Chapter X: Part 10

Nettle Rash.--This is an eruption on the skin, often coming suddenly and going off again, but sometimes of long standing. It resembles in appearance the sting of a nettle--hence the name. It is accompanied by an intolerable itching, and is a very sore trouble where it continues, or frequently recurs. Its cause is usually defective digestion. We should not depend on drugs for a cure, but treat first the whole spinal system. Rub the whole back smartly with vinegar. Wipe this off, and rub again with gentle pressure and warm olive oil. Put on the soapy cloth (_see_ Soap) with the lather very finely wrought (_see_ Lather), and free from excess of moisture. Over this lathered cloth put a good blanket Fomentation (_see_), changing it once or twice, so as to keep up the heat for half-an-hour. When all this is taken off, we should rub again with vinegar and oil, as at first. If the case is a sudden attack, we may soak the worst parts of the eruption with weak vinegar; but if a chronic one, the rash is better left untouched. The treatment to the spine may be continued daily. If the rash has been irritated into running, scabby scores by scratching, it may be cleaned with weak vinegar. A little cream of tartar or powdered rhubarb and carbonate of soda mixed in equal parts may be taken internally after meals--say about one-fourth of a teaspoonful in a little water. If this quantity exercise too great a cooling effect, smaller doses will produce very good results. Kneipp Linen Underwear will in many cases of such skin trouble give great relief.

Neuralgia.--This is severe pain in one part or other of the body, sometimes followed by swelling of the painful part, but frequently without much sign of anything wrong at that point. It is, as the name implies, a trouble affecting the _nerves_ which are connected with the painful part, and usually there is nothing whatever wrong where the pain is felt. Where, however, violent pain in the head or jaws results from chill, there is an altogether different trouble, though it is often called by the same name.

We have seen a man who had been in agony all night with pain all over his head. We took a large piece of flannel, about the size of a small blanket, rolled it up so as to get about a quart of boiling water poured into the heart of the roll. We kneaded the whole for a little time, to have the heat and moisture well diffused through the flannel. We now placed a large towel fourfold on the pillow under the patient's head, so that it could be brought as a good covering over the hot blanket when that was on. We opened up the blanket steaming hot and laid the head in the heart of it, bringing it carefully up all round, then brought the large towel over all, and tucked him tidily in about the shoulders. In less than two minutes he exclaimed, "I'm in Paradise!" The pain was all gone, and in its place was a positive sensation of delight. There was nothing here but a chilled skull to deal with, and as soon as it felt the heat and relaxed, the man was perfectly relieved. Then came the question as to how what had been got was to be secured, so that he might continue well. After he lay about three-quarters of an hour in this hot fomentation of the head, we took it off, and rubbed gently some warm olive oil into the roots of the hair, and all around the head and neck. We then gave all a good dry rubbing with a hard towel, and covered up his head carefully, and kept it covered for a day or two. He required no more treatment of any kind.

But when this treatment increases the pain, or fails altogether to remove it, we have a trouble which calls for the _very opposite treatment_. Then we have true neuralgia, which may be in any part of the body, and which is relieved by cooling the roots of the nerves which supply that part. For the face and jaws, cold must be applied to the back of the head, neck, or brain generally. For pains in arms, cold is to be applied to the upper, and for pain in legs to the lower part of the spine; for pain in the body, cool the whole length of the spine. The cooling is done by cloths moistened in cold water and well wrung out, pressed on gently over the part, and renewed as they grow warm. If the patient feels chilly, foment or bathe the feet and legs up to the knees during the process of cooling. This may require to be done for an hour. Finish by rubbing the parts cooled with hot vinegar and olive oil, and wiping off.

Even young people are exposed to a great deal of suffering from this source, and we feel sure that every one of these may be at once relieved and cured by the vigorous use of the cold compress. When the patient is warm in bed, the cold compress is one of the most delightful of applications; and the warm olive oil, to keep what has been got, make up a real blessing for the sufferer.

We have seen cases in which the cold compress has been applied up and down the spine, but not with that full effect which could be desired. Somehow it has not power enough in the hands applying it to reach the roots of the evil. The want in such a case is generally of a person sufficiently skilful in the use of the cold towel. There is a way of pressing it gently over all the parts under which the affected nerves lie, which secures the cooling of those roots very effectually. But such skill is not always at hand when needed. Well, mustard is spread over the surface of the cold towel, and the compress, thus increased in power, is placed all along the centre of the back. We find that very soon the pain begins to moderate, and ere long it has ceased. If it has to be applied more than once, cayenne is greatly to be preferred. The pepper does not hurt the skin, the mustard very soon does. A cold damp towel, folded at least four-ply, and placed properly, after being sprinkled well with cayenne, has an excellent effect.

In wild toothache, or bad nerve pain in the head, massage all over the head for a considerable time will often cure. We know cases in which agonising pain was thus removed years ago, and it has never returned. There was first rubbing, in a gentle soothing way, over the whole head. At a certain point, that began to lose its soothing influence. The cold towel was then wrapped round the head, and gently pressed. As soon as it warmed it was changed. This was done for perhaps three or four minutes, and the rubbing repeated. The whole was kept up for about an hour. All pain and uneasiness were then gone, and there was no return of either.

It will be seen that it is essential properly to distinguish between the pain requiring heat and that requiring cold for treatment. In any case it is safe first to try the heat. Failing relief with this, the cold may be tried. Sometimes the cooling of the head and spine succeeds in driving off several attacks, but eventually fails to relieve. If in such a case the cold is applied over the stomach, there is frequently almost instant relief. Where the attacks can be traced to indigestion, or come on always a certain time after a meal, this is the proper method from the first. Where a decayed tooth is the cause of pain, of course go to the dentist.

Night Coughs.--These frequently remain as the so-called dregs of some illness, and are found very persistent. They are also frequently very alarming, as they are thought to indicate some trouble in the lungs, and as immediate steps should be taken to check this, it is well to consult a good doctor. But, though coughing at night does of course accompany lung disease, it is by no means a chief symptom. Also, it is evident that the treatment applicable to bronchitis and other chest inflammations will often fail to relieve a night cough, because the night cough in question is due to nervous irritation or indigestion. Narcotics are useless and hurtful. Great relief is frequently found from inhaling the smoke of burning nitre or saltpetre. Blotting paper may be soaked in a solution of saltpetre, dried and lighted. Place the burning substance near enough the patient for him to inhale the smoke, but not so near as to interfere with _easy_ breathing, especially in cases where there is great weakness.

When patients are fairly strong the back should be rubbed with warm olive oil for ten minutes or so in the morning before getting out of bed. Then apply a cold towel, well wrung out, folded lengthwise along the spine, and over it a dry one. Let the patient lie on this, and renew it when heated, continuing altogether for fifteen minutes or so. Give another fifteen minutes' rubbing with the hot oil before dressing. If the patient feels chilly during the cooling, foment the feet and legs at the same time.

Nightmare.--In serious cases of this trouble, the patient awakes some time before he gains any power whatever to move, feeling held as in a vice. But in common instances, the attack is entirely during sleep, and accompanied by frightful dreams. A heavily-loaded stomach, pressing on the solar plexus of the nerves, is a very common cause. The burdened nerves partially cease action, and this gives rise to the trouble. Anything similarly affecting these organic nerves will cause it also; but if the stomach be at fault, reduce the food and let the last meal be light and not later than six o'clock. This followed by a cup of hot water, before going to bed, will work a perfect cure. When it is feared there may be an attack, _lying on the face_ in bed will often prevent it, even if the patient so lies for a very short time, and then turns on the side again.

When students, or school children, are over-driven (_see_ Children, various articles), nightmare, very persistent, is one of the symptoms. In such cases, there is _urgent need_ of rest, or most serious consequences may follow. Treat as recommended in Depression, and if any nervous troubles show themselves, treat as in various articles on nerve affections. Bad dreams, especially with children, are a sure sign of something wrong with the health, and should always lead to investigation, that their cause may be found and removed.

Night Pains.--If these are of the nature of _cramps_, which come on while lying in bed, the treatment is similar to that given above as morning treatment for Night Coughs, only the cooling must be continued for three-quarters of an hour or longer, fomenting the legs if any chilliness is felt. Cold towels may also be wrung out before going to bed, and put within reach. These may be applied when the cramps come on. They will usually relieve speedily.

Spasmodic asthma may be relieved by the same treatment. It often comes on when lying down, and cold towels applied as above directed will generally relieve. Fomentations must be given to the feet and legs, if any feeling of chill is felt.

Where there is _difficulty in breathing_ on lying down, usually the heart is at fault. Sometimes the heart is all right, and this hard breathing is nervous, caused by too sudden lying down. To lie down, propped up with pillows, which may be removed one by one, is often sufficient to cure it. The treatment in the morning as in Night Coughs will also greatly help.

Another set of night troubles are such as arise from unwise use of foods or drinks before going to bed. Tea taken at or near bedtime will often cause sleeplessness, and will be apt also to give spasmodic asthma; so will all indigestible foods. These overpower weary organs that need rest and sleep, and not food. Most people will do well to take their last meal four hours before retiring. Taking supper is a habit, and in many cases a very bad one.

Night Sweats.--This distressing symptom, which accompanies various illnesses, can in most cases be easily cured. The whole skin is to be sponged over at bedtime with CAYENNE LOTION (_see_). This is best done under the bed-clothes. Acetic acid, the effective essence in vinegar, has an astonishing power in healing and stimulating the skin. When it is assisted by cayenne its healing power is very great indeed. The nerves are stimulated, the too open pores closed, the skin cleansed, and the whole system invigorated by such a mixture, and as a result the night sweats disappear. Even where the case is hopeless, much suffering may be prevented by the use of this mixture. In conjunction with other treatment, its use may even turn the scale towards recovery.

Noise and Disease.--Perhaps nothing shows more the lack of human feeling in many people than the manner in which they inflict sore distress on the sick and dying by means of noise. Moreover, recovery is retarded, and has sometimes been wholly prevented, by nothing but a _noise_. It must be understood that talking, and also singing, which are delightful to some, become intolerable pain to the delicate and weak. They really are _worn out_ by them. And the wearing out is _real_: it is a destruction of nerve substance, when the nerve of the patient is already too feeble. Shutting doors violently, and the endless "house noises," must be avoided. Even a long, loud prayer at the bedside of the sick is utterly out of place. It may become necessary, in order to prevent such abuses, to exclude from the sick-room some who will be greatly offended thereby; but courage to defend a patient against well-meaning intruders is one essential qualification of a good nurse. Oil doors that _squeak_, fasten windows that _rattle_, but above all keep quiet the tongues that _clatter_. Let all whispering in the sick one's hearing be avoided. Speak quietly but distinctly, so that the patient may not think you are hiding anything from him. Wrap the coals in pieces of paper, so that they can be put on the fire by hand, avoiding the noise of shovel or tongs.

No one has a right to do what distresses others, and especially when they are sick. This principle should guide action. Acting thus will give untold rest and ease to the troubled.

Nostrils, The.--The disease called Polypus, affecting the mouth or nostril with growths which are usually removed by force, is one of those troubles curable by proper use of vinegar or weak acetic acid. The extraction of the Polypi is painful, and we have ourselves seen them so completely cured, that it is a pity not to make very widely known a method of avoiding extraction. A small glass syringe or a "nasal douche" (rubber is best) should be got, such as may easily be used for syringing the nostrils, or gums, if the growth be on these. Syringe the growths well with vinegar or ACETIC ACID (_see_), so diluted with water as only _very slightly_ to smart when it is applied. Use this slightly warm, and force it well up the nostril, so that it goes even back into the throat. This should be done for a considerable time: not so as to feel painful, but long enough to produce a decided effect, which remains on ceasing. Dry the nostrils with a little soft lint or clean rag, and force in a little fine almond oil. Do all this twice a day for a fortnight at least. In a bad case, a BRAN POULTICE (_see_) may be applied to the back of the head and neck, coming down over the spine between the shoulders.

Similar growths on other membranes, if accessible, may be cured by acid in a similar way.

This treatment is excellent for an ordinary cold in the head.

Nourishment.--Nothing is more required in healing than properly to _nourish_ the enfeebled body. In its commencement proper nourishment demands a proper mixture of food and saliva. In fever, if there be little or no saliva present, food requiring much saliva to fit it for digestion only injures. This is the case with so-called _rich_ foods, especially. Excessive thirst usually marks this deficiency of saliva. Always consider carefully the flow of saliva before feeding a patient in a weak state. Get the mouth to "water" somewhat before giving food. We have seen a cold cloth changed several times over the stomach start the flow of saliva almost miraculously, relieving the thirst, and prepare for nourishment which could not be taken before.

Going further into the matter, we see that very likely the stomach requires assistance to dispose of even well-salivated food. There may be a lack of gastric juice. In this case, frequent and small quantities of hot water supplied to the stomach will greatly help it. A wineglassful of hot water taken every ten minutes for two, four, or ten hours will be sufficient (_see_ Digestion; Indigestion). It is well to think ten times of the readiness of the system to digest, for once of the food to be taken. If the stomach be either burning hot or cold and chilly, let it be cooled or warmed, as the case may be. Either use cold towels or give hot water as above, as the case demands. When it is brought into something like a natural state of feeling, you may then give food. The hot water will often not only prepare the stomach, but will start the flow of saliva in the mouth, and that even when the cooling cloth has failed to do so.

A medical man will, at times, forbid water, however thirsty the patient may be. He is not unlikely to be labouring under a serious mistake. It may be just the want of water which is causing the very symptoms which he thinks to cure by withholding it. We never saw anything but suffering arise from withholding water from the thirsty.

Milk is a prime element in nourishing the weak. Mixed with its own bulk of boiling water, or even with twice as much, it is immensely more easy to digest. The simple water is of vast importance, and the milk mixed with boiling water is quite a different substance for digestion from the fresh pure milk. It is better to have a teaspoonful of milk and water really digested than a pint of rich milk overloading the stomach.

Many persons put lime-water into the milk to make it digestible. In doing so they put a difficulty in the way, in the shape of the lime. If one tries to wash his hands in "hard" water, he sees how unfit that water is to do the proper work of water in the blood and tissues of the body. Now, it is not difficult to meet this evil where the only water to be had has a great deal of lime in solution. Boiling this water makes it deposit much of its lime. If a very, very small bit of soda is mixed with it in the boiling, it lets down its lime more quickly and completely.

Alcoholic drinks--wine, porter, or ale--are often given as means of nourishment. They are hurtful in the extreme, as the spirit contained in them spoils, so far as it acts, both the saliva and the gastric juice. Rum and milk, sack whey, and other such preparations are equally bad, and have killed many a patient.

While suitable nourishment is necessary for the sick, great care should be taken to avoid giving too much. Often the amount of food the patient requires or can assimilate is _exceedingly small_. Injudicious attempts to "keep up the strength" by forcing down food that cannot be digested often destroy the little that remains, and remove the only hope of cure. (_See_ also Assimilation; Biscuits and Water; Blood; Bread; Buttermilk; Child-Bearing; Constipation; Diet; Drinks; Dyspepsia; Foods; Heartburn; Infants' Food.)

Nourishment, Cold in.--If a person is in fever, and is burning with internal heat, a little bit of ice, sucked in the mouth, gives great relief. The relief is got in this way: the melted ice, in the form of water, is little in bulk in proportion to the heat which is absorbed in melting it. To absorb the same heat by means of merely cold water, would imply a great amount of water, and an inconvenient filling of the stomach. The heat used up in melting the small bit of ice is great, and the amount of water exceedingly small. This gives benefit without inconvenience; hence, to suck a bit of ice is to be much preferred in such a case to taking a drink of cold water.

Within proper limits, beyond all question, cold is, in certain cases, essential to nourishment. For example, in a case of thirst such as we have noticed, the heat of the stomach extending to the mouth is drying up all the juices that should go to secure digestion and assimilation. The saliva is dried up, and the gastric juice equally so. Cold is applied to the pit of the stomach (not ice, but a moderate degree of repeated cold), and the result is, these juices begin to flow. Nourishment is the consequence, and very clearly, in such a case, it is the consequence of cold. In other words, it is the result of reducing the excessive internal heat, and leaving something like the proper degree behind.

The place which cold has in nourishing is, so to speak, negative--that is, it is useful only in reducing overheating. But when we remember how a frosty morning sharpens appetites and makes the cheeks glow with ruddy health, we see that such reduction of overheat is not infrequently required.

Nourishment, Heat in.--Heat is absorbed in building up the bodily tissues, and given off when they are disintegrated. To rightly understand this is of great importance in all treatment. When a living substance is growing, it demands heat. An illustration of this is the sun's heat causing what we call "growing weather." Again, where substances are breaking up, as in burning wood, heat is given out. In the stomach, a certain amount of heat is needed during digestion. If it is not given, indigestion ensues. To swallow ice, where the stomach has already insufficient heat, is then great folly. On the other hand, to take hot water is to do the very thing which gives the stomach what it needs, and so to relieve the indigestion. Many times, when the stomach simply stands still from lack of energy, it will move immediately on getting a glass of hot water to help it. Similarly, a little genial heat assists other failing organs. As we have shown how cold diminishes the excessive action of inflammation and fever, so we now point out that if you can find out what organs are feeble and acting insufficiently, and stimulate them with gentle heat, you are on the way to a cure.

Nursing Over.--Few vital processes are more remarkable than that by which food fitted for adults becomes in the mother's breast food fit for the little infant. In nursing it is well to remember that all food is not equally fit to be so changed. Well-boiled porridge, of either oat or wheaten meal, is probably as good as can be got. Malt liquor, though causing a large flow of milk, most seriously deteriorates its quality, and should be entirely avoided. But in this article we think chiefly of the mother, and of the necessary drain of blood and vital force which she bears in nursing. In most cases this drain is easily borne, in others the child is fed at the mother's expense. The supply of power, in such cases, is not equal to the loss of it in feeding the child, and the reserve in the mother's body is slowly used up. She becomes thin and pale, and her nervous system begins to suffer. When this is the case, either means must be used to increase her vital power, or nursing must at once be given up. Of course, where she may have had insufficient or unsuitable food, a change of diet may work a cure; but, as a rule, the drain of nursing will have to be stopped. To help her restoration, whether she ceases to nurse or not, use the following mixture and treatment: Boil a stick of best liquorice for half-an-hour in a quart of good soft water. Add one quarter of an ounce of camomile flowers, and boil for another half-hour. Keep the water up to the quantity by adding _boiling_ water as required. Strain the mixture, and give a dessertspoonful thrice a day before meals. If the dessertspoonful be found too much, a teaspoonful may be taken. The patient, if any heart trouble is felt, should go to bed early, and have the feet and legs fomented, and cold cloths pressed over the heart. This may be done for three or four nights. After this, each night for a fortnight the back should be well washed with SOAP (_see_) and hot water, and rubbed with vinegar and hot olive oil. Let each be dried off before the other is applied.

Oil, Olive.--A little oil only should be applied to the skin at once. Any such _smearing_ as dirties the clothes or bedclothes is quite unnecessary.

Since the first edition of these papers was published, the use of oil in the "massage" treatment has become so widely known that methods of rubbing are better understood, and its results more appreciated. Hence it is now easier to procure pure oil, and our readers should be able to get it cheaply at any first-class grocer's.

Opium.--_See_ Narcotics.

Oranges.--Some things regarding this useful fruit require to be noted by those using them in sickness. To eat the whole substance of an orange except the outer rind is to give the digestive system some hard work. We have known most serious stomach disturbance caused to the healthy by doing so. Some parts of the inner rind and partitions of the fruit act almost like poison. These should always be rejected. The juice is most beneficial. It is best given to patients by squeezing the orange into a glass, and _straining_ it through muslin into another glass. Add its own bulk of water and a teaspoonful of sugar, if liked. This may be taken warm or cold, and will do where even milk and water cannot be taken. (_See_ Drinks).

"Outstrikes."--These appear on the skin from various causes. In the case of infants, they often appear on the head and face during teething.

An experienced medical man is cautious in the extreme of quickly healing the distressed skin. He is afraid of "driving in" the eruption on the brain. Perhaps he refuses to do anything whatever to heal the head. From what we have seen, however, even in the worst cases, when head and face and neck were one great sore, we feel assured that there is no need why this distress should be continued at all. It may be, at least in many cases, safely and not very slowly healed.

The _whole_ skin of the infant must be brought into vigorous and healthy action. The head at first need not be touched; but the entire skin not affected should be sponged with warm vinegar, and then dried, rubbed with warm olive oil, and this wiped off carefully and gently, so far as it does not adhere to the skin under the soft dry towel. Quite enough remains to do all the good required; and if more is left on, a chilliness and nastiness are felt, which prejudice many against the use of it altogether.

It is well, in many cases, not to touch the child with _water_ or _soap_. The vinegar and oil cleanse the skin and do all that is required. Then vinegar very much diluted should be used warm to apply with a soft rag to the sores. Take a teaspoonful of vinegar in a breakfastcupful of warm water. If this causes the child to cry when applied, then dilute still further. Vinegar weak enough to cause hardly any feeling when it touches the sore, will _heal_; stronger vinegar will _injure_.

We have known a nurse try to heal an outstricken face by means of good vinegar at its full strength. She was instructed to use the vinegar very much diluted, but fancied it would heal faster if much stronger. She might just as well have fancied that it is better to put one's cold hands into the fire than to hold them at some distance when wishing to warm them. The child's face was made greatly worse, of course, and the cure abandoned. It is therefore necessary to urge that a strength of acid which secures only the most gentle sensation of smarting is essential to cure. The weak vinegar is first applied to the outer and less fiery parts of the outstrike. Try to heal from this inwards, by gradual advances from day to day. On the less affected parts the weak acid may be applied twice a day; on the sorer parts only when itching is so distressing as to demand it.

We have seen a child whose head, face, and neck were one distressing sore; we have taken the cloth with the diluted vinegar and daubed a square inch or so of the skin on which the fiery eruption was so full, and in less than two minutes we have seen the colour change into a healthy pink, and remain that colour when the olive oil was applied. The child's sores yielded gradually, till the whole illness was removed.

Sometimes such eruptions, in adults as well as children, arise from suppressed perspiration, or from the perspiration being of an acrid and irritating nature. It is sometimes apparently the result of the rubbing off of a little of the skin, or it comes on without any known accident. For a time it seems scarcely worth noticing, and is consequently neglected; but gradually it spreads on the surface and gives uneasiness, especially after the patient has been some time in bed. It goes on till a large portion of the skin from the knee to the ankle is reddened and roughened with a moist eruption. Now remedies of various kinds are tried, but the evil gets worse and worse. The person affected is often a struggling mother or widow, who has to keep on her feet all day in anxious toil, and neither gets very good food during the day nor proper rest during the night. Month after month goes past, and no relief comes. The positive agony which such persons suffer is incredible to those who have not experienced anything of the kind.

Here the great difficulty often is to get the patient the very chief condition for cure--that is, perfect rest for the affected limb. If this can in any way be secured, all else is comparatively plain sailing. But this is sometimes impossible: the children may not be in a position to be left, or the little business cannot be allowed to die, as it would in a month's time if not attended to, or some other hindrance is in the way. We must just do the best in the circumstances. We shall say that we are compelled to do without the rest, probably also without certain other things. Rest is very desirable, and so is a gentle rubbing all over the body, first with warm vinegar and then with olive oil, but there is perhaps no one capable of doing such a thing whose services can be secured. It is easy to "order" very useful processes, but among many who would not be exactly called "poor people" it is not easy to have the "order" carried out. We must often do without this double rubbing, and yet cure the diseased skin of the afflicted limb. Let the reader remember that it is no matter of choice that we dispense with the rest and the rubbing. If they are possible, by all means let them be taken advantage of to the utmost.

For treatment, unless distinct running sores are formed, bathe the limb with warm water and M'Clinton's Soap, which will remove all crusts, scabs, &c. Then apply zinc ointment. Do not bathe or poultice after the first time. All secretion can be removed by a piece of cotton wool dipped in warm olive oil. If deep running sores have formed, then we must have a water-tight box of rough deal in which the whole leg up to the knee can be bathed for an hour in hot water. We see no reason why it should cost much over a shilling to get this, and it would be a sore want if it could not be procured. It is so made that the leg and foot can rest easily in it while it is nearly full of hot water. It need not be wider than just to hold the limb easily. Some good-hearted joiner will put five small boards together so as to meet this want. We shall suppose that it is supplied. Now for a few cloths, such as will cover the diseased parts, about three-ply all round. Then for vinegar or acetic acid, so diluted with water that it will just cause a slight smarting when heated and touching the affected skin. It must not be so strong as to cause burning, nor so weak as to give no sense of its presence at all, but between these extremes. It can be tried when too weak, and vinegar or other acetic acid added till a gentle smarting is felt. The cloths are dipped in the diluted and heated vinegar, allowed to drip till no more falls off, and then laid tenderly all round the sore. A strip of dry cloth may then be wound round so as to keep these on, and the leg thus dressed placed in the bath. It should be kept there, with now and again a gentle movement, and the strong comfortable heat of the water kept up for an hour, unless the patient should feel sickness before that time. If this comes on, the water is too hot; but, instead of merely cooling it, the bath may cease for the time, and water not so hot may be tried on a second occasion. Whether the hour has been reached or not, good has been done. The leg is taken out of the hot water and gently dried--not rubbed, but dried without rubbing. Then as much cloth as will go twice round all is dipped in warm olive oil, and this is pressed out a little, so that it may not run. The oiled cloth is wrapped all round the limb. Some dry cloth is also wrapped round, and the first treatment is completed. This should be repeated every night before going to bed, for a week at least. It may be required for a fortnight if the case is bad and no rest at all can be had during the day. We should say the cure may fail for want of this rest, but this is not likely. In the morning as soon as convenient, the diseased skin should be soaked with a warm vinegar cloth, so that it shall smart just a little. It should then be dressed again with the warm olive oil. If at any time during the day or night it gets irritated and troublesome, this morning dressing may be repeated. It will not be very long before the one leg is as good as the other. The general health, too, of the patient will be sensibly improved.

It is scarcely necessary to point out that a similar treatment to this will cure "outstrikings" of the same sort in the arms and other parts of the body, as well as upon the legs. There is required only some such modification of the appliances as may meet the particular case. For example, we have seen the outstriking between the shoulders, so that it could not be reached by bathing, unless by appliances utterly out of the question in the circumstances. But dressing with hot vinegar cloths, allowing these to remain on for twenty minutes or so, and then dressing with warm olive oil, allowing this to remain for two or three hours, is quite possible to any one who is so affected; and this will usually be sufficient for a cure.

You have, perhaps, been cured temporarily more than once with arsenic, and the evil has returned worse and worse. In that case you may require all the more patience and the longer application of the above treatment; but, once cured in this way, you will not, so far as a good long experience enables us to judge, be likely to have any relapse. In very bad cases we have seen poultices of mashed potatoes made with buttermilk cleanse the diseased parts most effectually, and then the acid takes healing effect very speedily. In these cases ordinary medical treatment had utterly and hopelessly failed.

Pain, Severe, in Limbs.--This is often not due to any trouble in the joint itself, but to some disorder in the large nerves which have their roots in the lower part of the back. In the case of severe pains in the back of the leg, ankle, or knee, when a chill to the large limb nerves has been the cause, and has raised inflammation, the patient should be put warm in bed. Take two large towels, thoroughly wrung out of cold water. Fold one six or eight ply thick. Gently press this, avoiding cold shock to the patient, over the lower part of the back. When this towel gets hot, spread it out to cool, and apply the other. Continue this with each towel alternately, and when finished, or after an hour, rub the skin with warm olive oil and cover up with new flannel. Similar cold applications to the _upper_ part of the spine will cure such pains in the wrists. If the cold application intensifies or fails to relieve the pain, it is well to try the ARMCHAIR FOMENTATION (_see_).

Sometimes light pressure in the form of squeezing the muscles of the lower back is very useful. A very gentle pressure on the right parts is most pleasant to the sufferer. At first it simply relieves in some degree the weary feeling of the limbs. When it is at all well done, it soon raises a gentle heat, which slowly passes down the limbs, even to the very toes. This is just life itself communicated to the limb. But we must not confine our treatment to the spinal cord. The squeezing, or gentle pressure, must be carried down the limb; and when new life has been infused so far, it will be well to apply the pressure between the hands to the swollen and painful part. _See_ Massage.

Palpitation.--Ordinarily we are not aware of the beating of the heart, enormous as is the work it does; but in certain cases this beating becomes distressingly violent, especially on lying down flat or in ascending hills or stairs. The latter cases are the more serious, yet both kinds we have found quite curable. In treatment, fomentation must be avoided, and so must doses of the nerve-damaging drug, digitalis. The best way is to _cool the heart_, and thus relieve its superabundant action. But care must be taken that _cold be not applied to a feeble heart_, but only where action is evidently superabundant. It is usually easy to distinguish the two kinds of palpitation. The cooling can be done by pressing towels wrung out of cold water all over the heart region of the left side. Then rub the part so cooled with olive oil, dry off, and let the patient rest. This may be done in the morning before rising. In cases where the heart is feeble, the following treatment should be carried out instead of the cold towels:--Begin at bedtime with a cloth covered with creamy soap lather, and placed quite warm all over the body of the patient. It should be fastened on with the body of a dress, or thin vest, so that it may be kept close to the skin during the night. In the morning the back should be gently washed with hot vinegar, dried, and gently rubbed with warm olive oil. In those cases where the palpitation is only part of a general nervousness, which causes great distress and sleeplessness at night, the back should be lathered all over with soap (_see_ Lather and Soap) at bedtime, and the cloth with lather left on all night. In the morning, dry off, rub gently with hot vinegar, and then with hot olive oil. If the palpitation resists this treatment, then cold towels should be gently pressed to the _spine_, until the whole system is quieted. The back should then be rubbed with warm olive oil. So far as this restless action is concerned, this is all that is required for complete cure. We are writing thus in view of cases declared hopeless, but the patients are now in perfect health. We remember one at this moment in which the heart's action was so bad that the head could not be raised from the pillow, but the person was in a few weeks as well as any one could wish to be.

No one who has not seen how readily the surplus vital action passes out of the system when simple cold is rightly applied, can imagine how easily such cases are cured. It seems to us absurd to speak of "heart disease" in many of the cases in which people talk of it and set the case down as hopeless. It is absurd, simply because it is not heart disease, but only a little more action than is comfortable, and which is reduced in a few minutes by a cold towel. No doubt care and willingness to work a little are required, if one would relieve a sufferer in such a case as this, but that care and energy are sure to have the best of all rewards.

Palpitation often arises from indigestion, in which case _see_ Indigestion.

Palsy.--_See_ Paralysis.

Paralysis.--This serious trouble in slighter forms affects one side of the face, or even one eye only. More serious attacks involve the arm, and even an entire half of the body. It may come suddenly, or may creep slowly over the frame. In very old persons the case is usually hopeless, as life itself is fading. In earlier life, and in less serious cases, a cure is to be expected from proper treatment. Cupping, blistering, or opiates must be avoided, as all tending to reduce vital energy. Treatment must aim at increasing this, not reducing it. Take first the case of paralysis slightly affecting the face. When the patient is warm in bed, place a BRAN POULTICE (_see_) not too hot, on the back of the head and neck. Let the patient lie on it, first rubbing the neck and back of head with olive oil. Do this for an hour each day. At another time wash the back of head and neck with SOAP (_see_) and water, then with vinegar, and finally rub with hot olive oil. Keep the parts warm with good flannel always.

If the whole side be affected, foment strongly the whole spine, and treat it in a similar way to the back of the head, as prescribed above. We have known cases of comparatively speedy cure by this simple means. The heat simply vitalises the partially dead nerves. For paralysis of the lower limbs, the treatment is applied to the lower part of the spine principally, but also to the whole spinal system. There is no fear of injuring the patient in this treatment, and we know of many cases of most delightful cure secured by it. What is called the ARMCHAIR FOMENTATION (_see_) is an excellent method of dealing with paralysis of the lower limbs or any part of them, and may be resorted to if the above treatment fails. Care must be taken in any case to avoid a chill after fomenting, which might make matters worse than at first.

Perspiration.--By this term we mean not only the sensible perspiration which is felt as a distinct wetness on the skin during exertion or heat, or in some illnesses, but also, and chiefly, the constant insensible perspiration. This latter is far more important than the former. No one could live many hours without it, for by its means several pounds weight of waste is got rid of every day. Its importance we saw lately in the case of a child greatly swollen in dropsy. A flannel BANDAGE (_see_) wrung out of warm water, placed round the body, reduced this swelling completely, without any _sensible_ sign of excretion. A very gentle treatment, increasing this insensible sweating, will often cure without weakening, where violent perspiring medicines or treatment cause great weakness. A damp flannel bandage placed round the lower half of the body all night for a few nights will produce a remarkable increase of insensible perspiration, and in many case forms a good substitute for sweating drugs. Along with this the soapy lather may be used at bedtime all over the skin (_see_ Lather and Soap). We have seen a swelling of the hand, which made a medical man talk of amputation, cured by these means. Acetic acid, or white-wine vinegar, rubbed over the skin, produces a similar increase of insensible perspiration, and may be used without fear of injury. This done once a week will go far to reduce sensitiveness to cold. Indeed, the use of M'Clinton's soap and water, along with good acetic acid sponging once a week, will prevent many serious ills by securing a constant gentle excretion of hurtful waste through the stimulated skin.

Piles.--This very common trouble is caused by one or more of the veins in the lower bowel losing their elasticity, so as to protrude more or less from the anus, especially when the stress of a motion of the bowels forces them out. When no blood proceeds from this swollen vein, it is sometimes called a _blind_ pile. If blood comes, it is called a _bleeding_ one.

There are few illnesses more prevalent than this, few that seem to be less rationally dealt with, and yet few that are more easily cured.

It is distressing to think of what some poor people have to suffer from this disease, while they are still compelled to go on working, and even walking, in the most depressing sufferings. It is still more distressing to think of the painful operations which some have to undergo in having the relaxed portions of these veins cut out. Even when the piles have got to a very advanced stage it is not difficult to cure. It will generally be found that there is Constipation (_see_), so first of all, the bowels must be regulated. This may be done by means of liquorice and senna mixture, and strict attention to diet and exercise. Then the nerve action in the lower back is to be stimulated by applying to the back below the waist a large BRAN POULTICE (_see_). Rub the back after this with hot vinegar, dry, rub with olive oil, and wipe off the oil gently. Do this at bedtime. Into the bowels may be injected (with the fountain enema) first one or two injections of warm water; then an injection of warm water and white-wine vinegar. Be particular to have this mixture not too strong. A trial may be made with one tablespoonful of vinegar to a pint of water. If any pain is caused, inject simple lukewarm water and use the vinegar and water next time weaker. A very weak mixture has a wonderfully healing effect. After one pint of this mixture has been injected, an injection of cool water (but not cold) should follow. The vinegar should be so weak that it will cause no pain, properly speaking,--only just the slightest sensation of smarting. It will be possible to use the water colder and the vinegar stronger as you get on with the cure, but in both, your own feelings and good sense will guide you. This direction will suit other cases of internal syringing, in which membranes have got relaxed, and need to be braced with cold and weak acid. In all such troubles it should be remembered that the warm or tepid water is used at first only because the cold might be felt uncomfortable till the surfaces are prepared for it. It is the cold that does the good. After this, protruding piles may be gently manipulated by the fingers and pushed back into their place. During this the patient must press outwards, as if to discharge fæces from the bowel. The anus will then open and permit of the piles being pressed in. The injecting treatment may be given twice a day. If too painful, even bathing the parts with the vinegar and cold water has great healing power.

Let the sufferer, if at all possible, have _entire rest_ for a fortnight during the treatment, and lie down as much as convenient.

In mild cases, simply bathe the piles with cold water and press them back into their places. A daily wash of the anus with SOAP (_see_) and warm water, followed by a cold sponging, will do much to prevent piles.

Pimples on the Face.--_See_ Face.

Pleurisy.--The pleura is the tender double web, or membrane, which lines the inside of the chest on the one side and covers the lung, or rather encloses the lung with its other fold. Each of the two lungs has its pleura in which it works, and each side of the chest is lined by one side of this sensitive organ. The slender lining passes round the greater part of one whole side of the body with one-fold, and round the whole of the lung with the other. Let us suppose (which often takes place) that the front of the body is defended with what is called a "chest protector," but the sides and back are exposed to a chilling atmosphere. Part of the pleura, and that part which is farthest from the surface, is sheltered, but the greater part of it, and that nearest the surface, has no such protection. In the case especially of women this is the state of things. It seems as if people thought that they only need to keep a few inches of the breast warm--that is keeping the chest all right--though the sides just under the arms, and the back under the shoulder-blades, are of far greater importance. The throat is even muffled, and a "respirator" worn, so that fresh air is not allowed to get inside the lungs, while the pleura is exposed to chill at the back. The consequence of this is that vital action is so abstracted from the pleura that the tension of its small vessels is relaxed, and blood is admitted as it is not intended it should be.

Severe pain is felt on one or both sides, and round under the shoulder-blade. A painful cough arises, and great fever is produced. In such a case the treatment is on the same principle as that given in Lungs, Inflammation of the, which should be read. The inflamed part must be cooled by applying towels well wrung out of cold water round the side, applying a fresh one when that on the part becomes warm. If the pain does not leave in half-an-hour of this treatment, or if the patient be weak to begin with, or if any chilliness is felt, pack the feet and legs in a large hot fomentation. The cooling of the side may then go on safely until a curative effect is produced. We may not be able to give the theory of action of this treatment, but we know that in many cases it has perfectly and very speedily been successful, and that it leaves no bad results, as blistering and drugging are apt to do. We know of one case in which it took twenty-four hours' constant treatment to effect a cure. But it did effect it. Two friends took "shifts," and saw that all was thoroughly done. This will give an idea of the proper way to go about the matter.

Poisoning.--The following are the antidotes and remedies for some of the more common forms of poisoning.

Alcohol.--The patient is quite helpless, and there is usually a strong smell of alcohol. If the patient is intoxicated at the time give an emetic. If there is evident prostration from a long bout, keep him quiet and warm. Hot tea not too strong may be given.

Alkalis (_e.g._, ammonia, soda or potash).--Give dilute vinegar, followed by white of egg.

Arsenic.--Emetic, followed by white of egg. Keep very warm.

Carbolic.--Readily identified by smell of tar or carbolic. Wash mouth well with oil. Give an emetic.