Part 138

For a long time it has been well known to the medical profession that in various critical states of the human system absolute silence, or the nearest possible approach to it, is not the least important condition to be secured. Accordingly muffled knockers, streets covered with straw or spent tan, and attendants moving about with noiseless step, are universally recognised as the signs and the requirements of severe disease. But the truth that noise is a contributor to the wear and tear of modern city life has scarcely yet been realised by the faculty, not to speak of the outside public. Consequently, while a zealous war is being urged against other anti-sanitary agencies, no general attempts for the abolition of superfluous noise have yet been made. We cannot, perhaps, give anything approaching to a scientific explanation why sound in excess should have an injurious effect upon our nervous system. We feel that noise is distressing, exhaustive. The strongest man after days spent amidst noise and clatter, longs for relief, though he may not know from what. It may even be suggested that the comparative silence of the sea-side, the country, or the mountains, is the main charm of our summer and autumn holidays, and contributes much more than does ozone to restore a healthy tone to the brains of our wearied men of business. Indeed, if we consider, we shall find that this is the most unnatural feature of modern life. In our cities and commercial towns the ear is never at rest, and is continually conveying to the brain impressions rarely pleasant, still more rarely useful or instructive, but always perturbing, always savouring of unrest. In addition to the indistinct but never-ceasing sea of sound made up of the rolling of vehicles, the hum of voices, and the clatter of feet, there are the more positively annoying and distracting elements, such as German bands, organ grinders, church bells, railway whistles, and the like. In simpler and more primitive times, and to some extent even yet in the country, the normal condition of things is silence, and the auditory nerves are only occasionally excited. It is scarcely to be expected that such a change can be undergone without unpleasant consequences.

The question has been raised, why should some noises interfere with brain work by day and disturb our rest at night so much more than other? A strange explanation has been proposed. We are told that sound made incidentally and unintentionally--such as the rolling of wheels, the clatter of machinery (except very close at hand), the sound of footsteps, and, in short, all noises not made for the sake of noise--distress us little. We may become as completely habituated to them as to the sound of the wind, the rustling of trees, or the murmur of a river. On the other hand, all sounds into which human or animal will enters as a necessary element are in the highest degree distressing. Thus it is, to any ordinary man, impossible to become habituated to the screaming of a child, the barking and yelping of dogs, the strains of a piano, a harmonium, or a fiddle on the other side of a thin party-wall, or the clangour of bells. These noises, the more frequently we hear them, seem to grow more irritating and thought-dispelling.

But while admitting a very wide distinction between these two classes of sounds, we must pause before ascribing these differences to the intervention or non-intervention of will. We shall find certain very obvious distinctions between the two kinds of sound. The promiscuous din of movement, voice, and traffic, even in the busiest city, has in it nothing sharp or accentuated; it forms a continuous whole, in which each individual variation is averaged and toned down. The distressing sounds, on the other hand, are often shrill, abrupt, distinctly accentuated and discrete rather than continuous. Take, for instance, the ringing of bells: it is monotonous in the extreme, but it recurs at regular intervals. Hence its action upon the brain is intensified, just as in the march of troops over a suspension bridge, each step increases the vibration. The pain to the listener is the greater because he knows that the shock will come, and awaits it. Very similar is the case with another gratuitous noise, the barking of dogs. Each bark, be it acute or grave, is in the highest degree abrupt, sharply marked, or _staccato_, as we believe a musician would term it. Though the intervals are less regularly marked than in the case of church bells, we still have a prolonged series of distinct shocks communicated to the brain. All the other more distressing kinds of noise possess the characters or shrillness, loudness, and of recurrent beats or blasts.

As an instance of an undesigned, unintentional noise being distressing to those within ear-shot, we may mention the dripping of water. A single drop, whether penetrating through a defective roof, falling from the arch of a cavern, or issuing from a leaky pipe, and repeated at regular intervals, is as annoying as the tolling of a bell, the barking of a dog, or the short, sharp screams of a fretful infant. The only difference is that the noise is not heard as far. We may hence dismiss the “will” theory, and refer the effects of noises of this class to regularity, accentuation, and sharpness.

It is particularly unfortunate that the multiplication of sound should accompany, almost hand in hand, that increase of nervous irritability and that tendency to cerebral disease which rank among the saddest features of modern life. A people worn out with overwork, worry, and competitive examinations might at least be spared all unnecessary noise. Many persons cannot or will not understand how necessary silence is to the thinker. A friend of the writer’s, engaged in investigating certain very abstruse questions in physics, is often compelled to throw aside his work when an organ grinder enters the street, and suffers with acute pain in the head if he attempts to go on with his researches.

We should therefore propose, as measures of sanitary reform, the absolute prohibition of street music, which is more rampant in London than in any other capital in Europe. The present law, which throws upon the sufferer the burden of moving in the matter, is a mere mockery. Another necessary point is the abolition of church bells. In these days of innumerable clocks and watches every one can tell when it is the time for divine service without an entire neighbourhood being disturbed for some 20 minutes at a time. Nonconformist places of worship collect their congregations without this nuisance. Further, all dogs convicted of persistent barking should be disestablished. And lastly, harmoniums, American organs, and wind instruments in general should be prohibited, except in detached houses. (_Journal of Science._)

_Chapped Hands._--(_a_) Some persons are sadly troubled with their hands cracking. It sometimes comes from a persons health; but there is one great thing to keep in mind--that is, every time you wash or wet your hands, be sure and dry them well. Always, after wiping them, hold them to the fire till quite dry. This is very important. As an outward application, spermaceti ointment, with a small quantity of lead acetate and some camphor well mixed is a good thing. Rub some well in at night on going to bed, and do not use strong soap.

(_b_) A mixture of 1-2 dr. hydrochloric acid to 4 oz. water for use in case of chapped hands, and even when the skin is cracked and bleeding, relieves the complaint at once, and if persevered in effects a cure.

(_c_) Into a 3 oz. glass-stoppered bottle pour ½ oz. pure glycerine; fill up with distilled water and shake. A few drops in the palm rubbed and distributed over the hands when nearly dry, after washing, will in a short time render the skin like satin. It is well to scald the bottle before filling, to check the development of vegetable organisms (“ropiness”). Do not increase this quantity of glycerine, or it will make your hands sticky.

(_d_) One part (say 1 oz.) pure glycerine, 1 of Eau-de-Cologne, 2 of water; mix them in a bottle and use a few drops well rubbed in after every washing of the hands, and as frequently in the day as can conveniently be done.

(_e_) Mix equal quantities pure glycerine and pure water together, and add as much common salt as the liquid will dissolve. Rub this frequently on the cracked portions of the hands, giving an extra quantity just before going to bed.

(_f_) Salicylic acid and borax, each 1½ dr., glycerine up to 2 oz.

(_g_) Equal quantities carbolic acid and glycerine.

_Chilblains._--(_a_) Chilblains are likely to be caused by sudden change from cold to heat or _vice versâ_. This will explain why the hands and feet, nose and ears, are mostly the parts affected, because they are the parts most prominently exposed to such changes. Invalids and scrofulous persons are more likely to suffer than the robust and healthy. As prevention is better than cure, care should be taken to protect the parts by substances which are non-conductors of heat. Woollen socks, stout boots, and warm gloves are safe preventives, and especially taking care not to warm the parts affected by cold by any other means than friction, and in case of persons predisposed to chilblains, the frequent ablution of the extremities in tepid water and the use of good yellow soap is advisable, bathing the feet and hands in tepid water slightly salted, every night, is a good antiphlogistic. Should these means fail, where the skin is not broken, use a liniment of 1 oz. camphorated spirits of wine mixed with ½ oz. Goulard’s extract; but the best remedy is a lotion composed of 1 dr. iodine in 3 oz. rectified spirits of wine, to be applied with a brush not more than once a day. Should the chilblain be broken or ulcerated a different treatment must be adopted--warm poultices ought to be applied, and discontinued after about 3 days; the sores must then be touched with the tincture of iodine once a day, and then dressed with basilicon ointment; when they begin to granulate freely, a simple dressing of the above ointment is sufficient to complete a cure. Care ought always to be taken not to let chilblains break through the skin, as they are very liable to mortify.

(_b_) Copper sulphate in solution is about the best thing to allay the itching before they break. Also is used with very good effect an embrocation composed of 1 dr. tincture of capsicum and 7 dr. soap liniment. After they have broken, the best application will be carbolic acid and linseed oil--1 part of the former to 5 of the latter, to be applied with a feather (the pure acid should be used for this). This is the most useful application for any open sore.

(_c_) 1 dr. sugar of lead, 2 dr. white vitriol, then add 4 oz. water; shake well before using. Rub well on the affected parts with the hand before a good fire; the best time is in the evening. Do not use this on those that are broken. This scarcely ever fails to cure the most inveterate chilblains by once or twice using.

(_d_) Quite effective for unbroken chilblains, but it might be poisonous to broken ones, so be very careful:--A small quantity of yellow soap is dissolved in very little water, then methylated spirit is added to just thin it a little, then add, while hot, tincture of iodine drop by drop, stirring it the while; when it begins to change colour there is enough; let get cold, and apply night and morning, letting it dry on. It is only good while the spirit is in it.

(_e_) Take some precipitated chalk, and mix it in a mortar (or with a knife in a plate, but the first way is best) with some salad oil to something thicker than cream--about the thickness of Devonshire cream. At night apply it thoroughly over all the fingers, rubbing it in, and smearing it thickly on them, putting a pair of gloves on. Persevere every night.

(_f_) 6 gr. copper sulphate, ½ oz. Eau-de-Cologne, ½ oz. distilled water. To be applied twice a day with camel-hair brush. A capital remedy to arrest inflammation in chilblains.

(_g_) 2 oz. black bryony root, 10 oz. spirit of wine, 2 oz. water. Macerate 7 days and filter. Apply night and morning with a camel-hair pencil.

_Cold Feet._--(_a_) There are two remedies--the hot bottle and lamb’s-wool socks, either or both of which may be used. When we consider that during the day, whilst we are active, we wear stockings and shoes, does it not seem strange that at night, when the temperature of the air is lower, and when we are inactive, that our feet should have less covering than during the day? The reasonable plan is to have a special pair of socks for night use, putting them on when going to bed, and change them when getting up; the result will be better and more serene sleep, consequently we shall be more able to undergo our daily exertions. A good walk for ½ hour before retiring warms the feet, and sends a nice glow all through the body, and disposes to sleep. (_b_) Wear horse-hair soles winter and summer, as a remedy for cold and damp feet.

_Coughs and Colds._--The _British Medical Journal_ remarks that there are several well-known processes by which a cold may be caught. As a disease, there is nothing so common; and yet it is only very recently that anything like an approach to a knowledge of its pathology has been attained. There is now, however, a large accumulation of evidence which points very strongly in the direction that “taking cold” is actually “being cold.” Colds are most frequently caught from a wetting. The clothes we wear are good non-conductors of heat, and so prevent the loss of body-heat which would occur without them. But let them become moist or saturated with water, and then they become heat-conductors of a much more active character, and a rapid and excessive loss of body-heat follows. Nothing is more certain, however, than that prolonged exposure in wet clothes is commonly followed by no evil results; that is, so long as there is also active exercise. The loss of heat is then met by increased production of heat, and no harm results. But let the urchin who has been drenched on his way to school sit in his wet clothes during school-hours, and a cold follows. No matter how inured to exposure the person may be who, when drenched, remains quiet and inert in his wet clothes, he takes a cold. Here there is an increased loss without a corresponding production of heat, and the temperature of the body is lowered, or the person “catches cold.”

The effect of exercise in producing heat is well known. Unless the surrounding air be of a low temperature and the clothes light, the skin soon glows with the warm blood circulating in it, and then comes perspiration with its cooling action. Here there is a direct loss of heat induced to meet the increased production of heat. Exercise, then, in wet clothes, produces more or less a new balance, and obviates the evil consequences which would otherwise result.

The loss of heat is more certainly induced if the skin be previously glowing and the circulation through the skin, the cooling area, be active. Thus, a person leaves a ballroom with his cutaneous vessels (pores of the skin) dilated, and a rapid loss of body-heat follows, unless there be a thick great-coat or a brisk walk; if the clothes become moistened by rain, or be saturated with perspiration, the radiation of heat is still more marked. Such is the causation of the cold commonly caught after leaving a heated ballroom. It is probable that exhaustion is not without its effect in lowering the tonicity of the vessels, and so those of the skin do not readily contract and arrest the loss of heat.

A damp bed gives a cold, because the moist bedclothes are much better conductors of heat than are the same clothes when dry. The temperature of the body is lowered, and a cold results. Long exposure in bathing leads to similar consequences. The second feeling of cold in bathing tells that the body is becoming chilled, and that the production of heat is insufficient to meet the loss. A run on the river-bank, or a brisk walk after dressing, commonly restores the lost balance.

The plan of permitting the wet clothes to dry on the wearer is very objectionable. The abstraction of heat from the body by the evaporation of moisture in the clothes produces a marked depression of the body-temperature, and a severe cold. This is most strikingly seen in the effects of a wetting in the Tropics. The smart shower or downpour is quickly followed by a hot sun and a breeze, and the loss of heat under these circumstances is considerable. The person is “chilled to the bone,” and the effects are felt for a long time afterwards.

Alcohol has been abandoned in Arctic regions. It dilates the cutaneous vessels and increases the loss of body-heat. The drunken man perishes of cold when the abstainer survives.

When the exposure follows a long continued warmth, the cutaneous vessels do not contract, but become dilated or paralysed, and then a large bulk of warm blood courses through the cooling surface, and a great loss of body-heat is entailed. Not only so, but the current of chilled blood passes inwards to the right heart and the lungs. Inflammations of the lungs are common along with severe colds; and this is possibly the explanation. Such inflammation is specially liable to occur if at the same time cold air be inspired. The cold respired air and the currents of chilled blood together, produce those vaso-motor disturbances in the lungs which, in their graver aspects, are known as pneumonia.

The practical considerations which are the outcome of this review of the pathology of cold are these. Never wear wet clothes after active muscular exertion has ceased, but change them at once; meet the loss of the body-heat by warm fluids and dry clothes; avoid long-sustained loss of heat which is not met by increased production of heat; increase the tonicity of the vessels of the skin by cold baths, &c., so educating them to contract readily on exposure--by a partial adoption, indeed, of the “hardening” plan; avoid too warm and debilitating rooms and temperatures; take especial care against too great a loss of heat when the skin is glowing; and prevent the inspiration of cold air by the mouth by some protecting agent, as a respirator. We can readily understand how a respirator should be an effective protection against winter bronchitis in those so disposed. Of course, no one should, even in summer, dispense with the use of flannel next the skin, or some substitute, such as merino. It is as important at that period of the year, as in winter.

Dr. Graham gives the following advice: “When you come out of a cold atmosphere you should not at first go into a room that has a fire in it, or if you cannot avoid that, you should keep for a considerable time at as great a distance as possible, and, above all, refrain from taking warm or strong liquors when you are cold. This rule is founded on the same principle as the treatment of any part of the body when frost-bitten. If it were brought to a fire it would soon mortify, whereas, if rubbed with snow, no bad consequences follow from it. Hence, if the following rule were strictly observed--when the whole body, or any part of it, is chilled, bring it to its natural feeling and warmth by degrees--the frequent colds we experience in winter would in a great measure be prevented.”

To neglect the conditions upon which strength of constitution and purity of blood depend, and then strive to avoid in a sedulously careful manner the evil influence of colds upon the body, is like neglecting the substance for the shadow of health; or more properly, it is like one who starves his body, and then strives to keep quiet in order that his strength shall not be exhausted. Let food be taken, and the exhaustion from exercise will not ensue; let all the conditions of health be observed, and then the natural changes of the weather will fall harmlessly on the healthy functions of the body.

Occasionally a cold may be arrested, in the first stage, by taking at the very outset, a hot bath on retiring to rest, with 10 gr. Dover’s powder at bedtime, followed by a hot drink, such as a basin of hot gruel or a tumbler of hot toddy, with a dose of castor-oil in the early morning about 6 o’clock. It is well to remain indoors for the day. Should, however, these means fail, or the ailment have progressed too far before the remedy is applied, and the patient complains of soreness of chest, with cough and feverishness, then he should keep bed for 3 days. Mustard and linseed poultices are to be applied to the chest, warm diluent drinks are to be given, such as gruel, with honey and vinegar in it, to promote gentle perspiration, and to relieve the severity of the cough. Ipecacuanha wine, 10-15 drop doses in water every 4 hours, will be found useful in promoting expectoration. Laxative medicine will probably be necessary, and the diet should be light.

The Continental remedy, lime-flower tea or tisane de tilleul is made in a teapot in the same way that tea is made, substituting lime blossoms for tea leaves, and using about 4 times the quantity to make it. It is taken hot, and used for colds, coughs, &c., much in the same way that gruel, wheys, and possets are taken in England.

Dr. Ferrier, of King’s College, communicates a remedy for cold in the head, which has been found effectual. It is a white powder used as snuff, and composed as follows:--2 gr. hydrochlorate morphia, 2 dr. acacia powder, 6 dr. bismuth trisnitrate. The whole makes up a quantity of powder, ¼-½ of which may be safely taken in 24 hours. Dr. Ferrier has twice cured himself of very severe colds by this means, once by the use of bismuth trisnitrate alone, which is a very powerful remedy for catarrh of the mucous membrane, and is the most important ingredient in the above mixture. Others have used the snuff with perfect success. Instead of increasing the tendency to sneeze, it almost immediately begins to diminish it. (_Lancet._)

Prof. Strambio, in a note to an Italian medical journal, says that, notwithstanding the failure of all remedies hitherto recommended for the immediate cure of a cold, he wishes to communicate to the profession the great success he has found attending a new one in his own person, and to ask them to test its efficiency. He found prolonged mastication and swallowing of a dried leaf or two of the _Eucalyptus Globulus_ (Blue gum) almost immediately liberated him from all the effects of a severe cold.

In the treatment of persistent cold in the head, or nasal catarrh, when there is much discharge from the nasal passages, we are advised to use a spray-producer with the following solution:--1 gr. carbolic acid, 2 dr. glycerine, 2 oz. water. After the passages are clean, a small quantity of vaseline is melted in the bowl of the spray-producer, and 2-5 drops pinus canadensis mixture are added. This mixture consists of:--15 gr. pinus canadensis, ½ oz. glycerine, ½ gr. carbolic acid, 1½ oz. water. This is to be applied by the spray to every part.

Dr. Sheppard says, in respect to the use of hot water as a remedial agent in the treatment of inflammation of the mucous membranes:--“I have used hot water as a gargle for the past 6-8 years. In throat and tonsil inflammation, and in coryza (cold in the head), if properly used in the commencement of the attack, it constitutes one of our most effective remedies, being frequently promptly curative. To be of service, it should be used in considerable quantity (½-1 pint at a time), and just as hot as the throat will tolerate.”