Chapter 25

Soapy Blanket, The.--It seems necessary, in getting people to use the best means for the recovery of health, carefully to consider, not the diseases to which they are subject only, but especially the processes of cure. We require to go into the very nature of things, so to speak, and to make it all palpable to the inquirer. For example, you prescribe a little olive oil on the skin, and the nurse is horrified at its being suggested that she should "block up the pores." Her idea is that these pores are only little holes in the skin, so that, if you fill them up with oil, the insensible perspiration will not get through. Now let us observe that a pore is a complete organ in itself, and has at least three things that characterise it. (_See_ page 285). First of all, it is a living thing. It is so as really as a finger is a living organ, or an eye, or an ear. When it dies, it is as much an opening as ever, but it ceases to secrete the perspiration which is constantly separated from the current of the blood when it was healthily alive. When it is sickly, though still living in a weak degree, it secretes, but so sluggishly that the substance which it separates from the blood does not pass off easily--it gets, so to speak, thick and sticky, and remains in the pores.

In the second place, the substance which a pore secretes will not combine with certain things, and it will chemically combine readily with other things. When the pore is sickly, it may be aided, first, by the introduction of heat, which becomes vital action, and secondly, by the use of such substances as will readily combine with its secretion. The heat makes it secrete more perfectly, and the chemical combination makes the removal of the secretion easy. It is possible to block the pores up, but it is not very easy to do so. A healthy pore will send its secretions out through very close stuff. It is only by something like very strong varnish that it can be prevented.

There is wonderfully little danger in ordinary life of any such "block" as this. But there is very great danger of the pore being deprived of its secretive power, and of its power to open its mouth when that is so much wanted. Warm olive oil sets millions of pores to full work sometimes in a few seconds.

Now let us look at the application of the soapy blanket in the light of these remarks. Here is a poor patient, sitting in an armchair by the fireside, labouring to get breath. It makes one feel burdened to see him. What is wrong? Are the pores blocked up? No; but they are more than half dead, and what they do secrete is not such an ethereal thing as it should be. Nearly all the work of getting rid of the waste of the body has been thrown for months upon the poor lungs. The kidneys, too, have got far more than their share, just because the pores are sickly.

The remedy is the soapy blanket. This most valuable means of stimulating the healthy action of the skin (as prescribed in many articles in this volume) is prepared and applied as follows:--Have a good blanket, and plenty of M'Clinton's soap (_see_ Lather and Soap). Shear down a tablet or two into boiling water--as much water as the blanket will absorb. The blanket may be prepared as directed in article Fomentation, using these boiling _suds_ instead of water. Have the patient's bed ready, and spread on it a double dry sheet. Soak in the suds a piece of thick flannel large enough to go round the body under the armpits. Wring this out and put it on the patient. Wrap the blanket tightly round the patient from the neck downwards. Tie something round the waist to confine it close to the body. Put the patient into bed, and wrap the feet well up in the blanket. If it is not sufficient to cover them, an extra piece of soapy flannel must be used. Then wrap the sheets over the patient above the moist blanket, and cover all nicely up. In removing the blanket, which may remain on half-an-hour, it is well to proceed gradually, uncovering the body bit by bit, sponging each part with hot water and vinegar or weak acetic acid (_see_ Acetic Acid), and rubbing hot oil on after drying. Dry this oil off, and cover each dried part of the body either with clothing or blankets before uncovering a fresh part.

There is a modification of this treatment which suits more weakly persons, and suits also those who must do all, or almost all, for themselves. A long flannel or flannelette nightdress is used in this, instead of the blanket. This is covered on the whole of the inner side with well-made soap lather. When so covered it is put on at bedtime, and a dry nightdress put on over it. Both are then fastened as closely as possible to the skin, and the patient goes to sleep thus clothed. If the night is cold, the greatest care must be taken to be well covered, and brought to as good a heat as possible. In the morning a very great change will have come from this treatment. When the whole body is washed down with warm water, dried, and nicely rubbed with fresh oil, the skin is found very considerably changed, and in case of asthma the breathing relieved.

If cold is taken when this process is fairly gone through, it would be very astonishing indeed; but if it is badly done, a person might get chilled instead of comforted. Therefore every care must be taken to keep the patient thoroughly warm. The result of one effectual pack is usually sufficient to convince the poor sufferer that he is being treated in the right way. The effect of the second is greater, and so on to the fourth or fifth, beyond which he need not go as a rule. He will do well once a day to wash with hot vinegar and rub after with the oil. These should not be required more than a fortnight at most. If chilliness continues, it is well to put on cotton stockings on going to bed, and even to bathe the feet and oil them before doing so. This bathing may be continued every night for a fortnight.

Sores.--These will be found dealt with under many headings throughout this book (_see_ Abscess; Bone, Diseased; Blood; Boils; Breast; Cancer; Carbuncle; Cauliflower Growth; Eruptions; Erysipelas, etc.), therefore we here only treat generally of two kinds of common sores. The first is the surface sore, which eats inwards; the second, the deep-seated sore, which eats outwards. The first usually begins as a small pimple like a pin's head, and, if neglected, breaks, and gradually increases in size. Its origin is something which has caused the minute vessels of the skin at the spot to give way, so that they remain congested with bad blood, which soon becomes practically poisonous, and so the sore enlarges and eats into the surrounding tissue. If such a sore appears on the leg, it is often due to over-pressure through too much standing. Rest, with the leg kept horizontal or inclined slightly upwards to the foot, will often be enough to cure. When complete rest cannot be had, a thigh bandage (_see_ Veins, Swollen) should be worn.

To treat the sore, it should be washed twice a day with BUTTERMILK (_see_), and afterwards thoroughly soaked with weak ACETIC ACID (_see_), and dressed with antiseptic lint, or, if that cannot be had, with buttermilk cloths. A buttermilk poultice (_see_ Potato Poultice) may be used. But if no rest can be had, the sore will be extremely difficult, if not impossible, to heal.

The second kind of sore, arising from an abscess under the part, or diseased bone or membrane far down beneath the skin, is to be treated on the same principles, using weak acetic acid for the syringing, and buttermilk only for the surface. The method of treatment is such as will secure the contact of the weak acid with _every part_, even the deepest, of the wound. Procure a small pointed glass syringe, which must be kept _thoroughly clean_. The point of this may be inserted into the sore, and care taken that the weak acid penetrates into the very bottom, and thoroughly soaks all the diseased parts. This syringing should be repeated until the wound is thoroughly clean in every part. If pain is set up, the acid is too strong. Syringing with lukewarm water will at once relieve this, and then weaker acid may be used. This treatment may be given twice a day, and the wound properly dressed after it. Attention must be paid in all treatment of sores or wounds to the proper cleansing and boiling of all materials and instruments used. Wash the hands in hot water and M'Clinton's soap, using a nail-brush, before touching or dressing a sore.

Boil some soft clean rags for five minutes, and wash the sore with these, using water that has been boiled and allowed to cool to blood-heat, to which a few drops of acetic acid have been added, but not so much as to be painful on the sore.

If a syringe is used, boil it before using, and only use boiled or distilled water in all operations. This secures the destruction of the germs (or Bacteria), which are now known as the cause of the inflammation and suppuration of wounds and sores of all kinds.

Spinal Congestion.--In some cases of this trouble the symptoms are very alarming, consisting in violent convulsive movements, which seem altogether beyond the possibility of relief. It is something to know that these terrible kickings and strugglings arise from simply an accumulation of blood in the vessels of the spinal cord, irritating it violently, as an electric current might do. Sedatives and narcotics will be useless. Leeches applied to the spine will sometimes cure by withdrawing the blood from it, though such treatment leaves no bracing and strengthening effect, but the very opposite. Use the cold towel, wrung out and placed along the spine, together with a hot blanket FOMENTATION (_see_) to the feet and legs, up over the knees. The patient must be gently held still, as far as possible, so that the treatment may be applied. The applications will not be at once successful, but after an hour's work something like permanent relief should come. Above all, the nurse must keep cool and calm in mind and manner. There is no need for hysterics, and any excitable person should be kept out of the sick-room. If the skin of the back has been broken by blistering or any such treatment, a fine lather (_see_ Lather; Soap) should be spread over all the back, and on this a soft cloth. Above this the cold towels may be safely and comfortably applied. It will do no harm if the treatment be continued for even two or three hours.

Spine, Misshapen.--Often in the case of delicate infants or children, the bones of the spine fail to have the necessary hardness to bear the strain which comes upon them, and the spine gets more or less out of its proper shape. If this softness of bone continues, no amount of mechanical support, or lying down, will cure the misshapen spine. Therefore means should be taken by proper diet and nourishment to help the production of good bone substance in the child's body. The best bone-making food we know is good oatmeal, as well-boiled porridge (boiled for two or three hours), or as oatmeal jelly and gruel. Good air and water are also essential, and such treatment as is described in article on Children's Healthy Growth. Especially should attention be paid to constant supply of fresh air to the child's lungs. Windows should be wide open in all weathers, and if the child cannot walk far, it should be wheeled out for as long as possible every day the weather permits. Such supply of fresh air is of _vital importance_, and the want of it is frequently the sole cause of disease.

In other cases it is not the bones which are soft, but the muscles and ligaments which hold the spine in a proper position are defective. Where the bone is felt to be good-sized and hard, and the surrounding substance too soft, it is a case of this kind. To proper nourishment, in this case, must be added proper _exercise_ of the muscles concerned. Immovable plaster jackets are bad, because they forbid this. This exercise may best be given by rubbing (_see_ Exercise and Massage). Gentle rubbing and pressure over the back, with hot OLIVE OIL (_see_), will work wonders in such a case. During the rubbing the patient should lie down _at full length_. It must also be done so as to be _pleasant_, or it is of no use.

See that the patient has plenty of rest, and only as much walking exercise as is evidently enjoyed. There may be complications with other troubles--for example, a quick pulse and some fever heat, if the temperature is tested. That will require to be itself treated with repeated rubbings of finely wrought lather over the stomach and bowels. Until you have in some measure subdued this fever, you will not do much in the way of improving the muscles of the back. In many cases you will be able to bring the fever down completely, and then you will be free to exercise the muscles, and so to strengthen them that they will bring the spine to something like its proper shape. (_See_ Assimilation; Diet; Digestion; Nerves; Nourishment; Paralysis; Massage.)

Spine, Weakness of the.--_See_ Children's Healthy Growth.

Sprains or Racks.--A sprain is usually the result of some involuntary stress coming upon the part. If the injury be to the muscular substance only, it is easily healed; hot fomentations should be given to the sprained parts, with perfect rest and every possible ease and comfort by position, etc., and nature will soon effect a cure. If the injury be really to the _nerves_ which control the muscles, as is generally the case, the matter is more difficult. The muscle swells, but this is primarily due to the overstrain of the nerves in the sudden effort they make to bear a crushing load on the muscle. The pain is from pressure in the swelling, and also from inflammatory action.

The cure, then, must be applied to the motor nerves controlling the muscles, and is best applied at their roots in the spinal cord. If the arm, hand, or wrist be sprained, rub gently the upper spinal region with warm olive oil, continuing the rubbing _gently_ down the arm to the injured part (_see_ Rubbing) until the whole shoulder and arm glow with comfortable warmth. But all rubbing such as causes pain must be avoided. If such rubbing cannot be managed, then a hot BRAN POULTICE (_see_) must be placed between the shoulders, and a warm fomentation given to the shoulder and arm. The treatment should be given once a day, and ere many days the sprain should be cured. For ankle and knee sprains, the lower back and leg must be treated on similar principles.

Where the chest muscles that cover the ribs are sprained, rubbing and moist heat should be applied over the back and round the side where the sprain is, paying especial attention to the spine opposite the sprain, and using hot olive oil before fomentation and after, as well as to rub with.

If the belly be sprained, similar treatment should be given lower down the back.

If the back muscles are sprained, then the same treatment should be applied, taking special care to stimulate with moist heat and rubbing the part of the spine on a level with the injury, where the roots of the nerves lie which supply the sprained muscles. Care must ever be taken to avoid giving pain--to give pain is to increase the injury. To produce a glow of heat all through the parts is to cure it. (_See_ Muscular Pains.)

For a sprained heel, when there is some degree of inflammation about it, we should pack the whole foot in fine soap lather. Let it be in this all night, and also during the day when resting. Wash the foot with a little weak acetic acid, after being packed in the lather, to keep it quite clean. Now rub the whole limb from the ankle upwards in such a way as to press the blood onwards in the veins. Use a little oil, so that the skin may not suffer till a fine heat is raised in the whole limb. This may be done for a quarter-of-an-hour twice or thrice a day. It relieves the heel of all congestion, and lets good arterial blood flow to it, as it would not otherwise. An elastic bandage, not very tight, put on above the knee will help the cure. Sprained joints and muscles should have _perfect rest_ for a fortnight, and be used very cautiously for some time longer.

Spring Trouble.--Many persons are distressed by some form of eruption or inflammation in the skin in spring. The change of atmosphere and temperature at this time greatly increases the demands made upon the skin as an organ of perspiration, and this strain it is in many cases unable to stand--hence the trouble referred to. To prevent this, the skin must be brought into a better state of health and fitness for any extra work, so that it can bear without injury even very great changes of air and temperature. This may be done by regular application of soap lather (_see_ Lather and Soap) to the _entire_ skin each evening for three or four days, and then twice a week through all the season. Good olive oil may be rubbed on before and after the lather, or even mixed with it in rubbing on; if the cooling effect is found too great, two or three thick coats of lather should be put on, and then gently wiped off, and the oil applied. This, continued during the later winter and spring, should entirely prevent eruptions. But if these do appear, or have already come on, the irritation is apt to be so great that only very fine and carefully made lather can be used. It is better then to use _buttermilk_ instead of lather. But the BUTTERMILK (_see_) must be _new_, and if necessary weakened by addition of sweet milk; if old and strongly acid buttermilk be used, harm may be done. Do not _rub_ the milk on: _soak_ it into the parts by gentle _dabbing_ with a pad of soft cloth. This done frequently, even twice or three times a day, will almost always effect a cure.

It should be remembered that no amount of washing or bathing will do in this state of the skin. Water somehow, especially hard water, fails to produce this fine state of the surface. When spring trouble has set in, we would keep water entirely from the skin. Nothing does so well as good buttermilk. In some forms of spring eruption, a strong mixture of salt and water may be freely applied with great advantage. If this irritates, it should at once be discontinued, but in many cases the eruption will disappear under a few applications. The salt solution should be gently rubbed on, and left to dry on the skin (_see_ Skin, Care of; Underwear).

With the increasing warm weather the body ceases to require as much food as in the cold days. Heavy stimulating food in warm weather will certainly cause an unhealthy skin.

Squeezing.--_See_ Rubbing.

Stammering.--This trouble is simply a loss of command of the vocal organs, and is distinctly _nervous_ in its cause. Especially must we look to the _roots_ of the nerves controlling the vocal organs, if we are to see the real difficulty. There is evidently a state of irritability and undue sensitiveness in these nerves which must be soothed down, if a cure is to be obtained. The roots of such nerves lie in the back of the head and neck, and they are best soothed by application of soap lather (_see_ Lather; Soap). This must be well wrought, and applied warm to the back of the head and neck in three or four coats. Then mix some _hot_ OLIVE OIL (_see_) with the lather, and apply with the brush gently to the parts. Altogether, in applying the various latherings, and the final oil-and-lathering, an hour should be spent, so as to continue the soothing effect during that time. The head may be soaped one night (_see_ Head, Soaping the), and this treatment given the alternate night. Where the case is of long standing, it may take long to cure it, or a cure may be impossible, but some mitigation will result from this treatment. The Sabbath should in all cases be a day of rest from treatment, and generally common sense will indicate that it be not continued too long. The patient may do a great deal for himself by the strictest watch on his enunciation, speaking slowly and deliberately, and breathing deeply. This will be difficult to maintain at first, but practice will make the habit unconscious. An instrument called a metronome may be had from a music shop (used for keeping time in practising), if a book be read aloud by the stammerer, pronouncing one syllable only to each beat, he will soon gain complete control of his voice.

Stiffness, General.--This is often an adjunct of old age, and sometimes occurs in the young and middle-aged as the result of chills. In _neither_ case is it incurable, but for a cure _rest_ is a first necessity. If there be standing and working for twelve or fourteen hours a day, we should not expect a cure at all. Rest must be had, at least twelve hours out of the twenty-four, and it is well if sixteen or even eighteen hours' rest can be taken (_see_ Rest). Then there must be heating the spine with moist heat (_see_ Fomentation). This is done to revive the organs which supply oil to the joints, by giving fresh vitality to the roots of the nerves which control these organs. But the heating requisite to do this must be gently and persistently applied. An hour's gradual heating is worth far more than half-an-hour's _half-burning_. Then, after the spine fomentation, which must be applied in bed, rub (_see_ Massage) the back with hot olive oil for a considerable time--say half-an-hour, if the patient can bear it (_see_ Exercise). Then the joints may be similarly fomented and rubbed at another time, back and joints being treated, say, every other day. If there be costiveness, treat as in Constipation, and give easily digested food (_see_ Assimilation; Digestion; Nourishment). Such treatment daily should remove stiffness, even in very bad cases.

Stimulants.--_See_ Alcohol; Narcotics.

Stomach Trouble.--If you would cure thoroughly, you must first make sure that the skin is doing its part well. Very often indigestion arises from irritation of the stomach, caused by the impurities in the blood which arise from defective skin action.

With strong people, exercise causing perspiration will often suffice to cure, in other cases where exercise cannot be had the Soapy Blanket (_see_) is effective. After the blanket, give a warm, gentle rubbing with hot vinegar or diluted acetic acid; and, finally, a similar rubbing with warm olive oil. This rubbing may be given by itself, where the patient is too weak to endure the blanket, or where the lather cannot be well applied. Even the rubbing with oil alone will do much to cure.

The problem in this case is to remove from the blood the irritating waste which is inflaming the stomach, and this is better done by cleansing and stimulating the skin than by means of drastic drugs. A lazy man will swallow a peck of pills rather than go through an ordeal of cleansing like this, but in that case he need not be surprised if his poor stomach become only poorer still, while his purse will not get any heavier. Besides this cleansing, take sips of hot water as recommended under Indigestion. A very plain and sparing diet should be taken, and great attention given to chewing all food till reduced to a liquid. For it must be remembered that the majority of stomach troubles have their origin in abuse of this organ, through overloading with food, or other dietetic errors. _See_ Diet; Assimilation; Biscuits and Water; Constipation; Cramp in Stomach; Diarrhoea; Digestion; Flatulence; Indigestion; Weariness.