Chapter VI: Part 6

How is it that vital action seizes these mere motor nerves and leaves the brain? There is a symptom in cases of epilepsy which tends to throw some light on this question. It is seen in the extreme activity of the brain, indicated by the incessant talking of the patient before a series of convulsions come on, when taken along with the extreme depression and silence that follow such a series. During whole nights, even, the sufferer will talk, till every organ is exhausted; then comes a series of violent convulsions, then a season of perfect silence and bewilderment.

This explanation of the disease points to the remedy. That which will nurse the brain, and at the same time lessen nervous force in the system, will tend to cure the evil. Strong fomentations round the lower part of the body may be used. Soap in fine LATHER (_see_) should be made to cover the skin at bedtime, and washed off with weak ACETIC ACID (_see_) in the morning. Easily digested food should be taken, and all so-called stimulants strictly avoided. We should endeavour to secure the soothing of the spinal system of nerves. This is done in a degree that is incredible to those who have not actually witnessed it by a persevering use of the cold treatment of the back. The best time is early in the morning, after the patient has had a good night's sleep. For a whole hour spinal treatment should then be used. We have no faith in any royal road to success in such a cure, but we have faith in common sense and right good work. Taking three towels, and putting two of them in cold water, the "operator" is ready to begin. It will be well first to rub the patient's back gently with a little warm olive oil. This will obviate all danger of shock or shiver when the cold cloth is placed on the skin. Then wring out one of the cold towels thoroughly, so as to have it damp and not dripping; fold it lengthways eight ply. Put the one over the other, place both on the centre of the patient's back as he is sitting up in bed to receive them, keeping the damp towel next the skin. Adjust these cloths nicely, make the patient lie down upon them, and cover him snugly up with the bedclothes. So long as the feeling is nice, let well alone. When the towel becomes hot, wring out the second, and change it on the back. Carry this out for a full hour, and if the patient is disposed to go to sleep again, encourage him to do so.

Continued for weeks every morning this humble treatment, without any addition, has an incredibly soothing effect on an excitable system. But it will be well to add to it some nursing of the head and feet, so that every encouragement may be given to a diffusion of nerve action over the body. At night, before going to bed, the feet and legs should be bathed in hot water for a quarter of an hour, dried, rubbed gently with warm olive oil, and a pair of soft cotton stockings drawn on. While the patient is being treated, every possible wearing and irritation of the brain must be avoided, and when lying on the cold towel, the head should be soothingly rubbed by a gentle hand. If an actual violent attack comes on, loose all tight clothes, place a piece of cork between the patient's teeth to prevent biting the tongue, give plenty of fresh air, and keep the patient in a recumbent position.

Everything should be done, by training, to increase the patient's self-control, and all stimulants should be avoided as most injurious. _See_ Head, Rubbing the.

It is important that those liable to these attacks should be kept employed. Nothing is so harmful as idleness. Everything tending to good health is of value, but the essentials of the treatment are found in soothing the spine as above, and stimulating the brain by the head rubbing. Unless in cases in which the very structure of the system has been, so to speak, altered by long-continued disease of this sort, we should look for good results from such treatment as this. Even in the worst cases it would be possible to mitigate the severity of the distress.

A difference in the focus of the eyes often causes a strain on the brain in the effort to adjust them. This sometimes causes epilepsy, and we have known many cases cured by the use of spectacles made to correct this inequality. In all cases of this disease, therefore, an optician should be consulted, to see if there is any defect in the eyes.

Other illnesses are sometimes mistaken for epilepsy: for example, the liver and kidneys in a defective state and impurities passing in the blood to the brain, will explain certain forms of that which passes as epilepsy. It is often easy to cure attacks of this nature by merely bringing the liver and kidneys into working order. If there is a yellowness of the skin, or other signs of the blood failing to be purified in a natural way, then that should first be dealt with, and the fits will often be removed as soon as good action is established in the purifying organs. But in all cases in which there is anything like real "fits," it will be found of great importance to study the over-and-under-actions of the nerve system as by far the most essential elements in the disease. _See_ Jaundice.

Eruptions.--_See_ Hives; "Outstrikes;" Saltrome, etc.

Erysipelas.--This troublesome disease is also known as St. Anthony's Fire, or the Rose. The skin becomes fiery red or even purplish in hue. A violent heat and pain in the part accompany this, and fever and general disturbance of the system follow in a severe case. Swelling of the parts follows, with much distress and danger. _Air_ irritates violently the sore parts, and is usually excluded.

In curing the trouble, regard must be had to the cause, which is usually a general failure of strength from overwork, worry, or some other disease. If a cure is to be effected, _rest_ of mind and body is necessary, and must be secured at any possible cost. For local application, the sore parts are thickly dusted with fine fresh flour, and covered with soft wadding or surgeon's lint. The air is excluded, and all is kept _strictly dry_. A waterproof covering over the lint will help this, but is not absolutely necessary.

But, now, is there nothing that can be done to quicken that inner action, the slowness of which has paved the way for all this mischief? This might be done in two ways. After the affected parts, say the face, have been secured in this pack of flour, it will be easy to place a hot blanket, soaked partly, but not at all _wet_, with boiling water, all round the head of the patient. As soon as the heat begins to enter the head, a sense of comfort will be experienced. Care must be taken to keep the _inner cloths dry_, and heat is best given by an india-rubber bag. When this cannot be had, however, the blanket may be used. At intervals, as the patient feels it desirable, this fomentation may be renewed. It will hasten recovery as well as arrest the spreading of the malady, while it will secure such recovery as will not readily dispose to a return of the evil. The feet and legs are likely to be cold. As the sufferer lies still in bed, but not when the other fomentation is on, these should be wrapped in a hot fomentation, allowed to lie in it for a good half-hour, taken out of it and dried, rubbed with warm olive oil, and covered with a pair of soft cotton stockings. If this treatment is at all well carried out, the feeling of comfort given will soon tell how it is working. Of course, if the feet and legs are the parts affected, the fomentation must be applied elsewhere, say on the back, or on the haunches.

Where erysipelas appears in connection with wounds or sores, the same treatment is to be pursued, as far as possible consistent with dressing the sores. These should be carefully cleansed, dusted with boric acid, and covered with a layer of wadding bandage. The limb should be raised to a horizontal position. Simple food should be given, and the sufferer kept quiet. In all cases of skin trouble, linen should be worn next the skin. _See_ Underwear.

Exercise.--Where this is advised medically, it is often taken in a manner far from wise. For weakly people seeking strength, exercise should never be pursued to the extent of fatigue. Up to a certain point it does good; beyond that, harm. The beginning of harm is indicated by the feeling of weariness. At the same time it must be remembered that what is felt as weariness may be merely laziness. This must be energetically combated. There is no royal road to health any more than to learning.

In some cases this disinclination for exercise may arise from too much or too rich food, and a more sparing diet may remove it. _See_ Appendix; Physical Culture.

When even walking is out of the question, a kind of exercise may be given by gently massaging the limbs while the patient is in bed. The back muscles should also be gently rubbed and kneaded, so as to cause them to move under the skin, without effort on the patient's part. But no fatigue must be caused. The amount may be gradually increased as the patient can stand it. _See_ Brain Exercise; Massage.

Exhaustion.--Often very serious trouble takes the form of simple overwhelming weariness. The patient's system has been wrought down till it can no longer respond even to stimulus, and life itself seems ebbing away. In such cases treat as for DEPRESSION (_see_) avoiding too energetic treatment, and gradually infusing new life by massage and fomenting.

Expectoration.--What is commonly called a "cough and spit" is sometimes due to some serious trouble of the lungs, and in all cases a doctor should be consulted at once. Often, however, it is due to the failure of the skin or other organs duly to carry off the waste of the body, which then accumulates in the air tubes. If we get a good revivifying treatment of the skin, such cough and spit will speedily be cured. A mild vapour bath, with thorough SOAPING (_see_ Soap) will usually be sufficient in a slight case.

Sometimes there is a sweating of the skin itself which does not cure expectoration, but which must itself be cured. That is the night or early morning sweating, which is very reducing. It is the insensible perspiration which is needed to remove the spit. Give one good sponging over the body with acetic acid; follow this the evening after with cayenne "tea," afterwards rubbing with warm olive oil. For two or three evenings repeat this treatment. There should then be a loosening of the phlegm, and a lessening of the flow through the lungs. The sufferer may be very weak, and yet these things may be so gently and kindly done, that no fatigue is experienced.

If above treatment does not cure, the SOAPY BLANKET (_see_) may be used once a week, with daily sponging with vinegar or weak acetic acid, and rubbing with warm olive oil. This should cure in a few weeks, where there is no real disease.

Eyes, Accidents to.--Three distinct classes of these are to be considered. They require very different treatment.

When the eyeball is cut or pierced, if the cut be deep or large, a surgeon must deal with it. But if small, a drop or two of castor oil let fall into the eye will often be all that is required. Where inflammation comes on, the tepid pouring recommended below for bad eyes will greatly help. If more severe, the treatment for inflamed eyes may be given. _Perfect rest_ and _thorough exclusion of light_ are very important.

If the eye is bruised, bathe with warm water, to which a little vinegar or boracic acid has been added. If after bathing, pain continues, drop in castor oil, and on the outside of the eyelid lay a pad dipped in a mixture of equal parts of laudanum and water. Change this cloth frequently until the pain is relieved.

Treat in this way also for insects stinging the eye.

When the eye is burned, either by sparks or by some burning chemical substance, cold cloths should be persistently applied to the eye. The softest rags or surgeon's lint should be cut up into small pieces that will just cover the eye. Dip these in the coldest water, and press it out a little, so that it will not run off. Place these little bits of wet cloth one after another on the eye or eyes affected. The patient will not be able to endure pressure further than the weight of the cloths themselves. These can be taken off and changed for cold ones as the feeling of the sufferer directs. After a time the cooling will be felt to have gone far enough, and the cloths may be allowed to lie; when they get too warm they can be taken off, or if the heat and pain return they can be renewed.

While this treatment is going on it will be necessary to open the eyelids at intervals, so as to let off the tears that collect in such cases and cause great distress. These will flow out when in the most gentle way you have laid one thumb on the upper eyebrow, and the other just below the lower eyelid, so that you can draw the lids just slightly open.

Eyes, Cataract on.--This disease has been arrested, and in earlier stages even cured, by the treatment described in, Eyes, failing sight. By means of this treatment we have seen a totally blind eye restored in a few weeks.

Eyes, Danger to Sight of.--Where inflammation has gone so far as to lead to suppuration, or even to ulceration of the eyes, there is grave danger of blindness, and this is often the case with infants and children who have been wrongly treated or neglected. In such a case, cease at once all irritating and painful treatment and drugs. First, wash the eyes by gently dropping over them distilled water, or boiled rain water which has been cooled. The water should be used about blood heat.

After an hour or so, have another warm bathing by means of gentle pouring over the eyes, but do not rub the eyelids. Let there be no friction beyond that of the soft and warm water running over the face in the bathing. Rather have patience till that washes all waste matter away than run any risk of irritating the eyeball. All this time watch what the sufferer evidently likes, and follow his likings--that is, as to warmer or colder water, and so on. It will not be very long before you have thoroughly cleaned the eyes, while at the same time you have infused fresh life into them. To the water used a little vinegar or acetic acid should next be added, or Condy's fluid may be used when it is convenient. But care must be taken that no great smarting is caused. _See_ Acetic Acid.

As the discharge from ulcerated eyes is very infectious, care should be taken not to communicate it to other persons' eyes. Strict cleanliness should be observed, and all rags employed should be burnt, and disinfectants used to cleanse the patient's and nurse's hands, etc. Towels should be boiled for half-an-hour before being washed, after they have been used in such a case.

Now a most important matter must be attended to. Castor oil is the most soothing that can be used with the eyes. Fresh olive oil comes next, but it is usually just as easy to get the one as the other. With a feather, or fine camel's-hair brush, and as gently as possible, cover the eyelids with this oil heated to about blood heat. Do not try to force it on the eyeballs, but if the lids open so much as to let it in, allow it to lubricate the eyeball also. Rub it gently over the eyebrows and all round the eyes, and dry it gently off. Cover the eyes then with a soft covering, and let them have perfect rest.

It sometimes happens that a tiny piece of dust or iron may stick in the surface of the eye, and refuse to be washed away by the tears. Take a square inch of writing paper, curve one of the sides of it, and draw it lightly and quickly over the spot. Never use any sharp instrument or pin. Repeat the operation a few times if unsuccessful.

Diet as recommended in article Eyes, Hazy Sight.

Eyes, Failing Sight.--This often comes as the result simply of an over-wearied body and mind, without any pain or accident whatever. It appears as an inability to see small distant objects, or to see at all in dusky twilight. The sight is also variable--good when the patient is not wearied, and bad when he is tired. When this comes on under thirty years of age, the eyes have almost certainly been overworked, and need rest. Rest from all reading and other work trying for the eyes is the best cure. If this can be had, it should be taken, with much outdoor exercise. Fresh air is a fine tonic for the eyes. Where total rest cannot be had, take as much as possible, and nurse the failing nerves as follows. Apply the bran poultice, as directed for inflamed eyes, just as long as it is felt to be comforting--with one patient it will be longer, with another shorter. Now there is a cooling of the brow and of the eyes themselves, which is as important almost as the heating of the back of the head. We always find, as a matter of fact, that a cold application opposed to a hot one produces a vastly better result that two hot ones opposed, or one hot one by itself alone. So we find in the case of the eyes. We have now, as we write these lines, eyes under our care that are mending every day by means of a bran poultice at the back of the head and neck, and a cold cloth changed on the brow and eyes. They do not mend anything like so well if heat alone is used. Rub the back of the head and neck with hot olive oil before and after poulticing, and dry well. Do this for an hour at a time, _twice_, or if possible _three times_, a day. Continue for a fortnight, cease treatment for a week, and again treat for another fortnight. This should make such improvement as to encourage to further perseverance with the cure. Sometimes failing sight follows neuralgia. In this case the rubbing described in Eyes, Squinting, given twice a day for fifteen or twenty minutes each day, will be useful in addition to above treatment.

Even in cases in which "cataract" is fully formed, we find that the disease is arrested, and the patient at least gets no worse. But where this malady is only threatened the haze soon passes away. We most earnestly wish and pray that this simple treatment should be as widely known as there are failing eyes in this world of trial.

Eyes, Hazy Sight.--Frequently, after inflammation, and even when that has ceased, the sight is left in a hazy condition. The eyes may be in such cases rather cold than hot, and not amenable to the cooling applications. The whole system also lacks vital action. First, in such a case, wash the back thoroughly all over at night with hot water and SOAP (_see_). Dry well and rub hot olive oil into the skin until dry. In the morning rub the back for a few minutes with vinegar or weak ACETIC ACID (_see_) before getting out of bed, dry, and rub with warm olive oil. A strip of new flannel should be sewn on the underclothing, so as to cover the whole back. The feet and legs should be bathed (_see_ Bathing Feet) twice a week. All alcoholic drinks, and most drugs, should be avoided, while only such food should be taken as can be converted into good blood. Half a teacupful of _distilled_ water should be taken before each meal. The whole of this diet tends to produce healthy blood, which is the great means of dissolving all haziness in the lenses and humours of the eyes.

Every drop of alcohol does so much to reduce that action. We have heard this beautifully described by one of the foremost of living medical men. He began by stating, what no one can doubt, that a certain quantity of alcohol taken by the strongest man will kill that man as effectually as if he were shot through the head with a rifle bullet. Now a certain portion of alcohol takes a man's sight entirely away. Half that quantity will only render his vision "double"--that is, unfit him to see objects as they really are. Half that again will only perceptibly impair the power of the eyes; but the action of the smallest particle of the substance is the same in nature as that of the largest quantity. Hence that action is to reduce the very efficiency of the nerves of the eye, which it is of such immense importance to nurse to the uttermost. No mere dictum, however strongly expressed, can hold for a moment against this transparent reason. Hence, if a person must take alcoholic liquor, the cure of inflammation in his eyes, and of the thickening of the transparent portions of these organs, is simply out of the question unless the disease is comparatively slight, and his nervous constitution strong.

The very same reason holds good of tobacco. So of opium. So of every other narcotic, whatever it may be called. Hundreds of men lose their eyesight by the use of tobacco alone. We have seen their eyeballs gradually becoming sightless when no change could be detected in their eyes--only the optic nerve gradually lost its sensibility till they were entirely blind. We are perfectly aware that there are those who will scout the idea of such an effect, and prescribe these very narcotics largely in such cases; it is because such drugs are used and ordered that we are compelled thus to reason about them. In all cases of failing eyesight they should be carefully avoided. So should all foods which are not easily converted into healthful blood.

Eyes, Healthy.--Cheap, ill-printed literature is responsible for much eye trouble, and it is well worth while to pay, if possible, a little extra for books well printed, especially in the case of those who read much. When reading sit erect, with the back to the light, so that it falls over the shoulder. Too fine work, dim light, wrong diet, and want of exercise produce the dull and strained eye, which eventually becomes seriously diseased. Opening the eyes under cold water will help to strengthen them, and massaging the muscles of the eye by passing the finger and thumb round the socket (with scarcely any pressure on the ball itself) will be found of advantage.

Eyes, Inflamed.--For all kinds of burning inflammatory pain in the eyes, the following treatment is most effective. Place a hot BRAN POULTICE (_see_) beneath the back of the head and neck while the patient lies on the back. Press gently fresh cool damp cloths, frequently changed, all over the eyeballs and sockets, so as to draw out the heat. No one who has not seen this done can imagine how powerful a remedy it is. It may also be necessary, if the feet be cold, to foment up to the knees. This last fomentation is best done at bedtime, and the feet and legs should be rubbed with olive oil, and a pair of cotton stockings put on to sleep in, to keep the feet comfortable.

If the eyes are very sensitive the treatment should go on in dim light, as may be felt necessary. The poultice and cold cloths may be used for an hour twice a day. In bad cases, where sight has been seriously affected, a good rubbing of all the skin of the head with the finger tips may be given before the poultice is applied. This rubbing must not be a trial to the patient, but gently done, with kindly good will, and it must be pursued for fifteen or twenty minutes, until the whole head is in a warm glow.

Eyes, Inflamed, with General Eruptions over the Body.--In some cases the eye trouble is only a part of a general skin inflammation, accompanied with heat all over the body, and an acrid, irritating discharge from eruptions on the face and elsewhere, especially on the head. The cold cloths and poultice will not work in such a case. The chief agent in the cure is fine soap lather (_see_ Head, Soaping). Let the head be shampooed with it for half-an-hour. The whole body should then be lathered and shampooed for a short time in a warm bath; this is best done at bedtime. Much water is not needed; warm soapy lather, well rubbed all over, is what is required. Ordinary soap will make the skin worse; only M'Clinton's will do to soothe and heal it (_see_ Soap). If white specks show on the eyes, the treatment in article on Eyes, Danger to Sight of, will cure these. When this complaint is obstinate and refuses to heal, medical advice should be sought, as blood poisoning is probably present.

Eyes, Paralysis of.--The partial paralysis of the muscles of one eye produces double vision, so that the patient sees two similar objects where there is only one. This double vision is often, however, the result of stomach derangement. If so, it may soon pass away. The true paralysis is more persistent. To cure this, rub the entire skin of the head gently and steadily with the hands and finger-tips (stroking always _upwards_) for some fifteen minutes. Then apply cold cloths to the eyes as already directed. If the cold cloths are uncomfortable, hot ones should be tried. Do this for fifteen minutes also. Continue alternately for an hour twice or three times a day. We have known one such day's treatment remove the double vision _entirely_, and no relapse occur, but in most cases the treatment must be persevered in and returned to until the paralysis is overcome.

Eyes, Spots on.--These spots are of two different kinds, and yet they are very much the same in nature and substance. What is called "a cataract" is of a different character. We refer not to this, but to the spots that form on the surface of the eyeball, and those that form in the membrane of the eyelid. When inflammation has gone on for some time on the eyeball itself, portions of whitish matter form on the glassy surface and soon interfere with the sight. When inflammation has gone on in the eyelid, little knots like pin-heads form, producing a feeling as if sand were in the eye. Afterwards these knots grow large and swell the eyelid, and at times the matter in them grows hard, and seems to take up a lasting abode in that tissue. Strong and destructive liquids or powders are sometimes applied, that so affect the whole substance of the eye as to cause blindness. Nothing of this nature is required at all. First, the skin of the head must be dealt with. You will find that this is hot and dry, and somewhat hard on the skull. Rub this gently with the dry hands for a few minutes, then press a cloth tightly wrung out of cold water all round the head. Rub and cool alternately for half-an-hour or more if it continues to produce an agreeable feeling. When the head is all soothed, and good action has been secured, at least on its surface, begin with the eye itself. The same treatment is required for both classes of cases. The eye will be shut at first. You take a fine camel's-hair brush, such as is used by artists, and some vinegar or acetic acid, so weak that you can swallow a portion of it without hurting your throat. This is a very good test of strength for the acid. You carefully brush over the outside of the eyelids and all round the eye with this weak acid. This must be done most carefully and patiently for a length of time, till all sweatiness is washed off, and a fine warm feeling is produced by the acid. The matter softens and breaks up, so that it begins to pass away. We have seen a little ball of hard white matter break up and come away after a single brushing carefully done. When the matter is in the eyelid, and is so situated that you can brush over it in the inside of the lid, it is well to do so; but this operation must be gently and carefully done. When you have brushed with the acid long enough, dry the eyelids and cheek carefully, and rub with a little fresh olive or almond oil. It will be well to cover the eye from the cold, and from any dust that might irritate. You will soon find that it is as clear and sound as could be wished.

Eyes, Squinting.--Various affections of the eyeball muscles cause this. To cure it is often easy, sometimes very difficult. The method of treatment is to stimulate all the nerves of the head and face, and at the same time to soothe their irritation. This is accomplished by massaging the brow and entire head. It must be gently and soothingly done. The open hands are drawn upwards over the brow from the eyebrows, the rubber standing behind the patient. Then both sides of the head and the back of the head are stroked similarly. After this the whole head is rubbed briskly with the finger-points. This should be done often, even four or five times in the day. If the patient objects, it is being unskilfully done; the right sort of rubbing is always pleasant. A squinting eye has been cured in a few rubbings, where the case was a simple one. If the head becomes very hot, it may be cooled as directed above for Children's Sleep. Squinting may be produced or increased by that state of the stomach and bowels in which worms are bred.

Face, Skin of.--To secure a healthy appearance of this is worth much trouble, and any eruption or unhealthy redness is a great trial, especially to ladies. To cure and prevent these, it is usually necessary to look first to the _diet_. A disagreeable redness of the nose, and pimples in various places, is the common result of too much rich food, not to speak of alcoholic drink, which is always most injurious to the face skin. The use of corsets is another fertile source of this trouble, and many in their desire to improve their figure ruin their faces. Plain, easily digested food is to be taken. Tea must only be used _at most_ twice in the day, and should be exceedingly weak. Half-a-teacupful of hot water should be taken before every meal, and everything possible done to promote digestion. The whole skin must be brought into a healthy state by daily washing with M'Clinton's soap (_see_ Soap); no other should be used for toilet purposes. It is far better than the boasted and expensive "complexion soaps," and can now be had in various forms. Many faces are injured by the kind of soap used in washing. The use of the kind we recommend is remarkably pleasant and beneficial, and a full account of it, and of our motives in recommending it, will be found under article Soap. If, however, the face will not stand the touch of water at all, good BUTTERMILK (_see_) forms the best wash and cooling application. Also a _cloth mask_ may be worn all night, lined inside with soft creamy soap lather. In violent face irritation this last treatment is especially valuable.

For pimples on the face, the general treatment for the skin mentioned above (_see_ Eyes, Inflamed) is to be used, especially applied to the skin of the back. The buttermilk wash may also be used, but the best effect comes from the general treatment of the skin.

Fainting.--Fatigue, excessive heat, fright, loss of blood, hunger, etc., are common causes.

The action of the heart is temporarily interfered with, and pallor, a sweat on the forehead, with an indescribable feeling of sinking away, precede unconsciousness.

The first thing to do is to bend down the patient's head till it touches the knees, and keep it there for a few minutes. After he has partially recovered consciousness, the clothing should be loosened, and all tight bands or braces removed. The face and hands should be bathed in cold water, slapping the face with a wet towel. Some stimulant, such as hot tea, coffee, or sal volatile, may then be given.

If there is a wound causing loss of blood, it should be attended to at once.

In case fainting is due to hunger, the greatest care should be taken to give only small quantities of food after recovery, as a large amount may prove fatal.

A sip of cold water, or bathing the face with cold water, will generally prevent a threatened fainting. If there appears any immediate danger of a relapse, keep the patient in a horizontal position for some time.

Persons liable to fainting fits should be careful to avoid extremes of temperature, such as very hot or very cold baths.

Fall, A.--After a fall from a height, where there is no apparent outward injury, there is often such a severe shock to the spinal cord and brain that continued unconsciousness occurs. In such a case, foment the spine at first, to remove the effects of the concussion. This may bring on serious difficulty of breathing, owing to congestion of the spinal cord. This can be removed by applying cold cloths along the spine. If the difficulty of breathing be present from the first, then apply the cold at once. The first effect of such a fall is to deprive the brain and spinal cord of vital force. This must be restored by _heat_. Subsequent effects due to congestion can be removed by cold. The effects of a shock in a railway accident may be similarly treated. Common sense will guide in using heat or cold by watching the effect. Where heat fails try cold. This is the simple rule. It is good also to give the patient some simple purgative medicine, and some warm drink. _Avoid all doses of alcoholic drinks._ We have known the flickering flame of life almost extinguished by a teaspoonful of brandy.

Feeding, Over.--It is well to remember that over-feeding is a relative term. To take more than a weak stomach can digest, is to over-feed, although very little be taken. We give some invalids food every two hours but that food is only two-thirds of a teacupful of milk, mixed with a third of boiling water. In every case we must watch to give the right amount, no less and no more. Every case will require to be considered by itself in the light of common sense. The amount of food eaten should be just sufficient to supply the body with material to replace that consumed in work, build up its wasted tissues and leave a slight surplus over for reserve store. Anything more is harmful. In youth, if too much be eaten, nature relieves herself by giving the transgressor of her laws a bilious attack, during which there is no appetite, and so the excess is worked off. In later years this safety valve does not work, and the surplus is generally stored as useless fat, impeding the action of the heart or other internal organs, or as gouty deposits in various parts. The Anglo-Saxon race at all events does not limit its diet as we think it should, and Sir Henry Thompson, M.D., has stated that in his opinion more ill-health arises from over-eating than from the use of intoxicating liquor, great a source of illness as this last undoubtedly is.

Temperance in diet is absolutely necessary therefore, if one would be healthy, and the avoidance of stimulating foods, with a restriction of flesh foods especially, is a precept which the great majority of well-to-do people need to attend to.

Bilious attacks, headaches, indigestion, etc., are simply nature's protest against the excess of food being forced upon her, and the natural cure is to severely restrict, or still better, entirely stop the food supply for a day or two. The idea that "the system must be kept up" is a very foolish one; people have lived for forty days and upwards on water alone, and a few days' fasting is a far safer remedy for the troubles we have mentioned than purgative drugs.

Those who have a stomach which quickly rebels against too much or unsuitable food, may, as Sir Henry Thompson says, congratulate themselves on having a good janitor preventing the entrance of what would injure. The man who can and does eat anything, rarely lives to old age.

The perfect appetite which comes from the moderate use of simple foods is a relish which must be experienced to be appreciated.

One way in which the amount of food needed to satisfy the appetite and build up the body may be very largely reduced, is by increasing the amount of mastication. If each bite of food is chewed and chewed until it is all reduced to a liquid state, the amount required will be less than half of what is usually taken, and so much less strain will be thrown on the excretory organs.

Feet, Cold.--Continued coldness of the feet gives rise to many more serious troubles, and should always be attended to. There is no better cure than daily BATHING THE FEET (_see_), followed by rubbing for several minutes, say five, with hot olive oil after drying. Rub briskly, until the feet glow. Put on dry warm stockings, and see that all foot-gear is kept as dry as possible. Another method of curing cold _sweaty_ feet is to rub the soles with CAYENNE "TEA" (_see_), and afterwards with warm olive oil. Dry carefully, and wear an extra pair of dry cotton socks or stockings. When the sweating is very abundant and obstinate, there is usually more or less failure in the nerves which keep the skin in order. The feet must then be properly _bathed_ (_see_ Bathing the Feet), then dried and treated with cayenne lotion as above.

Feet Giving Way.--Where there is a great deal of standing to be done by any one, the feet sometimes yield more or less at the arch of the instep. This becomes flattened, and even great pain ensues; lameness sometimes follows. Young girls who have to stand much are especially liable to suffer in this way. In the first place _rest must be had_. Wise masters will provide due rest for their employees, foolish ones overwork them. Rest is not against, but in favour of work; work cannot be well done without due rest. The proper rest for feet such as we speak of will be the most easy and comfortable position. _Comfort_ is the test of the right treatment. Bathe the feet in hot water for a good while, using plenty of soap. Rub gently with hot olive oil, pressing any displaced bones into, or near, their place. Carefully avoid giving pain. Massage similarly with oil the whole limb, and also the back (_see_ Massage). Do this every day at least once. You may have months to wait, but a sound limb is worth a good deal of patience. When standing is absolutely necessary, strips of strong sticking plaster passed down from above the ankle bones, and round under the instep, help greatly.

Boots are better than shoes, and should be comfortably easy, with low heels.

Fever.--In all fevers, to _cool down_ the excessive heat of the patient (_see_ Heat, Internal) is the best process of treatment. This may be best done by continued cooling of the head. Have a towel well wrung out of cold water. Fold it so as to envelop the head. Press it gently to the head all round, changing the place of pressure frequently. Have a second towel ready, and continue cooling with freshly cooled towels perhaps for an hour or an hour-and-a-half. Then leave the last cold towel on, and put a dry towel above it. The next cooling, when the fever heat again arises, may be given, if it can be managed, by placing a cold towel along the spine. Cover this with a dry one, and let the patient lie on it. Change this, though not quite so frequently as in the case of the head. Work _carefully and gently_, so as not to annoy the patient. If ice can be had, it may be put in the water used to cool the cloths. If the feet be cold, foment them in a blanket (_see_ Fomentation). Keep this on the feet for an hour. There will most likely be great relief with even one course of such treatment. It must, however, be _persevered in_ until the fever be conquered. In any case of fever, when a patient is too weak to bear the hot fomentation and cold towels, we would recommend rubbing the feet and limbs if cold with hot oil, and the stomach and chest, and if possible the back with soap lather. It is well at first to soap the stomach only, and for some time; and each time till the last it is well to wipe off what you have rubbed on, so that the skin may be as clean as possible for the next. To do this only once is often quite sufficient to soothe, so that the patient falls off into a gentle, natural sleep.

Now, no one need imagine that there is any difficulty in the way of anyone carrying out the right treatment. We have known a young sister who saw her brother brought home in fever. The medical man predicted a long and serious illness, and the necessity of being prepared for all the usual features of such a case. The sister heard all in thoughtful silence, but when the doctor went away she said to herself, "May not I lower this flame? At any rate I will try." So through the night she so effectually cooled her brother's head that when the medical man came next day he expressed his most agreeable disappointment, saying, "It is to be a very light case after all." So it turned out to be, but it would not have been so but for that brave sister's aid. We cannot but earnestly beseech all who have the opportunity to go and do likewise. Often, especially among the poor, dirt and hot, close air have made the fever room a source of frightful danger to all around. Absolute cleanliness, abundance of pure air, and disinfection of the stools, should always be attended to.

Fever at Night.--Frequently, in illness, a fever sets in as night approaches, and increases toward midnight, passing away during the day. The treatment may be as below for Intermitting Fever.

Fever, Delirium in.--_See_ Delirium.

Fever, Gastric.--In this fever, now known as a form of Typhoid, the disease spreads a sort of blight over the nervous centres, and from the first greatly lowers their power. The patient is too weak to bear the powerful cooling recommended in Fever; there is also a tendency to prolonged and "low" fever. First of all, in such a case, the feet and legs must be fomented. Watch against burning the patient, but get as good and powerful a heat as possible right up over the knees. Then after about fifteen minutes the cooling of the head may proceed as in fever. Both cooling and heating must proceed together.

We must think of not merely relieving, but of curing the patient, by attacking the poisonous substance where it has lodged in the nerve centres of the bowels. Pure water, with just as much acetic acid or vinegar dropped into it as will make it taste the least sour, should be given in tablespoonfuls (and hot) as frequently as the patient can take it without discomfort. If possible it should be distilled water, or rain water filtered, but certainly as pure and soft as can be procured. There is no drug that can be prescribed that is equal to pure water, and no acid better than common white vinegar. These three things--the strong fomentation of the feet and legs, the cooling of the head, and the dissolution of the poisonous substances by means of pure water, and their counteraction by means of acid in very small strength--will do wonders in gastric fever. The "turn" may be secured in a week instead of three, if these things are skilfully and persistently applied. We should say that the strong fomentation and cooling of the head should not be done oftener than twice a day, and only once if the patient feels too weak for twice. But as a general rule, the person who is ill will wish these things at least twice a day. The sips of water should be given, say in a dozen separate tablespoonfuls at a time, at least thrice a day--oftener if desired by the patient.

For food there is nothing equal to good fresh buttermilk. All alcoholic drinks are damaging in a high degree in such an illness as this. Sweet milk, if somewhat diluted with good water, will do, but there is nothing so good as the buttermilk fresh from the churn.

Absolute rest in bed is necessary, and no solid food should be given to the patient until his temperature has been ten days at normal point. All food given in the illness should be liquid enough to pass through the meshes of a milk strainer. Care should be taken in this matter, as death has often followed the taking of solid food, when otherwise recovery would have come.

Milk should always form the largest portion of the diet, and may be given with arrowroot or oatflour. Beef tea is of little use, and is always to be avoided if there is a tendency to diarrhoea. Plenty of cold water may always be given.

In a community which is visited by gastric fever as an epidemic this fact is striking--only a portion of the people are affected by the visitation. Here is one man who drinks the water which gives gastric fever to another; that water goes into his stomach as it does into that of his neighbour, and passes through his system the same, yet death is the result in one case, and not even sickness or inconvenience in the other. In the latter case the system has the power of resistance, and our aim should be to increase this. Therefore we say by all means look to the healthful state of the lungs and bowels when you have the least reason to fear that bad water may bring gastric fever to you or yours. If there is any tendency to constipation get some liquorice, and boil it thoroughly with about half an ounce of senna leaves to a twopenny stick. Strain well, and let all in any danger have a teaspoonful of this thrice a day. It will do wonders in keeping matters in a good state within. If possible, give a good rubbing all over once a week with hot vinegar, and follow that up with warm olive oil. That will do a great deal to keep things right outside. Take and give more rest than usual to the toil-worn when such danger is near, and have as good food provided for all as is possible. There may be danger in the air, and still worse danger in the water to those whose vital force has got low, while there is none in either to those whose systems are in good tune.

You are, perhaps, ready to ask if we care nothing about bad water? Certainly; we care a great deal about it, as we do about bad air. By all means condemn wells and streams that are corrupted, and insist on the opening of better ones. Make it a first condition of having anything to do with a place for habitation that it has good air and good water. We are only pointing out the best safeguard when neither the one nor the other can be insured.

In all cases where water is suspected, it should be boiled before use.

There is, in great numbers of persons, both old and young, what may be called the natural aptitude of healing. They are kept back from trying to help because it is regarded as so dangerous a thing to go near fever, and also to interfere where only professional skill is legally allowed. To apply such a remedy as that which we have here sketched for gastric fever is perfectly safe in both senses. No medical man worthy of being regarded will find any fault with it, and there is no danger to either the patient or the person applying it.

The mode we have pointed out involves nothing that may not be easily had by the very poorest. What is wanted is only one or two who shall be Christian enough to care just a little for human bodies as well as human souls, and who shall study such simple and accessible remedies, and be ready to guide their fellow-creatures in a time of trouble.

Fever, Hay.--_See_ Hay Fever.

Fever, Influenza.--This is a slow, smouldering kind of fever. For treatment, pack the feet and legs in hot fomentation over the knees, and apply cold cloths over the stomach and heart, taking care in applying the cold if the patient is weak. In such a case only moderately cool cloths should be used. Carry out these two processes effectively, and a cure should soon result. Give light food--milk and water, and milk diet generally. Give small quantities frequently rather than a good deal at once.

Fever, Intermitting.--For this the treatment may be given as in gastric fever, and, in addition, the stomach and bowels should be carefully lathered over with soap lather (_see_ Lather). This has a wonderfully soothing effect. It may be spread with the hand over the skin, and fresh supplies gently rubbed on until much of the fever is removed. Some five minutes' lathering at a time is enough--this may be done several times a-day. Carefully dry after it, and let the patient rest.

It will be well to anticipate such attacks by softening the skin when it shows a tendency to be hard and dry. A gentle rubbing now and again with fine lather and good olive oil will secure this. We say lather and oil because, when there is no fever heat, lather by itself is too cooling, but when mixed with a little oil the mixture is comforting rather than chilling, and softens nicely.

Fever, Rheumatic.--This results from severe damp chills, usually following exhaustion from some cause. Its best treatment at an early stage is by heat applied to the spinal nerves. If the trouble be chiefly in the legs, treat the lower back; if in the arms, treat the upper back. The heat is best applied by a large BRAN POULTICE (_see_). A teaspoonful of tincture of Guaiacum may be given before each poulticing, which may be done twice a day for an hour. We have known an illness that threatened to last six weeks cured in one week by this means. Give also teaspoonfuls of hot water from time to time.

Where the trouble has advanced to severe fever, and swelling of the joints, an entirely different treatment is best. Let a lather of soap be made (_see_ Lather), and spread over the chest first, and afterwards gradually over the whole body. After four or five coats of lather have been put on, wipe off with a dry cloth, and proceed to lather again. We have seen half-an-hour of this treatment, well done, greatly relieve the fever; it was continued twice a day, and in three days the trouble was conquered. Care must be taken not to chill the patient. The soaping can be accomplished with only a small part of the body uncovered at once, and, with proper precautions, the bed can be kept perfectly dry. If a proper liniment is procured and lints sprinkled with it wrapped round the joints, the pain will be wonderfully relieved. But such liniments are only to be had on the prescription of a really good medical man, who will not, if he really seeks to heal, and knows his business, object to our treatment being applied.