Chapter CD: AB. 3 aces 150 (6)

Cocoa Jelly.--Mix 1 dessertspoonful cocoa in ½ pint water, stir over the fire until it boils, sweeten it with ¼ lb. lump sugar, or according to the taste of the patient. Stir into it, whilst boiling, ½ oz. gelatine, soaked in ½ pint cold water for some hours, flavour with vanilla, and stir occasionally until the jelly begins to set.

Coffee Jelly.--Soak ½ oz. gelatine in ½ pint cold water, dissolve it in ½ pint very strong coffee, sweetened to taste. Extract of coffee can be used to flavour this jelly, and answers well.

Porter Jelly.--Procure a cow-heel (which should be thoroughly cleaned) and 2 calves’ feet; wash them in cold water, and put them into a pan with 5 pints water, and let them boil until the meat leaves the bones; strain the liquor through a hair sieve, and let it stand for one night in a cool place. Next morning put the stock into a pan with 1 lb. loaf sugar, ½ pint porter, the juice of 4 lemons with their rinds cut very thin, and the well-beaten whites of 8 eggs. Let all boil together till it rises to the top of the pan; then throw in a teacupful of cold water; then let it boil slowly about 20 minutes, at the expiration of which time add 1 wineglassful brandy. Boil 5 minutes longer, then lift the pan from the fire, and let it remain at the side of the fire, to keep hot. In about ½ hour the scum will collect in a lump, leaving the liquor quite clear. Run it into moulds.

Port Wine Jelly.--Take ½ pint port wine, 2 oz. isinglass, and ½ lb. white sugar candy. Let the ingredients be put together in a jar and stand for 6 hours; then put the jar into a saucepan of water, and as soon as it boils take it off the fire and strain through muslin; when cold it is fit for use.

Restorative Jelly.--Put into the jar in which the jelly is to be kept 2 oz. isinglass, 2 oz. white sugar candy, ½ oz. gum arabic, and ½ oz. nutmeg grated. Pour over them 1½ pint tent or port wine. Let it stand 12 hours, then set the jar in a saucepan of water, and let it simmer till all the ingredients are dissolved, stirring it occasionally. The jelly must not be strained. A piece the size of a nutmeg to be taken twice a day. If nutmeg is not liked, any other spice will do as well to flavour it.

Blanc Mange.--It is better, if possible, to soak the gelatine for this cream all night, because it will then dissolve in warm liquid, whereas if it is only lightly soaked, the milk must be boiling. Warm 3 gills milk or cream, and dissolve in it ½ oz. gelatine, previously soaked in ½ gill water. Sweeten to taste, and flavour with extract of vanilla. When nearly cold, stir into the blanc mange the whites of 2 or 3 eggs beaten to a strong froth. This blanc mange will be found light and nourishing in cases of great weakness.

Rice Cream.--(_a_) Boil 2 oz. fine rice in water for 5 minutes, strain it, and boil until tender in 1 qt. new milk. Rub the rice through a sieve to a pulp, and add to it any milk not absorbed in the boiling; ½ oz. gelatine to 1 pint rice and milk. The gelatine can be soaked and dissolved either in milk or water. Stir over the fire until mixed, sweeten and flavour to taste. Stir the cream occasionally until cold, then lightly mix in the whites of 2 eggs beaten to a strong froth; when on the point of setting put it into a mould.

(_b_) Make 1 pint milk or cream into custard with the yolk of an egg and 2 oz. sugar; then dissolve in it ½ oz. gelatine previously soaked. Mix with it 1 oz. rice which has been baked or boiled in milk until perfectly tender, flavour with vanilla, and add 1 teaspoonful brandy if liked. Rinse a mould with cold water, put the cream into it, and let it stand until firm enough to turn out.

Semolina Cream.--Soak 1 oz. semolina in 1 gill cold milk for an hour, boil it until soft in ½ pint milk. Dissolve ½ oz. gelatine, previously soaked in ½ gill water, in ½ pint boiling milk, sweeten it with 2 oz. lump sugar, flavour to taste, and when the cream is beginning to set, put it into a mould.

Alexandra Cream.--Make ½ pint rice cream (_a_) or blanc mange as directed in the foregoing recipes. Dissolve ½ pint Nelson’s port wine jelly (sherry can be used if preferred, but the colour is not so tempting), either adding water or claret, according to the directions given with the jelly. When both the cream and the jelly are on the point of setting, put first a layer of the latter into a mould, then of the former, and so on until all is used. (Mary Hooper.)

_Beef Tea._--(_a_) Cut 1 lb. beefsteak into dice, rejecting all skin and fat. Put into a stewpan a bit of fresh butter the size of a bean, throw in the meat, and sprinkle over a small pinch of salt. Cover the stewpan closely, and set it on the range at a low heat to draw out the juices, which will take 20 minutes. Take care there is no approach to frying, as that would dry up the extract and destroy the character of the tea. About every 5 minutes during the process drain away the gravy as it comes; if the meat is fine and fresh there will be at least ⅓ pint, and when all is drawn set it aside, either to use as extract of beef or to be added to the tea when finished. Now put to the meat 1 pint water, and let it boil gently for ½ hour. Pour the tea off, but do not strain it, as such nourishment as it contains lies in the thick portion. Of course if a patient is unable to take any solid this rule will not apply, and the tea must then be strained either through a linen or flannel bag. Having drained off the tea whilst still boiling hot, put into it the juices at first extracted, and having taken off every particle of fat it will be ready to serve.

(_b_) Cut the meat into small pieces, cover with water, and simmer an hour. If it is allowed, 2 or 3 peppercorns and a minced shallot--it is milder than onion--will be a nice addition to the tea.

(_c_) Cut the meat into very small pieces, and put it in a jar having a closely fitting lid, with cold water. The jar can be placed in the oven for 1-2 hours, according to the heat, or in a saucepan of water to boil for 1½ hour.

In all cases where it can be taken, beef tea should be slightly thickened, and especially when bread is refused. Boiled flour is best for this purpose; genuine arrowroot may also be used. The yolk of an egg beaten up in the broth-cup, and the tea poured boiling on to it, is excellent.

The meat from which beef tea has been prepared will make good stock, or be excellent if properly treated for the dinner of the family, who, be it remembered, have the chief of the nourishment in the fibre.

It is important in the preparation of beef tea to preserve the fine flavour of the meat, and to use such scrupulously clean vessels that no foreign taste can be imparted to it. The shin of beef should not be chosen for this purpose, for it gives more gelatine than juice. The best part is beefsteak or the neck; the first will yield the most gravy, and does not cost above 2_d._ per lb. more than the coarser portion of the ox.

The idea that beef tea should be boiled a long time in order to extract all the goodness of the meat is a mistaken one, for the gelatinous matter thus gained is of comparatively little value, whilst the delicate aroma of the tea is lost by long boiling.

_Gruel._--Made as it should be, gruel is rarely disliked, and is more nourishing, and in many cases to be preferred to arrowroot--a thing most difficult to procure genuine, and very expensive. Made thin, as is customary, it is a comfort in sickness, is soothing to the stomach, and gives warmth to the body; made thick as a porridge it is the most nourishing of cereal foods. Robinson’s Embden groats, and Robinson’s patent groats, prepared by Keen, Robinson, and Bellville, are the only kinds of which gruel can be properly made. They are entirely free from the acrid flavour which is so disagreeable in inferior preparations of oatmeal, make a most nourishing and digestible gruel, with the advantage of being easily and rapidly served up--if made from the patent groats, the Embden takes longer--ten minutes only being required in the process of cooking. Robinson’s Embden groats were introduced about the year 1764 by Mr. Martin Robinson as an improvement upon the “whole gritts” then in use. In 1823 letters patent were taken out for a greater improvement known as Robinson’s Patent groats, now in use in all parts of the world. Take of the patent groats one tablespoonful, mix into a smooth paste of the consistence of cream with a wineglassful of cold water, pour this into a stewpan containing nearly a pint of boiling water or milk, stir the gruel on the fire while it boils for ten minutes; pour into a basin, add a pinch of salt and a little butter, or if more agreeable some sugar, and a small quantity of spirits if allowed. If made with water, milk or cream can be added afterwards.

A delicious substitute for gruel is made as follows: 1 oz. each rice, sago, and pearl barley; put 3 pints water, and boil gently for 3 hours, when the liquor should be reduced to 1 qt. Strain it in exactly the same manner as groat gruel, and flavour with wine, brandy, or anything else that may be suitable. If made a little thicker, say with 1½ oz. each ingredient to 3 pints water, a jelly will be produced, which may be eaten cold with sugar, fruit, syrups, or preserve.

_Arrowroot._--(_a_) To make plain water arrowroot, with an Etna, put on ½ pint water to boil in the saucepan; mix, in a cup, 1 dessertspoonful arrowroot with a little water; pour the mixture into the boiling water, and cook it for 2-3 minutes, stirring all the time.

(_b_) Milk arrowroot is prepared exactly in the same manner. Some persons affirm that arrowroot should never be boiled, or it will lose its astringent qualities. In some particular cases, when strong astringents are needed, it should not be boiled, and should only have boiling water or milk poured upon it; but when the digestion is weak, it is better for the patient to take arrowroot cooked. Sifted sugar may be added according to taste; and in water arrowroot a little wine or brandy is generally given.

_Pastry and Bread._--Any fat that is greatly heated decomposes, and gives rise to certain fatty acids that are sure to disagree with delicate persons. That is the reason why pastry and fried food are unfitted for invalids. Very plain pastry, made light with baking powder, is sometimes admissible; but a small egg or milk loaf with the inside taken out, and baked crisp and hot, is a much better substitute. Sponge cake is best of all cakes, because it is made without any butter. Bread should not be new, but may be baked crisp in the oven. Crust is often more digestible than crumb. A change in bread is easy to arrange; if it is only a change of shape, it is better than monotony. A French roll, loaves of baking powder bread, brown and white pulled bread, crisp biscuits, are easy to get in most places.

_Puddings._--(_a_) Boil ½ pint milk with cinnamon, lemon, and bay leaves; add 2 oz. sugar, 1 oz. flour, a little salt, and 3 eggs; beat all together, and steam this custard in a plain mould or basin, previously spread inside with butter; when done firm and quite cold cut into square pieces and dip in frying batter; drop separately in boiling fat, and fry a light brown colour, and dish them up on a napkin. (_b_) 6 oz. finely-grated bread, 6 oz. currants, 6 oz. sugar, 6 eggs, 6 apples, some lemon peel and nutmeg; let it boil 3 hours. (_c_) Weight of 2 eggs in butter, which beat to a cream, same weight of flour, same of pounded white sugar, the grated rind and juice of 2 lemons; bake ½ hour in a small flat pie-dish, with a rim of paste round the edge, serve with sifted sugar on the top, and send up very hot. (_d_) ½ lb. best beef suet, ½ lb. grated breadcrumbs, ½ lb. beaten white sugar, 3 eggs, well beaten and strained; the grated rind and juice of a large lemon, stick a mould with raisins, pour in the mixture, boil 2 hours.

_Treacle Posset._--Heat ½ pint milk in the saucepan, and when in the act of boiling, pour in 1 gill (¼ pint) treacle. The milk instantly curdles. It must be taken off the spirit lamp and allowed to stand for 10 minutes, and then strained through a piece of muslin to separate the curds. This must be drunk hot. White wine, whey, and lemon whey, are prepared in a similar manner, only substituting a glass of sherry in one case, and a glass of lemon juice in the other, for the treacle. All wheys must be strained before they are taken.

_Restorative Soup._--Take 1 lb. newly-killed beef or fowl, mince it very fine, add 8 fl. oz. soft or distilled water, 4-6 drops pure hydrochloric acid, 30-60 gr. common salt, and stir well together. After 3 hours the whole is to be thrown on a common hair sieve, and the fluid allowed to pass through with slight pressure. On the flesh residue in the sieve pour slowly 2 oz. distilled water, and let it run through while squeezing the meat; there will be 10 oz. extract of meat, of which a wineglassful may be taken at pleasure. It must not be warmed to a greater extent than putting a bottle filled partially with it to stand in hot water. If the flavour be disagreeable, 1 wineglassful claret may be added to 1 teacupful.

_Milk Toast._--Take 2 slices bread and toast well--that is, crisp. Take new milk or cream, also a bit of butter (varying according to toast required), and melt in a saucepan together. Then dip in the slices of toast, let them soak for a moment or two, lift on to a deep plate, and pour the remains of milk and butter on top. Serve very hot; add salt as required.

_Hot Milk._--Milk that is heated to much above 100° F. loses, for a time, a degree of its sweetness and density; but no one fatigued by over-exertion of body or mind who has ever experienced the reviving influence of a tumbler of this beverage as hot as it can be sipped, will willingly forego a resort to it because of its having been rendered somewhat less acceptable to the palate. The promptness with which its cordial influence is felt is indeed surprising. Some portions seem to be digested and appropriated almost immediately; and many who fancy that they need alcoholic stimulants when exhausted by labour of brain or body will find in this simple draught an equivalent that will be as abundantly satisfying and more enduring in its effects.

_Caudles._--The basis of all caudles is flour gruel, made either with water or milk, that made with milk being the most nutritious, while both are equally digestible. In cool weather a quantity of gruel may be made and kept in a cool place, and portions of it heated and used as required. When gruel enters largely into the diet, its acceptability to the patient will be augmented by varying the flavouring or spice used in its preparation. If, therefore, a quantity is made plain, it can be sweetened and variously flavoured as it is heated for immediate use.

Cold Wine Caudle (a nutritious, digestible, and slightly stimulating food, useful in all sickness where starch and wine are not objectionable).--Make a good gruel by mixing smoothly 1 tablespoonful flour with ½ pint cold milk or water, and stirring it into ½ pint boiling milk or water; add a level teaspoonful of salt, and let the gruel boil for 5 minutes, stirring it to prevent burning. To ½ pint cold gruel add 1 egg beaten to a froth, 1 glass of good wine, and sugar and nutmeg to suit the palate of the patient.

Hot Wine Caudle (preferably to cold caudle generally, and useful in the same physical condition indicated in the preceding recipe). Heat ½ pint gruel; beat the yolk of a raw egg to a cream with 2 tablespoonfuls pulverised sugar; beat the white of the egg to a stiff froth; when the gruel is boiling hot, quickly beat a glass of good sherry or Madeira wine into the egg yolk and sugar, stir the hot gruel into it, and then add the beaten white of the egg. Work very quickly, and serve the caudle hot.

Cream Caudle (an equally valuable food with the two preceding caudles, useful under similar physical conditions). To 1 pint gruel add 1 glass good wine, 1 gill sweet cream, 1 tablespoonful noyeau or any good cordial, and sugar to suit the patient’s taste. Use hot or cold, but preferably hot.

_Digestive Foods._--Where the digestion is weak, as is generally the case in sickness, much benefit may be derived from partially digested foods. Maltose is a sugar which does not readily undergo acetous fermentation, and therefore will not give rise to acidity and dyspepsia. This is a great matter, as cane sugar added to stewed fruit and milk puddings readily undergoes acetous fermentation in many stomachs. The lævulose sugar of fruit, like maltose, readily undergoes alcoholic but not acetous fermentation. Maltose being less powerfully sweet than cane sugar, a greater quantity is necessary to sweeten the pudding. If the raw starch, semolina, sago, or tapioca be first put in the dish by itself, and placed in the oven for an hour (taking care not to have it burnt by the oven being too hot), not only are the starch cells cracked, but a certain conversion of the starch into dextrine takes place. If to this be then added an equal quantity of ground malt and some hot milk poured on, and the dish be allowed to stand a few minutes before being put into the oven again, the diastase of the malt acts upon the farina and converts it into dextrine and maltose. Dextrine and maltose being soluble, the pudding is very thin. Such a pudding is admirably adapted for invalids and dyspeptics, as requiring scarcely any digestion in the body. For those with whom ordinary milk puddings produce acidity, such a pudding is specially suitable. Ground malt may be added to fresh milk, and forms an admirable food in cases of acute disease. Baked flour perhaps goes better with meat broths, to which it gives a high food value. (Well-baked flour requires but a touch of saliva to render it soluble, and, added to meat broths and gravy soups, renders them very nutritive.) Malt, being sweet, goes better with milk, or apple-water, or tamarind-water, or lemonade, and gives us a food which being all but independent of the digestive act, can be most usefully employed in the sickroom. Beef-tea (which alone is scarcely a food) and milk-and-seltzerwater pall upon the palate of the sick person, who craves variety just as do healthy persons. The adoption of ground malt as a food will solve for us one or two knotty questions connected with feeding people when the digestive power is feeble. Drinks like lemonade, made with malt instead of cane sugar, would not only not go sour in the mouth and stomach, but would contain some phosphates and soluble albuminoids, and so form admirable beverages in feverish states. The many malt extracts now in the market are well adapted for such end. (_Lancet._)

An excellent peptonising apparatus, for the predigestion of foods for the sickroom, is sold by Savory and Moore.

_Drinks._--Orange-whey.--The juice of 1 orange to 1 pint of sweet milk. Heat slowly until curds form, strain and cool.

Egg-Lemonade.--White of 1 egg, 1 tablespoonful pulverised sugar, juice of 1 lemon, 1 goblet water. Beat together.

Sago-Milk.--3 tablespoons sago soaked in a cup of cold water one hour; add 3 cups boiling milk; sweeten and flavour to taste. Simmer slowly ½ hour. Eat warm.

Baked Milk.--Put ½ gal. milk in a jar, and tie it down with writing-paper. Let it stand in a moderate oven 8-10 hours. It will be like cream, and is very nutritious.

Punch without Liquor.--Take the juice of 6 oranges and 6 lemons, adding sugar to suit the taste. Put to this a quantity of pounded ice and some sliced pine-apple, pouring over it 2 qt. water. This is an agreeable summer beverage for anybody, sick or well.

Rice Water.--Wash 2 oz. best rice and boil it fast for ½ hour in 1 qt. water. Any flavouring may be added, or a small piece of stick cinnamon or shred lemon peel may be boiled with the rice, and sugar used according to circumstances. Lemonade made with rice water when cold is very nice and refreshing.

Gum Arabic Water.--Put into an earthenware jar 1 oz. finest picked gum with 2 oz. sugar candy and 1 pint water; set it in a saucepan of water, and stir occasionally until dissolved. This is very useful as a night drink for hectic cough, and will allay the tickling in the throat. It should be kept as hot as possible. The little French porcelain veilleuse is best adapted for this purpose.

Lemon Juice.--Few people know the value of lemon juice. A free use of lemon juice and sugar will always relieve a cough. Most people feel poorly in the spring, but if they would eat a lemon before breakfast every day for a week--with or without sugar, as they like--they would find it better than any medicine. Lemon juice, used according to this recipe, would sometimes cure consumption:--Put 1 doz. lemons into cold water and slowly bring to a boil; boil slowly until the lemons are soft, then squeeze until all the juice is extracted; add sugar to taste, and drink. In this way use 1 doz. lemons a day. If they cause pain, lessen the quantity and use only 5 or 6 a day until you are better, and then begin again with 1 doz. a day. After using 5 or 6 doz., the patient will begin to gain flesh and enjoy food. Hold on to the lemons, and still use them very freely for several weeks more. Another use for lemons is for a refreshing drink in summer, or in sickness at any time. Prepare as directed above and add water and sugar. But in order to have this keep well, after boiling the lemons, squeeze and strain carefully; then to every ½ pint juice add 1 lb. loaf or crushed sugar, boil and stir a few minutes more until the sugar is dissolved, skim carefully and bottle. You will get more juice from the lemons by boiling them, and the preparation keeps better.--_Lancet._

Linseed Tea.--Take 3 tablespoonfuls linseed, about 1 pint water, and boil for 10 minutes. Strain off the water, put in a jug with 2 lemons, cut in thin slices; put also some brown sugar. A wineglassful of wine is an improvement. This has been found most nourishing for invalids.

Barley Water.--Barley water is an important article in the invalid’s dietary. Dr. Pye Chavasse, in his work entitled ‘Advice to a Mother,’ strongly recommends Robinson’s patent barley, prepared by Keen, Robinson, and Bellville, of London. Take of the patent barley one ounce mixed with a wineglass of cold water, pour this into a stewpan containing nearly one quart of boiling water, stir this over the fire while boiling for five minutes, then flavour with a small bit of lemon peel or cinnamon and sweeten according to taste. Equal quantities of milk and barley water make a very nourishing drink, especially useful in feverish cases. Barley water should not be mixed with milk or syrup before required for use, as in a warm atmosphere it undergoes changes, and sometimes slightly ferments.

Almond Milk (an exceedingly nutritious beverage, useful in most conditions of illness).--Pour 1 qt. boiling water upon ¼ lb. shelled almonds, and when the skins soften rub them off the kernels with a clean towel; pound the almonds thus blanched in a mortar, putting in 3 or 4 at a time, and adding 4 or 5 drops milk, as the almonds are being pounded, to prevent oiling--about 1 tablespoonful milk will be required for the ¼ lb. almonds; when the almonds are finely pounded, mix them with 1 pint milk, 2 tablespoonfuls sugar, a level teaspoonful salt, and the yellow rind of a lemon, and place the milk over the fire to boil; meantime, beat 3 eggs smoothly, and strain the almond milk into them, stirring the mixture as the milk is strained in; return it to the saucepan, and place it in another pan of hot water, over the fire, stirring it constantly until it begins to thicken; then remove it at once from the fire, strain it, and use it.

Barley Milk (a demulcent, refreshing, and nutritious beverage, useful in fevers and gastric inflammation).--Wash 4 oz. pearl barley in cold water until the water is clear; put it over the fire in a double kettle with 1 qt. milk and a level teaspoonful of salt, and boil it until the milk is reduced one half; then strain off the milk and sweeten to suit the taste of the patient. The barley may be used as food by adding to it a glass of wine and a little sugar.

Irish Moss Water (a bland, nutritious drink, excellent in feverish conditions and in colds).--Wash ½ oz. moss in plenty of cold water; then soak it for 10 minutes in 1 pint cold water; then add 2 pints cold water, 1 tablespoonful sugar, and 1 in. stick cinnamon to it, and boil it until it is about as thick as cream; strain it, add more sugar if it is desired, and use while warm. The yellow rind of a lemon may replace the cinnamon as flavouring.

Icelandic Moss Chocolate (a very nutritious drink, suitable for use when abundant nourishment is required).--Wash 1 oz. moss thoroughly in cold water; then put it over the fire to boil in 1 pint water. Grate 1 oz. chocolate fine, mix it with ½ cupful cold milk, stir it into 1 pint boiling milk, and boil it for 5 minutes; then add it to the boiling moss, strain them together, sweeten them to suit the taste of the patient, and use the beverage warm.

Imitation Kumys (Koumiss).--(_a_) Fill into a strong champagne bottle, good, fresh, unboiled cow’s milk to such a height that after the addition of 1 oz. granulated or powdered sugar, and after corking, there would still be left at least 1 in. of empty space below the cork. Before corking, add a piece of fresh compressed yeast, about the size of 2 peas, then cork and tie the cork firmly down. In place of compressed yeast, 1 teaspoonful good beer yeast may be taken. The contents of the bottle are well shaken, repeatedly, then the bottles are placed in the cellar, where they are turned up and down a few times during the day. From and after the fifth day the mixture is ready and may be drunk to about the twentieth day. It is best to prepare about 6 bottles full at a time, refilling each after it has been emptied and cleaned, so that the treatment, after being begun, may not be interrupted. On opening the bottles, the contents are very apt to foam over, hence the bottle should be opened while being held over a plate. It should never be opened where there may be any furniture or dresses about, which might be soiled by spattering. A good milk-wine or kumys should have a homogeneous appearance of the consistence of thin cream, should be effervescent when poured out, of an acidulous, agreeably vinous odour and taste, and should not be full of lumps, or taste like butter-milk. On first using kumys it produces loose bowels, but this effect soon passes off.

(_b_) 200 parts condensed milk, 2000 parts water, 2 parts lactic acid, 1 part citric acid, and 30 parts brandy are mixed and carbonated. Cork well and let it stand for 2 days in a warm room till it froths.

=Administering Physic.=--Never allow a bottle of lotion for external use to stand beside a bottle of medicine to be taken internally. Keep them entirely separate, and _keep all medicines in a place where children cannot by any possibility reach them_. One further piece of advice, which is unfortunately but seldom attended to, is deserving of attention, namely, after an illness has terminated either in recovery or death, _empty out all the medicine bottles_, and on no account retain any of them for future use. Spoons differ very much in size, and it is not wise to trust to them in measuring medicines. It is best to get a medicine glass or spoon, either of which can be got at a chemist’s for a few pence. In giving sick people medicine there are 3 points which ought carefully to be remembered--namely, regularity, punctuality, and exactitude. Those intrusted with the administration of medicine to sick persons should _always_ read the label of the bottle before administering the medicine. By doing so they will probably save themselves a lifelong reproach. An inhaler for taking medicated vapours in bronchial and catarrhal affections may be extemporised out of a pickle bottle fitted with a perforated cork and a bit of tube. A special apparatus (Dr. Felton’s) is sold at 7_s._ 6_d._ by Savory and Moore.

To mask the taste of cod-liver oil:--(_a_) Use Allan and Hanbury’s “perfected” oil. (_b_) Put a little salt in the mouth before taking the oil. (_c_) Add 30 drops sulphuric ether to the dose and take it quite cold. (_d_) Add a little iodoform and essence of anise; say 96 grm. oil, 20 c. grm. iodoform, 4 drops essence.

Quinine may be enclosed in gelatine capsules when otherwise refused. If in powder it is best mixed with a little milk.

Keep a separate measure and separate glass for administering such drugs as castor-oil, cod-liver oil, asafœtida, valerian, &c.

Pills should be placed well towards the gullet and washed down with a drink. Or they may be hidden in jam, or wrapped in rice paper, and then washed down. Powders may be mixed in jam, treacle, honey, milk, or water.

To remove the taste of nauseous medicines from the mouth chew a small piece of bread and spit it out.

The best times for administering medicines, according to the frequency with which they are ordered, are as follows:--

“Daily.”--At 9 A.M. or at bedtime.

“Night and morning.”--9 A.M. and bedtime.

“Twice-a-day.”--10 A.M. and 6 P.M.

“Three times a day.”--10 A.M., 2 P.M., 6 P.M.

“Every 4 hours.”--10 A.M., 2 P.M., 6 P.M., 10 P.M., 2 A.M., 6 A.M.

Never wake a patient to administer medicine or food unless ordered to do so.

To apportion doses according to age, reckon 21 years and upwards as adults requiring full dose; then 17 will take ¾, 14 will take ½, 7 will take ⅓, 4 will take ¼, 3 will take ⅙, and 2 years or under will take ⅛ of the full dose.

Medicines are classified according to their general properties, the following being the chief:--

_Anæsthetics_--produce insensibility to pain.
_Anodynes_--procure relief from pain.
_Antiseptics_--prevent putrefaction.
_Antispasmodics_--check spasms and cramps.
_Caustics_--destroy animal tissues by a kind of burning.
_Collyrium_--an eyewash.
_Diaphoretics_--induce perspiration.
_Diuretics_--increase the flow of urine.
_Emetics_--cause sickness (vomiting).
_Expectorants_--favour spitting.
_Liniments_--for rubbing in.
_Narcotics_--induce sleep.
_Purgatives_--cause very loose bowels.
_Refrigerants_--cooling.
_Sedatives_--calm the nerves.
_Soporifics_--induce sleep.
_Styptics_--arrest bleeding.
_Tonics_--increase the appetite and give a stimulus to the system.

The principal domestic remedies, with their doses (m. means minims, gr. grains, table. tablespoonful, tea. teaspoonful, dr. drams, oz. ounces, dess. dessertspoonful) and properties, are as follows:--

Aloes (compound decoction): 1-3 tablespoonfuls; pleasant purgative, useful in habitual constipation, and will often relieve headache.

Alum: 10-20 gr. in whooping cough and internal bleeding; 1 tea. (in treacle) as an emetic; 15 gr. in 10 oz. water as a collyrium; 60 gr. in 10 oz. water for gargles and injections; astringent (coddling the mouth) and styptic.

Ammonio-citrate of iron: 5-10 gr. in water; tonic.

Antimonial wine: 5-15 m. 3 times a day in bronchitis and fever, diaphoretic; 1 table. (for adults), emetic.

Aromatic chalk: 20 gr. in water checks diarrhœa.

Belladonna liniment (compound): externally applied on rag covered with waterproof for 12 hours as local remedy for rheumatism and lumbago; anodyne.

Bicarbonate of potash: 15-20 gr.; antacid; taken with lemon juice or citric acid as a cooling drink.

Bicarbonate of soda: 10-20 gr.; antacid; checks heartburn and stops diarrhœa.

Blue pill: 3-5 gr.; alterative; cures bilious attacks.

Borax: 1 in 24 parts water as a gargle for sore throat.

Calomel: 1-3 gr.; powerful purgative and alterative; taken for biliousness.

Camphor liniment (compound): stimulant liniment.

Carbonate magnesia: 5-30 gr. in milk; antacid, gentle aperient; useful for children.

Castor oil: ½ tea. (infants), 2 table. (adults), on milk, wine, or orange juice, or blended with glycerine or egg-yolk; most reliable aperient.

Chlorate potash: 10-20 gr., stimulant; 1 dr. with 4 dr. honey and 8 oz. water, gargle for sore throat; lozenges, overcomes effect of high altitudes on the respiratory system.

Chloric ether: 20-30 m. in water, cordial and antispasmodic; relieves cramp, violent cough, spasms, &c.

Chloroform: not to be inhaled or taken except in a doctor’s presence; sedative; applied to rheumatism, stings, and toothache as an anodyne.

Citrate of iron and quinine: 3-5 gr. in water; tonic and binding.

Citrate of magnesia (granular effervescent): 1 dess. in tumbler cold water; cooling aperient.

Cream of tartar: 20-60 gr., diuretic and cooling; ½ oz. in 1 qt. of water, fever drink.

Dover’s power: unfit for children; 5 gr. in wineglassful water, diaphoretic, checks diarrhœa and cures fresh colds; 3 gr. after meals prevents chest-ache.

Epsom salts: 1-4 dr. in water; purgative.

Essence of camphor: 30 m. in wineglassful water; exhilarating.

Essence of ginger: ½ tea. in wineglassful water; cordial stimulant, useful in chest-ache.

Essence of peppermint: 10-15 m. on sugar; exhilarating, warming and antispasmodic.

Extract of bark: 10-30 m. in wineglassful water; valuable tonic in neuralgia and fever.

Friar’s balsam: ½-1 dr. with sugar and egg-yolk, stimulating expectorant; applied on cuts.

Glycerine: may replace sugar for sweetening drinks and medicines; much used for softening the skin.

Goulard’s extract: 5 m. in wineglassful water as an eyewash; 1 in 40 of water, astringent, applied to bruises and sprains as a wash.

Gregory’s powder: 1 tea. in wineglassful water, cooling mild aperient.

Grey powder: 3-5 gr. (adult); aperient, acting on the liver.

Ipecacuanha powder: 15 gr. emetic.

Ditto wine: 10-20 m., expectorant for coughs; 1 table. (adults), repeated at 10 minutes intervals, emetic.

Jalapine: 2-6 gr., aperient for children.

Laudanum: 10-20 m., anodyne and soporific; with equal quantity opodeldoc, applied as an anodyne.

Lime-water: antacid; checks infantile diarrhœa; mixed with sweet oil affords great relief when applied to burns.

Liquorice powder (compound): 1 tea., mild aperient, best for piles.

Milk of sulphur: 1 tea. rubbed up with milk, gentle aperient and cooling, useful in rheumatism and piles.

Morphia bimeconate: 5 m. increasing every 3 hours; most valuable sedative and soporific; applied as an anodyne after the part has been reddened by compound camphor liniment.

Muriate (chloride) of ammonia: 10 gr. in wineglassful water, good expectorant in bronchitis; 1 oz. with 1 oz. alcohol and 10 oz. water; stimulant lotion for sprains.

Nitrate of silver: 2-4 gr. in 1 oz. water, lotion for sore nipples; 20 gr. in 1 oz. water, throat wash in diphtheria.

Nitre (saltpetre): 5 gr. in saline draught, cooling and diuretic for fever; ¼ oz. in ½ pint barley water, gargle for inflamed sore throat.

Nitric acid (dilute): 10 m. with 5 m. tincture of chiretta, 15 m. tincture of orange and 10 m. syrup in 1 wineglassful water, excellent between meal-times for convalescents.

Opodeldoc (soap liniment): excellent applied to bruises, stops swelling and discoloration.

Paregoric: 30-60 m., checks coughing.

Prepared chalk: 15-30 gr. repeated, with cinnamon and tincture of catechu, antacid and astringent for diarrhœa and cholera; made into a cream with water, cooling shield for burns.

Rhubarb: 1-5 gr., tonic to bowels; 10-20 gr., aperient followed by astringent.

Sal volatile: 30-60 m. in wineglassful camphor julep; antacid, antispasmodic, and exhilarating.

Santonine: 2-3 gr. on 3 alternate nights, followed by castor oil in the morning, expels threadworms from children.

Spirit of minderus: 15-20 m. in gruel at bedtime, excellent diaphoretic and cure for coryza (cold in the head); 20 m. in wineglassful water, eyewash; 1 table. in tumbler water, cooling lotion.

Spirit of nitre: 20-30 drops in wineglassful water, or 1 tea. in hot gruel at bedtime, diuretic and diaphoretic, for colds.

Sulphate of copper: 10-15 gr. in wineglassful water, rapid emetic in poisoning.

Sulphate of potash: 10-20 gr. with 10 gr. rhubarb and 15 gr. sugar in peppermint-water, mild aperient.

Sulphate of quinine: 1-5 gr. 2 or 3 times a day, tonic, useful in neuralgia, dyspepsia, weakness and fever.

Sulphate of zinc: 20 gr. in wineglassful water, emetic; 1 gr. in 1 oz. water, eyewash, astringent.

Sulphuric ether: ½-1 tea. in camphor julep, exhilarant.

Syrup of senna: 1 tea. (adults), mild aperient.

Tincture of arnica: with 4 times its bulk in hot water for fomenting bruises.

Tincture of chiretta: 10-30 m., tonic, useful in dyspepsia.

Tincture of colchicum: 10-20 m. at night after a light meal, diaphoretic, valuable in gout, rheumatism, and dropsy.

Tincture of henbane: 15-60 m., narcotic and anodyne.

Tincture of lavender (compound): 1 tea. with ½ tea. sal volatile in water, stimulant, antispasmodic, and exhilarant.

Tincture of quinine: 1-2 tea. in wineglassful water 2 or 3 times a day, tonic.

Tincture of rhubarb: 2-4 tea., cordial and purgative.

Tincture of squills: 1 tea. with wineglassful water, expectorant; take 1 dess. at short intervals to check coughing.

Tincture of steel: 5-15 m. in wineglassful water, tonic, astringent, and diuretic, good in weakness and dyspepsia.

Tincture of valerian: 1 tea. in camphor water, antispasmodic and stimulant, valuable in nervous headache.

_Common Complaints._--Without making the least pretence to give such information as will enable the sick man to dispense with the services of the physician or surgeon, whose aid should be promptly sought, there are many matters which by careful study may enable the threatened attack to be warded off, and there are a variety of ailments and troubles which are not generally deemed of sufficient importance to be worth troubling a doctor about. It is these subjects which claim treatment here, and with which the following paragraphs will deal, leaving all special and serious diseases in hands which have been trained to the work.

=Accidents and Emergencies.=--The first piece of advice to every one is to attend a series of lectures given every winter by the St. John’s Ambulance Association at very numerous centres all over the kingdom. This will convey an amount of knowledge and practical experience such as can never be attained by reading alone. Even Volunteers, who have gone through a course for the Army Hospital Corps, will do well to supplement it for every-day life with a course of St. John’s Ambulance lectures.

When you have not witnessed the occurrence of an accident, make some inquiry of the bystanders or patient as to its cause before taking any other steps, as this will often indicate what kind of injury is to be looked for. Never proceed to lift or remove a patient with broken limbs or bleeding wounds till the necessary bandaging and staunching have been done: let traffic be interrupted, if need be, rather than risk converting a simple hurt into a fatal one.

The ordinary accidents and emergencies of every-day life will now be dealt with in alphabetic order.

_Bites and Stings._--These may be divided into two classes--those of insects and those of poisonous or rabid animals.

Of Insects.--First remove the sting (of a bee or wasp) by pressing a small key on the spot, whereby the sting is forced into the hollow barrel; then apply any of the following lotions:--(_a_) Rub the bite of mosquitoes with a solution of borax in ammonia. (_b_) When bitten by midges, the best applications are oil of camphor and laudanum, equal parts, applied on lint; or (_c_) 6 oz. Goulard water, ½ oz. laudanum, applied on lint. (_d_) ½ dr. extract of belladonna; ½ oz. glycerine; 3½ oz. water; to be well mixed, and made into a lotion. The parts to be washed with a small quantity--about a teaspoonful or two at a time. (_e_) Goulard water mixed with a little Eau de Cologne makes an excellent wash for the skin in case of gnat bites. (_f_) Keep an onion always at hand, and instantly when bitten squeeze or cut it, so that the juice should flow into the puncture, rubbing it gently over the place; its effects are equally efficacious in the sting of a wasp or bee, always provided the sting does not remain in the wound. (_g_) Ipecacuanha powder is very effective in allaying the pain caused by the sting of scorpion, hornet, and wasp, also mosquito and midge bites. For scorpion stings, &c., make a paste of the powder with a little water, and apply it to the wound in a patch about the size and thickness of a shilling. (_h_) In bee sting, first remove the sting as quickly as possible with a forceps or by scratching with a finger, but never with the thumb and forefinger, because this squeezes more of the poison into the wound. Next squeeze the wound until a drop of blood comes out, and rub the place as large as a florin with an aqueous or dilute alcoholic solution of salicylic acid. The effect is still better by injecting the salicylic acid into the wound with the hypodermic syringe. After this the spot is painted with collodion, to keep out the air. (_i_) Gnat bites, stings of wasps, bees, &c., may be cured by applying a tincture of minderus, laudanum, and Goulard water in equal parts. (_j_) Sweet oil, or camphorated spirit of wine, is a good thing to apply to bite of the mosquito. (_k_) One raw egg well beaten, ½ pint vinegar, ½ oz. spirit of turpentine, ¼ oz. spirit wine, ¼ oz. camphor; these ingredients to be well beaten together, then put in a bottle and shaken for 10 minutes, after which to be corked down tightly to exclude the air. In ½ hour it is fit for use. To be well rubbed in 2, 3, or 4 times a day. (_l_) The leaves of the common dock, bruised and well rubbed on the part affected, alleviate the pain. (_m_) For bee stings: after pulling out the stings, break some lettuce leaves close to the stalk, and apply the milk afterward. (_n_) Anything “strong,” in a popular sense, will generally suffice to decompose and destroy an organic poison if instantly applied. This is why the juice of an onion answers the purpose. Anything equally pungent would do as well. (_Lancet._)

Poisonous bites.--There is great similarity in the immediate treatment desirable in the bite of snakes and mad dogs, the object being to prevent, as far as possible, the absorption of the poison by the blood. In the same category come any poisonous wound, as from arrows, &c. (_a_) Buckland recommends the following outlines:--(1) Suck the wound, if possible, most vigorously, taking care that there be _no sores on the lips or in the mouth_. In all cases before sucking fill the mouth with oil or salt and water if possible. (2) Apply, if you can, a cupping glass, or cut off the tip of a cow-horn, cut the bottom level, apply it over the wound, and exhaust the air by the mouth; when exhausted fill up the hole by means of a bit of wax or other material placed into the mouth before the operation of sucking is commenced. This is the mode adopted by the Kaffirs. (3) Wash the parts with hartshorn (ammonia). (4) Tie a ligature tightly above the wounded part. (5) Give doses of hartshorn and water as strong and as frequently repeated as the patient can bear them. (6) Send for the doctor as quickly as you can.

(_b_) Favourable results have followed using chloride of lime, a filtered solution of which was injected into the same place where the fatal virus (snakes’) had previously been introduced. In 17 trials made in succession, the poisoned animal survived without the slightest disturbance of its healthy condition.

(_c_) First tie a ligature above the part bitten. Then slightly cauterise with a lucifer match. Next swallow tumbler of raw brandy, to be repeated whenever the feeling of sinking comes on, till the liquor (which goes down like water) is tasted, and begins to affect the head. Meanwhile the patient is to be walked about by two men by force if he cannot do so alone or wants to lie down, which would be fatal. (Sir R. Burton.)

(_d_) Permanganate of potash may be added to the list of antidotes, as it is said to counteract very effectively the poison of serpents, when an equal quantity of filtered (1 per cent.) solution of permanganate of potash is injected 1-2 minutes after the poison.

(_e_) Probably a vapour bath immediately after being bitten by a venomous reptile or rabid dog will be found to prove one of the best remedies, the intense perspiration induced carrying off the poison. Excessive exercise following a poisonous bite generally effects a cure for this reason.

_Bleeding._--Bleeding may result from a wound or from the bursting of a blood vessel, and may occur outwardly or inwardly. Bleeding from a wound may be arterial (coming from the arteries which carry the blood from the heart to the body and limbs), venous (coming from the veins which take the blood back to the heart), or capillary (coming from the capillaries which convey the blood to the extremities and surface of the body). In arterial bleeding, the blood is bright scarlet, and escapes in jerks, as if from a pump; this is highly dangerous. In venous bleeding, the blood is dark coloured, and flows away in an uninterrupted stream. In capillary bleeding, the blood leaks or oozes out. In some wounds all three kinds of bleeding will occur simultaneously. The foremost method of arresting external bleeding is by pressure, either on the wound itself or on the blood vessels feeding it, and in the case of a limb, it should be elevated above the body to retard the flow of blood towards the part. As the pressure is to be made on the vessels leading to the wound, it is obvious that in arterial bleeding the pressure must be between the heart and the wound, while in venous bleeding it must be beyond the wound.

The simplest and readiest way to apply pressure is by the fingers. But first of all some knowledge of anatomy and physiology is necessary to guide the operator where to press. Bleeding from the head and upper neck requires pressure to be exerted on the large artery which passes up beside the windpipe and just above the collar-bone, as in Fig. 110. The artery supplying the arm and hand runs down the inside of the upper arm almost in line with the coat seam, and should be pressed, as shown in Fig. 111. The artery feeding the leg and foot can be felt in the crease of the groin, just where the flesh of the thigh seems to meet the flesh of the abdomen, and this is the best spot to select in the case of a male patient; but in the case of a female, unless the injury were very high up the thigh, it would be more judicious perhaps to apply increased pressure around the leg about half-way between the hip and the knee. Pressure with the hands will not suffice to restrain severe bleeding for any length of time, and recourse must be had to a ligature.

The simplest and most available form of ligature is a pocket-handkerchief or neck-wrap, or any other article of attire long and strong enough to bind the limb. Fold the article necktie fashion, then place a smooth stone or anything serving as a firm pad on the artery, tie the handkerchief loosely, insert any available stick in the loop, and proceed to twist it as if wringing a towel until tight enough to stop the flow of blood, as in Fig. 111.

In the case of bleeding from an external wound or sore on the body, employ direct pressure over the bleeding point. If the bleeding is from the interior of the nose or other cavity, apply cold water or ice over the bleeding part or near it, and keep the patient perfectly quiet on the back, or let the patient stand erect with head well thrown back. Injection of hot water into the nostrils is very effective. When the bleeding is from a diseased surface or ulcer, and direct pressure does not stay it, a compress should be soaked in a strong solution of alum, or in steel-drops, and again applied over the point which is bleeding. Should the wound from which the blood is coming be large and gaping, you may stuff firmly into it a compress of some soft material large enough to fill the cavity; but this should always be avoided if possible, as it prevents the natural junction of the sides of the wound, and is very likely to introduce the germs of poison. In any case of bleeding the patient may become weak or may faint, but unless the blood is flowing actively, this is not necessarily a serious sign, and the quiet condition of the circulation during the faint often assists nature in staying the bleeding, by allowing the blood to clot, and so block up any wound in a blood-vessel. Unless the faint is prolonged, or the patient is losing much blood, it is better not to hasten to relieve the faint condition.

When blood is being coughed or vomited up in considerable quantities, ice or iced water or milk should be given, and the patient be allowed to breathe cool fresh air freely. If the blood is coming from the lungs, inhaling steam of turpentine and hot water mixed (2 tablespoonfuls turpentine to 1 qt. hot water) will often reduce the evil; apply cold wet cloths to the chest.

_Broken bones._--Never move a patient with a broken bone till it has been suitably bandaged. Broken bones (fractured) are of three kinds--(_a_) simple fracture, when the bone is simply broken in one place; (_b_) compound fracture, when there is a wound in the flesh communicating with the broken ends of the bone; (_c_) comminuted fracture, when the bone is broken into pieces. The occurrence of a fracture may almost always be learned from the history of the accident, the patient having generally felt or heard the bone snap; other indications are deformity of the limb, such as shortening or bending, and on taking hold of the limb, you will find there is increased movability, and will hear and feel a peculiar grating caused by the broken ends of the bone rubbing against each other, called “crepitus”; also pain and loss of power in the limbs.

It is not imperatively necessary to do anything to a broken limb before the arrival of a doctor, except to keep it perfectly at rest, unless the patient must be moved; then, to prevent further mischief, the broken ends of the bone _must_ be put in position and kept there. The first step is to pull the limb till the sinews and muscles stretch sufficiently to let the two ends of the bone meet each other. When this has been done, splints and bandages must be applied to keep the ends from shifting again.