Chapter IX: Part 9

Limbs, Drawn-up.--We have had many cases of contracted limbs, arising from various causes. Some of these have been completely cured, even when the tendons or _cords_ which were contracted were going to be _cut_ by medical advice. In one case, however, of which we knew, the medical man ordered the very treatment we employ.

In the first place we must have EXERCISE (_see_). This may be given by massaging the back and limbs with a gentle squeezing motion for half-an-hour twice a day (_see_ MASSAGE). Use hot olive oil for this rubbing, and _persevere_. If the feet be sweaty, rub them with the CAYENNE LOTION (_see_). But the effective cure will be found in the careful and persevering rubbing and pressure.

Sometimes we find that a failure occurs in the large haunch joint itself, and that is not only shown by pain and stiffness, but by one or more sores that discharge matter, indicating that the bone is diseased. At the same time, the sinews of the limb affected give signs of contraction, and the heel soon refuses to come to the ground in walking. There is clearly a lack of vital energy, such as is wanted to heal the bone and nourish the leaders in this limb: this lack may have been showing itself for years. Apply the ARMCHAIR FOMENTATION (_see_). Soon the sores begin to put on a healthier appearance, and ere long they heal up. With this and the rubbing, the sinews begin to relax and lengthen out, so that the heel comes nearer the ground. The limb may even have become smaller than the other, but it grows so as to come up with the healthy one: this will be the case though the fomentation is done equally to both. It is a curious thing that the body is so constituted that general healthy growth tends to bring on weaker parts more rapidly than stronger ones, so as to restore proper proportions. The new force applied to the roots of nerves on both sides of the spine does not make the healthy limb grow so as to keep in advance of the weakened one; it makes the weakened one grow so as to come up with the healthier. You do not therefore need to confine the fomenting to one side; it is better to apply it equally to both sides, and to leave the laws of the constitution to arrange all matters as to proportion. These laws never fail to do so perfectly. In the hands of a really skilful surgeon, much may be done to remedy diseased bone by the modern methods of antiseptic treatment and operation, but where these are not available, the above treatment has most excellent effects, and has sometimes cured where the surgeon has failed.

Limbs, Fractured.--It is not always easy to say definitely whether a bone is broken or not. In general, however, the following are signs of fracture:--(1) Loss of power in the limb; (2) Swelling or pain at the injured spot; (3) Distortion of the limb, usually shorter than natural; gentle pulling makes it temporarily regain its natural position; (4) When the limb is gently moved, it moves at some spot between the joints, and a grating sound is heard; (5) In case of a bone which lies near the skin, a touch will perceive the irregularity due to the fracture.

Pending the surgeon's arrival, if there is a fracture, do not attempt to move the patient till the limb is so secured that the broken bone is prevented from moving. If the arm bone is broken, put one splint inside and another outside the arm, and tie two bandages, one on each side of the fracture. Sling the arm in a small arm-sling like the straw envelope of a bottle.

If the thigh be fractured, get a long splint, such as a broom handle or a rifle, placing it from the pit of the arm to the foot. Bandage around the chest, the hip bones, legs, and feet, and then by two bandages, one above and the other below the fracture.

If the leg bone or bones be broken, an umbrella makes a good splint. Another splint should be applied on the inside of the leg, the two firmly bandaged together, and finally the legs tied together.

If the knee-cap only be fractured, tie the leg on a splint from hip to foot, and keep the limb raised.

Almost any firm substance which can keep the limb at rest can be used for a splint, but if hard it should be padded. If the fracture is accompanied with severe bleeding, stop the flow first before attending to the fracture. (_See_ Wounds.)

Limbs, Inflamed.--Entirely different treatment from the above is needed for such a thing as inflammation of the elbow, wrist, shoulder-joint or knee.

Say it is an inflamed elbow that is to be treated. We describe this; but similar treatment, with very slight variation, such as common sense will suggest, answers for the other joints.

Have two large plain towels wrung out of cold water, and folded so as to wrap six ply thick round the elbow. See that the patient is otherwise warm. Place one of the towels round the joint, and gently press it (avoiding pain) so as to draw the heat out of every part. When this is hot substitute the other, and continue with fresh cooling--for an hour if necessary. The cloth may require to be changed perhaps thirty times; but the guide to this is furnished by its heating. When hot, change it. This may be repeated frequently, until the inflammation is subdued.

Limbs, Uncontrollable.--This trouble is found in the double form; first, of limbs which will not move when their owner desires to move them; and, second, limbs moving in excessive jerks when they are not desired to do so. These cases are often combined, the limbs being rigid at one time and jerking violently at another. There is no wasting or unhealthy appearance. We have found this condition caused by excessive walking, running, and standing, combined with exposure to frequent wettings. The result is, in essence, that _motor_ power in the limbs is in excess, while _controlling_ power is defective: the case is indeed similar to St. Vitus' Dance (_see_). Bathe the feet (_see_ Bathing Feet) in hot water, and apply cold towels folded and wrung out of cold water (but not iced) along the spine. Keep this up for an hour-and-a-half at a time. By that time the hard rigid feeling in the limbs will probably have disappeared, but great helplessness will be felt. You have removed the excess of motor energy, and must now increase the voluntary energy. This will be accomplished by gently rubbing the back and limbs with hot olive oil, as in Limbs, Drawn-up. This treatment, repeated daily, will usually soon cure.

Liquorice.--_See_ Constipation.

Liver, The.--Where biliousness prevails, without any symptom of real liver disease, it is well first to look to the state of the stomach and bowels. Take a teacupful of hot water twenty minutes before meals, and the liquorice mixture (_see_ Constipation) after meals. Then give a strong blanket fomentation to the feet and legs for an hour in the evening. If there be pain or feverish heat in the region of the bowels, press cold cloths over the painful part while the feet are fomented.

When the liver is really swollen, hardened, or painful, the pulse will either be quick with feverish symptoms or slow with coldness. If it be a feverish case, press cold cloths over the liver, changing them when warm, for an hour: at the same time foment the feet and legs as directed above. See that there is heat enough to make the patient comfortable under the cold applications. Inflammation of the liver will readily yield to this treatment.

When the case is a _cold_ one with slow pulse, use no cold cloths, but apply fomentations over the liver, as well as to the feet and legs. Smoking and alcoholic drinks must be entirely given up--these habits are peculiarly severe on the liver. The treatment will not be likely to cure in a day or in a week, but patient perseverance with the fomentations should eventually effect a cure. Too rich food throws a great strain on the liver, and a plain and spare diet with prolonged mastication is necessary with above treatment if a cure is to be effected.

Locomotor Ataxia.--This disease is a most difficult one to deal with, and any healing is very slow work. Patients past middle life are specially difficult cases, but we have known cure, or at least great mitigation in younger persons by the following treatment. Beginning, say on a Tuesday, let the lower back be well rubbed with hot olive oil, the patient sitting with the back to the fire, and well covered, except where being rubbed. Continue this rubbing for half-an-hour and not longer than three-quarters-of-an-hour. On Wednesday, soap the back well with soap lather (_see_) and after the soap rub with oil again. Next night, rub with acetic acid (Coutts's) full strength, until the skin is red and smarts moderately. Repeat this on Friday, and on Saturday and Sabbath do nothing. On Monday rub with acid again, and on Tuesday, etc., proceed as before. All treatment is best done at night, and the patient must be kept warm. He should also spend as much time as possible in the open air.

Lumbago.--Lumbago differs from both paralysis and cramp of the lower back in that it is not chiefly nervous, as these are, but is a trouble in the muscular substance itself. The muscles are either sprained or chilled, so as to have lost for the time their elasticity. Blistering, burning, and all such irritating treatment are only so many helps to the disease. The true method is found in gentle moist heating of the lower back by a BRAN POULTICE (_see_), not too hot, but renewed, if need be, for an hour each evening. Follow this up with a rubbing with hot olive oil. Wear a belt of new flannel round the body night and day in winter, or if exposed to cold. The treatment is simple, but if persevered in, cures most obstinate cases.

Lungs, Bleeding from.--This is usually taken as a most alarming, and even hopeless, symptom. It is not necessarily so at all, and even when a considerable amount of blood is lost, the patient may recover. Therefore, let friends not be frightened when this occurs, but bend their energies to proper treatment, and all danger may be averted. All alcohol must be avoided; it is most hurtful in such cases. Pack the feet and legs in a hot blanket FOMENTATION (_see_) and press cold cloths gently and equally over the chest or back where the blood is felt to be coming from: thus you stimulate the enfeebled nerves and brace the relaxed lungs at one and the same time. Relief will usually be felt at the end of two or three minutes. Continue the application till all pain and uneasiness are gone.

_Before_ taking the legs out of the warm pack, dry the chest carefully, rub it with warm olive oil, and wrap it up in good new flannel. Then take out the feet and dry them well; rub them gently and well with warm oil, put on a pair of soft cotton stockings, and allow the patient to rest. Squeeze an orange and give him an orange drink (_see_ Drinks).

When you have used this fomentation to the feet, and cold cloths once or twice, it will be well to place a large bran poultice across the lower part of the back, taking care again that this is only comfortably hot. When you have had the benefit of this once or twice, you may place a similar poultice between the shoulders; but this only after you have so far succeeded in cooling down the inflamed lung or lungs, as the case may be. During the whole of the treatment it will be well to watch what is agreeable to the sufferer. It is not only that a certain treatment, or degree of treatment, comforts, but that it comforts because it heals. Move the patient as little as possible during treatment, and do and say all possible to soothe the mind.

The whole treatment should be gone over a second time within twelve hours. The second day give one application of the treatment only, and repeat once again the third day. Except for the first time, the treatment may be limited to half-an-hour. Avoid hot food or drink, but it is not necessary to have it positively _cold_. This treatment we have found perfectly successful in many cases.

Lungs, Congestion of the.--Treatment as below. Read preceding and succeeding articles.

Lungs, Inflammation of the.--This is a common trouble in our climate, and, fortunately, one not difficult to cure if taken in time and properly treated. It is usually the result of a chill, and is accompanied with pain and inability to breathe properly, distressing fever, and often delirium. To begin with, all its evils arise from the relaxing of the vessels of the lungs, so that these swell, and the excess of blood causes inflammatory action to supervene. To guard against it, then, those influences must be avoided which reduce vitality; where they cannot be avoided, all must be done to counteract them. Mere exposure to cold or wet, unless accompanied by exhaustion from hunger, or grief, or other influence of the kind, rarely causes this trouble.

Where the trouble has set in, the treatment is the same as recommended above in Lungs, Bleeding from. If the patient be a very strong person, and the fever very great, the fomentation to the feet may be dispensed with; but if any uncomfortable coldness is felt, or the patient not above average strength, it should always be applied. No one who has not seen it can imagine the magical effect such treatment has. It is simple, but its efficiency has been demonstrated in a very large number of cases of cure.

Malaria.--Is now known to be conveyed by the bite of a certain kind of mosquito. Those who live in a malarious district should carefully exclude these from their houses, and by draining swamps and covering water butts prevent their breeding, which is always in stagnant water. If, however, exposure to infection cannot be prevented, much may be done to strengthen the system to resist it. Firstly, note that there is a great deal in the _food and drink_ of a family compelled to live in such a district. If they live largely on animal food, and drink alcoholic liquors, they will seriously add to the power of malarial influence. The use of simple food and _pure water_ will very much lessen it. Let us note that the very opposite of the popular superstition is the truth. A single glassful of gin, whiskey, or brandy, instead of "fortifying" against such infection, actually knocks down the "fortifications" which nature has reared against its power. These drinks, then, must be strictly avoided.

Massage.--This seems a very simple thing to do, but is by no means easy to do right, and it is very desirable that any one who can see it done by a qualified person should take advantage of the opportunity. The rubber must keep his attention closely fixed on the work, and though this is fatiguing to body and mind, it is absolutely necessary if the patient is to derive full benefit from the treatment. The skin should first be lightly rubbed with olive oil; except in very special cases "friction" between hand and skin is to be avoided. The hand should move the skin to and fro over the muscles and bones beneath, and should be always elastic, so as to go easily in and out of the hollows, and avoid violent contact with projecting bones in the case of emaciated patients. The good rubber should know anatomy so far as to understand where bones and muscles lie (_See_ Diagram, page 216). An intelligent moving of all the muscles of a part is almost equal in benefit to gymnastic exercise, and can of course be given to those for whom gymnastics are out of the question. Yet such rubbing may fatigue a very weak patient, and care must be taken not to carry it too far at one time. There should also never be any hurting of the skin. Where the hands are felt too rough, the back may be covered with a soft cloth, oiled with olive oil. All _strong_ strokes in rubbing the limbs should be directed _inwards_ to where the limb joins the body. The lighter strokes should be outwards. It is always well to have a light and heavy stroke, as a joiner has in sawing.

As an instance of how to squeeze, let us take an arm that has got wrong somehow. If you take this arm between your two hands very gently, you feel that it is harder than it should be. The large muscles, even when the arm is at perfect rest, have a hard feeling to your hands, and not the soft, nice feeling which a perfectly healthy arm has. Probably the muscles have been over-stretched, and sprained, or they have been chilled, and so have lost their elasticity and softness. Well, it will be so far good if you can bathe this arm in hot water. It will be better still if the hot water used is full of SOAP (_see_). You can make this bathing ten times more effective, if you only know what is meant by a proper squeezing of the muscles. You use your two hands in the water of the soapy bath, and taking the arm between them, gently press the muscles between your hands, with a sort of working upon them that makes the blood in the stiff parts rush out and in, according as you press or relieve the pressure. If you can only get hold of the idea, it will not be difficult to do this right. It may be that the cords of the arm are not only hard, but also contracted, so that the arm cannot be straightened or bent as it ought to be, but it is still so squeezable that you can squeeze the blood out of it, and it is still so elastic that when you relieve it of the pressure of your hands the blood rushes back into it. If this squeezing is kindly and slowly done, it will feel very pleasant, and very soon its good effect will be perceptible.

It is sometimes thought that there is some "magic" in one person's hands that is not in another's. Here is a case in which one person has rubbed, he thinks, perfectly right, and no relief has come. Another brings relief in a few minutes. It is concluded that some mysterious "gift" is possessed by the latter. This may do well enough for an excuse when you do not care to have the trouble of curing your fellow-creatures, but it is not true. If we are to "covet earnestly the best gifts," it must be possible for all of us to get them. "The gift of healing" is surely one worth "coveting," and we think must be within reach, or we should not be told so to covet it. _See also_ Head, Rubbing the.

Measles.--An attack of this disease generally begins with a feeling of weariness. Then it appears as running and irritation of the eyes and nostrils, at which stage it is often taken for a common cold, the symptoms being very similar. Then this irritation spreads more or less over all the breathing apparatus, and finally the eruption appears in smaller or larger red patches, sometimes almost covering the face and other parts. The usual advice given is to keep the sufferer warm. It is good to do this so far as _avoiding chills_ is concerned, but if the room be overheated and kept close and dark, only harm will ensue. The blinds of the windows should be kept drawn up to their full height, to admit as much _light_ as possible. _Fresh air_ should be admitted by keeping windows open. If the patient complains of sore eyes, these may be shaded by a screen, but not by lowering the blinds. This admission of free air and light is a very great preventive of the "dregs" which form so troublesome a feature in measles. The room can easily be kept sufficiently warm by fire in winter, even if the window be open. The patient must not be allowed to read or use his eyes much, or very serious mischief may ensue.

When it first appears in eyes and nose, a good large BRAN POULTICE (_see_) should be placed at the back of the neck and down between the shoulders. Cold cloths should then be pressed over the brow and upper face. Do this for an hour. Give to drink lemon or orange drinks (_see_ Drinks), taken hot, and in small quantities at a time. If this treatment is well done several times, the trouble may possibly be checked at the beginning. Where it has gone further, and cough shows irritation of the air tubes and lungs, then foment the feet and legs while applying cold cloths over the chest, as in BRONCHITIS (_see_). If there be fever, and no signs of rash, then, to bring it out, pack in the SOAPY BLANKET (_see_). Where this cannot well be done, a most effectual pack is a small sheet wrung out of warm water and wrapped round the whole body, with a blanket wrapped well round it outside to retain the steam about the skin. But the soap is better. As a rule, there is not much need for further treatment when the rash fully develops. If, however, fever still remains, rub all over with hot vinegar. This is best done in the evening.

When all fever has subsided, a good rubbing of the _back only_ may be given with warm olive oil. This may be done once a day. The feet should be watched lest they get clammy or cold.

For food, wheaten-meal porridge and milk food generally is the best. Do not give too much food at first, and keep the bowels well open.

Medicines.--The delusion that health can be restored by swallowing drugs is so widespread that we think it well to quote the following wise words from the _Lancet_:--

"An eminent physician not long deceased was once giving evidence in a will case, and on being asked by counsel what fact he chiefly relied upon as establishing the insanity of the testator, replied without a moment's hesitation: 'Chiefly upon his unquestioning faith in the value of my prescriptions.' It might perfectly well be contended that this evidence failed to establish the point at issue, and that faith in the prescriptions of a physician hardly deserved to be stigmatised in so severe a manner. But admitting this, there is still little to be said in favour of the sagacity, even if we admit the sanity, of the numerous people who spend money and thought over the business of physicking themselves, and who usually, if not indeed always, bring this business to an unfortunate conclusion. The whole tendency of what may be called popular pharmacy during the last few years has been in the direction of introducing to the public a great variety of powerful medicines, put up in convenient forms, and advertised in such a manner as to produce in the unthinking, a belief that they may be safely and rightly administered at all times and seasons, as remedies for some real or supposed malady. All this, of course, has been greatly promoted by column after column of advertisement in magazines and lay newspapers; but we are compelled to admit that the medical profession cannot be held free from some amount of blame in the matter or from some responsibility for the way in which drugs have lately been popularised and brought into common use as articles of domestic consumption. Medical men have failed, we think, sufficiently to impress upon the public and upon patients that the aim of reasonable people should be to keep themselves in health rather than to be always straying, as it were, upon the confines of disease and seeking assistance from drugs in order to return to conditions from which they should never have suffered themselves to depart. The various alkaline salts and solutions, for example, the advertisements of which meet us at every turn, and which are offered to the public as specifics, safely to be taken, without anything so superfluous as the advice of medical men, for all the various evils which are described by the advertisers as gout or as heartburn, or as the consequences of 'uric acid,' do unquestionably, in a certain proportion of cases, afford temporary relief from some discomfort or inconvenience. They do this notwithstanding persistence in the habit or in the indulgence, whatever it may be, the over-eating, the want of exercise, the excessive consumption of alcohol or of tobacco, which is really underlying the whole trouble which the drugs are supposed to cure and which at the very best they only temporarily relieve, while they permit the continuance of conditions leading ultimately to degeneration of tissue and to premature death. This is the moral which it is, we contend, the duty of the profession to draw from the daily events of life. The natural secretions of the human stomach are acid, and the acidity is subservient to the digestive functions. It cannot be superseded by artificial alkalinity without serious disturbance of nutrition; and the aim of treatment, in the case of all digestive derangements, should be to cure them by changing the conditions under which they arise, not to palliate them for a time by the neutralisation of acid, which may, indeed, give relief from present trouble, but which leaves unaltered the conditions upon which the trouble really depends. Those who look down the obituary lists of the newspapers will be struck by the fact that large numbers of people, in prosperous circumstances, die as sexagenarians from maladies to which various names are given but which are, as a rule, evidences of degeneration and of premature senility, while many who pass this period go on to enter upon an eighth or ninth decade of life. The former class, we have no doubt, comprise those who have lived without restraint of their appetites, and who have sought to allay some of the consequences thence arising by self-medication, while the latter class comprises those who have lived reasonably, and who, if annoyed by imperfect digestion, have sought relief by ascertaining and by abandoning the errors from which it sprang."

Among the most pernicious and dangerous of all the patent medicines on the market are the so-called "Headache Powders," whose almost instantaneous effects testify to the potency of the drugs they contain. Such powerful agents carry their own condemnation, for they cannot in the nature of things _remove the cause_ of the pain; hence their action is limited to narcotising the nerves. The disease continues, the damage goes on, but the faithful sentinels are put to sleep. These headache powders so increased the deaths from heart failure in New York City a couple of years ago that it became necessary to warn the public against them.

Memory, Loss of.--A more or less complete suspension of this faculty is a not uncommon form of mental and bodily illness. We do not so much mean the mere fading of past impressions as the loss of power to recall them, so that we cannot recall what we wish to remember. This is a result of any serious bodily weakness. It will come on through any exhausting exertion, or prolonged and weakening illness. Stomach disorder will also cause it. In this last case, drinking a little hot water at intervals will usually put all right. A cup of very strong tea will so derange the stomach in some cases as to cause temporary suspension of memory. We mention these cases to prevent overdue alarm at a perhaps sudden attack. The loss of mental power in such cases does not always mean anything very serious.

Just as the stomach affects the memory, so also much use of memory and mental strain tells severely upon the stomach. Digestive failures in strictly temperate persons often arise from an overstrain of the mind.

We explain these two actions, the one of body on mind, and the other of mind on body, so that care may be taken, on both sides, of the complex nature we possess. If this is done, there will be little chance of memory failing.

Mind in Disease.--Often a person, because of physical failure, becomes possessed of an utterly erroneous _idea_, which no reasoning can change or remove. Indeed, reasoning in such cases is best avoided. Attention should rather be directed to the physical cause of the mental state, with a view to its removal. Very probably you will find there is want of sleep, with a dry hard state of the skin of the head, and too high an internal temperature. You may then work wonders by soaping the head (_see_ Head, Soaping). The back also should be soaped similarly. If too great a cooling effect is produced by this, wipe off the soap and rub hot olive oil on the back instead. If this is not sufficient, rub the limbs also with the hot oil. We have seen the most pronounced insanity yield to this treatment, where the cause has been _physical_ and not mental. The secret of success is in so balancing the heat and cooling applications that the utmost possible soothing can be given without any chill.

Miscarriage.--An expectant mother should lead a quiet, orderly and healthful life (_see_ Child-birth). By this we do not mean laziness nor idleness, nor treating herself as an invalid. On the contrary, plenty of work, both physical and mental, and regular exercise are most beneficial, but care should be taken that work should not go the length of over-fatigue, and excitement, worry and anxiety should be carefully guarded against. The round of parties and other social functions into which many brides are drawn, frequently becomes the cause of miscarriage and other troubles. Any excitement, mental or physical, is most injurious, and the husband and wife who sacrifice present enjoyment will be richly repaid afterwards in the greater vigor and healthiness of the child; while those who live for the present will often have bitter regrets of what might have been.

If any weariness, heaviness, or pain are felt in the region of the abdomen, groin, or back, half-a-day, a day, or a few days in bed should, if possible, be taken. If any appearance of bloody discharge be noticed, there is decided danger of miscarriage, and the patient should immediately go to bed, remaining, as far as possible, perfectly flat on the back until the discharge ceases. It is even useful to raise the feet higher than the head, by placing bricks or blocks under the feet of the bed. The covering on the bed should be light, only just what is necessary to keep one comfortable, and the windows should be kept open. Light food should be sparingly taken for a day or two; not much liquid, and nothing hot should be drunk. A towel, wrung out of cold water, placed over the abdomen or wherever pain is felt, and changed when warm for a fresh cold towel (_see_ Bleeding), will help to soothe the pain, allay the hemorrhage, and induce sleep. The mind should be kept at ease, for such precautions, taken in time, will probably put all right. After the hemorrhage has entirely ceased, and all pain disappeared, some days should be spent in bed, and active life be only gradually and cautiously returned to. When there is danger of miscarriage, purgatives should be avoided; a mild enema is a safer remedy, if needful, but for two or three days perfect rest is best, and if the food be restricted, the absence of a motion of the bowels will not do any harm. The patient should, of course, have the bed to herself.

Miscarriages most frequently occur from the 8th to the 12th week of pregnancy. The time at which the menses would appear if there were no pregnancy, is a more likely time for a miscarriage than any other.

It should be remembered that miscarriages are very weakening and lowering to the general health, and to be dreaded much more than a confinement. The latter is a natural process, and, under healthy conditions, recovery of strength after it is rapid, while a miscarriage is unnatural, and is frequently followed by months of ill-health. Another thing to be remembered is that a habit of miscarriage may be established; after one, or more especially after two or three, there is likelihood of a further repetition of such accidents, resulting in total break-up of health.

Muscular Action, Weak.--The heart is the most important of all muscles. Sometimes the action of this is so weak that the pulse in the right wrist is imperceptible, and that in the left extremely feeble. The heart may be beating at the usual rate, only its stroke is much too feeble; and the effects are found in enfeebled life generally, sometimes shown in fainting fits. If such come on, lay the patient flat on his back, and if consciousness does not return shortly, apply a hot FOMENTATION (_see_) to the spine.

Sometimes this heart weakness is only a part of a general muscular failure. Muscles elsewhere in the body may even swell and become painful. If strychnine be prescribed, refuse it. It has only a temporary power for good, soon passing into a wholly bad effect. Thoroughly good vapour baths will effect some relief, and may be taken to begin with. The best remedy is found in gentle rubbing and squeezing the muscles in every part, specially attending to any that may be swollen and painful. Squeeze gently the muscular mass, so as to press the blood out of it. Relax the pressure again so as to admit the blood. Where no help can be had, we have known a patient so squeeze herself as to restore action to a useless limb. But of course it is best if it be well and frequently done, say twice a day, by a really careful operator who has some idea of anatomy. This may seem a simple remedy, but we have known two inches added to the length of a shrunken limb by its means, and the patient restored from apparently hopeless lameness to fair walking power. _See_ Massage.

Muscular Pains.--These pains occur usually when a patient has been for some time in one position, sitting or lying, and rises suddenly in a particular way. They sometimes take such hold of the breast or back muscles as to make it appear as if some serious disease were present; even in the limbs they may cause great distress on any sudden motion. They may arise from a gradual _overdoing_ of the muscles concerned. They are similar to what is commonly called a sprain, but as they are _gradually_ produced their cause is often overlooked, and needless distress of mind caused by taking the pain for that of cancer or some such trouble. We write to point out that pains do not always mean serious disease, and before any one becomes despairing about their health, they should make sure they understand their case thoroughly.

These pains, too, refuse to yield to ordinary hot and cold methods of treatment. The remedy is found internally in half a teaspoonful of _tincture of Guaiacum_ in a teacupful of hot water three times a day. After two or three days, a teaspoonful of the tincture may be taken in the cup of water. Continue until two ounces of tincture have been used. Or the tabloids of _Guaiacum and sulphur_, now found in our drug shops, may be taken, one tabloid representing the half-teaspoonful of tincture.

Externally, rub gently yet firmly the affected muscles with warm oil for ten minutes or so once a day for a week or ten days. Of course, rest must be taken, and the overstress which caused the trouble avoided in future.

Mustard Oil.--Where this is recommended the cold-drawn oil is meant, not the essential oil. The latter is a fiery blister.

Narcotics.--The use of these to give temporary relief, often degenerating into a habit, causes so much serious disease that we have felt constrained to insert an article warning our readers in regard to it. The use of tobacco we have found a fruitful source of dangerous illness. It tends to destroy nerve power, and through this to relax the muscular system. It has a most dangerous effect upon the mind, relaxing the brain, and even causing some of its functions to cease. It hinders clear reasoning, and in many cases brings on incipient paralysis. It is a fruitful source of cancerous diseases of the mouth. It destroys keenness of vision. It is of no use to quote exceptional cases in such an argument. Great men have smoked, as some great men have habitually drunk, to excess. But that is no argument for the average man of whom we speak. The very difficulty he has in giving up the use of tobacco indicates a diseased state of the nerves, which no wise man will willingly bring on himself.

The effect of the continued use of opium, chloral, and many drugs taken to gain soothing or sleep is _dreadful_: so much so that we have seen patients who were deprived of them, after some time of continuous use, perfectly _mad_ with agony. Let our readers remember that the relief given in using such drugs comes from a benumbing of the vital nerves. Their influence is _deadening_, and, if strong enough, kills as surely as a bullet. The wise medical man will, if he does administer such drugs, take care they are only taken once or twice. If a doctor orders their continual use he is to be distrusted. By all means let our readers avoid the terrible snare of ease and sleep obtained through narcotics. It is generally easy to give relief, in the various ways described in these papers, without resort to any such hurtful methods.

Suppose that you try a very hot application to the roots of the nerves affected, if you can guess about where those roots are. The doctor should help you to know this. The hot poultice is put on--we shall say it fails to relieve. Well, you put on a cold application at the same place. That relieves slightly. Whichever of the applications relieves should be followed up vigorously. Do not say, "Oh, it gives relief for a little, and then the pain returns." Follow up the little relief, and change from heat to cold as the pain or relief indicates. You can do no possible harm by such processes, and in multitudes of cases all will soon be right, and no opiate required at all. But you must not think all remedies at an end when you have tried one or two singly, and relief does not yet come. The large hot poultice may be put on the roots of the affected nerves, and ice-cold cloths placed on the branches of these nerves at the same time. Then the cold ice cloths may be placed on the roots and the hot on the branches. But remedies are not exhausted, by any means, when you have thought of two or three applications of heat and cold. The whole nerve system can be influenced by the rubbing of the head and spinal region, so as to wake up a strong increase of vital action in the nerve centres there. We have seen a patient who had been for months under medical treatment, and in agony except when deadened with narcotics, rendered independent of all such things by a little skilful rubbing alone. Perhaps you object that these remedies are "very simple." Well, that would be no great harm; but if they are so simple, you are surely a simpleton if you let your poor nerves be killed with morphia, while such obvious remedies are at hand. (_See_ Massage.)

Neck, Stiff.--For this, rub the whole back with soap lather (_see_ Lather; Soap), and then with acetic acid and olive oil. Rub the neck itself as recommended for Muscular Action.

Neck, Twisted.--This arises from the undue contraction of some of the muscles in the neck. It generally shows itself first in the evening, after the day's fatigue, and if neglected, or treated with blistering, iodine, etc., may become a chronic affliction. Yet it is not difficult to cure by right means. Opium should never be used. We have seen terrible suffering follow its use. The true cause must be attacked, which is an undue irritation of the nerve which controls one of the muscles, so that it contracts and pulls the head away. The nerves of the muscles which counteract this pull are also probably low in vitality, so that there is a slackening on one side and a pull on the other.

First of all, for a cure, there must be _rest_. Not more than three hours at a time should be spent in an erect posture, and between each spell of three hours let one hour be spent lying down. Avoid _all_ movement while lying, as far as possible. Secondly, soap the back thoroughly with LATHER (_see_) at bedtime. Cover the well-lathered skin with a large, soft cloth, leaving the cloth and lather on all night, and covering over all with flannel in sufficient quantity to keep the patient warm. If the spasmodic twitching comes on, apply cold cloths repeatedly to the back of the neck for an hour in the morning. If this is felt too cold, apply for a shorter time.

If the neck has become hard and fixed in a wrong position, rub as recommended in Muscular Action. This treatment has cured many cases.

Nerve Centres, Failing.--Many diseases flow from this cause, but at present we only consider one. That is where a "numbness" begins to show itself in fingers and toes, and to creep up the limbs. No time should be lost in treating such a case. It arises from failure in the spinal nerves, and these must be nursed into renewed vitality. This will be greatly helped by wearing over the back next the skin a piece of new flannel. Rub (_see_ Massage) the back with warm olive oil night and morning, working especially up and down each side of the spine. Pursue this rubbing gently but persistently, but do not fatigue the patient, which may easily be done. Cease rubbing the moment fatigue manifests itself. Continue this treatment for weeks even, and also treat, as in next articles, _mind_ as well as body. (_See_ Locomotor Ataxia.)

Nerve Pain.--_See_ Pain.

Nerve Shock.--After a fright, or some very trying experience, some part of the nervous system is frequently found to have given way. Heat is felt in the stomach. Then, if no treatment is given, curious feelings come on in the back of the head. Even inflammation of the stomach and brain may come on in severe cases. In any such trouble, alcoholic drinks, blisters, opium, and all narcotics are to be strictly avoided. These only lessen the already weak nerve power. Show the patient in the first place that there is no need for anxiety, the vast majority of such cases being easily curable by right treatment. We have seen this relief of mind alone effect a perfect cure. Therefore see to giving it. Wring tightly out of cold water two ply of new flannel, large enough to go round the lower part of the body, from waist downwards to hips. Put these round the patient, with two dry ply of the same flannel above them. Wear this night and day for a week or a fortnight. Keep the feet always warm and dry. Give plain, easily digested food. If St. Vitus' Dance shows itself, treat as directed under that head. Study the case in the light of all said on nervous troubles in these pages, and you will be able to cure almost any symptoms which may arise.

Nerves, Shaken.--By this we mean, not the nerve trouble which follows a sudden injury or fright, but the result of long-continued worry and overwork. Sleeplessness, great irritability of temper, depressing thoughts, restlessness, and even a wish for death, are all symptoms of this trouble. In any effort to cure it, the _mind_ must be largely considered. Thoughts of the constant care of a loving, Divine Saviour for even the least of His children, must be encouraged. Work, which is an intolerable burden when depressing thoughts are encouraged, will become easy when these are removed. If you get the sufferer made hopeful for time and for eternity too, you have half won the battle.

Again, in bodily matters, food or drink which is exciting must be given up, or very sparingly used. Tea should only be taken weak, and _at most_ twice a-day. Avoid long conversations, and especially discussions and debates. Let the head be soaped (_see_ Head, Soaping) with soap lather at night, and rub all over with hot vinegar and olive oil before rising in the morning. Many a shaken nervous system will speedily recover under such treatment. Take also _eight good hours_ for sleep, and allow no ideas of business or work to intrude upon them. No more valuable habit can be formed, by the healthy as well as by the nervous, than this. The whole will should resolutely be bent to remove the attention from every trying thought, when the hours of work are past, and especially on retiring to rest. Always recollect that this _can_ be _done_; assert mentally, or if necessary, audibly, that it shall. Do not let initial failure disappoint you; persevere and a habit will be formed. When the brain gets a fair rest in its hours of leisure, it is usually equal to all demands in ordinary hours of work.

All brain workers, in their leisure hours should let the brain rest, and if they must do something, let it be as diverse from their work, and as easy on the thinking power as is possible. (_See_ Worry).

Nerves, Spinal.--The spinal cord is continuous with the back part of the brain. It is a mass of nerve fibres, and from it branch off in pairs, all the way down from the brain, the great nerves which move the limbs and muscles of the body, and receive the impressions of sensation for conveyance to the brain. It is permeated by numerous blood vessels, which supply what is needed for the upkeep of the whole mass. When these relax, and become overfilled with blood, we have congestion of the spinal cord. This may often be easily remedied by cold cloths applied over the spine, with fomentations to the feet if necessary (_see_ Children's Healthy Growth; Fall; Paralysis; St. Vitus' Dance). If, on the other hand, the vessels are contracted, or the blood supply defective, we have great languor and coldness. This usually may be remedied by rubbing over the spine with hot olive oil. Violent heat, or blistering, simply destroys the skin, and hinders healthy action. Gentle heat, or gentle cooling, long continued, is the best treatment. Especially is this true in the case of little children (_see_ Children's Healthy Growth). For treatment of the nervous system, peculiar attention should always be paid to the point where all the spinal nerves enter and issue from the brain. This is at the hollow usually present at the base of the back of the skull, where it is jointed on to the spinal bones. Rubbing here is most powerful, either with acetic acid or olive oil, and hot or cold cloths should always be well pressed into the hollow, when applied to the head or upper spine. (_See_ Diagram, page 234).

Failures of muscular power are caused by failure in the spinal cord. If a child cannot walk, but only trails his legs, or if he cannot hold his head erect, skilful rubbing with hot oil on the spine will often quite cure the defects. Do not rub too hard. Feel for the muscles around the spine, and gently insinuate healing influence with your fingers, so as to reach the nerves below. Use a moderate quantity of oil, and the effects will be marvellous.

Nerves, Troubled.--Often a state of the nerves exists, without any apparent unhealthiness, which makes the whole system so sensitive, that ordinary sights, sounds, and smells become unbearable, and the patient feels the ordinary round of experience, which would never be noticed otherwise, an intolerable burden. Strange feelings all over the body, and an indescribable series of seemingly "fanciful" troubles, come on. It is of no use, and indeed injurious, to treat such cases as merely fanciful. The wrong bodily condition must be righted if the mental condition is to improve. The first thing needed is _quiet_. Quietness rests the overstrained nervous system very much. Nerve-benumbing drugs are most hurtful (_see_ Narcotics). Let the light in the room be subdued, and strong smells avoided. To rest the skin nerves, wear only Kneipp linen underclothing, and flannels _above_ this if required. Bathe the tongue and palate by taking mildly warm water into the mouth and ejecting it again. Soap the head, and all over the body, if it can be done without chilling, three times a week. (_See_ Head, Soaping; Lather, etc.).

Nervous Attacks.--What we call, for want of a better name, "nerve force," or "nerve action," is at any one time a definite quantity. In health it is distributed to all the sets of nerves equally, so that all work in harmony. But if its distribution be altered in certain ways, we find "fits" or "attacks" coming on. Action is greatly exaggerated in one part, and as greatly lessened in another--hence violent movements and complete unconsciousness co-exist. Children often have such fits. Where they arise from _indigestion_ as a result of bad food, the cure is found in teaspoonfuls of hot water, and a hot sitz-bath coming up over the bowels. Where bad blood causes the fits, poultices over the kidneys will usually help greatly. (For fits of teething children, _see_ Teething.) _See also_ Epilepsy.

Nervousness.--This frequent and distressing trouble is to be traced to a state of the nervous system in which sensibility has got the upper hand, and self-control is partly lost. It is difficult accurately and briefly to describe, but is an easily recognisable state. Firstly, then, we say this is a physical trouble, and the patient must not be blamed for it, but encouraged kindly to make every effort of _will_ to throw it off. A strong will can be cultivated, just as a strong arm, by _exercise_. Peaceful thoughts and Christian faith can also be cultivated, and anxious and disturbing ideas put down. Uniform, steady conduct on the part of all around is an enormous help to the nervous. For physical remedies, use no alcoholic drinks. These give temporary relief, but are fatal in their after effects. To cure nervousness is impossible unless these are given up. The physical treatment necessary will be found under Nerves, Shaken, and Nerves, Troubled.

Nervous Prostration.--Persons suffering from nervous prostration have probably allowed the urgency of seeming duty to drive them on in work till the vital energies have been fairly exhausted. At last they are completely broken down, and the very fountains of life are dried up. The brain itself has become incapable of giving sleep, or sound thought. But there is no need for despondency: this trouble is perfectly curable, only the right means must be employed.

In every case of real "nervous prostration," our question must be--How shall we enable this vital element to recreate itself? The answer is, with heat. Here we may detail the process which we know to be successful. Dip a four-ply cotton cloth in cayenne lotion, and lightly wring out. Lay this gently over the stomach and bowels, and over this an india-rubber bag full of hot water. All must be only hot enough to be comfortable. This application may remain on for two hours without any change, then it is repeated. Where no bag can be had, a good thick fomentation should be used instead. _See_ Nerves, Shaken; Nerves, Troubled, and all articles on nervous trouble.

Much depends on consideration of the individual case, and careful thought and strong sense are needed on the part of all dealing with such cases. (_See_ Changing Treatment.)

Dessertspoonfuls of light food should be given every half-hour, and increased in quantity as the patient can bear it. Avoid alcohol and all narcotics.