Chapter 29

Worry is by no means a necessary concomitant of high civilisation, it is rather an accompanying mental disease due partly to low nerve power, which itself is due to erroneous methods of life--errors of diet, want of pure air, cleanliness, exercise, etc. Partly, too, is this low nerve power due to mental causes peculiarly Western. The _Asiatic_ with his power of concentration, reflection, contemplation, with his patience, endurance, calmness, knows nothing of this scourge of European and American life. Even the Japanese, progressive and efficient as they are, possess this native contented, sweet, calm disposition, a habit of mind which, if they can retain, will be of enormous value to them in coming years.

Wounds, Bleeding of.--After sending for a surgeon the first thing to be looked at in case of any wound is the bleeding. Sometimes this is trifling and needs no particular effort to staunch it. When, however, a vein or artery has been lacerated the flow must immediately be attended to.

If the blood be welling up from the wound and of a dark red colour it is venous blood, if it spurt up from the wound and be of a bright red colour it is arterial blood. What has to be done is to place a pressure on the vein or artery to prevent the blood escaping.

Venous bleeding may generally be stopped by putting a pad of lint dipped in cold water on the wound and tying it on with a bandage. If the blood continues to flow, tie a bandage round the limb on the side of the wound _away_ from the heart and keep the limb raised.

Arterial bleeding must be treated by tying on the pad and bandage, and if the bleeding continues, stopping the flow in the artery on the side of the wound _nearest_ the heart, and at some point where it passes over a bone so that pressure may be efficiently applied. The bandage for thus tying an artery may be simply made by knotting a handkerchief (Diagram IV.), putting something solid inside the knot, then placing the knot on the artery at the desired point and tying tightly. If required this may be tightened by putting a stick under and twisting round, then tying the stick in position (Diagram II.).

If the palm of the hand is cut, put a pad inside the hand, close the fingers, and tie the bandage round the clenched fist.

If the wound is in the forearm, put a pad in the bend of the elbow, and tie the forearm firmly up on the arm. If the wound is above the elbow stop the main artery in the way above indicated. This artery runs pretty well under the inner seam of the sleeve of a man's coat. Diagram I. shows how this artery may be stopped by direct pressure of the hand; Diagram II. how a tourniquet may be applied.

For bleeding in the arm-pit, press in a pad and tie the arm down to the side. It may be necessary here to compress the artery with the thumb. The artery here lies behind the inner bend of the collar bone lying on the first rib.

In case of arterial bleeding about the head apply the bandage as in Diagram III. The pressure is here applied right over the wound, as the skull is always behind on which to press the artery.

A wound in the leg should be treated in a similar way to a wound in the arm. Diagram V. shows the stopping of bleeding above the knee.

Do not remove the pressure until the arrival of a medical man.

Wounds, Ill-Smelling.--For all such wounds, the best method is frequent cleansing with vinegar or dilute ACETIC ACID (_see_) by means of a small glass syringe, such as may be got at any druggist's (_see_ Abscess; Wounds, Syringing). We know one case where the patient was expelled from a curative home because of the evil smell of his wounds, three careful cleanings out with dilute acid so removed all odour that the patient was at once readmitted. Where the wound is very tender, soak soft cloths or lint in the dilute acid, and lay them on the wound three or four ply thick. Remove and renew them every quarter-of-an-hour till the smell is gone. Of course the cloths should be immediately washed or, better, burned. In using the syringe, care should be taken _to suck out_ the ill matter, as well as to send the dilute acid well down into the sore. Careful cleaning of the syringe with _boiling_ water before use is necessary.

Wounds, Soothing.--During the process of _healing_, wounds often give a great deal of pain, even when all is going well. It is this pain we here show how to relieve. After an operation under chloroform, itself painless, the process of healing is often very painful. We are sure this pain need not be endured, but to prevent or cure it we need to see what is its cause. Two causes are specially notable--_pressure_ and _cold_. By skilful handling and bandaging, undue pressure may be avoided by the surgeon. But a great deal can be done by any one to keep cold from the seat of injury. Have a bag of soft flannel, as fine as possible, made so as to surround the wounded part. This bag is filled with _dry_ bran, heated in an oven or otherwise, without being wet. Of course the heat must not be great enough to cause any discomfort, but sufficient to give a fine sense of relief. This application is for a wound which has _not_ become inflamed, but is doing well.

When inflammation has set in, and the patient is fevered, the opposite treatment is applied. Over the dressing apply three or four folds of dry cotton cloth, and over this again apply cold towels (_see_ Towels, Cold Wet) until the pain is relieved. Good sense must regulate this treatment, of course, and excess of cold be avoided. But with ordinary care this need never cause anxiety.

Wounds, Syringing.--Very great good can often be done by a little careful syringing of internal wounds. Take, as an illustration, a case of a kind we have often seen. It is that of a young patient with a wound on the lower part of the leg, a good long way below the knee. This wound will run in spite of all that has been done to dry it up. The opening in it is very small, and one would think it ought to be easily cured, but it is not so. The truth is that this wound is from two to three inches distant from where the real sore is situated in the limb. The wound is well down towards the ankle; the real sore is well up towards the knee. There is a corroding matter generated in the internal sore, and that runs down under the skin, and keeps cutting its way out at the wound. Until this is rectified, there will be no successful healing. Ointments that might do well enough on a small external sore have no effect in this case. The real sore, however, is easily reached and cured by the right use of a small pointed syringe. The kind most easily procured is made of glass, and costs about sixpence. Choose one that has a small smooth point, which can be easily inserted into the hole in the wound. This should be done without causing any pain. The point of the syringe should be dipped in hot water till it is as near as possible to blood heat: that is, it should neither be hotter nor colder than the skin it has to touch. If you are sufficiently careful on this point, all else will be comparatively easy.

Before you actually try to insert the syringe, observe in what direction the wound is likely to be extended under the skin. It will probably be upwards--almost certainly it will be so, as the waste matter, by its weight, tends to fall down. The sore at the top insertion of a muscle near the knee will send its matter down the leg, perhaps near to the ankle. Fill the syringe with warm water only, as near blood heat as you can have it. When you have got the point of the syringe even a very little way into the wound, you can inject a little water, and in doing this you will probably learn more nearly where the actual sore is to be found. The water will probably come out as fast as you send it in, but it may not come till a good quantity has gone in. Now, as you fill your syringe a second time with water at the same degree of heat, you will add a single drop of strong acetic acid, or twelve drops of white vinegar to a teacupful. You must be careful that this is not exceeded at this stage, or you will cause great pain. Moreover, you do no good to the sore by making the acid so strong as to cause suffering. If it is only just so strong as to cause a comfortable feeling of warmth, it will be all right for its curative purpose. Even very weak acid combines with the irritating waste matter that is keeping the sore diseased, and produces the desired healing effect. You have only to add one drop after another of the acid to your full teacupful of warm water, till the feeling produced by the syringing is all that could be desired. In the case of the limb that we refer to, a sensible mother used the syringe and the acid so skilfully as to heal the internal sore in a very short time, and thus the external wound quickly disappeared. Of course, if the wound is so very deep that the acid cannot be got up to cleanse it thoroughly, surgical aid should be sought.

It may be well, however, to take another case or two for further illustration. Here, then, is a decayed tooth extracted, but the part from which it is taken does not heal, as is usual. The hole in the gum does not close, and a discharge of offensive humour flows from it constantly. The bone of the upper jaw is evidently wasting, and the decay has extended somehow considerably up the side of the nose. The hole, however, is so small, that the usual glass syringe cannot enter it. We got an exceedingly small instrument, used for the injection of morphia under the skin. The point of this syringe is a needle with a point that is hollow nearly to the very end. When this point was broken off, the hollow part was so small that it entered the hole in the gum, and so it was easy to inject the weak acid up to the bottom of the sore, which had come to be only a little under the eye. About an inch and a half of hollow had to be washed out with the acid. But in a very short time all discharge ceased, and the cure was perfect. Both of these cases are comparatively simple, but they show clearly the great value of this use of acetic acid.

Carbolic acid is much more commonly used for such a purpose. It has the drawback of being liable itself to melt away the healthy tissue, and to make a wound larger. Acetic acid never does this, and so heals more quickly and certainly.

We might take a much more difficult case. It was that of an abscess and bad sore in the lower bowels. It was supposed to be necessary to perform a very dangerous operation in order to try to cure this--not much hope was held out of its being possible really to cure. It was, however, quite possible to reach the sore by the injection of acetic acid. The sufferer was directed to have this done regularly. In a very short time there was a complete cure. In such a case all that is wanted is an ordinary india-rubber enema. A much larger quantity of water is required, but about the same strength of acid. First of all, as much acidulated water as can be taken up with comfort is injected: after a minute or so this is passed off. Then another is used in the same way, and passed off also. A third syringing may be employed, when about half-a-teacupful is taken and retained. If the acid gives no comfortable feeling of warmth it needs to be strengthened till it does so, but not so that it produces any pain. The operation really well done is not in the least painful, but, on the contrary, rather comfortable.

There is still one syringing which we may notice--that of suppurating ears. If an ear is discharging from some internal sore, nothing is more important than syringing with acetic acid, but it must be done with very peculiar care. The water used should be as nearly as possible of exact blood heat, and the acetic acid of the exact strength at which it will give a fine comfortable feeling in the ear. It must neither feel as if it were a mere wetting of the ear, nor that it gives the least pain. The syringe, too, must be used gently, so as not to force the water strongly against the internal parts that are so tender. It is a soaking operation rather than a forcible urging of the water into the ear which is wanted. If this is nicely done, say twice a day, the acid will reach the sore, and we may confidently look for a cure. Even when the bones are wasting, as we have seen in the case of the upper jaw, if this acid can be really brought to bear upon the sore, it will be cleansed and healed. In this simple way we have seen many, both old and young, delivered from sore trial, and made to enjoy life and health again.

PHYSICAL CULTURE.

Much weakness might be prevented and often cured by light gymnastic exercises practised twice a day, say on rising and at bedtime, giving tone to the muscles and bringing into regular use many which in ordinary daily life are seldom or never used. The various vital organs of the body owe much of their health to the proper exercise of the surrounding muscles; it will be seen then how necessary a system of regular exercise must be. The best way to learn this is to take a course of Swedish Drill or other good system at one of the gymnasiums which are now so common in Britain and America. But as many of our readers live in places where such cannot be had, we shall try to indicate by diagrams some simple movements which can be practised by anyone.

A few general rules should be borne in mind:--

Begin with a short time, say five minutes; omit at first the more fatiguing movements and gradually increase as the strength improves.

The time spent need never be long; fifteen or twenty minutes is long enough at any one time.

Do the movements slowly and deliberately, stretching the muscles to their full extent.

Fix your mind on the particular limb that is being exercised.

Practice in a room with open window, with little clothes on, or with none; a daily air-bath is very conducive to health.

Each exercise need not be performed more than three times, until strength is fairly great.

Never go on with the exercises so long as to be more than just a little tired.

It is a good plan to write out the exercises clearly on a good-sized card or sheet of stiff paper, which can be set where it will be easily seen while one is exercising.

1.

POSITION 1.--Stand before a glass with head well up, chin in, neck elongated, shoulders down and back, arms hanging straight down, abdomen in, back slightly curved, heels together, toes slightly apart.

2.

ARMS BEND.--While in position, bring the arms up at the sides so that the tips of the fingers touch the shoulders. Return to position 1.

3.

HIPS FIRM.--Place hands on hips, well back, fingers together, and thumbs to the back. Now, slowly bend the head back as far as it will go, and slowly raise it again, taking care all the time to keep the chin in. Position 1 again.

4.

NECK REST.--Bring the arms up on a level with the shoulders, hands straight with forearm and finger tips nearly but not quite touching behind the neck. Head always quite erect. While in this position, bend the body from the waist sideways, first to one side, then to the other, as far as it will go without moving the feet. When bending to the left, _feel_ the muscles of the right stretching and _vice versa_. Return to position 1.

5.

Bring arms to position 2, then extend them straight upwards, rising on the toes at same time and drawing the body to its greatest height. Bring arms again to position 2 and then down to position 1.

6.

Bring arms to position 2 and extend them sideways, turning palms and hands downwards. Come back to position 2 and then position 1.

7.

Bring arms to position 2 and extend them forwards, return to position 2 and position 1.

8.

Hips firm (hands placed as in 3). Raise the heels a little, bend the knees slightly outwards and keep the upper part of the body perfectly erect. Lower the body about half-way down, then raise it again.

9.

Same as 8, only go down as low as possible. It is not easy at first to keep one's balance, the upper part of the body erect all the time, especially when trying to rise. Return to position 1.

10.

Arms bend (_see_ 2). Place the feet sideways, about a foot apart. Now bend the upper part of the body back, curving only the chest back, keeping the waist still. Position 1.

11.

Bring arms to position 2 and extend upwards as in fig. 5. Now bend the body forwards till the hands nearly touch the floor, keeping the head between the arms, knees straight and arms straight and parallel to one another. Return to position 5, then position 2 and then position 1.

12.

Hips firm (_see_ 3). Raise one knee till the leg is bent as in the illustration, keep toe pointed down. Do the same with the other leg. Return to position 1.

13.

Same as 12, only stretch leg backward as in illustration, keeping knees straight. Return to position 1.

14.

ARMS FORWARD BEND.--Bend the arms in front of the body, as in the illustration. Extend one foot back and rest toe on ground. Position 1.

15.

Arms as in 14. Fling right arm out sideways and turn head to the right as far as it will go without moving the rest of the body. Same to left. Position 1.

16.

Hips firm (_see_ 3). Kneel with toes extended backwards. Now bend the body backwards from the knees, as far as possible, keeping straight and firm as in illustration. Rise and return to position 1.

17.

One arm, HIP FIRM, the other NECK REST (_see_ 3 and 4). Bend the body as in exercise 4. Return to position 1.

18.

Arms bend (_see_ 2). Feet stride (_see_ 10). Now turn the body at the waist as far as possible to right, then to left, taking care not to move the hips. Return to position 1.

19.

LEAP ON THE SPOT.--Hips firm (_see_ 3). Raise the heels, slightly bend at the knees as in illustration, jump and alight on toes again with knees slightly bent. Straighten knees and let heels sink to the ground. Position 1.

20.

Hips firm (_see_ 3). Stand near a chair or bed and slip one foot sideways under a rail. Now bend sideways as far as possible. Position 1.

21.

As 20, only stand facing the support and bend back. Position 1.

22.

Kneel as in 16. Extend arms as in 6. Now turn the body from the waist as far to the right and as far to the left as possible. Position 1.

23.

Deep breathing (_see_ Breathing, Correct method of) should be practised several times during these exercises. Stand in position 1. Now raise the hands slowly to the level of the shoulders, keeping the arms straight and moving them sideways. While raising the arms, slowly fill the lungs with air, and when lowering them let it slowly out.

DUMBELL EXERCISE.

As an efficient and inexpensive way of developing all the muscles of the body dumbells have no rival. Especially are they valuable for those whose sedentary life forbids much active exercise, and as they only require a very short time each day for their practice, do not interfere materially with the work of the busiest. The accompanying exercises have been given with a view to the complete and symmetrical development of the body. They should be practised in their entirety every morning and evening, after rising and bathing and before retiring, in as nearly a nude a condition as practicable. And they should be practised with a serious and complete concentration of the mind upon each muscle as it is in turn exercised. This concentration is immensely fatiguing at first, but is necessary in order to derive full benefit from them. Just as in practising musical exercises for execution, a short time well spent is more valuable than a longer time with a wandering and uninterested mind, so in dumbell exercise it is above all the quality and not the quantity of the exercise which is of importance.

Increase the number of times each exercise is done weekly or daily, beginning say at 10 or 20, according to strength, and endeavouring to be able to be double this number in a short time.

1a.--Arms by side forced well back, finger nails to front. Inhale.

1b.--Raise bells to shoulders, contracting biceps. Exhale.

2a.--Arms by side forced well back, finger nails to rear. Inhale.

2b.--Raise bells to shoulders. Exhale.

3a.--Extend arms sideways in line with shoulders, finger nails up. Inhale.

3b.--Bring bells to shoulders, contracting biceps. Exhale.

4a.--Arms by sides, chest well out. Inhale.

4b.--Cross arms in front, contracting chest muscles. Exhale.

5a.--Arms extended in front level with chin. Exhale.

5b.--Bring bells back sideways in line with shoulders. Inhale.

6a.--Upper arms close to sides, bells level with shoulders. Exhale.

6b.--Raise bells above head as far as possible. Inhale.

7a.--Arms by sides forced well back, finger nails to rear. Inhale.

7b.--Raise arms up level with shoulders rounding back. Exhale.

8a.--Lean over to right, left knee bent, right leg straight.

8b.--Repeat to left.

9a.--Lunge out to left, right leg straight, raising left hand above head, right hand at side.

9b.--Repeat to left.

10a.--Heels together, chest well out, hands on hips.

10b.--Sink on toes, raising heels from ground, gradually resume upright position, keeping back straight.

SEX AND HEALTH.

The treatment of the relations of the sexes to one another, and the enormous influence over health of both body and mind which these exercise, cannot be attempted in a treatise such as this. Such articles would occupy far too much space, as from the nature of the subject much detail must be given, and explanations must be as complete as possible. The Editor of these Papers has therefore written a book for children, and one each for boys and girls. These will be found advertised at the end.

Numbers of persons consult us on these matters, and much has come to our knowledge which is astonishing and saddening as well, in regard to the widely prevailing ignorance of both young and old regarding the sex functions. This is largely due to culpable neglect on the part of parents and others who have charge of the young.

Parents are often unwilling to speak of such matters, and would desire rather to place a good book on the subject in their children's hands. Many such books have been published, but none that we have seen have seemed to us quite satisfactory. Due attention must be paid to both the physical and moral sides of the matter. Hence our resolve to write as we have indicated. The books will be found duly advertised at the end of this volume.

It will no doubt be said that it is a pity to suggest ideas of sex to an innocent child, but surely those who look back on their own youth will remember that there came a time when the problem of their own origin suggested itself.