Part 143

Eczema.--Of this skin disease there are many forms, all arising more or less from a disordered state of the blood, and demanding medical advice. As a general rule, the patient should avoid soap in washing, using oatmeal instead. Starchy food, such as potatoes, are deemed unsuitable, while plenty of green vegetables and fruit should be taken. Clean linen is essential, and the patient’s towel should not be used by any one but himself.

Itching.--This troublesome affection may be cured by the use of the following:--(_a_) 500 grm. milk of almonds; ¼ grm. each corrosive sublimate and ammonium chloride. (_b_) 60 grm. glycerine of starch; 5 grm. bismuth subnitrate; 5 grm. zinc oxide. (_c_) 1 litre infusion of mallow; 50 grm. cherry-laurel water (filtered); 10 grm. borax. (_d_) Vaseline often gives relief.

Ringworm.--Whenever the disease is observed, efficient measures should be taken to cure it, instead of wasting time with feeble popular remedies, such as ink, permitting the affection to spread and become established. The hair should be cut for ½ in. round each patch of ringworm. Get a small camel-hair brush, and a solution of the following composition: 30 gr. iodine; 2 drm. colourless oil of tar. Apply the solution carefully with the brush to the diseased part only. Repeat the application in a week. Strong carbolic ointment may be applied _around_ the patch. It is a most obstinate disease, and requires the exercise of great patience. Children suffering from ringworm should not be much confined in the house, and it is a good rule to give them cod-liver oil, or steel wine, or both.

_Sweating_ (excessive).--_(a)_ In the Michigan _Medical News_, Dr. Currie recommends in sweats, from whatever cause, 1 pint alcohol, 1 drm. sulphate quinine. Wet a small sponge with it, and bathe the body and limbs, a small surface at a time, care being taken not to expose the body to a draught of air in doing it.

(_b_) For sweating of the feet, Dr. Meierhof, in the _Maryland Medical Journal_, directs the patient to immerse his feet morning and night for about 10 minutes, in warm water at 115°-120° F. in which a teaspoonful (1 dr.) powdered commercial soda (impure carbonate of soda) is dissolved. The feet are then thoroughly dried, after which they are painted all over with a coating of compound tincture of benzoin, which acts as an antiseptic astringent and by its mechanical presence on the skin. This treatment is continued for about 10 days, after which it is practised once daily, or every other day, as the necessities of the case may require.

(_c_) M. Vieusse, principal medical officer at the Military Hospital at Oran, states that excessive sweating of the feet, under whatever form it appears (whether as mere super-secretion accompanied by severe pain, or with fœtidity), can be quickly cured by carefully-conducted frictions with bismuth subnitrate; and even in the few cases where this suppresses the abundant sweating only temporarily, it still removes the severe pain and the noxious odour which often accompany the secretion. He had never found any ill consequence follow the suppression of the sweating.

(_d_) Napthol has been recommended as an effective remedy against excessive sweating of the palms of the hands, foot-soles, and arm-pits. These places should be moistened once or twice daily, with a mixture of 5 pt. naphthol, 10 pt. glycerine, 100 pt. of alcohol, and afterwards dusted, either with pure starch or with a mixture of 2 pt. naphthol, 100 pt. starch. In the case of sweating feet, small pellets of antiseptic cotton are dipped in the powder and placed between the toes.

_Tooth Troubles._--To preserve the teeth, rinse the mouth after every meal. If the gums are naturally irritable and tender, a few drops of tincture of myrrh in water should be used to rinse out the mouth, twice or thrice daily. The first tooth brush should be used as soon as there are teeth to use it upon. An ideal tooth powder should be alkaline, since acids dissolve the tooth substance; finely pulverised, that it may not mechanically abrade; antiseptic, to prevent decomposition of food lodged between the teeth, and perhaps to destroy the microbes which are always found choking the tubules of carious dentine; it should contain nothing irritating to the gums; and, lastly, it should be pleasant to the taste, or it will not be used. Fluid dentifrices do not, as a rule, clean the teeth effectually, unless they contain some ingredient which acts upon the enamel itself; and those preparations which are eulogised as making teeth white or preventing deposit of tartar, should be avoided. Charcoal was at one time a very popular form of dentifrice, and is even now largely used, but from the amount of silica it contains it will rapidly wear away teeth that are not of exceptional hardness; and moreover, the gums in some instances become tattooed in a curious manner from absorption of minute particles. Pumice-powder, again, is too gritty; and camphorated chalk is said to make the gums spongy. Precipitated chalk forms the best basis for a tooth powder, to the base of which may be added pulv. saponis and ol. eucalypt., 1 dr. of each; and if there is no objection to the taste, ½ dr. carbolic acid. (_Lancet._)

The tooth brush, which should be used night and morning, should be small, and have its not too stiff bristles arranged in separate bundles (in order that they may pass readily between the teeth and into the natural depression). The outer and inner surfaces of both front and back teeth should be brushed. The direction of the brushing should be from the gums; that is, downwards for the upper teeth, and upwards for the lower. This mode of cleaning the teeth is the best preventive against decay, which causes toothache, and also against the accumulation of tartar, which makes the breath foul, and in course of time causes the teeth to loosen and fall out.

Toothache.--(_a_) The following is a formula recommended by Prof. Babaieff in the _British Medical Journal_:--Melt 2 parts white wax or spermaceti, and when melted, add 1 part carbolic acid crystals, and 2 parts chloral hydrate crystals; stir well till dissolved. While still liquid, immerse thin layers of carbolised absorbent cotton wool, and allow them to dry. When required for use, a small piece may be snipped off, and slightly warmed, when it can be inserted in the hollow tooth, where it will solidify. The ease produced by this simple method is really very great.

(_b_) The following remedy is given by a dentist of great reputation:--First wash the mouth well with warm water, then use the following tincture: 10 gr. tannin, ½ dr. mastic, 10 drops carbolic acid, dissolve in ½ oz. sulphuric ether.

(_c_) Dr. Dyce Duckworth says toothache may be relieved by holding in the mouth a solution of bicarbonate of soda, say ½ dr. in 1 oz. water.

(_d_) A correspondent of the _Electrician_ gives the following as an instant remedy for toothache:--With a small piece of zinc and a bit of silver (any silver coin will do), the zinc placed on one side of the afflicted gum, and the silver on the other, by bringing the edges together, the small current of electricity generated, immediately and painlessly stops the toothache.

(_e_) Equal parts carbolic acid and collodion applied on a pledger of wadding and thrust into the hollow tooth. Apt to cauterise the mouth somewhat. The saliva must not be swallowed.

(_f_) Anæsthetic in dentistry: 6 dr. pulv. camphor, 1 oz. æther. sulphur. Apply this to the gum surrounding the tooth to be removed, until the gum turns white, when the tooth can be extracted with scarcely any pain.

_Warts._--(_a_) Apply a little nitric acid (aqua fortis) very carefully. Take a small stick--a lucifer match--dip it into the acid, and so apply a tiny drop to the top of the wart. It soon becomes yellow, and in a few days the top can be picked off. Repeated applications in the same way are necessary.

(_b_) Light a match or taper and apply the flame for a second, till you feel a sting, to the top of each wart, for 3 days in succession, when a watery blister will form round each wart, which you must burst, and throw all the warts away, which will be found to be quite loose, causing no pain; they will never return again, and no trace of them will be left after a short time.

(_c_) Prof. Unna recommends the continuous application of mercurial ointment containing 5 per cent. arsenic or a plaster containing in each 8 sq. in. 154 gr. arsenic and 77 gr. mercury.

(_d_) A plaster of black soap, applied each night for a fortnight, according to Vidal, will soften a wart so that it may be scraped off.

(_e_) Cellier’s treatment is to transfix the principal wart with the point of a pin, the head of which is then to be held in the flame of a candle until the wart is destroyed; it will drop off in a few days. The remaining warts will then usually disappear.

(_f_) A touch of castor oil (the best) once a day. It is a slow process, but, nevertheless, a sure remedy, and painless. Choose night time just before going to bed, to rub in well a little castor-oil, and then take a cloth or towel and rub any that remains off. Continue it for a month or two, for it needs persevering in. In some cases there will be no alteration for 2 months; but sooner or later they all die away. Some die away and others can be taken off, as if they had lost their roots.

SUPPLEMENTARY LITERATURE.

Spencer Thomson: ‘A Dictionary of Domestic Medicine and Household Surgery: with a chapter on the Management of the Sickroom, by Dr. Steele.’ London. 1883. 10_s._ 6_d._

John Gardner: ‘Household Medicine and Sickroom Guide: a familiar description of diseases, remedies, methods of treatment, diet, &c., expressly adapted for family use.’ London. 1882. 12_s._ 6_d._

Charles J. Cullingworth: ‘A Manual of Nursing, Medical and Surgical.’ London. 1883. 3_s._ 6_d._

E. Symes Thompson: ‘Colds and Coughs; their causes and consequences.’ London, 1877. 1_s._

J. Milner Fothergill: ‘Food for the Invalid, the Convalescent, the Dyspeptic, and the Gouty.’ London. 1880. 3_s._ 6_d._

Prosser James: ‘Sore Throat; its nature, varieties, and treatment.’ London. 1879. 6_s._ 6_d._

Edward John Waring: ‘Remarks on the Uses of some of the Bazaar Medicines and Common Medical Plants of India, with a full index of diseases, indicating their treatment by these and other agents procurable throughout India, to which are added directions for treatment in cases of drowning, snake-bites, &c.’ London, 1875. 5_s._

Gordon Holmes: ‘A Treatise on Vocal Physiology and Hygiene, with especial reference to the Cultivation and Preservation of the Voice.’ London, 1881. 6_s._ 6_d._

W. H. Corfield: ‘Health.’ London, 1880. 6_s._

J. L. Milton: ‘The Hygiene of the Skin.’ London, 1877. 1_s._

James W. Allan: ‘Notes on Fever Nursing.’ London, 1879. 2_s._ 6_d._

John Beadnell Gill: ‘Indigestion; what it is, what it leads to, and a new method of treating it.’ London, 1881. 4_s._ 6_d._

Erasmus Wilson: ‘Healthy Skin; a Popular Treatise on the Skin and Hair, their Preservation and Management.’ London, 1876. 2_s._ 6_d._

Henry Thompson: ‘Cremation; the Treatment of the Body after Death.’ London, 1884. 1_s._

Florence Nightingale: ‘Notes on Nursing: what it is, and what it is not.’ London, 1884. 2_s._

Henry C. Burdett: ‘Hints in Sickness: Where to go and what to do.’ London, 1883. 1_s._ 6_d._

William Henry Day: ‘Headaches: Their Nature, Causes, and Treatment.’ London, 1880. 6_s._ 6_d._

Mary Hooper: ‘Cookery for Invalids, Persons of Delicate Digestion, and Children.’ London, 1883. 2_s._ 6_d._

E. Bibby: ‘Invalids Abroad; Hints on Travelling, Nursing, and Cooking.’ London, 1879. 2_s._ 6_d._

Henry C. Angell: ‘The Sight, and how to preserve it.’ London, 1878. 1_s._ 6_d._

T. Wharton Jones: ‘Defects of Sight and Hearing; Their Nature, Causes, Prevention, and General Management.’ London, 1877. 1_s._

Charles J. Cullingworth: ‘The Nurse’s Companion; a Manual of General and Monthly Nursing.’ London. 2_s._ 6_d._

William Murrell: ‘What to do in Cases of Poisoning.’ London, 1884. 3_s._ 6_d._

Lionel S. Beale: ‘On Slight Ailments, including the Principles of Treating Disease.’ London, 1887. 5_s._

M. Charteris: ‘Health Resorts at Home and Abroad; with a Section on Sea Voyages.’ London, 1885. 4_s._ 6_d._

E. J. Domville: ‘Manual for Hospital Nurses.’ London. 2_s._ 6_d._

_THE BATHROOM._

BATHING IN GENERAL.

Bathing is of several kinds. There is the morning tub and the sea dip which are taken to brace up the system; then there is the hot bath, more for sanitary and cleansing purposes; and finally come hot-air and vapour baths which are generally of a more or less medicinal character. These will be considered in rotation.

_Cold Bathing._--All persons in health and of average strength may use a cold bath daily, in summer at least. In winter, mornings of extreme frost try the strongest constitution, and few are likely to benefit by a plunge on these occasions. For the most part, individuals of moderate powers and free from disease may carry the cleanly practice of summer through the winter months. A word on the bath itself. Those who take it should begin in summer, not winter, and so become gradually accustomed to its lowest temperature. No one should linger over it; 3-4 minutes are ample. After immersion, the body should be quickly and well dried and rubbed before dressing. Light gymnastic, dumb-bell, or club exercise, may occupy the next few minutes, the clothes being partly on if the weather be cold, and breakfast, or a cup of warm tea or coffee, should shortly follow, to prevent chilling.

There are those whom a cold bath injures, instead of invigorating. The readiest test of benefit is the glow of free surface-circulation, or at least the absence of any decided sense of chill after immersion. Some do not experience this. Among these are the subjects of heart weakness, arising from whatever cause; it may be consequent on organic disease of the heart, on old gout or rheumatism, or on overwork and underfeeding, in which case it is a part of a general debility. Again, there is in some a tendency to engorgement of one or other deep-seated organ with blood, a kidney, the liver, &c. This is commonly the result of a previous inflammatory attack, or of visceral disease at the time existing. Surface-cold aggravates the congestive tendency. Obviously, therefore, such persons, if they bathe, ought to use tepid water; and, in renal disorders, this method is often advantageous. In slight cases, cold is not injurious if the ablutions be expeditiously gone through, and restricted to periods of summer weather. The aged should avoid cold baths, and commonly do. Infants, if ordinary despatch is used in bathing and in dressing, have no reason to fear them. Their powers of reaction are excellent.

Cold baths chill down the feeble circulation of the badly nourished, and provoke a physical torpor which is obstructive to the processes of nutrition. They drive the blood from the surface of the body in upon vascular organs, whose circulation is already sluggish from general weakness. They thus produce discomforts which aggravate existing languor, and enhance the feeling that food and drink ought not to and therefore cannot be taken. A bath described as one “from which the chill has been taken” is too cold for subjects under medical advice who are in need of extra feeding.

In any case it is unwise to bathe out of doors when copious perspiration has continued for some hour or more, unless the weather be excessive or the sweating has been induced by loading with clothes rather than by exertion. When much perspiration has been produced by muscular exercise, it is unsafe to bathe, because the body is so fatigued or exhausted that the reaction--that is, the return of the momentarily displaced blood to the surface--cannot be ensured, and the effect may be to congest the internal organs and notably the nerve centres. From congestion of the nervous centres comes cramp, so often fatal in bathing.

If the weather be “chilly,” or there be a cold wind so that the body may be rapidly cooled at the surface while undressing, it is not safe to bathe. Under such conditions the further chill of immersion in cold water will take place at the precise moment when the reaction consequent upon the chill of exposure by undressing ought to occur, and this second chill will not only delay or altogether prevent the reaction, but convert the bath from a mere stimulant to a depressant, ending in the abstraction of a large amount of animal heat and congestion of the internal organs and nerve centres. The actual temperature of the water does not affect the question so much as its relative temperature as compared with that of the surrounding air. Practically, there ought to be a good deal of difference between the two, the water being much lower than the air and the body being--without great or long persisting perspiration--much warmer than the water, of course, but not so much warmer than the atmosphere as to be chilled by undressing. In short, the aim must be to avoid two chills; first, from the air, and second, from the water, and to make sure that the body is in such a condition as to secure a quick reaction on emerging from the water, without relying too much on the possible effect of friction by rubbing. It will be obvious that both weather and wind must be carefully considered before bathing is commenced, and that the state of the organism as regards fatigue and the force of the circulation should also be considered, not merely as regards the general habit, but the special condition when a bath is to be taken. These precautions are eminently needful in the case of the young or weakly.

Sea bathing is regarded, naturally, as more bracing in its character than river bathing. The saltness of the water and the sharp air of the sea together tend to invigorate us. As a rule, the bather can remain longer, without injurious effect, in salt than in fresh water. The sudden shock which results from a plunge into river or sea may be attended by bad effects in the case of persons who are subject to fits of any kind or to disturbance of the heart’s action. Another highly important question in bathing has reference to the care of the ears. Wherever any tendency to ear-ache or inflammation of the ear exists, bathing must be cautiously indulged in. A dive has been known to be followed by rupture of the “drum” of the ear, owing to the sudden pressure to which this membrane has been subjected in passing from the air under the water. Again, persons who have suffered from discharges from the ears--common after scarlet fever, for example--and in whom the drum of the ear may be perforated or irritable, abscess of the brain may follow injury produced by the sudden dive or by plunging the head beneath the water. Placing cotton wool in the ears is a necessary precaution for any who have tender ears, and a safe practice for all. Further, do not dive too much and avoid swimming on the back, for from the position of the ears the water gets into them a great deal more than even in diving. When getting out, besides giving a good rub down with a rough towel, always carefully wipe the ear and the glands behind the ear dry.

No child under 2 years of age ought, under any circumstances, to be bathed in the open sea, and no one, child or adult, can enter the sea without danger while under the influence of emotional excitement. Under 2 years of age, a child’s body is too weak to gain any benefit from the shock of immersion in the open sea. Its nervous and circulating forces are too feeble for the development of that vigorous reaction, without which sea-bathing is either useless or hurtful. In the absence of strength for such reaction a sea-bath tends to chill an infant’s body, and predispose to internal congestion. At any age the shock of immersion in the sea brings risk of danger, and even of death, when the emotions are powerfully excited, and especially when the mind and body are dominated by that most depressing of human emotions--fear. Infants are not always bathed in the sea merely with the intention of making them strong. There is an old seaside tradition that babies diligently bathed become fearless in the water when they grow up. This notion is also false. Than that infants gain courage by being plunged in the sea, it is more probable that many a nervous child has acquired a dread of bathing which no after-experience could remove, because it was compelled in fear and trembling to plunge under water. If a child be sufficiently robust to develop a good reaction, if it be over 2 years of age, and, above all, if it be not afraid, it may be bathed in the sea with advantage. If any of these conditions be wanting, sea-bathing for children is likely to be positively injurious. (_Brit. Med. Jour._)

Attacks of cramp, to which even expert swimmers are liable, may arise from many causes. Where special nervous diseases do not exist, the so-called “cramp spasms” are, as likely as not, due to some irregularity in digestion, or to some imprudence in bathing at wrong times and seasons. Bathing after a full meal may induce so-called “cramps,” and it is to be feared that many a fatal case of drowning, attributed to some hidden nervous cause, has had a far simpler origin in digestive disturbances reacting on the nervous system, and through this system propagated to the muscles.

The ordinary rules--drawn up by the Royal Humane Society--which should be observed by all bathers, whether in fresh or salt water, and whether swimmers or not, are simple and readily borne in mind.

1. Never bathe within 2 hours after a meal.

2. Never bathe when exhausted or in ill-health. The practice of plunging into the water after exercise is to be thoroughly condemned.

3. Never bathe when the body is cooling after perspiration.

4. A morning bathe may be taken by those who are strong and healthy before breakfast on an empty stomach.

5. The young, or those who are delicate, should bathe 2-3 hours after a meal, and in the forenoon, if possible.

6. The signs which forbid open-air bathing altogether are chilliness and shivering after entering the water, numbness of hands and feet, and deficient circulation generally.

7. When the body is warm, bathing may be indulged in, provided undressing is quickly accomplished, and the body is not chilled before entering the water.

8. On leaving the water, dry and dress _quickly_. Standing about undressed, after leaving the water, is, under any circumstances, injurious.

9. Rather cut short, than prolong, the bathe. Swimmers possess the power of remaining in the water for a considerable time, in consequence of their active movements. But even in their case injury is often wrought by unduly extending the exercise. The slightest feeling of chilliness should be taken as a sign to leave the water at once.

It is a recognised fact that a sudden head douche of cold water is apt to cause giddiness in many persons from its effect on the brain-circulation, which forms in itself a peculiar part of the blood-system. Cases of persistent headache, often accompanied by giddiness and faintness, have followed sea and river bathing; these effects having disappeared when the practice of plunging the head below water was discontinued. Persons thus affected cannot do better than omit the head from the bath, and, in shower baths, stoop forward or lean backward and sidewise, so that the water shall fall on back, chest, and shoulders, but not on the head.