Chapter XIII: Part 13

In all cases, common sense must be used, but we think we have given sufficient indication of principles to enable a thoughtful nurse or mother to treat successfully almost any case. Where very cold cloths on application cause shivering and crying, either use tepid cloths, slightly cooler than the skin, or warm the _surface_ of the cold folded cloth by holding for a short time to a fire, and then apply to the patient. The warm surface thus first touches the skin, and afterwards the cold in the body of the cloth penetrates gradually.

Temperature (_see_ Heat, Internal).

Tempering Treatment.--Much, if not all, of the success in any case of treatment depends on its being properly tempered to the strength of the patient. In putting on LATHER (_see_), for instance, a delicate and nervous child will be greatly annoyed if soaped all over at once. But if one arm be done and finished, then the other, then the breast, and so on to the abdomen, the back, and the legs, _bit by bit_, the effect will be soothing in the extreme. So with MASSAGE (_see_); so also with applying a cold towel. If it chills and terrifies the patient when suddenly "clapped on," common sense would suggest holding it to the fire till the _surface_ is warm. This warm surface will give no shock when applied to the skin, and the cold in the body of the towel will gradually penetrate and do its work. Also, as we have frequently repeated, the _strength_ of ACETIC ACID (_see_) must be carefully looked to, when it is used. It must ever be remembered that some of the finest and noblest spirits are inhabitants of frail bodies, which, with right treatment, are strong enough, but suffer terribly in rough hands.

Thirst.--This forms a severe feature in many cases of illness, and has to be treated variously according to its kind. It may be due first to _dryness_ in the membranes of the throat and stomach; secondly it may be due to a _concentrated_ or _deranged_ state of the juices of the body; thirdly, it may be the result of a _burning heat_ in the body. It will not be difficult for a careful person to say in any case which of them is the cause. The nature of the disease will indicate it. A little cold water may be given first. If this fails, a cold cloth over the stomach (_see_ Changing Treatment) may be tried. If these are not successful, a few tablespoonfuls of hot water may be given. The first of these meets the simple dryness, the second cures the burning heat, the third meets the case of concentrated and deranged juices in the body. A few drops of vinegar, lemon juice, or other fruit acid (_see_ Drinks), will often greatly assist the hot water in its duty. All alcoholic drinks are worse than useless in real thirst. Any power they possess is either due to the effect they have on the artificial thirst they create or to the water they contain. And the danger of rousing or creating the dreadful desire of the drunkard is so great, that they ought never to be given to relieve a patient's thirst.

If the cold water is known, from any cause, to be dangerous to the patient, then hot water will do equally well. If the thirst arises from some drug which has been taken, then hot water should always be given.

Again, the _locality_ of the dryness causing thirst indicates the best method of quenching it. If only the mouth and tongue be dry, then it will be sufficient to wash out the mouth with the water, or acid drink, not swallowing, so as to avoid unnecessary loading of the stomach. If throat and mouth are cool, and only the stomach burns, then the cold towel above that is the best treatment.

There is no need, except in very special cases, for iced water. Tap water is generally cool enough, unless stored in heated cisterns. In this case a little ice may be used to bring it down to a temperature of 45 deg. or so, but not below 40 deg.

Throat Hoarseness.--This is best treated by a good large BRAN POULTICE (_see_) on the back of the head and neck. While the patient lies on this, cold towels must be changed on the front above the "apple" of the throat. Do this for an hour twice a day. Or, if the feet be cold, give treatment as in Teething. There must also be _rest from talking_. Procure a good camel's-hair throat-brush from the druggist, and brush the back of the throat well with weak ACETIC ACID (_see_) several times a day, or simply gargle if there is difficulty with the brushing. The brush must be carefully cleansed, and dipped in the _strong_ acid after use.

Especially is it necessary to give up, in such cases, the use of tobacco. Where the trouble has lasted for years, it may be slow to heal, and the poulticing may be done only once a week. In ordinary cases, a day or two's treatment should cure.

Many times we have seen a good fomentation of feet and legs alone give very sensible relief. Never be satisfied with putting a hot bottle or brick to the feet. This is a lazy way of dealing with a serious case. Have the feet and legs up to the knees rubbed with vinegar and olive oil, and wrapped in a large blanket fomentation. It is not the mere dry skin of the soles of the feet that needs warming: the whole legs, especially the muscles, require the moist heat of a thorough fomentation. Circulation is at once accelerated just where it is wanted, so as to lessen the pressure where the vital stream is pressing too heavily and lodging in a dangerous congestion. It is good even if the feet are not very cold, but only cool, to ply this part of the remedy well. Where the patient is strong enough to sit out of bed, a good hot foot-bath will do instead of this fomentation.

Throat, Sore.--The first question in any case of sore throat, is, What is the temperature of the patient? (_see_ Heat, Internal). If this cannot be ascertained, at least we can say whether the patient is feverish or not.

Let us first take the case where there is no fever. Get the patient warmly to bed. Foment (_see_ Fomentation) carefully all round the neck, first rubbing on a little olive oil. Renew the fomentation every five minutes for three-quarters-of-an-hour at least. Allow rest for an hour. Then foment thoroughly the feet and legs up over the knees. When this is done, and the heat kept up, cool the throat with constant fresh cold towels. Let this go on for an hour. Finally sponge the whole body with warm vinegar. Rub lightly over with olive oil, dry, and allow to rest. Probably the throat will be cured. If not, repeat the treatment the following day.

Where there is fever with the sore throat, first make sure whether the feet are hot or cold. If cold, put on fomentations as above. Even if the feet are only cool this should be done. While the feet and legs are thus fomented thoroughly, change cold towels on the throat every three minutes for an hour. Sponge all over as above directed, and allow to rest. If the feet are hot, cold towels alone are applied to the throat; but if the feet get at all chilled while such cooling is going on, they must be fomented.

If there is vomiting and sickness along with the sore throat, the other symptoms of scarlet fever should be looked for, and medical aid obtained if possible.

But here is a case where the most experienced eye, aided by the best possible instrument, sees nothing wrong in the throat itself, but the cough and difficulty of breathing point to the throat. The trouble is not there, but in the roots of the nerves by which vital energy is supplied to the windpipe and other vocal organs. You must go to the back of the neck, and to the back between the upper parts of the shoulders, and there affect the roots that are really in a state of distressing over-action. If you are skilful enough in applying cold, and your patient has plenty of general warmth, you need nothing more than a cold towel, changed pretty often, and nicely pressed over the proper parts. If this fails, have recourse to a cloth with mustard spread like thin butter on it, say about six inches broad and a foot long. Lay this gently on the spine at the back of the neck, and down as far as it goes. Apply your cold compresses now over this as well as you can, and the violent spasmodic symptoms will be mitigated. If one trial is not sufficient, sprinkle the cold cloth with cayenne. If the result can be reached by the cold cloth alone, it will be best. If mustard or cayenne must be applied, observe very carefully that they should never distress the patient. As much as can be borne quite easily, and no more, should be employed. Whenever a remedy becomes seriously distressing, we may be pretty sure it has ceased to be remedial, for the time at least.

Throat, Sore (Clergyman's).--Those who are in the habit of using their voice much should be very careful to produce it in the proper way. It is noticeable that actors (who learn to produce their voice properly) do not suffer from what is known as clergyman's sore throat.

The voice in speaking should be pitched, as a rule, considerably lower than is usually done, especially if speaking in public. Any tightening of the throat muscles should be avoided, and the voice sent out from a full chest well expanded.

Those who are musical should take a note on the piano enunciating the vowels in their natural order ([=a], ay, ee, o, oo) on this note. Then proceed to the next note; the whole of the octave may thus be gone over. Choose an octave most consonant with the range of the voice.

Then add the consonants: b[=a], bay, bee, c[=a], cay, etc., etc. Thus a perfect command over all the possible combinations of vowels and consonants may be attained.

There is absolutely no reason why any musical person should have an unmusical voice, especially since this bad production of the voice often strains the muscles and inflames the mucous membrane of the throat. In connection with this question of music, it should be remembered that almost irretrievable injury to the voice may be done by allowing a boy to continue singing after his voice has begun to "break."

It is not a good plan to be constantly "clearing" the throat whilst speaking. One gets to imagine after a while that it needs clearing when it really does not.

Alcohol and tobacco are both undoubtedly injurious to the voice. A little honey and lemon juice will be found the best gargle if a gargle is required.

Deep breathing is of great assistance in endeavouring to produce the lower note, in fact it is not possible to produce a full note except from a full chest. In this connection it may be said that it has been observed that deep-chested, deep-breathing, slow-speaking people are frequently possessed of certain estimable points of character, such as prudence, firmness, self-reliance, calmness. If one is going to be angry, ten deep breaths might save a world of trouble. (_See_ Breathing, Correct method of).

Thumb, Bruised and Broken.--Frequently a tradesman will strike the thumb or finger a serious blow with a hammer, in missing a stroke. If not treated properly, the whole hand may be destroyed, but if promptly plunged into warm clean water and kept there, even the broken bones can be handled quite comfortably, and all pain and uneasiness pass away ere very long. Plenty of bathing in clean warm water, and proper setting and dressing, are all such an injury requires.

Toothache.--This trouble appears in two opposite characters. In the one it is cured by rightly applied heat, and in the other by cold. If it is merely the soft substance in the tooth which is affected, local cooling applications will cure, if persisted in. If it be the nerve terminating in the tooth which is irritated, then even the extraction of the tooth may fail to give relief. Both cold and hot applications to the tooth or cheek will then probably prove useless.

In such a case, apply COLD TOWELS (_see_) gently pressed over the head and back of the neck. If the case be a bad one, the feet may be put in a hot bath, or fomented. Persevered in for an hour, this treatment is almost certain to cure. It may take away all pain in a few minutes. After the pain is cured, dry well, and keep the head moderately warm.

But if the toothache is caused by a severe chill to the head, and that be still cold, it should be packed in a hot fomentation. This gives almost instant relief. Rub on a little oil when the fomentation comes off, and keep the head warm.

It should not be difficult to distinguish the cases requiring heat from those requiring cold. In any case, if the first application of either increases the pain, try the other.

Towels, Cold Wet.--A towel of the ordinary kind, and full size, is soaked in a basin of cold water and carefully wrung out until it is merely damp. Prejudice against this treatment is often aroused by putting on the cloths wet, and in a slack, blundering way, so as to make the patient most uncomfortable. It is then folded and applied to the skin, as directed. While applying the first, a second towel may be in the water. It is then wrung out and applied, while the first is placed to soak afresh. In prolonged cooling, care must be taken that the water in the basin does not get too warm. It should be frequently changed. The nurse should gently press the towels on the part, frequently changing the position of her hands. They should not merely be laid on, but gently pressed, unless this causes pain. The towels will need to be changed when hot, and will take from two to five minutes to lose their cooling effect, according to circumstances. Where cold increases the patient's distress, it is almost always safe to substitute heat. _See_ Cooling in Heating; Fomentation.

Tumours.--A large, soft, fleshy tumour is usually simply an accumulation of waste material, which should have been excreted from the body if all the organs were in healthy working order. Where such a swelling exists, the first consideration is diet. For this, Barley (_see_) as chief food will do very well. Lemon and orange juice (_see_ Drinks) should be the drinks. The barley must _not_ be cooked with milk, and the drinks must be made with _pure water_. This plain diet will help very much towards the removal of the tumour.

Then the back should be rubbed (_see_ Massage) with hot olive oil twice a day. This treatment alone has often removed the disagreeable swellings on the neck so often afflicting women.

Also, fine soap lather (_see_ Lather; Soap) should be gently rubbed repeatedly over the tumour itself. This _alone_ we have known remove tumours, so it is important.

The three forms of treatment, all applied carefully, will cure all but very obstinate cases. _See also_ Armpit Swelling; Hydrocele.

Where fibrous tumours exist, the treatment is to _douche_ cold water on the part affected, while the rest of the body is kept warm. In case of such a growth in the abdomen, the patient sits in cold water, while the feet are placed in hot water, and the whole body warmly wrapped in blankets. Cold water is then thrown against the spot where the tumour lies. If the tumour is discovered early, its growth may be entirely stopped by this means. Such treatment for several minutes twice a day has in our own experience cured cases pronounced incurable. _See_ Sitz Bath.

Turnip Poultice.--Part of a raw turnip is grated down to a pulp. As much of this is prepared as will cover the inflamed part. It is put on next the skin, and covered with a soft cloth. All is then tied nicely up in another cloth. In violent inflammation of the knee joint, this is a most valuable soothing application. Placed on discoloured and shrivelled skin, it is marvellously curative. When applied, the patient must be _thoroughly warm_. This warmth must be maintained while the poultice is on, as it has a powerful cooling effect.

Typhoid Fever.--_See_ Fever, Typhoid.

Ulcers.--An ulcer is an "eating sore": that is, a sore containing matter which eats away the skin and flesh, thereby extending itself, and increasing in depth as well. To stop this diseased process, the virulent matter in the ulcer must be killed or neutralised, and this can usually best be done by means of vinegar or weak ACETIC ACID (_see_), which is most powerfully antiseptic. The only difficulty is to avoid irritating the sore by the application of too strong acid. The treatment by weak acid is very effective, but it must be a fairly prolonged and thorough soaking. Apply a little at a time to the sore. Use warm water if pain be caused. Continue the soaking for even an hour at a time, twice or even three times a day. The wound may be dressed with good fresh olive oil after each soaking. Usually, nothing else will be required, but it must be thoroughly done.

In a very severe case, mix in a teacupful of hot water as much saltpetre as the water will dissolve. Add to this a teaspoonful of acetic acid, and use this to soak the sore instead of simple weak acid. Then, if healing does not come, it is probably because rest is not taken, and most likely also because there is deficient vitality in the whole system. Let the treatment with the lotion be given in the morning. Secure rest during the day, and in the evening, for an hour, thoroughly foment the feet and legs up over the knees. Once a week for two weeks give the SOAPY BLANKET (_see_) instead of this treatment, and in the morning rub all over the body with hot vinegar. This powerfully stimulates the vitality of the whole system. Even a very bad ulcer should give way under a careful course of united acid soaking, rest, and this stimulating treatment.

Unconsciousness.--There are two opposite causes of unconsciousness. One is congestion of the brain, the other sheer nerve exhaustion. Either will produce a prolonged suspension of consciousness very different from a mere passing faint. In the case of congestion, the head will be hot and the feet cold. The cure is therefore at once seen to be to cool the head and foment the feet in a hot blanket up to the knees. This is the treatment usually to be given to young children. When aged people, or those much exhausted from any cause, become unconscious from lack of vitality, there will be rather a _general_ coldness, and no special heat in the head. We have seen such a case of "coma," which had lasted for forty-eight hours, come all right in ten minutes, by simply fomenting the back of the head and neck, and all down the spinal column. Press a thickly-folded piece of flannel wrung out of hot water carefully and gently over these parts, and often in a few minutes the mental power comes back. Care must be taken not to scald the patient. _See_ Fomentation.

Underwear.--There is a common and very popular error, namely, that of putting too much clothing on our bodies, under the mistaken idea that additional weight means additional warmth. The fact that the main object of clothing is to preserve the natural heat of the body is lost sight of, and little attention is paid to the selection of proper garments for wearing next the skin. Every day the skin of an average healthy individual gives off so many pints of moisture, which must not be allowed to settle on the body if health is to be maintained. After long and exhaustive trials, we have come to the conclusion that the best material for wearing next the skin is knitted linen, and the best knitted linen of the kind, and in fact, the only pure linen mesh material which we have seen, is known as _Kneipp linen_, and can be obtained from all leading retailers and outfitters in this and other countries. The name of the nearest agent may be had by sending a card to the Kneipp Linen Warehouse, 2 Milk St., London, E.C. In winter light woollen underwear can be worn over the linen if desired, thus retaining the hygienic advantages of the linen, as well as the warmth of the wool. As the wool does not touch the skin, it will not require frequent washing, and so will not become felted up.

Linen is the symbol of cleanliness, the priests of old, as we read in Ezekiel, being commanded to wear it, and not wool or any garment causing sweat.

Our reason for specially naming Kneipp linen is that we know it is _pure linen_, whereas we know that what is sold as linen mesh is frequently half linen and half cotton.

Linen is the most absorbent material for underwear. It soaks up moisture very rapidly, and dries with equal rapidity. Hence linen is always preferred for towels and bandages. Those who use it for underwear will not require to change the clothes after exercise, as they would if wool were worn next the skin. The ordinary woven linen is clean but cold: Kneipp linen is so constructed as to be clean and warm. This material retains air in its meshes, and a layer of dry air next the body is the best method of preserving an even temperature, and thus avoiding colds and chills, which are so prevalent in a climate such as ours. Wool is entirely unsuited for wearing next the skin. It does not absorb the perspiration rapidly nor radiate it freely, and after several washings it becomes felted, and in that condition is absolutely injurious to health. It is the material par excellence for outer clothing, but all inner garments coming in contact with the body should be composed of pure linen. (_See_ Skin, Care of).

Uric Acid.--This acid is found in persons of a gouty tendency, such tendencies being a great deal more common than is imagined.

It is really a waste product formed by the activity of the body cells, and should properly be mainly transformed into urea and so excreted. If it is not so transformed it accumulates in the blood and deposits in stony formations in different parts of the body, as in the joints, kidneys and bladder, causing very serious disease. Pure air and plenty of exercise will assist its transformation.

It is also taken into the body in various foods, particularly meat and tea, which are very rich in it or kindred chemical substances, therefore, anyone having such a tendency should avoid these. The consumption of sugar should also be limited. Avoid alcohol and use plenty of green vegetables and fruits.

The tendency to a "uric acid" constitution is hereditary, and is prevalent among families who live high. Such should be continually on the watch lest their diet should precipitate an attack. Water should be freely drunk, and plenty of bathing with subsequent rubbing of the muscles or massage is advisable.

Drugs are to be avoided as they often result in painful heart affection, and besides do not strike at the real root of the disease.

Soda or lithia water may be taken either with or without milk. Brine baths may be taken when practicable.

Urinary Troubles.--A healthy man usually evacuates about 30-40 ozs. of urine daily, the excretion being greater in the winter than in the summer, owing to the checked perspiration. The urine should be of a pale straw colour and transparent. Where any irregularity in the urine, either in quantity or quality, is suspected, it is wise to use soft boiled or distilled water only, for drinking, and to take frequent sips of it throughout the day, and especially early in the morning. Either pure hot water, hot water and lemon juice, or whey, will help the action of the kidneys when this is sluggish.

Where the bladder is irritated and painfully sensitive, a large hot BRAN POULTICE (_see_) should be applied to the lower back. While the patient lies on this, cold towels (_see_ Towels, Cold Wet) should be changed over the bladder in front. While giving such treatment once or twice a day, _rest_ must be taken, if a cure is to be obtained. For a patient to say that rest cannot be had, is to say that cure is impossible.

Where there is a tendency to stoppage of the urine, a warm sitz-bath should be taken. The patient first sits in three inches deep of comfortably hot water. More water at the same temperature is poured gradually in at intervals, until it rises well up over the abdomen. This will usually relieve even a bad case.

Treat with bran poultice and cold towels, as above recommended, after the warm bath has given relief. It should be remembered that the _cold_ is the healing power, bracing the bladder and all its muscles and vessels. Hence more than a slight cooling is needed. But the cooling is only possible when good heat is kept up on the base of the back. This treatment also cures the swelling of the bladder which often accompanies restriction of urine.

Where a positive growth interferes with the urinary discharge, this may often be actually _melted away_ by soaking with weak ACETIC ACID (_see_), when it is at all possible to reach it. The power of cure possessed by acetic acid is incredible, except to those who have seen it exercised, and its persistent use would, we are use, save many lives, if people would only try it.

We would also advise the four-ply flannel bandage, with two plies damp and two dry. This round the body has a wonderfully soothing effect. So has a nicely applied lathering with SOAP (_see_). As in most other troubles, special care must be taken to keep the feet warm.

Vaccination Trouble.--When a child is suffering after vaccination, we should have him gently rubbed all over--thrice at least with M'Clinton's soap (_see_ Lather). No one who has not seen this well done can believe how blessed are its effects on an irritated skin. It soothes incredibly. When thoroughly covered and covered again with well-made lather of this soap, the child will sleep beautifully. We should soap head and all, and let the little man sleep all night in the soap. He may be sponged in the morning with weak vinegar and water to clean off the remains of the soap, if there are any. Now, there will occur a most important question: Is the child cold or feverish? If cold, then mix some good olive oil in your rubbing with the lather. If hot, use no oil. If cold, rub all over with warm oil before applying the lather. It will make no difference, or next to none, if the disease has broken out as a visible skin disease, only it will be necessary to use the vinegar on the unbroken parts of the skin and not to distress the child by painful smarting. The soap will not need to be so restricted. That cures the most tender sores, and soothes in a delightful way.

Vegetables, Green, and Fruit.--We would strongly recommend our readers to continually have these valuable foods on their tables. It is possible to obtain them in some form or other during the entire year. They contain very valuable salts, which are of the greatest use in preventing disease. These salts are absolutely necessary for life, and though found in other foods such as meat, are particularly abundant in these vegetables. If cooked they must be carefully prepared, as the salts are very soluble in water (_see_ Cooking). Vegetable salads and fruit salads are to be recommended. Those of gouty or corpulent tendencies will find these of especial use. By keeping the blood alkaline they are a preventive of many diseases. Spinach, cabbage, lettuce, and all the fruits offer a variety from which at each season one may choose.

It is to be observed that common salt and salt such as bi-carbonate of soda, do not adequately replace those food salts. Indeed, over-consumption of common salt is harmful, besides leading to unnatural thirst.

Fresh fruits and vegetables are always to be preferred to tinned ones.

Veins, Swollen.--The swelling of veins in the leg is a very common trouble, especially in middle and later life. At first this may cause no pain, one vein appearing as a little blue lump. Then as the trouble increases, knots of veins seem to rise, especially below and behind the knee. Great pain follows, and sometimes the veins burst, causing bad sores, not easy to heal.

All this generally springs from _overstrain_ upon the limbs. Long continued standing, in circumstances otherwise unfavourable to health, is the usual cause.

This shows the primary necessity of _rest_. Let the patient lie down as much as possible, or at least sit with the sore limb or limbs supported on a chair so as to be nearly level. If this can be done thoroughly, all work being given up for a month or so, a cure is not very difficult. But where this rest cannot be had, an elastic band, such as is used by bootmakers to make strong boot gussets, about six inches broad and one foot long, should be procured. Fasten this round _above_ the knee, well up the thigh. This will greatly help to relieve the blood pressure on the lower leg, and is better than elastic stockings. Before these bands are slipped on, the leg should be well rubbed or stroked _upwards_, as described at the end of Circulation. This rubbing empties the swollen veins, and gives great relief.

We have seen a man with both legs full of swollen veins ready for bursting, and most painful, get on two such bandages, and go on digging and working with perfect ease, while the veins sensibly contracted with no other application. But it is not necessary nor wise to confine medical measures to the use of such bandages. Rest is in some cases absolutely necessary.

Even where partial rest can be had, it is important to wear these bands and rub as described. But if possible, the patient should rest in bed for one week. To restore power to the relaxed vessels, a large bran poultice should be applied across the haunches behind, rubbing olive oil before and after. Apply this for fifty minutes each night during the week in bed. Wear a broad band of new flannel over the parts after the poultice. In the morning give the same treatment. If in a week the veins are not better, continue the treatment for another week. The elastic band is, of course, not worn in bed, but may be put on on rising as a security against relapse.

We have seen persons over sixty years of age completely cured in this way, when the necessary rest could be had.

If the _skin_ give signs, by dryness and hardness, that it is out of order, instead of treatment with the bran poultice, the SOAPY BLANKET (_see_) may be applied on the first night. The patient may on other nights be lathered with soap (_see_ Lather; Soap), and the soapy cloth worn on the back for a night or two, sponging all over with hot vinegar in the morning.

Where the veins by bursting have caused sores, treat with weak vinegar as directed for Ulcers, and after each acid soaking, bandage the whole limb (putting lint on the sores and dressing them properly) with an ordinary surgical bandage, just so tightly as to give relief, and not tight enough to cause any pain. Over-pressure injures. This treatment, with the necessary _rest_, will in most cases effect a cure in a few weeks.

Vomiting.--In many cases of severe illness, the stomach rejects all food, and the patient comes near to dying of simple starvation. On the slightest nourishment being taken, retching and vomiting ensue, the stomach being irritated beyond all possibility of its doing its work. This occurs in cancer and ulcers in the stomach, as well as in various disorders and stomach inflammations.

"Rum and milk," "claret," and all alcoholic drinks are most injurious in such cases, and should _never_ be given. To soothe the irritation, the stomach should be soaped in the same manner as recommended in Head, Soaping the (_see also_ Lather). We have seen, even in very bad cases of cancer, such an application cause all retching to cease almost at once. When this has been carefully and gently done, give exceedingly small quantities at first, of infants' food, or milk and boiling water. To give any "rich" things is a fatal mistake. Oatmeal jelly may be given also, but beginning with a teaspoonful at a time (_see_ Assimilation; Digestion; Nourishment). By gradually working up the amount, a patient's life may be saved on this simple oatmeal jelly which would be lost if richer things were given. Often the stomach rejects food simply because it is surfeited. It may be that the liver is out of order, having had too much to do. Abstinence from food for a day or two, and then reducing the meals to two, taken, say, between 10 and 11, and 5 and 6 o'clock, will greatly help. Masticate the food till it is reduced to a liquid, in this state the quantity required will be wonderfully reduced and the work of the stomach lessened.

Water, Hot.--The frequent prescription in these papers of hot water, to be taken often in small quantities, makes it of importance that some explanation of its action should be given.

We see, frequently, such a thing as this: a person is confined to bed, sick and ill; there is no desire for food, but rather a loathing at the very idea of eating; distressing symptoms of various sorts are showing that the work of digestion and assimilation is going on badly, if really going on at all. The patient is started on a course of hot water in half-teacupfuls every ten minutes. When this has gone on for perhaps six or seven hours, he begins to be very hungry, and takes food with relish, probably for the first time for months past. In the meantime a greatly increased quantity of water has passed from the body one way and another, but has all passed loaded with waste material. The breath is loaded with carbonic acid and other impurities; the perspiration is loaded with all that makes it differ from pure water; the urine, especially, is loaded with waste separated from the blood and tissues of the body. The space, so to speak, left vacant by all this washing away of waste matter makes its emptiness felt by a call upon the stomach to furnish fresh material. Some will say that the hot water merely passes off by the kidneys without entering the circulation at all. This is impossible, and facts, patent to everyone, demonstrate that they are in error. The substances with which the water becomes impregnated show that it has been mingled with the circulation, and the wholesome effects produced prove that it has made itself useful.

"Hard" water, as it is called, will not do so well as "soft" water. Distilled water is best of all. So much superior is it, indeed, that its use cannot be too strongly insisted on. It can be had from the druggist at twopence per quart.

Where nourishment is given with too little water, the food will often fail almost entirely to enter the circulation. But a little warm water, somewhat above blood heat, but not too hot, will make all right. This is especially seen in nourishing infants (_see_ Infants' Food). Food, then, will not act as water does, nor will water act as food. Even a little sugar mixed with the hot water completely alters its effect on the body. As it has already dissolved the sugar, it cannot dissolve what is needed to be removed from the body. Sugar and water is not a _bad_ mixture, but it will by no means do instead of pure water in the cases we contemplate. On the other hand, a mixture of alcohol with the water is ruinous, and that just in proportion to the quantity of alcohol, small or great. Beer, for example, can never do what is required of water, nor can wine, or any other alcoholic drink. Tea added to the water also alters its quality. The water _alone_, and as nearly perfect in purity as it can be got, is the only thing which will do the necessary work.

Sometimes one finds a great prejudice against hot water. You see one who is miserable through derangement of the stomach and digestive organs, and you mention "hot water." The very phrase is sufficient to put an expression of strong prejudice on the face. Yet that very hot water is perhaps the only thing that will cure the patient. If you wait a little, there will be an opening to explain that hot water is very different to tepid water. Under blood heat, and yet heated, water tends to produce vomiting; above blood heat, nothing will so well set the stomach right. This is true, however, only when the water is taken in very small quantities. You must see that the water is not smoked in the heating or otherwise spoiled. And also that it be not too hot. If it scalds the lips it is too hot. When it is comfortably warm, but not tepid, it does its work most effectively.

Water for Drinking.--Every care should be taken to have drinking water absolutely pure. Diarrhoea and many infectious diseases may be conveyed by impure water. In gouty cases as much water should be taken as possible (provided the heart is sufficiently strong) in order to wash away the waste matter. The same applies to fevers. If there is a suspicion of water being contaminated mere filtration should never be relied on, the water should be boiled.

After many of the treatments given by us in this book, considerable thirst will be experienced. Cold water in such cases may always be given. In fact, in any internal congested condition cold water will stimulate the nerves of these organs, and make them act on the blood vessels. In all cases where drugs, especially mineral drugs have been recklessly indulged in, cold water should be taken in abundance. Care must be taken, however, not to unduly stimulate the circulation or nervous system, and any signs of this, such as headache or want of sleep indicate the curtailment of the amount drunk.

Water in the Head.--In cases where this trouble is suspected, very often there is nothing wrong but a more or less congested state of the brain, owing to some severe chill or some disease elsewhere in the body. There may be violent heat in the head, and even the "drowsiness" which is so serious a symptom, without any real "water in the head" at all. Leeching and blistering in such a case are grave mistakes. Cold towels (_see_ Towels, Cold Wet), or a gentle pouring of cool water on the head, will often be sufficient to remove all trouble. We have seen a bad case of brain congestion cured and consciousness return almost immediately after the pouring had begun. The feet also may be fomented (_see_ Fomentation). The cold towels and pouring may be used alternately on the head, which will give a more powerful effect. Let the water poured be almost lukewarm, a little under blood heat. There is no need to cut the hair, or use any acid or drug in the water. The _cooling_ is all that is needed. Incipient water in the head may in a very large number of cases be checked and cured by the same treatment. It can do no harm in any case, and has saved many lives.

Water on the Chest.--Sometimes a large watery swelling appears in one part or another of the chest. It is practically a bag of liquid waste, due to deficient action on the part of the kidneys or skin. Treatment should be given as recommended in Dropsy, and, besides, the four-ply moist flannel bandage should be worn over the skin. This will in many cases speedily effect a cure.

Weakness.--Often there follows, after the cure of an inflammatory disease, very great weakness. This in itself is sometimes a great danger, but can usually be removed by proper care and nursing. The common method of administering wine, brandy, or other alcoholic liquor, is the very worst that could be adopted. Hot water will prove a valuable stimulant, when a stimulant is required. Any NOURISHMENT (_see_) to be given should also be just a little warmer than blood heat. For drink, the unfermented wine made by Frank Wright, Chemist, Kensington, London, is of great value. It is simply the pure juice of the grape. If milk be given, it should always be diluted with an equal bulk of boiling water. The fomentation of the feet and legs will greatly help in restoring vigour. This should be done gently at first, where the weakness is great. Afterwards, when the patient can bear it, the ARMCHAIR FOMENTATION (_see_) will be found serviceable. All this, of course, is on the assumption that only _weakness_ and no fever is the trouble. Where fever is present, other treatment is necessary.

Sponging all over with warm vinegar is also a most invigorating thing. Do this once, and afterwards the treatment may be varied by the real stimulant of cayenne being used in the form of an infusion strong enough to rouse the nerves, as is done by the acid. This has the advantage of saving the skin, if that is tender, and keeping off eruption, which is apt to come if the acid is often used. We think it well to use the acid once or so, and the cayenne infusion as frequently as anything of the kind is required. Rubbing with olive oil is also most beneficial. But both must be done very cautiously where there is great weakness. To rub the whole body at once will then be too much. But it may be done bit by bit, stopping whenever fatigue or chilliness is felt by the patient. _See also_ Heat and Weakness.

Weaning.--Many of the troubles which come in this process arise simply from ignorance or want of thought on the part of the nurse or mother. Sometimes the child, having been burned with a hot teaspoon, will afterwards refuse all that is offered in such a spoon. In such a case use an egg-spoon of bone, or a small cup. Sometimes spoons of various metals, having peculiar tastes, are used, and the child refuses them. When food is refused, it is well therefore always to see that it is not the spoon or dish which is the real reason.

Again, food ill-fitted for the child's digestion is offered. In this case the child is doing the right thing in refusing it. Milk and hot water, in equal quantities, with a very little sugar, is a mixture which can always be given with safety. In weaning, the nurse should begin by using this alone. Gradually a very little thin oatmeal jelly may be added, and the strength of the mixture increased. If there should be indigestion, a few teaspoonfuls of hot water will usually cure it. If the bowels are inactive, mix a little pure CANE SYRUP (_see_) with the food. Avoid all drugs as far as possible. If the whole process be _gradual_, there will usually be little or no trouble with the child. If, where teething and weaning are both coming together, the child should be seized with chill and shivering, a good blanket FOMENTATION (_see_) may be wrapped round the body and legs. Dry after this, and rub with warm OLIVE OIL (_see_). Generally this will induce sleep, in which case leave the child _warm_ in the fomentation until it awakes (_see_ Teething).

In weaning, the mother often suffers as well as the child. The supply of milk in the breast being over-abundant, the breasts become hard and painful, and feverishness comes on. In this case the breasts must be emptied, either by some other person, or by the various ingenious instruments sold by all druggists. Then a large, cold damp cloth should be placed over the emptied breast, and changed once or twice, rubbing afterwards with a little olive oil. This, in ordinary cases, will cause the flow of milk to cease. Where the swelling is very hard and almost inflammatory, the breast should be fomented for five or ten minutes, then emptied, and a cold cloth applied as above directed. If all this fails, a BRAN POULTICE (_see_), or hot bag with moist flannel covering, should be applied between the shoulders. While the patient lies on this, cold towels (_see_ Towels, Cold Wet) should be changed on the breasts. This will usually effectually stay the secretion of milk. This last treatment is rarely required, but is harmless and most efficient.

Where mother and child are both sickly, weaning must be carefully conducted. But it must ever be remembered that a child is far more healthily nourished on a bottle of good cow's milk or condensed milk (of _first-rate quality_) than on a sickly mother's milk. This is the case even if the child be ill. Only let the bottle not be too strong. _See_ Children, numerous articles.

Weariness.--Where persistent weariness is felt, and the least exertion brings on a feeling of lassitude, there is evidently an undue exhaustion of nerve force in the body. Too rapid action of the heart is a frequent cause. In such a case all exciting ideas and influences should be kept from the patient's mind, and rest taken. The heart's action should also be reduced by careful lathering with soap (_see_ Lather; Soap). Where the weariness is really serious, great care must be exercised, and treatment very gradually administered. Rest must be given whenever exhaustion shows itself (_see_ Heat and Weakness; Weakness; and articles on Nerves and Nervousness). Where the heart's action is very slow, and requires to be stimulated, REST (_see_) must be taken, and treatment given as recommended in the case elsewhere. _See_ Depression.

In other cases we find weariness arising from an irritated state of the stomach. Where there is no particular nerve exhaustion, the fiery and inflamed state of the stomach membranes forbids sleep, and causes a great feeling of tiredness. Headache (_see_), and even fainting fits, sometimes come on in such a case. All the nerves are excited, so that even touching the head or skin is most painful. Yet all can be traced to an inflamed stomach as the cause. Such a case, to be successfully treated, requires considerable resolution. In one case the treatment was as follows: First, the feet and legs up to the knees were wrapped in a large FOMENTATION (_see_). A cold wet towel was then folded lengthwise so as to be four-ply thick. The end was laid on the stomach, and _gently pressed_. In about half-a-minute it was hot. The towel was then shifted so that a fresh cool part lay over the stomach, and so on throughout the length of the towel. Handfuls of finely-wrought soap LATHER (_see_) were then prepared and laid on the stomach. Then the cold cloth was again renewed on top of the lather. For _two hours_ this was continued, and by that time the worst symptoms had abated. A little fresh oil gently rubbed over the stomach completed the treatment for that time. When the heat again arose, the same treatment was repeated, and so on till a cure was effected. Five or ten minutes' cooling would have been utterly useless. The heat evolved in the stomach required two hours steady cooling, and might have required more. The feelings of the patient are ever the best guide in such a case. As long as the cooling feels "delightful" it may safely be continued, if the heat to the feet is kept up.

If the weakness is very great, it may be necessary to keep to milk and hot water, such as an infant would thrive on, for a short time. If the weakness is not so great, it will be possible for the patient to take a little gruel or porridge made from wheaten meal, and also good fresh buttermilk. The stomach may be far from ready to take eggs and such things, but quite able to digest the "poorer" food, as it is often called. To give the really weak as perfect rest of mind and as easily digested food as possible, are conditions that must not be overlooked if we would be successful in their cure.

White Leg.--When a limb becomes swelled and white, pouring hot water very gently over it with a sponge or cloth will have a blessed effect. It may be continued for an hour at a time for several times. If this ceases to be comforting, it should be discontinued and the limb dressed with warm olive oil, a soft cotton rag being put next the skin, and soft flannel above that. Of course absolute rest should be taken.

Whooping Cough.--The cough is a spasmodic action of nerves which are otherwise healthy enough, so that when the violent action ceases, the child's health is much as usual. Any irritation of nerves or temper will, however, bring on an attack, and should therefore be avoided, and all soothing mental influences should be encouraged. Three or four teaspoonfuls of hot water taken frequently, and given whenever an attack comes on, will give great relief. We have ourselves seen a child thought to be dying relieved at once by nothing more than this. Therefore it should never be neglected as too simple.

Also the feet should be bathed once in two nights (_see_ Bathing Feet) in warm water (not too hot), dried and rubbed gently with olive oil. On the night when the feet are not bathed, let the back be lathered with _warm_ lather (_see_ Lather; Soap), quickly dried off, and then a little olive oil _gently_ rubbed on.

In ordinary cases, this will be sufficient to ward off all danger in the disease, but in severer attacks the feet and legs may be fomented (_see_ Fomentation) while the child is in bed, and cold towels changed along the spine while the fomentation remains on, so as to lower the nerve action over the main centres. This is best done in the morning before the patient arises. If anything like inflammation sets in in any part of the chest, treat as recommended in Bronchitis or Lungs, Inflammation of.

As far as possible, all causes of irritation to the patient must be removed or avoided. In the time of whooping cough, the sunniest way of managing the child is the best.

The other children, if any, in the house, should have the footbath and oil, and the back wash, as recommended above. This will lessen danger of infection, and make the attack lighter if they should take it.

Worms.--Where the juices and organs of the body are thoroughly healthy, worms will not appear. Before they can breed, there must be more or less of failure in the patient's health. This shows us that the cure for worms is not so much some poisonous substance which will destroy them, as such an increase of healthy action in the system as will prevent their development. The bowels must be kept open by suitable diet as it is most important to avoid Constipation (_see_). In case of worms in children, stimulus and help are specially needed by the _mucous membrane_ or inner lining of the stomach and bowels. To give this, and at the same time to neutralise and remove waste material from the membrane, a little vinegar and warm water may be frequently given, in teaspoonfuls. This is best taken from an hour to half-an-hour before meals. It is often needful to use some soothing, nourishing substance, such as liquorice, boiled with a little camomile, taken, say after meals, while the acid is taken before them: this has an excellent effect. At the same time, an enema of warm water and vinegar should be given twice a day. Where Santolina (_see_) can be procured, its use will speedily effect a complete cure. Change of air, holiday from lessons, and any other means of increasing the general health, should also be utilised.