Chapter 26
Stomach Ulcers.--Generally the _tongue_ will tell whether the stomach is ulcerated or not. If the tongue is fiery-looking, and small ulcers show themselves on it, while food produces pain in the stomach, there is little doubt of the presence of ulcers there. The tongue may at once, in such a case, be brushed with weak acid (_see_ Acetic Acid) or vinegar, so as to cleanse the surface and produce a _gentle_ smarting. This brushing will quickly produce a healing change in the tongue, which guides us to the cure of the stomach. This will be attained by swallowing teaspoonfuls of the same weak acid. Two or three of these should be taken at intervals half-an-hour before food. If the case is severe, the skin over the stomach must be carefully soaped, as directed in article on HEAD SOAPING (_see also_ Lather; Soap). The four-ply flannel BANDAGE (_see_) should also be worn. Do not use drugs, such as iron, arsenic, or soda, and avoid all narcotics. Persevere with the weak acid, and a cure will come unless in very obstinate cases indeed. Care must be taken to avoid irritating food. Milk, or milk and boiling water is the best diet. A general symptom is severe pain after eating, relieved by vomiting.
No fluid should be taken hotter than the finger can be held in it. This is indeed a good rule always in matters of food and drink, which are often taken too hot, to the injury of the stomach.
Stone.--_See_ Gravel.
Stoutness.--_See_ Breath, and the Heart.
Strangulation or Hanging.--Often accidentally caused in children or intoxicated persons. Waste no time in going for or shouting for assistance. At once cut the rope, necktie, or whatever else causes the tightening. Pull out the tongue and secure it, commence artificial respiration at once (_see_ Drowning), open the windows, make any crowd stand back.
St. Vitus' Dance.--This proceeds from a simple irritation of the spinal nerves, and is to be cured by soothing the spine with persistent cooling. In mild cases this cooling is easily applied with towels wrung out of cold water, and folded so as to lie at least four-ply thick along the whole spine. If narcotic drugs have been largely used, and the nervous system spoiled thereby, a severer form of the trouble comes on, and requires a good deal of care and persistence in cooling. In all cases the cooling of the spine must only be done when the patient is _warm in bed_.
It will be of great importance, in carrying out this process, to use olive oil in such a way, all over the body, as to help in maintaining the general normal heat. In addition to these suggestions, it may be well to remark that the appearances in such cases are, as a rule, worse than the reality. For instance, the motion of the eyes and of the tongue makes one imagine that the sufferer has lost all reason, and even consciousness of normal character. But this is not so; the brain may not be affected at all, and the worst feeling is that of weariness. We have seen a patient smiling through the most distressing contortions--that is, most distressing to the ordinary observer. It is of great importance that any one who treats such cases should be _cool_ and _kind_.
It will sometimes be impossible for one person to keep the patient in bed and covered with the clothes so as to keep warm. If so, two must do it. It is, however, to be remembered constantly, that the patient feels it much more agreeable to be held within even close limits than to be allowed to throw arms and legs, and head and body about in all directions. This is a most invaluable truth in such cases. It will not do to hold as with an iron grasp, so that no degree of movement is allowed; but you may hold softly, so that no motion, such as will even disturb the bedclothes, shall take place. This must be done so that all the body shall be comfortably warm when the cold towel is laid along the spine and pressed gently to the centre of the back. In comparatively mild cases, we give an hour of this cooling process every morning only, and the warm washing and anointing with olive oil at bedtime; but in such cases as we sometimes meet with, where drugs have done their mischievous work, it is necessary to cool much more frequently. For instance, when the morning cooling has laid the irritation, and the patient is quiet for an hour, or, perhaps, only half-an-hour, the movement returns. The persons applying the cure are afraid to repeat it till another morning has come. But they need not be so. Or, they apply it for five minutes, and are afraid to continue it longer. They may quite safely apply it as long as they can keep the rest of the body comfortably warm. If they can keep nice, soft blankets well round the patient, as a rule it will not be difficult to keep up all general heat. Let us suppose that, when warm in bed and asleep, the patient wakes up, and the diseased movement begins; it will be well then to ply the back with the cold towel. If the movement is perfectly still in half-an-hour, a rest may be given. If the movement soon returns, the cold can be applied till perfect quiet is had again. This will, perhaps, be secured in twenty minutes or so. A rest and comfortable warming may be given again. If the movement still returns, it may be met by the same cooling process again. If only the heat is kept up all right, the cold towel may be used till the spinal irritation is finally gone.
This simple mode of treatment we have found to be perfectly successful, not only in removing every symptom of nervous irritation, but in giving most vigorous health to patients who, to begin with, were truly miserable-looking subjects. This may be looked for, as well as the mere removal of the malady.
It should be noted that one outstanding feature of St. Vitus' Dance is that the movement ceases _during sleep_. If this is not the case, other treatment is called for. _See_ Paralysis, and articles under Nerves; Spine, etc.
Sunshine.--Is a most valuable aid to health, acting as a physical and mental tonic. The sunbath, for either portions of the body at a time, or for the whole body, will be found very beneficial to nervous sufferers, and also to those having a tendency to certain skin diseases. Its tonic effect is very noticeable on the hair, giving it better growth and richer colour. Sunlight should be admitted freely into bedrooms and sitting-rooms, for it is hostile to the growth of many of those microbes which cause disease.
Tapeworm.--The only sure sign of the presence of this parasite in the intestine is the passing from the bowels of some of its joints or ova. Its presence in the body is a serious matter, always giving rise to more or less inconvenience and disturbance to health. We mention it here because we know of a very good and harmless remedy which will completely expel the worm. This may be obtained from D. Napier & Sons, herbalists, 17, Bristo Place, Edinburgh, postage paid, for 2s. One dose will be sufficient.
We dislike _secret_ preparations, yet when we come across a remedy which never fails, we confess to putting aside our dislikes and getting it.
The best thing is, however, to prevent the worm obtaining access to the body. All food, especially beef and pork, should be thoroughly cooked, and all cooking processes, and all places where meat is kept should be thoroughly clean. Where this is the case, tapeworm will never occur.
Tea.--Tea should not be infused longer than three or four minutes, and cream should be used with it. The albuminous matter in milk tends to throw down some of the tannic acid in an insoluble form. It should not be taken too hot, and if taken at a meat meal (which is undesirable), not till quite the conclusion of the meal. Much tea-drinking produces nervousness and indigestion. If taken _very_ weak it forms a pleasing addition to the morning and evening meal, but taken as it usually is, and especially between meals, such as at afternoon tea, it is a serious cause of ill-health.
Teeth.--In order to prevent decay, the teeth should be carefully brushed at least once a day, preferably at night, but better still after each meal. There is no better dentifrice than pure soap, and M'Clinton's tooth soap, being specially prepared from the ash of plants and a pure vegetable oil, does not leave the objectionable soapy taste in the mouth which all soda soaps do.
The prevalence of bad teeth is believed by many to be due to processes of milling, which remove the bone and enamel making properties of the grain. So much of the natural salts of the grain are removed to make bread white that it ceases to be the staff of life. A contributory cause is the consumption of large quantities of sweets or candies, especially between meals. White bread lodging in the teeth and thereby producing acid fermentation, is believed to have a bad effect on them, also too hot or ice-cold liquids. Remember also that the teeth cannot be healthy if they are not exercised. The Scotch peasant when he ate hard oat-cake had splendid teeth, as the Swedish peasants who eat hard rye-bread still have. Sloppy foods hastily bolted will ruin the digestion and thereby the teeth, besides depriving them of the work essential to their good condition. If teeth do decay they should be seen to by a dentist at once, as their presence in the mouth is injurious to the general health.
Teething.--At the outset, it must ever be remembered that this is _not_ a disease. It is a natural growth, and often is accomplished without any trouble at all. It is, however, a comparatively _quick_ growth, accomplishing much in a little time, as a plant in flowering. This _rush_ of growth in one place draws upon the vitality available for general purposes in the child's body, and if this vitality is not very large, trouble ensues. Diarrhoea, cold feet, and lack of spirit and appetite thus arise. If at this stage the lower limbs and body be carefully fomented (_see_ Fomentation), all trouble may cease at once; at least a very great deal will be done to relieve it. Give three teaspoonfuls of warm water, slightly sweetened with pure CANE SYRUP (_see_), three times a day. A little of the confection of senna will do instead of this if desired. The fomentation must never be so hot or so long at a time as to cause discomfort. Irritation is bad for a teething infant, and all must be done soothingly if success is to be gained. Also it will not do to foment and rub with oil a _feverish_ child. Such cases must be treated differently, as we shall see, and it is easy to distinguish them from cases without fever. Meantime we would say that in many cases where vital force is low without fever, the treatment by fomentation as described is of great value.
In regard to the artificial "cutting" of the gum by surgical instruments, we would say that such should only be resorted to when the tooth is very near the surface indeed, and by a careful surgeon who knows what he is about. The irritation in the gums which makes it thought of at all can be usually allayed by simple means. Let the mother dip her finger in good vinegar and water, just strong enough to slightly smart the lips, and rub it on the irritated gum. This can of course be done often, and is most powerfully soothing. It may indeed do all that is required. But if more general symptoms appear, such as sleeplessness and heat in the head, cooling of the head is required. Have two little caps made of _thick_ cotton cloth, one slightly larger, so as to fit on above the other on the child's head. Wring the smaller out of cold (but not ice-cold) water, and put it on. Press it gently on the head, and if the heat and restlessness continue, cool it again, perhaps twice or three times. When the restlessness is relieved, leave the damp cap on the head, and place the dry one on over it. If the heat returns, repeat the process. This treatment, though a mere cooling of the brain, has saved ere now both reason and life, and should never be lightly thought of or despised.
Often the stomach is seriously disordered during teething, both vomiting and purging resulting. In small degree these are not dangerous, but they are better avoided. If severe, they are the beginning of often fatal trouble.
To quiet the excited bowels, nothing is better than enemas of cool water. It need not be too cold, but just a little under blood heat, with a little vinegar added. One tablespoonful of vinegar to a pint of water. Also a "baby's bottle," prepared with water at blood heat (98 deg.), _without any milk or sugar_, will greatly assist the stomach if given to be sucked. In such cases infants usually suck this water greedily. It is most soothing to the stomach. Half a teacupful at a time is enough. In the evening wash the child with warm water and SOAP (_see_) rub all over with warm olive or almond oil, especially the back up and down. Then place a BRAN POULTICE (_see_) over all the back, taking care to have it just comfortably warm. When this is fastened on, an ordinary pocket-handkerchief wrung out of cold water is folded and laid over the bowels. This is changed for a fresh one as soon as heated, and _gently_ pressed all over. The milk, if the child is brought up on the bottle, may be given now, reduced in strength for a time. This treatment will often cure without enemas, which may then be dispensed with. Great improvement in health may be expected after a few days of such treatment. A cool handkerchief, similar to that on the bowels, may also be applied to the head, if that is heated.
Some form of head eruption often comes on after a long time of heated head. A little sour buttermilk, vinegar, or weak acetic acid, not stronger than to cause a slight smarting _tried in the nurse's nostrils_, will relieve almost instantly the itching which accompanies this. If strong acid be used, matters are made worse, and great pain caused. The acid, weak as we have described, at once neutralises the irritating substance exuded from the eruption. It also prepares the way for a cure. If astringent lotions are employed, drying the sore, and driving it in on the brain, serious injury may be caused. But if healing takes place under soaking with weak acid, no such result need be feared, for this simply removes the unhealthy state of the part. Water, especially _hard_ water, must be absolutely kept away from such a head. No more must be used than is necessary to dilute the acid; and, if it can be got, the acid of buttermilk is decidedly preferable. The whole body, when feverish, may be cooled in a tepid bath, several times a day if necessary, having the water just at blood heat.
Besides these outside effects, teething often causes brain disorders. (_See_ various articles on Children.) The infant should be watched carefully, and if the eye be dull, and the head heavy with feverish symptoms, the head should be cooled at once as above directed, and if the feverish symptoms are not marked, and the feet cold, the feet, legs, and lower body should be wrapped in a good warm fomentation. Where the trouble has gone so far that insensibility comes on, the treatment is the same, only the cloths had better be wrung out of _iced_ water if available. It is important to not only lay the cloths on the head, but to _press_ them. Take the little head in your two hands, and so bring the cool cloth close to every part of it, while you lift up a prayer for help from the Great Healer. Keep at this till your feeling tells you it is time to change the cloth. Take off the hot one and put on the cool one. Go on with the gentle pressure again. It does require work, but it is well worth work to save a precious life. You must so work that you will cause the least disturbance possible to the little sufferer. It may be you may require to keep this up for many hours, but you will probably find that some signs of sense appear ere you have gone on very long, and you may see that natural sleep has succeeded the drowse that lay in the worn-out brain. If so, you will allow the head to lie still in the cold cloth, and change only when it gets very warm. If natural heat has been fully restored to the legs and feet, you will let these rest also.
We know of a case where the brain seemed gone, and the medical man abandoned hope; but the head was cooled with ice cloths, while the feet and legs were kept in a hot fomentation, for a whole night, and all danger was passed by the morning. So that, even in very bad cases, this should be perseveringly tried.
For diet, in teething, the child must get easily digested food, and all "rich" foods--brandy, beef-tea, etc.--must be avoided.
Involuntary starting, and the manifestation of great fear on waking out of sleep, frequently arise from irritation of the spine during teething. The cold compress applied along the spine when the child is warm in bed will relieve this. It may be applied (_see_ Towels, Cold) twice or thrice a day. If the feet are cold, these may be fomented at the same time. If the head is cold, it may be fomented also. If it is hot, cool it. This treatment relieves the irritation of the mouth, as well as removes the starting. If _both_ head and feet are hot, then you need only cool the spine.
In all cases, common sense must be used, but we think we have given sufficient indication of principles to enable a thoughtful nurse or mother to treat successfully almost any case. Where very cold cloths on application cause shivering and crying, either use tepid cloths, slightly cooler than the skin, or warm the _surface_ of the cold folded cloth by holding for a short time to a fire, and then apply to the patient. The warm surface thus first touches the skin, and afterwards the cold in the body of the cloth penetrates gradually.
Temperature (_see_ Heat, Internal).
Tempering Treatment.--Much, if not all, of the success in any case of treatment depends on its being properly tempered to the strength of the patient. In putting on LATHER (_see_), for instance, a delicate and nervous child will be greatly annoyed if soaped all over at once. But if one arm be done and finished, then the other, then the breast, and so on to the abdomen, the back, and the legs, _bit by bit_, the effect will be soothing in the extreme. So with MASSAGE (_see_); so also with applying a cold towel. If it chills and terrifies the patient when suddenly "clapped on," common sense would suggest holding it to the fire till the _surface_ is warm. This warm surface will give no shock when applied to the skin, and the cold in the body of the towel will gradually penetrate and do its work. Also, as we have frequently repeated, the _strength_ of ACETIC ACID (_see_) must be carefully looked to, when it is used. It must ever be remembered that some of the finest and noblest spirits are inhabitants of frail bodies, which, with right treatment, are strong enough, but suffer terribly in rough hands.
Thirst.--This forms a severe feature in many cases of illness, and has to be treated variously according to its kind. It may be due first to _dryness_ in the membranes of the throat and stomach; secondly it may be due to a _concentrated_ or _deranged_ state of the juices of the body; thirdly, it may be the result of a _burning heat_ in the body. It will not be difficult for a careful person to say in any case which of them is the cause. The nature of the disease will indicate it. A little cold water may be given first. If this fails, a cold cloth over the stomach (_see_ Changing Treatment) may be tried. If these are not successful, a few tablespoonfuls of hot water may be given. The first of these meets the simple dryness, the second cures the burning heat, the third meets the case of concentrated and deranged juices in the body. A few drops of vinegar, lemon juice, or other fruit acid (_see_ Drinks), will often greatly assist the hot water in its duty. All alcoholic drinks are worse than useless in real thirst. Any power they possess is either due to the effect they have on the artificial thirst they create or to the water they contain. And the danger of rousing or creating the dreadful desire of the drunkard is so great, that they ought never to be given to relieve a patient's thirst.
If the cold water is known, from any cause, to be dangerous to the patient, then hot water will do equally well. If the thirst arises from some drug which has been taken, then hot water should always be given.
Again, the _locality_ of the dryness causing thirst indicates the best method of quenching it. If only the mouth and tongue be dry, then it will be sufficient to wash out the mouth with the water, or acid drink, not swallowing, so as to avoid unnecessary loading of the stomach. If throat and mouth are cool, and only the stomach burns, then the cold towel above that is the best treatment.
There is no need, except in very special cases, for iced water. Tap water is generally cool enough, unless stored in heated cisterns. In this case a little ice may be used to bring it down to a temperature of 45 deg. or so, but not below 40 deg.
Throat Hoarseness.--This is best treated by a good large BRAN POULTICE (_see_) on the back of the head and neck. While the patient lies on this, cold towels must be changed on the front above the "apple" of the throat. Do this for an hour twice a day. Or, if the feet be cold, give treatment as in Teething. There must also be _rest from talking_. Procure a good camel's-hair throat-brush from the druggist, and brush the back of the throat well with weak ACETIC ACID (_see_) several times a day, or simply gargle if there is difficulty with the brushing. The brush must be carefully cleansed, and dipped in the _strong_ acid after use.
Especially is it necessary to give up, in such cases, the use of tobacco. Where the trouble has lasted for years, it may be slow to heal, and the poulticing may be done only once a week. In ordinary cases, a day or two's treatment should cure.
Many times we have seen a good fomentation of feet and legs alone give very sensible relief. Never be satisfied with putting a hot bottle or brick to the feet. This is a lazy way of dealing with a serious case. Have the feet and legs up to the knees rubbed with vinegar and olive oil, and wrapped in a large blanket fomentation. It is not the mere dry skin of the soles of the feet that needs warming: the whole legs, especially the muscles, require the moist heat of a thorough fomentation. Circulation is at once accelerated just where it is wanted, so as to lessen the pressure where the vital stream is pressing too heavily and lodging in a dangerous congestion. It is good even if the feet are not very cold, but only cool, to ply this part of the remedy well. Where the patient is strong enough to sit out of bed, a good hot foot-bath will do instead of this fomentation.
Throat, Sore.--The first question in any case of sore throat, is, What is the temperature of the patient? (_see_ Heat, Internal). If this cannot be ascertained, at least we can say whether the patient is feverish or not.
Let us first take the case where there is no fever. Get the patient warmly to bed. Foment (_see_ Fomentation) carefully all round the neck, first rubbing on a little olive oil. Renew the fomentation every five minutes for three-quarters-of-an-hour at least. Allow rest for an hour. Then foment thoroughly the feet and legs up over the knees. When this is done, and the heat kept up, cool the throat with constant fresh cold towels. Let this go on for an hour. Finally sponge the whole body with warm vinegar. Rub lightly over with olive oil, dry, and allow to rest. Probably the throat will be cured. If not, repeat the treatment the following day.