cheesy sub-
stance called sebum, and occurs commonly on the scalp or
neck. Doctors call wens sebaceous cysts. They are round,
dome-like, semi-fluid tumors, but quite harmless. They may
be easily removed under cocaine without pain, by any sur-
geon.
White Leg. — A swelling of the whole of one leg, occur-
ring, sometimes, in women after childbirth, also in con-
valescence from pneumonia or typhoid fever.
Symptoms. — For a few days, pain and tenderness of one
WHITLOW 313
thigh, and feverishness. The limb swells slowly, and in a
few days will be very white, hard, and shining, like a hard
bolster in a white pillowslip. The veins can be felt as hard
as whipcord down the leg. The swelling begins to go down
again in about ten days and the leg may recover altogether.
But very often some degree of weakness and aching remain
in the leg for months or years.
Treatment. — Rest in bed, and quiet, with the limb raised
on a pillow. At the onset, give the patient a pill contain-
ing two grains of quinine and % grain of opium every six
hours. But before that, administer a sharp purge like a
drachm or more of compound jalap powder. Do not move
the leg about, or poultice it, or rub it; everything depends
on its being kept still. Every time it is moved there is a
risk that a piece of blood clot from one of the inflamed veins
may be dislodged and carried by the blood stream to some
distant part, such as the brain or lungs, and cause fright-
ful damage, or even death. This mischief is called em-
bolism.
White Swelling. — This is the name given to tuberculous
disease of a joint, especially of the knee, but it should not
be used by those who care for accuracy.
Whitlow. — This is a name given to almost any kind of
inflammation of the fingers. The inflammation is caused
by a germ or a mixture of different germs, which get into
the blood through any crack or tiny sore on the fingers,
especially at the edge of the nails.
Symptoms. — Throbbing pain in a finger, made worse by
hanging the hand down, relieved by raising the arm.
Swelling and redness and tenderness and pain, especially
at one spot.
In the least severe kind of whitlow the skin rises like a
blister over it and then, if the blister be pricked or cut,
matter will escape and the whitlow will soon be well. The
second and more severe type is when the inflammation is
right in the soft pulp of the flesh of the finger, especially
likely to occur after getting a splinter into the finger. This
kind of whitlow is to be continuously fomented or held in
hot water. Presently the matter comes to the surface,
bursts through, and the inflammation gradually subsides.
The third and really serious kind of whitlow may develop
from the others if they are neglected. The inflammation
goes right down to the tendon of the finger, gives intense
314 WHOOPING COUGH
pain, swelling and tenderness all up the arm, swollen glands
in the armpit and a general feeling of illness. If neglected,
this whitlow may cause loss of a finger, or even of a hand
or arm. The treatment must be left to the skill of a sur-
geon.
Whooping Cough. — This is a very contagious disease,
which attacks children so readily that very few children
grow up without suffering from it. The infection of the
disease seems to be in the air, and we suppose that the out-
breathed air and the phlegm of those who are suffering
from it spread the poison which starts other cases, but as
yet the scientific observers, with their microscopes, have not
been able to discover any definite germs. The disease occa-
sionally appears as an epidemic, attacking a large number
at once in the same locality, but, in general, each new case
is infected separately from a previous case. For example,
a child may get the infection from sitting in an omnibus
opposite to a child who has a severe fit of the cough.
Whooping cough is called Pertussis by doctors, and an old
English name was Chin-cough. It rarely occurs more than
once to anyone.
It generally begins as a common cold, passing on to a
cough, with a little f everishness ; and then after a week or
more, the cough changes its character; it tends more and
more to come on in fits of coughing, with free intervals.
There may be only two or three fits of coughing in a day,
or as many in an hour. The cough develops a peculiar
quality of a shrill sound or whoop, which, once recognized,
is hardly ever mistaken. It occurs at the end of a fit of
coughing, when the patient is almost strangled by the length
of time the cough has lasted. These coughing fits may end
in vomiting or in nose-bleeding, and a child suffers so much
in them that he dreads each onset. Directly after a fit,
however, the patient seems to regain courage, and if sick-
ness has occurred, he soon gets hungry again. Cases gen-
erally last three weeks, but children may continue to whoop
for three months. It is a very disagreeable disease for
nurses and patients, but its great dangers lie in the com-
plications which are so apt to develop. Measles occasion-
ally occurs with whooping cough, and makes the child even
more ill, and increases the danger. Bronchitis and pleu-
risy, and also pneumonia and congestion of the lungs, are
the most common and most dangerous diseases which ac-
WHOOPING COUGH 315
company whooping cough, and when there are any symp-
toms of either of these, medical aid must be sought for at
once. The severe cough is also liable to injure the ears,
and may cause bleeding behind the whites of the eyes ; and
even convulsions are occasionally set up, and cause great
danger.
Treatment.— Isolation is the first question to be dealt
with. As the disease will last for eight to ten weeks or
more, it is no use to begin a system in a half-hearted way.
If possible, where there is more than one child in a house,
the sick one should be sent away ; and if he is too sick, then
the other children must be sent away. The child ought
really to have two rooms to use, but in any case, from the
rooms which it uses everything that can be damaged by
disinfectants must be removed, because the rooms will have
to be disinfected afterwards. The child must be warmly
clothed, but must have plenty of fresh air and not be cod-
dled. When we come to mention medicines we find our-
selves in a fix : there are so many different ways af treating
the disease. We always discountenance the treatment of a
disease which may be so serious as whooping cough, with-
out a doctor, and we know that most doctors have their
routine way of dealing with it. Yet a few remarks may be
useful. The disease generally runs its course; very little
can be done with medicines, and a great deal can be done
by good nursing. The following is a very good prescrip-
tion for a two-year-old child with whooping cough : — Phena-
zonum, 1 drachm; ammonium and sodium bromides, of
each 1 drachm; syrup of chloral, 6 drachms; chloroform
water to 4 ounces. Give a teaspoonful every three hours.
Caution. — This contains poisons and must be given only in
measured doses.
Additional recipes for use in whooping cough : —
(1) Yeo's inhalation method of treating whooping
cough. An iron dripping-spoon is kept on the fire and
carbolic acid is dropped on to it and evaporated until
the air of the room is full of carbolic fumes. The
throat of the child to be painted with glycerin of car-
bolic acid. The following lotion to be sprayed in front
of the child's face (with eyes shut) from time to time
— Glycerin of carbolic acid, 1 drachm; bicarbonate
soda, 10 grains ; hot water, 1 ounce.
316 WOEMS
(2) Instead of carbolic, eucalyptus or terebene may
be used.
(3) Resorcin (2 per cent.) solution may be both
sprayed into the room and painted in the throat.
(4) Ipecacuanha wine, 4 fluid drachms; ammonium
bromide, 3 drachms ; paregoric, 4 fluid drachms ; syrup
of tolu, 1 fluid ounce; chloroform water, to 4 fluid
ounces. A child of seven years may be given a tea-
spoonful of this in a wineglassful of water three times
a day. A good prescription.
(5) Another useful one is: — Ammonium chloride,
25 grains ; bicarbonate of soda, 40 grains ; sodium ben-
zoate, 70 grains ; chloroform water, 1 fluid ounce ; anise
water, to 3 fluid ounces. A teaspoonful may be given
to a child of four, every four hours.
Winter-Cough.. — There is no cough peculiar to the winter.
This name means chronic bronchitis, which is worse in the
cold and damp weather and better in the warm weather.
(See "Cough" and "Bronchitis.")
Worms. — Under this heading we describe briefly the
principal worms which are sometimes found in the bodies
of human beings, especially in the bowels of children.
The TAPEWORM is a flat, long worm, whitish, like a piece
of tape and consisting of a tiny head, with suckers which
enable the worm to attach itself to the inside lining of the
bowel and to draw its nourishment from thence; a thin
tapering neck like a piece of white thread ; and a long body
of several separate segments or divisions. The body may
be as long as a yard or more, and the whole worm lies coiled
up in the bowel. Bits of it get broken off from time to
time, and appear in the motions, but so long as the head
holds fast, the worm does not die, but keeps on adding seg-
ments to itself.
Cause. — The tapeworms are taken into the body by eat-
ing the flesh of pigs or cattle which have harbored them.
Pork with worms in it is called "measly pork," and is not
uncommon among the poorer class of butchers' shops.
There is a little tapeworm also, which is sometimes caught
from pet dogs. The dog picks up garbage and rubs its nose
in the filth of the gutter and then may communicate worms
to anyone who allows it to lick his face or touch his food.
Signs of worms. — Children with tapeworm generally have
THREADWORM 317
enormous appetites, diarrhea alternating with costiveness,
headaches and even fits or convulsions. From time to time
you can see several inches or feet of tapeworm in the mo-
tions.
Treatment. — (1) Keep the child in bed.
(2) Give, for three days, a very spare and light diet
and a tabloid or two of cascara sagrada every night. This
gets the bowels free from much solid residue of food, and
makes the other treatment much more likely to succeed
the first time,
(3) On the fourth day, at nine in the morning, give
patient a capsule of ten minims of the extract of male
fern; another similar dose half-an-hour later; another
again at ten o'clock. Then, at eleven o'clock, a fluid
ounce of compound senna mixture, or an ounce of castor
oil. When the bowels have acted, give some breakfast.
The reason for these repeated doses is that if only a
single dose is given it may pass quickly over the worm
and fail to kill it.
(4) When the bowels do act, the motion ought to be
passed into a bedpan with a piece of black thin crape or
cloth over it. Then the white neck and head of the worm
may easily be found.
Until the head has been found, the cure cannot be
considered to have been accomplished. It is very small,
hardly bigger than a pin's head.
THREADWORM. — The threadworm is about a quarter of
an inch long, white, and threadlike. These worms live in
the lower bowel or rectum.
Signs of threadworm. — Diarrhea, nervous irritability,
and even fits ; picking of the nose, scratching of the funda-
ment, grinding of the teeth during sleep and bed-wetting.
Treatment. — The irritation at the back passage may be
relieved by applying weak, white, precipitate ointment. In-
ternally the child should have one santonin lozenge, at bed-
time, every night, for a week, and a small dose of castor oil
in the morning; also injections of warm salt water or sea
water into the back passage.
BOUND WORM. — The roundworm looks something like an
ordinary garden worm, only pale yellowish in color. It is
about ten inches long. These worms live in the bowels and
318 WRY-NECK
feed there ; but sometimes one wanders into the stomach and
is vomited up, or into the nose, and may even try and get
through the nostril. These worms are fond of getting into
round openings. They cause a too-great appetite, varied
sometimes by a complete loss of appetite, and sometimes
diarrhea, and pain in the belly.
Treatment. — To a child give 5 grains of santonin in one
dose, at bedtime, and a large dose of castor oil in the morn-
ing.
Wry-Neck. — In wry-neck the head is twisted to one side.
It may be caused by the scars of a burn, or of operations
for swollen glands, which drag the head over to one side.
But by far the most common sort of wry-neck is caused by a
spasm or cramp of the muscle called sterno-mastoid which
jerks the head to one side, often in a very painful fashion.
Tailors and shoemakers are very liable to the complaint.
Infants during birth, when the delivery has been difficult,
are apt to suffer from a rupture of the sterno-mastoid mus-
cle, so that the one on the other side drags the head over to
that side.
The cure of every case of wry-neck must depend entirely
on its own merits and its causes. We can give no help in
these pages.
THE END
INDEX
Topics printed in small capitals are found also in their regular
alphabetical place in the body of the book.
abortion, 198
ABSCESS, 1
abscess of the lung, 179
absinthe, 286
acetylene gas, 174
aconite, in fevers, 110; for sore
throat, 264
ACIDITY (Sour Stomach, Heart-
burn), 2
ACNE. (See BLACKHEADS)
acquired syphilis, 277
ADENOIDS, 3
adenoids, 207, 212
adhesive plaster, in medicine
chest, 186
adrenaline, for bleeding, 224
advertising, 273, 301
AGE AND WEIGHT, 4
ague, 182
ALCOHOL, ACUTE POISONING BY, 5
alcohol, as skin antiseptic, 12;
as food, 25; for sponging in
fevers, 110; a cause of in-
sanity, 162; in insomnia,
165; unnecessary drink, 193;
secret abuse of, 204; ex-
cesses, 215, 221, 244; in ty-
phoid, 293
ALCOHOLIC DRINKS, MODERATION
IN, 5
alcoholic drinks, 5; abuse of, 6;
moderation, 7 ; amount in
health, 8; not to be admin-
istered for apoplexy, 13, 236
alcoholic paralysis, 116
alkaline bath, formula for, 22;
soap, 125
alkaline, mouth wash, 78; tooth
powders best, 78
alkaloe, 12, 212
aloe, 218
aloe, belladonna and strychnine
pill, 69
alum, lotion for feet, 29; for
bleeding, 20S, 225, 227; for
sore throat, 264
alum powder, in medicine chest,
187, 190
aluminium acetate, for abscess, 1
amaurosis, 265, 266
ammonia, for stings, 26
ammonium acetate, in fevers, 110
ammonium bromide, 208
ammonia, in medicine chest, 186
arnputation? 117
ANAEMIA, 8
anemia, 132, 133, 149, 203, 227,
287, 306
ANAESTHETICS, 10
anasarca ( see DROPSY ) , 89
ANEURISM, 10
aneurism, 289, 305
ANGINA PECTORIS, 11
anise, 57
antinomy, for eczema, 96; for
sore throat, 204
antipyrin, 110, 132, 158, 264, 297
ANTISEPTICS, 11; list of, 112
antitoxin, diphtheria, 73, 84
anus, the, 217
anyl nitrate, for angina pectoris,
11
apenta water, 69
APOPLEXY, 12
apoplexy, 211
APPENDICITIS, 13
APPETITE GOOD, BAD AND INDIF-
FERENT, 14
319
320
INDEX
aristoe, antiseptic powder, 12
armpits, lotion for, 217
arnica, tincture of, for stings,
26; not to be used for gout,
123
aromatic chalk powder, in medi-
chine chest, 187
Arsenic for boils, 31; for eczema,
96, 223; in psoriasis, 229;
poisoning, 288
arterio-sclerosis, 305
artificial feeding, 154; lighting,
172
arthritis, 234, 238
artificial respiration, 90
ASCITES, 16
ashes. 234
aspirin, for lumbago, 178; for
rheumatism, 235
asses' milk, 196
ASTHMA, 16
asthma, 206
asthma powders, 17
asylums, 160
BABIES LOST BY OVERLAYING IN
BED, 18
BACKACHE, 19
bacon, 64. (See also DIETS)
bacteria, in milk, 194-5
ballin bottle, 196
bandages, in medicine chest, 186,
188
bandage, for bleeding in varicose
veins, 29; for abscess of
breast, 31
BANTING, 20
banting, 67
BARBERS' ITCH, 21
BARLEY WATER FOR INVALIDS, 21
barley water, 48; in measles, 185
BARRENNESS, 20
BATHING, THE IMPORTANCE OF,
22
baths, 214; conium, 167; sul-
phuret, 167
Baume AnalgSsique Bengue1, for
gout, 123
beans, in diabetes, 80
BED CASE; 23
BEDSORE, 23
bedsores, 293
BEEF TEA, HOW TO MAKE, 23
beef juice, 48; tea, for influenza,
158
beer, 25, 216
belching, false relief of, 152
belladonna, for bruises, 34
benzoin, 189; for tonsils, 264
BEVERAGES, 24
bicarbonate of potash, in rheu-
matism, 235, 239
bicarbonate of soda, for teeth,
282; for tongue, 287, 297
bichloride of mercury, 28
bichloride of mercury (corrosive
sublimate), for cuts, 29;
for boils, 31; for abscess, 1;
as antiseptic, 12; as disin-
fectant, 86
bicycles, for reducing, 67
bilious attacks, 271
birthmarks, 25, 292
bismuth, 144
BITES AND STINGS, 26
BITES OF DOGS, 26
black and blue, 268
BLACK-EYE, 27
BLACKHEADS, 27
BLADDER, DISEASES OF, 28
bladder, 299
blankets, 235
Blaud's pills, for anaemia, 10
blebs, 253
bleeding, in scurvy, 247; wash-
ing wounds, 283
BLEEDING FROM VARICOSE VEINS,
28
blister, for ear noises, 207
blistering, for lumbago, 178
blood-poisoning, 230, 253, 287
BLOOD- SPITTING, 30
BLOOD-VOMITING, 30
blue mass, in fevers, 110
blood, in rickets, 240
blue pill, for liverishness, 69
BOILS, 30
Boracic acid, as antiseptic, 12,
212
boric acid for eczema, 97 ; for
barbers, 26 ; for shingles,
144; in scurf, 246
boric acid powder, in medicine
chest, 187, 189
boric lint, 40, 297
INDEX
321
boric lotion, for black eye, 27;
ointment for housemaid's
knee, 146
borine, as toilet antiseptic, 12
/boroglyceride, 246
borolyptol, as toilet antiseptic,
12
bottles, for feeding, 196
bowels, 192, 203; in pregnancy,
227; in rheumatism, 237;
with ulcers, 297, 307
BRANDY AND EGG MIXTURE, 31
brandy, amount of alcohol in, 25 ;
for diarrhoea, 48; in col-
lapse, 200; after poisoning,
222
bread poultice, 226, 264
break-bone fever, 198
BREAST, ABSCESS OF, 31
breast feeding, 195
breasts, bandaged in pregnancy,
227
breath, 153, 192
BREATH, UNPLEASANT OR FOUL,
32
breath, shortness of, 32
breathing, exercises for bust de-
velopment, 36
BRIGHT'S DISEASE, 32, 168, 230,
299
brimstone, 218
BROKEN BONES, 32
bromide of sodium, for seasick-
ness, 247
bromides, 165
bromine, for epilepsy, 101
bromural, for insomnia, 166
BRONCHITIS, 33
bronchitis, 184, 289, 314
BRUISES, 34
brushes, 186
brushes and combs, 245
brush, throat, 188
BUBO, 34
bubo, 120
bug bites, 233
BUNION, 35
BURNS, 35
BUST DEVELOPMENT, 36
buttermilk, substitute for, 170
cachous, useless, 32
caffeine, 132; in medicine chest,
187
calamine lotion, for eczema, 95
calcium phosphate, 207
calomel, for boils, 31; for gall
stones, 117; in medicine
chest, 187, 189; for piles,
218; in sciatica, 243; for ul-
cers, 297
camphor liniment, 178
camphor, water, in chicken pox,
45; for chilblains, 46
CANCER, 37
cancer of the liver, 176; of the
stomach, 272; tongue, 286,
292, 308
candle light, 173
carbolic acid, 12; in chicken pox,
45; poisoning from, 222;
disinfectant, 246; for stye,
274
carbolic acid lotion, in medicine
chest, 187
carbolic oil, for catheter, 40; for
barbers, 126; for scurfiness,
257
carbolic soap, 40; in medicine
chest, 186, 188
carbolic tooth powder, 282
carbonate of soda, for scaliness,
230
CARBUNCLE. (See also GLANDS)
carre" ammonia process, 139
carron oil, for burns, 36
carrots, in diabetes, 80. (See
DIETS)
cascara, 10, 69
cascara sagrada, 227, 230, 317
castor oil, for eczema, 96 ; in
medicine chest, 187; for
poisoning, 200; in piles,
218; as purge, 230, 293
cataract, 265, 266
CATARACT. (See EYE DISEASES)
CATARRH. (See COLD IN THE
HEAD)
catarrh, 74, 263
catarrh of the stomach, 215
catechu, for sore throat, 264
CATHETER, 39
cauliflower, in diabetes, 80. (See
DIETS)
caustic potash, 286, 308
322
INDEX
celery, avoid in asthma, 17
champagne, for tonic, 39
CHANCRE, 40
chancre, 277, 278
CHANGE OF AIR, 41
CHANGE OF AIR AS A REMEDY, 42
CHANGE OF LIFE, 43
cheese, to be avoided in asthma,
17; in consumption, 64.
(See also DIETS)
cheese cloth, for filtering air, 92
cess pools, 249
chaps, 254
charcoal poultice, 226
CHEST, DEFORMITIES OF, 44
CHICKEN POX, 45
chicken pox, 232, 300
CHILBLAINS, 45
chilblains, 254
childbirth, 298
child crowing, 46
chills, in scarlet fever, 243
chloral, 227
chloral, overindulgence, 165
chlorate of potash lozenges, 289
chloride of lime, 86
chloride of zinc for sore throat,
264
chlorobrom, in seasickness, 247
chloroform, as anaesthetic, 10
chlorosis, 9
chocolate, 25
CHOKING, 46
cholalogues, 230
CHOLERA, 47
cholera, 248
Christian Science, not for broken
bones, 33; chancre or syph-
ilis, 41
chrysarolin ointment, 229
cider, 25
cigars, 285
cigarette smoking, 201, 284
CIRCUMCISION, 48
circumcision, 111, 298
cirrhosis of the liver, 175, 215;
stomach, 215
citrate of magnesia, 69, 230
claret, 25
Clark, Sir Andrew, 9
CLEANING, 48
cleanliness, for blackheads, 3
CLIMATE FOR INVALIDS, 50
clothing, 215
cloves, oil of, 287
coal gas, 173
cocoa, 25
cocaine, 10; and bismuth oint-
ment, 69; for ulcers, 297,
312
codeine, in diabetes, 81
codliver oil, for acne 33; chil-
blains, 45; for consumptives,
64; for coughs, 71; for rick-
ets, 239; for spine disease,
267
coffee, antidote for opium pois-
oning, 25; for headaches in
anaemia, 133
coffee, after poisoning, 222
colchicum, in fevers, 110; wine
for gout. 123, 1781; for gout,
239
cold baths. (See BATHING)
cold cream, 27
COLD IN THE HEAD (Nasal Ca-
tarrh), 56
cold in the lip, 144
COLD-ON-THE-LIP, 57
colds, 214
COLIC, 57
colic, 155, 223
collapse, 58
colocynth, 218, 230
cologne poultice, 226
coma, in diabetes, 80
COMA, 58
CONCUSSION OF THE BRAIN
(Stun), 58
confinement, calculation for, 227
CONFINEMENT, 59
congenital syphilis, 276
conium ointment, for piles, 218
conjunctiva (see EYE DISEASES),
105, 214
constipation, 69, 218
CONSUMPTION, 59
consumption, 64, 245, 289, 292
convulsions (see FITS), 111
Cooper-Hewitt light, 173
cornea, clouds on, 265
cornea (see EYE DISEASES), 106
corn plasters, 66
corn solvents, 66
INDEX
323
CORNS AND BUNIONS, 66
CORPULENCE OR OBESITY, 66
corrosive sublimate, in catheter-
ization, 40; (see also bi-
chloride of mercury) for
barbers, 126, 223
corsets, 215
COSTIVE BOWELS, 68
costiveness, 230
cotton wool, for stings, 26
country, superior vitality in, 42;
good for children, 43
CRACKED NIPPLES, 71
CRAMP IN THE CALF OF THE LEG,
cramps, 71
cream of tartar, 230
CREMATION, 71
creosote, in medicine chest, 187
189, 287
CRETINISM, 72
cricket, 273
cross-eyes, 269
croton oil, for ulcers, 297
croup, 72
cubeb cigarettes, 17
curly hair, 128
cut throat, 73
cyanide of potash, 222
cystitis (see BLADDER), 28
dandruff, 245
DEAFNESS, 73
deafness, 289
DEATH, SUDDENj 75
DELIRIUM TREMENS, 76
delirium tremens, "D. TVs," 5,
77, 197, 286
demented persons, 197
dental hospitals, 282
DENTAL HYGIENE, 77
depilatory, 129
dermatol, 12
DIABETES, 78
diabetes, 299
DIARRHEA, 81
DIARRHEA IN BABIES, 82
diarrhea, in children, 2; in con-
sumptives, 64; infants, 155;
summer, 194, 196; rickets,
207 ; poisoning, 233, 248, 270
Diet
for consumptives, 64
for constipation, 69
diabetes, 80
epilepsy, 101
gall stones, 117
gout, 124
milking mothers, 154
infants, 155
pneumonia, 220
rheumatism, 236
rickets, 240
seasickness, 247
teeth, 282
athletic training, 290
typhoid, 293
vegetarian, 303
modified vegetarianism, 304
Diet in relation to age avid ac-
tivity, 194, 305
DIGESTIBILITY, 83
digitalis, for the ear, 207
dilated stomach, 271
dill water, 57
DIPHTHERIA, 83
diphtheria, 110, 162, 194, 196,
248, 263
DIPSOMANIA, 84
disinfectants, in typhoid, 294
DISINFECTION, 80
DISLOCATION, 86
DOSAGE, 86
Dover's powders, 110, 188, 190,
243
DRACHMS AND OUNCES, 87
drainage, for mosquitoes, 198
DREAMS, 88
dress, in pregnancy, 227
DRINKING CUP, 88
dropsy, 230, 243
DROPSY, 89
DROWNING, 89
drunkards, 299
drunkenness, 230
dry cupping, 178
Dunbar's pollantin, for hay fever,
131
DUST, 91
DYSPEPSIA (866 INDIGESTION), 93
EAR DISEASES, 93
ear, the, 224, 242
324
INDEX
ear syringe, 186
earth closet, 248
ECZEMA, 94
eggs, 69, 83. (See also DIETS)
egg julep, for baldness, 20
egg-nogg, formula for, 31
elastic ulcer, 303
electric light, 172
electricity, 204, 211
electrolysis, for birthmarks, 25;
superfluous hair, 129
elephantiasis, 198
embolism, 221
emetics, 200
EMETICS, 98
emphysema, 289
empyema, 219
ENEMA, 98*
enteric fever, 292
epileptics, 197
EPILEPSY, 99
epilepsy, 111, 216, 298
epithelioma, 308
epsom salts, 187, 189, 200, 230,
297
epsom salts, in fever, 110; after
poisoning, 223
eruptions, of beggars and tramps,
231; from external agents,
231; in syphilis, 277, 288
ERYSIPELAS, 102
erysipelas, 253
ether, anaesthetic, 10; compound
spirits of, for hiccough, 144
ethyl chloride, 10
ethylate of soda, 308
eucaine, 10
eucalyptol, for toilet use, 12
EXERCISE AND RECREATION, 103
eye bath, 1S6
EYE DISEASES, 105
eye-strain, 214
eyes, 213
eythema, 255
FAINTING, 108
fasting, 152
fat, 193
feather duster, to 'be avoided, 49
feeding cup, 186
feeding, for children, 153-156
feet, lotion for sweating, 217
femoral hernia, 140
ferric chloride for ingrowing toe
nails, 285
ferric perchloride, 218
FEVEB, 109
feverish colds, 188
figs, 230
filariasis, 198
filters, 311
fireplaces, 138
first aid, drowning, 90
fish, 64. (See also DIETS)
FITS, 111
fits, 13, 278
flatulence, 152
flies, 195, 294
FLIES, 112
fly paper, 114
FOMENTATIONS, 114
fomentations, better than poul-
tices, 225
FOODSTUFFS EXPOSED TO STREET
DUST AND DIRT, 115
football, 273
foreskin, too tight, 28; cleanli-
ness in, 48; tightness, 299
formaldehyde gas, 8*5
Formamint lozenges, for sore
throat, 264
freckles, 255
Freeman's pasteurized, 155, 196
fresh air, for cholera, 47
Friar's balsam, 46: in medicine
chest, 187, 189
fruit jellies, 236
fruits, 303. (See DIETS)
GAIT AND APPEARANCE, 116
gallstone, 176
GALLSTONES, 117
galls and opium ointment, 218
game, 202. (See DIETS)
GANGRENE, Or MORTIFICATION, 117
gangrene of the lung, 179
garbage, 114, 234
gastritis, 271
GENERAL PARALYSIS, 117
gentian, tonic, 201
German measles, 185, 233
GIDDINESS, 118
gin, 25
gingerbread, 69
GLANDS, SWOLLEN, 119
glaucoma, 265, 266
INDEX
325
glycerine, for cracked nipples, 71
glycerine of the subacetate of
lead, 187, 188
glycerine of tannin, for nose
bleeding, 208
glycerine suppository for piles,
69
glycothymoline, 212
goat's milk, 111
GOITER, OB DERBYSHIRE NECK (see
also CRETINISM), 120
gold fish, 199
GONORRHEA, 121
gonorrhea, 120, 216, 305
Gordon, Alexander, 184
GOUT, 122
gout, 9, 11, 17, 216, 228, 244,
297, 299, 303
granular lids, 107
grates, as ventilators, 137
gray hair, 128
gray powder, 187, 190
grease, on hair, 127
GROG BLOSSOMS, 124
GUMBOIL, 125
gummata, 278
gut, the, 13
gymnastics, 273
Hahnemann, 145
hair, the, 64, 213; loss of, 256
HAIRDRESSERS, HINTS TO, 125
HAIR, HOW TO TAKE CARE OF, 127
HAIR, LOSS OF ( S66 BALDNESS ) ,
129
hair wash, a, 20
HAIRS, SUPERFLUOUS, 129
hallucination, 180
hamamelis and cocaine, 218
hamamelis ointment, 187
HANGING, 129
HANGNAIL, 130
HARELIP, 130
HAY FEVER, 130
HEADACHE (VARIETIES OF), 131
headache, 169, 193
HEALTH RESORTS. (See CLIMATE
FOR INVALIDS)
HEARTBURN, 133
heartburn, 152
HEART DISEASE, 133
HEATING, 136
HEATSTROKE (SUNSTROKE), 139
hematocele, 143
hemiplegia, 210
hemisine, for bleeding, 224
hemorrhoids, 217
HERNIA, OR RUPTURE, 140
HERPES, 143
HICCOUGH, 144
Higginson Syringe, 99, 186, 222
hip baths, 28; for piles, 2181
HIP-JOINT DISEASE, 144
hip-joint, 116
hockey, 273
holidays, 275
Holt, 153; formula for modified
milk, 154
HOMEOPATHY, 145
honey, 69, 230. (See DIETS)
hook-worm, 248
hot-water bottle, 223
HOUSEMAID'S KNEE, 146
humidity, in heating, 138
Hunyadi Janos, 69
Hutchinson, ointment for psori-
asis, 229 ; plan for ring-
worm, 258
hydrobromic acid, 101
hydrocele, 142
HYDROCELE, 146
hydrophobia ( see BITES OF DOGS ) ,
26
hydrothorax (see DROPSY), 89
hydrotherapeutic baths, 214
hypnotism, 204
HYPOCHONDRIASIS OR NEURAS-
THENIA,, 147
hysteria, 132, 204, 206, 216, 299
HYSTERIA, 148
ice, for consumptives, 62
ice bag, for appendicitis, 14, 220
ichthyol, for chilblains, 46; for
red nose, 125
IDIOSYNCRASY, 150
illusion, 180
IMPERIAL DRINK, 151
IMPOTENCE, 151
incinerators, 234
incontinence of urine, 298
incubation, periods of in fevers,
109
incubation, typhoid, 298
Indian clubs, 280
INDIGESTION, 151
326
INDEX
INFANT FEEDING, 153
INFANTILE PARALYSIS, 156
INFLAMMATION. (See ABSCESS)
INFLUENZA, 157
influenza, 162
inguinal hernia, 140
inhaling cigarettes, 284
INSANITY, 158
insanity, 196, 216
INSOMNIA, 164
intertrigo, 276
intestines, 213
iodide of potassium, 150? 239
iodide of sodium, for asthma, 17
iodine, for chilblains, 46; for
housemaid's knee, 146, 187
iodine, tincture of, as skin anti-
septic, 12
iodoform, antiseptic powder, 12
ipecacuanha, as emetic, 200
ipecacuanha wine, in medicine
chest, 187, 190
iron, for anaemia, 9; for boils,
31; for bleeding, 225; for
sore throat, 264; syrup of,
267
ironing lumbago, 177
iron tonics, for hysteria, 150
ITCH, 166
ITCHING OF THE SKIN OF VARIOUS
PARTS, 166
jalap, 218, 230
Japanese furniture polish, 49
jaundice, 198
jellies, for consumptives, 64.
(See DIETS)
kerosene, 173; for m(
198; for lice, 213
KIDNEY DISEASES, 168
kidneys, disease of, a cause of
anaemia, 9; of apoplexy, 12;
in diabetes, 15, 19, 111; in
gout, 122, 198; alcoholic,
215; in rheumatism, 237; in
Salisbury treatment, 240; in
scarlet fever, 242
KOUMISS, HOME-MADE, 170
Lady Webster pill, 69
lanolin, for black eye, 27
laudanum, 190; for poisoning,
222; for ulcers, 297
laxative salts, 31
laxatives, 69, 218
LEAD POISONING, 170
lead poisoning, 203, 288
leeches, 93, 220
lemon juice for tongue, 287
lemonade, in measles, 185; in
rheumatism, 236
lemon water, 56
lens (see EYE DISEASES), 106
lice, 213
LICE, 171
licorice, 218
licorice powder, 69
LIGHTING, 172
lime, as disinfectant, 113, 249;
syrup of, 267; in typhoid,
294
lime water, 223, 308
liniments, 204
linseed jacket poultice, 220
linseed poultice, 226
linseed meal poultice, for sore
throat, 264
lint, 186, 230
liquor antisepticus alkalimis, 191
Lister, Lord, 102
listerine, 12
liver, congestion of, 287
LIVER, DISEASES OF THE, 174
liver, the, gO, 81, 218, 230, 240,
278
liver colic, 176
lobelia, 17
LOCKJAW. (See TETANUS)
lockjaw, 283
locomotor ataxy, 116, 305
LOCOMOTOR ATAXY, 176
lotion, for eczema, 97; for lice,
171; for scurfmess, 257
lumbago, 234, 236
LUMBAGO, 177
lunar caustic, 308
lungs, 212, 220
LUNGS, DISEASES OF THE, 178
lymphatic glands, in syphilis, 277
MADNESS, SYMPTOMS OF, 179
magnesia, 218, 223, 256
maize, 69
malaria, 198
INDEX
327
male fern, extract of, for worms,
317
MALIGNANT, 183
malt, for chilblains, 45; for
cough, 71
malt extract, 64; in rheumatism,
236
maltine, 64, 267
maniacs, 197
manure piles, breed flies, 112
mare's milk, 196
marriage, cure for hysteria, 132,
216
MASSAGE, 183
massage, for cramps, 71; for
paralysis, 211; for sprains,
268
masturbation, 149
MEASLES, 184
measles, 232, 253
measure, 186
meats, 83
meat extracts, 236. (See DIETS)
MEDICINE CHEST, 186
medicines, avoid, unless recom-
mended by doctors, 151
melancholies, 197
Meni£re's disease, 119
meningitis, 312
MENINGITIS, 191
MENSTRUATION, 191
menstruation, 227
methylated spirits, for bedsore,
23
mercury, for syphilis, 279
mercurial poisoning, 289
MIDDLE-AGED MAN, The, 192
migraine, 132
MILK, 194
milk, in constipation, 69; modi-
fied by Holt's formula, 154;
in measles, 185; as antidote,
223; in rheumatism, 236
MELK, ARTIFICIAL HUMAN, 195
milk diet, for appendicitis, 14;
for asthma, 17; milk foods
in constipation, 164
MIND FAILURE, 196
mineral waters, for gallstones,
117
MISCARRIAGE, CAUSES OF, 197
miscarriages, 276
monomaniacs, 197
Moore system, 173
morning sickness, 228
morphine, for lead poisoning, 288
morphine, in sleeplessness, 165
MORTIFICATION. ( See GANGRENE )
MOSQUITOES, 198
mosquitoes, 183
MOTHER'S MARKS. (See BIRTH-
MARKS )
mouth, the, 212
MUCOUS MEMBRANES, 199
mud baths, 177
MUMPS, 199
mushrooms, 202
MUSSELS, 200
mustard, in warm water, for al-
coholic poisoning, 5; bath,
prescription for, 22, 57
mustard poultice, 226
mustard and water, emetic, 200,
222
muzzling dogs, 27
nails, 213
nasal sound, 208
naso pharynx, 212
NERVOUS DEBILITY, 200
NETTLERASH, 201
nettlerash, 233, 255
NEURALGIA, 202
neuralgia, 17
neuralgia- jaw, 287
NEURASTHENIA, 204
neurasthenia, 312
NEURITIS, ALCOHOLIC, 205
NEUROSIS, 206
NIGHTMARE, 206
NIGHT-TERRORS, 207
NIGHT SWEATS, 207
nipples, in pregnancy, 227, 228
niter, spirits of, in fever, 110
nitrate of potash, for asthma, 17
nitric acid, 308
nitrous oxide gas, 10
nodes, 278
NOISES IN THE EAR, 207
nose, 212
NOSE-BLEEDING, 208
nuts, bad for asthma, 17, 303.
(See DIETS)
oatmeal, in rheumatism, 236
observation, 116
328
INDEX
obstetric belt, 227
oedema ( see DROPSY ) , 89
Oertel system, 67
oiled silk, 186, 230
olive oil, 64 ; for eczema, 97 ; for
lice, 213
onion juice, for stings, 26
onion poultice, 226
open air, cure for colds, 42; for
consumption, 63, 201
operation, for neuralgia, 204; for
piles, 218; for cross-eyes,
269; varicocele, 302
ophthalmia (see EYE DISEASES),
106, 213
opium, in diabetes, 80; for
eczema, 96; for ulcer, 297
ovaries, in mumps, 200; in
syphilis, 278
overeating, 218
OVERLAYING. (See BABIES LOST)
overwork, 118
oxalic acid, poisoning, 222
oxide of mercury ointment, 274
oxygen, 179; in pneumonia, 221
oysters, digestibility of, 83, 287.
(See also DIETS)
OYSTERS, RISK OF EATING, 208
pail system, the, 248
PAIN, 209
palsy, 286
paralysis, 12, 278, 298, 305
PARALYSIS, 210
paralytic insanity, 197
paranoia, 162
paraplegia, 210, 211, 305
paregoric, in medicine chest, 187,
190
paresis, 211
Pasteur treatment, 27
Pasteurized milk, 195, 294
pastils, 186
pastries, 17, 64, 236. (See also
DIETS )
PATHOLOGY, 211
peas, in diabetes, 80. (See also
DIETS )
peeling, in scarlet fever, 242
peppermints, for seasickness, 247
pepsin, in consumption, 64
perchloride, for bleeding, 223
perchloride of iron, for erysip-
elas, 103
perforated ulcer, 272
peroxide of hydrogen, 3; anti-
septic, 12; for cuts, 29; for
bruises, 34; for tetanus, 283
PERSONAL HYGIENE, 211
PERSPIRATION, 217
phenacetine, 132; in medicine
chest, 187, 190
phenol, 218
phosphate of soda, 230
phosphorus, 133, 223
phosphorus poisoning, 289
phthisis, 287
PHYSIOLOGY, 217
pickles, avoid in asthma, 17.
(See also DIETS)
picrotoxin, for night sweats, 207
piles, 9, 187
PILES, 217
pimples, 27-28, 253
pipes, best for smoking, 284
plastermulls, 97
Platt's Chlorides, 86
plenum system, 138
PLEURISY, 219
plug, for epileptics' jaws, 102
plumbing, good, 249
PNEUMONIA, 220
pneumonia, 184, 314
podophyllin, for gallstones, 117
poison, 150, 186
POISONING, 221
pollatin, Dunbar's, 131
polypus, 207
POLYPUS, 223
pomatum, on hair, 127
Poplar charcoal, 152
poppy-heads, fomentations of, for
black eye, 27
pork, bad for asthma, 17. (See
also DIETS)
porter, bad for asthma, 17. (See
also DIETS)
potassium permanganate, in te-
tanus, 283
potassium permanganate, as anti-
septic, 12
potatoes, in diabetes, 80. (See
also DIETS)
POULTICES, 225
INDEX
329
poultices, for appendicitis, 14;
for black eye, 27; not for
gout, 123; in mumps, 200.
( See also FOMENTATIONS,
114)
pregnancy, 191, 208, 218
PREGNANCY, HYGIENE OF, 227
prescriptions,, for colds, 34, 56;
for the skin, 37 ; for cholera
morbus, 48; for cough, 57.
(See also RECIPES)
prevention of disease, v-vi, 162,
192, 294
PREVENTION OF INSANITY^ 162
privates, itching of in diabetes,
8*0
privy vaults, 114
prostrate gland (see BLADDER),
28, 299
proud flesh, 296
prunes, 69, 230. ( See also DIETS )
prurigo, 166
pruritus, 167
Prussian blue, 223
Prussic acid, 222
psoriasis, 253, 278
PSORIASIS, 228
pulse, in pleurisy, 219
puncture, for lumbago, 178
pupil (see EYE DISEASES), 105
purgatives, for acne, 3 ; not for
appendicitis, 14; for head-
aches, 133, 187. (See also
DIETS )
PURGATIVES, 230
pus, 1, 3
pustule, 253
pyaemia, 287
pyridine, for asthma, 17
quack medicines, 200
quarantine, after fevers, 110
quassia, 201, 297
quinine, for eczema, 96; for tem-
perature, 110; for malaria,
182, 188, 201; for sore
throat, 264
quinine, ammoniated tincture of,
for influenza, 158
quinsy, 264
QUINSY, 231
rabies, 26
rash, 110, 232, 242, 276
RASHES ON THE SKIN, ARTIFICIAL,
231
RECIPES
consumption, 64
cough s; 70
tooth powder, 78
diarrhea, 82
disinfectant, 85
eczema powder, 96
eczema cold cream, 97
various emetics, QS
enema, 99
ophthalmia, 106
gout, 124
for barbers, 126, 127
scanty hair, 127
superfluous hairs, 129
flatulence, 152
water brash, 152
foul breath, 153
conium baths, 167
lead poisoning, 171
drunkenness, 175
measles, 185
neuralgia, 203, 204
neuritis, 206
sweating in consumption, 207
polypus in womb, 224
wind in the stomach, 230
purge in rheumatic gout, 230
anaemia, 230
purge in dropsy, 230
laxative for children, 231
rheumatism, 237
sore throat, 243
sciatica, 244
dandruff, 246
scurf, 246
painful menstruation, 192
stomach discomfort, 272
white leg, 313
whooping cough, 315
rectum, the, 217, 222, 223
red gum, 255
RED GUM, 233
REFUSE DISPOSAL, 234
retention of urine, 299
retina (see EYE DISEASES), 106
rhatany, for sore throat, 264
rheumatic fever, 134, 235, 287
330
INDEX
RHEUMATIC GOUT (RHEUMATIC
ARTHRITIS), 238
RHEUMATISM, 234
rheumatism, 198, 203, 228, 244,
274, 305
RHEUMATISM, CHRONIC, 236
rhubarb pills, in medicine chest,
187, 189
rhubarb and soda, in red gum,
234
rhubarb, 258
RICKETS, 239
rickets, 207
ringworm, 213, 257
RINGWORM. ( See SKIN DISEASES )
Robinson's Barley Water, for
baldness, 21
Rochelle salts, in fever, 110
rose cold, 130
roundworm, 317
rum, amount of alcohol in, 25
rupture, 302
RUPTURE. (See HERNIA)
Russian baths, 214
Saint Vitus's dance, 116, 240
sal hepatica, 69
salicin, for rheumatism, 235
salicylate of soda, for cramps, 7,
239
salicylate treatment, 235
salicylates, in fevers, 110
saline cathartics, 110
saline purges, in pregnancy, 227
SALISBURY TREATMENT, The, 240
Salisbury treatment for fat, 67
salol, for gallstones, 117, 187,
190
salt water baths, 214
salts, 223
sal volatile, in medicine chest,
187
sanitas fluid, 246
sarcoma, 292
sardines, 17, 64. (See also
DIETS)
scabs, 253
scales (see MEDICINE CHEST),
186
scalp diseases, 256
scarlatina, 253, 287
SCARLET FEVER (SCARLATINA),
242
scarlet fever, 194, 248, 263
SCIATICA, 243
sciatica, 234
scratching, 202
screens, 114
SCROFULA, 244
scrofula, 15, 216
scrotum, the, 146, 301, 308
SCURF, 245
scurfiness of scalp, 257
SCURVY, 246
sea air, 50
sea-kale, 80
SEASICKNESS, 247
secondary syphilis, 277
Seidlitz powders, 3; 230, 243
SELF-DOCTORING, 247
senna, in medicine chest, 20, 187,
218, 230, 317
senna mixture, for worms, 317
septicaemia, 196
serums, 221
SEWAGE DISPOSAL, 248
sexual excesses, 149, 298
sex hygiene, 151, 216
sexual power, loss of in diabetes,
80; varicocele, 301
shampoo, 128
shaving brushes, 126
shellfish, 64, 202. (See also
DIETS )
shingles, 143
shoes, 66
silver nitrate, for ophthalmia, 7,
z!3
SIMPLE LIFE, The, 250
SINS AGAINST HEALTH — HYGIENIC
MISDEMEANORS, 251
Six hundred and six ("606"),
280
skin, 192, 212
SKIN DISEASES, 252
SLEEP, HINTS ON OBTAINING, 259
sleeping draughts, 260
SLEEPLESSNESS, 260
sleeplessness, 169
SMALLPOX, 262
smallpox, 232, 300
smelling salts, 187
smoking, 252, 284
soap, dry, for feet, 29; eczema,
97; hang nails, 130
Social evil, the, 305
INDEX
331
sodium phosphate, 69; for gall-
stones, 117
sodium salicylate, 178
softening of the brain, 305
SORE THROAT, 263
sore throat in syphilis, 278
sorrel, 223
sour stomach, 2
Spanish onions, 69
SPECIALISTS, 264
SPECTACLES AND FAILING SIGHT,
265
SPINAL CURVATURE DEFORMED
BACK, 266
spiritus alkalinus saponis, in
scurf, 246
spleen, in rickets, 240
splint, 32
sponge, avoid in surgery, 296
SPRAINS, 268
SQUINTING, 268
STAMMERING, 269
Standard floor dressing, 49
starch, in diabetes, 80. (See
also DIETS)
starch poultice, 226
starchy foods, not for infants,
111. (See DIETS)
Stavesacre ointment, 166
stays (corsets), 227
steak, raw, for black eye, 27
steam heat, 137
sterile gauge, 29
sterno-mastoid muscle, 318
stethoscope, the, 135
stewed fruits, 69. (See DIETS)
still births, 305
stomach, the, 9, 213, 215
STOMACH DISEASES, 270
stomach pump, improvised, 98
STONE IN THE BLADDER, 272
stone, 298, 299
stoves, 138
stricture, 122, 299
stramonium, for asthma, 17
stroke, apoplectic, 12
STRONG, HOW TO BECOME, 273
struma, 245
STRUMS. (See SCROFULA)
STUN. (See CONCUSSION OF
BRAIN )
STYES, 274
suckling, too long, 198. (See
PREGNANCY)
sugar, 80. (See also DIETS)
sugar of lead, 223
sulphate of magnesia, for giddi-
ness, 119
sulphate of soda, for erythema,
256
sulphate of sodium, 230
sulphate of zinc, for sore throat,
264
sulphide of calcium, 31
sulphonal, 217
sulphur, as disinfectant, 86
sulphur bath, formula for, 23
sulphur ointment, 166
sulphuric acid, 223
SUMMER HOLIDAYS, 274
sunlight, 172
SUNSTROKE. (See HEATSTROKE)
suprarenal extract, 131
suprarenalin, for bleeding, 224
SWEATING. (See PERSPIRATION)
sweets, 236. (See DIETS)
swimming, 214
SYPHILIS (The "BAD DISORDER"),
275
syphilis, 9, 11, 118, 120, 162,
176, 189, 198, 203, 211, 216,
228, 239, 244, 305
syringes, for deafness, 74
syringing, for ears, 94
table-rapping, 181
tablespoonfuls, 186
taller., how to grow, 28*0
tamarinds, 230
tannic acid, for cracked nipples,
71
tannin, for sore throat, 263
tapeworm, 15, 316
tapioca, 69. (See DIETS)
tar ointment, 229
tar water, for colds, 34
TATTOO MARKS, 280
tea, 25, 236, 252. (See also
DIETS)
teaspoonfuls, 186
tea drinking, 201, 252
teeth, care of, 281
teething, 112, 207
teetotalism, 5, 6
temperance, 5
INDEX
temperature (see FEVER), 108;
in health, 220
tennis, 273
tertiary syphilis, 278
testicles, 142; in hydrocele, 146;
in mumps, 200; in syphilis,
278; one sufficient for pro-
creation, 302
TETANUS (LOCK-JAW), 283
thermic fever, 140
thermometer ( see MEDICINE
CHEST), 186, 188
Thompson, Sir Henry, 194, 305
thread worm, 317
throat, 242. (See also DIPHTHE-
RIA, SCARLET FEVER, SYPH-
ILIS)
thrombosis, 221
thymol ointment, for stings, 26
thyroid gland of sheep, for
goiter, 121
thyroid, 229
tight lacing, a cause of death,
75
tinned foods, 64
TOBACCO: OUGHT WE TO SMOKE
IT?, 284
tobacco, 204
toe-nail ingrowing, 285
TONGUE, DISEASES OF, 286
tongue, the, in scarlet fever,
242
tonsils, 242
tonsilitis, 264
TOO FAT (see CORPULENCE), 287
TOOTHACHE, 287
toothbrush, 282
trachoma, 217
TRADE DISEASES, 288
trade eruptions, 231
TRAINING, 289
treacle, 69, 218
triplex, 69
trusses, 142, 147
TUBERCLE, 291
tubercle bacilli, 112
tuberculosis, 162, 194, 196, 248,
267
tumor, 299
TUMOR, 292
Turkey figs, 69
Turkish baths, 214
turnips, in diabetes, 80
turnip poultice, 264
turpentine, for bleeding, 225; in
psoriasis, 229
TYPHOID FEVER, 292
typhoid fever, 112, 162, 194, 196,
209, 248, 287, 312
typhoid germs, 112
ulcer of the stomach, 272
ULCERS, 294
umbilical hernia, 140
Unna, Professor, 97
Unna's method for ulcers, 296
urethra, the, 121
uric acid, 240
URINARY TROUBLES, 298
urine, quantities per day, 168;
analysis in pregnancy, 227,
273
urotropin, for gallstones, 117
urticaria, 201
VACCINATION, 300
vaccination, 111
vaccine treatment for boils, 31;
for consumption, 63
vacuum cleaning, 49
valerianate of zinc, 133
VARICELLA, 301
varicocele, 142
VARICOCELE, 301
varicose ulcer, 297
VARICOSE ULCER, 303
varicose veins, 217
VARICOSE VEINS, 303
varioloid, 262
vaseline, 27, 229
vegetables, 69, 83, 236. (See
also DIET)
vegetarian diet, 229
VEGETARIANISM, 303
venereal disease, 263, 275
VENEREAL DISEASES, 305
VENTILATION, 306
ventral hernia, 141
veratrine ointment, 207
vermin, 171
vertigo (see GIDDINESS), 118
vesicle, 253
vinegar, for black eye, 27; not
for consumptives, 64
vinegar and water, for lice, 171
vomiting, 153, 223
INDEX
333
Walker-Gordon pasteurizer, 155
wall plaster, 223
WARTS, 308
WATER, 309
WATER ON THE BRAIN, 312
water brash, 152
WATER BRASH, 311
WATER CRESS, 312
water, for sleeplessness, 259
waterproof sheet, 186
WATER PURIFICATION, 311
weights, in medicine chest, 186
WEIR-MITCHELL TREATMENT, 312
Walsbach, 173
WENS, 312
Westcott, Martyn, remedy for
sleeplessness, 259
wheals, 253
whiskey, 25, 223, 227
white arsenic, 222
WHITE LEG, 312
white mixture, 230
white swelling, 313
•whitewash, 86, 223
whiting, 223
WHITLOW, 313
WHOOPING COUGH, 314
wholemeal bread, 69
wine, 216. (See also DIETS)
WINTER COUGH, 316
Winter, Doctor, 153
womb, diseases of in miscarriage,
198; polypus, 225
wood ashes, as disinfectant, 249
WORMS, 316
worms, 15, 207, 269
WRY-NECK, 318
X-ray, in diagnosis, 33; not a
cure for cancer, 38
yellow fever, 198
Yeo's method, whooping cough,
315
zinc lotion, for black eye, 27
zinc ointment, 144, 187, 202
zinc oxide, for trusses, 142
zinc sulphate, 187, 189, 200
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