Chapter XI: Part 11

Chloral.--Emetic; warm coffee, and even an enema of coffee. Artificial respiration (_see_ Drowning) may be necessary if breathing gets very low.

Chloroform or Ether (inhaled).--Fresh air. Pull tongue forward, and begin artificial respiration. If heart has stopped, strike chest two or three times over region of heart.

Chloroform or Ether (swallowed).--Emetic; enema of hot coffee; keep awake. If necessary, artificial respiration.

Copper.--Emetic, white of egg to follow.

Laudanum.--There is intense drowsiness and contraction of pupils of eye. Give an emetic and plenty of strong coffee. Walk patient up and down. On no account allow him to give way to the desire for sleep.

Mineral Acids and Glacial Acetic.--If any neutralising agent, such, _e.g._, as lime, chalk, soda, or calcined magnesia, is at hand, give it at once. Or give an emetic, followed by oil or milk and water.

Mushrooms.--Emetic; castor oil and enema.

Nicotine (tobacco).--Emetic; stimulate and keep warm; keep patient lying down.

Oxalic Acid.--Neutralise by chalk or lime water, but not by soda or any alkali. Give plenty of water; apply hot fomentations to loins.

Phosphorus.--Often caused by children sucking matches. There is a burning in the throat, and often vomiting. Give an emetic. After this some barley water or milk may be given.

Prussic Acid.--Almost hopeless. Emetic; artificial respiration.

Snake Bite.--Suck the wound, and apply a drop or two of strong ammonia to the bite. Ammonia may be also inhaled. Artificial respiration often necessary.

Strychnine.--Emetic; keep quiet and darken the room. Chloral or bromide of potassium may be given. If spasms threaten respiration, artificial respiration is necessary.

Tartar Emetic or other Antimonial Poisons.--If vomiting is not present, induce it by an emetic. Give doses of strong tea. Keep very warm by hot blankets.

Good domestic emetics are a teaspoonful of mustard in a tumblerful of water, or a tablespoonful of salt in the same quantity of water.

Poisoning, Blood.--Where this arises from a more or less putrid wound, what is aimed at in the treatment is to stop the manufacture of the poison in the wound by cleansing and healing it. This done, the other symptoms will subside. The wound should be carefully brushed with a camel's-hair brush and vinegar or dilute ACETIC ACID (_see_). This should be followed up with a poultice of boiled potatoes or turnips, beaten up with the same weak acid. Leave this on all night. Brush again well with the acid in the morning. In the matter of diet eat what will produce healthy blood, and by open-air exercise seek the same end. But the daily brushing and poulticing, or even twice daily if necessary, will work wonders on the poisoned wound. Care should be taken where any cut or wound has been made in the flesh, that it is carefully washed, and any dirt or foreign matter removed. Especially is this to be attended to if a rusty nail or penknife has inflicted the injury.

Polypus.--_See_ Nostrils.

Potato Poultice.--Potatoes boiled and beaten up with buttermilk, spread out in the usual way, make this useful poultice. Weak acid or vinegar may also be used instead of buttermilk. The potatoes should be boiled as recommended below.

Potato, The.--The proper cooking of this root is so important for health, owing to its universal use, that we here give directions which, if followed out, make potatoes a dish acceptable to even a very delicate stomach. Difficulty of digestion often arises from the potatoes not ripening properly, especially in cold soil, and since disease has become so widespread. Their unripe juice is positively poisonous, and when they are merely boiled is not completely expelled. The potatoes should be _steeped_ in warm water for an hour before they are boiled. The water in which they have been steeped will be greenish with bad juice, and must be thrown away, and the roots boiled in fresh water as usual, giving a thorough _drying_ after the boiling water is poured or strained off. So prepared, the potatoes make a very digestible dish.

Poultice, Bran.--_See_ Bran Poultice.

Prostration, Nervous.--The various articles under Nerves and Nervousness should be read. Here we give simply the treatment for failure in the digestion and bowel action. This arises from failure in the great nerve centres near the middle of the body. External treatment may be given as follows:--Dip a cotton cloth, four-ply thick, and large enough to cover the stomach and bowels, into cayenne Lotion (_see_), and lightly wring it. Lay this gently over the stomach and bowels. Over this an india-rubber bag of hot water is laid. Take care that the heat is not _too great_ or the mixture _too strong_. All must be just hot enough to be comfortable. This application may remain on for two hours, and then be repeated. The cayenne is greatly to be preferred to mustard for many reasons. Give the most easily assimilated food possible. A teaspoonful of gruel each half-hour, increased to a dessertspoonful, if the digestion will bear it, and preceded in all cases by a tablespoonful of hot water. This should be continued for twenty-four hours. Proceed very cautiously then to increase the nourishment, on the lines of Assimilation, Diet, Digestion, etc., giving oatmeal jelly, wheaten porridge, Saltcoats biscuits, and such diet, _gradually_ bringing the patient back to ordinary food.

Pulse, Counting the.--Most valuable information as to the nature and progress of disease is derivable from the pulse. Every one should learn to count it, and to distinguish the broad differences in the rapidity and nature of the beat. Such a distinction as that between BRONCHITIS and ASTHMA (_see these articles_), which require almost directly opposite treatment, is at once discerned from the pulse. In bronchitis it beats much too quickly, in asthma it is natural or too slow. In many cases we have seen asthma, which in cough and spit is very like bronchitis, treated as bronchitis, with bad results. These would all have been avoided if the pulse had been intelligently counted. Count the pulse, if at all possible, for _half-a-minute_. This multiplied by two will give the rate per minute, by which it is judged. If this rate per minute be above 100, there is a good deal of feverish or inflammatory action somewhere. If below 60, there is considerable lack of vital power, requiring rest and food to restore it.

In adults the rate for males is from 70 to 75 beats per minute, and for females 75 to 80. In infants the healthy pulse may be at birth 130 to 140 per minute, diminishing with increase of age. In the case of any child under five and over one year, if the pulse beats, say, 108 in the minute, it is too fast. The pulse of an adult may go down as low as 60 or even 50 per minute, but there is then something wrong.

Cooling the head is always safe with high pulse and feverishness, and often this alone will ward off disease and restore the healthy condition. If the pulse be low, fomentations to the feet should be applied, along with cooling action elsewhere, if necessary.

Purple Spots on Skin.--These arise first as small swellings. The swellings fall, and leave purple patches behind, which, if the trouble continues, become so numerous as to spoil the appearance of the skin. This especially occurs in children or young people, whose skin is exceptionally delicate. What has occurred is really much the same as the result of a blow or pinch, leaving the skin "black and blue." Some of the delicate vessels in the skin have given way, and dark blood collects on the spot.

The treatment is to sponge all over the body and limbs with warm CAYENNE "TEA" (_see_), only strong enough to cause a slight smarting. It should never cause pain. If it does so, the tea is too strong, and should be diluted with warm water. The soapy LATHER (_see_) may also be used, and olive oil may with advantage be rubbed on as well. Milk and boiling water should be given to the patient every two hours during the day, with a few drops of the cayenne "tea" in it. This is a true stimulant, and worth all the whiskey in the world. The object of the treatment is to nurse the patient's strength, and stimulate the skin. An intelligent study of many articles in this book will guide the thoughtful how to act.

Racks from Lifting.--_See_ Muscular Pains; Sprains.

Rash, or Hives.--Infants are often troubled with large red, angry-looking spots, breaking out over the body, and causing trouble by their heat and itching. These are commonly known as hives. If the water in which a child is washed be hard, it will sometimes cause the skin to inflame and become "hivey." If the soap has much soda in it, it will also cause this. What is called glycerine soap, and much of what is sold as peculiarly desirable, is utterly unsuitable for an infant's skin. Soda soap will cause serious outbreaks even worse than "hives," and will often not be suspected at all, as a cause.

Only M'Clinton's soap, which is made from the ash of plants, should be used on tender skins.

When the "hives" are not very troublesome, they are apt to be neglected; but this should not be, as in most cases this is the time they may be easily cured. The true element in cure is found in attention to the _skin_, as distinct from the stomach or blood. M'Clinton's soap (_see_ Soap) applied as fine creamy lather will _cure_ hives, and will never, we think, fail to do so. We know of a nurse plastering an infant's body with this soap, so that it was blistered. This is a totally wrong way of working. The right way is to work the soap and hot water as described in article Lather, and to apply it gently with the brush to the parts affected. After applying it with gentle rubbing for some time, and leaving some on the sore places, the infant will usually be soothed to sleep. Where over-cooling is feared, with a weak child, a little olive oil is gently rubbed on with the second coat of lather. In any case of itchiness the above treatment is almost certain to cure. Often the infant is suffering from too rich diet. (_See_ Children's Food.) In such cases, thinner milk, and a little fluid magnesia administered internally will effect a cure.

Remedy, Finding a.--It will sometimes occur, in the case of those endeavouring to cure on our system of treatment, that on applying what is thought to be the correct remedy, the trouble becomes worse. For example, where there are violent pains in the legs, a bran poultice is put on the lower back, and it is rubbed with oil. The pains become worse instead of better, and perhaps our whole system is abandoned and condemned. Now, all that is required here is to think and try until we find the _true_ remedy. If the pain in the legs is rheumatic, the hot poultice is all right. If it has been cramp, what is needed is a cold cloth on the lower back, instead of heat. In the example above given, what is needed is not to abandon the treatment, but to rectify the mistake, and apply cold instead of heat. In a great many forms of illness the same principle holds good. It is safer, where there is any doubt, to try heat first, but not in a very strong manner. If this gentle heating makes matters worse, gentle cooling may be tried. If the heat does good, it may be continued and increased, but never beyond the point of comfort. If the cold does good, it also may be continued on the same principle. What the patient feels relieving and comforting, is almost sure to be the cure for his trouble, if persisted in. _See_ Changing Treatment.

Rest.--In every person there is a certain amount only of force which is available for living. Also this force, or _vitality_, is _produced_ at only a certain definite rate. Where the rate is very low, only perfect quiet in bed for a time can bring down the expenditure far enough to enable the vital force gradually to accumulate, and a cure to be effected. Sitting, in such cases, may be serious overwork.

When rest is ordered, we are often met by the reply that it is impossible, as work cannot be given up. It is, however, often possible to get a great deal more than is taken. Every spare moment should be spent lying down in the most restful position. It is an important element in nursing to give such a comfortable recumbent position to a patient as constitutes perfect rest, and the nurse who does so, does a great deal to cure.

There is with many a prejudice against rest. It is somehow believed that it is a weakening thing to lie still in bed. "You must get up and take exercise, and enjoy the fresh air." This is a very good order for a person who has the strength for bracing exercise and fresh air. But this is absent in a person truly ill. That person's vital force is low, and the organs that supply it are feeble in their action. The fresh air may enter the chest, but the lungs are not in a state to make good use of it. "Exercise and fresh air" only consume the sufferer. On the contrary, rest and fresh air allow the weak vital force to recruit. The sort of exercise which is wanted in such cases is given by others in massaging or such squeezing the muscles as stimulates the organic nerves without using vital force in the sufferer. We have repeatedly succeeded in giving new strength by some weeks in bed, when it could not have been given otherwise. It is all very well for a young, strong person, only a very little out of sorts, to take a cold sitz-bath for ten minutes, and then a walk of a mile or two in mountain or seashore air. But this treatment would be death to one really ill. Perfect rest in bed, with an abundant supply of air through windows open night and day, would save the life which such "exercise and air" would send out of the world. It requires only a little common sense to see this. "He must be weakened by lying in bed so long." There is no such "must" in the nature of things. On the contrary, it may be absolutely necessary to his getting strength that he should lie still for weeks on end. You may, no doubt, give us instances in which a person was compelled to get up, and was thereby made to lose the delusion that he was not able to do so; but such instances in any number will not make one strong who is actually weak. Make sure first that vital energy is supplied, and when that supply rises to a certain degree it will not be easy to keep your patient in bed.

We would also note that true rest can never be had in a forced position. A limb bound down is not resting. The agonising desire to change its position shows this. True rest is found always in _freedom_ and _ease_. It may be necessary to put splints on a limb, but it must never be done where rest is aimed at. Usually there is a position of comfort to be found. Let the patient find and keep that. He will then have rest.

For instance, an exhausted patient is lying at full length in bed, but under the waist there is a hollow which is bridged over by the back. This part of the back calls for a considerable amount of force to hold it over this hollow, but we get a pillow inserted under the back, the muscles relax, and the patient rests. In packing and fomenting an inflamed knee, for example, it is usually better done in a slightly _bent_ position, which is more restful than a straight one. Employ two or three small pillows to prop it comfortably. And so on, in multitudes of cases, the earnest healer will be guided by the patient's own restful feelings. _See also_ Noise; Veins.

Restlessness.--In slight cases, where the patient simply cannot sleep for tossing about in bed, a cold towel placed along the spine, with a dry one above, will usually relieve, especially if changed and cooled several times as it grows warm. If heat be specially in the head, then that may be cooled in the same manner till peace settles down in the brain.

But we must go on to consider those cases of restlessness in which there is no extra heat in either spine or brain. Tea may have been taken in a rather strong infusion, or so late that its peculiar influence may be the cause of the restlessness. It is necessary to avoid this beverage if such restlessness is to be escaped; still it will generally be found that in cases in which tea has caused serious wakefulness and restless tossing, that there is more than the mere effect of the herb, and that superabundant heat is present also; then the application already pointed out will give relief.

Now take an instance in which it seems to be the mind that causes the tossing rather than the body. Preachers after earnest preaching are in many cases sleepless and restless too; so are almost all persons when currents of exciting thoughts have been set agoing in their minds. Then, no doubt, it is necessary to get at relief from the spiritual side, by means of thought fitted to calm down the excitement that has been raised. But it is never well to forget that in all such cases there is a material as well as a spiritual aspect of the experience. Many preachers take a sitz-bath before going to bed after a day of service, and find that somehow when sitting in the cool water the over-driven brain begins to slacken pace. If from any cause you are restless and cannot lie still, even after the head and spine have been cooled as we have described, it is well to take a sitz-bath in cold water for a few minutes. Dry and wrap up well, and you will be quiet after. Certain forms of coughing apparently cause the most serious restlessness. A warm poultice should be placed between the shoulders, and cold cloths pressed gently on the breast.

If there is extreme shrinking from everything in the least degree cold, then you need to go a step back in your treatment. A sponging of the most gentle kind, with CAYENNE LOTION (_see_) and water, all over the body, given very carefully for three or four days, once a day, will put away the shrinking to which we refer. This should be done with tepid water at first, but as the skin freshens it will be found comfortable to do it with cool water. In tender cases the poultice or hot bag will need to be comfortably warm, and not hot. The cool cloth must not be wintry cold, nor even at first summer cold. It is, however, necessary to get at the hot and irritating surfaces that are causing the cough, with more or less that is cooling. We may do this ever so gradually, but we must do it, if we would succeed in giving rest from the cough. In a strong person's case there is really no difficulty. It is an easy matter to put on cloth after cloth till the irritated part is reached and cooled. But when the patient is spent to all but a skeleton, and has restlessness from frequent coughing, it is a very different matter. Still to the very last the irritating heat may be kept down, and long sleeps given, when otherwise it would be hard work indeed to get through the last stages of illness. We write thus because we know it is possible to give precious relief even when it is out of the question to save life. It is possible to make even the last night on earth comparatively a peaceful one, instead of its being so very restless as it often is. This is to be done just by cooling the parts that irritate, and these only. Generally, heat may be required rather than cold, but at the part which is irritating and keeping up the coughing, there must be cooling. The kind and capable nurse who can carry out this cooling is beyond all price. Those only can understand this who have been delivered from an all but incessant cough by means that produce no reaction. It is also well to remember that we now and again give life by means of rest when we had no idea of giving more than temporary comfort. We have repeatedly had cases in which there seemed no hope of doing anything further than giving relief, but that relief has turned out to be the commencement of cure.

Rheumatic Fever.--_See_ Fever, Rheumatic.

Rheumatism.--We feel urged, in first considering this sore and very common trouble, to quote the old adage that "prevention is better than cure." Many people laugh at wettings, and some foolish young ones even seek exposure. We would impress upon all such that the effects of exposure may be, and often are, cumulative: that is, you may escape any direct effect for years, and then find your recklessness end in rheumatism for the rest of your life. Let care, then, be taken to avoid wettings, unless these lie in the way of duty. Change clothes as speedily as possible when they are wet, and encourage the skin to all healthy action by proper care and exercise. Even with the skin all right, a wise man will not act in a foolhardy way, but if he must get wet and chilled, he will probably not suffer very much.

We would strongly recommend the use of Kneipp linen underclothing (_see_ Underwear). It powerfully stimulates the skin, and, by conducting away the perspiration, prevents chills. We have known many who suffered severely from rheumatism being quite cured by the use of this material. It is as comfortable as it is hygienic.

But supposing the rheumatism does come on, it may be treated, in mild cases, by gradual and steady moist heating. For the method of applying this, _see_ Fomentation and Armchair Fomentation. If the case is comparatively a fresh one, there will be need for no more than this fomenting, repeated several times at intervals of two to four hours.

Where the nervous system has been seriously affected, the fomentation must be gradual, and the moist heat gently insinuated into the parts affected. Where narcotics have been used, these _must_ be given up if a cure is to be hoped for.

In certain chronic cases, which are very largely nervous in their origin, a powerful soothing influence is required. This is secured by the use of soap lather (_see_ Lather; Soap). Cover the back and head, piece by piece, with this, rubbing it on and off four or five times. Cover the fifth application with a soft cloth, and leave it on for the day in the morning, and for the night in the evening, the patient being in bed. Hot olive oil or occasionally cold drawn oil of mustard is gently rubbed on the stiff parts; when this cloth is removed, gently knead or squeeze the oil into the muscles. If during the lathering the patient feels too cold, a little olive oil should be mixed with the lather. A change to a dry climate from a damp one sometimes does a patient good, but when that is not possible, great relief, and in many cases cure, is to be had by this treatment.

Ringworm.--This distressing and most infectious trouble is due to a small parasite. Where that settles in the skin, a reddish _ring_ soon appears, and gradually widens, leaving a leprous white patch of skin within it. Care should be taken at once to cure this, as, if it spreads widely, serious results follow. Fortunately it is slow in growth, and can easily be checked and cured. The method of cure is to soak the rings well with vinegar or weak acetic acid. Of strong acid use three tablespoonfuls to a quart of water. By even the first good soaking with this, the developed parasites are killed, but the eggs are not. These hatch out by degrees, so that renewed soaking and "dabbing" with the acid and a soft cloth are required. Each application may be continued for fifteen minutes. If the hair, as on the head, interferes, it may be cut closely, but need not be shaved. In a bad case the daily soaking with acid may not be sufficient. Then a poultice of potatoes and buttermilk (_see_ Buttermilk Poultice) may be applied first, and afterwards the weak acid. Secure that there be felt, before the close of each application, a _slight smarting_, to show that the acid has really soaked in. It is not difficult to guard against its spreading in a family or school. All that need be done is, once a week or so, to see that the whole skin of those exposed to infection, head included, is freshened by a wash all over with vinegar, and then protected with a gentle rub of olive oil. If this is done we should have little fear of contagion. Such a weekly freshening would ward off other evils as well as this one.

Rose.--_See_ Erysipelas.

Rupture.--The abdomen is formed of a series of _rings_ containing the bowels, and holding them in proper position. If the muscles and tissues holding these rings _yield_ so as to permit them to separate a little, what is called "rupture" takes place. It may be caused by violent muscular efforts, heavy weight lifting, jumping from a height, etc., etc. The rings are not broken, but only displaced, and especially with young persons, the "rupture" can soon be brought all right, but even with the aged, in all cases it may be mitigated, if not cured, by proper treatment.

The first thing is to replace any part of the bowels which may have escaped through the opening of the rings. Lay the patient flat on his back. He must not be treated in any other attitude. Then rub the swelling gently _downwards_. It _must not_ be rubbed upwards, or it will be made worse. This rubbing will soon bring the bowel into its proper place. Give some time and kindly care to this treatment, which is very important. Then get a surgical instrument maker to fit a proper truss. See that this really fits. If it hurts in any way when first put on, it does not fit well enough. Avoid for a considerable time any effort likely to strain the part. Take light and easily digested food; give up all alcoholic drinks and the use of tobacco.

Saliva.--_See_ Digestion; Nourishment.

Saltrome.--The disease known by this name in Canada breaks out in the hands, especially on the palms. The skin cracks open and refuses to heal up. Sometimes, if the hands do heal, the trouble comes out on other parts. It is probably due to the long-continued use of bad and strongly irritating soap in washing the hands and face, conjoined, in Canada, with the great dryness of the air.

The treatment for prevention is the regular use of M'Clinton's soap (_see_ Soap). Where the trouble has developed, the hands and face, if involved, should be packed in cloths soaked in buttermilk. Then over the packing we should foment with large hot flannel cloths (_see_ Fomentation). Renew, if necessary, the buttermilk packing, and after a thorough fomenting, leave the buttermilk cloths on all night, with dry ones on top. Then gently anoint with OLIVE OIL (_see_). This treatment, with some rest and the use of the above-mentioned soap, should soon effect a cure.

Santolina.--This plant is the _Chama Cyparissos_, or ground cypress. It is of the greatest value as a remedy for worms in the bowels (not tapeworm), and also acts as a stomach tonic of no small value. It is cut at the end of the season, made up in small bunches of six stalks or so, and hung up to dry. When required for worms, boil one of these bunches in three teacupfuls of water until it is reduced to two teacupfuls. Half-a-teacupful of this is given to a _child_ with worms, each morning before any food, for four days. In the evening of the fourth day an ordinary dose of liquorice powder is given to move the bowels. For a _grown-up person_ the quantity is a full teacupful each morning. If a child picks at his nostrils, or grinds his teeth while sleeping, the santolina will cure him, even if no other symptom of worms is noticed. It may with advantage be used in all cases where there is indication of the failure of the mucous membrane of the stomach and bowels.

Where required as a stomach tonic, santolina should be infused with boiling water, as tea is. About half-an-ounce of the dried herb is infused, and a small teacupful taken as hot as can easily be drunk about an hour after each meal. Half the quantity will do for young people under fourteen. Do this six days in succession. Then take none for six days. Then again take it for three days. This treatment may be repeated after a week.

Sciatica.--This is a severe pain in the lower back, shooting sharply down the back and calf of the leg. It arises from inflammation of the large nerve which supplies these parts of the leg with power. Most commonly it is caused by exposure of the hips or lower back to cold and damp, as by sitting on the grass or a stone seat.

The cure for it, in the earlier stages, is the application of the ARMCHAIR FOMENTATION (_see_). This may be applied for an hour, and renewed immediately for another hour if the patient can stand it, and then rest given for two hours, and the fomentation applied for two hours again, or at least for one, taking care to rub with oil and wrap up in comfortable flannels between and after the treatment. This may be done again on the second day. The fomentation may then be given once a day until the pain is removed.

Be quite sure that no trifling application will succeed with such a disease as this. It will not do to use less heat than will go through and through the haunches of the patient; and that amount of heat is not very small. You must have a good soft blanket if possible, your water must be boiling hot, and you must have plenty of it.

If the hot treatment causes increase of pain, this indicates that a stage has arrived in which _cold_ is to be applied instead of heat to the lower back, to subdue nerve irritation. Before or after this stage, cold application will do harm, so it is well always to try heat first, as in the great majority of cases that is what is required. When cold is applied, the patient _must be warm_, and if necessary the feet and legs should be fomented.

To keep what is got either by the soothing influence of cold or by the stimulating power of heat, it is good to rub with hot olive oil, and to dry this off well in finishing, and also to wear a good broad band of new flannel round the lower part of the body. This band ought not to be so tight as to confine the perspiration. _See_ Changing Treatment; Remedy, Finding a.

Scrofula.--The treatment under Glands, Swollen, should be followed. But besides, the whole membranous system of the glands must be stimulated. Daily rubbing briskly over the whole body with the cold-drawn oil of mustard for a quarter-of-an-hour will have this effect, and even by itself may cure.

Good, easily digested food must be taken (_see_ Abscess; Assimilation; Diet; Nourishment), and overwork avoided. Continued work, as with a child at school, may quite prevent a cure, while if the work ceases, the cure will be rapid. It is better to have health and holidays than sickness and school. Where there is a family tendency to scrofula, care should be taken to treat promptly any case of glandular swelling.

Scurvy.--Is a disease springing from disordered digestion, and caused sometimes by partial starvation, but more frequently by a deficiency of vegetable acid in the food. It often manifests itself in skin eruptions, the skin peeling off in scales. To ward off or cure this disease, fresh food should always be used, and salted or tinned foods avoided. Especially should abundance of green vegetables and fruit be used, and where such cannot be obtained in sufficient quantity, lemon juice is valuable. Too much exposure, fatigue, and impure air, aided by a wrong diet, are the causes that formerly made scurvy so prevalent in the navy. It has almost disappeared since a regular allowance of vegetable acid has been served out.

Seamill Sanatorium and Hydropathic.--Very soon after the appearance of these "Papers on Health," the need was felt for some establishment where the treatment expounded here could be given by trained attendants under Dr. Kirk's personal supervision. The site was fixed on the Ayrshire coast, in the parish of West Kilbride. This region was chosen because special advantages of soil, climate, and scenery recommended it. The soil along the shore is almost pure sand, and dries rapidly after rain. The climate is extremely mild, high hills sheltering the whole region from north and east winds, and the Arran mountains, intervening some sixteen miles over the sea to the west, collect much of the rain. Hence, although near some very rainy districts, the Seamill neighbourhood is peculiarly sunny and dry. In winter the sun reflected from the water, and beating on the face of the hills, makes the shore climate most genial, and when other places only a few miles away are encased in ice, flowers will be blooming in the gardens at Seamill. In the very best part of this district a villa was secured in 1880 by some gentlemen interested in the treatment, with grounds abutting on the sand of the seashore.

Here treatment was carried on with great success, until it became evident that larger premises were needed. In 1882 Mr. James Newbigging was secured by Dr. Kirk as manager and head-bathman, and worked under Dr. Kirk until the latter's death in 1886.

Mr. Newbigging then bought the establishment. Since that time, it has constantly increased in size and efficiency until it now accommodates close on a hundred patients.

Very many have come to Seamill almost or quite hopeless, and have left it with health restored and vigour renewed.

It ought to be mentioned here that in all his dealings with this establishment Dr. Kirk never had any pecuniary interest in it, always giving his services free. Nor has the writer, or any of Dr. Kirk's family, any pecuniary connection with the place. All information as to the establishment may be had by writing to the Proprietor or Manager, Seamill Sanatorium, West Kilbride, Scotland.

Sea-Sickness.--The cause of this is a nervous derangement of the internal organs, by which the bile passes into the stomach instead of, as it normally does, passing down into the intestines. A tight bandage round the middle of the body, so as to oppose resistance to this, will help _so far_. When the sickness has come on, a teacupful of hot water, at intervals, will very largely mitigate, and will often cure it. Even half a teacupful or a tablespoonful will prove sufficient in many cases where the teacupful cannot be taken. If this small quantity of hot water be taken every ten minutes, the worst effects of sea-sickness will not be felt, and far more relief obtained than most people will believe until they have tried it.

Sensitiveness.--When the nervous system is in a certain state, all impressions on it are exaggerated, and the patient suffers from light sounds, and various irritations, far more than is usual or healthy. This state makes treatment difficult, because either cold towel or hot flannel distresses the sufferer, and by this does more harm than good. Narcotics only do harm, without any good, and leave the patient worse.

The nervous system may in such cases be soothed by soaping the back with soap lather (_see_ Lather; Soap). The lather is to be blood heat, and very soft and creamy. Spread it all over a soft cloth as large as the back (having first warmed the cloth), and then place it gently on the back, lather side next the skin. Let this be done at bedtime. Fasten the cloth on the back with a bodice that will fasten closely, and let the patient sleep on it. Wash off in the morning with warm vinegar and water half-and-half. Rub with oil and dry off. Let the patient take twice a-day, for eight days, a teaspoonful of well-boiled liquorice and a tablespoonful of hot water. This treatment will usually abate the sensitiveness in a week or so, and bring the patient within reach of other remedies. For example, it will, after a week or so, even in very trying cases, be possible to foment the feet and legs once a day, and rub them with warm olive oil. It will even be possible and well to foment with a hot blanket across the haunches, and in this way to bring on comparatively strong health. Change of air and scene will then be desirable: it is highly refreshing to one who is in the way of recovering, though only harassing to one who is feeling despondent and increasingly ill. We generally, when asked if a "change" would not be good in such cases, reply, "Yes, if once you have got health enough to enjoy it." When that has been fairly secured, stronger measures may be used with advantage. We feel much sympathy with those who suffer from sensitiveness, as so many do, and earnestly pray that these remarks may be blessed to such sufferers.

Shampooing.--_See_ Head, Soaping.

Shingles.--Though not often fatal, this illness gives serious trouble. Its outstanding feature is a rash which comes out as a more or less regular belt round the body, or over one shoulder. The rash forms, if allowed to go on, into blackish scabs, and is accompanied in some instances by severe pains shooting through the body. It arises from a failure of the digestive system, therefore the stomach must be as little taxed as possible. Let hot water be sipped in teaspoonfuls for half-an-hour at a time, several times a day. For external treatment, wring a small sheet out of cold water and vinegar, and pack the whole trunk of the patient in this for half-an-hour. Do not use olive oil. The vinegar packing may be renewed in an hour, and as often as the patient feels it agreeable. The mixture of vinegar and water must be weak enough not to be painful on the skin. If the pains in the body persist, then cold cloths may be applied, not very large at first, to the spine, while the patient is warm in bed. Should the feet be cold, this cooling of the spine must not be done until they are wrapped in a hot fomentation up to the knees. If the scabby eruption is very obstinate, the SOAPY BLANKET (_see_) applied daily for two or three days should clear it away. Wheaten porridge, gruel, and milk diet is best. A drink may be made of hot water and lemon juice, with five or six drops of tincture of cayenne added to a tumblerful, and sweetened to taste. _See_ Drinks.

Shivering.--This is often a trivial matter, but sometimes it is a symptom of a serious chill. It may be only the effect of a thought, or of some mental shock, but in any case it is a nervous disturbance, and failure of energy, causing us to lose control of the nerves which produce the shivering movements.

For ordinary shivering, the result of cold, treat as in Cold, Taking. For cases where the vital action has evidently become very low, foment the patient as directed in Angina Pectoris.

If pain in some part, as in a nursing breast or tender lung, indicates inflammatory action there, cold towels may be applied to that part while this fomentation is on. Renew the cold cloth as often as the patient feels it agreeable, keeping up the heat of the fomentation all the time. Increase the size of the cold cloth if the patient finds this pleasant; stop if it becomes unpleasant. Many serious troubles are checked in the first stage by treatment on these simple lines.

Sick Headache.--_See_ Headache.

Sitting (or Sitz) Bath.--This bath, in whatever form administered, is essentially a sitting in cold water with the feet out. The feet, in fact, are better to be warmly covered up while the patient sits in the bath. The most important thing to be considered in all such baths is the degree of vitality possessed by the patient. If he has much vitality, then the bath may be deep and longer continued--as long as even forty minutes. If the vitality be low, the bath must be brief and very shallow--it may be even necessary to make it as short as _one minute_, or even less. In some cases, as a beginning, a mere dip is all that is required. This leaves a large discretion to the nurse, and is a matter which common sense should be able to decide. To try a short bath first, and repeat it several times, rather than to give one long one, is the safest plan. It will soon be found out how much the patient can bear. If the vitality be so low as to make the simple sitz-bath a danger, the feet may be immersed, for the one or two minutes of the bath, in a small bath of hot water, and the patient well wrapped up all over in warm blankets.

In some cases it is necessary to _pour_ cold water on relaxed organs, which, especially with females, will sometimes not be braced up by mere immersion. But such pouring must be done with caution. Half-a-minute of it is _a long time_; one quarter-of-a-minute or less will usually be enough, even in important cases. If longer applications have only done harm, then let our friends try the one-minute bath, or the quarter-minute stream of water. In many cases we have known this make all right. Such short baths may be taken twice or thrice a day.

Skin, Care of.--Among the vast majority of people air and water far too seldom touch the skin. Want of water makes it unclean, and want of water and air make it slow in reaction. Now, a healthy skin is of the utmost value when one is attacked by disease. It can regulate the temperature of the various organs, and the application of heat or cold to it will cause a reaction at once. Much of our treatment as given in this book is directed towards stimulating the action of the skin. It is obvious that in health as in disease the skin can and does so act on the internal organs.

It should be the aim of everyone that this most important part of the body should receive careful attention by a strict watch on the diet, by cleanliness, tonic water baths (cold, tepid, shower, as may be found to suit), and by tonic air baths. Light clothing and porous underwear will also be found of use. We have already drawn attention to the value of Kneipp linen as the most suitable form of underwear (_see_).

Skin, A Wintry.--Something like an epidemic of skin trouble is often experienced in cold, wintry weather. First, the skin becomes dry and hard. A moist and sticky exudation replaces the ordinary sweat, and great irritation is felt when the skin is exposed to the air. If the sticky exudation be completely rubbed off, this irritation ceases. In this, and in the absence of inflammation, "wintry skin" differs entirely from eczema. The remedy is to rub all over every night for three or four nights with the CAYENNE LOTION (_see_). If this does not effectually cure, lather all over with soap and olive oil (_see_ Lather; Soap), before rubbing with the cayenne lotion. If the treatment of the whole skin at once is felt to be too severe, it may be cured by taking it in parts.

Skin, Creeping.--A sensation sometimes very much annoys patients, which they describe as like thousands of small creatures creeping over the skin. It most commonly arises from defective working of the pores. A kindred trouble may be noticed along with this creeping. It is as if a stream of cold water were passing down the back. That causes great discomfort in many cases.

The cure is sponging frequently with weak ACETIC ACID (_see_) or even good buttermilk. The skin being in such cases very sensitive, it is well to treat it bit by bit, a small part at a time. Take one limb, then another, then part of the back, and then another part. Besides this sponging with acid, and before it is done, the skin should be gently covered with lather (_see_ Lather; Soap). If this treatment is not successful, a little olive oil, with cayenne lotion, may be mixed with the soapy lather, and will make its effect more powerful. This creepy feeling is sometimes the result of cold, and some extra clothing may remove it. _See_ Underwear.

Sleep.--No greater mistake could be made than to curtail the hours of sleep. Eight hours should be taken as a minimum, and any weak person should take ten hours. More and better work can be done by a person who takes fully eight hours' sleep than by one who tries to do with less.

Sometimes strong tea or coffee is taken to drive away sleep, and so the nervous system is injured and sleep will not come when it is desired. Tea or coffee should never be taken except _very_ weak, and the person who accustoms himself to this will very soon come greatly to prefer it.

Sleeplessness.--In search of sleep men do many things both dangerous and foolish--sometimes even fatal. Sleeplessness arises in so many ways and from so many causes, that it is often hard for the patient to find a cure, and he will try anything in desperation. A little thought should prevent this state of mind. For instance, we have a man who tries to get sleep by fatiguing himself by long walks in the open air or hard physical work of some kind, but he only grows worse. Now, a little thought will show that sleep requires a certain amount of brain energy. If the supply be below this amount, the brain is _too tired_ to sleep. Violent exercise of any kind will only make matters worse. So "keeping people awake" all day is tried, to make them sleep at night. It fails from the same reason--that it _reduces_ brain power. All narcotics in the end fail similarly. There comes a time when they have so reduced brain power, that even an enormous dose fails to give sleep, and the patient comes dangerously near poisoning himself--sometimes, indeed, does so outright. In all these cases, that which has worn down the brain _must be given up_ as a first condition of cure. Whether brain work, over-excitement and dissipation, alcohol or tobacco, the cause must be removed, and rest taken in the open air, or in well ventilated rooms.

This done, we come to treatment. Soaping the head (_see_ Head, Soaping), or even the application of towels wrung out of cold water, will often, when the cause has been removed, do all that is needed to give sleep. These remedies, especially the first, should be at once applied, if the sleeplessness is accompanied, as is usual, with _heat in the head_. Even where the fevered head is connected with indigestion, the stomach will be powerfully helped by a good soaping of the head at bedtime. If, on the contrary, the head is cold, then warm fomentations to it will be the proper treatment. Perhaps the very best guide will be to aim at what will make both head and feet perfectly comfortable, and _both_ of natural heat. If cold, the feet must be bathed or fomented, and the legs also up to the knees. Sometimes the pouring of warm water in a _douche_ over the head will act perfectly, instead of the fomentation; but pouring _cold_ water must be avoided, or only very cautiously resorted to (_see_ Sitz-Bath and Restlessness).

Sometimes sleeplessness proceeds from the use of bad drinking water, through its effect on the stomach and bowels. In this case, of course, the first thing is to see that no bad water is drunk. People cannot be too careful about a water supply. Usually boiling for half-an-hour renders water safe enough, but this is not always the case. Care must then be taken to see that water from any corrupted source is not used. When it is given up, treatment as above may be applied.

If the sleeplessness be caused by a nasty tickling cough, put a BRAN POULTICE (_see_), or similar FOMENTATION (_see_) on the back _behind_ where the cough catches. Then change cold towels _in front_ over the same place. Soap the head, and sleep will probably soon come.

Where palpitation of the heart causes sleeplessness, change cold towels over the heart, fomenting the feet if necessary, and the palpitation will usually soon yield. _See_ Brain; Children's Sleep; Exercise; Head; Rest.

Smallpox.--If an epidemic prevails in the neighbourhood, or a case occurs in the house, after _due and carefully performed_ vaccination of the family, the important matter to regard is _cleanliness_. Frequent and thorough washing and changing of all the clothes worn next the skin will do much to prevent possible infection. If the clothes are often changed, then, and well washed, and the skin gets a daily washing with soap and is sponged with hot vinegar, there is little danger of infection during an epidemic of smallpox, or even when nursing the disease. Acetic acid, or white wine vinegar, is even a more powerful cleansing agent than carbolic acid, and has the advantage of being non-poisonous.

It is important in treatment to attack the disease early. We have known an attack completely defeated, and the patient cured, by a wet-sheet pack administered at the right time. The early symptoms are a great weariness and chilliness. In this _cold_ stage, half-a-teaspoonful of cream of tartar, in two tablespoonfuls of hot water, should be given every half-hour. Also (and this is important) wrap the feet and legs up over the knees in a large hot FOMENTATION (_see_). The head also may be packed in hot cloths. If the fever does not rise, the applications may continue. If the fever does come on, _cold_ cloths must be persistently changed on the head. This we have known _reduces_ the bodily temperature two degrees in half-an-hour, when if left alone it would probably have _risen_ two degrees. The whole body may be packed in a damp sheet, covered with dry blanket, and this continued cooling of the head still proceeded with.

When the eruption has appeared, and the violent itching set in, the eruption must be persistently _soaked_ with weak ACETIC ACID (_see_), or good white wine vinegar and water. In this soaking, avoid giving the patient pain by too strong acid. The necessary healing power will be found in such a mixture as will only cause the eruption slightly to smart.

It is not necessary to treat a patient all over at once. You will do better if you take one or two pimples at a time. You can then pass from part to part slowly, getting over the whole. You can use a little olive oil after this soaking with vinegar, and so keep off all danger of chill such as might occur if too much of the surface were treated at once.

If these simple means are well applied from the first, it must be a very bad case indeed which will not be cured, and most likely without any marks being left on the skin.