THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 MRS. PRUDENCE W. KOFOID 
 
HOME HYGIENE AND 
 PREVENTION OF DISEASE 
 
HOME HYGIENE AND 
 PREVENTION OF DISEASE 
 
 BY 
 NORMAN E. DITMAN, M.D. 
 
 NEW YORK 
 
 DUFFIELD & COMPANY 
 1912 
 
Copyright 1912, by 
 DUFFIELD & COMPANY 
 
INTRODUCTION 
 
 One of the most important developments of modern medi- 
 cine has been the fact that it is now realized that it is far 
 better to avoid than to contract illness, even if the modern 
 methods of treatment have robbed disease of many of its 
 old-time terrors. A consequence of this has been that the 
 modern physician takes every opportunity to instruct his 
 clientele how to avoid contracting disease. 
 
 It is with a belief that this part of the physician's in- 
 structions can be advantageously supplemented with infor- 
 mation which the average person can have constantly at 
 hand that has made the publishing of this book seem dis- 
 tinctly called for. Simple as a physician 's advice may seem 
 for the avoidance of any disease, it is often necessary to 
 have this advice in a form where it can be more carefully 
 studied and digested if we are to develop a "hygienic 
 sense" which will enable us more or less instinctively to 
 avoid the paths which lead to disease. 
 
 The public as a class has been saved much suffering and 
 avoidance of future inconvenience by the knowledge which 
 it has assimilated on first aid to the injured. Similar bene- 
 fit should result from popular appreciation of the methods 
 of first aid to the sick. For often, in the case of illness * ' a 
 stitch in time saves nine. ' ' 
 
 One justification of a popular work of this kind is that 
 not only can its readers render the best aid to the incipient 
 or slight invalid; but they should be enabled to better 
 appreciate when an ailment has become serious enough to 
 require expert medical attendance, or when a disease is 
 from the outset beyond the aid of unskilled hands. 
 
 There are few in our modern era of civilization who do 
 not understand the workings and failings of automobiles, 
 engines, phonographs, sewing machines and household ap- 
 pliances. It would seem the part of discretion therefore 
 if we knew at least as much about a few of the commoner 
 workings and failings of the human body a machine of 
 
INTRODUCTION 
 
 far more importance to all of us than all the mechanical 
 appliances in the world. 
 
 It is with this purpose in view that the author of this 
 work ventures to place it in the hands of the public, ex- 
 pressing, at the same time, the hope that some of the more 
 technical of the information imparted will be employed 
 with discretion. To those living in rural districts where 
 the service of physicians is difficultly obtainable it is hoped 
 that the information herein contained will be a means of 
 saving life and avoiding unnecessary suffering. To those 
 living less far from the trodden highways it is hoped this 
 work will prove to be an aid to the physician educating 
 the human kind to a more intelligent appreciation of his 
 efforts, lessening the numberless irritations and infinite 
 inconvenience resulting from the human gad-fly "minor 
 ailments"; and materially lightening the load of long- 
 suffering humanity from preventable sickness. 
 
 In many cases it is difficult to judge from a patient's 
 symptoms the precise character of the disease from which 
 he is suffering, and it is obvious that except in the simplest 
 cases no one but a medical man can form a reliable opinion. 
 It must be made clear that the object of this book is not to 
 displace the family doctor, but to furnish the reader with 
 general information regarding medical subjects; and that 
 while pains have been taken to ensure accuracy, the author 
 and publishers can accept no responsibility for errors. 
 Nearly all the medicines mentioned in the text (except 
 those marked POISON) may be obtained from licensed drug- 
 gists without the prescription or signature of a medical 
 man, but persons who treat themselves in accordance with 
 the directions contained in the book must realize that they 
 do so on their own responsibility. 
 
 N. E. D. 
 
HOME HYGIENE AND 
 PREVENTION OF DISEASE 
 
HOME HYGIENE AND PEEVENTION 
 OF DISEASE 
 
 Abscess, When some part of the body is damaged by 
 injury or poisoned by a germ, inflammation is set up, and 
 the symptoms of heat, redness, swelling, and pain, begin to 
 appear. If the supply of good blood is sufficient to over- 
 come the poison or to repair the damage done, then the 
 inflammation grows less and less until at last the mischief 
 is as far repaired as ever it can be. But if the poison is 
 too strong, or the damage too severe, then the inflammation 
 increases in intensity, until there is formed a swelling which 
 has in the middle of it an isolated collection of dead blood- 
 cells, constituting what we call "matter," or "pus," sur- 
 rounded by a red ring of inflammation. The results of the 
 struggle between the blood and the poison are thus walled 
 in so that they cannot do much more damage, and this 
 state of the part is called an abscess. 
 
 If possible we try to avoid the formation of an abscess, 
 either by destroying the bacteria causing the trouble, by 
 helping the inflammation or by relieving the process by 
 cutting into it and washing out the poison. 
 
 The first may be accomplished by applying wet dressings 
 composed of sterile gauze saturated with a solution of bi- 
 chloride of mercury (1-2000) or aluminium acetate. 
 
 The inflammation may sometimes be helped by causing 
 an increased flow of blood to * he part by applying a vacuum 
 cup. Warm applications may hasten the formation of an 
 abscess, but when an abscess has once formed the sooner it 
 is opened the better. If, on looking at an inflamed swell- 
 ing, you can see a yellowish spot anywhere, then the 
 swelling has become an abscess, and ought to be opened at 
 once, and the pus let out. 
 
 Nowadays the fear of the surgeon's knife is unnecessary. 
 A doctor will always save the patient pain by using some 
 
2 ACNE 
 
 anaesthetic to deaden the feeling in the part. (See "Anaes- 
 thetics.) And the sooner the cutting is done the smaller 
 will be the scar, and the sooner the whole trouble will be 
 over. 
 
 Acidity (Sour Stomach, Heartburn). This is not a disease 
 in itself, but merely one of the symptoms of indigestion or 
 dyspepsia. It is a sign that either too much food is being 
 taken, more than can be thoroughly digested, or that there 
 is something radically wrong with the digestive process 
 that is, with the kind of food taken. A change is needed. 
 Not that you must go away to the seaside, but that you 
 must alter your mode of living, eating, and drinking. The 
 sour taste in your mouth, the feeling of weariness after a 
 night's rest, the dream-harassed slumber all these may be 
 removed by simple means. First, get your teeth attended 
 to, so that the food may be properly chewed. Then, have 
 your meals at stated intervals punctually. Avoid all 
 spirituous liquors, drink only at the end of a meal, avoid 
 too much meat, and pastry, and cheese, and pickles; and 
 take a teaspoonful of bicarbonate of soda and a teaspoonful 
 of carbonate of magnesia in a tumbler of water every night 
 at bedtime. In addition, go to bed early, rise early, take 
 plenty of exercise, and your "sour stomach" will soon be 
 only a memory of a disagreeable past. (See also "Indi- 
 gestion/') 
 
 (1) For acidity and sour-smelling diarrhea in children 
 under 10: Sodium bicarbonate, 2 grains; mercury and 
 chalk, 2 grains ; magnesium carbonate, 5 grains. (Mix and 
 make a powder to be taken every other night. ) 
 
 (2) For acidity, heartburn and painful digestion: 
 Liquor of bismuth, 1 drachm ; infusion of quassia, 1 ounce. 
 (This draught to be taken three times every day.) 
 
 (3) Powders for acidity and heartburn : "White bismuth, 
 10 grains; magnesium carbonate, 10 grains. (Make a 
 powder to be taken in half a bottle of soda water twice a 
 day.) 
 
 Acne. (See "Blackheads.") The little pores and fol- 
 licles in the skin sometimes get blocked up by dirt, and as 
 described under "Blackheads," there remain little tiny 
 pouches of fatty matter, which can be squeezed out by 
 pressure with a key, or by the finger-nails. Sometimes the 
 dirt which blocks the entrance to the pores remains fixed 
 in the tubes, and then the blackheads become red and in- 
 
ADENOIDS 3 
 
 flamed and are called acne spots. These pustules, or small 
 abscesses, presently come to a head, and then burst, dis- 
 charging matter. This matter pus is poisonous, and if 
 carried by scratching finger-nails to another part of the 
 skin, causes fresh acne spots there. Acne spots leave un- 
 sightly scars. In older people a variety of "acne" is apt 
 to appear on the nose, especially on the red shiny nose of 
 the alcoholic drunkard. 
 
 Treatment. In young people too much smoking, and in- 
 digestion due to bolting the food are the general causes of 
 the complaint. The first and last of the treatment is 
 summed up in the word cleanliness. The skin must be kept 
 very clean indeed, not only by frequent washing, but by 
 rubbing violently with rough towels after the washing. 
 The rubbing makes the skin red, and that is what is wanted, 
 for the increase of blood improves the nourishment of the 
 skin and helps it to fight against the evil effects of dirt and 
 germs. 
 
 Thin people with acne ought to take cod-liver oil, and fat 
 ones should drink a purgative mineral water, or take a 
 Seidlitz powder every morning. When the acne pustules 
 are already formed, steam the skin, and clean it well with 
 friction and soap, and then, using a new needle, prick the 
 yellow point in each spot and squeeze out the pus, and wipe 
 it away with a cloth dipped in peroxide of hydrogen. 
 Then bathe the skin well, and rub in white lotion. This 
 may be reapplied several times during the day. 
 
 All the cotton-wool, gauze or lint which has been used 
 is to be burnt, and the needle also. And the hands should 
 be washed, and the nails scrubbed, with carbolic soap. 
 
 Adenoids. Adenoids, or, properly speaking, "adenoid 
 vegetations, ' ' are overgrowths of the glandular tissue which 
 is found in the back of the upper part of the throat, just 
 where the nasal cavity opens behind. They are allied to 
 the enlarged glands which are so common about the angles 
 of the jaws in children and in their necks ; and their pres- 
 ence causes a great susceptibility to catching cold. The 
 adenoids, if plentiful, block up part of the passage through 
 which breathing takes place and prevent the proper de- 
 velopment of the lungs. Not only that, but they cause 
 deafness. About ninety per cent, of all the cases of deaf- 
 ness among children are due to adenoids. Children with 
 adenoids generally look stupid, keep the mouth open, and 
 
4 AGE AND WEIGHT 
 
 breathe through it, and are listless and lack concentration. 
 Lastly, such children are often nervous and irritable and 
 are prone to bed-wetting and to have nightmares. 
 
 Treatment. If the child cannot sleep with its mouth 
 shut, or play without getting out of breath, the adenoids 
 ought to be removed by operation. There is nothing else 
 of any use. 
 
 Age and Weight. The proper relations between age and 
 weight are shown in the following tables ; which, however, 
 are not to be taken as representing an invariable standard. 
 Many persons of less weight than is here shown enjoy ex- 
 cellent health. 
 
 I. CHILDREN. 
 
 Years of 
 age 
 
 Boys 
 
 Girls 
 
 
 Ibs. 
 
 Ibs. 
 
 5 
 
 50 
 
 40 
 
 6 
 
 54 
 
 43 
 
 7 
 
 57 
 
 48 
 
 8 
 
 60 
 
 52 
 
 9 
 
 64 
 
 57 
 
 10 
 
 69 
 
 62 
 
 11 
 
 73 
 
 69 
 
 12 
 
 79 
 
 78 
 
 13 
 
 84 
 
 89 
 
 14 
 
 92 
 
 98 
 
 15 
 
 103 
 
 106 
 
 II. ADULTS. 
 
 Male 
 
 Female 
 
 Height 
 
 Weight 
 
 Height 
 
 Weight 
 
 ft. in. 
 
 Ibs. 
 
 ft. in. 
 
 Ibs. 
 
 5 2 
 
 126 
 
 4 10 
 
 98 
 
 5 3 
 
 133 
 
 4 11 
 
 102 
 
 5 4 
 
 139 
 
 5 
 
 105 
 
 5 5 
 
 142 
 
 5 1 
 
 110 
 
 5 6 
 
 145 
 
 5 2 
 
 114 
 
 5 7 
 
 148 
 
 5 3 
 
 121 
 
 5 8 
 
 155 
 
 5 4 
 
 128 
 
 5 9 
 
 162 
 
 5 5 
 
 135 
 
 5 10 
 
 169 
 
 5 6 
 
 139 
 
 5 11 
 
 174 
 
 5 7 
 
 148 
 
 6 
 
 178 
 
 5 8 
 
 158 
 
ALCOHOLIC DRINKS 5 
 
 Alcohol, Acute Poisoning by. When spirits are given to 
 children, or when adults go in for a debauch and drink 
 excessive quantities of alcoholic liquors, the alcohol acts 
 as a deadly poison and sometimes kills on the spot. 
 
 If death does not occur, the drinker to excess becomes 
 more or less collapsed, his muscles are relaxed and he lies 
 helpless and perhaps insensible. If left in this state he 
 may sink and die, or he may perhaps sleep it off, or he 
 may catch inflammation of the lungs and die of that in a 
 very short time. The treatment is to empty the stomach 
 first ; give a drink of warm mustard and water. When the 
 doctor comes he will probably give a stronger emetic, if 
 the mustard- water has not yet acted, and then will ad- 
 minister hot, strong coffee injections into the rectum (or 
 back passage) with a Higginson syringe, and rouse the 
 patient by every possible means. Later on the sick man 
 will require a long rest and plenty of liquid nourishment. 
 
 The delirium, which sometimes comes on at the end of a 
 long spell of drinking, and which is known as "D.T.'s" or 
 Delirium Tremens, may be fatal after a few hours of horri- 
 ble suffering and mental agony. Careful and constant 
 nursing is required, sleep and plenty of food. These cases 
 should be treated by a doctor. 
 
 Alcoholic Drinks, Moderation in. The writer pleads for 
 moderation in the drinking of alcohol, as in all things else 
 for conscience sake, for the stomach's sake and for the 
 sake of society, the comfort and well-being of which all 
 are bound to consider. 
 
 Probably never, throughout the world's history, has been 
 seen so widespread and drastic a movement against the 
 use of alcoholic drinks as the modern so-called Temperance 
 Movement ; so-called because the most of the reformers aim, 
 not at "temperance," which means moderation, but at 
 total-abstinence. It cannot be denied that there is much 
 that is admirable in this movement in a time of excessive 
 drinking, and that the motives of the promoters are lofty 
 and command respect. Seeing around them the millions 
 who are being made unhappy, unhealthy, criminal, or mad, 
 by excess of alcohol, the total abstainers are teaching that 
 even the moderate use of alcohol is full of danger, and that 
 everyone owes it to himself to give up every form of it. 
 The last word of science up-to-date is definitely on the side 
 of the reformers, and against alcohol even in moderation. 
 
6 ALCOHOLIC DRINKS 
 
 "Even the smallest doses," says the scientist, "lessen 
 energy and efficiency to some extent, and have the in- 
 evitable reaction of depression." These truths are pretty 
 generally known by this time, and if, in consequence, all 
 who dearly value their health do not at once become total 
 abstainers, it is probably because they realize that most 
 people have funds of health and energy within them, far 
 greater than are required in the mere daily routine of life ; 
 and they are of opinion, too, that with that superfluity of 
 energy they ought to be allowed to do as they please. To 
 be a lifelong total abstainer means to be quite safe from a 
 host of diseases to be on the safe side entirely as regards 
 the diseases due to alcohol. It means never to be brain- 
 fuddled, never to be sentimentally maudlin ; easily to avoid 
 being grossly impure or vicious; or at any time entirely 
 at the mercy of ruffianly men or scheming and evil women ; 
 and lastly, it means to save much money which would 
 otherwise be spent on the vices which seem to be insepara- 
 ble from excessive indulgence. And the really healthy 
 youth, starting in life with an equable commonplace tem- 
 perament, a fair knowledge of the possible evils of drunken- 
 ness, and no drinking companions to prompt him, would 
 almost certainly prefer to do without alcohol altogether, 
 and would go on his way rejoicing, healthy, happy and 
 sober-minded even if a bit of a prig. 
 
 The moderate drinker, on the other hand, desirous of an 
 occasional emotional excitement in the dull routine of life, 
 lives in a different set of circumstances. He knows, or 
 may know, of loftier flights of imagination (as well as 
 deeper depths of depression) than the teetotaler; he has 
 generally more sympathy with the poor, the afflicted, and 
 the tempted, than the total abstainer, who is too apt to be 
 self-righteous. Among the moderate drinkers have been 
 some of the world's greatest men and most honored names. 
 
 All the serious disadvantages of alcohol are connected 
 with its abuse; it would be ignorant and foolish to deny the 
 advantages of its use. Just as a tired horse at the sound 
 or touch of the whip makes a grand effort to complete its 
 task, despite fatigue, so will a man or woman sometimes 
 overcome a serious difficulty by the help of the stimulus 
 supplied by alcohol. 
 
 The great majority of mankind in every land have al- 
 ways used alcohol, more or less in moderation; the general 
 
ALCOHOLIC DRINKS 7 
 
 feeling everywhere has been always against the abuse of 
 it. Hence arises the question, so very difficult for the 
 individual to solve "What is moderation?" 
 
 We have all of us seen plenty of examples of men and 
 women of advanced age, who are in good health, and who 
 are known to have drunk beer, cider, wine or spirits all 
 their lives ; so that there can be no doubt that it is possible, 
 for some of us at any rate, to enjoy the benefits of alcohol 
 in moderation, and to reach a healthy old age. 
 
 Now all alcoholic beverages produce, in moderate doses 
 and well diluted, a certain pleasurable effect called stimu- 
 lation. If the majority of alcoholic drinks were not as 
 shamefully adulterated as they undoubtedly are, people 
 would find that the stimulant effect came sooner and with 
 smaller quantities, and that the after-effects are less dis- 
 agreeable. It is the cheap adulterated rubbish that nearly 
 every publican sells so much of to the poor which does 
 harm to those who honestly desire moderation. The drink 
 manufacturer makes large profits, and almost in every case 
 adds something to the liquor he sells to increase the thirsti- 
 ness of the customer. No wonder moderation is difficult 
 to maintain. 
 
 By a " stimulant " effect we mean a sense of well being, 
 an elation, a hopefulness, warmth, and good humor. The 
 same small dose gives appetite, increases the rate of the 
 pulse, and supplies, sometimes, fresh energy for a disagree- 
 able task. 
 
 Now, every stimulant effect has a corresponding period 
 of depression. This will be noticed, perhaps, an hour after- 
 wards, and may last an hour or two ; or the period may be 
 spent in sleep, when the depression passes unnoticed and 
 recuperation takes place as well. 
 
 When a hard task has to be long continued, even a small 
 dose of alcohol does more harm than good, and to repeat 
 the dose will do even more harm. After a long task is 
 completed a dose of alcohol is comforting, sedative and 
 refreshing and promotes the sleep that is so greatly needed. 
 One thing is certain, namely, that alcohol does not confer 
 any additional working power. It may give a temporary 
 stimulus to body work or brain work, but reaction succeeds, 
 and leaves the body and mind less active than before. 
 
 We come then, to this conclusion, that the greatest diffi- 
 culty, as regards moderate drinking, lies in the fact that 
 
8 ANAEMIA 
 
 just as no two persons are alike in size, weight, constitution 
 or appetite, so the quantity of alcoholic liquor which will 
 help one man and do him no harm, repeated daily for years, 
 may entirely ruin a man who has weak organs or some dis- 
 ease of the heart, liver, or kidneys. What may be modera- 
 tion in you may lead to my early death. How then is a 
 person to judge whether he may take any alcohol or not, 
 and how much, and how often? 
 
 The answers are, after all, fairly definite. Drink none 
 at all if you desire perfect safety, and especially if any 
 relations or ancestors of yours were of drunken habits. If 
 you will drink, drink as little as you can, especially if your 
 life is sedentary and you cannot get much exercise. Drink, 
 in any case, only at meal times, and you will not go far 
 wrong. Set your face against the senseless parrot cry, 
 ''Come and have a drink," and the foolishness of creating 
 an artificial thirst, which leads to the benefit of one person 
 only the drink-seller. It is natural and proper for young 
 people to like convivial society, but the society of the public- 
 house bar has nothing to recommend it. Young women do 
 not find it necessary to be continually taking nips of alcohol 
 to bring out their wit and gayety, and young men would do 
 well to bear the fact in mind. There is nothing "manly" 
 in the silly sleepiness, or the bubbling frothy gayety in- 
 duced by too many drinks. Directly you feel the stimulus 
 of the first drink, alcohol has done^ all the good in its power, 
 and more alcohol does harm. It is when the stimulation is 
 felt, of course, that there is the greatest temptation to 
 secure some more, and then begins the poisoning of the 
 system and the overworking of the liver and kidneys. 
 Actual experiment has shown that from 1 ounce to 1% 
 ounces of absolute alcohol represents the quantity of alco- 
 hol which a healthy man may daily consume without ill 
 effects. (See also "Beverages.") 
 
 Anaemia. Ancemia means bloodlessness, but nobody is 
 bloodless, and so the word is used to mean any state of 
 health in which the blood is not of as good a quality as it 
 should be. The pink color of the lips and other "mucous 
 membranes" is due to the red color of the blood which 
 circulates under the surface of them. A person may be 
 anemic (or poor blooded) because he has lost a quantity 
 of blood by accident, or because he is badly nourished, or 
 because he is poisoned by some disease, or chemical poison 
 
ANAEMIA 9 
 
 such as lead. Or he may be anaemic because his blood- 
 making powers are not up to the mark. We shall describe 
 only the more common forms of anaemia, such as is not 
 caused by loss of blood. 
 
 1. CHLOROSIS or Green Sickness. This is the anaemia 
 so common in young girls about 13 or 14 years of age. In 
 a bad case of this kind of anaemia, the girl looks pale, or 
 yellowish and sallow-tinted, her lips pale pink, her cheeks 
 a little flushed. On the backs of the hands the veins show 
 pink through the whitish skin instead of purplish through 
 a pink skin. She is languid, weak and tired, and is liable 
 to headaches, giddiness, fainting-fits, shortness of breath 
 on going upstairs, and swollen ankles at bedtime. Her 
 appetite is poor and she complains of a feeling of a heavy 
 weight on the chest after meals. At the same time, she 
 may be fat, or at any rate plump. Such girls are very 
 often emotional and hysterical (see "Hysteria") and full 
 of sentimental sickly fancies. They nearly always have 
 some disturbance of the female functions; very often in 
 anaemia the courses stop altogether, and the girl grows 
 irritable and apt to shut herself up or moon about alone. 
 
 Treatment. This may be summed up in a sentence. 
 Take iron and keep the bowels freely open. Iron, in some 
 form or another, will have to be taken continuously for 
 three months or more. Iron, if given in large doses and 
 often enough, will cure nearly all cases. But even iron 
 is useless unless the bowels are kept freely open. This is 
 Sir Andrew Clark's medicine for chlorosis, and it will be 
 found suitable for a large number of cases, though not for 
 all:- 
 
 Sulphate of magnesium, 6 drachms ; sulphate of iron, 24 
 grains; aromatic sulphuric acid, 1 drachm; tincture of 
 ginger, 2 drachms; compound infusion of gentian, to 
 8 ounces a sixth part to be taken twice a day. 
 
 2. ANAEMIA in Adults. The treatment of this must de- 
 pend upon the cause of it. Lead-poisoning (see "Lead- 
 Poisoning"), gout, syphilis, kidney-disease, malaria, severe 
 bleeding piles, discharges, stomach inflammations all these 
 may be causes of anaemia. 
 
 Iron, given in some form which will not upset digestion, 
 is the real cure for anaemia. To begin treatment the pa- 
 tient must take a smart purge of Epsom salts, then continue 
 
10 ANEURISM 
 
 with iron and a bitter tonic like quinine. Thus Tincture 
 of perchloride of iron, 10 fluid drachms; sulphate of qui- 
 nine, 1 drachm, 20 grains; glycerine, 2 fluid ounces; water 
 to 8 fluid ounces. Take two teaspoonfuls of this mixture 
 in a wineglassful of water thrice daily after meals. 
 
 Persons who are very weak as well as anaemic may find 
 the following pill very useful : To make one pill Arseni- 
 ate of iron, a quarter of a grain; reduced iron, 5 grains. 
 Take one pill morning and evening after meals. 
 
 One of the most widely used of all iron preparations in 
 the treatment of anaemia is Blaud's pill in combination 
 with cascara or some other laxative. There is another 
 form of anaemia known as pernicious anaemia which is diffi- 
 cultly curable and which may terminate in death. There- 
 fore in the case of any anaemia which does not respond 
 readily and quickly to the ordinary modes of treatment 
 for anaemia, a good physician should be quickly consulted. 
 
 Anaesthetics. This is the word which means all the 
 different medicines used to send people to sleep the arti- 
 ficial sleep and insensibility to pain, called anaesthesia. 
 The art of using anaesthetics is now so well understood that 
 no one need be afraid of them. A very few deaths occur 
 every year from anaesthetics in the case of people with 
 unsuspected bad heart disease or broken-down constitu- 
 tions. 
 
 The chief drugs used are ether, chloroform and nitrous 
 oxide gas for producing artificial sleep, and cocaine, eu- 
 caine and ethyl chloride to produce insensibility of the 
 skin. The choice of anaesthetic must, of course, be left 
 entirely to the judgment of an expert, but as a matter of 
 fact there are almost no cases of illness (in which an opera- 
 tion is really required), for which a suitable anaesthetic can- 
 not be found. 
 
 Aneurism. Inside the blood vessels, of course, there is 
 always a great pressure of blood, caused every moment by 
 the beating of the heart, which pumps blood round the 
 whole body. The pressure is great, and the blood vessels 
 (arteries and veins) have to bear it without giving way. 
 This they could not do unless they were elastic, as in fact 
 they are. The arteries are elastic tubes, dilating when 
 more blood rushes through them, and contracting when 
 there is less blood. An artery never ruptures, even 
 when the heart is beating furiously, so long as it retains its 
 
ANTISEPTICS 11 
 
 elasticity. But in old age the arteries become less elastic, 
 less able to cope with sudden alterations of pressure, and 
 the same thing happens even in youth in the presence of 
 such diseases as gout, syphilis, and alcoholism. The weak- 
 ening of the arteries in these diseases may affect all the 
 blood vessels of the body, or only certain of them, or some- 
 times only small patches on a very few of them. This 
 disease of the arteries is called atheroma, and everyone 
 with atheromatous arteries who is subjected to physical 
 strain or hard manual labor, is liable to have an aneurism. 
 An aneurism is a blood-tumor connected with an artery 
 and caused by the weakened inner wall of the artery di- 
 lating and giving way before suddenly-increased pressure 
 of blood. Once an aneurism is formed, it has a slight 
 tendency to self-cure, and will get well spontaneously if 
 suitable medical treatment and nursing can be obtained. 
 Of course, the signs and symptoms of an aneurism depend 
 altogether on the position of it it may be behind the knee, 
 in the chest, in the lungs, in the abdomen, or almost any- 
 where else. The symptoms are always pain, more or less, 
 and the results of the pressure on other organs. Nothing 
 more can be said here about aneurisms ; they are in no way 
 suited for home-doctoring, and, in fact, often tax the in- 
 genuity and skill of the cleverest and most experienced 
 medical man. 
 
 Angina Pectoris, or BREAST PANG, is a sudden cramp of 
 the heart itself. The first attack often proves fatal, but 
 some people have several attacks before they die. The pain 
 is intense, like no other pain on earth, and accompanied 
 by a fear of impending death. It lasts about a minute. 
 The cause of the condition is almost unknown. 
 
 Persons who have had one attack must regard themselves 
 as likely to have another, and they should always carry 
 about with them small glass capsules of amyl nitrite, the 
 vapor of which, released by breaking the tube, is to be 
 inhaled by the patient. Recurrence of the attacks may, 
 perhaps, be prevented by avoidance of excitement. 
 
 Antiseptics are substances, mostly of a chemical or min- 
 eral nature, which possess the property of arresting or 
 preventing the growth of bacterial organisms which are 
 capable of producing poisonous substances in animal tis- 
 sues with death or decay of the body cells. The changes 
 which take place in a wound or ulcer or sore when germs 
 
12 APOPLEXY 
 
 get into it are called septic processes, sepsis, or putrefac- 
 tion. (See also "Abscesses" and "Inflammation.") 
 
 The choice of an antiseptic must depend upon the pur- 
 pose for which it is to be used. 
 
 The following is a list of the better known antiseptics. 
 
 Bichloride of Mercury or Corrosive Sublimate. Pre- 
 pared in tablets. Used in strengths of 1 in 1000 or in 1 in 
 2000 parts of water, for inflammatory processes of bacterial 
 origin. 
 
 Peroxide of Hydrogen. Used in full or % strength to 
 cleanse dirty and infected wounds. 
 
 Boracic Acid. Saturated or y z saturated solution. For 
 mild inflammations of mucous membranes. 
 
 lAsterine, borolyptol, eucalyptol, borine, alkalol and 
 glycothymoline. For toilet antiseptic purposes, as mouth 
 washes, etc. 
 
 Alcohol, and Tincture o/ Iodine. Both are good, in full 
 or % strength, as skin antiseptics when the skin surface is 
 not broken. 
 
 Potassium permanganate. One in 250 parts of water. 
 An active oxidizing agent with antiseptic and deodorizing 
 properties. 
 
 Carbolic acid is little used nowadays on account of the 
 danger resulting trom strong solutions or when it is in- 
 completely dissolved. 
 
 Among the best known antiseptic powders are iodoform, 
 dermatol and aristol. 
 
 Apoplexy. This is the medical name for a "stroke." 
 The person affected falls down as if struck, unconscious, 
 breathing heavily and snoring. Before the attack there 
 are generally some warnings, such as headache and sudden 
 giddiness on stooping, noises in the ears, temporary deaf- 
 ness or blindness, squinting, nose-bleeding, vomiting, de- 
 pression, sleepiness, thick speech. Certain persons are 
 more liable than others to have a stroke. Such are the 
 sedentary, the high livers, with fat stomachs, large heads, 
 florid cheeks, and short thick necks, and persons over fifty. 
 Intemperance and its resulting kidney disease make people 
 very liable to apoplexy. 
 
 A stroke may have various results complete recovery 
 occasionally occurs; some paralysis of the hand, arm, or 
 leg may remain, with or without loss of the faculty of 
 speech; or death may occur. An attack of apoplexy may 
 
APPENDICITIS 13 
 
 come on in one of three ways. (1) The patient falls down 
 unconscious, with red face, snoring, and convulsions; or 
 (2) he has a violent pain in the head, is pale, sick and 
 faint and gradually becomes unconscious; or (3) he sud- 
 denly becomes paralyzed, but does not lose his senses. He 
 may recover or get worse. Sometimes you see a man in 
 the street "in a fit," and the fit may be epileptic or apo- 
 plectic, or perhaps only drunken. It is sometimes ex- 
 tremely difficult even for a doctor to decide whether a man 
 is drunk or ill, and whether he ought to be left to the police 
 or carefully looked after. Such a man in a fit may be 
 both drunk and ill, or might have become ill and taken some 
 alcohol to cure himself in vain. These "fits" are quite 
 beyond the power of the ordinary layman to deal with. 
 He ought on no account to administer brandy or any strong 
 alcoholic drink, unless he chooses to run the risk of being 
 censured by a coroner, and the sick man's death attributed 
 by the doctor to his interference. All he can do is to give 
 the sufferer as much air as possible, to loosen belts, bands 
 and collar, and prevent his damaging himself in his strug- 
 gles, and to await the doctor's arrival. 
 
 Appendicitis. As most people know, the abdomen con- 
 tains, coiled up in it, a very long tube (about 26 feet, in 
 fact), called the intestine, or gut, or bowel. In this tube 
 the food after leaving the stomach is mixed with various 
 digestive juices, such as the bile, and when ready, is ab- 
 sorbed into the blood vessels of the gut, and thence into 
 the general circulation, to be made into blood fit to nourish 
 the body. Now, the tube which extends from the stomach 
 onwards for 20 feet, is a narrow tube, called the small gut ; 
 then begins a much larger tube which goes on to the back 
 passage. This larger tube, the large intestine, begins at 
 a spot just beneath the skin of the belly, on the right side, 
 close to the bony prominence of the hip. At a few inches 
 from the beginning of the large bowel, there is, in most 
 people, a little blind tube hanging from it. This little bit 
 of a tube is only about as big as a goosequill, from two to 
 five inches long, and is of no use whatever. It is called 
 the appendix, and sometimes the food or foreign bodies as 
 they pass along through the large intestine, set up irrita- 
 tion and inflammation in it. For instance, a cherry-stone, 
 swallowed, may irritate the appendix and so cause it to 
 inflame, and bring on appendicitis itself. The abscess 
 
14 APPETITE 
 
 which forms as the result of all this bursts at last into the 
 belly cavity, or is opened by the surgeon. But not all 
 cases of appendicitis get as far as that. 
 
 The causes of appendicitis are many and various. While 
 nobody knows how to avoid getting the disease it is be- 
 lieved that of any one cause constipation is the most potent. 
 
 The symptoms of appendicitis are these: (1) Sudden 
 pain all over the belly, getting worse and worse, and finally 
 settling down to the right side of the lower part. The sick 
 man lies on his back and draws his right leg up. (2) Loss 
 of appetite, sickness, constipation. (3) Tenderness to 
 the touch, especially at a point two-and-half inches from the 
 bony prominence of the hip-bone in the direction of the 
 navel. (Dr. McBurney's "Spot.") (4) Feverishness. 
 (5) Swelling in the part referred to. 
 
 In an ordinary case these symptoms increase for a few 
 days, then gradually subside and the disease gets well. 
 
 Treatment. Very light milk diet, and rest in bed. 
 Poultices or an ice-bag to the painful region. Do not give 
 purgative medicines. 
 
 All cases must be seen by a doctor, who alone can tell 
 whether they are going to be serious or not and whether 
 an operation will be necessary or not. 
 
 Appetite, Good, Bad and Indifferent. By appetite the 
 medical man means the desire for food which every person 
 possesses when in good health. 
 
 I. A loss of appetite is one of the earliest signs of ill- 
 ness, and it usually continues so long as the patient is in 
 any way seriously ill. 
 
 It is so pleasant a state to have a good appetite that 
 patients will come to a doctor about a loss of appetite, with- 
 out being in any other way ill. When this is the case the 
 fact is generally that the person has been eating too often 
 and too much, or, at any rate, more than his stomach can 
 manage to make good use of. When too much food is 
 taken, and too little work done, the whole system becomes 
 overloaded with waste products, in excess of the quantity 
 which the bowels can carry off, and the liver and kidneys 
 become affected, and their whole work disorganized, and 
 so the blood becomes impure. Loss of appetite is an ad- 
 vantage under such circumstances. Many people boost of 
 a large appetite who would live longer and feel better if 
 they ate less. Rich people, with good cooks, who eat heavy 
 
APPETITE 15 
 
 late dinners, are rarely very robust for any long time to- 
 gether, and large numbers of them have to go abroad once 
 a year to undergo a course of abstinence and mineral 
 waters at some Spa or health resort. 
 
 Many old people are in perpetual suffering from nothing 
 more irrational than having indulged a good appetite while 
 they were young and reckless. 
 
 The old physicians knew this, and used to say that he 
 who wants good health should care little about eating, and 
 should leave the table before he feels quite satisfied. 
 Among the poor, however, and in our towns, a loss of ap- 
 petite is generally a sign of disease, which may be acute 
 or chronic. 
 
 II. All fevers and states of inflammation are ushered in 
 by want of appetite, and most chronic states of ill-health pro- 
 duce the same state before they have existed for long. For 
 example, phthisis, or consumption of the lungs, scrofula, 
 and cancer. Serious acute illnesses often leave behind 
 them a state of debility or weakness, which lasts for several 
 weeks, and in this state also the appetite is often fastidious, 
 and needs to be tempted. 
 
 III. While loss of appetite is one of the most common 
 symptoms of illness, doctors are also consulted by sick peo- 
 ple who want to eat too much, and for some who do eat 
 enormously. 
 
 An excessive appetite is a sign of disease in most cases, 
 but we do also find it present in some persons who are not 
 ill in any way. Some badly-managed children are very 
 large eaters, and occasionally we see an adult man or woman 
 gorging food ; such persons are often weak in mind. Chil- 
 dren with intestinal worms will sometimes be found to have 
 an unnatural craving for food. In olden times doctors 
 used to say that if a man had a tapeworm within him, he 
 had to eat more than usual to feed the worm; but at the 
 present day we should say that the tapeworm sets up an 
 irritation in the coats of the intestine, which shows itself 
 in a false sense of hunger. 
 
 Imbecile children will eat at all times, and will eat any- 
 thing ; even chalk, cinders, coal, and pencils in some cases. 
 
 The disease called diabetes, not uncommon in people at 
 or beyond middle life, often gives rise to a voracious ap- 
 petite. This disease is marked by the production of an 
 enormous quantity of water from the kidneys, and this 
 
16 ASTHMA 
 
 urine is peculiar because it contains sugar dissolved in it. 
 Many a diabetic person will consume one or even two 
 pounds of rump steak at a meal without suffering from 
 any indigestion. Navvies, coal miners, and others who 
 work long hours at very laborious work, and get high 
 wages, often have voracious appetites, and eat very large 
 quantities of food, generally of a wholesome sort, however ; 
 but they eat more than they need, for it is a mistake to 
 suppose that even the hardest laborer requires all the food 
 a man can eat. The excess of food must be got rid of some- 
 how, so the liver and kidneys are called upon to work in 
 a dangerous, overloaded condition, and they frequently get 
 damaged in consequence even before such men reach the 
 age of 40, and in many cases these organs break down com- 
 pletely from over-strain, passing into states of disease which 
 lead to an early death. The over-feeding of children is 
 often the result of undue encouragement by the parents. 
 A child is, perhaps, rather thin, and is, therefore, prompted 
 to stuff, and so gets into the habit of over-eating. In many 
 such cases we have observed the child to get no plumper, 
 and this is because it had not needed more food, but better 
 powers of digestion, and over-feeding led to further dis- 
 orders rather than to improved nutrition. 
 
 Ascites. Sometimes patients see this word on their hos- 
 pital tickets. It means dropsy of the belly. The abdomen 
 is full of, or contains, fluid, and may have to be tapped. 
 It may be caused by disease of the liver, heart or kidneys. 
 (See "Dropsy.") 
 
 Asthma. This word is often used loosely to mean any 
 kind of shortness of breath. It should only be used to 
 refer to a spasmodic disorder of the air passages, neither 
 acute nor chronic, but paroxysmal (occasional). It is 
 liable to complicate chronic bronchitis, but it is an error 
 to believe that all extra severe attacks of that complaint 
 are connected with real asthma. 
 
 Shortness of the breath which is not spasmodic is usually 
 caused by some organic disease of the lungs, heart, or kid- 
 neys and is best cared for by the sufferers' placing them- 
 selves, at the earliest possible moment, in the hands of a com- 
 petent physician, who can determine the cause and direct the 
 proper treatment. 
 
 A patient who is subject to asthma seems perfectly well 
 before the attack and then is suddenly seized, often dur- 
 
ASTHMA 17 
 
 ing sleep, with the most violent breathlessness ; feeling a 
 tightness at the chest, he gasps for breath and grasps at 
 near objects such as the bedpost to help him to breathe. 
 The attack may last a few hours or a few days, and then 
 suddenly pass off. One of the curious features of people 
 who suffer from asthma is their tendency to skin eruptions. 
 
 The real and exact cause of the attacks is a spasmodic 
 narrowing of the air-passages of the lungs, but what causes 
 the spasm is very often not known. A nerve-troubled 
 family history is generally found in people who have these 
 attacks, and sometimes instead of an attack of asthma they 
 will have one of gout, or neuralgia, or madness. 
 
 No doubt every lung disease predisposes a little to attacks 
 of asthma, especially in gouty people. Some climates 
 cause attacks, while others seem to do them good. But no 
 doctor can safely prophesy what sort of climate will cer- 
 tainly suit a given case of asthma. If you have attacks 
 where there are trees, go where there are none ; if by the 
 sea, then go inland. 
 
 It is pretty certain that attacks of indigestion cause 
 attacks of asthma in those subject to them. So all asth- 
 matics ought to avoid cheese, pickles, celery, sardines, 
 pastry, porter, pork, and nuts. No late suppers should be 
 taken on any account. 
 
 Between the attacks one can only try and live quietly and 
 without much excitement. As to climate, the sick per- 
 son, whether a child or an adult, should live, if possible, 
 away from fogs, dust, and smoke. More than that cannot 
 be said about the climate. Solid food should not be taken 
 after four o'clock in the afternoon. Children are often 
 asthmatic and do not "grow out" of the disease. 
 
 Iodide of sodium may be taken with advantage by most 
 asthmatic people twice daily, in five-grain doses. 
 
 Before an attack, the sufferer may take lobelia or 
 pyridine, but both drugs must be taken only under medi- 
 cal supervision. Milk is the only diet allowed during the 
 attacks. As for inhaling the smoke of asthma-powders, it 
 is a useful proceeding. White blotting paper, soaked in 
 a saturated solution of nitrate of potash, and two or three 
 strips of it burnt, and the vapor inhaled, is a simple 
 remedy. Many people find instant relief by smoking 
 stramonium or cubeb cigarettes. 
 
 The disease itself does not shorten life. People do not 
 
18 BABIES LOST BY OVERLAYING IN BED 
 
 die in attacks of asthma. But if they occur too frequently, 
 they increase the bronchitis which they too often accom- 
 pany. Once in a while, a child grows out of the complaint, 
 but adults never lose it altogether. 
 
 Babies Lost by Overlaying in Bed. Is it not a very serious 
 state of affairs that hundreds of babies are overlain in 
 London and New York every year? And can nothing be 
 done to make infant life more safe ? The root of the matter 
 lies in the old custom of the country that of having an 
 infant to sleep in the mother's arms, or at any rate, in her 
 own bed, and with the father. Overlaying is practically 
 unknown on the Continent of Europe, the reason being that 
 it is a recognized custom for parents to obtain a cot as soon 
 as a baby comes. The old-fashioned wooden box, cot, or 
 cradle used to be handed down from one generation to 
 another, and used for every baby as it came along. In 
 Germany and some other countries, there was a strict law 
 that no mother or nurse should have an infant under two 
 years of age in bed with her, under a heavy penalty, and, 
 if the law being broken resulted in a child's death, and 
 an infant got suffocated in bed with a grown-up person, 
 there was a conviction for manslaughter, and a long im- 
 prisonment followed. 
 
 In this country there are, of course, many cradles in 
 use, especially in country districts, but in our cities and 
 among the poor it is an almost invariable rule to find 
 young infants in bed with both parents. We want to 
 teach parents that the life of an infant under one year of 
 age is never safe in bed with a mother; it is too feeble to 
 breathe easily under any covering, and suffocation is bound 
 to follow when an infant's mouth and nose get squeezed 
 against a mother's breast, or if her arm rest upon or over 
 them, or even if heavy bedclothes get pulled up over a 
 child's head. Until baby is a year or more old it is sel- 
 dom strong enough to rouse up a mother when it is dying ; 
 its struggles for fresh air are too feeble to awake a woman 
 who sleeps soundly. In our towns women work hard and 
 go to bed late; sleep like logs, many of them, for hours, 
 in utter ignorance that the baby whom they love is dying 
 beneath them. There is no medicine which can make 
 mothers sleep lightly, and there are no means of avoiding 
 overlain babies except by insisting on the use of a cradle. 
 It is only reasonable to urge that the clergy should do their 
 
BALDNESS 19 
 
 best to get this reform carried out. There are, of course, 
 numbers of babies overlaid because their mothers drink 
 too much, but we feel quite sure that the number of such 
 is small compared with the total number of babies who die 
 suffocated in bed, overlaid by parents tired with the day's 
 work. 
 
 There is no reason for the non-possession of a cot for the 
 baby. 
 
 Backache. Pain in the back is a very common ailment 
 indeed, especially that form of it called by women " bear- 
 ing-down pain." It is very often a sign of nothing more 
 than tiredness of the muscles of the back ; but, on the other 
 hand, it may be a symptom of disease in some internal 
 organ. 
 
 Under "LUMBAGO" you will find a full account of the 
 pain due to rheumatic trouble in the back muscles, as well as 
 several valuable ways of dealing with all kinds of back- 
 aching. Backache in young growing persons may be due 
 to general debility, and then keep an eye open for curva- 
 tures and weakness of the spine. Actual disease of the 
 spine itself more often causes what is called "referred" 
 pain in the front of the belly. Some kinds of kidney di- 
 seases (see "Kidney Diseases") cause backache. Gall- 
 stones cause backache especially on the right side and in 
 the right shoulder. Ulcer of the stomach (see "Stomach 
 Diseases") will often cause local pain in the back at the 
 level of the last rib. But the commonest causes of women 's 
 backache are menstrual disorders, catarrhs of the womb, 
 falling of the womb (due to getting up too soon after mis- 
 carriage or childbirth), inflammation of the womb, and 
 tumors of every kind, connected with womb or ovaries. 
 
 Very little can be done towards curing the backache un- 
 til we know what causes it. If a young man or woman 
 has severe backache, that is not due to "growing pains," 
 or general weakness, or curvature of the spine, let him or 
 her save a sample of the urine which he or she passes first 
 in the morning, and submit it to the doctor for analysis. 
 Under "LUMBAGO" will be found plenty of "cures" for 
 those whose backache is due to something that cannot be dis- 
 covered, or cannot be treated, and we refer all sufferers 
 to that article. 
 
 Baldness. This may be permanent, as in old age, or 
 temporary as after fevers, in debility, syphilis, and con- 
 
20 BANTING 
 
 sumption. Even those who are bald with increasing age 
 need not despair, however, for so long as any hair-growing 
 follicles are left in the skin they may be stimulated into 
 activity. The hair requires plenty of brushing and wash- 
 ing about once a fortnight, or three weeks. The washing 
 should be done in hot water, with a little household am- 
 monia in it, and then some ordinary yellow soap should be 
 used, or, better still, egg julep as a lather. When the 
 scalp is clean, dry it and the hair by rubbing with rough 
 towel. 
 
 A good hair-wash for the baldness following an illness 
 is Castor oil, 20 parts; tincture cinchona, 10 parts; tinc- 
 ture rosemary, 10 parts; tincture jaborandi, 10 parts; bay 
 rum, 100 parts. Shake well and rub into scalp frequently. 
 
 Women who are weak and anaemic should try this lotion 
 to prevent hair shedding: Salicylic acid, 3 drachms; 
 liquefied carbolic acid, 1 drachm; castor oil, 3 drachms; 
 alcohol, q. s. to 6 ounces. Make a lotion. To be rubbed into 
 scalp. 
 
 When the hair falls off because of scurfmess of the scalp, 
 use this lotion: Resorcin, 1 drachm; ether and castor oil, 
 of each, 1 drachm; eau de cologne, one ounce; rectified 
 spirits, 6 ounces. Mix. 
 
 If the scurf is very thick and very greasy, and the hair 
 comes out by the roots, try this lotion : Resorcin, 40 grains, 
 ether and castor oil, 2 drachms; eau de cologne, half-an- 
 ounce ; bay rum, four ounces. Rub into the roots night and 
 morning on clean rag, which is to be burnt immediately 
 after use. (See also "Skin Diseases" IV.) 
 
 Banting. "Doing Banting" means dieting one's self in 
 a special way in order to get thin. Banting was the in- 
 ventor of this particular method of reducing weight. In 
 one year, Banting reduced his weight from 196 to 154 
 pounds. 
 
 The Banting diet is very scanty, but many very fat 
 people adopt it with good results. Here is the dietary: 
 
 Breakfast. Six ounces of meat, any meat except pork 
 or veal; one ounce of dry toast, or dry biscuit; 10 ounces 
 (half-a-pint) of coffee or tea, without sugar. Dinner (five 
 hours later). Six ounces of meat (except pork, veal, eels, 
 salmon or herring), or of any kind of poultry or game; 
 six or eight ounces of any vegetable except potato, beetroot, 
 turnip, carrot or parsnip ; one ounce of dry toast ; a plate 
 
BARRENNESS 21 
 
 of cooked fruit, unsweetened ; 10 ounces of claret and water. 
 Tea (four hours later). Three ounces of cooked fruit, un- 
 sweetened, with plain rusks; eight ounces of tea without 
 milk or sugar. Supper (three hours later). Four ounces 
 of meat or fish, or game, or poultry, as at dinner; six 
 ounces of claret, or claret and water. 
 
 This method of treating extreme fatness is deservedly 
 popular, but for some people it may not be enough to keep 
 up the strength. Such people should not try and eat 
 more, but should adopt the Oertel method, which is similar, 
 but has a higher proportion of fat and starchy foods, and 
 is combined with regulated hill-climbing. 
 
 Barbers' Itch. Hairdressers generally know enough 
 about skin diseases to be aware that they sometimes help 
 to spread contagious skin diseases by insufficient attention 
 to the cleanliness of brushes and other utensils which they 
 make use of in the ordinary course of business. One of 
 these is called "barbers' itch." It may affect the eye- 
 brows, eyelashes, mustache, beard, and armpits and 
 groins. There are little tender pimples which form around 
 the hairs, and develop into tiny abscesses (pustules), and 
 the hairs come out easily. When the hairs are out the 
 matter comes out too, and perhaps at once affects the next 
 hair-sheath. The disease is most obstinate to cure. The 
 hairs have to be pulled out and the matter has to be gently 
 squeezed out of the follicles; after that you must rub in 
 some antiseptic ointment, such as yellow oxide of mercury 
 ointment, or 2 per cent, resorcin in vaseline or cacao butter. 
 
 Under the heading of ' ' Hairdressers ' ' we give some hints 
 as to the prevention of such diseases. 
 
 Barley Water for Invalids. DIRECTIONS. Mix one 
 dessert-spoonful of Robinson's Patent or Prepared Barley 
 with a wineglassful of cold water into a smooth paste. 
 Pour this into a stewpan containing one quart of boiling 
 water, and stir over the fire for five minutes. Flavor with 
 lemon and sugar, either or both, according to taste, allow 
 the mixture to cool, and strain off the barley sediment. 
 For invalids requiring nutriment, a large quantity of 
 barley should be used and the straining of sediment omitted, 
 or not, as directed by the doctor. 
 
 Barrenness. The treatment of barrenness must obviously 
 depend on the cause of it, and only a doctor can decide 
 this point. 
 
22 BATHING 
 
 Bathing, The Importance of. In order to maintain good 
 health, it is of the utmost importance to keep the skin of 
 the whole body clean. "We may notice among persons whose 
 habits we know of, that those who take daily baths are not- 
 able for health and for having a good color and clear com- 
 plexion. We are constantly getting rid of used-up mate- 
 rial through our skins by perspiration and by evaporation. 
 The pores of the skin tend to become blocked up unless 
 often washed, and when the pores are obstructed more work 
 is thrown on the kidneys. Persons in robust health are all 
 the better for having a daily bath of cold water ; those who 
 are less strong are wise to have a morning bath of warmed 
 water. Such a practice is well worth the trouble of the 
 process and the loss of time, and it should be followed in 
 houses with conveniences for it. When a daily bath is 
 not practicable, a warm bath should be taken once a week 
 at bedtime, and during pleasant weather a bath in the 
 sea, or in a river, or in a town swimming-bath, is very 
 desirable. It is not desirable to remain in any bath very 
 long, and on getting out the whole body should be rubbed 
 with rough towels until the skin is all pink and glowing 
 with warmth. When a person does not feel a hot glow after 
 a cold bath, he should not bathe in quite cold water. It 
 is only foolhardiness to risk taking cold baths in the open 
 air during winter weather. Medical men describe and ad- 
 vise several sorts of baths. For instance, the cold bath 
 generally means the use of water just at the temperature 
 it happens to be according to the weather. Baths of 
 warmed water require the use of a thermometer to regulate 
 the heat to the degree ordered. In general domestic use, 
 of course, it is customary to test the heat of the water by 
 the hand; this, however, is an uncertain guide. Delicate 
 children may easily be scalded by hot water which does not 
 feel painful to a nurse's hand. A bath called by a doc- 
 tor "tepid" means of heat between 84 and 92 degrees 
 Fahrenheit scale. A warm bath is from 92 to 98 degrees; 
 the latter is blood-heat. This feels hot to the whole body, 
 and is most suitable for a general washing with soap. A 
 hot bath is of a heat from 98 to 105 ; this is only to be used 
 as a form of medical treatment. A mustard foot-bath is 
 made with a half-teacupful of mustard powder to a gallon 
 of hot water. An alkaline bath, used in skin disease, is 
 made by adding carbonate of soda to warm water. A 
 
BEDSORE 23 
 
 sulphur bath, to cure itch, is made by adding two drachms 
 of sulphurated potash to each gallon of water. Soak the 
 affected hands and arms in it. 
 
 Bed Case. This is an old-fashioned name for cases of 
 hysteria of a certain kind. Instead of being up and about, 
 doing their share of work in the world, the subjects of this 
 pitiable condition prefer to be regarded as interesting in- 
 valids. They dislike being told that they look well. They 
 like to believe, or to make their friends believe, that they 
 have a mysterious internal complaint, and that their doctor 
 considers them very interesting and obscure cases. They 
 often are tranquil and cheerful, and have good digestions 
 for dainty food. They always have some speciality in the 
 way of a disease always obscure and invisible. Either it 
 is * ' something wrong with the spine, ' ' or with the * ' womb, ' ' 
 or ' ' the nerves, ' ' and they say, in order to attract the sym- 
 pathy which is as bread and cheese to their vain and little- 
 minded selves, that they have ''horrible pains/' If these 
 patients can be brought into a healthier state of mind by 
 cheerful companions, or nurses who will stand no non- 
 sense, they may be cured. But, unfortunately, too many 
 of them are quite comfortable in their selfishness and do 
 not in the least desire to be made like other people, or 
 deprived of their friends ' sympathy. (See l ' Neurasthenia" 
 and "Hysteria.") 
 
 Bedsore. A bedsore is a sore or ulcer which forms on 
 some part of a bed-ridden invalid, and it is due to pressure 
 and moisture combined. The chief places are the heel, 
 the buttocks and the bottom of the spine. A nurse should 
 regard the formation of such a sore on her patient as a 
 disgrace, generally, and due to her own carelessness or 
 want of watchfulness. The sick person must be kept quite 
 dry and unsoiled by sweat, discharges or urine. Look out 
 for redness over parts which are lain upon, and rub them 
 a little daily with methylated spirits, dry thoroughly and 
 dust with some clean powder. If the skin once gives way, 
 the ulcer is very difficult to heal, and the doctor's atten- 
 tion must be called to it. Otherwise the sick person will 
 have an additional trouble which ought to have been 
 avoided. Bedsores occasionally occur in very old, para- 
 lyzed, and dying folks, but in most cases can be avoided 
 by proper attention. 
 
 Beef Tea, How to Make. (1) Cut up a pound of lean 
 
24 BEVERAGES 
 
 gravy beef into small pieces, put them into a covered jar 
 with two pints of cold water and a pinch of salt; put the 
 jar on the hob, let it warm and simmer gradually for two 
 hours, taking care it never reaches boiling point. An- 
 other method is: (2) Chop fine a pound of lean beef, add 
 a pint of cold water and leave for two hours. Then let 
 it simmer on stove for three hours, but never let it get 
 much hotter than 160 F. A thermometer will be wanted 
 in nurseries where this method is made use of. Make 
 up for the water lost by evaporation by adding cold water, 
 so that a pint of beef tea shall represent a pound of beef. 
 Strain, and carefully squeeze all fluid from the beef. 
 (Bartholow.) (3) Beef tea and oatmeal a very nourish- 
 ing meal: Mix thoroughly a tablespoonful of groats with 
 two tablespoonfuls of cold water and add to a pint of hot 
 beef tea made as in (1). Heat up again for ten minutes, 
 stirring all the time, and strain through a coarse sieve. 
 
 Beverages. All "drinks" contain a large proportion of 
 water, and, in fact, the daily drinking of a large amount 
 of water is a necessity for health. An average adult needs 
 water, in one form or another, to the extent of from 2% 
 to 4 pints a day. It should be filtered or boiled, or both. 
 We shall now consider the principal beverages from a 
 medical point of view: 
 
 Tea and Coffee are much alike both in their composition 
 and in their effects. They stimulate the system and are 
 quite harmless, in moderation. Cocoa, on the other hand, 
 is a true food. 
 
 Tea ought to be made with boiling water, and water as 
 "soft" as possible. If your tap-water is hard, boil it for 
 fifteen minutes with a pinch of carbonate of soda before 
 you make the tea. Everybody knows the effects of tea- 
 drinking. We need only say that green tea has much 
 stronger effects than black. If tea gives rise to any sort 
 of indigestion or palpitation of the heart, it may be be- 
 cause it has "stood too long." In any case, tea ought to 
 be drunk after a meal, and not with a meal, and a little 
 carbonate of soda should be added to the pot. "High tea" 
 the meal consisting of tea and meat is a fruitful cause 
 of indigestion. 
 
 Coffee ought to be freshly roasted, and freshly ground 
 in order to be at its best as a drink. Coffee in moderation 
 stimulates the heart and lessens the sense of fatigue. Too 
 
BIRTHMARKS 25 
 
 much coffee may depress the heart and make it irregular, 
 and cause an uncomfortable feeling in the cardiac region; 
 it may also cause heartburn and flushing of the face, es- 
 pecially when strong black coffee is drunk after a meal. 
 It then delays digestion of the food. Strong coffee is a 
 splendid antidote to poisoning by alcohol or opium. (See 
 "Poisoning.") 
 
 Cocoa is a very nutritious food. It contains both body- 
 building and energy-giving foods, and should be used in- 
 stead of tea by the poor especially. 
 
 Chocolate is a very excellent and agreeable drink, con- 
 taining a deal of fat and starchy material, and plenty of 
 sugar. Bilious people should not drink it. It is a food 
 rather than a beverage. 
 
 Alcohol is a useful food in very small quantities, an 
 agreeable stimulant in larger quantities, and in excess is 
 a powerful narcotic poison. A great authority says that 
 one fluid ounce or one-and-a-half ounces of absolute alcohol 
 in twenty-four hours is the most that any healthy adult 
 can take with probable impunity. One ounce of pure 
 alcohol is contained in about: 
 
 2% fluid ozs. of whisky. Half-a-pint of claret. 
 2 fluid ozs. of brandy. Two pints of bitter beer. 
 2 fluid ozs. of gin. One-and-a-half pints of porter. 
 
 1% fluid ozs. of rum. Two-and-a-half pints of lager 
 
 beer. 
 6 fluid ozs. of sherry. Two pints of cider (varies very 
 
 much) . 
 
 NOTE See also "Drachms" and "Ounces".) 
 Birthmarks. Blemishes at birth are of various kinds. 
 The commonest, perhaps, are "port- wine stains" on the 
 skin. These are purplish patches of fantastic shape, due 
 to dilated blood vessels. Sometimes they increase in size 
 as time goes on; more often they only increase slowly for 
 a few months and then remain quite stationary. They can 
 sometimes be improved by electrolysis, but more often not. 
 Old wives tell tales about "strawberry-marks," and 
 "mouse-marks," and say that they are the results of some 
 of the mother's experiences during pregnancy; these no- 
 tions are but silly superstitions. Other " mother 's-marks " 
 are hairy moles and colored moles, all called by doctors 
 
26 BITES OF DOGS 
 
 ncevi (ncevus is the Latin for mole). These are more 
 likely to be removable by electrolysis. 
 
 Bites and Stings of insects may be bathed with tincture 
 of arnica, onion juice, thymol ointment, or dabbed with a 
 piece of rag or cotton-wool soaked in ammonia solution. 
 Cloudy household ammonia will do nicely. An insect bite 
 must not be scratched or a sore may result from poisoning 
 by dirty nails. 
 
 Bites of Dogs. If an ordinary healthy dog bite a per- 
 son, there is no need to fear hydrophobia. Not all dogs 
 which bite are ''mad dogs." In fact, "madness" in dogs 
 means the rare disease called rabies. There is a very cur- 
 ious, but entirely nonsensical, superstition that if a mad 
 dog which has bitten someone is shot afterwards the suf- 
 ferer will be saved. Rabies in the later stages is easy 
 to recognize; the poor animal who suffers from it lies ill, 
 curled up in a corner, with foamy mouth and hanging 
 tongue, and is more or less paralyzed. In the earlier 
 stages of this "madness," the dog is sulky, suspicious, and 
 snappish, and may, perhaps, run after anyone who annoys 
 it, and bite him. But even when bitten by a "mad dog" 
 a person need not develop hydrophobia. The poison in 
 the dog's saliva will probably have been wiped off in the 
 clothes through which it bites. 
 
 For the same reason mad-dog bites of the hands are 
 dangerous and those of the face especially so on account 
 of the great blood supply. 
 
 As hydrophobia, once developed, is almost always fatal, 
 the first thing to do is to cauterize the bite. Only a sur- 
 geon can do it properly, but anyone with the necessary 
 hardy courage could burn out the wound with a cautery, 
 such as is used for fancy poker-work, or a red hot poker, 
 or a pair of lady's curling-irons. 
 
 The disease is comparatively rare. Still, every bite of 
 a dog ought to be seen to by a medical man. 
 
 Hydrophobia may develop a few days after the bite, 
 but in many cases there is an interval of weeks or months. 
 
 When bitten by a dog it is most important to establish 
 the fact whether the animal is rabid or not. This may 
 be done by one of two methods. 1st Keep the dog alive, 
 under observation. 2nd Kill the dog, cut its head off and 
 forward, as quickly as possible, packed in ice to some 
 health department laboratory where a diagnosis can im- 
 
BLACKHEADS 27 
 
 mediately be made by a microscopical examination of the 
 brain. By no means let the dog escape, or be killed and 
 lost sight of. 
 
 If, in either case, the dog is proved to have rabies, the 
 subject bitten must begin immediately the Pasteur treat- 
 ment: either at a department of health, a Pasteur In- 
 stitute, or as can now be done, by his own physician at 
 his own home. 
 
 All public spirited citizens should appreciate the fact 
 that rabies, which is becoming very common in this coun- 
 try, can never be blotted out until widespread muzzling 
 of dogs is carried out at least for a limited period fol- 
 lowed by a permanent national quarantine such as en- 
 forced in England, where rabies is now an unknown disease. 
 
 Black-Eye. A purple discoloration of the skin of the 
 eyelids, cheek, and perhaps forehead, due to a blow, or 
 fall; the color results from blood being effused under 
 the skin from veins bruised by the violence. Very severe 
 blows may have injured the bone deeper still. The whites 
 of the eyes may also be stained crimson or purple. A 
 black-eye will gradually get well if left alone, but it is 
 a good plan to apply cold lotions of spirit and water, or 
 vinegar and water, or a piece of raw steak, if attended 
 to at once; if the case be found painful at a later stage 
 apply warm poultices, or fomentations of poppyheads. 
 The dark color will fade away, becoming red and then 
 yellow before the skin becomes white again. In the final 
 stage rub the part gently with white vaseline, lanolin 
 or cold cream. If the skin is broken as well as bruised, 
 treat the case with fomentations of boric lotion, followed 
 by zinc ointment. 
 
 Blackheads. There are comparatively few young peo- 
 ple whose skins are entirely free from "blackheads." 
 They show as little black pimples on the skin of the nose 
 or forehead or chin; but also on the shoulders, back, and 
 chest. They look a little like grains of gunpowder em- 
 bedded in the skin. If they are squeezed out between the 
 finger nails, or with the barrel of a small key, they look 
 like little white curly maggots with black heads. Some- 
 times the little plugs are more like tiny orange pips. They 
 are quite harmless, but they disfigure the face very much, 
 and they may, and often do, become acne spots (see 
 "Acne"). They ought to be squeezed out, but gently, 
 
28 BLEEDING FROM VARICOSE VEINS 
 
 because if it is roughly done, there is sure to be an acne 
 spot formed there, and then the skin must be washed 
 vigorously with soft soap and hot water and dried with 
 a rough towel. This ought to be done at bedtime, and 
 then the following paste must be rubbed in : Glycerine, six 
 drachms; kaolin, one ounce; and vinegar, half-an-ounce. 
 
 Bladder, Diseases of. There are two ''bladders" in the 
 human body the gall bladder in the liver, and the urinary 
 bladder, to which the urine passes as it comes from the 
 kidneys until the bladder gets uncomfortably full. In- 
 flammation of the urinary bladder is called cystitis. 
 
 1. The signs of cystitis are: Pain in center of lowest 
 part of the belly; too great frequency in passing water; 
 bad smell, turbidity, and whitish sediment in the urine; 
 f everishness ; shivering fits. 
 
 Treatment of acute cystitis. Rest in bed, hot hip baths, 
 milk diet, plenty of water to drink, and urotropin (5 
 grains) to be taken three times a day. This is the treat- 
 ment of an attack of cystitis caused by catching cold. 
 But cystitis, and pain and bloody urine, may be due to 
 a stone in the bladder, or to other things, and then the 
 disease requires very skilled treatment. Other diseases 
 of the bladder are irritability, tumors, and rupture (noth- 
 ing to do with " hernia"). 
 
 II. Irritability of the bladder (with very frequent de- 
 sire to pass water) may be caused by cystitis, stone, 
 stricture, enlarged prostate gland, gouty acidity of the 
 urine, piles, too tight foreskin, etc. The treatment, of 
 course, depends on the cause, which only a doctor can 
 decide. 
 
 Bleeding from Varicose Veins. In persons who suffer 
 from varicose veins the skin of the parts affected at length 
 becomes brownish, shiny, and so badly nourished that the 
 very slightest injury may give rise to a troublesome sore. 
 The sore does not heal because the parts are so badly sup- 
 plied with blood, and the ulcer (see under "Ulcers" 6) 
 may penetrate to one of the swollen veins under it and give 
 rise to a sudden copious loss of blood. In a few seconds 
 the sufferer may lose blood enough to cause a serious faint- 
 ing fit, which arrests the bleeding for a short time. If 
 you ever see anyone bleeding furiously from a sore on 
 the leg where there are knotted and swollen veins, make 
 him lie down on his back, raise the leg, and apply pressure 
 
BLISTERS 29 
 
 with a handkerchief rolled into a pad, directly on to the 
 Heeding spot and bandage it tightly there, or bandage both 
 above and below the wound. Then send for a doctor. 
 
 BLEEDING from the back passage, or rectum, generally 
 shows the presence of piles, or ulceration, or inflammation 
 of the bowels. A small occasional loss of blood in a full- 
 blooded person is rather a good thing, but in all cases 
 a doctor should be told about it, as it may be curable, or 
 it may be the sign of a disease elsewhere which ought to 
 be medically treated. 
 
 BLEEDING from the nose. (See "Nose-bleeding.") 
 
 BLEEDING WOUNDS. When a cut is received on fingers or 
 arms the wound should first be thoroughly cleaned with 
 water and peroxide of hydrogen or bichloride of mercury 
 solution (1-1000). Then pressure should be applied pref- 
 erably with sterile gauze and a firm bandage applied. If 
 the cut has been a severe one this may have to be followed 
 by attention from a physician to tie off the bleeding 
 points and perhaps sew up the wound. All wounds of 
 the face, when small ones, should be sewed up by a physi- 
 cian, otherwise the numerous muscles of that part of the 
 body will cause the wound to gape and leave an ugly 
 scar. 
 
 If the bleeding from a wound can not be controlled by 
 direct pressure a tourniquet should be applied with pres- 
 sure over the main artery of the extremity some place on 
 the heart side of the wound. 
 
 Blisters. A blister is a watery bleb of the skin. It may 
 be caused on the hands by rowing, or other exercise, and 
 on the feet by too much walking. A burn may cause a 
 blister, so may a bruise, or a scald, or an attack of ery- 
 sipelas. 
 
 For feet inclined to blister, bathe daily with a lotion 
 of alum and 10 per cent, chromic acid (poison), or smear 
 the inside of the socks with dry soap. For actual blisters, 
 prick them with a clean needle, let the fluid out, and put on 
 a piece of soap-plaster or other clean dressing. For small 
 blisters, leave them alone ; if inflamed, apply zinc ointment 
 or show them to the doctor. If the blister has not been 
 caused by any ordinary event, it may be a symptom of 
 a skin disease, and skilled advice must be obtained. 
 
 Blistering may be produced artificially by certain plasters, 
 or by blistering fluid, for the purpose of curing pain or 
 
30 BOILS 
 
 bringing down inflammation. A blister should never be 
 put on without medical advice. 
 
 Blood-Spitting. This means coughing up blood, and blood 
 can only be ' ' coughed ' ' up from the windpipe or the lungs. 
 Sometimes an aneurism (see "Aneurism") bursts into the 
 air passages, but in all other cases blood from the lungs 
 means lung disease more or less serious. The coughing up 
 of blood is accompanied by a tickling sensation in the 
 throat, and the patient goes on coughing up blood for 
 some little time; the blood is generally scarlet, and mixed 
 with air-bubbles. The commonest cause of blood-spitting 
 is tuberculous disease of the lung; then comes congestion 
 of the lung from chronic heart disease; then acute pneu- 
 monia and bronchitis ; then disease of the voice box ; then 
 an aneurism; and the most unusual cause is from con- 
 stitutional disorders, such as scurvy. 
 
 When a patient begins to spit blood in small quantity 
 put him to bed and give him pieces of ice to suck, or sips 
 of cold water. If he spits or coughs up a large quantity, 
 keep him lying down with his head on a low pillow, and 
 try to keep your own presence of mind, and cheer him up 
 until the doctor comes. It is all that you can do. 
 
 Blood-Vomiting. The first thing to find out is whether 
 the blood that is vomited comes from the stomach or not. 
 A man may bleed from his lung, or from the back of his 
 nose, and the blood may be swallowed and afterwards 
 vomited. So be sure to notice particularly all the charac- 
 ters of the blood and of the vomiting. Tell the doctor if the 
 blood is bright red, or dark red, if it comes into the hand- 
 kerchief when the nose is blown, and whether the gums 
 are sore or not. Blood is dark red and clotted if it comes 
 from the stomach, and light red and frothy if it comes 
 from the lungs. The more accurately you can describe 
 to the doctor all the details of vomiting, and its relation 
 to food and drink, the more accurate is his advice likely to 
 be, and the more speedily he will be able to begin the neces- 
 sary treatment. Until the doctor comes, keep the patient 
 in a lying-down position and let him suck small lumps of ice. 
 
 Boils. The appearance of boils usually indicates a "run 
 down" condition. Under these conditions the tendency to 
 the occurrence of boils is increased by excessive use of 
 tobacco and alcoholic drinks or constipation. They are 
 
BREAST, ABSCESS OF 31 
 
 exceedingly common in people suffering from diabetes. 
 
 A boil is an abscess of the skin a red, painful, in- 
 flamed lump, which when "ripe" is full of matter called 
 pus, and contains a "core," which is made of dead tissue, 
 and must be got rid of before the inflammation will heal. 
 
 A boil may sometimes be aborted by the following pro- 
 cedures: Take a cathartic (calomel followed by laxative 
 salts), scrub the inflamed area with soap and hot water, 
 pull out any hairs near the central area and apply gauze 
 soaked in bichloride of mercury (1-000 in 50% alcohol). 
 Stop smoking and drinking. Further aid may be ob- 
 tained by the inoculation of a vaccine (against suppuration) 
 by a physician. 
 
 If the boil comes to a head it must be opened by a 
 physician, cleaned out and drained. Afterward it may 
 be necessary to take sulphide of calcium (gr. 1/10) and a 
 tonic of iron and arsenic with a course of vaccine treat- 
 ment. 
 
 Brandy and Egg Mixture (EGG-NoGG). Mix together the 
 yolks of two eggs, half-an-ounce of refined sugar, two 
 ounces of good cognac and four ounces of cinnamon water. 
 
 Breast, Abscess of ("MILK- ABSCESS"). Causes. Ab- 
 scess of the breast rarely occurs except during suckling. 
 A cracked nipple is generally the path through which the 
 germs of inflammation get into the breast itself; and they 
 are able to set up inflammation there because the breast is 
 neglected and gets too full of milk, owing to the fact, that 
 the nipple being sore, the baby is put too much to the other 
 breast. This is very bad for the baby, who is drawing his 
 very life from the other breast. 
 
 Treatment. Whenever, because of cracked nipple, or 
 for any other reason, a baby does not make use of one 
 breast, it must be regularly emptied by a breast pump, 
 such as all druggists sell. If inflammation is beginning and 
 some part of the breast is getting hard and tender, let the 
 woman purge herself well, foment the breast every two or 
 three hours, and support the breast with bandages or a 
 sling passed round the neck and under the gland. But if 
 an abscess seems to be forming, let the doctor see it with- 
 out delay, for an early incision will often save weeks of 
 pain and illness and avoid the formation of a foul and 
 troublesome ulcer. 
 
32 BBOKEN BONES 
 
 Breath, Unpleasant or Foul. This may be the result of un- 
 healthiness of the stomach or of the mouth and teeth. The 
 breath of a person whose digestion is good, and who keeps 
 the teeth clean is quite free from anything objectionable. 
 It is useless to try and cure unpleasant breath with cachous 
 or scented lozenges, so long as the food is not masticated 
 properly ; or if too much alcohol is drunk, too much smoking 
 or snuff-taking is indulged in, and the teeth are not brushed 
 regularly every night at bedtime. (See the article on " In- 
 digestion" and " Teeth.") 
 
 BREATH, SHORTNESS OF. This may occur only after exer- 
 tion, such as climbing the stairs, or it may be always present. 
 Shortness of breath may be spasmodic (see "Asthma,") 
 or continuous, which would be a sign of heart disease or 
 advanced lung disease, or chronic bronchitis. Shortness of 
 breath on exertion in young girls is generally due to 
 ancemia (which see), or to heart disease caused by rheu- 
 matism. In older people, shortness of breath on exertion 
 is more likely to be due to a "fatty heart" (perhaps one 
 of the results of tippling), or to a weak flabby heart (after 
 Influenza), or to chronic bronchitis. In the last case, sul- 
 phuric ether taken internally in small doses will give re- 
 lief. 
 
 The reader will understand that there is no royal cure 
 for shortness of breath itself. We must first discover what 
 it is caused by, and treat that condition appropriately. 
 But there are very few cases of shortness of breath which 
 a doctor cannot greatly relieve. The shortness of breath 
 which occurs in young girls is very amenable to treatment 
 and such cases should never be neglected. 
 
 Bright's Disease. Acute Bright 's disease is an ailment 
 in which the kidneys are inflamed, the urine scanty, the 
 eyelids swollen, and albumin is passed in the water. It 
 must be treated by a doctor. (See "Kidney Disease.") 
 
 Broken Bones. If, after any injury, a bone is thought 
 to be broken, a doctor can not be seen too quickly. It is 
 much easier to replace broken bones soon after the accident 
 than later. When a bone is broken there is pain at the 
 site of the fracture with swelling, tenderness on pressure, 
 and inability to use the part. If only on-e bone of the 
 lower arm or leg is broken the other bone, acting as a splint, 
 may prevent complete loss of use. 
 
 After a simple fracture, a splint of a thin piece of board, 
 
BRONCHITIS 33 
 
 covered with cotton, should be applied and bound firmly 
 with a bandage. 
 
 If the broken end of the bone protrudes through the 
 skin (compound fracture) do not try to put it back in 
 place before the doctor arrives as it has been infected and 
 unusual precautions are required to prevent the forma- 
 tion of suppuration and an abscess. 
 
 Diagnosis of broken bones is nowadays practically al- 
 ways confirmed by the X-rays. 
 
 By this means also it can be determined whether the 
 broken ends have been replaced in the proper position. 
 
 If there is one form of illness for which Christian Science 
 is not fitted to treat it is broken bones. 
 
 Broken bones require from three to six weeks to heal, 
 depending upon the size of the bone and the age of the 
 subject. Some fractures in old people, as that of the neck 
 of the femur at the hip, heal only with the greatest diffi- 
 culty. 
 
 Voluntary motion of the muscles of a fractured part must 
 be begun as soon as possible, otherwise they rapidly shrink 
 from disuse and it may take a long time to recover the use 
 of the part. 
 
 Bronchitis. This means inflammation of the air tubes in 
 the lungs (see also ''Lung Diseases"). It is a catarrh of 
 the air tubes just as a cold in the head is a catarrh of the 
 nose and throat (see also "Cold in the Head"). It affects 
 persons of all ages, from infancy to old age. Its chief 
 symptom is a cough (see also "Coughs"). When the 
 disease is acute, the sufferer has much fever and general 
 illness, but the cough is the chief feature. At first it is 
 hard, and no phlegm is coughed up, but later it becomes 
 easier and the patient spits up a lot of yellowish thick 
 phlegm, sometimes tinged with blood. 
 
 Acute bronchitis may be fatal, and must be treated by 
 a doctor. Chronic bronchitis, in its various forms, such as 
 a "winter cough," is more or less easy to relieve, but very 
 difficult, and often impossible, to cure. The patient ought 
 to live in a dry climate, or failing that, a warm one. He 
 must dress warmly and keep his skin active with frequent 
 baths, and his bowels always well open. There are three 
 different types (among others) of persons with chronic 
 bronchitis. 
 
 (1) One type has a dry catarrh, a painful difficult 
 
34 BUBO 
 
 cough and thick, sticky phlegm, which is very hard to get 
 rid of. For such a case as this we recommend: Sodium 
 iodide, one drachm; sodium bi-carbonate, four drachms; 
 chloride of ammonium, two drachms; solution of mor- 
 phine, one drachm; chloroform water, eight ounces. Take 
 a teaspoonful three times a day. 
 
 (2) A second type is one in whom there is a lot of 
 coughing, not painful, but noisy, and plenty of watery 
 phlegm. Such persons would be benefited by: Tar water 
 (1 in 10), a wineglassful of half-a-pint, twice or three times 
 a day. Sulphur lozenges and Cod-liver oil are also useful 
 in such cases. 
 
 (3) The third type is the bronchitic aged person old 
 and feeble, and wheezy. A good remedy consists of syrup 
 of tolu, half ounce; ammoniacal mixture 2 ounces; com- 
 pound tincture of camphor 3 drachms; and water up to 6 
 ounces. A tablespoonful may be given thrice daily, or 
 every four hours. Petroleum Emulsion is also an excellent 
 remedy given after meals. 
 
 It must always be borne in mind that a long continued 
 cough which is difficult to cure is one of the first signs of 
 tuberculosis or consumption. Therefore, if a cough has 
 been impossible to cure after three or four weeks, a physi- 
 cian should be consulted to make sure that tuberculosis is 
 not developing. The greatest hope for cures in consump- 
 tives lies with those who recognize their condition the earli- 
 est. 
 
 Prevention. Much can now be done to prevent the oc- 
 currence of bronchitis and colds and consequently tubercu- 
 losis in the following way : 
 
 Avoid the inhalation of dust. Keep up the resistance 
 of the body to germ invasion by cold morning baths, out 
 of door exercise, nutritious diet without excess of alcohol 
 and tobacco and avoidance of undue fatigue. 
 
 Bruises. If a bruise is accompanied by breaking of the 
 skin it should be cleaned with peroxide of hydrogen and 
 dressed aseptically until the skin has healed. 
 
 If the skin is not broken it may be rubbed with any 
 healing, soothing lotion such as belladonna liniment the 
 most efficacious thing being the massage which removes 
 the extravasated blood and lymph and thus diminishes the 
 swelling and consequent pain. 
 
 Bubo. (See "Glands.") A bubo is a swollen gland. 
 
BURNS 35 
 
 The word is generally applied to the glands in the groin, 
 swollen as a complication of venereal disease. The treat- 
 ment is surgical, and requires skill and a careful use of dis- 
 infectants. 
 
 Bunion. This is the inflammatory swelling which takes 
 place on the ball of the great toe of a person who wears 
 ill-shaped boots. Good boots are straight on the inner 
 edge and not cut to a point. The remedy lies in buying 
 better-made boots. A bad bunion may require a little op- 
 eration called ' ' excision of the joint. ' ' 
 
 Burns. It is quite evident that burns of the body may 
 be of every possible variety as regards extent and depth, 
 If a hot cinder falls on one '& flesh it may burn a deep hole ; 
 if one's clothes catch fire, there may result a very exten- 
 sive burning of the skin only, and the fat and muscles be- 
 neath may not be damaged. There is always a certain 
 amount of " shock" to the nervous system after a burn, 
 and the greater the surface burned the greater will be the 
 shock. A hot coal burning a hole in the flesh will not 
 shock the patient so greatly as a surface burn of any part 
 of the body. 
 
 In the case of a small burn, we have only to think about 
 the burn, and how to get it well. We shall consider this 
 first. There are two things necessary to know: First, 
 how to keep the burned part clean and free from germs of 
 disease, which are generally floating about in the air, and 
 are on the hands and clothes of everybody in cities and 
 towns; and, second, how to relieve the dreadful pain and 
 smarting, and to keep the raw place free from all mechan- 
 ical irritation. 
 
 First, then, remember, that flesh or skin which has just 
 been burned is already probably quite free from " germs," 
 or, as doctors say, ''aseptic," because fire is the destroyer 
 of disease germs. So that it is our duty to see that noth- 
 ing that can possibly be contaminated goes anywhere near 
 the burn. Rags, oil, flour, etc., are all very well, but they 
 may not be "clean" in a medicinal sense. Every house- 
 hold ought to have a little packet of pure boric acid powder 
 in the cupboard, and this should be dusted over the burn. 
 Blisters should be pricked with a darning needle, whose 
 point has been held in a flame for half a minute, and the 
 fluid allowed to trickle away or mopped up with medi- 
 cated cotton-wool. Then over the powdered place you may 
 
36 BUST DEVELOPMENT 
 
 put a layer of medicated cotton-wool or a piece of boric 
 lint. In any case, if you are going to treat the burn your- 
 self, wash your hands and brush the nails with 5 per cent, 
 carbolic soap before you begin. Then, even if the burn 
 does not heal properly and there is a lot of scarring, you 
 feel that you have done your best. With regard to scar- 
 ring, do not forget that a burn on the face or hands, or 
 neck, may result in contraction of the skin, which may 
 disfigure the patient and spoil his looks for life. 
 
 For anything but a trivial burn, a doctor must be called 
 in. No one else can apply really suitable treatment in any 
 given case, especially if medicines are required in addition. 
 Some like oily applications for burns, and use carron oil, 
 composed of equal parts of linseed oil and lime water. 
 
 The alkali which the carron oil contains neutralizes the 
 acid from the burn and thus prevents the pain which re- 
 sults when acid is applied to exposed nerves. 
 
 Some physicians, instead of using oil, prefer to expose 
 burns to the air, neutralizing the acid with a solution of 
 sodium bicarbonate. This is undoubtedly preferable for 
 large surface burns where the oxidizing function of the 
 skin must be aided not interfered with. 
 
 Bust Development. Doctors are constantly being asked 
 by their lady patients for some unobjectionable method of 
 developing their figures. That being so, and seeing that 
 there are numbers of expensive preparations advertised 
 for this purpose on the market, we give our readers a few 
 hints. Undeveloped figures are generally a sign of poor 
 nourishment, and the first thing to do is to eat only the 
 most nourishing food and attend to the digestion and the 
 state of the teeth. Eat porridge, plenty of bread and 
 cheese, and eggs, and milk, and puddings, and avoid pic- 
 kles and nuts, and too much meat. Breathing exercises are 
 of the first importance. Every morning, before breakfast, 
 throw open the window, have no tight bands or belts, or 
 braces on, stand erect with heels together and shoulders 
 thrown back, and fill the lungs with fresh air, slowly, to 
 their utmost extent. When full of air, hold it in as long as 
 you can, and then breathe it slowly out again. At first it 
 will tire you, but persevere. Do it fifteen times, then lie 
 down quite still and rest; then fifteen times again, then 
 continue dressing. After three weeks your lung capacity 
 will be much improved and then you may begin to fatten 
 
CANCER 37 
 
 and nourish the skin of the neck, shoulder and breasts. 
 This is done by rubbing in the following preparation for 
 five minutes night and morning; rub gently and firmly, 
 and in a circular direction, with the palm of the hand: 
 Elderflower water, half-a-pint; simple tincture of benzoin, 
 half-an-ounce ; tincture of myrrh, a few drops ; mix well and 
 add best linseed oil, half-a-pint. 
 
 The intelligent reader will understand that all such 
 methods as the above are, though often highly satisfactory, 
 of much less real value than courses of suitable gymnastics 
 would be. It is better to be in good muscular condition on 
 the chest and elsewhere, than to be merely fat, because fat- 
 ness varies with the time of the year and state of the 
 health; and a woman with suitably-developed muscles sel- 
 dom lacks a comely natural covering of fat and a healthy 
 and rosy skin in addition. 
 
 Cancer. It seems to be a fact that there is an ever in- 
 creasing mortality from cancer in every part of the civi- 
 lized world. The word "cancer" is used in a very vague 
 way, almost as if it could be considered interchangeable or 
 synonymous with "tumor." Every cancer is a tumor, 
 but very few tumors are cancers. " Tumor" means a 
 swelling, and nothing more than that. There are at few- 
 est ten different kinds of cancer, and they vary in course, 
 in origin, and in causation. One of the commonest kinds 
 of cancer, especially in males, is Epithelioma, which is al- 
 ways caused by mechanical friction of a part in a predis- 
 posed person, and is nearly always preceded by an ulcer 
 of that part, caused very often by excess of alcohol or to- 
 bacco. Scirrhous cancer is the form which women gener- 
 ally have, and most often in the breast, as the indirect 
 result of a blow or anything else which may hinder the 
 proper performance of the functions of that organ. Only 
 10 or 11 per cent, of women affected can really trace the 
 tumor from a blow, or some other mechanical violence. 
 And then there is a group of fatal tumors called cancers 
 by the public, but which are called Sarcomas by the doc- 
 tors. Sarcomas are different from cancers in some im- 
 portant ways, but resemble cancers in that, if not removed 
 in time, they will kill the patient. A malignant growth, 
 whether Epithelioma, Carcinoma, Scirrhous, Sarcoma, or 
 any other kind, kills the patient by exhausting his strength, 
 and the only treatment is to have it removed by operation, 
 
38 CARBUNCLE 
 
 or burnt away by strong caustics. Even then it may come 
 back again in another place, and if the other place is one 
 which we cannot get at by the knife, of course we cannot re- 
 move the tumor, and the patient must die. It is now believed 
 that cancer cells, in small collections, exist in many people 
 from birth; and that the tendency for them to grow into 
 tumors is hereditary. Not everybody who has a few can- 
 cer cells in his body has cancer, however a tumor may 
 never develop. As to the real immediate causes of cancer 
 we know almost nothing. In a predisposed person, long- 
 continued mechanical friction, or any other kind of me- 
 chanical injury will, perhaps, make a cancer form; and 
 any old lump, or tumor, or sore, may become cancerous, if 
 it is irritated long enough. If there is cancer in your 
 family, you should guard against neglecting bruises, blows, 
 sores, or inflammations of every kind; and you should, to 
 be quite on the safe side, drink no alcohol and sn.oke no 
 tobacco. It cannot be shown conclusively that cancer has 
 anything to do with food, soil, or climate. 
 
 Prevention: A large proportion of the deaths by can- 
 cer could be avoided if the cancerous condition were rec- 
 ognized early enough and removed soon enough. There- 
 fore the moment a suspicious lump is observed in the 
 breast, a sore on the lip which will not heal, indigestion 
 which will not improve, or if there are evidences of blood 
 from the uterus which cannot be explained by normal 
 processes lose no time in seeking medical advice to get a 
 diagnosis. 
 
 Pain is one of the most common symptoms in cancer, 
 but do not rely on this symptom alone in making a diogno- 
 sis of cancer for it is sometimes absent. 
 
 Do not try to temporize with X-ray and blue light cures. 
 
 You may be losing invaluable time. See a doctor as soon 
 as possible. 
 
 Carbuncle. This is a large boil, affecting several glands 
 in a group. (See also " Glands. ") The inflammation is 
 more severe, the pain is greater, and there is more general 
 illness than with ordinary boils. The seat of the trouble 
 the skin of the affected part is raised, firm, bright, red 
 and hot. In most cases the inflammation does not im- 
 prove but gets worse for about ten days, and becomes a 
 brawny red painful swelling, on the back of the neck, or 
 elsewhere. Then it softens, becomes dotted with " heads" 
 
CATHETER 39 
 
 or yellow points, and at each point the skin gives way and 
 yellow blood-stained pus comes out. The carbuncle may 
 even then continue to get larger. The skin between the 
 holes dies and sloughs, so that there is a "core," and a 
 ragged foul ulcer. The nearest glands are swollen and 
 tender also, and the patient has shivering, aching, fever, 
 and general illness. Death may occur from blood poison- 
 ing. 
 
 It occurs sometimes in persons of robust health, because 
 it is due to poisoning by germs, but weakly people are more 
 liable to be attacked. Many cases end in death from ex- 
 haustion, especially if they have diabetes as well. 
 
 The treatment of a small carbuncle is the same as for a 
 boil. (See "Boils.") Paint the surface of the skin with 
 glycerin of belladonna, and apply hot compresses. The 
 surgeon must be called in, and he will make a cross-shaped 
 opening with his knife, and let out as much of the poison 
 as possible. The cavity will have to be scraped and mopped 
 out with strong germicides. 
 
 But besides the local treatment, the patient himself it 
 is generally a man will require treatment. He must have, 
 if he is to recover, a liberal diet, and a strong tonic, suited 
 to his age and state of health. Until after the slough has 
 been cleared out, he ought to avoid stimulants, but port 
 wine or champagne may be required in the after-treatment. 
 Afterwards a change of air and a rest are most neces- 
 sary. 
 
 Cataract. (See "Eye Diseases.") If you read the first 
 paragraph on eye diseases you will know what the lens is. 
 A cataract is an opaque spot on the lens of the eye. It is 
 commonest in persons over fifty as one of the forms of the 
 decay of age. Cataracts in young persons are generally 
 the result of injuries to the eye. 
 
 Many cataracts can be removed by skillful eye surgeons, 
 with restoration of sight. 
 
 Catarrh. (See "Cold in the Head.") 
 Catheter. A catheter is a tube for passing into the blad- 
 der to draw off the urine. No one but a doctor can use 
 the instrument properly, but sometimes patients have to 
 be taught to pass it on themselves, because they are unable 
 to pass their water in the natural way. We give here full 
 medical directions as to how to treat a catheter, which has 
 to be used daily by the patient himself. We may remark 
 
40 CHANCRE 
 
 that a few persons regularly use a catheter without taking 
 any precautions whatever, but sooner or later such behavior 
 is always disastrous. An unclean catheter takes germs 
 from the outside air into the bladder, and sets up inflam- 
 mation there, which may be fatal. 
 
 A man who has to use a catheter regularly should use a 
 red rubber one generally, and a gum-elastic one only when 
 absolutely necessary. The smallest roughness or fraying of 
 the catheter should cause it to be discarded. Have a bottle 
 of a pint of 1 in 2,000 corrosive sublimate lotion ; it is quite 
 cheap and the drug is sold in tabloid form. Wash the 
 hands with carbolic soap before handling the catheter, and 
 the privates also, whenever practicable, before pushing the 
 catheter into the bladder. Let the catheter lie in the lotion 
 for five minutes before use, and then lubricate it with 1 in 
 40 carbolic oil. It is a good plan to squirt some lotion 
 through the catheter (with a glass syringe kept for the pur- 
 pose) before introducing it. 
 
 After use, the catheter ought to be washed with soap and 
 water, and lotion run through it. Then roll it in a piece 
 of boric lint and keep it in clean paper until wanted again. 
 If these precautions are taken, a man may go on using the 
 catheter daily for years without risk. If such precautions 
 are neglected, the patient may at any time contract a ca- 
 tarrh of the bladder or something even more serious. 
 
 Chancre. This word means a sore, caused by the poison 
 of a venereal disease. There are two types of chancre, the 
 soft and the hard. The soft sore is a local disease, it de- 
 velops from a pimple which appears within a few hours 
 and gets well, if properly treated, in a few weeks. But 
 the glands in the groin may enlarge and become an abscess 
 called a bubo. This disease is curable, and no ill-effects 
 are transmitted to the children. But it is intensely con- 
 tagious. The hard sore, on the other hand, is nothing more 
 nor less than the first stage of the dreadful disease called 
 syphilis (which see). This sore develops in from two to 
 three weeks. The disease lasts for two years at least, and 
 can be transmitted to the innocent children of marriage, 
 as well as to the wife. 
 
 Upon the development of such a chancre the man or 
 woman must immediately place him- or herself under 
 good medical advice. They not only owe it to themselves 
 to get well, but it should be their greatest concern that they 
 
CHANGE OF AIR 41 
 
 do not further spread the disease. This might be done by 
 direct contact of the parts or later, through other disease 
 conditions in the mouth, through common drinking cups 
 and eating utensils. 
 
 The best way to avoid the inconvenience and agony of 
 this disease is by not contracting it; and the best way to 
 avoid contracting it is by leading a clean moral life. 
 
 To try to treat a disease like chancre or syphilis by 
 Christian Science is one of the greatest crimes of modern 
 times. 
 
 Change of Air. Nowadays we all say we want a change 
 of air and a holiday occasionally, but our grandfathers 
 tell us that they did not want, and did not get, trips to the 
 seaside, nor holidays from Saturday to Monday, nor any 
 long autumn vacation, but they kept on at the same work 
 year after year. What is the reason for this change? 
 Are we less vigorous than our forefathers? Or do we 
 work harder and have more worries than they did? 
 There are reformers who tell us that we are a degenerate 
 race, and there seems much evidence in favor of that view ; 
 and there is an easy explanation offered for our accept- 
 ance. Modern improvements in medicine and surgery have 
 saved thousands of invalid lives during the last fifty years, 
 and these thousands of unhealthy persons have had fam- 
 ilies, and their children are more or less tainted by hered- 
 ity of scrofula, tubercle, or some other form of blood- 
 poisoning. Whatever may be the cause, we moderns do 
 really need rest and change very frequently, and it is wise 
 to consider how to get the best effect out of our oppor- 
 tunities. It is quite certain that persons of ample means 
 who can go away for a month to a health resort or to a 
 seaside village, or who can go for a sea voyage under com- 
 fortable circumstances, will derive great benefit there- 
 from. It is, however, quite a different matter for the poor 
 worker, who has to stint himself in his ordinary mode of 
 life in order to get away from his home at all. Most of us 
 love pleasure and change for their own sake, and we are 
 apt to take them without much concern as to whether we 
 shall really benefit in health. The average man is very 
 apt to overdo his pleasures when he gets out of harness, 
 and may certainly drink too much when on a holiday. Our 
 railways offer us very tempting short excursions, but we 
 are apt to find ourselves tired and exhausted after a long 
 
42 CHANGE OF AIR 
 
 railway journey in a crowded railway train. Persons who 
 do not travel often in trains frequently catch severe colds 
 when the weather is unfavorable ; and the seaside lodgings 
 to which the middle class and poor traveler have to go are 
 often small, poky, dirty, and badly ventilated, and land- 
 ladies frequently prepare meals less carefully than the 
 housewife does for her family at home. The unfortunate 
 result is that a holiday away from home does not always do 
 all the good that is expected of it. 
 
 Change of Air as a Remedy. Apart from drugs, there is 
 no remedy of greater service to the invalid, the convales- 
 cent, and delicate person, than change of air. Change of 
 scene and occupation are also valuable in the treatment of 
 many minor ailments. For almost all complaints a change 
 to the seaside is likely to produce improvement, if adopted 
 after the disappearance of all acute symptoms. Sea air is 
 more full of ozone, and is slightly saline, and is notable 
 for improving the appetite and for giving tone to the 
 nervous system. To the town dweller, and especially to 
 those who have to work long days in factories and close 
 rooms, the fresh sea air is life-giving; and even a few 
 hours of life on the seacoast blows all impure air out of 
 the lungs, and so does much to purify the blood. The 
 pure air of the countryside inland, far from towns and 
 factories, is often of almost equal value as a tonic remedy 
 to one who is recovering from an exhausting illness. 
 There are also thousands of persons who are of a scrofulous 
 or tuberculous constitution, and children with rickets, 
 who are hardly able to survive in towns. These will often 
 grow up stronger, and even hardy, if removed to country 
 villages or to the seaside. Country-born and bred persons 
 are always superior in vitality to town dwellers, and this 
 is one reason why it is such a national misfortune that the 
 present-day tendency is for the young to desert country 
 life and open-air occupations in favor of the town employ- 
 ments, which are never so healthy or free from risk. 
 Town dwellers, accustomed to narrow streets and courts, 
 often have a notion that they would be more liable to ill- 
 nesses from catching cold; but this is a mistaken idea, for 
 open-air life for a month renders persons much less liable 
 to catch chills than they ever were before. The winds 
 from open fields are much less dangerous than the draughts 
 of air met with at street corners in towns. Persons who 
 
CHANGE OF LIFE 43 
 
 in London catch a cold if they, for an exception, ride out- 
 side an omnibus, will not be made ill by a long ride on 
 a coach among the Welsh or Scotch hills, because the air 
 is purer and freer from germs. Delicate children should 
 always be sent away from town for a long visit to country 
 relatives, whenever it is possible, and quick recoveries will 
 often be found to occur after whooping cough, diphtheria, 
 enlarged glands and rickets, if treated by a three to six 
 months' country residence. 
 
 Change of Life. (MENOPAUSE, CLIMACTERIC, THE 
 CHANGE.) This is the time of life in a woman when she 
 ceases to menstruate (see "Menstruation"), and, as a rule, 
 becomes incapable of bearing children. This change oc- 
 curs between the ages of 45 and 50, and sometimes comes 
 on abruptly and suddenly, but in other women it is more 
 gradual and sometimes accompanied by great loss of 
 blood. 
 
 This change of life is a very critical period in the life 
 of every woman. Every part of her seems to share in the 
 general disturbance. Her bodily organs are all more likely 
 than ever to become disordered, and hardly any woman 
 escapes some ill-health at this time. Headaches, flushings, 
 giddiness, and loss of blood are common. Great irritabil- 
 ity of temper, over-sensitiveness, fancifulness, wrong- 
 headed suspiciousness, unseemly behavior and coarse con- 
 versation, all these are characteristic of even the most ami- 
 able and respected women at their change of life. 
 
 If any germs of disease exist in a woman, they will often 
 develop at a fearful rate at "the change," and women 
 ought not to neglect to take medical advice at that time. 
 It is impossible to map out any line of treatment for a con- 
 dition which varies so greatly in different women, but it is 
 always a safe rule to keep the bowels and skin acting very 
 freely and to avoid excitement and late hours, and especially 
 to avoid alcoholic drinks. 
 
 It should be borne in mind by all husbands, and, in fact, 
 by all adults, that a woman, heretofore reasonable, amiable, 
 lovable, and just, may, at the change of life, become tem- 
 porarily ill-tempered, unreasonable, wildly and absurdly 
 jealous, and unjust; these things are to some extent beyond 
 her control, and she must be treated with the patience and 
 forbearance which are shown to invalids and children. A 
 "sweet reasonableness" must not be expected of her, 
 
44 CHEST, DEFORMITIES OF 
 
 though she is unable, in many cases, to see that there is 
 anything unusual in herself. 
 
 Chest, Deformities of. A healthy chest is well-rounded 
 in every way; it is covered with a fair layer of skin fat 
 and no bony points project; the shoulder blades lie against 
 the back of it and are covered with firm muscle. The 
 grooves between the ribs can hardly be seen. In section 
 such a chest is oval, slightly flattened behind. Such is the 
 healthy chest containing healthy lungs and a strong heart. 
 If the chest has a shape different to that, it may, perhaps, 
 still contain healthy lungs, but those lungs are very liable 
 to disease. The different kinds of deformed chests are 
 these : 
 
 Flat Chest. This is either due to undevelopment or to 
 lung disease. The chest is flat instead of rounded, the 
 ribs are too straight and there is not much room inside for 
 the lungs to expand. Such a chest may be greatly im- 
 proved by the regular use of a "developer." 
 
 Pigeon-breast. The cross-section of such a chest is tri- 
 angular, the breast bone forming a sort of keel in front, 
 as it does in the breast of a pigeon. The ribs are flattened 
 to the sides. The cause of this deformity is some obstruc- 
 tion to breathing in infancy, so that the lungs have not 
 been properly filled with air. Such obstruction may be 
 adenoids or enlarged tonsils. (See "Adenoids.") 
 
 Bulging of one side of the Chest is caused by lateral 
 curvature or twisting of the spine on its axis. 
 
 Rickety Chest. This is very characteristic, and is one of 
 the effects of rickets in childhood. The ribs are too soft 
 while the lungs are developing, and so they yield at the 
 weakest parts and form two grooves down each side of the 
 body; and there is a row of knobs down each side of the 
 breastbone where the ribs join it, knobs which are caused 
 by rickety enlargements of the ends of the bones. The 
 lower part of the chest is apt to bulge from lying over the 
 liver. Such a chest, though ugly and misshapen, is not es- 
 pecially prone to disease. 
 
 Barrel Chest (see "Strong, How to Become.") This 
 deformity consists of an undue roundness of the chest, the 
 result of blown-out and inelastic lungs. The chest is too 
 short, the ribs too horizontal, and the shoulders raised. 
 
 Long Chest. This is the opposite of barrel-shaped. The 
 ribs slope down, the neck is long, the throat prominent, 
 
CHILBLAINS 45 
 
 and the shoulder blades stand out behind like wings. The 
 lungs inside such a chest never are, and never have been 
 properly expanded, and are very prone to become tuber- 
 culous "consumptive." The deformity is curable by the 
 correct use of a "developer." 
 
 Chicken-pox. The medical name is Varicella. It is quite 
 distinct from smallpox, which, however, it resembles some- 
 what. Chicken-pox develops about a fortnight after ex- 
 posure to infection. It is not very contagious. There is a 
 rash which comes out on the first day of illness, in succes- 
 sive crops of small pimples, on the chest, mostly, but also 
 on the face. There may be a little fever. Death almost 
 never results from chicken-pox. 
 
 The rash is characteristic; it consists of pink pimples, 
 which become blebs containing watery fluid in about twelve 
 hours. In a few hours more the fluid becomes milky in 
 appearance and then the spots begin to dry up, and the 
 pink ring round them gradually fades. A few of the pocks 
 leave small whitish scars. 
 
 Treatment. Light diet, isolation, and attention to the 
 bowels are all that are necessary. The child must be pre- 
 vented from scratching the spots. The itching may be re- 
 lieved with a weak lotion of camphor water and carbolic 
 acid, which any good druggist will supply. 
 
 Chilblains. Nearly everyone is familiar with the ap- 
 pearance of chilblains, and a very large number of people 
 whose circulation is weak suffer from them every winter. 
 The skin affected with a chilblain is tender, and itches 
 abominably as soon as it gets warm. As the inflammation 
 goes down there is generally some shedding of the skin. 
 In underfed and scrofulous children the skin of a chil- 
 blain sometimes breaks into a painful ulcer or sore, which 
 is very difficult to heal. A further stage in the same 
 process is frostbite, in which the part gets at last swollen 
 and almost violet in color and little blebs form. 
 
 We must not forget that though chilblain is a local dis- 
 order, it is due to bad circulation of the blood, and this is 
 often accompanied by poorness of the blood, which is what 
 doctors call anaemia ; so that it may be necessary to get the 
 doctor to prescribe tonics and blood-forming foods, par- 
 ticularly cod oil and malt, as well as to treat the chilblain 
 locally. 
 
 The chief thing is to stimulate the circulation of the 
 
46 CHOKING 
 
 blood in the affected parts. For this purpose the parts 
 must be kept warm. If the hands are affected, mittens or 
 knitted woolen gloves must be worn continually, and, un- 
 less the feet are disabled by pain and swelling, plenty of 
 walking must be done, and the feet and legs must be kept 
 warm with woolen worsted stockings. After washing it is 
 important to dry the parts as thoroughly as possible and 
 to rub the chilblain with a rough towel. Friction is al- 
 ways useful if it can be borne. For painting on the chil- 
 blain there are three useful remedies tincture of iodine, 
 spirits of camphor and friar's balsam all homely med- 
 icines. 
 
 If the skin breaks the ulcer must be treated as any 
 other ulcer, but it is better to let a doctor treat it, because 
 chilblain ulcers do not heal at all easily. 
 
 If the chilblain ever becomes a real frostbite, the only 
 way is to rub it with snow until the circulation is restored. 
 If you warm it rapidly at a fire you may lose a finger or 
 nose from mortification. And all persons who are subject 
 to chilblains are likely to be benefited by taking ichthyol as 
 a medicine. (See also "Skin Diseases" II.) 
 
 Child Crowing. The other common name for this is spas- 
 modic croup ; the medical name is Laryngismus. The 
 symptoms of the ailment are twitching of hands and face 
 (which may occur even during sleep), and a sudden great 
 difficulty of breathing, so that the child gets terrified and 
 runs to its mother. The spasm ends as suddenly as it be- 
 gan, with a loud crowing noise. Sometimes children die 
 in the attack without having uttered a sound, though this 
 is rare. 
 
 Treatment. It is especially rickety children, and those 
 with worms, who get these spasmodic attacks. The doctor 
 ought to be asked for advice as soon as the first one occurs. 
 If a bad attack comes on, put the child into a warm bath, 
 or if none is ready, dash cold water on its face and head, 
 and tickle the back of the throat with a finger, to make it 
 sick. Further treatment must be by medicine ordered by 
 the doctor. (See also "Croup.") 
 
 Choking. This may be caused by something which ob- 
 structs the air passages, a piece of food, a * ' plate ' ' of false 
 teeth, a marble, or a toy; or by a sudden swelling of the 
 passages themselves, as happens after swallowing certain 
 poisons, in diphtheria, and occasionally in chronic Bright 's 
 
CHOLERA 47 
 
 disease. Or the throat muscles may be paralyzed and 
 lumps of food may get into the windpipe instead of slip- 
 ping easily down the gullet. 
 
 Everyone recognizes choking, there is no need to describe 
 it. If a child chokes, and coughs vigorously, let him alone, 
 but put a cup of water or tea in his reach, so that when he 
 is ready he can wash the lump down. If the coughing is 
 feeble and the face is getting dusky, slap him on the back, 
 giving him a slap in time with each effort of coughing. 
 Do not get excited, however. But if he really seems to be 
 suffocating (and this takes a little time to happen), force 
 his teeth open, hold them open with the knife handle, and 
 sweep the finger along the back of the mouth from side to 
 side. If the child is very small, turning it upside down 
 and holding it up by the feet is very good practice. 
 
 If suffocation seems to have taken place already and the 
 child is livid and seems dead if the doctor has not yet ar- 
 rived the child's only chance is to open the windpipe 
 and let the air in through a hole. Take a sharp-pointed 
 penknife, or one blade of a pair of scissors, feel for 
 ''Adam's apple" in the throat, and then push the knife in 
 just below it, and keeping exactly in the middle line, and 
 having opened the windpipe enlarge the wound downwards 
 a little. Air will rush into the windpipe and lungs, if you 
 have been quick enough, and you have saved his life. You 
 may need to hold open the windpipe wound with the scis- 
 sors blades. But more likely the obstructing lump of food 
 will be coughed up then and all will be well. 
 
 In cases of choking, where the throat is swollen, the same 
 opening of the windpipe may be necessary. A person who 
 swallows boiling tea or soup by mistake may get an in- 
 tensely swollen throat and may choke. Nothing can be 
 done without a doctor's advice. 
 
 Cholera. This term is used to describe three entirely 
 different conditions, namely, cholera infantum, cholera 
 morbus and Asiatic cholera. The last is the epidemic form. 
 
 Cholera infantum. Is an acute disease of childhood 
 characterized by high fever, vomiting, purging and col- 
 lapse, caused largely by hot weather, faulty feeding, denti- 
 tion and bad hygiene. 
 
 This is a very serious condition and calls for prompt 
 treatment, preferably by a physician. 
 
 Treatment consists of fresh air, coolness, laudanum in 
 
48 CLEANING 
 
 very small doses to arrest diarrhea, brandy to counteract 
 collapse, with bowel irrigations. 
 
 Barley water and beef juice are relied on for nourish- 
 ment as soon as the stomach can retain food. 
 
 Prevention. During the hot summer months give the 
 child only breast or pasteurized milk and meats and fruits 
 of undoubted freshness. 
 
 Cholera Mor~bus. An acute disease resembling true chol- 
 era but rarely ending fatally, usually caused by eating 
 partially decayed meat or fruit. 
 
 It is characterized by intense cramps in the stomach, 
 vomiting, purging, fever and great prostration. 
 
 Give a dose of castor oil if it can be retained, brandy for 
 the prostration, morphine by hypodermic injection, hot ap- 
 plications to the abdomen and ice for the thirst. 
 
 Asiatic Cholera. True Asiatic cholera, which is always 
 more or less prevalent in India, China and Arabia, has 
 lately reached our thresholds. Prevention is the most im- 
 portant measure for us to observe. Preventive measures 
 consist in having efficient quarantine officers, with quaran- 
 tine of suspicious cases. As cholera is a water-borne dis- 
 ease freedom from contracting it is usually assured by 
 using only boiled and filtered water and eating no uncooked 
 food. Discharges from suspicious cases should be disin- 
 fected. 
 
 An attack of cholera is marked by the sudden onset of 
 pain and spasms in the bowels, vomiting and diarrhea of 
 thin rice-water-looking stools followed by great collapse 
 and death in 50 per cent, of the cases. 
 
 In any suspicious case a physician should be called at the 
 earliest possible moment. 
 
 Circumcision. This means the removal of the foreskin 
 of the male. The little operation is performed on every 
 Jewish and Mohammedan male child as a religious rite. 
 It certainly promotes local cleanliness and lessens the risk 
 of local disease. Every qualified medical practitioner is 
 competent to perform circumcision. The parts will be 
 healed in about a week, but will take longer in the case of 
 an adult. The operation is often performed to cure bed- 
 wetting. 
 
 Cleaning. A large number of the infectious or germ dis- 
 eases are contracted by inhaling the germs in the dust. It 
 
CLEANING 49 
 
 is of the greatest importance therefore that in homes, and 
 places where people gather in large numbers this source 
 of disease should be reduced to the smallest possible pro- 
 portions. 
 
 As the weekly body bath of our ancestors has given way 
 to the daily bath of our time, so has the dreaded cataclasm 
 known as ''spring house cleaning" given way to our daily 
 or weekly cleaning. This has been rendered possible 
 largely by the use of the modern vacuum cleaner, by the 
 use of which carpets, floors, mattresses, furniture and cur- 
 tains can be thoroughly cleaned without removing them 
 from their regular positions. 
 
 Almost worse than no cleaning or dusting is the use of 
 the feather duster, which simply stirs up the dust, making 
 it easier to inhale, and never doing more than moving it 
 from one place to another. If the vacuum method of 
 cleaning is not available, the feather duster may be re- 
 placed by moist cloths, or moist saw dust on the floors, 
 which will prevent 'dust from flying about during the 
 process of sweeping. 
 
 Rooms containing the least number of dust-catchers are 
 the most sanitary and healthiest, and hard wood floors 
 with rugs are preferable to carpets. 
 
 In cleaning parquet flooring care should be taken to 
 clean the floor first with "paille de fer" which can be 
 bought for a few cents. This can be rubbed on the floor 
 with the foot to take out all grease and other stains before 
 applying floor wax. Butchers floor wax polish is the most 
 satisfactory as it leaves no oil. 
 
 In cleaning furniture or any wood with polished surface, 
 the best article is that known as "The Japanese Furniture 
 Polish." 
 
 White painted surfaces, if soiled or greasy, should be 
 wiped over lightly with a cloth dampened with turpentine 
 and wiped with the grain of the wood. 
 
 For the floors of public buildings the use of such sub- 
 stances as Standard Floor Dressing is recommended to 
 allay dust and promote cleanliness. 
 
 For ordinary flooring no better initial form of cleaning 
 has ever been devised than the occasional old-fashioned 
 scrubbing with soap, water and scrubbing brush with use 
 of a mop, provided that these articles are subsequently 
 
50 CLIMATE FOR INVALIDS 
 
 properly disposed of or cleaned, so that the germs they have 
 collected cannot again become free and escape into the air. 
 
 Climate for Invalids. There is no model or perfect 
 climate in the world; none which will suit every kind of 
 invalid. The dry ones have wind and dust; the moist, 
 warm ones have malaria, and are relaxing; the cold, dry 
 ones are not thus all the year round. If you want luxuri- 
 ant vegetation and scenic beauty of that kind, then you 
 find that the climate must be hot and damp, a very bad 
 climate for nearly all consumptives. Sea air is excellent 
 for many people, but does some asthmatic people much 
 harm, and neuralgic people are very liable to be in pain at 
 the seaside. 
 
 People with shattered constitutions ought to avoid warm, 
 relaxing climates like the Florida Coast Resorts and choose 
 places like Redlands and Riverside ( Cal. ) , Aiken, Asheville, 
 Virginia Hot Springs, Lakewood, St. Lawrence River, 
 Bermuda or the Hawaiian Islands. 
 
 Nervous, excitable people should avoid such climates as 
 those of Colorado, Idaho, and Wyoming. 
 
 A choice of climates for a few of the common diseases 
 follows : 
 
 Pulmonary Tuberculosis. Arizona, New Mexico, Sierra 
 Madre (Cal.), Colorado Springs, Adirondacks, Asheville, 
 San Moritz (Switzerland). 
 
 Nervous, Excitable People. Bermuda, Jamaica, Cuba, 
 Florida Coast Resorts, Hawaii, Southern California, Ashe- 
 ville, Aiken, Old Point Comfort, Atlantic City, Lakewood. 
 
 Neurasthenia. Yellowstone, Yosemite, Grand Canyon of 
 the Colorado, Niagara, Great Lakes, Canadian Rockies, 
 White Mountains, Maine Woods, St. Lawrence River, Mex- 
 ico, Bermuda, and foreign travel. 
 
 Heart Disease. Watkins Glen Springs. 
 
 Rheumatism. Virginia Hot Springs, Mt. Clemens 
 (Mich.), Watkins Glen Springs, Saratoga Springs, Paso 
 Robles and Glenwood ( Col. ) , Richfield, and Poland Springs. 
 
 Convalesence. Lakewood, Atlantic City, Aiken, Vir- 
 ginia Hot Springs, Southern California, Bermuda. 
 
 Liver, Skin and Digestive Disturbances. Saratoga, Rich- 
 field, Arkansas Hot, French Lick and Poland Springs. 
 
HEALTH RESORTS 51 
 
 HEALTH RESORTS. 
 
 Adirondacks. General elevation, 1,500 to 2,000 feet. 
 Climate cool. Large number of cloudy days with high 
 humidity. Soil light and sandy. Tree growth pine, bal- 
 sam, spruce, and hemlock. 
 
 Popular for the treatment of pulmonary diseases of tu- 
 bercular origin. 
 
 Best known resorts are Saranac, Ampersand, Paul 
 Smiths, Lake Placid, Blue Mountain Lake, Raquette Lake, 
 Keene Valley, and Adirondack Lodge. 
 
 Aiken. Near the Georgia line in South Carolina. Ele- 
 vation, 500 feet. Pine country with sandy soil. Few 
 rainy days and comfortable winter climate. Desirable for 
 convalescence relaxation. 
 
 Arkansas Hot Springs. Light alkaline-calic thermal 
 springs used in the treatment of syphilis, gout, rheuma- 
 tism, neuralgia, and skin diseases. Numerous fine hotels 
 and baths. 
 
 Asheville. Near the Blue Ridge Mountains, North Caro- 
 lina, on a plateau of 2,250 feet elevation. One of the most 
 popular of the southern health resorts utilized especially 
 in the treatment of pulmonary tuberculosis and diseases of 
 the lungs. It is also a desirable climate for convalescence 
 and rest after nervous strains. 
 
 Atlantic City. On the Jersey Coast. The best known 
 of the northern coast resorts. Abundantly supplied with 
 fine hotels and sanitoria. Chief health features are de- 
 rived from comforts available at the hotels, the baths, and 
 the boardwalk near the ocean, broad and of great length. 
 The climate, though somewhat milder, is not greatly dif- 
 ferent from neighboring places. It is of most use medi- 
 cally to convalescents and to those needing rest and re- 
 laxation. 
 
 Bermuda. A beautiful island 36 hours from New York 
 by comfortable steamer. Patronized to the greatest extent 
 by Americans about Easter-time. Delightful climate most 
 of the year, many diversions and a restful atmosphere. 
 Chief towns are St. Georges and Hamilton the latter 
 place having two good hotels. Ideal spot for convales- 
 cents, nervous irritability, cardiac and renal conditions, 
 and for a rest cure. Best accommodations for invalids 
 
52 HEALTH RESORTS 
 
 in the Bermuda Sanitarium on Ferry Reach in West St. 
 Georges. 
 
 Colorado Springs. Attractive health resort at the foot 
 of the Rocky Mountains near Pike's Peak, altitude, 6,000 
 feet. Abundance of sunshine, cool climate, low humidity, 
 dry porous soil, beautiful scenery and beautiful residences, 
 with pleasant social life. 
 
 This climate is admirably suited to pulmonary tubercu- 
 losis especially the incipient forms. 
 
 Eastern Health Resorts. Maine, Moosehead and 
 Rangely Lakes. Cool, clear air. Fine fishing and camp 
 life. 
 
 Poland Springs and Rockland fine hotels and good 
 climate. 
 
 Mt. Desert and the Maine coast. Cool refreshing climate. 
 
 Frequent fogs. Attractive social life. 
 
 Florida Coast Resorts. Jacksonville, St. Augustine, 
 Palm Beach, Ormond and Tampa. Well supplied with 
 magnificent hotels. Climate equable, temperate, warm and 
 humid. Good for physical and mental relaxation but poor 
 for pulmonary troubles. 
 
 French Lick Springs. Orange County, Indiana. Sul- 
 phated saline waters. 
 
 Glenwood Springs. Glenwood Springs, Colorado. Alti- 
 tude, 5,200 feet. Fine accommodations. Cool, bracing 
 air. 
 
 Hot saline sulphur springs with fine pool and baths, and 
 natural sulphur vapor cave. 
 
 Of value in chronic rheumatism, gout, cutaneous and 
 renal diseases. 
 
 Hawaiian Islands. Twenty-one hundred miles south- 
 west from San Francisco 6% days by steamer. 
 
 Volcanic origin. Beautiful scenery. Tropical vegeta- 
 tion. Equable, comfortable climate, occasionally warm and 
 moist. 
 
 Lakewood. Ten miles inland from the Jersey Coast. 
 Sixty miles south of New York easily accessible and well 
 supplied with fine hotels. In the heart of the Jersey pine 
 belt where the soil is dry and sandy. Temperature usually 
 10 warmer than New York. 
 
 Well deserved reputation for curing protracted colds, 
 catarrh, influenza, and all forms of convalescence. 
 
 Mt. Clemens, Mich. Strong saline springs with good ac- 
 
HEALTH RESORTS 53 
 
 commodations. Useful in chronic rheumatism with stiffened 
 joints, and neuralgia, scrofulous disorders of skin, bones and 
 joints. 
 
 Old Point Comfort. North of Hampton Roads, Va,, near 
 Fortress Monroe. Temperature variation from 40 
 (Winter) to 80 (Summer). Bathing, boating and attrac- 
 tive social life. Of benefit to people suffering from catarrh, 
 bronchitis and nervous troubles. 
 
 Poland Springs. South Poland, Maine. Superb hotel. 
 Mild alkaline-calic water, used in treatment of rheumatism, 
 gout, dyspepsia, renal and hepatic disorders. 
 
 Richfield Springs. Lake Canandaigua, N. Y., altitude 
 1,750 ft. Beautiful country. Attractive hotel life. White 
 Sulphur Springs of value in insomnia from overwork, 
 nervousness or anxiety, stomach disorders, gout, rheumatism 
 and some disorders of the liver and kidneys. 
 
 Saratoga Springs. The most famous watering place in 
 the United States, with many large hotels. Most of the 
 waters may be described as muriated alkaline-calic car- 
 bonated waters. The best known are the Congress, Geyser, 
 Hathorn, Kissingen, Seltzer, United States, Vichy, Carlsbad 
 and Champion Springs. As these waters are quite potent 
 they should be taken under medical supervision. 
 
 They are most used in dyspepsia, engorgement of the 
 liver and portal system and chronic constipation. 
 
 St. Lawrence River. The Thousand Islands offer a de- 
 lightful region for rest and recreation with cool, equable 
 medium-moist climate. Fine hotels, or rough camps are 
 available. 
 
 Southern California. Coronado. Attractive coast resort 
 with fine hotel and equable marine climate. 
 
 Los Angeles. Enterprising city 14 miles from the ocean 
 and also from the mountains. Mild climate many fogs. 
 
 Monterey. One hundred and twenty-five miles south 
 of San Francisco on the Pacific Coast. Fine hotel Del 
 Monte and beautiful country-gardens and drives. Climate 
 mild, equable but humid. 
 
 Pasadena. Nine miles from Los Angeles altitude 900 ft. 
 Twenty miles from the sea and five from the mountains. 
 Charming city of attractive homes and fine hotels. Rest- 
 ful climate. 
 
 Santa Barbara. Climate mild and equable like the 
 Riviera. Many foggy days. Good hotel. 
 
54 HEALTH RESORTS 
 
 Adapted for cases of nervous exhaustion and con- 
 valescents. 
 
 San Diego. One of the most equable climates in the 
 United States, with maximum number of sunny days, al- 
 though the humidity is not low. Nights are cool. Adapted 
 to cases of nervous exhaustion. 
 
 Sierra Madre. Twelve miles north of Los Angeles. Alti- 
 tude 1,700 ft. Most desirable climate in Southern Califor- 
 nia for consumptives. 
 
 Paso Robles. El Paso de Robles, California. Altitude 
 800 ft. Climate mild and luxurious, atmosphere pure, 
 balmy, and invigorating, equable and dry. Hot springs 
 are sulphurous and alkaline. Good bathing accommoda- 
 tions. Beneficial to sub-acute and chronic rheumatism, 
 scrofula, blood, glandular and cutaneous affections. 
 
 Redlands. Elevation 1,350 ft. at foot of San Bernardino 
 Mountains. Fertile country, climate warm but not hot, 
 and equable. Comfortable for invalids. 
 
 Riverside. Elevation 850 ft. Sixty miles east of Los 
 Angeles, eight miles from Redlands. Many fine residences 
 and hotels. Fertile orange country. Comfortably warm 
 and dry climate. Delightful for invalids and convalescents. 
 
 Strong Medicine. In Large Doses for Those Whose 
 Enthusiasm is Failing. 
 
 Yellowstone National Park (Wyoming). A museum of 
 nature containing geysers, boiling springs, terrace and 
 crater formations, cliffs of obsidian, deeply cleft canyons, 
 petrified trees, sulphur hills and pine forests. Situated 
 on a plateau of 8,000 ft. elevation surrounded on all sides 
 by mountains. 
 
 The Grand Canyon of the Yellowstone is a magnificent 
 canyon 20 miles long, 600 to 1,200 ft. deep, with walls of 
 gorgeous colors. Climate bracing. Nights cold. 
 
 Grand Canyon of the Colorado (Arizona.) One of the 
 most stupendous natural wonders of the world. 3,000- 
 5,000 ft. deep, 217 miles long, 10-13 miles mide. The 
 walls are terraced and carved into a myriad of pin- 
 nacles and towers and are tinted with various brilliant 
 colors. 
 
 To the south are the cliff dwellings, the petrified forest 
 and the land of "silence, sunshine and adobe." Elevation 
 of the rim of the canyon about 7,000 ft. Climate dry and 
 bracing, with cool nights. 
 
HEALTH RESORTS 55 
 
 Yosemite Valley (National Park). On the west slope 
 of the Sierra Nevada Mountains in California. A valley 
 with level floor 8 miles long with enclosing walls 3,000- 
 5,000 ft. in height almost vertical. The chief features 
 are the Yosemite Falls (2,500 ft), Bridal Veil Fall, El 
 Capitan peak (7,042 ft.), and Half or South Dome (8,852 
 ft.). 
 
 Niagara Falls, New York. On the Niagara River. 
 One of America's greatest natural wonders. American 
 Falls 167 ft. high, 1,000 ft. wide. Canadian Falls 158 ft. 
 high, 2,550 ft. wide. Volume of water 12 million cubic ft. 
 a minute. 
 
 The Great Lakes. "In all the world no trip like this." 
 A delightful steamer trip of several days on fine steamers 
 from Buffalo via Mackinaw to Duluth or Chicago, through 
 Lake Erie, the Detroit River, Lake St. Clair, Lake Huron, 
 Lake Michigan or Lake Superior through the Sault St. 
 Marie. Pure bracing air, pure water, at times out of sight 
 of land, at times running close to picturesque and refresh- 
 ing land scenery. 
 
 Canadian Rockies. Banff 4,520 ft. elevation. The head- 
 quarters of the Canadian National Rocky Mountain Park. 
 Fine hotels here and at Laggan (5,040 ft.) Glacier (4,095 
 ft.) and Field (4,064 ft.) the last near the famed Yoho 
 Valley. The magnificent mountain peaks of this region are 
 almost innumerable averaging 10,000 to 12,000 ft, in height 
 and of a rugged nature. Ideal camping and fine hunting, 
 with cool bracing air. 
 
 Virginia Hot Springs. Large modern hotel and elabo- 
 rate baths. Popular health resort in Spring and Fall. 
 Alkaline-calic springs resembling those of Aix-les-Bains, 
 used in rheumatism, gout, sciatica, neuralgia, etc. Com- 
 petent physicians. 
 
 Watkins Glen Springs. Watkins, N. Y. on Seneca Lake. 
 A modern, well-equipped sanitarium with beautiful sur- 
 roundings. Salinic-calic waters charged with carbonic acid 
 gas used in the treatment of glandular and rheumatic 
 troubles, gout, lumbago, sciatica and chronic diseases of 
 the heart. For the last the Schott method is employed as 
 at Nauheim. 
 
 White Mountains. The air of the White Mountains is 
 cool, pure and clear. Popular resorts are Bethlehem, 1,459 
 ft., Jefferson, 1,440 ft., Dublin, 1,500 ft., Franconia, 1,100 
 
56 COLD IN THE HEAD 
 
 ft. and Bretton "Woods, where is located the magnificent 
 Mt. Washington hotel. 
 
 Cold in the Head (Nasal Catarrh) . What is the meaning 
 of that very common kind of catarrh called a cold in the 
 head? It is probably this that the catarrh (with all its 
 sneezing, shivering, nose-running) is an effort on the part 
 of nature to get rid of some germs which we, in a minute 
 of depression (due, e. g., to cold, fatigue, or worry, or lack 
 of food), breathed into our mouth or nose and allowed to 
 settle and breed there. Do what you will with a cold in the 
 head, you cannot "cure" it, and if you hasten nature's 
 three day process too much, then the system may fail to 
 throw off the poison, and the cold "gets down into the 
 chest" as we say, and we get, perhaps, bronchitis. The 
 present writer is sure that all colds are first local to the nose 
 or throat, and that local treatment, aiming both at easing 
 the symptoms and encouraging the natural process, is most 
 likely to be serviceable. A cold, then, takes three days, 
 more or less, to run its course, and the sensible way of 
 dealing with it since we cannot "cure" it, is to help it 
 along and give the system every chance of throwing it off. 
 This "throwing-off" the poison is done by the kidneys, 
 lungs and skin, but chiefly by the two former, for the skin 's 
 nervous apparatus has been rather out of order since the 
 "cold "was "caught." 
 
 So the best "cure" is to make the blood as pure as we 
 can. As soon as ever you know that you have got a cold, 
 start right away to treat it. This is done (1) by keeping 
 indoors from the moment that the cold is caught, in a well- 
 ventilated (not stuffy) but warm room say 60-65 F. 
 by wrapping up, as long as any feeling of chilliness or f ever- 
 ishness lasts ; and by sleeping a little more warmly at night 
 than usual. (2) As you are to rest and stay indoors, even 
 if not in bed, for three days, you require very little food, 
 and no meat food. Your object is to clear the blood of all 
 impurities. Drinks of hot lemon water should be taken 
 often, to wash out the stomach and bowels and flush out 
 the kidneys. 
 
 Now as to medicines. Take two grains of calomel fol- 
 lowed by aperient salts. Take frequently repeated 
 coryza tablets containing aconite and belladonna, and 
 douch out the naso-pharyngeal passages frequently with 
 dilute borolyptol, listerine, glycothymoline or alkalol. 
 
COLIC 57 
 
 But your cold is, perhaps, a more serious infection than 
 you thought; you are feverish and wretched, and cough a 
 little. Have a hot mustard foot bath at bedtime, then ; and 
 when in bed, a basin of hot gruel. Get as much rest and 
 sleep as you can. For the cough, take ipecacuanha wine, 
 10 drops, and paregoric, 20 drops, in some water every 
 three hours (smaller doses for children). 
 
 On the fourth day, if much better, you may go out, if 
 warmly wrapped; don't overweight yourself with clothes, 
 however. Then begin a tonic medicine quinine and iron 
 mixture twice a day. (See also "Cough" and "Sore 
 Throat") 
 
 Cold-on-the-Lip. This is a little skin eruption which oc- 
 curs on the lips, or in the nostrils sometimes, when one 
 has a "cold in the head." Its proper name is herpes, 
 and it is described under that heading. The same eruption 
 is apt to occur on the private parts, and in some people, 
 round the waist, where it is called shingles. (See 
 "Herpes.") It is contagious to some extent and may be 
 communicated by kissing. It is not dangerous. 
 
 Once formed these herpetic vessels are very difficult 
 to control, but they may sometimes be aborted, in the earliest 
 stages, by peroxide of hydrogen and camphor cream locally, 
 in connection with a calomel cathartic. 
 
 Colic. A violent sudden pain in the abdomen. 
 
 (1) Flatulent colic is often very sudden and very pain- 
 ful, but it is caused by nothing more serious than "gas" 
 in the bowels, which makes them swell out, and which is 
 caused by decomposition of food, the indigestion being due 
 to something wrong with the bile or other of the digestive 
 juices. Such colic is especially common in weak and in 
 hysterical people, also in artificially-fed infants. 
 
 (2) Wind colic in small infants must, of course, be treated 
 by attending to the feeding, and to more cleanliness in the 
 bottles and teats used. This griping in children is some- 
 times cured by a smart purge (say two teaspoonfuls of 
 castor oil) ; but when a child is continually having griping 
 attacks (as shown by it making grimaces and drawing up 
 its legs), there can be no doubt that the food disagrees with 
 it. Oil of anise, one or two drops on a small lump of 
 sugar, may be given every hour and Dill water is a favorite 
 remedy in teaspoonful doses every hour. In adults the 
 colic is generally due to some irritating article of food which 
 
58 CONCUSSION OF THE BEAIN 
 
 may be purged out with an ounce of castor oil. A hot- 
 water bottle applied to the belly gives much relief. 
 
 (2) Lead colic. (See "Lead-Poisoning.") 
 
 (3) Renal colic. (See "Stone in the Kidney.") 
 (2) Liver colic (See "Gall- Stones.") 
 
 (4) Liver colic. (See "Gallstones.") 
 
 (6) Intussusception or telescoping of the gut. 
 
 (5) Volvulus, or twisting of the gut. 
 
 The last two are rare. Intussusception of the gut is 
 similar to what takes place in the fingers of a tightly-fitting 
 glove as they are turned outside in when the glove is drawn 
 off a warm hand. The intense pain, bowel obstruction, pas- 
 sage of blood from the rectum and collapse of the patient 
 show what has happened and very soon there is a big 
 tumor to be felt in the belly and the patient begins to 
 v omit the contents of the bowels. Nearly all the cases are 
 in children who have been too severely purged. It is use- 
 less for a layman to attempt to treat that. 
 
 Collapse. By this word is meant the state of utter pros- 
 tration which may follow a serious accident, a great loss 
 of blood, an acute fever, or a blow in the pit of the stomach. 
 Very great grief may have a similar effect. In all cases 
 of collapse or shock, keep the sufferer warm, elevate the 
 extremities, loosen the collar and all constricting bands 
 and stimulate with sal volatile, smelling salts, aromatic 
 spirits of ammonia, whisky or brandy. 
 
 Coma. By this term is meant insensibility, unconscious- 
 ness, in which the patient cannot be roused, and touching 
 the naked eyeball with the finger tip produces no effect. 
 The breathing is deep and slow and noisy. The chief causes 
 of coma are apoplexy (which see) and diabetes (which see). 
 Sometimes the comatose person dies without regaining con- 
 sciousness; sometimes he recovers. In diabetic coma, how- 
 ever, his chances of recovery are very small. 
 
 Concussion of the Brain (Stun). A blow on the head or 
 a fall may so shake up the brain as to cause the patient 
 to be stunned. This is shown by pallor of face, and a 
 state of faintness and unconsciousness, which may last 
 only for a few minutes, or may continue for hours. Re- 
 covery may soon occur with vomiting, if there be no severe 
 internal injury to the head, but if the concussion has led 
 to bleeding in or upon the brain great danger to life will 
 
CONSUMPTION 59 
 
 ensue. Put patient in bed and keep head high and send 
 for doctor. 
 
 Confinement. To calculate when a baby will be born, 
 take the date of the last day of the last menstruation, add 
 seven days and go back three months. For instance, if 
 the last day of the last menstrual period was January 7th, 
 add seven days January 14th, and go back three months, 
 to October 14th, which will be the date of the birth of the 
 child. 
 
 Constipation. (See ''Costive Bowels.") 
 
 Consumption. This disease causes more deaths in this 
 country than any other form of illness. In infancy it at- 
 tacks the brain, in childhood chiefly the bowels, and in early 
 manhood the lungs suffer most often. In former days the 
 disease used to be called a decline. To be "in a decline" 
 meant that the lungs were diseased, and that an early death 
 by gradual wasting was possible. 
 
 Until quite recently consumption, the medical name for 
 which is phthisis, was considered to be essentially an in- 
 herited disease; but of late years medical opinion has 
 changed, and all doctors now consider that phthisis is 
 capable of being caught by infection, which arises from 
 germs breathed in from the air having escaped from con- 
 sumptive lungs, or from those contained in tubercular milk 
 and tubercular meat. 
 
 To-day we do not believe in the inheritance of consump- 
 tion from parents. Each case of consumption is viewed as 
 a case of infection by the germ of the disease. What may 
 be inherited, is a weakly state of body, favoring infection. 
 
 The alteration in modern medical opinion has been due 
 to the great improvement effected in microscopes in recent 
 years, by which it has been possible to discover the pres- 
 ence of extremely minute organisms, called bacteria or 
 bacilli, in the phlegm coughed up by consumptives, and even 
 in their saliva, their urine, and blood. By experiments on 
 animals it has been shown that inoculation with these bacilli 
 will cause the disease to break out in them. 
 
 These bacilli, however they may enter the human body, 
 whether in our food, or in milk, or by being inhaled in the 
 air we breathe, will set up the state of disease now called 
 tuberculosis; and the part first attacked, although most 
 often the lungs, may be the bowels, kidneys, or skin. 
 
 II. Cattle also may die naturally from tuberculous dis- 
 
60 CONSUMPTION 
 
 eases set up by infection with bacilli, and it is an accepted 
 opinion that children may get infected from milk taken 
 from cows already diseased. Even grown-up persons may 
 become infected with tuberculosis by eating the meat ob- 
 tained from diseased cows. It is for this reason that so 
 much attention is now given to the examination of 
 slaughtered animals in butchers' shops. 
 
 Cattle are certainly liable to tuberculosis of the internal 
 organs, and may die of it. The slaughter houses of our 
 cities are now under inspection, so that diseased meat may 
 be discovered and destroyed; but until recently the Jews 
 alone were particular about refusing the meat of diseased 
 cows, and it is certain that the Jews have always had a 
 lower death rate from consumption than Christians. With 
 the Jews it is a matter of religion to have their butchers' 
 meat passed by a Hebrew official, and it is then marked 
 as Kosher. 
 
 The principal contagion from consumption of the lungs 
 is found in the phlegm coughed up and expectorated. In 
 this phlegm the bacilli are to be found in millions. When 
 the phlegm dries up and is powdered under foot, the wind 
 blows the germs about, and women's long skirts spread 
 them from room to room. This dust is inhaled, and falls 
 into our drink and food, and so the disease is spread. 
 
 If there is one point more important than all others, it 
 is that all consumptives should spit into basins or bottles 
 containing antiseptic liquids, or else into paper handker- 
 chiefs, which can be burned. These are now procurable 
 very cheaply. 
 
 Consumptive patients, although they feel great debility, 
 have a bad digestion, frequent cough, and often suffer 
 from diarrhea and night sweats, yet they are generally 
 of a hopeful turn of mind. They grow gradually weaker 
 and thinner month after month, and yet are always look- 
 ing forward to a recovery, which is unlikely. 
 
 III. In cases of consumption or tuberculous disease of 
 the lungs, it is usual to find one lung affected before the 
 other, or one lung much more affected than the other ; and 
 the upper lobes, under the collar bone are generally the 
 first to suffer. The disease at first causes patches of con- 
 solidation, which may either dry up and become chalky 
 nodules, or else, if the general health be bad, the patches 
 soften down, and abscesses form. The lung structure gets 
 
CHRONIC CONSUMPTION 61 
 
 eaten out into holes by ulceration; these are called cavi- 
 ties, and matter, with phlegm, collects in them, especially 
 at night ; hence it is that consumptives so often have a severe 
 cough in the morning, the cough being for the purpose of 
 getting rid of the accumulation. Phthisis is not usually a 
 painful disease, the only pain in the chest being usually 
 due to attacks of pleurisy in the dry stage. Much dis- 
 comfort is, however, often felt from the disordered, shallow, 
 and rapid breathing. 
 
 Yty. ' ' GALLOPING CONSUMPTION. ' ' Although consump- 
 tion is most common in its chronic form there is an acute 
 variety, most commonly seen in young adults, in which the 
 first symptoms are fever, shortness of breath, and weakness, 
 and these lead on to death in a few weeks. In such cases the 
 lungs are found after death studded with numerous quite 
 small points of disease, which have abolished the use of 
 the lungs for breathing purposes, and death is from the 
 impurity of the blood. 
 
 V. "CHRONIC CONSUMPTION." Chronic phthisis or 
 tuberculous consumption of the lungs seldom causes death 
 the first year, and it may last for many years, and even 
 after a long course there may be an almost complete re- 
 covery. This slow recovery is more common of late years 
 than formerly; this good result is from the modern plan 
 of open-air treatment and good feeding. 
 
 The ordinary consumptive patient is a pale, round- 
 shouldered, thin person, with a chronic cough, who suffers 
 from loss of appetite, indigestion, and occasional diarrhea; 
 his heart is feeble, and he is short of breath, and is liable 
 to night sweats. 
 
 A long continuing cough, spitting of a little blood, and 
 a very slow gradual loss of weight and fat, with weakness 
 are the most frequent signs of the onset of consumption, 
 and should always alarm a patient's friends, and this occurs 
 before any notable lung diseases can be found by examina- 
 tion. As the beginning of the disease is so faintly marked, 
 there being no violent or urgent symptoms, it very often 
 happens that the ailment is well established before any 
 curative measures have been undertaken. This is a great 
 misfortune, because consumption of the lungs is especially 
 a disease which is curable at the beginning but incurable 
 when the structure of the lung has been destroyed, and 
 the lung is full of cavities. 
 
62 TREATMENT OF CONSUMPTION 
 
 The diagnosis of the disease, although still imperfect, is 
 much more easy than in olden times ; the modern physician 
 examines the chest by observing its state of expansion by 
 the breathing; he feels its expansion with the hands; by 
 tapping the chest all over he discovers any loss of the natural 
 elasticity, and by the use of the stethoscope he hears the 
 sounds made by the air entering and leaving the lungs, 
 and can discover whether the air tubes are too dry, 
 or if they contain liquids, such as phlegm, blood or mat- 
 ter; and can discover whether or not the lung is already 
 eaten out into hollow places, called cavities. 
 
 Cases of serious lung disease vary widely as to symp- 
 toms, and especially as to the presence or absence of bleed- 
 ing. The coughing up of blood is a very alarming symp- 
 tom, and one which in rare cases may cause sudden death 
 from fainting or suffocation. In most patients, however, 
 blood-spitting, or haemoptysis, is only slight, but it may be 
 frequent. When it occurs quite early in the case, and is 
 only trifling in amount, it does no harm, and, indeed, serves 
 the useful purpose of calling attention to the nature of 
 the illness, and it leads to prompt and serious treatment 
 of the patient. When it is profuse, it causes weakness, for 
 a consumptive patient cannot afford to lose blood, and is 
 generally already pale, and his blood of poor quality. 
 Haemoptysis is a serious matter when it occurs from the 
 rupture of a large blood vessel in a cavity in the lung, and 
 immediate medical aid must be summoned, and until a 
 doctor arrives the patient must be put to bed, with head and 
 shoulders raised, and must be cautioned not to talk or use 
 any exertion. Ice may be given him to suck in small quan- 
 tities. 
 
 VI. Treatment of Consumption. (1) The treatment 
 consists of every effort to improve the general health of 
 the patient by sanitary methods, by good feeding, by open- 
 air life, and gentle exercises, and by the treatment and 
 cure of all painful and exhausting symptoms as soon as 
 they arise. 
 
 It must be admitted that although science has been at 
 the work of searching for an antidote to the poison of 
 tuberculosis for hundreds of years, the constant result has 
 been failure. 
 
 Mercury, iodine, and arsenic have each had a short repu- 
 tation as a cure for phthisis; and so have creosote, car- 
 
TREATMENT OF CONSUMPTION 63 
 
 bolic acid, guaiacol, and sulphur. Dozens of substances 
 have been tried as vapors and inhalations in hopes of kill- 
 ing the germs in the air tubes of the lungs, such as turpen- 
 tine, terebene, eucalyptus oil, prussic acid, iodine, naphtha, 
 tar vapor, and oxygen gas ; but they have all failed to check 
 the disease. Then, again, local applications to the chest 
 have often been vaunted as cures, such as applications of 
 iodine liniment, and turpentine, mustard plasters, and 
 blisters of cantharides ; also the use of issues and of cup- 
 ping. 
 
 There are many clever physicians in different parts of 
 the world at work on the treatment of consumption by vac- 
 cines and serum. Marmorek, F. von Behring, Wright, 
 Trudeau and others, are those to whom we look for further 
 knowledge on this subject, but though they are all success- 
 ful in some of the cases, they do not succeed often enough 
 to enable them to pin their faith to any one method. There 
 is no doubt, however, that the use of some vaccines in the 
 form of certain tuberculins is of appreciable assistance 
 to the other methods of treatment in the early cases of con- 
 sumption with slight involvement of the lung. 
 
 VII. Treatment of consumption. (2) After mention- 
 ing so many medicines which do so little good to persons 
 who are suffering from phthisis, or tuberculous consump- 
 tion of the lungs, we may fitly advise as to the treatment 
 which may be expected to lengthen life, and so give nature 
 a chance to cure the disease, for that seems the utmost which 
 present knowledge can do. 
 
 Reliance must be placed more on general principles than 
 upon drugs, and most important are the open-air life, 
 plenty of good food, and the addition of the preparations 
 of cod-liver oil and malt. It is of great importance, on 
 the other hand, to avoid unhealthy, close bedrooms, gas- 
 lit workshops, and the too close associations with other per- 
 sons. Cases of consumption, early taken to fresh air 
 sanatoria and there treated, almost invariably recover. 
 The main point is to detect the disease in its early stages. 
 
 The utmost importance must be given to rules to avoid 
 self-contagion, by cleanliness, changes of clothing and bed- 
 linen ; and remember that these patients must never swallow 
 the phlegm they cough up, but must use a pocket spittoon 
 or a paper handkerchief, which can be burnt. 
 
 The most certain way for a consumptive to infect other 
 
64 TREATMENT OF CONSUMPTION 
 
 people is to cough or sneeze without protecting the mouth 
 with a piece of cloth. As a result of the coughing the 
 saliva is expelled in a fine spray which may float about in 
 the air and be inhaled by someone else at a distance of 
 several feet. 
 
 The next most certain way for a consumptive to infect 
 other people is to spit on the floor anywhere around him; 
 and the reason is that when the phlegm dries it becomes 
 ground into the dust by the feet, and the dust floats up into 
 the air which others breathe, gets into the air tubes of their 
 lungs, and thus starts the disease in a new place. 
 
 The consumptive needs to be treated as an invalid, 
 and should be made to take regulated exercise and 
 regular rest, and regular meals. The appetite may be en- 
 couraged by mixtures containing vegetable and acid tonics, 
 and the digestion may be assisted by doses of pepsin, and 
 pancreatin, or by food partly digested by chemical proc- 
 esses. 
 
 Much milk and milk foods are necessary, and well- 
 cooked dishes, but the cookery is better plain and good than 
 of the fancy sort; avoid giving shellfish, pastries, cheese 
 and vinegar ; but give more than usual of fresh fruits, dried 
 fruits, jellies, fresh fish and fresh, boiled vegetables. Dried 
 fish, bacon, ham, and tinned foods are less digestible, and 
 are unsafe. Emulsion of cod-liver or olive oil, or sardines 
 with oil, are all valuable, and so are malt extract, maltine, 
 meat extract, preparations of blood and bone marrow. 
 Sedative medicines are needed for the cough, with astringent 
 mixtures for diarrhea, also special drugs to check night 
 sweats and losses of blood. 
 
 Night sweats are a serious symptom, which must be 
 checked by medicines, as far as possible, because they cause 
 great prostration, and are also a source of danger by caus- 
 ing the sufferer to lie in wet linen, in which state he may 
 fall asleep and lie uncovered, and so catch fresh cold. In 
 these cases patients should wear flannel clothing and lie be- 
 tween blankets. 
 
 Diarrhea of a particularly intractable sort often occurs 
 in the latest stage of consumption, and may resist all medi- 
 cines. It is believed to be due to ulcerated spots within 
 the bowels. The aromatic confection powder is often use- 
 ful, given with paregoric, or chalk and opium mixture. In 
 
TREATMENT OF CONSUMPTION 65 
 
 severe cases doctors may give dilute sulphuric acid and 
 opium; or 10 grains of camphoric acid thrice daily. 
 
 The cough of consumptives varies very much in charac- 
 ter. If dry and barking, it may be due to pleurisy ; a very 
 frequent cough is often due to slight attacks of congestion 
 of the lungs. A continuous cough, with profuse expectora- 
 tion, is a sign that patches of the lungs are softening and 
 breaking down into cavities. A cough with clear, frothy 
 phlegm shows the occurrence of a little passing attack of 
 bronchitis. 
 
 We append a few "recipes" which may be useful al- 
 ways remembering that doctoring without a doctor is not 
 without risk. 
 
 VIII. Treatment of Consumption. (3) 
 
 (a) For daily fever and night sweats. Quinine 
 4 hydrochlorate, 30 grains; calcium hypophosphite, 
 
 64 grains; tincture of nux vomica, 160 minims; 
 tincture of orange, 1 fluid ounce; glycerin, two 
 ounces; water, to eight ounces. Take one table- 
 spoonful of this mixture half an hour before 
 meals thrice daily. 
 
 (b) For night sweats. Atropine sulphate gr. 1/100 
 taken at bedtime. 
 
 (c) For a cough of irritation, without much phlegm 
 a dry hard cough. Codeine, 2 grains; syrup 
 of orange flowers, 1 ounce; distilled water, 1 
 ounce. Take a teaspoonful occasionally, holding 
 it in the mouth a minute before swallowing. 
 
 (d) For a cough with much phlegm. Pure creosote, 
 % drachm ; spirit of cinnamon, 4 drachms ; tincture 
 of orange, 2 ounces; glycerin, to 4 ounces. Take 
 a teaspoonful in a wineglassful of water three 
 times a day. 
 
 (e) Vomiting Take a hot drink of milk and a tea- 
 spoonful of brandy half an hour before meals ; and 
 5 grains of pepsin, and a few drops of lemon juice 
 after the meal. 
 
 (f) Loss of appetite tonic. Tincture of nux vomica, 
 5 minims; sodium bicarbonate, 5 grains; spirit 
 of chloroform, 20 minims; infusion of calumba, 
 1 ounce. Take this dose an hour before each meal. 
 
66 CORPULENCE 
 
 (g) Diarrhea (1) If without pain castor oil, 1 
 teaspoonful; hot milk, 2 tablespoonfuls ; brandy, 
 1 teaspoonful. Take this draught first thing in 
 morning. (2) If with much "wind" in stomach 
 Liquor calcis saccharatus, 1 drachm. Thrice 
 daily. (3) If with pain Give an enema into 
 the rectum of 10 drops of laudanum and five grains 
 of tannin in 2 ounces of mucilage of starch, twice 
 a day. 
 
 Corns and Bunions. Nothing much can be written about 
 corns or bunions that will be of real service. They are 
 thickenings of the skin caused by pressure or irritation of 
 badly-fitting boots. When the bones of the toe and the 
 joint also become involved we call the trouble a bunion. 
 The first requisite is a well-fitting pair of boots, roomy 
 enough, and straight along the inner side. Hard corns 
 ought to be shelled out neatly by a competent chiropodist. 
 Amateur chiropody is generally foolishness. A soft corn, 
 which is one that has become sodden and soft through neg- 
 lect and perspiration, needs ordinary cleanly surgical treat- 
 ment. If a bunion is forming, a boot made with a toe post 
 inside should be worn; but later on nothing but a little 
 operation on the joint will be of any use. A great many 
 corns have a tiny drop of pus right in the inside of them, 
 and that causes an irritation which makes the skin hard 
 over them. A good chiropodist will know how to deal with 
 it. Of course, there are corn solvents, which aim at soft- 
 ening the skin so that you can peel it off; and there are 
 corn plasters which relieve the pressure of the badly-fitting 
 boots. But the really sensible way to deal with a corn is 
 to have it removed by a chiropodist, and to wear more suit- 
 able broad-toed boots in future. Solvents (so-called) are 
 of little use in bad cases. 
 
 Corpulence or Obesity (Too FAT). Obesity is very 
 greatly a question of heredity and no amount of dieting 
 will make a difference to some people. It may be said 
 that when proper dieting cannot reduce corpulency, along 
 with exercise and attention to skin and bowels, no drugs can 
 possibly influence this condition of body. 
 
 There are a few well-recognized causes of being too fat. 
 One is over-indulgence in alcohol, another is a too indulgent, 
 selfish and luxurious life, and another is a too sedentary 
 
CORPULENCE 67 
 
 life. Women very often get very fat at the time of the 
 change of life (see " Change of Life."). Idiots are very 
 often too fat, and so are many anaemic girls. 
 
 With regard to dieting, there are two main causes of get- 
 ting obese the eating of too much fat-forming food, and 
 the inability of the body to deal with the food properly. 
 Of course, these two causes may act together. A person 
 who is too fat may be eating too much every day, and may 
 also be too feeble to make use of the food he eats, so that 
 it gets stored up in his body as fat, and he has to carry it 
 about with him. Speaking generally, to begin to get too 
 fat is to begin to grow old, and that is why people should 
 and do avoid it. That is why the old gentleman who has 
 left business takes to gardening, to keep down his fat; 
 and why the middle-aged maiden lady, with a small cozy 
 income used to go bicycling for exercise. If you are too 
 fat and want to reduce it, first consult a doctor. Let him 
 examine your heart, liver and lungs, because they may be 
 hampered by the fat, and any sudden exercise may cause 
 faintness and even death, if the heart be fatty. If there 
 is no serious mischief yet in any organ, you may prepare 
 to take down the fat. There are four ordinary ways of 
 doing this: (1) To "do Banting," i. e., to go without 
 all fats, sugars and starchy foods, and eat only lean 
 meat and green vegetables (see "Banting") ; (2) To eat 
 less sugars or starchy food such as puddings, bread, etc. ; 
 (3) To drink almost no liquids with meals and none at all 
 between meals; (4) The most complete and thorough 
 method is that of Oertel. It consists in (a) climbing hills 
 for hours every day ; ( b ) meals in small quantities, at long 
 intervals; (c) only one or one-and-a-half pints of fluid is 
 allowed to be drunk in every twenty-four hours. Of course, 
 all these plans require a little effort of will, and perse- 
 verance, and so many fat people are also lazy that they 
 seldom can get up enough energy to carry out any plan 
 thoroughly. An excellent plan is to eat every day only one 
 pound of raw, or nearly raw, gravy beef, minced up, and 
 divided into four meals, accompanied by the drinking of 
 as much very hot water as possible (see "Salisbury Treat- 
 ment"). 
 
 Note that certain persons are by habit of body and in- 
 heritance inclined to develop undue stoutness. In such 
 cases it is dangerous to attempt to reduce body weight be- 
 
68 COSTIVE BOWELS 
 
 yond a certain point. Interference with the natural bodily 
 constitution always results in disaster, and therefore the 
 family history must be taken into account in all cases of 
 treatment of obesity. 
 
 Diet for persons who are too fat. FORBIDDEN. All fat 
 and fatty meats such as goose, duck, pork. All fatty fish, 
 salmon and eels. All light farinaceous puddings. Po- 
 tatoes, peas, beans, and such vegetables. Butter, cream. 
 All sweet jams; sugar with fruit or tea. It is starchy and 
 sugary foods which tend to make fat. 
 
 ALLOWED. Lean meat and lean poultry in strict modera- 
 tion. Lean ham and tongue. Fish without rich sauces, 
 and with lemon or vinegar. Green vegetables, cress, let- 
 tuce, French beans, etc. Fresh fruit in small quantity. 
 Dry oaten biscuits and gluten bread. A tablespoonful of 
 good whisky, in water, after lunch. Tea or black coffee 
 without sugar, at breakfast or tea-time. 
 
 Costive Bowels. An enormous number of people suffer 
 from costiveness or CONSTIPATION ; and it is quite com- 
 mon to find people taking medicines that other people have 
 told them are "good for costiveness," instead of trying to 
 find out what their own costiveness is caused by, and seek- 
 ing to remedy that particular cause. We shall say nothing 
 here about the costiveness which is merely a symptom of 
 some disease, such as fever, anaemia, Bright 's disease, and 
 so on. The commonest causes of constipation in otherwise 
 healthy people are : 
 
 1. Sedentary habits, so that the muscles of the bowels 
 
 are lax and weak, like all the other muscles. 
 
 2. Unsuitable diet and habits of eating. 
 
 3. Nervousness, because of pain in the back passage, 
 
 due to piles, or ulcers, etc. 
 
 4. Something wrong with the liver, so that there is not 
 
 enough bile secreted, though there may be too 
 much in the blood, causing jaundice. 
 5. Occupations which cause continual free perspira- 
 tion ; and diseases like diabetes. In such cases the 
 bowels are costive because there is not enough 
 water left in them. 
 
 (1) Women are generally more sedentary than men, 
 especially milliners and shop girls; but men clerks and 
 those confined to the house also are very apt to be costive. 
 
COUGH 69 
 
 Young women too often have a false delicacy in these 
 matters, which leads them to postpone relief of the bowels. 
 All such sedentary persons should make a habit of attempt- 
 ing relief of the bowels at a fixed hour every day, until 
 success is attained. This rule is much more important than 
 it appears at first sight. 
 
 Secondly, regular bodily exercise must be taken. Time 
 must be found for it somehow. Walking is best. 
 
 Thirdly, a laxative should be taken regularly for a time 
 until the habit has become "second nature" to the bowels. 
 A purge is too strong; a laxative such as one of these is 
 best : 
 
 Cascara pill, Triplex pill, aloe belladonna and strych- 
 nine pill, Lady Webster pill, compound licorice powder, Sal 
 Hepatica, Hunyadi Janos, apenta water, sodium phosphate, 
 or citrate of magnesia. 
 
 (2) As to diet in costiveness or constipation, many 
 people eat too much meat, and many others take too little 
 fluid. An excellent plan is to take half-a-pint or more of 
 pure cold water before breakfast and again before going 
 to bed ; or else to drink a free draught of water after every 
 meal. Some prefer to drink hot water. The following 
 foods are liable to cause constipation : Eggs, milk, tapioca, 
 sago, rice. And these are "good for constipation": 
 Green vegetables, stewed fruits, wholemeal brrad, maize, 
 prunes, Turkey figs, honey, treacle, gingerbread (excel- 
 lent), Spanish onions. The bad habits of eating are, to eat 
 too fast, to bolt the food without chewing it, to drink too 
 much alcohol, to drink tea with meat foods. 
 
 (3) Nervous people with piles or fistula dread a motion 
 of the bowels. They should use a glycerin suppository 
 every other day, and apply cocaine and bismuth ointment 
 locally. 
 
 (4) Liverishness is generally accompanied by costive 
 bowels. Regular exercise must be taken and a blue pill to 
 affect the liver, may be taken at night, and a little apenta 
 water in the morning. 
 
 (5) Persons who sweat a great deal ought to drink 
 plenty also. 
 
 Cough, Let it be clearly understood that a cough is not 
 a disease in itself, but only a sign of some disease. A 
 cough may show the presence of indigestion, for example, 
 being caused by irritating food in the stomach ; or of bron- 
 
70 COUGH 
 
 chitis (inflammation of the air tubes in the lungs) ; or of 
 tuberculous disease of the lungs (see " Consumption") ; or 
 of a relaxed throat; or of inflammation of the voice box; 
 or of a tumor, such as an aneurism, in the chest. 
 
 The first thing to discover then is, what causes the cough? 
 To stop the cough is not to cure the disease, and sometimes 
 it may be even dangerous to stop a cough. 
 
 If the cough is hard and short and frequent, it is prob- 
 ably due to indigestion, and no phlegm is coughed up, or 
 "raised," as country people say. If it is hard, painful, 
 brassy in sound, and later on accompanied by much phlegm, 
 it may be due to bronchitis. 
 
 Children with short, hacking coughs, often have worms 
 in the bowels. Many infants cough during teething. A 
 sudden cough coming on at night, hoarse, harsh, noisy, 
 clanging, and panting for breath, will mean the disease 
 called croup. 
 
 It is impossible, in the limits of such a book as this, to 
 do more than give the intelligent reader a general idea 
 about the meaning of coughs. As to treatment, it ought, 
 of course, to be left to the skill of a medical man. Yet 
 there are cases in which some of the following formulas 
 may be useful: 
 
 1. For a croupy cough. Ipecacuanha wine, antimonial 
 
 wine, syrup of squills of each, 2 drachms; dis- 
 tilled water, to 3 ounces. For a child of about a 
 year old. A teaspoonful to be given every quarter 
 of an hour until vomiting occurs ; then half a tea- 
 spoonful every three hours, until cured. 
 
 2. For winter cough in adults. A few drops of tere- 
 
 bene (pure) on a piece of sugar dissolved in mouth 
 thrice daily; or a teaspoonful of glyco-heroin in 
 water every 4 hours or so. 
 
 3. Routine mixture for chronic bronchitis in middle- 
 
 aged people. Carbonate of ammonia, 24 grains; 
 tincture of squills, 2 drachms ; compound camphor 
 tincture, 3 drachms ; infusion of senega, 8 ounces ; 
 iodine of potash, 24 grains. A tablespoonful of 
 this mixture may be taken twice a day and two 
 tablespoonfuls at bedtime, additional. 
 
 4. For chronic cough in a rheumatic person. Salicylate 
 
 of soda, 6 drachms ; glycerin, % ounce ; colchicum 
 
CEEMATION 71 
 
 root wine, 6 drachms ; compound syrup of squills, 
 iy 2 ounces; camphorated tincture of opium, 2 
 ounces. Take a teaspoonful in some water every 
 four hours. 
 
 Some chronic coughs, even if not of a tuberculous nature, 
 are benefited by cod-liver oil and malt and some require a 
 change of climate. It must always be borne in mind that 
 a chronic cough may mean the beginning of consumption. 
 Therefore a cough should never be allowed to continue for 
 more than two weeks without consulting a physician to 
 find out what the cause of its continuance is. Remember 
 that an early diagnosis in pulmonary tuberculosis or con- 
 sumption is half the battle won. 
 
 Cracked Nipples. Many women who suckle children suf- 
 fer from painful cracks and sores of the teats of the breasts. 
 They ought to be wiped quite dry after suckling, and 
 glycerin of tannic acid painted on with a brush into the 
 cracks. Alcohol, in the form of methylated spirit, or 
 spirits of wine, may be used to bathe them if they are soft 
 and tender. Slight cracks may be painted with flexible col- 
 lodion. (See also "Pregnancy, Hygiene of.") 
 
 Cramp in the Calf of the Leg. Many people are occasion- 
 ally seized with painful cramps of the calf muscles when in 
 bed at night. The causes of such cramps are over fatigue, 
 nervous exhaustion and ' l goutiness, " by which we mean 
 that the body is not able to throw off waste matters through 
 skin and kidneys, as well as usual. 
 
 Treatment. (1) Sometimes smart rubbing of the 
 affected muscles will relieve the spasm. 
 
 (2) At other times, applying tight elastic bandage 
 round the thigh relieves the cramp at once. 
 
 (3) The calf muscles are used to draw up the heel; 
 those which push down the heel and raise the foot are 
 ' ' antagonistic ' ' to the calf muscles. It is often a good 
 plan, then, to forcibly raise the foot by muscular action. 
 
 (4) Massage of the legs will cure bad cases. 
 
 (5) Five grains of salicylate of soda swallowed 
 thrice daily, between meals, may do good. 
 
 Cremation. The number of persons who agree with the 
 principle of cremating the dead grows greater every year. 
 
72 CROUP 
 
 Instead of consigning every corpse to the ground, there to 
 lie and decompose in a wooden coffin, and perhaps to con- 
 taminate the underground watercourses and spread disease 
 among the living, many thoughtful people to-day prefer to 
 destroy the lifeless clay by fire, and thus to purify it and 
 render it harmless to the living. Every dead body sooner 
 or later becomes dust ; cremation only brings about the same 
 process in a quick, cleanly way, and the furnace destroys 
 at the same time the teeming myriads of disease germs 
 which exist in nearly every corpse. Cremation is done, too, 
 without the smallest sacrifice of sentiment or decency, and 
 we may well hope that in coming years the public at large 
 will become so educated, so intolerant of the foulness of 
 disease and putrefaction, that they will gladly submit the 
 bodies of their loved ones to purification by fire, and leave 
 instructions in their wills that their own bodies may also 
 be thus cleansed and rendered harmless. 
 
 Cretinism is a medical word which is applied to a state 
 of stunted growth, both mental and physical, due to the 
 absence of a soft gland called the thyroid gland, which is 
 situated under the skin and muscles, across the lower part 
 of the neck and windpipe, and which does lie there in every- 
 body except cretins. Cretinism is common in certain dis- 
 tricts. The cretin may live to be a good age, and is often 
 good-tempered, quiet and fat. The skin is dry and rough, 
 the face is vacant looking, the hair stubbly, the hands short 
 and spade-shaped, and there are bosses of fat just over the 
 collar bones. These poor creatures often improve under 
 medical treatment. 
 
 If the thyroid gland wastes away in an adult, the adult 
 will generally become cretinoid, but his state is called 
 myxo3dema; and he also is susceptible of being improved 
 up to a certain point by giving him extract of thyroid 
 gland. But though in both these conditions it is not diffi- 
 cult to improve the body, it is very hard to restore or 
 improve the mind. 
 
 Croup. This word, unfortunately in common use among 
 the poor, ought not to ~be used, because it has been made to 
 mean so many different ailments. Child crowing (which 
 see) has been also called false croup. The name "false" 
 ought to be reserved for spasmodic inflammatory laryn- 
 gitis, or inflammation of the voice box, which is accom- 
 panied by noisy breathing. The word croup itself means 
 
DEAFNESS 73 
 
 "a noise in the windpipe." The right use of these names 
 is as follows : 
 
 False croup is an inflammation of the larynx, accom- 
 panied by a hoarse noisy cough and difficulty of breathing ; 
 such indrawing of the breath being accompanied by a coo- 
 ing or crowing noise. If the child is left alone the spasm 
 will probably pass off, and on waking the child seems 
 almost well, but hoarse. Attacks may occur again on sub- 
 sequent nights. The medical names are spasmodic laryn- 
 gitis and inflammatory croup. 
 
 Membranous croup is probably always genuine diph- 
 theria of the larynx and the disease only resembles the 
 other kinds of croup in the shortness of breath and a noisy 
 cough. This is also called true croup. 
 
 Spasmodic croup is described under the heading of 
 "Child Crowing" (which see). It is purely a nervous dis- 
 ease and there is no inflammation about it. Mothers some- 
 times call the attacks "passion fits" and "holding the 
 breath." It is apt to occur during teething. Its medical 
 name is laryngismus stridulus. 
 
 If there is the slightest suspicion that an attack of croup 
 is true croup or diphtheria a physician should be called 
 immediately, for in these cases if diphtheria antitoxin can 
 be administered early death rarely occurs. If the admin- 
 istration of antitoxin is delayed several days the chances 
 of death are about one in ten, while if no antitoxin is ad- 
 ministered the chances of death are much greater. 
 
 In any case of suspected croup look for a white diph- 
 theritic membrane on the tonsils, pharynx or in the nose. 
 Sometimes the membrane is in the larynx and is then in- 
 visible to the unaided eye. 
 
 Cut throat. A throat may be cut by a murderer or by a 
 suicide. Death may follow from loss of blood if the large 
 blood vessels in the neck are severed; but a wound of the 
 windpipe is not necessarily fatal. If a case is seen when 
 no skilled assistance is at hand, it is probably best to leave 
 the case alone and the fainting which follows is the best 
 thing that can happen to check the flow of blood. Send 
 for a doctor and a policeman at once. 
 
 Deafness. Do not be misled into seeking temporary rem- 
 edies for deafness. Remember that it is a sign, a symptom, 
 and not a disease. You must first try to discover which 
 part of the hearing apparatus is in fault, and then direct 
 
74 DEAFNESS 
 
 your attention to remedying the fault if possible (see also 
 "Ear Diseases"). In most cases, at the outset, and in an 
 early stage of deafness without pain, you may syringe out 
 the ear with a glass syringe (or, better still, an india rubber 
 enema syringe), and a lotion made of a teaspoonful of 
 baking soda in half a pint of warm water. Continue until 
 all "wax" and dirt and dried discharge have been washed 
 away. Dry with a towel, and not by poking in a piece of 
 cotton-wool on the end of a hairpin ! If there be still some 
 wax, leave a bit of cotton-wool soaked in a very strong soda 
 solution, in the ear for a few hours; then squirt again. 
 If the ear is too tender to allow this to be done properly, 
 put a poultice on the side of the head; or, better still, a 
 hot onion (see "Poultices"). If now the deafness is not 
 gone, it must be caused by catarrh, which makes the mucous 
 membrane lining the whole hearing apparatus swollen and 
 hot, and interferes in several ways with hearing. There is 
 no "certain cure" for this catarrh; there is no "cure" at 
 all, really. You cannot learn too soon that a catarrh is 
 only the local sign of a general constitutional weakness. 
 You may apply douches, ointments, gargles, drops, etc., as 
 much as you like, and they are all useful to relieve the 
 discomfort; but they will not cure. A nasal catarrh, like 
 every other catarrh, must be cured by improving the bodily 
 health, and specially by change of air. You must call the 
 doctor in to prescribe lotions, douches and drops that may 
 be necessary to your special case; but you, yourself, must 
 see to the cure. You must live in a well-ventilated house ; 
 must have the window open at night; must dress lightly 
 but warmly and use no such unwholesome clothes as eider- 
 downs and the furs of dead animals. You must eat all 
 you are able to, chewing the food well. You must rest in 
 bed enough; you must indulge in no bad habits (see "Hy- 
 gienic Misdemeanors"), and take no unnecessary stimu- 
 lants. Little by little, as time goes on, your general health 
 will improve and your liability to catarrhs will be con- 
 quered, and you need spend no more on deaf-curing insti- 
 tutes or medicines. If your weakness is hereditary so much 
 the worse for you, and the harder you must fight, and the 
 less dissipation you can afford. But catarrhal deafness is 
 not to be cured by medicines (though, of course, good medi- 
 cal advice and treatment are necessary to help you on your 
 way), but by living hygienically and wholesomely. 
 
DEATH, SUDDEN 75 
 
 Death, Sudden. We are not going to say anything about 
 death which occurs suddenly as the result of an injury or 
 an accident. We are referring only to sudden, unforeseen 
 death occurring in a person whom we had supposed to be 
 in no immediate danger of dying at all. 
 
 No one dies suddenly, apart from the effects of violence, 
 as long as all his organs are sound. But there are diseases 
 which develop slowly and secretly, without letting the pa- 
 tient know of their existence by pain or feeling of illness. 
 Not absolutely without signs, we mean; but without signs 
 enough to alarm the patient, though his doctor may know 
 at a glance that he is liable to die suddenly. For example, 
 a man with advanced disease of his blood vessels may only 
 complain occasionally of a little indigestion, or flushing, or 
 shortness of breath. A man with diabetes eats heartily, 
 sleeps well, and is cheerful, but he may die to-morrow all 
 the same. One cause of sudden, unforeseen death is fatty 
 heart, probably caused by the patient's own faulty mode 
 of life, or indulgence in alcohol. Another cause is valvular 
 heart disease which may exist for years, and only kill when 
 the poor overworked heart is suddenly overtaxed. Another 
 cause is the dreadful angina pectoris, or breast pang a 
 sudden, terrific pain at the heart, a sense of impending 
 death and then sudden death, or absolute recovery. Some 
 people have three or four attacks of real angina before 
 one carries them off. This is not the same as the acute 
 attacks of heart pain that so many hysterical females com- 
 plain of. Those are often due to wind in the stomach, and 
 do not cause death ! The bursting of an aneurism, or blood 
 tumor, occasionally causes death unforeseen, because an- 
 eurisms occasionally exist quite unsuspected, especially in 
 robust and hard-working mechanical laborers. 
 
 Another set of causes is connected with the brain, and 
 are such as tumors of the brain, and bleeding into the head, 
 between the brain and the skull. People with epilepsy 
 sometimes die suddenly in a fit. In the Reign of Terror, 
 and doubtless occasionally since also, death has occurred 
 from emotion terror, rage, or despair, and even joy. 
 Tight-lacing has caused sudden death. Then there are 
 deaths from sunstroke ; a great many people die every year 
 in New York from that cause. Some even die of heat 
 stroke in the depths of a shady wood, or while watching a 
 great house on fire. In Russia cold kills about 700 people 
 
76 DELIRIUM TREMENS 
 
 every year. A few children die every year, with sudden- 
 ness, as the result of tobacco smoking. Very stout people 
 are apt to die of sudden heart failure, especially during 
 exercise after over-eating, or while walking up a hill. 
 Anaemic girls, who are so often the victims of the indiges- 
 tion due to ulcer of the stomach, sometimes die suddenly. 
 This is due to the shock caused by the ulcer perforating 
 through the stomach wall and the food escaping into the 
 cavity of the belly ; where it soon sets up peritonitis. Per- 
 sons with gastric ulcer go about in hourly danger of this 
 peritonitis, and this complaint ought, therefore, never to be 
 neglected. 
 
 Delirium Tremens. DRINK MADNESS. In the career of 
 the moderate drinker there is sometimes an occasional de- 
 bauch. The excess is taken, the intoxication is passed 
 through, the long sleep that follows allows nature to recover 
 somewhat, and only a little indigestion remains, or perhaps 
 not even that. This is melancholy enough, seen as a spec- 
 tacle of human weakness; but we are accustomed to think 
 that "there is not much harm done." In the case of an 
 habitual drinker to excess things are different. A tem- 
 porary excess in his case is very likely to bring on what is 
 called drink madness, or delirium tremens. Any accident, 
 fall, shock, or an acute inflammation may bring on this 
 serious condition. The man is restless, irritable, and can- 
 not sleep ; so he flies to alcohol to calm him in pain. He 
 begins to talk incessantly, and to fidget about, or rush 
 violently from place to place. His talking becomes mutter- 
 ing, his muttering grows incoherent. He has horrid vi- 
 sions rats, snakes, and crawling reptiles glide about his 
 bed, and he hears the roars of devouring beasts, and the 
 voices of enemies conspiring to kill him. He attempts to 
 jump out of the window. He cannot sleep, he trembles, 
 cries, groans and raves, and will not eat or drink. 
 
 On the third or fourth day he dies of exhaustion, unless 
 he has been properly treated, in which case the restlessness 
 abates, sleep at last comes to his rescue, and he improves 
 until he is cured. For a time he has been thoroughly 
 frightened. He realizes his weakness and sin, and per- 
 haps rushes to sign the pledge. Unfortunately, the drink- 
 ing habit, once fully established, is rarely abandoned. But 
 every man must decide for himself. If he cannot drink 
 
DENTAL HYGIENE 77 
 
 moderately, without occasional excess, let Mm be manly 
 enough to abstain altogether. The golden mean is only for 
 the strong and self-respecting. 
 
 Treatment. Even in the mildest case the patient must 
 be treated as insane for the time being, and the doctor will 
 consider it his duty to impress upon the friends that the 
 sick man cannot be trusted out of sight for a moment. 
 He has horrid delusions, and at any moment he may commit 
 suicide, or murder. His room ought to be in darkness, and 
 he in bed. To nurse him will require great courage and 
 great tact, so as not to increase the struggles. It is a good 
 plan to put a sheet across him and tie down the corners 
 and tuck in the ends. Strong soups, jellies, beef essences, 
 and plenty of milk must be administered as often as the 
 patient will take them. It may be necessary to feed him 
 forcibly through a tube. 
 
 We shall advise no drugs. Sometimes drug after drug 
 is given to produce sleep and no sleep comes, and after- 
 wards the drugs, which have been lying undigested in the 
 body, suddenly take effect and poison the patient afresh. 
 Only a doctor can know whether or not to give drugs and 
 when to do so. 
 
 Dental Hygiene , The importance of taking care of the 
 teeth and preventing their decay is appreciated when we 
 realize that in a recent survey of school children 97 per 
 cent, of the boys and girls were found to have teeth in a 
 diseased condition. This means that all through their lives 
 unless their teeth are filled or replaced by false ones 
 they will be unable to chew their food properly, will suffer 
 from indigestion and malnutrition, and every time they 
 swallow they will swallow disease germs which lurk in the 
 (Jirty cavities of diseased teeth. The result will be a con- 
 stant low grade poisoning which will do much to impair 
 their health efficiency and happiness in after life. 
 
 This being the case what precautionary measures can be 
 taken to avoid having the teeth become diseased? 
 
 The teeth ought to be brushed after every meal. If this 
 cannot always be done we should at least take great care 
 to clean them just before bedtime and before breakfast. 
 
 The teeth should be brushed up and down as well as 
 crossways. The backs should be brushed as well as the 
 fronts. It is well after cleaning to draw a silk thread in 
 
78 DIABETES 
 
 and out between the teeth to take away any bits of food 
 which may have caught there and which will ferment if 
 allowed to remain. 
 
 Tooth powder is of service in keeping the teeth clean; 
 but none but alkaline tooth powders should ever be used, 
 as acids spoil the teeth. 
 
 Every morning and evening an alkaline mouth wash 
 should be used. A good example of such a mouth wash is 
 alkalol, or the official Liquor Antisepticus Alkalinus. 
 
 Once every six months the teeth should be cleaned by a 
 dentist in order that tartar which collects about the bases 
 of the teeth can be removed. 
 
 Offensive breath usually comes from decaying food par- 
 ticles which are allowed to remain between and about the 
 teeth. 
 
 A good inexpensive tooth powder may be made up by 
 your druggist as follows: 
 
 Bicarbonate of soda, y 2 ounce ; precipitated chalk, 2 
 ounces; pulverized orris root, 1 ounce; pulverized 
 Castile soap, 1 ounce. Flavor with peppermint or 
 wintergreen. 
 
 A dirty mouth full of disease germs is not only dan- 
 gerous to the owner, but to his associates as well, for every 
 spray from such a mouth in coughing, sneezing, or even 
 talking or reading, is laden with microbes which vitiate 
 the air to be breathed by others. 
 
 Do not forget that nature 's method of brushing the teeth 
 is by chewing foods having considerable firmness of con- 
 sistency. 
 
 This is the reason why the teeth of dogs and bears are 
 usually in such good condition. 
 
 Therefore it is well to include in one's dietary foods 
 which must be chewed to be swallowed, and then to be sure 
 to chew them sufficiently before they are passed on to the 
 stomach for digestion. 
 
 Diabetes. There are two forms of diabetes, distinct dis- 
 eases, but both characterized by the daily passage of too 
 large a quantity of urine. Diabetes insipidus is a nervous 
 disease, chiefly of children, who suffer from intense thirst 
 and an excessive amount of urine, which, however, contains 
 nothing unusual. 
 
DIABETES 79 
 
 Diabetes Mellitus is much more common. The symptoms 
 of it are these : 
 
 (1) Loss of weight and increase of weakness. 
 
 (2) Continual thirst. 
 
 (3) Frequent desire to pass water and the passage 
 of large quantities of it every day. The normal person 
 passes about 3 pints a day (see ll Urine Troubles ") 
 but the diabetic passes as much as 20 or 30 pints a day 
 sometimes. 
 
 (4) The urine is sweet (it contains grape-sugar), 
 very pale in color, is irritating to the private parts, 
 and often causes itching and skin eruptions. 
 
 (5) The appetite is sometimes enormous. 
 
 (6) The breath often smells sweet, as of apples. 
 
 (7) Skin eruptions of all kinds, especially eczemas, 
 are common. 
 
 (8) Indigestion, decay of the teeth, dry harsh skin, 
 are common signs. 
 
 Causes. Disease of the pancreas (sweetbread) is con- 
 sidered to be one cause of the symptoms. The liver is evi- 
 dently at fault, too, for the liver is the organ which deals 
 with the starches and sugars taken in the food, and which 
 ought to store them up (as sugar) for future use, instead of 
 letting them escape by the urine. The immediate causes 
 are not known either; too much brain work, too much 
 worry, too much business strain may all cause an attack. 
 Engine drivers suffer particularly from the nerve strain 
 they experience. 
 
 There are three more or less definite types of cases of 
 diabetes: 
 
 (1) Young patient, with much sugar in the urine, 
 with chest complications and general debility. The 
 escape of sugar cannot be controlled much by the use 
 of drugs or dieting, and the disease is fatal in a few 
 months. 
 
 (2) Middle-aged patient, with sugar leakage, which 
 can be controlled to a large extent by suitable treat- 
 ment and drugs, and which may last for from two to 
 four years. 
 
 (3) Elderly patient, in whom all the symptoms are 
 not very severe, and who gets great benefit from medi- 
 
80 DIET FOR DIABETES 
 
 cines and dieting, but who dies at last from consump- 
 tion of the lungs or coma after many years. 
 
 The complications of diabetes may be : 
 
 Neuritis and paralysis, various skin diseases, kidney 
 diseases, cataract, carbuncles, collapse or coma (in- 
 sensibility), gangrene (of lung, or of toes or fingers). 
 
 Coma, in diabetes, accounts for the deaths of about half 
 the total number of patients. It may come on quite sud- 
 denly as the result of an injury, or merely of fatigue. The 
 patient becomes collapsed, his breathing is slow, then very 
 slow, and his breath smells sweet (as of hay or apples), 
 and he quietly becomes unconscious and insensible and dies 
 at last without moving. Nothing can be done when coma 
 comes on. 
 
 Note about diabetes. Persons who suffer from boils, 
 eczema, carbuncles, itching of the privates, too much ap- 
 petite, continual thirst, loss of sexual power or desire, 
 ought to take a specimen of their urine to a doctor and 
 ask him to examine it for sugar. They may have early 
 diabetes. 
 
 Treatment of diabetes. This consists almost entirely in 
 suitable dieting and the use of opium as a medicine. As 
 to the dieting we are obliged to say that no two cases of 
 the disease do well on the same dietary. So that no dia- 
 betic patient can possibly do without a doctor. The great 
 point about the diet is that it must contain as little as 
 possible of either sugar or starch. 
 
 Every week of his life the patient ought to weigh him- 
 self, estimate the amount of sugar in his urine (which he 
 can learn to do for himself), and adjust both diet and 
 medicine from time to time in accordance with what he 
 notices about the sugar and his own comfort in life. We 
 can lay down no hard and fast rules ; but here are two lists 
 which may help some diabetic patient to diet himself: 
 
 He must not eat Potatoes, turnips, carrots, cauliflower, 
 peas, beans, seakale, apples, pears, oranges, gooseberries, 
 currants, plums, peaches; cornflour, bread, rice, sago, tapi- 
 oca, confectionery, pastry, liver ; sugar of any kind. 
 
 He may eat Any kind of meat, game, poultry, or fish; 
 all green vegetables ; cheese, butter, eggs, saccharin or saxin 
 in place of sugar; nuts. The only real difficulty is in the 
 
DIARRHEA 81 
 
 matter of bread. Bran bread, gluten bread, toasted thin 
 slices of baker's bread, almond cakes, cocoanut cakes, may 
 be eaten. 
 
 The question of drinks must be left to the doctor ; and so 
 must that of medicine. Codeine (from opium) still re- 
 mains the best drug to use in most cases. 
 
 Diarrhea. Diarrhea is of frequent occurrence, and it 
 arises from very different causes, and exists from the pres- 
 ence of many different diseased states. In infancy it is 
 commonly due to improper feeding, to over-feeding with 
 milk, or too early use of starchy foods with the milk, or 
 to the use of bottles, tubes, and teats insufficiently cleansed, 
 or to the use of milk food which has turned sour from 
 staleness, or hot close weather, or from being kept in rooms 
 with foul air. If an infant has frequent diarrhea, in the 
 absence of all these causes, there is a danger that the child 
 has tuberculous or consumptive disease of the bowels, which 
 is a most dangerous ailment. In older children diarrhea 
 is almost always set up by errors of diet, especially by 
 unsound fruit, and unwholesome foods. In adults occa- 
 sional attacks of diarrhea are also generally due to im- 
 proper food, or to some gross excess in some article of diet 
 or of drink. Impure drinking water from public courses, 
 or from private wells, or drunk from dirty cisterns, may 
 also produce diarrhea. The presence of many decayed 
 teeth, causing faulty digestion, is also a fertile cause of 
 upset bowels, with colic pains and frequent loose stools. 
 In addition to these various reasons for the presence of diar- 
 rhea, it must be remembered that it may be due to the pres- 
 ence of serious organic disease or to typhoid fever. Chronic 
 intemperance, which has partly destroyed the liver, is often 
 accompanied by a form of diarrhea, which rapidly reduces 
 the strength of the sufferer. Phthisis, or consumption of 
 the lungs, in its later stages, is in many instances ac- 
 celerated by very persistent and exhausting diarrhea, 
 which is due to tuberculous ulceration in the intestines. 
 In typhoid or enteric fever also the looseness of the bowels 
 results from a peculiar form of ulceration in the coats 
 of the large intestine. Acute attacks of severe diarrhea 
 also occur, generally in autumn in this country, in an 
 epidemic form; these are sometimes called cholera morbus. 
 
 Treatment. When diarrhea is set up by offending mat- 
 ters in the bowels, it is first necessary to effect complete 
 
82 DIARRHEA IN BABIES 
 
 removal by some simple non-irritating purgative dose, such 
 as castor oil, or compound senna mixture, or by Epsom 
 salts, with peppermint or ginger ; and then, later, to ad- 
 minister sedatives and astringents, such as chalk mixture, 
 aromatic confection, or paregoric. But if the diarrhea 
 be due to ulcerations in the bowels the highest medical skill 
 may be needed to keep it under control by means of more 
 powerful medicines and special care in diet. 
 
 Here follow some formulas which if used with discretion 
 and intelligence may be found useful : 
 
 For Summer Diarrhea,. Bicarbonate of soda, 4 grains ; 
 rhubarb powder, 1% grains; cinnamon powder, 1 
 grain; for one powder. A child of one year old 
 may take this powder twice a day. A dose of castor 
 oil with 10 drops of laudanum in it will often check 
 diarrhea. 
 
 For Alcoholic Diarrhea. Take a two-grain pill of 
 capsicum every four hours. 
 
 Chronic Diarrhea. Take a two-grain pill of acetate 
 of lead every four hours. (See also " Diarrhea in 
 Babies.") 
 
 Diarrhea in Babies. Diarrhea in babies is generally a 
 sign of inflammation of the intestines (enteritis) caused in 
 the first place by unsuitable food, and kept up by the want 
 of nourishment, which follows as a matter of course. ( This 
 disease is often spoken of among the poor as "consumption 
 of the bowels, ' ' but need not be connected with tuberculous 
 disease). If the mother looks at the child's "motions" in 
 the napkins she will see that they consist generally of masses 
 of lumpy curd (undigested cow's milk), rather like clots 
 of putty in appearance, smelling badly and greenish in 
 color. Along with the curdy mess is a little acrid greenish 
 discharge, which the nurse is apt to suppose to be urine, 
 but which comes really from the intestine. If opiates, 
 soothing syrups, or vegetable astringents (such as aro- 
 matic powders) are given, the baby will probably get worse 
 and perhaps die. The child vomits, and sinks into an 
 exhausted state, due simply to lack of nourishment. The 
 greatest mistake is to continue to administer cow's milk, 
 which the child cannot digest. Dr. Lennox Wainwright 
 recommends in these cases a diet mainly of albumen water. 
 This is made of the white of a raw egg, beaten up with 
 
DIPHTHERIA 
 
 half-a-pint of water, and sweetened with sugar and milk. 
 Alternate feeds may consist of whey (made with rennet 
 and milk and cream). No ordinary cow's milk may be 
 given. The only medicine required is gray powder in 
 doses of half-a-grain or so, according to the baby's age. 
 
 Digestibility of various kinds of food. An ordinary 
 dinner of soup, meat, vegetables, bread, pudding and 
 cheese, is digested in from four to five hours. Some of 
 the ingredients are more digestible than others. The fol- 
 lowing table gives approximately the hours required for 
 the digestion in the stomach of some of the principal 
 foods : 
 
 HOURS 
 
 Beef, boiled 3 
 
 " roast 34 
 
 " grilled 45 
 
 Cheese 3 4 
 
 Cabbage 3| 4 
 
 Carrots 3 3i 
 
 Eggs, raw 2 
 
 " fried or boiled 3 3J 
 
 " _ hard-boiled 3| 4 
 
 Goost, roast 4 5 
 
 Fish, boiled 1 \ 2J 
 
 Ham, boiled 2 3 
 
 Lamb 2J 
 
 Apples 
 
 HOURS 
 
 Mutton, boiled 3 
 
 roast 3 3i 
 
 Milk 2 
 
 Oysters, raw 2 
 
 Potatoes, boiled 2 31 
 
 Pork roast 5 
 
 Poultry 2 4 
 
 Tripe 1 
 
 Turnips 3| 4 
 
 Rice 12 
 
 Sago 1 2 
 
 Tapioca 1 2 
 
 Wheat Bread 3 4 
 
 3 4 hours. 
 
 Diphtheria. This is a disease in which there is inflam- 
 mation of the throat chiefly, but also, sometimes, of the 
 lining of the nose and air passages. What is called a 
 ''false membrane" is formed on the parts affected. This 
 is a whitish, tough substance, which covers a red, inflamed 
 and tender place. The disease does not begin, as a rule, 
 suddenly, but the sufferer complains of a bad sore throat, 
 and tenderness and swelling at the angle of the jaw, head- 
 ache, and sickness. He is feverish and ill, and so power- 
 ful is the poison of the disease, caused by a germ called 
 the bacillus of diphtheria, that the sick child (it is very 
 often a child under twelve years) becomes rapidly ex- 
 hausted, and may die suddenly of heart failure, or of 
 suffocation. This disease is contagious, especially if one 
 comes in contact with the sneezes or coughed-up phlegm 
 of the child. 
 
 A child with diphtheria gets rapidly worse, coughs, 
 
84 DIPSOMANIA 
 
 tosses restlessly in bed, gasps and wheezes. A doctor must 
 be called at once. If he is called as soon as there is a sore 
 throat, he will inject a substance called antitoxin, which 
 will soon cure the disease. Diphtheria is too serious a 
 matter for any amateur doctoring, and so we shall say 
 nothing about the treatment of it. But it is important 
 that the reader should know how serious may be the com- 
 plications and sequels of the disease. 
 
 First of all, a child with diphtheria of the throat and 
 air tubes may be suffocated at any moment, and a doctor 
 must be on the alert ready at any time to perform trache- 
 otomy, that is, to make an opening in the windpipe for 
 the patient to breathe through. Secondly, the child's pulse 
 must be carefully watched by the doctor in order to stave 
 off exhaustion, or else he may die suddenly. Thirdly, 
 pleurisy or pneumonia may develop. Fourthly, a few days, 
 or even weeks, after apparent recovery, the child may be- 
 gin to talk through his nose, and to choke over his food. 
 These signs are caused by paralysis of the palate of the 
 mouth, due to the diphtheritic poison. He may also squint, 
 or become weak in the legs. He may even die of paralysis 
 of the heart. Generally, however, he recovers in a few 
 weeks. 
 
 The chief things to remember in these cases are, to be 
 careful not to catch the breath of the patient ; to nurse him 
 in a room empty of everything except really necessary 
 furniture; to hang a sheet wetted with carbolic acid over 
 the room door; to use plenty of disinfectants; to give the 
 child no toys or books that cannot be burnt afterwards ; and 
 to keep everyone out of the room except the nurse and 
 the doctor. 
 
 Dipsomania. This is a form of drunkenness in which 
 the drunkard drinks to excess in bouts, or paroxysms, and 
 then goes for some time without drinking at 'all. Dur- 
 ing the attack the dipsomaniac drinks because he has a 
 craving to do so, which he has no strength to resist (and, 
 perhaps, in some cases, no desire either) ; and in the in- 
 tervals he does not drink because he suffers from remorse, 
 and has been made thoroughly ill besides; and, perhaps, 
 because the craving is absent, and he has lost for the time 
 all desire for alcohol. When the end of the period of 
 abstinence is over the craving comes back again, and, if 
 
DISINFECTION 85 
 
 he has any moral courage left, he will fight against the de- 
 sire until either he or the demon is conquered. But in- 
 dulgence in alcohol weakens everyone's moral nature, and, 
 by-and-bye, he cannot resist drinking, even though he may 
 wish to do so with all his unhappy soul. This is one of 
 the laws of the disease of drunkenness the fact that the 
 craving is periodical. It is easy for people to fancy that 
 if a dipsomaniac can stop for six weeks he could easily 
 stop during the seventh also, if he liked. It is not the 
 case. Just as in ague or malaria, the attacks come on more 
 or less regularly, and leave the patient fairly well between 
 times, so in dipsomania, when the craving comes he falls 
 into the slavery he becomes again a victim to the poison- 
 ous drug habit, and is no more free than the sufferer from 
 ague is. 
 
 Now, from what has been said, it will be seen that to 
 cure drunkenness, two things are necessary one, to stop 
 the supply of alcoholic poison, which weakens the moral 
 and physical resistance against itself; and the other, to 
 break up the rhythmic regularity of the attacks, to in- 
 terfere with their periodicity. These things are what 
 honest systems of cure aim at doing. In the intervals the 
 drunkard is fed up and rested and encouraged, so that 
 the ravages of the poison may be met by as strong a body 
 as possible ; and then, when the attack comes on, he is put 
 under restraint, so that he cannot possibly obtain the poison 
 which will ruin him, body and soul. 
 
 Disinfection. After every case of contagious disease and 
 advisedly after every case of infectious disease the room 
 and fabrics in contact with the case should be disinfected. 
 A disinfectant is an agent capable of destroying the in- 
 fective power of infectious material. 
 
 The most effective disinfectants are fire, steam and heat. 
 
 These will kill anything. The most useful disinfectant 
 for room purposes is formaldehyde gas. 
 
 After closing all cracks and crevices in a room by cotton, 
 adhesive plaster or paper, one pound of unslaked lime may 
 be put in a tin basin resting on bricks and on this is poured 
 y 2 pint of 40% formalin. This is sufficient for 1000 cu. 
 ft. of space. The room should remain sealed for 6-8 
 hours. 
 
 Formaldehyde gas may be made for this purpose. 
 
86 DOSAGE 
 
 Sulphur is frequently used, but is not as good as for- 
 maldehyde although it will destroy vermin, which for- 
 maldehyde will not do. For each 1000 cu. ft. to be disin- 
 fected 3 Ibs. of sulphur are to be burned. The heat gen- 
 erated by burning sulphur is so great that the pan con- 
 taining it should rest on bricks not on a wooden floor 
 directly. 
 
 These gases do not penetrate fabrics very far. 
 
 Chloride of Lime, and trikresol are good disinfectants 
 for discharges from patients. 
 
 Bichloride of mercury (1-500) is useful in the disin- 
 fection of bed clothing. 
 
 Lime in the form of whitewash is a capital form of cheap 
 disinfectant for country buildings and outhouses. 
 
 Among the proprietary disinfectants may be mentioned 
 Platt's Chlorides, C. N. Disinfectant and the English 
 Sanitas Fluid. 
 
 Dislocation generally means that the bones of a joint 
 are displaced, and this has been done by violence of some 
 kind. Every joint in the body is liable to be the seat of 
 dislocation, but dislocations of the collar bone, elbow, ankle, 
 and jaw, are most common. 
 
 The non-medical person cannot generally distinguish be- 
 tween a dislocation of a joint and a fracture, or break- 
 age, of the bone. Sometimes the bone is broken and dis- 
 placed also. The notable thing about most simple dis- 
 locations is that a joint which usually moves freely has 
 become fixed. Of course a dislocated collar bone is an ex- 
 ception to this, but it may be known by a lump in an un- 
 usual situation. No one, who is not a doctor, can possibly 
 hope to "reduce the dislocation" or put back the bone into 
 its place without a serious risk of doing more damage to 
 the joint. In the case of a dislocation of the jaw the pa- 
 tient's mouth is open, and he cannot close it. It may be 
 out of joint on one or on both sides at the same time. It 
 may occur during yawning. Nearly every dislocation is 
 accompanied by a sprain and a bruise; so refer to the 
 articles on those subjects. 
 
 Dosage. When the dose of a medicine is mentioned in 
 this book, it is a dose which would suit an adult. To find 
 out what dose to give a child or infant, consult the fol- 
 lowing table : 
 
DRACHMS AND OUNCES 
 
 87 
 
 
 
 For example, if t 
 
 he Adult Dose: 
 
 For a Child of 
 
 Give 
 
 Be One Drachm; 
 (or 60 grains, or 
 
 If One Ounce; 
 (or two table- 
 
 
 
 60 minims). 
 
 spoonfuls). 
 
 Less than 1 year old 
 
 y 1 ^ of adult 
 
 give 5 grains 
 
 40 minims 
 
 
 dose 
 
 
 
 2 " 
 
 i of full dose 
 
 7J 
 
 1 drachm 
 
 " " 3 
 
 ft 
 
 10 " 
 
 80 minims 
 
 f( (I 
 
 I 
 
 15 " 
 
 2 drachms 
 
 Between 4 & 7 yrs. old 
 
 I 
 
 20 " 
 
 160 minims 
 
 7 & 14 " 
 
 I 
 
 30 " 
 
 \ fluid oz. 
 
 14&20 " 
 
 
 
 40 " 
 
 5 drs. 20 ms. 
 
 Above 21 years old 
 
 Full dose 
 
 
 
 Drachms and Ounces. All through this book, prescrip- 
 tions for medicine will be found written in drachms and 
 ounces. When referring to a liquid medicine the words 
 drachm and ounce really mean fluid drachm and fluid 
 ounce. 
 
 There are 60 grains to a drachm, 8 drachms to an ounce ; 
 and there are 60 minims to a fluid drachm and 8 fluid 
 drachms to a fluid ounce. A minim is a measured drop. 
 Now, in domestic life, these measures correspond nearly to 
 certain familiar measures as follows : 
 
 A fluid drachm is about 1 tea-spoonful. 
 A fluid ounce is about 2 tablespoonfuls. 
 
 A tablespoon holds about . . half a (fluid) ounce. 
 
 A dessertspoon ' ' 
 
 A claret glass ' ' 
 
 A sherry glass 
 
 A port wine glass 
 A tumbler ' ' 
 
 two drachms, 
 four ounces, 
 two ounces, 
 two and half ounces. 
 10 fluid ounces, or half- 
 a-pint. 
 
 It will be easily understood that teaspoons and table- 
 spoons and glasses vary in size, so that they are not ac- 
 curate measures for medicines. It is always advisable to 
 have a properly marked medicine glass in the house and 
 to measure all medicines before giving them. Most modern 
 teaspoons will hold as much as 85 instead of only 60 
 minims. 
 
88 DRINKING CUP 
 
 Dreams. Dreaming is not quite a healthy condition. 
 No one ought to dream, pleasantly or otherwise. Sleep, 
 in fact, ought to be quite dreamless, and always is, if we 
 live hygienically. The meaning of dreaming is this 
 only a part of the brain is asleep ; in the remainder of 
 it, or in certain parts of it, thoughts run riot uncontrolled 
 by the higher centers of judgment and reason. Every 
 mental picture seems real; probability counts for nothing; 
 nothing is too absurd and nothing seems impossible, in 
 dreamland. When we realize the necessary truth of these 
 facts we see how ignorant and absurd it is to be influenced 
 or terrified by dreams, in our waking moments. A dream 
 is an uncontrolled fanciful riot of the lower mental facul- 
 ties, and the causes of this too-light sleep may be too much 
 mental worry, the bad habit of "thinking things out" in 
 bed, too heavy bed clothing, excessive blood supply to the 
 brain due to heart disease, excessive use of tobacco, which 
 depresses the heart, tight-lacing, costiveness of the bowels, 
 indigestion, and so on. The treatment of dreaming is the 
 removal, as far as possible, of the cause, and not the taking 
 of composing draughts or ' ' night caps. ' ' (See also ' ' Night- 
 mare.") 
 
 Many young men find that they are troubled with 
 dreams only when they sleep on the back. Such should 
 tie an empty cotton reel on the back over the spine by 
 a string round the waist, so that it will wake them and 
 make them turn to sleep on the side. Dreamers should 
 also avoid cigarette smoking and late suppers, and es- 
 pecially alcoholic drinks in the evening. 
 
 Drinking Cup. Reliable bacteriologists who have made 
 examinations of common drinking cups have found on 
 them the germs of diphtheria, tuberculosis, syphilis, in- 
 fluenza, meningitis, pneumonia and ordinary colds. 
 
 It is now known that infantile paralysis, measles and 
 scarlet fever can also be spread in this way, although the 
 germs of these diseases are so small they never have been 
 seen. 
 
 When a public drinking cup has been used by hun- 
 dreds of people it is not only probable that the germs 
 of one or more of these diseases remain on the cup, but 
 an absolute certainty. 
 
 For this reason the use of the common drinking cup in 
 public places is being rapidly abolished by law. 
 
DROWNING 89 
 
 In its place one of two devices may be used: The 
 bubble fountain without a cup; or the individual cup 
 which, as a folding pocket cup, may be carried about, or 
 the paper cup which, after having once been used, can be 
 thrown away or destroyed. 
 
 Dropsy. This is not a disease but a symptom of many 
 different diseases. There are several different kinds of 
 dropsy, too, though the word is generally used by the 
 public to refer only to swollen legs or to fluid in the ab- 
 domen. Dropsy is a collection of liquid somewhere in the 
 body as the result of a disease. Thus when there is dropsy 
 everywhere under the skin, it is called anasarca. The skin 
 is swollen and doughy to the feel. If you press your finger 
 into it, a dimple remains, which takes a certain time to 
 disappear. This sign is called by doctors ''pitting on 
 pressure. ' ' You can see anasarca round the ankles at bed- 
 time, in persons who have anaemia, or heart disease, or 
 merely a fatty weak heart, or Bright 's disease. In the 
 morning, after a rest, the swelling is gone. Dropsy of the 
 belly is called ascites. The fluid collects there as a result 
 of some disease of the liver or gall bladder. 
 
 Dropsy of the chest is called hydrothorax, and occurs 
 in heart and kidney diseases. Dropsy of the head or brain 
 is called hydrocephalus, or water on the brain. Very local 
 limited dropsical swelling, such as occurs near poisoned 
 wounds or injured joints or ''black-eyes," is called cedema. 
 
 Treatment. You have to treat the disease which caused 
 the dropsy, and that, of course, requires the skill of a 
 doctor. 
 
 But you have also to deal with the dropsical part. 
 JEdema of the legs, for instance, must be treated by rest- 
 ing the leg in a horizontal position. In some cases the fluid 
 has to be drawn off, or tapped, by the doctor, before relief 
 can be obtained. 
 
 Drowning. If any one of our readers should rescue a man 
 from death by drowning, or should come across a person 
 who is lying, apparently drowned and dead, on the shore 
 or bank of a river, let him send at once for a doctor, but 
 while the messenger is gone, there are many things that 
 he can do. 
 
 In drowning death may be caused by suffocation, or by 
 the shock produced by striking the head on a rock or on 
 the bottom of the pond. The appearance of the patient 
 
90 DROWNING 
 
 will vary accordingly. A person who has been suffocated 
 by the water will be ' ' black in the face, ' ' the veins of neck 
 and arms will be swollen; and the heart beats cannot be 
 felt. In death from shock the skin is pale, the face calm, 
 and no water has been sucked into the lungs because no 
 attempt at breathing has taken place. If the face and 
 mouth of a drowning person have been under the water 
 two minutes or more, there is probably no chance of his 
 being brought back to life. In the struggles of a drown- 
 ing man he draws water into his lungs and this water suf- 
 focates him. Now, there are four possible ways of deal- 
 ing with a person who is apparently drowned. They all 
 aim at "artificial respiration." The written descriptions 
 of these methods are of little use, however, in our opinion. 
 They can be learnt only in practical ambulance classes 
 where "first-aid" is taught. We shall, therefore, give only 
 a sketch of treatment, so that while the messenger is gone 
 for the doctor the man on the spot need not be wasting 
 valuable time. 
 
 (1) Turn the body on its face, with a rolled-up jacket 
 under the chest, and kneel on or press the chest with 
 the hands to force out water from the lungs. Open the 
 mouth and put the finger in to hook out any mud or 
 weeds that may block up the throat. Pull out the 
 tongue by grasping it with a handkerchief, so that it 
 cannot fall back and stop up the entrance to the wind- 
 pipe. Loosen all tight clothing. 
 
 (2) Then put the body on its back, with the roll under 
 the shoulder blades, and try to make the patient begin 
 breathing again. This requires much patience and pres- 
 ence of mind; above all, don't hurry. A person can 
 only breathe about 15 times in a minute, that is once 
 every four seconds. If you hurry, you do no good. Be 
 deliberate and steady and firm. 
 
 (3) Kneel down at the top of the patient's head. 
 Lean over him and seize his arms just above the el- 
 bows. Draw the arm slowly and steadily upwards until 
 you make them meet over the head. (This imitates the 
 first act of taking a breath, raising the ribs, and suck- 
 ing air into the lungs.) Keep the arms up while you 
 count "one two three" and then turn them down again 
 pressing them firmly and gently against the sides of the 
 
DUST 91 
 
 chest while you count three. (This imitates the act of 
 expiration, forcing the air out of the lungs again.) 
 
 Then repeat the process, slowly, deliberately, and 
 firmly, until you see that the patient is beginning to 
 breathe for himself. 
 
 (4) Then turn your attention to warming him. If 
 there is someone there to help you, let him attend to 
 that part of the business while you are doing the ' * arti- 
 ficial respiration." If blankets are obtainable, wrap the 
 patient up in them and commence rubbing the limbs up- 
 wards in the most energetic way. Take the boots and 
 stockings off and chafe the feet, if you have no hot-water 
 bottle. 
 
 (5) As soon as you can get the now recovering man 
 into a house or room, put hot bottles or hot bricks to 
 the abdomen, feet, under the armpits and between the 
 thighs. As soon as the patient begins to swallow his 
 saliva, make him swallow warm brandy and water, hot 
 coffee, or mulled wine. 
 
 Note. Artificial respiration must be persevered with 
 for at least an hour, even in apparently hopeless cases. 
 
 Once recovered and really alive, if the patient seems 
 to want to sleep, let him. It will aid his recovery very 
 much. 
 
 Dust. The subject of dust became of the greatest im- 
 portance to us when we came to realize what a vast amount 
 of disease was directly attributable to it. For example 
 in some of the dusty trades such as grinders, 49% of 
 all the deaths occur from consumption largely caused by 
 inhaled dust. 
 
 For our purposes consideration of the subject of dust 
 is best divided into inert and living dust (bacteria) ; and 
 in reference to its location, into that in the street, the 
 home, the workshop and the public building or convey- 
 ance. 
 
 Inert dust is chiefly dangerous on account of its irri- 
 tating character to the lungs, causing an increased 
 vulnerability to tuberculosis and other germ diseases. In 
 New York City 305 tons of iron and steel dust are pro- 
 duced monthly. 
 
 Dangerous disease germs may be the sole constituent of 
 finer dust or they may cling to the coarser inert particles. 
 
92 DUST 
 
 This is the reason why exposure to dust on streets so often 
 produces colds, catarrh, influenza, hay fever, tonsilitis, 
 pneumonia and tuberculosis. 
 
 Solid dust particles and bacteria which we breathe in 
 the air do not come out with the expired air, but are re- 
 tained on the moist surfaces of the mucous membranes of 
 the respiratory tract. The body ultimately finds a way to 
 dispose of much of this, but in this process it is liable to 
 sustain much harm. 
 
 Dust particles on the street come largely from small 
 fragments of sand, broken fibers of plants, pollen, fine hairs, 
 the pulverized excreta of domestic animals, ashes, fibers of 
 clothing and other fabrics, particles of lime or plaster or 
 soot, masses and clusters of micro-organisms. 
 
 So dirty is the air of the New York street that while in 
 a given quantity of air there were only 34 bacteria in a 
 private house, on the street there were 5,810. 
 
 For the removal of this street dust we are in the hands 
 of the city street-cleaning department. (Heaven help us.) 
 All we as individuals can do is to breathe through our noses 
 and our handkerchiefs and put our trust in the Lord and 
 our ballots in the box for the other political party at the 
 next election. 
 
 Home dust may be diminished by filtering all incoming 
 air through cheese cloth (if there is a proper ventilating 
 system), and by controlling the expectoration of invalids. 
 
 To avoid the collection of dust have hard floors, with 
 rugs which may be cleaned out of doors, few hangings, 
 and furniture upholstered with smooth surfaced fabrics. 
 
 It must be remembered that when air enters a room the 
 germs on dust settle. 
 
 The air passes out of the room purer but the germs remain 
 and keep constantly collecting in larger numbers. 
 
 In cleaning, anything which stirs up this dust is un- 
 desirable. (See Cleaning.) The best methods are the use 
 of the vacuum cleaner and the moist cloth, avoiding the 
 feather duster and the dry broom. 
 
 In the workshop the dust most to be feared is that 
 which is produced in the course of manufacture. The 
 dusty trades produce the greatest mortality from consump- 
 tion. The remedy is to have the dust removed at its point 
 of origin by a suction ventilator. 
 
 In factories and public places dust should be filtered out 
 
EAR DISEASES 93 
 
 of the air employed for ventilation. Special precautions 
 should be taken against the scattering of bacterial dust 
 from people by discouraging unprotected sneezing, cough- 
 ing and spitting. 
 
 Floors and furnishings should be such as to gather as 
 little dust as possible. Cleaning should be frequently done 
 (at such times as when the dust has well settled) by means 
 of vacuum cleaners, moist cloths, etc. (See Cleaning.) 
 
 Sunlight is one of the best agencies to take the sting out 
 of living (bacterial) dust. 
 
 Dyspepsia (see Indigestion). 
 
 Ear Diseases. Doctors speak of the " external ear," 
 which is the ear you see at each side of a person's head, 
 the "middle ear," which is inside the head and consists 
 of the delicate machinery of the hearing apparatus, and 
 of the "internal ear," which is the auditory (or hearing) 
 nerve. The commonest disease of the external ear is 
 eczema, which generally requires only very slight treat- 
 ment (see "Eczema"). 
 
 Of the hearing apparatus inside the head the only dis- 
 eases we need mention here are polypus and catarrh. The 
 former requires the skill of an aural surgeon for its re- 
 moval. 
 
 Catarrh of the middle ear is very common. When acute, 
 it is a part of a bad cold in the head, which has affected 
 the ear as well as the nose and throat. The ear-ache is 
 intense, because behind the drum of the ear there is a little 
 collection of matter which cannot get out. If the ear- 
 ache is treated by poulticing, the matter bursts through 
 the ear-drum, and comes out, and the relief is immediate. 
 Afterwards the little hole in the ear-drum heals up and 
 the hearing may then be as good as ever. Do not poke 
 anything into the ear, or you may injure the drum. In a 
 very severe case of ear-ache it is better to call the doctor. 
 He will very likely order leeches to be put on over the 
 skin at the back of the ear, and bleeding should be en- 
 couraged. Then with a fine-pointed delicate knife, he will 
 just prick the ear-drum, and let the matter out. If the 
 matter is allowed to break through the ear-drum by itself 
 there is a risk that the little hole or "perforation," will not 
 heal and that the catarrh will become chronic. 
 
 Chronic catarrh of the ear is very difficult to get rid of. 
 When any ear discharge appears, go to an ear surgeon at 
 
94 ECZEMA 
 
 once. Constant syringing may be tried, using a Higgin- 
 son syringe and warm boric acid solution. If the dis- 
 charge smells badly, drops of this lotion may be put into 
 the ear at bedtime: Sulphate of zinc and carbolic acid, 
 of each, 5 grains, and distilled water, one ounce. Much 
 ill-smelling discharge may mean that there is a polypus 
 there. But all such means often fail to cure, and syring- 
 ing does not reach the seat of the trouble. Wearing cotten- 
 wool in the ears only pens up the foul discharge. 
 
 Some wax in the ear is quite natural, but when there is 
 too much of it the patient gets noises and singing in the 
 ears, deafness and sometimes giddiness. Gentle syringing 
 with warm water is enough to dislodge the wax, but if this 
 is unsuccessful, go to a doctor about it without delay. (See 
 also "Deafness.") 
 
 Eczema. Eczema is one of the commonest of all skin 
 diseases and the name has been used so loosely that there 
 is the utmost confusion in the public mind as to what is 
 eczema and what is not, and as to what is "good for 
 eczema ' ' and what is not. It is a disease which has several 
 different stages and which requires different treatment in 
 each stage. It is a disease in which the three stages may 
 be present at one and the same time, in the same person. 
 The different stages can only be properly recognized by 
 a doctor, and the right treatment can only be applied by a 
 doctor. Not only that, but there are many cases of eczema 
 which are incurable. All things considered, therefore, the 
 layman who is going to treat eczema on his own respon- 
 sibility and knowledge has a hard task before him ; and the 
 person who goes about asking his friends or consulting the 
 newspapers for a "certain cure" is doomed to disappoint- 
 ment, because there is no such thing as a "certain cure" 
 for eczema. 
 
 However, a little elementary knowledge of the disease 
 will greatly help the intelligent reader and patient to give 
 intelligent assistance to the doctor in his difficult task, so 
 that we have decided to give a short account of this disease 
 and its treatment, and a few medical recipes. 
 
 Eczema is a catarrh of the skin just as a cold in the head 
 is a catarrh of the mucous lining of the nose and throat. 
 And just as the nose "runs" with fluid discharge and has 
 scabs when the cold is "drying up," so does the skin dis- 
 charge and scab over in eczema. This more or less con- 
 
ECZEMA 95 
 
 tinual "weeping" of the skin under the dried scabs is 
 characteristic of eczema. 
 
 Eczema seems to arise spontaneously, and instead of run- 
 ning a course, it smoulders on, sometimes better, sometimes 
 worse. There are very many varieties of eczema, but really 
 they are all different stages of the same process, though 
 no two cases of eczema are exactly alike. 
 
 An attack of eczema generally begins with sensations of 
 burning and itching; then the part gets covered with a 
 more or less deep red blush, then little blebs form on it 
 and you see all the signs of the catarrh of the skin swell- 
 ing, heat, redness, and pain. Then the blebs burst or are 
 torn open by the patient's scratching, and the skin "weeps" 
 a fluid which stiffens linen as if it were starch. After a 
 few days the patches dry up and heal, and then probably 
 another patch or two breaks out, until they may spread 
 all over the body. 
 
 We have described a mild case. In worse cases the skin 
 may become thickened and inflamed and cracked terribly; 
 the itching may cause weeks of sleeplessness and ill-health. 
 We have seen strong men crying with worry and irrita- 
 tion and want of sleep when the eczema did not look very 
 bad; and we have seen them scratch madly at the itching 
 skin until blood came, and until they became tired out with 
 pain and nervous exhaustion, and sink to sleep for a while. 
 Added to such terrors as these, there are sometimes extra 
 sores and boils produced by scratching and contact with 
 infected things. No wonder then that the doctor sometimes 
 feels in despair about a case of eczema. 
 
 There is no part of the skin which may not be attacked 
 by eczema. We shall refer especially only to a few of the 
 commoner varieties of the disease. 
 
 Scalp eczema is generally red and dry and covered with 
 crusts, and complicated with other kinds of skin disease. 
 Wash head with soft soap and apply weak sulphur oint- 
 ment. 
 
 Eczema of the ear is common and sometimes spreads right 
 into the ear hole. Cold cream should be applied. The 
 druggist can sell you some cheaper than you can make it. 
 
 Eczema of the palms leads to much cracking and swelling 
 and pain and soreness of the hands ; the nails often become 
 pitted and split and discolored. Soak the hands in a 
 calamine lotion bath for a half-hour occasionally. Keep 
 
96 ECZEMA 
 
 the parts always covered with weak sulphur ointment 
 spread on lint. 
 
 Eczema of the bathing-drawers area. This name ex- 
 plains itself. The eruption is confined to the parts which 
 would be covered by short bathing-drawers. The crusts 
 and swollen inflamed skin, so tender that the patient can 
 hardly sit down, make life almost unbearable. The parts 
 should be swathed in linen, soaked in calamine lotion, and 
 later on dredged lightly with a powder made up of talc, 
 87 parts ; starch, 10 parts ; and salicylic acid, 3 parts. 
 
 Eczema is sometimes associated with piles, which must 
 be treated by themselves (see ''Piles"). 
 
 Now, the causes of eczema are not well understood. Cer- 
 tain types of people, such as gouty people, are very liable 
 to it; but there is no real gouty eczema, and in Germany, 
 where there is very little gout, there is plenty of eczema. 
 The disease is just as common among the well-fed chil- 
 dren of the rich as among those of the poor. Breast-fed 
 children are not less liable to it than bottle-fed. 
 
 Eczema itself is not contagions. It can nearly always 
 be cured if a proper kind of treatment is adopted, and 
 stuck to perseveringly for a long time; but the home- 
 physicker has little or no chance of curing it with house- 
 hold remedies. 
 
 Treatment of eczema. We know that there are certain 
 individuals who believe that in every case of disease, es- 
 pecially skin disease, the "blood must be out of order," 
 therefore, they argue, you must give a medicine to * ' purify 
 the blood"; and the disease will cure itself then. Well, 
 there is a certain small amount of truth in the idea, and 
 it is worthy of a little of our consideration. A few cases 
 of eczema may be improved by blood-purifying medicines, 
 but in most cases the less drugging the better. No known 
 medicine will benefit every acute case of eczema. Arsenic 
 and antimony and opium are all useful in acute and pain- 
 ful cases, but these medicines being also poison must be 
 prescribed by the doctor himself. The following items of 
 treatment can be attended to by the patient himself: 
 A very simple diet, a free action of the bowels (castor 
 oil), no stimulants, rest in bed with light coverings, and 
 two-grain doses of quinine every four hours. This is the 
 way to treat an acute inflamed attack of eczema. The doc- 
 tor will add the other necessary medicines. 
 
ECZEMA 97 
 
 Now the local treatment of eczema is much more im- 
 portant. In applying local ointments and remedies, you 
 must keep two rules: 
 
 i- 
 
 (1) The strength of the remedy must be in propor- 
 tion to the degree of intensity of the disease. It 
 is hopeless to apply a strong ointment to a mild 
 attack of eczema. 
 
 (2) The remedies must be kept continuously applied. 
 It is useless to smear a little ointment on occa- 
 sionally. 
 
 Then, as regards the treatment itself: 
 
 Remove all crusts and scales, after softening them 
 with olive oil, with a piece of clean lint. Other- 
 wise the remedies cannot get down to the mis- 
 chief. The parts must never be washed with 
 ordinary water, and soap must never go near 
 the disease. The weeping surfaces may then be 
 bathed with a lotion made of a soloid of boric acid 
 dissolved in rain water, or water which has been 
 boiled, and dried by the use of muslin bags, con- 
 taining starch and boric acid powder in equal 
 parts. Then smear some of this cold cream on 
 a clean rag and keep it applied to the raw sur- 
 faces: Zinc oxide powder, 6 drachms; lanolin 
 ointment, 2 drachms ; olive oil, 1 ounce ; lime water, 
 1 ounce. 
 
 As to other ointments and preparations, you have to 
 "feel your way" in using them. The plastermulls in- 
 vented by Professor Unna are most useful to eczema pa- 
 tients. They are to be cut out to the exact size of the patch 
 of eczema. They are made of various medicinal materials. 
 For the terrible itching, dab on the following lotion with a 
 clean plug of cotton-wool: Carbolic acid, 1 drachm; 
 glycerin, 2 drachms; water, to 8 ounces. If that does not 
 relieve the itching, perhaps the following will be better: 
 Lunar caustic, 15 grains; sweet spirit of niter, 1 ounce; 
 detergent tar solution, 2 ounces. To be dabbed on with 
 cotton-wool (never with a sponge). 
 
 For the old hard chronic patches of eczema, which will 
 not heal or yield at all to other plastermulls or ointments, 
 
98 ENEMA 
 
 try sulphur plastermull ; and lastly the following: 
 Chrysarobin, 10 grains; lanolin, 1 ounce. 
 
 Lastly, do not forget that eczema is a catarrh of the skin, 
 and so the dryer the climate the better will the patient 
 get on. 
 
 Emetics. An emetic is a medicine which causes vomit- 
 ing. Here is a list of those most commonly in use : 
 
 (1) Give 30 grains (about half a small teaspoonful) 
 of sulphate of zinc in a tumblerful of tepid water. 
 
 (2) Or, give 10 grains of sulphate of copper dis- 
 solved in warm water. 
 
 (3) Or, give a dessertspoonful of mustard stirred 
 up in a tumblerful of warm water. 
 
 (4) Or, copious draughts of warmed sea water. 
 
 (5) To produce vomiting in cases of bad cough, 
 with sticky phlegm, which cannot be got rid of and 
 makes the patient retch: Give (to a child) a tea- 
 spoonful, and (to an adult) a tablespoonful or more, 
 of ipecacuanha wine. 
 
 (6) When the heart is feeble and an emetic is neces- 
 sary, a tablespoonful of sal volatile in a tumbler of 
 water may be very useful. 
 
 (7) If far from medical aid tickle the throat with 
 a feather. 
 
 Emetics are given (1) to children, especially those with 
 whooping cough, to help them to get rid of the phlegm; 
 (2) to drunkards who have "mixed drinks," and are be- 
 ing poisoned with alcohol; (3) to persons who have taken 
 poison. 
 
 (8) The stomach pump. The proper use of the 
 regular stomach pump cannot be taught here. But in 
 the absence of a doctor, a child who has taken poison, 
 or who has been fed upon poisoned food, may have 
 his stomach emptied through an india rubber male 
 catheter attached to an ordinary glass ear syringe. 
 Eub the catheter with a little oil before you slip it 
 down the child's throat. 
 
 Enema. A doctor will sometimes tell you to administer 
 an enema in his absence. An enema is an injection made 
 with an india rubber syringe into the back passage. An 
 
EPILEPSY 99 
 
 enema is generally given for the purpose of making the 
 bowels act freely; but it may be given for other pur- 
 poses, such as to apply a lotion to a sore or ulcerated 
 surface in the rectum, such as occurs in dysentery; or to 
 nourish the patient when he cannot take food by the mouth, 
 because of a cancer for instance; or to stop diarrhea. An 
 enema for making the bowels act is made of a pint of warm 
 water and soapsuds. Another excellent way of making the 
 bowels act is to use a little enema syringe made of vulcanite, 
 and inject about two teaspoonfuls of glycerine. The com- 
 mon form of syringe used for ordinary enemas is called a 
 "Higginson syringe." The patient ought to lie on his or 
 her left side, with a towel or mackintosh beneath him to 
 catch any drippings. The bone nozzle then, well oiled, 
 should follow a well-oiled forefinger into the bowel, and be 
 pushed upwards for one inch. Then withdraw the finger 
 and push the nozzle backwards and upwards for another 
 inch and a half. Then use the ball of the syringe. Many 
 patients like to put in the nozzle for themselves. It gives 
 no pain, and relief of the bowels is speedy. 
 
 Epilepsy. (I.) In olden times this disease used to be 
 called the Falling Sickness, because it consists of a series 
 of sudden fits in which the sufferer almost always falls 
 down, wherever he may be. A fit of epilepsy must not be 
 confused with other attacks, such as syncope or fainting, 
 nor with apoplexy, also called a fit. An epileptic fit or 
 attack consists of a sudden loss of power and sense, causing 
 a fall down, and convulsive twitchings of the muscles of 
 the arms and legs, of the face and jaws. Every fit of con- 
 vulsions is not epilepsy, for children are liable to have fits 
 from teething, from indigestion, or when sickening for 
 some fever or inflammation ; they also have fits from spasms 
 in the throat and windpipe. Any severe attack of convul- 
 sions occurring in a previously healthy child, man, or 
 woman, may be of epileptic origin, but no one could be sure 
 of this. This disease varies very much in severity, both 
 as to the frequency of the attacks, and as to the importance 
 of each fit. Some sufferers have several fits in a day, others 
 may have only one fit in a month or in a year. A fit may 
 come on suddenly, and last only a moment, or it may cause 
 a sudden fall, deep insensibility, general convulsions, 
 gnashing of the teeth, biting of the tongue, and foam at 
 the mouth, and may last for hours. Severe fits are fol- 
 
100 EPILEPSY 
 
 lowed generally by heavy sleep and then by headache and 
 exhaustion. In some exceptional cases the patient has 
 some warning of the coming fit, but in most persons the 
 attack is immediate, and the sufferer drops whatever he 
 may be holding, and falls without any power to save 
 himself from injury or from death. Epileptics are often 
 burnt, drowned, and suffocated in accidental manners ; 
 therefore, never leave an epileptic alone after a fit has 
 occurred. The great mystery about the disease is that 
 although from the symptoms we know that the brain and 
 spinal cord must be affected, yet after death sometimes no 
 fault can be found in them ; and at other times faults are 
 seen which may or may not account for the fits during life. 
 Sometimes surgeons discover neither brain injury, nor 
 tumor, nor bleeding, nor abscess. When there have been 
 several epileptic fits the disease is rarely cured, or recov- 
 ered from. Slight fits often lead to more serious mind 
 failure than severe convulsions, and often end in madness. 
 Epileptics should not marry, nor have families, for their 
 disease is very apt to reappear in their offspring. 
 
 (II.) What to do with epileptics is a very difficult prob- 
 lem, for being never safe from attacks of the disease they 
 are dangerous to have as servants in private houses, and 
 are not safe as workers in factories, nor in the Army or 
 Navy. Farm colonies have been instituted, and perhaps 
 such sufferers are more safe in the fields than anywhere else. 
 
 Epileptics have often bad tempers, and are passionate 
 and revengeful, while many are almost imbecile. A con- 
 siderable number of murders are done every year by epi- 
 leptics, after recovering from a seizure, their mad violence 
 being a sudden short outbreak, which soon passes off, and 
 may leave them quiet and reasonable, and sometimes quite 
 forgetful and unconscious of what they have done. Hered- 
 ity seems to be the most frequent origin of this ailment, 
 and the next most frequent cause is intemperance or mad- 
 ness in the parent. True epilepsy is not started by in- 
 juries, nor by the drunken habits of the person himself. 
 When anyone has had a series of fits, he or she rarely loses 
 them entirely, however treated by medicines, food, or diet. 
 Almost every known drug, vegetable, mineral, or animal, 
 has been given for this disease, and more than a hundred 
 have at some time or other gained some reputation as cura- 
 tives; but it is sad to have to say that there is but one 
 
EPILEPSY 101 
 
 which produces any definite improvement by making the 
 fits less severe, and the intervals between them of longer 
 duration. This drug is bromine, which, however, cannot 
 be given with advantage in its pure state; it is a deep 
 reddish-brown pungent liquid, obtainable from seaweed. 
 In medicine it is used combined with alkalies, and its most 
 usual preparations are bromide of potassium, bromide of 
 sodium, and of ammonium. A fourth form is a clear, color- 
 less, sour liquid, named hydrobromic acid. Bromide of 
 potassium has been most used, beginning with doses of five 
 grains for adults, and afterwards much increased. It is a 
 drug with a calmative effect, but taken continually it is 
 very depressing, and it is not wise to take it except under 
 medical care. Arsenic was once a common remedy, and 
 so was nitrate of silver ; solutions of salts of gold have been 
 tried, and now disused. Epilepsy is eminently a disease 
 for being periodically seen by a doctor, who will watch the 
 course of the treatment, and decide as to its success. 
 
 (III.) As to the treatment of these fits of epilepsy, apart 
 from medicines, we must say that neither a purely flesh 
 nor an entirely vegetable diet will remove the tendency to 
 these fits, nor will total abstinence. The use of tobacco 
 does not seem to have any curative effect, nor does it seem 
 to make the disease any worse. Epileptic fits are attacks 
 of convulsive spasms of the voluntary muscles. These 
 muscles are governed by impulses sent from the brain and 
 spinal cord through the nerves, and these spasmodic jerk- 
 ings are involuntary in onset, and cannot at all be checked 
 by the strongest effort of will. In severe fits, there being 
 temporary loss of the senses, of course the human will has 
 no chance of controlling the spasms. The disease called 
 hysteria, which occurs chiefly in nervous and delicate young 
 women, will sometimes give rise to fits which imitate an 
 epileptic seizure; but the history of the case, and the fact 
 that there is an absolute insensibility, serve to distinguish 
 the two ailments. An epileptic never gives more than one 
 cry in a fit at the onset, whereas the hysterical girl will 
 keep up a noisy disturbance of mixed crying, screaming, 
 and often laughter of a mad sort. In the hysterical fit 
 also the tongue is not bitten, nor is there foaming at the 
 mouth. The actual epileptic fit cannot be stopped until it 
 has run its course, except by means of chloroform or ether, 
 and this administration would, under the circumstances, 
 
102 ERYSIPELAS 
 
 be almost as dangerous as the fit itself. The most impor- 
 tant thing to be done for a fit is to prevent the patient 
 from self-injury, and from wounds and bruises from knock- 
 ing himself on the floor or against furniture. In any case 
 where there is gnashing of the teeth, it is a good plan to 
 put a firm, but soft plug of cork, or some similar material 
 between the jaws ; otherwise the tongue may be sadly bitten. 
 Persons who live in the same dwelling with an epileptic 
 should run to his assistance when any cry or moan is 
 heard, and the patient should be laid, if possible, on the 
 floor on a rug; or if put on a bed or sofa, he must be 
 prevented from falling. In general, no medicine can be 
 given during a fit, but in some very severe and long attacks 
 an anaesthetic, such as ether, chloroform, or nitrous gas, 
 may be administered by a doctor. 
 
 Erysipelas. This disease is less common than it used to 
 be, and the reason is that our sanitary arrangements are 
 much more perfect than they were. 
 
 Where there are defects of drainage, broken sewers, cess- 
 pits near houses, or worse still near wells, or where sewer 
 gas enters dwelling houses, there erysipelas used to be rife. 
 It was also a common disease in the surgical wards of our 
 hospitals before that famous surgeon, Lord Lister, intro- 
 duced the antiseptic mode of treating wounds. 
 
 Erysipelas may attack patients suffering from wounds, or 
 it may appear in a person who is otherwise out of health, 
 sickly, or of broken-down constitution. In either case the 
 true cause appears to be a special disease germ floating 
 about the air of a place. It used to be called a miasmatic 
 disorder, and by miasm was meant impure air air poi- 
 soned by exhalations from diseased persons, or from many 
 wounds, or from decaying animal matter. This was before 
 the time when the microscope became powerful enough to 
 discover very minute bacilli, bacteria, and microbes. This 
 disease is sometimes epidemic that is, affecting a great 
 number of persons at once ; or it may be sporadic that is 
 to say, occurring in solitary cases. 
 
 Erysipelas is always contagious, and although medical 
 men and nurses but rarely catch it when attending cases, 
 yet sickly people, or persons with open wounds, or with 
 ulcerated throats, often take the disease. 
 
 Erysipelas is an inflammatory fever of a severe type, 
 associated with painful redness and swelling of some part 
 
EXERCISE AND RECREATION 103 
 
 of the skin, and often of the face and head. The affected 
 skin becomes pink, then more and more red, and livid in 
 tint; it is puffy and tender, and the patch tends to spread. 
 It may attack the edges of an unhealthy wound, or any 
 old ulcer. The first symptoms are believed to appear about 
 six days after taking the infection; then there are chilli- 
 ness, shivering, and fever, headache, dryness of tongue, 
 much discomfort, and then the inflammation is found com- 
 ing out on some patch of skin, with pain and redness. If 
 the face is attacked, the swelling may be so great that the 
 features are hidden. Nausea, vomiting, and diarrhea are 
 common. Death may follow from exhaustion, from blood 
 poisoning, or from the disease attacking the windpipe, or 
 from its spreading inward to the brain. 
 
 As soon as the disease is discovered, the patient must be 
 put to bed and have a sharp purgative, and should have 
 no solid food. Some doctors apply poultices to the red 
 patches, while others prefer only dry applications, such as 
 starch, flour, or rice powder. 
 
 The perchloride of iron is generally prescribed by the 
 doctor in these cases. It is almost a "certain cure." Fif- 
 teen-drop doses of the liquor are taken with advantage by 
 some adults. French surgeons rub in a lotion of per- 
 chloride of iron, 30 per cent., with a lint swab, locally. 
 But most cases get well if the part is merely covered with 
 a mixture of equal parts of boric acid and flour, and the 
 strength of the patient kept up with iron tonics and stimu- 
 lants. 
 
 Exercise and Recreation. The most important factors in 
 the maintenance of health are the avoidance of infection, 
 the use by the body of pure fuel (food, drink, and air) 
 and the maintenance by the body of a high degree of 
 resistance to disease. Among the last means of health 
 preservation few are more important than exercise. 
 
 The main effect of exercise on the body is to increase 
 oxidation. It increases the rapidity of the circulation 
 everywhere and therefore causes in all organs a quicker 
 renewal of plasma, and a more effective removal of the 
 waste products of tissue combustion. 
 
 No man can continue healthy without exercise in some 
 form. Physical health requires bodily exercise. Mental 
 health requires recreation. 
 
 Though, as is the case with food and drink, some people 
 
104 EXERCISE AND RECREATION 
 
 require more exercise than others, yet the complete avoid- 
 ance of it results in digestive and nervous disturbances, 
 loss of vigor, and, if continued, in organic degeneration and 
 disease. 
 
 The form of exercise must vary with the habits, time, 
 strength, means and requirements of the individual. 
 
 The best form of exercise is that which is at the same 
 time recreation. 
 
 This is especially the case with children. Boys must 
 find amusement in their exercise and it is preferable if 
 obtained in the form of games with other boys. For 
 this reason the best exercise for boys is that obtained 
 by playing such games as the following: baseball, foot- 
 ball, tennis, cricket, lacrosse, hockey, handball and bad- 
 minton. 
 
 For girls: basket ball, skipping the rope, tennis, golf, 
 prisoner's base, head-on and the folk-dances and games are 
 good. 
 
 For adults the following are recommended: Walking, 
 which is an exercise available to all, is of little benefit un- 
 less the walk is fast and far. Running is good exercise 
 if not carried to the point of exhaustion. 
 
 Horseback riding is one of the best forms of exercise, 
 calling into play all the muscles of the body, shaking up 
 the organs and maintaining the interest of the rider. Polo 
 is the king of exercises, but available to few on account of 
 its expense. 
 
 The games baseball, football, cricket and lacrosse are 
 good games for the young adult. 
 
 Bicycling, rowing, boxing, wrestling, and fencing are 
 good sports and capital exercise. 
 
 There are few better forms of exercise for the nimble 
 adult than hockey, squash and handball. For the man of 
 middle age the best exercises are bicycling, horseback rid- 
 ing, tennis, golf, swimming and badminton. All exercise 
 should be taken in the open air if possible. If this is im- 
 possible recourse may be had to chest-weights, dumb-bells, 
 Indian clubs and the army setting-up exercises. 
 
 For those who are unable to indulge in such active ex- 
 ercise, or those who require a little more of the intellectual 
 element in their exercise, the following are healthy forms 
 of recreation: Gardening, camping, yachting and boat- 
 ing, botanizing, collecting of animals, birds, fish, butter- 
 
EYE DISEASES 105 
 
 flies, insects, etc. field work in archeology, ethnology, 
 paleontology, etc. 
 
 Intellectual stimulation on one hand, enjoyment of the 
 beauties of nature on the other hand ought to fill out 
 the time of recreation of every cultured person. 
 
 Those whose calling compels them to undergo bodily 
 exertion and exercise in the open air should rest the body 
 during their leisure hours, and should seek recreation par- 
 ticularly in intellectual stimulation, viz., in enlightened 
 discussion, in reading useful books, in contemplation of 
 works of art or in the enjoyment of good music. On the 
 other hand, he who is mentally occupied, and must spend 
 his hours of work standing or sitting in closed rooms, 
 should seek action for his body in his leisure hours by 
 suitable bodily exercise. 
 
 Social intercourse also affords congenial recreation not 
 injurious to health when confined within proper limits. 
 
 The exchange of thoughts with other people stimulates 
 the mind advantageously; the communication of our feel- 
 ings and experiences is a necessity for most people and 
 requires social conversation as well as proper interest in 
 the pursuits of our fellow-men. 
 
 There is a tendency to mental atrophy nowadays through 
 taking our intellectual amusements in a predigested form 
 as in the case of many of the present day theatrical 
 performances of little merit. A brain should be very tired 
 before it should be asked to be content with diversions of 
 such doubtful benefit. 
 
 Eye Diseases. Before learning anything about the dis- 
 eases of the eye, it is desirable for you to know the proper 
 names of some of the parts of the eye. The "white" of 
 the eye is properly called the conjunctiva; the colored part 
 is the iris, and the dark center of the eye is the pupil. The 
 pupil is really an opening in the eyeball, which allows rays 
 of light to pass into the eye in order to reach the back of 
 the eyeball where the optic nerve (the nerve you see with) 
 is spread out in a delicate layer called the retina. If you 
 look at your own eye in the looking glass, with a strong 
 light, you will see that the pupil is very small. This is 
 because the rays of light are strong and you don't need 
 many of them to see with. If you look at your eye in the 
 glass in a bad light, you will see that the pupil is much 
 larger it has dilated, in fact. So you see that the iris 
 
106 DISEASES OF THE EYE 
 
 is really a movable circular curtain, which can open and 
 close in order to allow as much light to pass into the eye 
 at any moment as is necessary for sight. The pupil is the 
 entrance for all rays of light, and it is protected from the 
 air by a transparent covering called the cornea. The 
 cornea is the glass window of the pupil, so to speak, and 
 just behind it, and behind the iris, is the lens which collects 
 the rays of light and focuses them on the retina. 
 
 Diseases of the Eye. (1) The cornea is very liable to 
 ulcer ation and inflammation. An inflamed eye cannot bear 
 the light. Such trouble as this is fairly common in chil- 
 dren after measles. All the forms of inflammation are 
 roughly classed together under the heading ophthalmia 
 (see below), and the signs are redness, wateriness, pain, 
 and dislike of light. Make the child wear a green shade 
 over the eyes. Put a little yellow oxide of mercury oint- 
 ment between the eyelids twice a day. Feed the child up. 
 
 (2) A more serious form of ophthalmia is the ulceration 
 of the cornea, caused by tuberculous disease. A doctor 
 must be called in. 
 
 (3) An ulcer or sore on the eyeball coming from a slight 
 injury such as the scratch of a twig or a person's fingers 
 may be very serious indeed. A doctor must be called in to 
 treat it. 
 
 (4) Children with inherited syphilis are very liable to 
 cloudiness of the cornea. (See also " Syphilis/') The 
 front of the eye in these cases gets to look like ground 
 glass and then seldom improves. 
 
 (5) "Catarrhal Ophthalmia. "This is a very bad "cold 
 in the eye. ' ' The eyes feel as if they had ' ' grit ' ' in them ; 
 the conjunctivas are bloodshot, the eyelids are stuck to- 
 gether in the morning; work is unbearable, because the 
 eyes cannot bear light. This ophthalmia is sometimes epi- 
 demic, generally in the springtime, and affects people of 
 all ages and both sexes. The attack lasts about a fortnight. 
 
 Treatment. Use zinc sulphate lotion, two grains to the 
 ounce, several times a day. Apply yellow oxide of mer- 
 cury ointment, four grains to the ounce of vaseline, be- 
 tween the lids at bedtime ; wear a green eye shade. 
 
 (6) "Gonorrheal Ophthalmia." This disease is caused 
 by bringing the pus of the venereal disease called Gonor- 
 rhea to the eye by the finger. It is a terrible disease and 
 often ends in blindness. Thousands of children are blind 
 
ERRORS OF VISION 107 
 
 or have defective vision because their mothers have suffered 
 from Gonorrhea. The treatment cannot be carried out 
 without a doctor. 
 
 (7) "Granular Lids." This name speaks for itself. 
 Among the poor it is very common to see eyelids which 
 are sore at the edges and seem to have been dusted over 
 with fine granules of sand. This disease, whether treated 
 or not, as a rule drags on its course for months or even 
 years, and the lids may become scarred and contracted, 
 and the eyelashes may grow inwards. Ulcers of the con- 
 junctiva are common then, and the sight is damaged. 
 
 (8) "Watery Eyes." All day long, whenever you blink, 
 a tear comes out of the little tear gland lying at the outer 
 corner of the eye, and is washed across the eyeball, and 
 escapes down a little tube, the opening of which you can 
 see at the inner corner of the eye next the nose. This 
 little tube is called the tear-duct and leads down into the 
 nose. If the eye were not washed continually like that, it 
 would suffer from the grit and dust which are always float- 
 ing about in the air. Sometimes people get a "cold" or 
 "catarrh" in the tear-duct, and it gets more or less stopped 
 up for a time. So the tears cannot escape, and remain 
 and make the eyes "watery," especially in windy weather. 
 If this does not get better in a few days, a sort of stricture 
 of the tear-duct may develop, and then a little operation 
 will be necessary. 
 
 (9) "Errors of Vision." If you cannot see as well as 
 other people, and if you value your sight, do not go to the 
 ordinary jeweler's shop, or even to the ordinary optician's, 
 or spectacle-seller's shop, but have your eyes properly ex- 
 amined by an oculist, and he will tell you not only whether 
 you require glasses but exactly what glasses are necessary 
 to correct your sight. It is a little more expensive, per- 
 haps, to consult an oculist than an optician, but the advice 
 and recipe for glasses once given, you will probably not 
 need to consult him again; and the eyesight is really far 
 too precious to trust to the tender mercies of a man who 
 merely wants to sell glasses, and knows nothing of eye 
 diseases. (The spectacle makers are, we believe, to be in- 
 structed in the future in the elements of the treatment of 
 errors of vision by means of spectacles. This will be a 
 real advantage to a large section of the public.) In 
 middle-aged persons the power of the eyes, to accommodate 
 
108 FEVER 
 
 themselves to all kinds of vision, sizes of print, distances, 
 etc., etc., is gradually growing less. At from forty to 
 forty-five years, even persons with ordinary sight begin to 
 require glasses. At forty-five a person with ordinary good 
 sight will require glasses, called plus-one-dioptre in order 
 to see to read; at fifty he will require two-dioptre glasses; 
 at fifty-five, three-dioptre glasses, and so on for every five 
 years up to sixty or sixty-five. A person who has always 
 been ''long-sighted" will need glasses for near vision 
 sooner than others. Short-sighted people will not need 
 glasses for near vision until they are quite old. 
 
 Fainting. When a person faints lay him on his back, 
 loosen the clothes round the neck and round the waist, and, 
 if the person be a tight-laced woman, cut her stay-laces. 
 Then, if in a moment or two the patient does not recover, 
 throw cold water on the face or put smelling-salts to the 
 nostrils. 
 
 Fever. Fever is an abnormal condition of the body char- 
 acterized by elevated temperature, quickened respiration 
 and circulation, faulty secretions and increased tissue 
 waste ; and dependent upon a perversion of the physiological 
 processes which usually so balance the generation and loss 
 of heat that a uniform normal temperature is maintained 
 (98.6 F.). 
 
 Fever is caused by (1) Local inflammations excited by 
 external causes, or the products of faulty metabolism (gout, 
 rheumatism) . 
 
 (2) The presence in the body of microorganisms, or of 
 toxines produced by them, as in typhoid fever, pyaemia, 
 diphtheria, malaria, etc. (3) Paralysis of heat-center, as 
 in thermic fever. 
 
 The only exact way of determining the degree of fever 
 is by the use of the clinical thermometer. This may be 
 inserted in the mouth under the tongue, under the arm- 
 pit, or in the rectum (the last method being the one always 
 employed with babies). A fever between normal or 98.6 
 and 101 is considered slight; 101 to 104 moderately to 
 decidedly high, 104 to 106 very high; and above 106 
 hyperpyretic and exceedingly dangerous. 
 
 Before beginning to treat a fever it is best, if possible, to 
 understand the cause. Then the specific treatment for that 
 special form of fever can be employed if there is one. 
 
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110 FEVER 
 
 form of treatment of fevers, which is rarely contra-indi- 
 cated, which is especially to be recommended in the early 
 stages of all febrile diseases. 
 
 This consists of rest in bed, a cool, well-ventilated room, 
 liquid or semi-liquid diet, a mercurial purgative such as 
 calomel (1 or 2 grains) or blue mass, followed by a saline 
 cathartic such as Epsom or Rochelle salts. 
 
 The elimination of the poisons causing the fever may 
 be increased by drinking an abundance of water; by in- 
 creasing perspiration and the fluid excretions by Dover's 
 powders, ammonium acetate or sweet spirits of niter. 
 Sponging the surface of the body with cool water, or water 
 and alcohol, helps to diminish body temperature through 
 evaporation. Among the drugs capable of reducing tem- 
 perature may be mentioned quinine, aconite, antipyrin, 
 phenacetin and acetanelid, but as the last three are coal- 
 tar products, which are somewhat depressing to the heat, 
 they should be used with caution. 
 
 As soon as a specific cause has been discovered, that cause 
 should be removed or the specific drug called for should 
 be administered. For example, if the cause of fever is an 
 abscess it should be opened, cleaned and drained. If the 
 fever is malarial, quinine should be administered ; if gouty, 
 colchicum ; and if rheumatic, salicylates. 
 
 Many of the infectious fevers are characterized by a 
 rash which develops after a more or less definite incuba- 
 tion period. Many of these diseases are contagious; there- 
 fore to prevent their spread they should be quarantined 
 until all danger of their transmission has passed. The 
 preceding table gives the duration of such a quarantine, 
 the incubation period of the disease, the character, time of 
 appearance and duration of the rash and the duration of 
 the illness. 
 
 Diphtheria is usually quarantined four weeks, if con- 
 valescence be complete, and no sore throat, albuminuria 
 or discharges remain; and bacteriological examination of 
 the throat is on two consecutive occasions negative. 
 
 Whooping Cough is quarantined five weeks from the 
 commencement of the whooping, if the characteristic spas- 
 modic cough and whooping have ceased. Earlier if all 
 cough be gone. 
 
 Mumps are quarantined three weeks, if all swelling has 
 subsided. 
 
FITS AND "INWARD FITS" 111 
 
 Fits, and "Inward Fits." Infants are specially liable to 
 have what mothers call fits; some uneducated mothers say 
 that besides real fits, babies have inward fits. By this 
 latter name they generally mean the grimaces seen on 
 babies' faces when they are suffering from indigestion, and 
 have stomach-ache and wind in the stomach and bowels. 
 
 Real fits are attacks of convulsions, and the presence of 
 convulsions is shown by violent, sudden, and involuntary 
 twitching of the limbs, clenching of the jaws, and rolling 
 of the eyeballs. In some cases all the muscles are affected, 
 while in others the face only is convulsed, or the limbs 
 only. In full-grown persons the only fits of convulsions 
 are those due to epilepsy a well-recognized, chronic dis- 
 ease, which renders a sufferer liable to convulsive attacks 
 at uncertain intervals; and fits occurring at the close of 
 blood poisoning from kidney disease, or resulting from an 
 apoplexy due to bleeding on the brain. (See ''Apoplexy.") 
 In childhood, however, fits of convulsions are quite com- 
 mon, and may be fatal, without showing an epileptic consti- 
 tution. 
 
 Causes: Such fits may be started by the onset of fevers, 
 or of inflammations of the lungs or kidneys, or by any 
 irritation within the body, or on the skin; for example, 
 curdled milk in the stomach, a biscuit food if given at too 
 early an age, colic, diarrhea, ulcers, coughs, and skin dis- 
 eases may all set up a series of fits; and so many slight 
 operations, such as vaccination, or the application of caustic 
 to a wart, or tying a thread around a birthmark, or circum- 
 cision. Convulsions or fits are dangerous to life by affect- 
 ing the windpipe and so causing suffocation by spasm; 
 convulsions of the muscles around the chest may so hinder 
 the breathing as to cause death; and spasm of the heart 
 leads to fainting and instant death. The occurrence of a 
 fit may point out the presence of disordered digestion, and 
 so lead to prompt treatment of the stomach and bowels, 
 which, under artificial feeding by the bottle or teaspoon 
 with cow's or goat's milk, or with condensed milk, is much 
 more common than when an infant is suckled. When 
 starchy foods, such as arrowroot, maizena, cornflour, baked 
 wheat flour, or biscuit are given with milk to infants, there 
 is always a risk of the occurrence of convulsions until a 
 baby is six months old or older, because until that age is 
 reached the juices of the stomach are unable to digest 
 
112 FLIES 
 
 starch, and the food gets into hard lumps, which do not 
 dissolve. The cutting of teeth in infancy is the other most 
 common cause of fits, and, because it causes so much pain 
 and disorder to the nervous system, it is always wise to 
 take special care of children when teething; but in any 
 case of convulsive fits, send at once for a doctor. 
 
 Flies. Housekeepers have for a long time considered flies 
 as a necessary nuisance. More or less attempt has been 
 made by many to keep them out of the house by screens 
 or to kill them by means of fly paper, but this was done 
 principally because they soiled the picture frames or the 
 chandelier, or because they were annoying when they set- 
 tled on the hands or face. Physicians and health officers, 
 however, have come to the conclusion that the common, 
 ordinary domestic fly that we have tolerated for so long, 
 is not only one of the most disgusting and filthy things 
 imaginable, but, what is worse, is probably the cause of 
 much sickness and many deaths. 
 
 The fly is usually born in a 'manure pile. Garbage, dead 
 animals, and refuse of all kinds is selected by the female 
 fly as a suitable place for breeding. 
 
 The fly is not at all particular as to his food; he likes 
 milk and cake and most all the kinds of food people eat, 
 but he can also be seen enjoying a hearty meal off the 
 contents of a privy vault, off the expectoration from a con- 
 sumptive, the discharges from sores on animals and men, 
 and many other equally repulsive substances. 
 
 The dirty habits of the fly ought to be enough to disgust 
 anyone and make him a determined enemy of the pest; 
 but, to make matters worse, the fly's liking for these re- 
 pulsive things makes him a positive source of danger. The 
 food of a fly is not served on a diminutive plate, but he 
 steps right into it ; and he not only eats all that he wants, 
 but he gets his legs and body and wings more or less 
 covered with whatever filth he is eating. And the filth 
 he so often chooses contains myriads of germs of disease. 
 
 By use of the microscope it has been shown that on a 
 single fly there may be as many as 6,500,000 bacteria or 
 germs; the average number is probably about 1,250,000. 
 These are not all disease germs, for there are bacteria that 
 are harmless ; but a few typhoid germs from a privy vault, 
 or tubercle bacilli from a cuspidor or from an expectora- 
 tion on the ground, or a small number of germs of diar- 
 
FIIES 113 
 
 rheal disease from the sewage-soiled bank of a stream are 
 enough to cause fatal illness. 
 
 And some of the filth and germs on the legs of the fly 
 are going to be deposited on the very next thing he settles 
 on; it may be milk in the pitcher or pail, it may be the 
 fruit or vegetables exposed for sale, it may be the bread 
 or cake, it may be the nipple of the baby's bottle, or it 
 may be the lips or face of the child as it lies asleep. 
 
 The many cases of typhoid fever that occurred among 
 the American soldiers in the various camps at the time of 
 the Spanish war were mainly due to the flies which had 
 access both to the bowel and bladder discharge of the sol- 
 diers and to their food. 
 
 Other diseases which may be transmitted by the flies are 
 summer diarrhea, infantile paralysis, cerebro-spinal men- 
 ingitis, tuberculosis, trachoma, septicaemia, erysipelas, 
 cholera, plague, anthrax and the intestinal parasites such 
 as tapeworms (through contamination of food by the eggs). 
 
 The fly is more, then, than a mere nuisance; it is a 
 positive enemy to life and health and must be exterminated. 
 And everyone must join in and do his share in this work. 
 We must all try to stop the breeding of flies, and we must 
 all do all we can to kill those that are born and to prevent 
 them from carrying disease. 
 
 The life cycle of the fly. The eggs of the fly are de- 
 posited upon putrefactive animal or vegetable matter. 
 From the eggs emerge the larvae or maggots, which feed 
 upon the decaying material. After a variable number of 
 days, they shut themselves into their skin, forming a hard 
 case (puparium) around themselves, from which they 
 emerge, by a marvelous transformation, as winged insects. 
 A single fly lays 120 to 140 eggs; the larvae or maggots 
 leave the eggs at the earliest eight hours after laying; 
 they mature in five to eight days, then pupate; the pupae 
 mature in five to seven days, the cycle from egg to fly 
 requiring at least ten days. 
 
 All stable manure and filth should be kept in a vault or 
 pit from which flies are shut out by screens, and lime 
 should be sprinkled freely and frequently over the contents 
 of the pit. This will not injure the value of the manure 
 as fertilizer, but it will stop the breeding of flies. As 
 ninety-eight flies out of every hundred are born in a ma- 
 nure pile, this ought to do away with a vast number of 
 
114 FOMENTATIONS 
 
 flies, and it is the most important measure in the war of 
 extermination. It is well to bear in mind, too, that it 
 takes ten days for the fly to develop from the egg; so if 
 manure is removed about once a week and spaded into the 
 ground, flies in process of development will be destroyed 
 before they reach maturity. 
 
 The other places in which flies breed must also be looked 
 after. Garbage should be kept in a covered receptacle, 
 and no refuse should be allowed to collect where flies can 
 get at it. Dead animals should be promptly removed and 
 buried or burned. 
 
 Privy vaults should be so constructed as to exclude flies. 
 Openings for ventilation, etc., should be screened with 
 wire or mosquito netting, and all cracks in the walls or 
 openings under the bottom should be closed. 
 
 Doors and windows of houses should be screened, espe- 
 cially in the kitchen and dining-room, and any room in 
 which there is a case of sickness. And care should be 
 taken to see that the screens fit accurately, and that they 
 are always in place, and that screen doors are not left 
 ajar or held open. If wire screens cannot be afforded flies 
 can be kept out by cotton mosquito netting tacked over the 
 windows. A piece of netting containing sixteen square 
 yards can be bought for half-a-dollar. 
 
 Flies that do get into the house should be chased and 
 killed, or should be caught by fly paper, etc. All dead flies 
 should be promptly burned. 
 
 Don't ~buy food exposed for sale in places where flies can 
 get to it. 
 
 Our houses are not the only places where fly screens 
 should be used. Slaughterhouses, butcher shops, markets, 
 candy stores, grocery stores, bakeries, and the wagons of 
 food peddlers of all kinds every place where any kind of 
 food is handled or sold should be screened. Flies should 
 never be allowed to come in contact with anything that is 
 to be eaten. 
 
 Fomentations are, on the whole, better than poultices. 
 They are made with flannel or lint, or boric lint best of 
 all. The lint is wrung out of boiling water in which poppy 
 heads have been soaking. To wring out warm cloths with 
 the hands is quite impossible, if the fomentation is to be 
 as hot as it ought to be, and in the process of wringing 
 much heat is lost. So in every household there ought to 
 
FOODSTUFFS EXPOSED TO DIRT 115 
 
 be a wringer, which is thus made: Take a towel, or a 
 piece of coarse towelling, or a piece of bed ticking, twelve 
 inches wide and thirty inches long. Make a hem at each 
 end wide enough to form a channel for a stick of about 
 eighteen inches long. Two pieces of broomstick will do 
 nicely. To use the wringer, put it, with the fomentation 
 lint folded into a pad on it, in boiling water, or else pour 
 boiling water on to it, and then seize the sticks, twist them 
 in opposite directions so as to squeeze all superfluous water 
 out of the fomentation. Untwist it again rapidly, seize the 
 fomentation, smooth it out, place it on the body, cover it 
 with a bit of oil-silk, and then a pad of cotton-wool and a 
 bandage. Apply another fomentation before the first gets 
 cold. 
 
 Foodstuffs Exposed to Street Dust and Dirt. Foodstuffs 
 exposed on the streets may become contaminated by dust 
 (see "Dust") and flies (see "Flies") and consequently a 
 source of disease when eaten in the uncooked state. 
 
 Regulations such as the following are now enforced by 
 many boards of health and should do much to ensure the 
 safety of our food supply. 
 
 A. The following are prohibited from being displayed 
 for sale outside any premises or in any street or public 
 place unless covered so as to be protected from dirt, flies 
 and other contamination. 
 
 1. Pastry bread, pies, rolls, cake. 
 
 2. Sliced fresh fruit, such as watermelon and oranges 
 when cut open. 
 
 3. Dried or preserved fruits dates and figs. 
 
 4. Candies or confectionery (does not include candy 
 exposed for sale when wrapped in paper). 
 
 5. Perishable food products which are not pared, peeled 
 or cooked before consumption, which includes : (a) Plums ; 
 (b) Berries; (c) Grapes. 
 
 B. The following shall not be hung or exposed for sale 
 in any street or outside of any shop or store or in any 
 open windows or doorways thereof: 
 
 1. Meat. 
 
 2. Poultry. 
 
 3. Game (except rabbits). 
 
 4. Fish. 
 
 C. The body of any animal, or any part thereof, used 
 for human food shall not be carted or carried through the 
 
116 GAIT AND APPEARANCE 
 
 streets unless covered so as to be protected from dust and 
 dirt. 
 
 Gait and Appearance. Every doctor cultivates as much, 
 as possible the faculty of observation. He is called in 
 to a patient and has patiently to listen to a long rigmarole 
 of complaints and description of illness, and he has to ar- 
 range what he has learned in a methodical way, asking 
 questions to fill up the blanks in the information given, 
 and at last he makes up his mind what is wrong with the 
 patient and decides what treatment will do him good. 
 But the clever doctor has more to do than that. He has to 
 notice that, very often in the case of women patients, the 
 account given is not quite truthful. Willfully or igno- 
 rantly the sick person has misrepresented or exaggerated 
 something. So, all the time that the talking is going on, 
 the doctor observes little details, and draws his conclusions 
 far more from what he sees than from what he hears. When 
 a patient approaches a doctor in his consulting room, he 
 walks towards him, and from his very gait and appearance 
 there may be a great deal to be learned. Sometimes it is 
 possible to "diagnose" a disease at the first sight of a 
 patient, just as you can diagnose a cold in the head from 
 seeing a person with watery eyes using his handkerchief 
 to blow his nose ! Note the elastic confident tread of a man 
 in good health; the shambling gait of the public-house 
 loafer; the dragging of the feet in people who are tired. 
 If a child cannot walk when it is a year and six months 
 old, you can safely diagnose stupidity, paralysis, or rickets. 
 A child with St. Vitus' dance walks jerkily and oddly, and 
 perhaps twitches with hands and face at the same time. 
 In paralysis agitans, the trembling palsy seen sometimes in 
 old age, the person totters along, getting quicker as he goes, 
 and at last is unable to stop himself except by running 
 against a chair or wall. His steps are all very short. 
 
 In locomotor ataxia the patient looks to see where he is 
 putting his feet; he lifts his foot high in the air in order 
 to be sure to clear the ground, and brings it down on the 
 pavement again with force. When he tries to turn sud- 
 denly, he nearly falls down; he cannot walk unless he can 
 see his feet. In alcoholic paralysis the foot is "dropped" 
 and it has to be lifted high in order to clear the ground 
 and the knee is much bent. In flat foot the person walks 
 with his toes turned out. The person with hip-joint dis- 
 
GENERAL PARALYSIS 117 
 
 ease takes a long step with the sound leg and swings round 
 the other one, thus walking lopsided. 
 
 Gallstones. A gallstone is a little dried-up mass of 
 bile-materials which forms in the gall bladder. When the 
 stone is pressed through the gall tube into the intestine, 
 it is sometimes too large to pass easily, and causes violent 
 colic in the belly, which continues until it gets out of the 
 narrow tube into the gut. The main symptom is intense 
 pain on the right side, occurring in spasms. 
 
 It must be carefully differentiated from appendicitis, 
 which occurs lower down on the right side. 
 
 The most common causes are sedentary habits, a rich 
 diet, and diseases of the liver and bile ducts and not 
 infrequently following typhoid fever. The pain is fre- 
 quently accompanied by a well-marked jaundice. 
 
 Hot fomentations may sometimes relieve the pain., but 
 morphine may be necessary. 
 
 An attack of gallstone colic may terminate at any time 
 in a surgical condition demanding operation, therefore a 
 physician should always be summoned during such an 
 attack. 
 
 The medical treatment consists of a regulated diet, 
 largely vegetable, and systematic exercise between attacks. 
 Mineral waters, sodium phosphate, calomel or podophyllin, 
 and salol or urotropin are useful drugs. 
 
 Gangrene, or Mortification. This name is given to the 
 death of a part, as of a finger, or of a foot, or of a portion 
 of flesh in a wound. It follows very severe local injuries, 
 when the blood supply is stopped by the tearing or wound- 
 ing of arteries and veins ; the same results occur when the 
 blood vessels are blocked by firm clots, as sometimes occurs 
 in weakly, aged persons. Gangrene may be of the dry 
 form in which the parts wither up, or "slough," or of the 
 moist form, in which the parts become a sodden decaying 
 mass. The gangrene may lead to blood poisoning and 
 death, but there may be a chance of prolonging life if the 
 part affected can be removed by the knife (amputation). 
 
 General Paralysis. This disease is nowadays treated in 
 asylums, and the sooner the afflicted person gets off to 
 where he can be suitably looked after the better for every- 
 body. The disease begins generally in the thirties. The 
 average age of death is forty. It affects all classes, espe- 
 cially of townspeople, men oftener than women. The most 
 
118 GIDDINESS 
 
 important cause is "Syphilis" (which see), and other 
 causes are mental worry, overwork, alcoholism, and head 
 injury. It would be useless in a book like this, to give a 
 long account of the disease, and, as it is incurable, nothing 
 need be said about treatment. The earlier signs by which 
 the disease may be known are : 
 
 (1) Changed mental condition jealousy, bad temper, 
 
 fancies, illusions, delusions, loss of memory, ex- 
 travagance of ideas, filthy and degrading habits. 
 The patient sometimes shows the first sign of 
 the disease when he goes to a shop and orders 
 quantities of things he does not want and cannot 
 pay for. Also, when he brags about his mil- 
 lions of money and watches and jewels when he 
 is really poor. 
 
 (2) Later, the pupils of the eyes are seen to be un- 
 
 equal, he loses the power to write, etc., and at 
 last becomes helpless and bedridden. 
 
 Giddiness. The medical name for this ailment is vertigo, 
 it is derived from a Latin word meaning to turn round, 
 and the principal feature of giddiness is a sensation that 
 the room and objects around are turning round you, not 
 that you yourself are turning round. 
 
 Giddiness may be only occasionally felt, and it may come 
 on quite suddenly, and may as quickly disappear, or it may 
 occur and not be got rid of for hours or days. It may 
 occur as the only symptom of ill-health, or it may be asso- 
 ciated with headache, and nausea, or sickness. 
 
 Giddiness is certainly a symptom due to a momentary 
 fault in the circulation in the brain, and may, of course, 
 be due to actual brain disease, but in general the cause 
 of giddiness is to be found in disturbances of the digestive 
 organs, and particularly from biliousness and other liver 
 troubles. 
 
 One form of giddiness can be brought on intentionally 
 by many persons, by turning round quickly while standing 
 upon one heel, or by waltzing ; many others feel giddy when 
 on the moving deck of a vessel at sea; others, again, feel 
 giddy when looking down from a high place, or over a 
 precipice. 
 
 Nervous persons who have had one real attack are apt 
 
GLANDS, SWOLLEN 119 
 
 to fancy they feel it coming on again; in severe cases of 
 nervous debility patients may feel giddy whenever they 
 get up from their beds or from their seats ; others are afraid 
 to cross open spaces for fear of falling. 
 
 Giddiness is commonly felt by patients who have lost 
 much blood, or who are exhausted by fever or any wasting 
 illness. Anaemic girls, pale from want of sufficient healthy 
 blood, are subject to attacks of giddiness. 
 
 This ailment is also related to epilepsy, for when such 
 sufferers have passed through an attack or epileptic fit, 
 they tell you it began by a giddy feeling. 
 
 Persons who are very robust, who eat much more than 
 they need, and are too full-blooded, are subject to giddiness. 
 Certain peculiar defects of eyesight lead to this unpleasant 
 symptom, and there is a disease of the internal ear, called 
 Meniere's Disease, in which giddiness is associated with 
 deafness. 
 
 The poisonous principles of tobacco produce a giddy 
 feeling in persons who are attempting to smoke for the 
 first few times, and, of course, everyone knows that alco- 
 holic drinks taken to excess, cause such giddiness as to 
 make men stagger and fall down. 
 
 In general we may say that if a person in good ordinary 
 health becomes giddy, the safest remedy to employ is a 
 thorough good purgative dose of sulphate of magnesia in 
 water. 
 
 Glands, Swollen. When an enlarged gland is formed on 
 a person who is in good health, we may be fairly sure that 
 the swelling is curable, because its cause is not, as a rule, 
 far to seek, and can be removed. Enlarged glands occur 
 in certain situations. These are chiefly, the neck below the 
 jaw, and just below the ear, the groins, the armpits and 
 just above the elbows. 
 
 Now in each of these situations there are groups of 
 " glands" which are called "lymphatic glands" in which 
 the blood circulates, and in which the blood undergoes 
 certain changes, fitting it for recirculation. If you cut 
 or scratch your finger or foot with a dirty instrument or 
 pin, the poison enters the skin through the wound, goes 
 into the blood, and is carried upwards towards the body. 
 If the poison could get into the body (or, when it does) 
 you become ill for a time. But if you are in good health 
 the set of glands which lie between the cut or wound and 
 
120 GOITER, OR DERBYSHIRE NECK 
 
 the heart try their best to stop the poison, and to destroy 
 it there. But if the poison is too much for them, then the 
 glands begin to swell from the irritation of the poison, 
 and get red, hot, and inflamed. As a fact the inflammation 
 is Nature's way of getting rid of the poison. Ear disease, 
 decayed teeth, enlarged tonsils, and vermin may all cause 
 the neck glands to be swollen. The cause must, of course, 
 be dealt with in every case. 
 
 Enlarged glands in the groin are produced by gonor- 
 rhea, syphilis, and by the poison from a sore place on the 
 leg or foot. 
 
 A swollen gland or ' ' bubo ' ' will very often get better by 
 itself, especially if poulticed. But often it becomes an ab- 
 scess, and then the matter or pus must be let out by a cut 
 with a surgeon's knife. It must not be forgotten that 
 persons with consumptive tendencies are most liable to 
 enlarged glands and these must be dealt with according to 
 the case. Sometimes it is wise to leave them alone and 
 they will gradually disappear. At other times they will 
 have to be dissected out, or scraped out, according to their 
 condition. In all cases cleanliness must be observed, sores 
 must be healed, and decayed teeth must be attended to. 
 (See also " Abscess.") 
 
 Goiter, or Derbyshire Neck (See also " Cretinism"). 
 By goiter is meant a swelling in the thyroid gland, an 
 organ lying on the front of the neck ; in health it is neither 
 seen nor felt, being very small and soft, but in goiter it 
 may swell up to a very large size, making a huge, bulging 
 tumor (on one or both sides of the middle line), which is 
 not painful, nor hot, nor inflamed. It grows gradually 
 and has but little tendency to go away, unless it is con- 
 tinuously treated; it is apt to appear first in childhood 
 from 7 to 12 years old, and may last a lifetime without 
 causing serious illness. It is most common in people who 
 live in valleys among mountains, and may be due to habit- 
 ual drinking of very hard water. 
 
 In treatment, the first requisite is to remove the patient 
 from the locality where the goiter has started, if it be one 
 where cases are of frequent occurrence; in all cases, how- 
 ever, change of air, scene, climate, and food are desirable. 
 Put the patient under the most healthy conditions, and 
 with plenty of open-air exercise and good food. The most 
 successful remedy is iodine given internally in many forms, 
 
GONORRHEA 121 
 
 such as iodide of sodium, iodide of potassium, or iodide of 
 iron, together with the external application of iodine oint- 
 ment or a mercurial ointment. Of recent years it has been 
 found that many cases improve when treated by doses of 
 the extract of the thyroid gland of the sheep ; this can now 
 be obtained in many forms, as a liquid medicine, or as a 
 powder or pills or tabloids. 
 
 Another form of goiter is that commonly called Grave's 
 disease, and in this case the disease has no relation to 
 climate, soil or water, and is accompanied by a peculiar 
 state of the heart and great blood vessels. The swollen 
 neck is associated with protruding eyeballs which give a 
 most notable appearance to the face, and yet the eyeballs 
 are in no way diseased; there are also present a highly 
 nervous state, shortness of breath and palpitation of the 
 heart with throbbing in the blood vessels. This disease 
 is also called "Exophthalmic goiter." It can be in no 
 way treated by domestic remedies with any hope of giving 
 relief. 
 
 Gonorrhea. Gonorrhea is a disease which one is ex- 
 ceedingly liable to contract upon departing from the moral 
 mode of living. It is readily transmitted from one sex 
 to the other and among married people may thus be trans- 
 mitted from the guilty to the innocent. It is a cause of a 
 large part of the pelvic inflammatory conditions for which 
 women require surgical operations and is the cause of a 
 great deal of misery in the world. 
 
 The most important thing to remember about gonorrhea 
 is that until it is entirely cured it can be readily trans- 
 mitted. 
 
 In this disease, in the male, there is an inflammation of 
 the urethra (the pipe for the passing of the urine), which 
 gives rise to severe pain and smarting, especially on pass- 
 ing water, and very often to much general illness as well; 
 fever, loss of appetite and weakness, in addition to the 
 continual discharge of pus from the pipe. The disease is 
 often the starting point of months or years of severe ill- 
 ness and pain. Most cases are curable by the surgeon, 
 especially if the treatment be conscientiously carried out, 
 but many half-cured cases get tired of being doctored, 
 return to their immoral ways and are a real menace to 
 society, to themselves, and to future generations. 
 
 The disease, in man, has dozens of possible complications. 
 
122 GOUT 
 
 Among the more serious ones are stricture, bladder disease, 
 abscess of the kidney, ophthalmia which may lead to blind- 
 ness, and gonorrhea! rheumatism. This last disease, which 
 occasionally affects women also, is in many cases incurable, 
 and in all cases very difficult to treat. 
 
 Gout. This is a very large subject, and it is difficult to 
 know where to begin to discuss it. It is pretty certain 
 that the word ought to be used to mean a very large group 
 of symptoms, such as are referred to under such loose 
 expressions as "goutiness," " gouty tendency," and the 
 like. We are obliged to say that, notwithstanding the 
 immense amount of research and study which have been 
 devoted to gout, we are not much nearer a thorough under- 
 standing of how it is caused. We know more about how 
 to guard against it, and how to treat it. But it is so mixed 
 up, in many cases, with something of a rheumatic nature, 
 that it is hard to cure, and sometimes even very hard to 
 relieve. The word gout comes from the French word 
 goutee (a drop), and from the Latin word gutta (a drop) ; 
 and we are still obliged to say (as the old Romans and 
 Greeks did) that gout is the result of the gradual deposits 
 of drops of some material in the joints and elsewhere. We 
 now know that the material is called bi-urate of sodium 
 (a chemical substance derived from uric acid), and we 
 know that it is deposited as a result of some defect in the 
 kidneys which prevents their getting rid of some of the 
 waste matters in the blood. But this defect is also con- 
 sidered to be a result of something wrong with the nervous 
 apparatus of the body. Gout, in fact, is a nervous disease 
 (in one sense), characterized by defective action of the 
 kidneys and hence in storing-up of waste matters in the 
 body. 
 
 Causes. The people who have gout are mostly those who 
 in the first place have what doctors call a neurotic 
 family history (see " Neurosis"), and, in the second place, 
 those whose kidneys are not equal to the strain of getting 
 rid of waste matters from the food. Men are more liable 
 to gout than women ; but, perhaps, women are more apt to 
 have "rheumatic gout." 
 
 Note that the heredity of this disease is so strong that 
 many persons who are and always have been strictly tem- 
 perate and moral and careful, yet suffer from gout. But 
 no doubt, a steady life in a gouty subject makes it unlikely 
 
GOUT 123 
 
 that he will be troubled much with gouty attacks. Paint- 
 ers and plumbers are liable to be gouty, because lead 
 poisoning is apt to cause the disease. 
 
 The two chief varieties of acute gout are regular gout, 
 which is gouty swelling of a joint, and irregular gout, which 
 is gouty pain and inflammation of some other part of the 
 body. 
 
 Signs of an attack of gout in a joint. Many people get 
 a warning that there is going to be an attack, a day or two 
 before. Such warning may be wind in the stomach, numb- 
 ness of fingers and toes, irritability of temper; sometimes 
 patients feel livelier than usual. The patient goes to bed 
 all right, and wakes up in the night, shivering and fever- 
 ish, just before an attack, with violent pain in a joint 
 generally the big-toe joint. 
 
 The gouty joint is so tender and so painful that the 
 patient cannot bear the weight of the bedclothes, and hates 
 to be touched. The skin over the joint is red, tight, and 
 shiny. After a few hours the pain abates, and is better 
 during the daytime; but comes on again next night; thus 
 continuing for about ten days. Then the skin over the joint 
 gets paler and peels off. While the attack is going on the 
 patient is very bad-tempered, thirsty and dyspeptic. After 
 it is over he feels better than he has done for years. Then, 
 sooner or later, another attack comes. 
 
 Treatment for an attack : 
 
 (1) Send for the doctor. 
 
 (2) Don't use arnica, or poultices, or ice for a gouty 
 joint. 
 
 (3) If the pain is bearable, wrap up the joint in 
 plenty of cotton-wool, covered with oil-silk, and lightly 
 bandaged. 
 
 (4) Otherwise, put the feet in a hot foot bath of 
 water in which are several poppy heads (obtainable 
 from the chemist). Or apply Baume Analgesique 
 Bengue to the joint and wrap it up in gauze or flannel. 
 Keep the part elevated. 
 
 (5) Let the sufferer send out for an ounce of colchi- 
 cum wine and let him take 40 drops of it at once in a 
 wineglassful of water. He will have to go on taking 
 colchicum in some form or other for some time; but 
 colchicum has a certain depressing effect on the heart, 
 
124 GROG BLOSSOMS 
 
 and no sensible man will take it without being super- 
 vised by his doctor. We only recommend him to take 
 those 40 minims in case the doctor might be delayed. 
 
 (6) Diet to be very light do not give concentrated 
 meat essences. 
 
 Signs of Chronic Gout. Dyspepsia, stone in the kidney, 
 swollen and knobby finger and toe joints with lumps of 
 chalkstones, skin eruptions, irritable heart, muscular pains, 
 etc. 
 
 Treatment of a gouty tendency. In young men gout is 
 avoidable and curable, especially if they become teetotalers. 
 There must be no greediness, nor gormandizing, and, in 
 fact, the less meat and pastry gouty people eat, the better 
 for them. Indolent habits are to be given up. Lots of ex- 
 ercise must be taken. Everybody who fears gout should 
 take a heaped-up teaspoonful of phosphate of soda, and 
 wash it down with a pint of clean water, every morning of 
 his life, before breakfast. When a person has all sorts of 
 pains and aches due to goutiness, he must be more careful 
 with his diet, and he may take the following medicine : 
 Bicarbonate of potassium, 6 drachms; iodide of potassium, 
 2 drachms; colchicum wine, 2 fluid drachms; camphor 
 water, to 12 ounces (mix). Take a tablespoonful of this 
 mixture, thrice daily, in a wineglassful of water, after meals. 
 
 Grog Blossoms. We should be very careful how we use 
 this vulgar and unscientific name of the disease which doc- 
 tors call "Rosacea," for though drink is often the cause 
 of it, or at least, the circumstance which keeps it up, yet 
 "grog blossoms" are occasionally seen on the faces of per- 
 sons who claim to be quite temperate and even teetotal. 
 At first the red flush comes on just after eating or after 
 exposure to the cold. Many women get red noses in the 
 open air on a cold day. If it gets worse the whole of the 
 middle part of the face, cheeks and nose, get permanently 
 red and the little blood vessels of the surface of the skin 
 get enlarged and visible. After a time this too-great nour- 
 ishment of the skin of the nose causes the skin glands to 
 overwork themselves, and so the skin gets shiny and greasy 
 and scaly as well as red. Then the skin, if at all coarse in 
 texture, gets covered with holes and pimples, and this con- 
 dition has given rise to the vulgar word "grog blossoms." 
 In cabmen and men who are prone to drink raw spirits 
 
HAIRDRESSERS 125 
 
 after much exposure to the open air, the skin now begins 
 to thicken, and perhaps to sprout into little lobules and 
 bulbs and knobs of fat. But there are unfortunate people 
 who never touch alcohol at all who get rosacea as a result 
 of chronic indigestion, or again it may be a personal pe- 
 culiarity, inherited from the parents. Even well-brought 
 up women get rosacea from exposure to the air and feeble- 
 ness of circulation. 
 
 The treatment is not hopeless if the patient will go with- 
 out alcohol for always, and give up tea and coffee until 
 cured. The doctor must be consulted to put the patient's 
 stomach in good order. After that, the sufferer from a red 
 nose is to take a 5-grain tabloid of ichthyol before breakfast 
 and before retiring to bed. After a fortnight the dose is 
 to be increased to eight grains, and after three weeks to ten 
 grains, until the case is cured. This is to be combined with 
 the local application of alkaline spirits of soap to the nose 
 and cheeks at bedtime, or by using ichthyol ointment. 
 
 Gumboil. A spot of inflammation, leading on to the for- 
 mation of an abscess, and commencing near the fang of a 
 decayed tooth. The gum is a very dense, hard structure, 
 and the growth of the abscess causes great pain; it forms 
 a red, tender swelling on the gum and may burst alongside 
 the tooth, or through the gum, or in the cheek. Give a 
 brisk purgative such as a dose of salts and senna, and get 
 a dentist to open up the hollow tooth or to lance the gum; 
 if this is not desired, some slight relief may be gained from 
 holding hot water in the mouth, or applying a few drops 
 of laudanum and spirit of camphor on cotton-wool to the 
 gum, or by hot poultices to the cheek. Gumboils often 
 recur and when this happens removal of the tooth is the 
 only remedy. 
 
 Hairdressers, Hints to. In some parts of Europe the 
 government authorities compel all hairdressers and barbers 
 thoroughly to disinfect all instruments and brushes imme- 
 diately after use. 
 
 If such excellent regulations were in force in this coun- 
 try we should soon hear no more of diseases contracted by 
 people in hairdressers' shops. Among the diseases spread, 
 partly in ignorance, partly by lack of thoroughness in 
 cleanly precautions, by hairdressers and barbers among 
 their customers, are Barbers' Itch (which see), different 
 forms of ringworm, boils, acne, itch, impetigo and others. 
 
126 HAIRDRESSERS 
 
 Of course, the self-respecting barber in this country also 
 uses disinfectants, and is as thorough in his cleanliness as 
 he knows how to be ; but sometimes, from ignorance of the 
 diseases in question, he does not know how properly to 
 guard against them. We have therefore drawn up a few 
 rules for the guidance of hairdressers in this matter of 
 the hygiene of the toilet. 
 
 (1) Everything in the shop ought to be thoroughly 
 cleaned at the beginning of the working day. Not only 
 must the rooms be swept out with a broom (that only re- 
 distributes some of the small dust and hair on the floor) ; 
 but a mop ought to be used after the broom, and the mop 
 ought to be kept in a bucket containing a lotion made 
 thus: Dissolve one-eighth grain soloid of corrosive subli- 
 mate in a quart of water. Renew this lotion twice a week 
 at least, and use it on the mop for disinfecting the dust 
 on the floor everywhere. In addition to this, all seats and 
 chairs and chair-backs should be sponged thoroughly with 
 this powerful germicide lotion, and all basins, tubes, and 
 taps also. 
 
 (2) All the barber's assistants should wear white cotton 
 washable jackets with short sleeves, and no frayed cuffs 
 beneath. All assistants should be required to wash their 
 hands and arms in carbolic soap 5 per cent., and to keep 
 the nails short and polished and clean. Nails should never 
 be cleaned with a knife or steel pick, but with a nailbrush 
 which is kept always in a little tray of lotion. 
 
 (3) Shaving brushes are peculiarly liable to convey con- 
 tagious diseases unless kept quite clean. They ought to be 
 washed in a corrosive sublimate lotion after every using. 
 Trays, like those used by photographers for developing 
 plates, should stand on the sideboard, half-full of boric 
 lotion, and all scissors, clippers, and razors ought to lie in 
 the lotion until just before use. Boric lotion does not 
 rust steel instruments. It is made by dissolving a boric 
 acid carton in a pint of boiling water. Some hairdressers 
 dip the razor into hot water just before use, but the 
 water must be boiling if it is to be of any special antiseptic 
 use. 
 
 (4) The soap used is important, but the choice of it must 
 be left to the individual barber. Be careful only not to 
 use the same cake of soap for a spotty chin and a healthy 
 skin in succession. The most hygienic way is to use one of 
 
HAIR, CARE OF 127 
 
 the soap-powder preparations, so as to have absolutely fresh 
 soap for each customer. 
 
 (5) After shaving, the razor should be wiped on a wash- 
 able india-rubber slab or tray, as is already done in many 
 places. A spotty chin should then be sprayed with the 
 weak corrosive sublimate lotion above mentioned, with a 
 few drops of scent in it, and a small square serviette may 
 be used to wipe dry. The powder afterwards applied 
 should be made of equal parts of talc, zinc oxide, and 
 starch. 
 
 (6) Combs used after hair-cutting should be disinfected, 
 and brushes should be washed with 5 per cent, carbolic soap. 
 
 (7) Hairdressers who adopt these thorough measures 
 should take care to advertise the fact in their windows. 
 
 Hair, How to take Care of. (1) Use little grease or po- 
 matum on your hair, unless your health is not good and 
 the hair is brittle and splits at the ends. Then you can 
 use a little pure olive oil which is to be rubbed on to the 
 scalp and not just smeared over the hair. 
 
 (2) No animal fat or lard or lamb's- wool ointment should 
 be used on the scalp. It only irritates the skin as it be- 
 comes rancid, and causes scurf. 
 
 (3) Don't wash the head with frequent irrigations of 
 cold water. Nothing so soon makes the hair gray and 
 scanty. 
 
 (4) To wash the head, make a lotion of a teaspoonful of 
 ammonia to a quart of hot rain water, and add two table- 
 spoonfuls of soft soap. A lump of carbonate of soda will 
 do instead of the soft soap if you prefer it. After washing 
 the hair, dry it very thoroughly on a rough towel not a 
 Turkish bath towel, full of fluff. If your hair is fair, that 
 method will suit it well. But if your hair is dark, use the 
 yolk of an egg beaten up with borax and rain water. 
 
 (5) For thin, scanty hair. Quinine sulphate, 1 drachm; 
 dilute sulphuric acid, 15 minims ; rectified spirit, 2 ounces ; 
 rose water, 8 ounces mix, and add glycerin, 2 drachms; 
 mix and shake well. Use this lotion, rubbed in the scalp, 
 twice a day. 
 
 (6) For thin, scanty dark hair. Take of good black tea- 
 leaves, 1 ounce; add boiling water, 1 pint. Infi se in a 
 teapot. Leave to cool. Strain off the infusion, <md add 
 to it, Jamaica rum, 3 fluid ounces. Rub some into the roots 
 of the hair with a piece of rag, morning and evening. 
 
128 HAIR, CAKE OF 
 
 (7) The color of hair is due to mineral pigments. Very 
 fair hair contains magnesia, and fair hair often remains 
 unchanged, even in old age. Brown and chestnut locks 
 contain sulphur, and a little iron; black hair pigment is 
 rich in iron. Gray and white hair have no iron and very 
 little sulphur. Therefore, most hair restorers and dyes 
 contain iron and sulphur. But all ordinary shop-sold dyes 
 are apt to be unsafe, and may have poisonous minerals in 
 them which will at last make the hair and scalp decay. 
 
 There is, in fact, no really satisfactory hair dye, as far 
 as we know. 
 
 (8) Greasy lank hair may be made somewhat dryer and 
 curlier by the use of such lotion as this: Bicarbonate of 
 soda powder, 2 drachms; borax powder, 2 drachms; eau- 
 de-cologne, 1 fluid ounce ; rectified spirit, 2 ounces ; tincture 
 of cochineal, 4 fluid drachms; distilled water, 16 ounces. 
 (Mix and shake.) 
 
 (9) For dry, stubby hair, instead of grease or pomade, 
 use: Eau-de-cologne, 8 ounces; tincture of cantharides, 1 
 ounce; oil of English lavender, 15 drops; oil of rosemary, 
 20 drops. (Make a lotion to be rubbed well into both hair 
 and scalp.) 
 
 (10) After an illness your hair may come out in hand- 
 fuls. To remedy this, cut it quite short and keep it so for 
 a year, using the lotion given above in paragraph (5). 
 This plan enables both air and light to get down to the 
 scalp and enables you to employ friction of the scalp with 
 a wire brush. Use no grease. 
 
 (11) Shampoo, for scurfy heads : Yolk of an egg, a pint 
 of rain water, an ounce of spirit of rosemary. (Mix and 
 warm before using.) 
 
 (12) "Silver hairs among the gold." A few gray hairs 
 appearing in a youth show that the scalp is badly nourished. 
 Get the doctor to prescribe you an iron tonic, and use cheap 
 claret as a weekly head wash. 
 
 (13) To make the hair curly. All shop-sold prepara- 
 tions for this purpose are risky to use. The following 
 "curling fluid" is free from objections: Carbonate of 
 potassium, 12 grains; warm water, made soapy, one pint. 
 (Disso ] ve. Stir up into a froth, damp the hair brush with 
 it and brush the hair thoroughly at bedtime, with the wet 
 brush. Then curl up the hair on rollers of wire and kid 
 [such as all first-rate hairdressers keep for sale]. In the 
 
HANGING 129 
 
 morning the curliness of the hair will outlast even rainy 
 weather to some extent.) 
 
 Never use crimping-irons, they only destroy the hair at 
 last. 
 
 Hair, Loss of. (See "Baldness.") 
 
 Hairs, Superfluous. Superfluous hairs on the faces of 
 women are a fruitful source of profit to skin doctors, 
 beauty doctors (so called), chemists, and hairdressers. 
 Electrolysis (or the removal of hairs by electricity) can 
 only be done by specialists. Perhaps as many as twenty 
 hairs may be removed at one sitting. There is only one 
 class of chemicals which may help in the matter caustic 
 alkalies, in combination with sulphides, and these are dan- 
 gerous. A paste is made thus: Quicklime, 16 oz. ; pearl- 
 ash, 2 oz. ; liver of sulphur, 2 oz. These are mixed and 
 finely powdered, and enough water is added, as required, 
 to make a paste. The paste is spread thickly on the skin 
 for three minutes, then it is scraped off with a bone paper 
 knife, and cold cream is applied instead. The lip or chin 
 thus treated will, perhaps, itch, grow red, and smart. The 
 epidermis is removed. The hairy, downy growth is all gone. 
 But the hair bulbs, deep down in the skin, remain, and later 
 on a fresh crop of hair comes up, as if nothing had been 
 done. A German physician has made a liquid depilatory. 
 Here it is: Tincture of iodine (1 in 10), half a drachm; 
 Venice turpentine, 1 drachm ; castor oil, 1% drachms ; recti- 
 fied spirit, 1% oz. ; collodion, 6 oz. Mix. This is painted on 
 the part at night, and next morning the film is peeled off; 
 and the hairs if they behave themselves properly, come up 
 by the roots. But sores may be left, and they are difficult 
 to heal. No one should try such experiments except under 
 skilled advice. 
 
 Hanging. If ever you come across a person who has 
 hanged himself or herself, or who has been hanged by 
 someone else that is, if ever you see a body hanging by 
 the neck get a knife or scissors and cut the body down. 
 Don't lose your presence of mind; don't be foolish enough 
 to stand horror-stricken, or to rush away and whisper the 
 awful fact to somebody else. This kind of foolishness is, 
 unfortunately, common enough in cases of hanging, but let 
 the reader of this book be more sensible. 
 
 Cut the body down. (Many a criminal or highwayman 
 in the old days was cut down by his friends and brought 
 
130 HAY FEVER 
 
 back to life again, even after half-an-hour 's suspension.) 
 When you have cut it down, loosen the noose round the 
 neck and perform "artificial respiration," as described 
 under "Drowning." (See "Drowning.") 
 
 If the neck is not broken you can probably restore the 
 patient back to life again. 
 
 Hangnail. This means a sore finger from irritation set 
 up by a little tag of skin peeling off near one of the nails. 
 
 When one is in a weak, unhealthy condition the skin of 
 the fingers becomes liable to fester whenever any little 
 scratch occurs; any little raw spots get infected with dirt 
 and become acutely painful. To obtain a cure clean the 
 part very thoroughly with soap and hot water, and then 
 with clean water, dry it, and paint the spot with flexile 
 collodion, or the liquid called "new skin"; under this coat- 
 ing the little ulcer will soon heal up ; after this rub vase- 
 line into the skin of the fingers every night for a week. 
 
 Harelip. This is a notch or cleft in the upper lip on one 
 side of the middle line, caused by a lack of proper develop- 
 ment of the face. Sometimes there is a notch on the other 
 side of the middle line as well, leaving a central flap of 
 lip (double harelip). There may be, in the same person, an 
 incomplete development of the palate as well, called cleft 
 palate. 
 
 Treatment. A very slight notch in the lip may be op- 
 erated on a few weeks after birth. Of course, there is no 
 cure for the deformity, except a plastic operation. Cleft 
 palate, if complete, can also be cured by operation, and 
 this ought to be done when the child is about 18 months 
 old. The deformity will interfere with learning to speak, 
 and until harelip is cured the child cannot suck properly. 
 
 Hay Fever. This refers to a peculiar catarrh of the nose 
 and eyes affecting some people from May or June to the 
 latter part of July (rose cold) or from the latter part of 
 August to the first frost (autumnal catarrh). 
 
 It runs in families, especially gouty families, and affects 
 chiefly men of high intellectual powers. It is, in fact, a 
 neurosis or functional nervous disease. 
 
 Signs. The eyes and nose water, the patient sneezes, has 
 a hard cough, and attacks of shortness of breath. But 
 there is no f everishness. The attack 'may last for several 
 weeks, though a change of air and scene, especially to a 
 barren and non-fertile district, will often effect a cure. 
 
HEADACHE 131 
 
 Treatment. In the first place, a person liable to hay 
 fever must avoid the fields during the summer. A seaside 
 place is generally the best to go to, provided it is bare 
 and there are no forests near. 
 
 The only medicine of much service is Dunbar's pollantin, 
 a few drops of which are to be instilled into the eyes every 
 morning during the attack. Lately, supra-renal-extract 
 spray, 5 per cent., has been used to spray nose and throat 
 with a good deal of success in these cases. A solution of 
 quinine used as a nose spray is also useful. 
 
 Headache (Varieties of). Headaches may be due to 
 dozens of different causes. No doubt the reader cares very 
 little about that what he or she wants is to know how to 
 cure a headache! But there is no royal road to anything 
 in life, and certainly not to the curing of a complaint. 
 That is why doctors are real necessities, in spite of the 
 quacks and their cure-alls. The man who analyzes, and 
 studies and builds up personal experience of disease, is the 
 only man whose opinion is worth anything in these matters ; 
 and every doctor will tell you that there is no royal road 
 to a cure. But he who studies the possible causes of head- 
 ache, and then applies his remedy, has some chance of cur- 
 ing the complaint. A dyspeptic headache may be known 
 by the pain being worse after food, and by its being accom- 
 panied by costiveness, acidity, and a feeling of sickness. 
 The headache of the ancemic girl occurs in girls who are 
 pale or yellow, and have pale lips, and suffer from palpi- 
 tation of the heart. Hysterical headaches are usually 
 worse at certain times, and are generally confined to one 
 special part of the head. Such headaches are said to be 
 like nails driven into the temples. Rheumatic or neuralgic 
 headaches are generally diffused over the whole head; the 
 scalp is tender, and there are rheumatic pains in other parts 
 or joints. Sick headaches are ushered in by flashes of light 
 in the eyes, dizziness, or temporary blindness. After the 
 headache, which is generally quite local, comes a feeling 
 of nausea or sickness. The headache of the person who 
 suffers from neurasthenia, or nerve exhaustion, is generally 
 a feeling of weight on Jthe top of the head, and is attended 
 with a good deal of confusion of thought. The temper is 
 irritable, and the patient is sleepless. There are many 
 other varieties of headache, some connected with actual 
 brain disease. But it is impossible to go into those in this 
 
132 HEADACHE 
 
 article. As to cures, they must obviously depend upon the 
 cause of the complaint. Anaemic and hysterical people 
 will always be subject to headaches, until the anaemia is 
 cured by large and continued doses of iron; and the hys- 
 teria is improved by marriage or by a little severe treat- 
 ment (see also "Hysteria"). 
 
 This subject seems so important that we shall give a 
 more detailed account of a few of the different kinds of 
 headache, and some prescriptions. We have already 
 warned the reader that he must study to find out the cause 
 of the headaches before taking remedies; and we may add 
 that many of the " headache powders" of the patent medi- 
 cine market are either dangerous or useless. 
 
 I. Migraine or Sick Headache. These headaches occur 
 periodically. They come on regularly at certain intervals, 
 or else occur quite unexpectedly without traceable cause. 
 The attacks may begin at any period of life and affect one 
 side of the head only. Some patients feel chilly and irrita- 
 ble and depressed before an attack ; then come disturbances 
 of vision spots and flashes of light, zigzag figures and 
 blurring of sight, even blindness for a time, especially 
 blindness of one half of the field of vision. The patient 
 seeks a dark room and a warm corner. Then comes a vio- 
 lent headache, which lasts about an hour or more, and is 
 followed by sickness and nausea and yawning. When he 
 has vomited several times, and a sour liquid has come up, 
 the headache ceases and the sufferer falls asleep. Severe 
 forms may last two days. The disease is frequently in- 
 herited, especially from gouty parents. 
 
 The treatment by diet is unsatisfactory; the most ab- 
 stemious sometimes have migraine. Between the attacks, 
 especially if they are regular, it is a good plan to take 
 five grains of butyl-chloral and twenty grains of sodium 
 bromide thrice daily for three days before the attack is 
 expected. Many people keep tabloids of antipyrin at home, 
 and swallow one when they feel headachy. But this is to 
 be condemned, because the drug lowers the heart. Phen- 
 acetin is better; and caffeine is better still; during attacks 
 take one grain with a little sugar of. milk every hour until 
 recovered. 
 
 II. Ancemia, Headache due to. The pain in this type 
 of headache is generally more or less continuous, and affects 
 sometimes the forehead, sometimes the back of the head, and 
 
HEAKT DISEASE 133 
 
 sometimes the top. Bodily and mental exertion make it 
 worse. The patient is generally costive, drowsy, listless, 
 and sleeps badly. Of course the anaemia itself must be 
 dealt with by the doctor. Tea and coffee are useful reme- 
 dies, but alcohol does harm. If the patient is hysterical 
 as well as angemic, let her take a one-grain pill of valerianate 
 of zinc and one-sixtieth grain of phosphorus twice a day, 
 for a month at a time, and ten to twenty grains of sodium 
 bromide at bedtime, occasionally, to produce sleep. 
 
 III. Congestive Headaches are due to over-indulgence 
 in food or drink; sluggish liver; the change of life (which 
 see), and heart disease. The blood vessels throb, the face 
 flushes, the pain gets worse when lying down, and there is 
 giddiness. These headaches cannot be cured by drugs, 
 except those drugs which relieve the causes of the condition. 
 But until the doctor comes, and until the general state of 
 health is improved, purgative medicines will always give 
 relief. 
 
 Health Resorts. (See "Climate for Invalids.") 
 
 Heartburn is a burning sensation, sometimes amounting 
 to pain, passing up along the food pipe or gullet from the 
 stomach to the back of the throat. Sometimes mouthfuls 
 of an acid fluid are brought up at the same time. It is 
 caused by Acidity (which see), and the return of acidified 
 food from the stomach. (See "Indigestion.") 
 
 Heart Disease. The heart, which is situated in the chest, 
 between the lungs, a little to the left of the middle, is the 
 most important organ of the body. It is formed of red 
 flesh or muscle, and contains four cavities, through which 
 the blood is constantly flowing from the veins, and on into 
 the arteries, to nourish the whole of the tissues of the body. 
 The heart is in a constant state of contraction and relaxa- 
 tion, which continues as long as life lasts; even its mo- 
 mentary stoppage causes a partial death, called fainting. 
 In order to maintain health, the heart must be in good 
 order, and whenever any part of the heart is injured by 
 disease, there are sure to be some symptoms of ill-health, 
 as well as some defect in the circulation of the blood. 
 
 Diseases of the heart may be considered in two groups 
 functional and organic; the first including all cases of 
 wrong action of the heart without disease or deformity of 
 the structural anatomy of the heart; the second includes 
 all defects of the walls of the heart, all faults in the 
 
134 HEART DISEASE 
 
 muscular texture, and all imperfections of the many valves 
 within the heart. All actual organic faults are incurable, 
 but some relief may often be given by suitable treatment. 
 On the other hand, functional heart diseases are often tem- 
 porary; they may come and go with variations in the 
 constitution. 
 
 The most common cause of functional heart symptoms 
 is the state called Anaemia, or bloodlessness, which means 
 that the blood is too weak and watery. It is shown by 
 pallor of the cheeks, and lips, and ears, palpitation on 
 slight exertion, a state of breathlessness, and a tendency to 
 fainting. Hysterical women also suffer from this form of 
 heart disease, and it is often seen in women past middle 
 age. Drunkards are liable to it, and an excessive use of 
 tobacco may cause a feeling of weakness, giddiness, trem- 
 bling, and faintness due to an unsteady cardiac action. 
 Patients who are weak after a serious illness, or after an 
 accident, have almost always a temporary loss of the strong, 
 regular action of the heart which is so necessary to per- 
 sonal comfort. Persons with feeble anaamic hearts often 
 have puffy ankles at night and swollen eyelids in the morn- 
 ing. The pulse is generally too quick, but too small, 
 thready and feeble ; there may be a dull pain in the chest, 
 and very often there is an inability to sleep lying on the 
 left side; in some cases there are headaches, giddiness, 
 noises in the ears, and flushings of the face. In these cases 
 a doctor must try simple remedies, in the hope that there 
 may be no organic disease, for the sounds heard by the 
 stethoscope much resemble those of real valvular disease. 
 
 I. Organic heart disease. The several forms of or- 
 ganic cardiac disease are due to actual faults in the heart's 
 muscles, and the valves within the heart. In some cases 
 these faults are present at birth, and continue during life, 
 but in other cases the mischief arises from over-strain, or 
 from rheumatic fever, or from fatty degeneration of the 
 muscles. A wasting or atrophy of the heart is also known, 
 and an over-growth or chronic enlargement of the heart is 
 often present as a secondary result of obstructions to the 
 circulation of the blood, as, for example, from chronic 
 alcoholic hardening of the kidney. Still another and very 
 fatal form of heart disease is called dilatation, in which 
 the heart is larger, but not heavier; and this is due to a 
 dilating, bulging, or enlargement of the cavities, while the 
 
HEART DISEASE 135 
 
 walls get thinner and weaker. This disease often leads to 
 sudden death from a faint, or from spasm of the heart. 
 There are four valves within the heart, through which the 
 circulating blood is constantly passing, and these have to 
 open and close about 70 times in each minute of our lives. 
 Whenever the valves are out of order, or deformed by such 
 inflammation of them as occurs with rheumatism, there is 
 more or less disturbance of circulation, leading to various 
 symptoms, such as pain, breathlessness, cough, palpitation, 
 fainting and dropsical swellings of the legs and face, all 
 due to the effects of the valve disease on the heart walls. 
 
 II. Valvular diseases, which are mostly due to attacks 
 of inflammation, caused by rheumatic poison, of the deli- 
 cate membrane lining the cavities within the heart, are of 
 two sorts first, those which obstruct and delay the blood- 
 flow through the valves, and, secondly, those which prevent 
 the correct closing of the valves at each contraction of the 
 heart. These valvular troubles due to inflamed membranes 
 are most commonly found to originate during the course of 
 acute rheumatism, during which the large joints of the 
 limbs are most affected. Another form of valvular mischief 
 arises in late middle life from the deposit of chalky flakes 
 and bony layers in the structures forming the valves; the 
 result is that the valves, which in youth and health are 
 delicately soft and elastic, become hard and brittle, and 
 are liable to lead to sudden fain tings and unexpected death. 
 The form of heart disease in any patient is partly judged 
 from the symptoms, and partly from the sounds arising 
 from the heart's action, which can be heard outside the 
 chest by means of the stethoscope in the hands of a skilled 
 physician. Skill in this process is not easy to acquire, and 
 when gained it needs constant use, for the ordinary person 
 hears nothing but confused and very slight sounds when he 
 applies the stethoscope to a chest. 
 
 III. The doctor's examination of the heart. The in- 
 troduction of the use of the stethoscope, which is a wooden 
 or metallic tubing, having at one end an ear piece and at 
 the other a chest piece, has very much increased the power 
 of the physician to diagnose or discover the nature of a 
 case of heart disease. This instrument is now also made 
 of india-rubber tubes, for use with either one or both ears. 
 By its means the sounds made in the lungs by the breathing 
 are also heard, and when listening to a chest in certain 
 
136 HEATING 
 
 positions both lung and heart sounds are heard at once, so 
 that experience and skill are needed to come to correct 
 conclusions as to the origin and meaning of chest sounds. 
 Diseases of the valves of the heart give rise to sounds called 
 murmurs. The study of these murmurs is by no means 
 easy, and it is, unfortunately, true that some forms of a 
 very serious heart disease do not produce any of these curi- 
 ous noises. Another mode of discovering heart diseases is 
 by the process called percussion, or rapping the chest sur- 
 face and noting the clearness or dullness of the musical note 
 produced. By this means a physician can tell how large a 
 heart is, and whether or not it is displaced from its correct 
 position between the two lungs. A doctor also gains a 
 knowledge of the heart's action by merely looking at and 
 gently feeling the chest surface. By these means he notices 
 the place and force of the heart's beat. The apex, or 
 pointed lower end of the heart, should tap against the chest 
 on the left side of the breastbone, about three inches from 
 it, and between the fifth and sixth ribs; its action should 
 be regular as to intervals, and regular also as to force. 
 Nervous people, however, will be found for a few minutes 
 to have an irregular throbbing action of the heart, called 
 palpitation, when a doctor tries to examine it. This alone 
 is no proof of heart disease, but only of nervousness. At- 
 tacks of palpitation, or heart-throbbing, are a frequent 
 symptom of heart disease, possibly only due to a weak, or 
 fatty, or nervous state of that organ, and are not a proof 
 of actual structural disease, nor of valvular mischief. 
 Shortness of breath and panting on exertion are also signs 
 that the heart is not in good order. The pulse, as it is 
 felt conveniently at the wrist, gives valuable indications 
 of the rate of the heart's action and its strength. When it 
 is irregular, and especially when it occasionally misses a 
 beat, medical advice should be sought. 
 
 Heating. There is perhaps no department of domestic 
 economy about which greater ignorance is displayed than 
 the warming of houses. Among the poorer classes more 
 especially, this ignorance, combined with more or less care- 
 lessness, leads to the most reckless waste in the consump- 
 tion of coal, even when poverty necessitates its being pur- 
 chased at the cost of considerable deprivation in other di- 
 rections. Poorly constructed fireplaces have been to blame 
 for this. In recent years some improvement has been ap- 
 
HEATING 137 
 
 parent, but even now we have not seen the last of the hide- 
 ous, hollow-backed iron grates. 
 
 Closely associated with the comfort, efficiency and 
 economy of heating is the subject of humidity of the air. 
 Humidity is harmful not only if too high but also if too 
 low. Room temperature should be maintained at 65 to 70 
 F. When heated air is maintained at a temperature of 
 72 F. the humidity is usually about 24%. 
 
 If now the humidity is artificially increased to 50% the 
 body feels the same sense of comfortable warmth if the 
 temperature is only 65 F. ; and in this reduction of tempera- 
 ture there is not only a saving in fuel cost of 12%%, but 
 the occupants of the rooms have increased freedom from 
 influenza, catarrh, coughs, and colds. 
 
 Overheated air which lacks moisture subtracts it from 
 any surface in the room the skin, hair, and mucous mem- 
 branes of a person hence the discomfort. The faults of 
 most heating apparatus are mainly due to their super- 
 heating the air, and to their lack of any provision for 
 ventilation. 
 
 The principal methods of heating are open fires, closed 
 fires and stoves, hot air and pipes containing hot water 
 or steam. One of the best methods is that known as the 
 "plenum" system. 
 
 Open fires carry off large volumes of air besides their 
 own products of combustion, stoves only a little ; hot pipes 
 not at all; while fender stoves not only do not ventilate 
 but add to the impurity of the air. 
 Grates or Open Fireplaces: 
 
 These are excellent aids to ventilation, extracting from 
 10,000 to 20,000 cubic feet of air per hour through the 
 chimney. If, however, pure air is not provided to meet 
 the demand the air of halls, kitchens, cellar or water-closet 
 is drawn upon with the result that good ventilation is not 
 accomplished. The ordinary fireplace is also extremely 
 wasteful of fuel, as only 12 per cent, to 14 per cent, of 
 the heat generated is utilized in a room, the remainder 
 escaping up the chimney. The common experience in a 
 room so heated is that the person near the fire is very hot, 
 while at any distance from the fire the room is cold. 
 
 Gas stoves are economical and cleanly in use, create no 
 smoke and can be lighted, extinguished or regulated in 
 a moment. 
 
138 HEATING 
 
 A gas stove burns from ten to twenty or more cubic feet 
 per hour, therefore the amount of air consumed, which must 
 be renewed, is considerable. 
 
 Stoves have their advantages and disadvantages. 
 
 There is less loss of heat than with open fireplaces or 
 grates, and the room is more uniformly warmed. The dis- 
 advantages are, poor ventilation, air which passes over 
 a stove becomes too dry, the burnt organic particles of 
 air may give a disagreeable odor and carbonic oxide gas 
 may escape, giving rise to headache and a feeling of dis- 
 comfort. 
 
 Hot Air is advocated by some authorities as the best 
 mode of warming houses, as well as public buildings. 
 
 This may be done by a basement furnace and conveying 
 the warmed air to all parts of the house by special channels. 
 The essentials for this form of heating are: a brick-lined 
 fire chamber, an exhaust flue for foul air and a supply of 
 fresh air from out-of-doors not from the cellar. 
 
 Hot Water and Steam Pipes are frequently employed for 
 warming houses as well as offices and public buildings. 
 This system, if properly applied, is an excellent one, but 
 one usually finds, in cases in which it is in operation, that 
 all principles of ventilation have been completely disre- 
 garded. The wholesome influence of the ordinary fire- 
 place in changing the air of the room is lost, with the 
 result that the same foul air, which has been breathed for 
 hours on end, is circulating in warm currents round the 
 room in question. 
 
 No system of warming by hot water or steam pipes is 
 admissible, unless both inlets and outlets are provided for 
 ventilation. The best method of introducing air into a 
 room warmed in this manner, is by so arranging the open- 
 ings that the incoming air must first circulate over the 
 hot pipes. These are known as ventilating radiators. A 
 very convenient form of such a device is the electric radia- 
 tor which possesses the advantage of yielding no products 
 of combustion and producing heat which is available im- 
 mediately the current is turned on. 
 
 The form of heating device which is by all means the 
 most preferable for public and semi-public places, theaters, 
 apartment houses, museums and private houses, if the ex- 
 pense is not a drawback, is the "plenum" system, or the 
 indirect system of radiation. 
 
HEATSTROKE (STINSTKOKE) 139 
 
 The out-door air is sucked in from near the roof-level 
 through a large shaft into a cold-air room, where it is 
 moistened and washed by a spray or water curtain, and 
 whence it passes through a dust-fitter, consisting of a 
 double layer of fine wire gauze or cloth. Thence it passes 
 through tempering radiators and humidifier into the re- 
 volving fan whence part passes through a second radiator 
 to be further warmed, the other part not further warmed 
 being mixed with this warmed air and the mixture carried 
 through flues to the rooms. 
 
 By this method the temperature and humidity of the 
 air can be controlled by thermostats and humidostats in 
 any room, the air is pure and clean, and circulation of air 
 is assured as it is not unusual to supply a million cubic 
 feet of air an hour by this method. 
 
 By introducing into this circuit a cooling plant operated 
 by expansion of air, evaporation of liquids or the Carre 
 ammonia process, rooms can be cooled in summer as well 
 as they can be heated in winter. 
 
 Heatstroke (Sunstroke) , When a person is exposed to 
 a broiling sun, or to intense moist heat, the body is apt to 
 become overheated and to suffer from the results. Those 
 who drink alcohol and those who are depressed by worry 
 and anxiety are the ones most liable to be made ill by 
 exposure to great heat. Among women, laundresses, 
 bakers, and sempstresses, in ill-ventilated, crowded rooms, 
 and tight-lacers are those who are most liable to heat- 
 stroke. 
 
 There are three different ways in which intense heat 
 may affect an individual: (1) The first is called Heat- 
 stroke. The person feels suddenly sick and giddy, then 
 drowsy. The skin is pale and clammy, the pulse is quick 
 and intermittent, the breathing is gasping and sighing. 
 The sufferer may die of heart failure (syncope). To cure 
 him, let him lie down flat, give him sal volatile (a tea- 
 spoonful in a wineglassful of water), or brandy, and rub 
 the hands and feet. 
 
 (2) Heat apoplexy. This looks just like an attack of 
 apoplexy (which see), occurring in a very hot place. There 
 is unconsciousness and there may be fits. Pump cold water 
 over head and back, rub the body with ice and give a rectal 
 injection of cold water. The body is intensely hot in this 
 form of heatstroke. If the patient doesn't recover his 
 
140 HERNIA 
 
 senses as his body gets cooler, shave his scalp and put a large 
 blister on. 
 
 (3) The most serious form of sunstroke is called 
 Thermic Fever. The heat of the body runs up to about 
 108 Fahrenheit or more, and the patient simply burns 
 rapidly away, if you cannot save him, in a day or two. He 
 has great thirst, quick bounding pulse, pains all over, 
 headache, vomiting and gasping for breath. The body may 
 be swathed in a sheet wrung out of cold water. 
 
 Hernia, or Rupture. This word means the protruding 
 of an organ into or through the wall of the cavity to which 
 it belongs. Thus, a hernia of the lung is said to be present 
 when there is a wound of the chest wall and the lung sticks 
 out or escapes through it. But the word hernia is at the 
 present day almost exclusively used to mean a rupture or 
 tear of some part of the belly watt, which allows a " knuckle" 
 of bowel to slip through it and appear as a tumor (or 
 swelling) beneath the skin. The rupture does not affect 
 the skin but the layers of muscles and membrane, which are 
 less tough. 
 
 The anatomy and contents of hernial protrusions are 
 difficult to understand, and we shall not attempt a popular 
 description. 
 
 The important thing for the sufferer and for the general 
 reader is to understand something about the different types 
 of rupture and the risks attending the neglect of a rupture. 
 
 Rupture at the navel (umbilical hernia) occurs in in- 
 fants sometimes, and is seen as a lump pushing the navel 
 an inch or two out of the belly, especially prominent when 
 the child strains or cries. A concave circular pad and 
 bandage will have to be worn. Some doctors make a pad 
 out of a cut beer-bottle cork and apply it with adhesive 
 plaster. 
 
 Inguinal hernia. This is a rupture at the groin. The 
 swelling may be either very slight, or considerable, and in 
 men the lump escapes down into the purse or scrotum, and 
 lies alongside of the testicle there. This is the commonest 
 form of rupture. 
 
 Femoral hernia is the variety which is most common in 
 women. There is a lump under the skin at the upper and 
 inner part of the thigh. 
 
 Double hernia. Any person may have a rupture on both 
 sides, and they may be of different varieties. 
 
HERNIA 141 
 
 Ventral hernia is the name given to a protrusion of the 
 bowel through some artificially-made opening, such as the 
 weak scar of an old abdominal operation. 
 
 Congenital hernia is one which exists at birth. 
 
 Acquired hernia is one which is developed later in life 
 through a strain or accident. 
 
 Reducible hernia is a rupture in which it is possible at 
 any time to return the tumor into the place where it be- 
 longs by gentle pressure with the fingers in the right direc- 
 tion. 
 
 An irreducible hernia is one which cannot be returned to 
 where it belongs, either because it sticks to its new sur- 
 roundings because of inflammation ; or because it has grown 
 too fat since it escaped through the rupture, or for some 
 similar reason. 
 
 A strangulated hernia is one in which a large knuckle of 
 bowel has been forced (by coughing or straining) through 
 a very narrow orifice, and the tightness of the opening in- 
 terferes with the proper circulation of the blood in the 
 bowel. By-and-bye the bowel tumor swells up, and unless 
 a surgeon can succeed in " reducing the swelling" or in 
 cutting through the band of constriction, the bowel will 
 mortify, and the patient will die of shock and blood poison- 
 ing. Any hernia may become strangulated. 
 
 Causes. Many hernias are produced suddenly by strain- 
 ing. The patient feels something give way and finds a 
 lump there. More often the hernia develops gradually, in 
 a person who is always lifting heavy weights or doing work 
 that is too much for him. In coughing or straining in the 
 w.c. the hernia "comes down," and the patient feels in- 
 secure and presses his hand over the rupture. Even a small 
 rupture is apt to produce constipation (costive bowels). 
 
 Symptoms of strangulation. If in a person, known or 
 not known to have a rupture, there occurs a sudden ab- 
 dominal pain at the seat of the rupture, stoppage of the 
 bowels, and vomiting, the probability is that he has a 
 strangulated hernia, and a doctor must be sent for at once. 
 Every minute of delay is dangerous. An operation will 
 probably have to be done in any case, but the longer the 
 delay the more severe will be the operation. Old persons 
 who may have had ruptures for many years without much 
 trouble from them may be taken with serious sudden vomit- 
 ing, pain, and costiveness; and such cases ought always to 
 
142 HERNIA 
 
 be examined to see if they have a strangulated hernia or 
 not. 
 
 Treatment. There are two ways of dealing with a rup- 
 ture. The person must either wear a truss or he must un- 
 dergo an operation for a radical cure of the hernia, and 
 in most cases the operation is by far the better way. 
 
 Of trusses, we may say that if a truss fits comfortably, 
 keeps back the hernia entirely and produces no pain nor 
 chafing of the skin, it may be considered in every way a 
 suitable instrument. 
 
 "In the case of infants, the constant application of a 
 truss day and night will effect a complete cure within a 
 year in the majority of instances of inguinal hernia," 
 writes Dr. Whitla. No baby is too young for a truss, but 
 it ought to be made waterproof and easily cleanable. The 
 truss may be left off six months after the rupture is con- 
 sidered cured. Adults must see that their trusses fit accu- 
 rately, which cheap trusses seldom do. A badly-fitting truss 
 causes a great risk of strangulation. Patients must have 
 two trusses in case of accidents, while one is undergoing re- 
 pairs. 
 
 The skin under the truss pad should be kept dusted with 
 zinc oxide. See that growing young people with ruptures 
 are kept supplied with powder, and with new trusses when 
 they grow out of old ones. 
 
 In young people with recent ruptures, well-fitting trusses, 
 worn night and day, may be regarded as curative in many 
 cases, after a year or two. 
 
 If a hernia be irreducible, either a special kind of truss 
 must be worn, or the hernia must be cured by an opera- 
 tion. 
 
 The operation for the radical cure of herina is not in itself 
 a dangerous one, and necessitates lying up for about three 
 weeks. Only an operating surgeon can decide whether the 
 operation ought to be done in any given case. Even old 
 people with old ruptures may be cured. 
 
 The operation involves no risk to the testicle or to any 
 other organ. 
 
 The ailments which may complicate, or be mistaken for 
 hernia, are: Varicocele, hydrocele (a collection of watery 
 fluid in the purse, alongside of the testicle) ; retained 
 testicle (that is, one which has not descended from the ab- 
 dominal cavity, where both testicles are before birth) ; 
 
HEKPES 143 
 
 hematocele (an effusion of blood in the purse) ; and 
 others. 
 
 Never pay heed to quacks who advertise "cure" of rup- 
 ture by means of lotions or plasters. 
 
 Herpes (Pronounced Her-peez). "Shingles" is the old- 
 fashioned popular name of the disease which medical men 
 called Herpes Zoster. It is one form of Herpes, which is 
 a skin disease marked by patches of inflamed skin, upon 
 which a group of little raised, red, tender pimples spring 
 up. These pimples grow for one or two days, and then 
 each one is found to contain a little drop of yellowish 
 liquid; at length they burst, or else the heads get rubbed 
 off, and a little sore discharging surface remains for several 
 days, and may dry up into one or more little scabs. If the 
 scabs are not disturbed the skin heals under them, and 
 when the scabs fall off there is only a little reddened patch, 
 and in a few days more the natural appearance is re- 
 stored, except for a pale-brown stain which lasts a few days 
 longer. Shingles appear generally on the ribs ; it may effect 
 one side only of the chest, or both at once, or one after the 
 other. 
 
 Shingles is generally accompanied by some constitutional 
 disturbance, and begins with a chill and shivering. Pain 
 is felt in the side, and the skin is tender, before any spots 
 appear; this pain is sometimes quite severe, and resembles 
 neuralgia. In children the rash is found to give rise to 
 intense itching, while in old people there is more pain and 
 tenderness than irritation. In some cases the pain ceases 
 when the rash breaks out, and is replaced by a sense of 
 constriction a tight feeling, with smarting. 
 
 The eruption often comes out, not all at once, but in suc- 
 cessive crops, until there may be perhaps a dozen little 
 patches, extending half-way round the chest. These run 
 the course already described. 
 
 It is very important that these pimples and vesicles should 
 not be torn by scratching, because if so injured there may 
 be several ulcers, which are difficult to heal, and will leave 
 ugly scars. In delicate and unhealthy persons the glands 
 in the armpit may become a little tender and enlarged for 
 a few hours. 
 
 This is a somewhat serious disease, especially in aged 
 persons; it seems to be generally set up by the effect of a 
 chill to the skin. The disease runs a course of a fortnight, 
 
144 HIP-JOINT DISEASES 
 
 but may last three or four weeks. In the beginning of the 
 attack it is well to go to bed and stay there for a week. 
 Salines and purgatives should be taken, and when the pain 
 is severe opium or morphine may be needed. Locally, zinc 
 ointment does good, or the rash may be dusted with dry 
 powder of starch with bismuth, or boric acid, and a little 
 dry morphine may be needed. 
 
 Mild cases, especially those which are relapses, may be 
 treated without a doctor, but if the pain and neuralgia 
 which accompany and follow the attack are bad enough 
 to require morphine, a doctor's prescription must be ob- 
 tained, or the chemist will not supply the medicine. 
 
 The special treatment of Herpes when it affects the lip 
 (see "Cold in the Lip") is to bathe it with water, as hot as 
 can be borne, in which some bicarbonate of soda has been 
 dissolved. Bathe it several times a day. When there are 
 scabs, do not pick them off but apply resin ointment at bed- 
 time. 
 
 Hiccough is a spasmodic indrawing of the breath, which 
 needs no special description as it is familiar to everybody. 
 Most cases of it are caused by mere indigestion ; but when 
 it occurs in such serious diseases as chronic Bright 's dis- 
 ease and typhoid fever, and lasts a long time, it is a sign 
 of grave importance. 
 
 Treatment. Generally none is needed. A teaspoonful 
 of compound spirit of ether, if swallowed, will generally stop 
 the hiccough. When continuous and excessive, the doctor 
 ought to be asked to treat it. 
 
 Hip-Joint Diseases. These are nearly always of a tuber- 
 culous nature, that is, are caused by the same germ which 
 causes "consumption of the lungs." The disease is com- 
 monest in children and young people. At the very first the 
 disease of the joint gives no pain in the hip joint itself, 
 but the child will complain of pain in the knee and down 
 the inner side of the thigh. Then the symptoms of the hip 
 mischief begin. 
 
 (1) Slight stiffness at the hip and wasting of the mus- 
 cles and flesh of the thigh on that side. The joint soon 
 gets "tired." 
 
 (2) If the child be put on his back in bed, you see 
 that he bends his hip a little, bends his knee a little, and 
 
HOMEOPATHY 145 
 
 turns the whole leg outwards, separating it from the 
 other. 
 
 (3) When the child walks during this stage, he walks 
 lame, and the diseased leg appears to be longer than the 
 one on the healthy side. 
 
 (4) Later, there are starting-pains in the joint at night, 
 and if you put the child on its back in bed now, or watch 
 it standing up, you will see that the leg of the diseased 
 side is turned inwards, nearer to the other and with that 
 knee over the sound knee. See him walk, and you will 
 notice that now the healthy leg seems to be longer than 
 the other one. 
 
 (5) If untreated by prolonged rest and splints, an 
 abscess will form in the diseased joint and the matter 
 may burst through the skin somewhere or go into the back 
 passage. If it all escapes and the child is pretty ro- 
 bust the joint may now get well, but it will remain stiff 
 and fixed. 
 
 It is useless to say more about treatment here. These 
 cases cannot be dealt with except by a surgeon. 
 
 Homeopathy. This system was the invention of a Ger- 
 man doctor, named Hahnemann. It is based on the theory 
 that ''like cures like"; for instance, vomiting ought to be 
 curable by an emetic! Keal Homeopathy has proved an 
 utter failure, both in practice and in theory, and the mod- 
 ern homeopathist is a faddist, and, if a successful healer, 
 cannot be true to his principles. The fundamental rules 
 of homeopathy are these : (1) Ascertain the effects of medi- 
 cine on persons in health; (2) choose the remedy whose ac- 
 tion corresponds with the symptoms of the patient; (3) give 
 the remedy by itself alone; (4) give a very small dose of 
 it. Hahnemann, himself, pretended that only infinitesimal 
 doses were necessary; that 1-100,000 grain of belladonna, 
 for example, is enough for each dose in the treatment of 
 scarlet fever. But, although the whole theory and practice 
 of homeopathy are unworthy of serious notice to-day, yet 
 the movement has had its uses in discouraging the over- 
 use of drugs, and in encouraging reliance on fresh air, 
 rest, and good nursing. Seeing that most cases of illness 
 tend to get well with suitable dieting, rest, and fresh air, 
 there can be no doubt that the addition of microscopic 
 
146 HYDROCELE 
 
 doses of drugs is, in the way of treatment, preferable to 
 the continual and indiscriminate tabloid-swallowing, which 
 is so common at the present day. 
 
 Housemaid's Knee. Over the kneecap, and below it, we 
 find a little flattened bag of liquid, intended by Nature 
 to act as a "buffer," and protect the joint from injuries 
 or bruises, such as might be produced by kneeling. In a 
 housemaid, who kneels often for long periods, while scrub- 
 bing and polishing, the little bag (called a bursa) at the 
 lower edge of the kneecap is apt to become inflamed and 
 enlarged, and at last to form a sort of tumor below the 
 knee, covered with a tough and reddened skin. 
 
 Treatment. Strong iodine liniment should be painted on 
 all over the bursa daily until it blisters. Then dress the 
 blister with clean rag or lint, smeared with boric ointment, 
 and a bandage. If this plan fails the doctor will "tap" 
 the swelling, let the fluid out, and inject a small syringe- 
 full of iodine tincture and water (equal parts). The io- 
 dine is squeezed out again after a few minutes, but it sets 
 up an inflammation in the little bag, which results in its 
 being obliterated. 
 
 Hydrocele. This is a collection of fluid in the scrotum 
 or purse of the male. It is a sort of dropsy of the bag 
 which holds the testicles. It may be either single or double 
 that is, on one side only or on both. The two sides of 
 the purse are quite distinct from one another, and each 
 testicle lies in a pouch of its own. 
 
 Causes. A hydrocele may be congenital that is, a child 
 may be born with it or acquired. Sometimes it seems 
 to come from a bruise, or to follow inflammation of the 
 testicles (orchitis), whether due to an injury or gonorrhea. 
 But very often the cause is quite unknown. 
 
 Signs. A hydrocele must not be confounded with hernia 
 or varicocele, or enlargement of the testicles, or hematocele 
 (blood tumor), but it is quite impossible to teach the or- 
 dinary reader how to distinguish between these various dis- 
 orders, because he probably has no knowledge of anatomy. 
 A hydrocele may be quite small, or it may swell to the size 
 of a pumpkin. It is not painful, or tender, or red, though 
 it may feel heavy. It is, when large, a pear-shaped swell- 
 ing with the pointed end towards the groin. In congenital 
 hydrocele the bag of liquid can be gradually emptied 
 through the neck of it into the abdomen, and fills up again 
 
HYPOCHONDKIASIS 147 
 
 when the patient stands up. The testicle is not interfered 
 with and can be felt at the back part of the lower end of 
 the swelling. 
 
 Treatment. In hydroceles in children a truss must be 
 worn to encourage the closing of the opening between the 
 purse and the belly. Some surgeons then irritate the skin 
 over it with iodine, and this makes the fluid absorb. Others 
 tap the little tumor and withdraw the liquid. After that 
 the hydrocele generally gets well of itself. But in adults 
 a truss is of no use, and either the hydrocele must be tapped 
 regularly as soon as it is too full to be comfortable, or else 
 an operation must be done which just removes the ''wall" 
 of the bag of fluid and then there can be no more dropsical 
 swelling for there is no place for it to collect in. Hydrocele 
 is not dangerous, nor is the operation for it a dangerous 
 one. 
 
 Hypochondriasis or Neurasthenia. This long scientific 
 and medical word is the name of a complaint which is very 
 common amongst us, though you may never have heard this 
 long word before. It is a condition of the mind in which 
 the sufferer is always fancying that he is in some way out 
 of health, and he makes himself miserable about it. 
 
 Most hypochondriacs are in the possession of very fair 
 health indeed ; in fact, there is seldom very much the mat- 
 ter with them except a disordered fancy. But they are so 
 selfishly wrapped up in their fancied ailments that they 
 hardly enjoy life at all. They really do suffer, from 
 nothing in particular ! But their sufferings are real enough 
 to them, and we should pity them because they have not 
 the strength of purpose to throw off their morbid fancies. 
 There are plenty of hypochondriacs among middle-aged 
 men, especially such as have got on in business, and have 
 not very much hard work to do. There are plenty of young 
 men also in the same category. They look at their tongues 
 in the glass every morning; they dose themselves con- 
 tinually ; they read the long accounts in the advertisements 
 of patent medicines, and they believe every word they read. 
 If a cold bath is advised, they take a cold bath; if a cold 
 bath is said to be injurious, they cease taking a cold bath. 
 They study all their insignificant little sensations, and read 
 up medical books, to try and find out what is wrong with 
 them. They suffer agonies of worry and trouble because 
 of the little knowledge which is to them so dangerous a 
 
148 HYSTERIA 
 
 thing. Some of them fancy they have this complaint, some 
 that ; and every little sensation makes them believe they are 
 in for some serious disease. They buy a clinical thermome- 
 ter, and tabloids, and tonics, and take everything and any- 
 thing except what a doctor advises. They never stick to 
 one doctor ; they go from place to place looking for a doctor 
 or a patent medicine advertisement which will understand 
 their terribly complicated case! There are many women 
 in the same condition, especially those who have no work 
 to do and plenty of time to do nothing in. Some few of- 
 them are curable. They want plenty of beef steak, bitter 
 beer, and wholesome stale bread and cheese; they should 
 avoid pickles and indigestibles, and they should take long 
 walks or get a muscle developer and use it. But their 
 minds really require more treatment than their bodies, and 
 they should work hard at anything which will give them no 
 time to think of Number One! Carlyle's advice to all 
 such people is excellent: "If you are not miserable, be 
 happy" there ought to be no half-way conditions. 
 
 Hysteria. This is a large subject, and it is impossible 
 for us to do more than give an outline of it. By Hys- 
 teria we mean a curable nervous disorder which leads to 
 various disturbances in health, such as numbness, pain, 
 paralysis, flushings, palpitations, and others too numerous 
 to mention. A person who is subject to these more or less 
 avoidable and self-caused symptoms is said to be hysterical 
 and to have hysteria; every attack of such symptoms is 
 called an hysterical attack or fit of hysterics. Clearly un- 
 derstand that hysteria is real disorder of the controlling 
 centers of the brain; it is not shamming, though an hys- 
 terical girl generally shams as well. 
 
 Most hysterical people are girls in their teens, but some 
 women are hysterical all their lives. Boys occasionally have 
 hysterical attacks, and even men are sometimes subject to 
 them. The tendency to hysteria is increased by bad or 
 weak moral training, especially by mothers who " cosset " 
 their children and lead them to expect undue sympathy in 
 every little trouble. The hysterical patient has no "back- 
 bone," no "grit," as we say: she is "namby-pamby" and 
 silly. We have to consider, then, what are the signs of 
 hysteria and what are the characters of an hysterical fit. 
 
 Hysteria. The girl or woman with hysteria is emotional 
 and perhaps very sentimental. She laughs or cries without 
 
HYSTERIA 149 
 
 sufficient reason. She wants to be taken notice of all the 
 time. Without sympathy she is miserable, and the result 
 is that she will (in bad cases) do or say anything which 
 will procure sympathy and fussing. She may even produce 
 illness in herself, swallow stones or needles, or make erup- 
 tions on her skin with acids or poisons in order to deceive 
 her doctor, and excite his and others' interest and sym- 
 pathy. In worse cases, she begins to fancy that she cannot 
 move an arm or a leg, and at last, having made herself be- 
 lieve that she can 't move it, she finds that she is really para- 
 lyzed. Or she may become voiceless, or rigid, or go to 
 sleep for weeks, or go without food for weeks, with or with- 
 out a religious motive. Sometimes the senses of an hys- 
 terical woman get so acute and sensitive that she cannot 
 bear the light of day and complains of the least touch or 
 noise. Her spine is very likely tender, and she has tender 
 spots in various places especially (1) at the top of the 
 head, (2) below the breasts, and (3) on each side of the 
 abdomen. 
 
 Sometimes the symptoms vary from day to day, for the 
 hysterical woman will soon find a new complaint if sym- 
 pathy seems to be on the wane. She cannot bear to be 
 forgotten and she loves to be pitied, though she will often 
 say that she wants no sympathy ! 
 
 The causes of hysteria are many; among them are: 
 bad moral and emotional training of the young, mastur- 
 bation, sexual excesses, impure literature, lack of physical 
 exercise and fresh air, ancemia, disappointment in love, loss 
 of social position, emotional shocks, grief, and so on. 
 
 An hysterical fit is something like this: the girl or 
 woman begins by laughing or crying, or doing both at once, 
 and complains of a feeling as if a ball were rising into 
 the throat and making a choking sensation. Then she falls 
 down * ' in a fit, ' ' and seems to be quite unconscious, but may 
 recover quite suddenly, especially if no notice whatever is 
 taken of her, or if someone says aloud that he is going to 
 drench her with cold water. But the forms of hysterical 
 fits are very numerous, and we cannot say more about 
 them here. 
 
 Treatment. Slight cases of hysteria can be treated at 
 home, hysterical girls who fast, sleep for days or weeks, are 
 paralyzed, erotic, or subject to trances, must be treated in 
 a suitable institution. The home treatment of hysteria is 
 
150 IDIOSYNCRASY, 
 
 not difficult if the parents and friends are sensible and not 
 sentimentally foolish. The girl needs plenty of rest, good 
 food, moderate exercise, laxatives for the bowels, iron tonics 
 for the blood but no fussing or sympathy. Special symp- 
 toms, such as pain, need medical advice. 
 
 As to the fits in slight attacks no treatment is needed. 
 The girl or woman must be encouraged at other times to 
 exert self-control, but when the fit comes leave her in a room 
 quite alone. Or watch her, if you are anxious, but only if 
 you can do it without her knowledge. She is very sharp, 
 and if she finds out you are watching, her fit will get worse 
 and worse. Yet she is not shamming, she is suffering from 
 a mental disorder. The mere mention of a jug of cold 
 water will generally cure her, because dislike of a cold 
 douche or the application of strong smelling salts to her 
 nose forces her to exert self-control. But if the name 
 "cold water" does not cure her, pour it over her, or dash 
 the water in her face without hesitation. The essential 
 thing, between the fits, is to make her understand that you 
 are sorry for her, but that she shall have no sympathy un- 
 less she tries to control herself. 
 
 Idiosyncrasy. This word implies nothing more than 
 "personal peculiarity," and is used by doctors with refer- 
 ence chiefly to the effect of medicines. Some people can- 
 not, for example, take even five grains of iodide of potas- 
 sium without getting watery eyes and all the signs of a cold 
 in the head! Others can take twenty grains of the same 
 drug, three times a day, with benefit. The same pecul- 
 iarities apply, of course, in the case of alcohol, arsenic, 
 shellfish, eggs, porridge; some people like these things and 
 some cannot take them without feeling ill. Many people 
 get singing in the ears and giddiness from even small doses 
 of quinine ; others take quinine to cure noises in their ears ! 
 ' ' One man 's meat may be another man 's poison, ' ' says the 
 old proverb, and it is a very true one. This makes it diffi- 
 cult to find a good definition for poison. Powdered glass if 
 swallowed, will probably cause death, and so might boil- 
 ing water, but one cannot call these things poison. One 
 man can take a quarter of a grain of morphine with noth- 
 ing but a feeling of drowsiness, whereas the same dose 
 would be fatal to many women and most children. 
 
 The moral to be drawn from all this is to avoid buying 
 and swallowing tabloid medicines without a doctor's pre- 
 
INDIGESTION 151 
 
 scrip tion and advice, just because someone (non-medical, 
 like yourself) has said that they are "good for" your com- 
 plaint. In health, certain medicines (like morphine, 
 atrophine and aconite) are actually poisonous; in some 
 forms of disease, and with some idiosyncrasies, they are 
 beneficial, and may even save life ! 
 
 Imperial Drink. For persons with feverishness or any 
 acute feverish disease, and for those with Bright 's disease, 
 who suffer much from thirst. Pour a pint of boiling water 
 on a large teaspoonful of cream of tartar, a little sugar, 
 and a few bits of lemon peel. Strain when quite cold and 
 serve. 
 
 Impotence. Let no one hesitate to consult a doctor. A 
 young man may imagine that other young men are not 
 troubled with these matters, but really they are very com- 
 mon, and the doctor has heard the whole story before, many 
 a time, and is quite well able to tell you how to deal with it. 
 
 Indigestion. So very many persons are always suffering 
 from chronic indigestion, that we feel obliged to refer to 
 this subject at length. Some have dyspepsia, or indiges- 
 tion, because the digestive organs the stomach, bowels, or 
 liver are diseased ; others suffer because they eat either too 
 much, or eat unwholesome food; while a third group of 
 patients suffer indigestion because they drink to excess. 
 Habits of chronic intemperance are sure to ruin the coats 
 of the stomach, and to harden the liver, sooner or later, and 
 very often injure the kidneys as well. In the early days 
 of free drinking a change to total abstinence is often quickly 
 followed by a complete recovery; but when alcoholism has 
 destroyed the liver cells there can be no recovery of good 
 digestion. Apart, however, from alcoholic drink, the con- 
 sumption of too large a quantity of food, and especially 
 the habit of taking meals too close together, may render 
 a state of healthy digestion impossible. The stomach needs 
 rest as much as the mind, or the body in general ; it ought 
 to empty itself into the intestines, and remain empty for 
 one or two hours between each meal. Almost all of us eat 
 too much; that is, we eat more than is needed to supply 
 energy and to keep up the body weight. Persons in poverty 
 who cannot get enough to eat rarely suffer from indigestion. 
 Most people are all the better for an occasional day of fast- 
 ing, say, once every month. The Roman Catholic Church 
 was wise in making all Catholics fast on one day every 
 
152 WATERBRASH 
 
 week, and also live sparingly for forty days every year in 
 Lent, which, happens in the springtime. When indigestion 
 is the result of organic disease of the stomach or liver, or 
 when it is an accompaniment of consumption, there will be 
 great difficulty in curing it. Medicines may have to be 
 taken for months together, and seem to have very little 
 effect in giving relief. The usual symptoms are deficient 
 appetite, unpleasant taste in the mouth, oppression felt in 
 the chest after food, and this may last for hours (see also 
 "Acidity") ; pains in the chest, flatulence, and belching 
 upward of wind or gases. Some persons also have water- 
 brash and heartburn, also occasional nausea and vomiting; 
 the action of the bowels may be either relaxed or too con- 
 stipated, and there may be piles. The treatment of indi- 
 gestion must vary with the peculiarities of the patient and 
 with its cause. (See also "Salisbury Treatment.") 
 
 Very few people will take the trouble carefully to study 
 even a popular work on Indigestion, and so they go on 
 suffering for years, and only learning by bitter experience 
 how to avoid the chief troubles of dyspepsia by avoiding 
 the foods (sometimes) that they most enjoy! We have de- 
 cided that our best plan is not to describe the types of 
 indigestion but to resort to the method of giving a list of 
 the principal symptoms and hints as to how to deal with 
 them. Of one thing be certain the cure must be by means 
 of proper diet, not by drugs. 
 
 Heartburn (see article on "Acidity"). 
 
 Flatulence (Wind in the Stomach, Belching, Fullness 
 after Food). It is a mistake to belch, or to try and "raise" 
 the wind; more air is swallowed and the distress only in- 
 creases. A little dried Poplar Charcoal (say 5 grains, with 
 5 grains of bismuth subnitrate) swallowed in a cachet just 
 before each meal is very useful. A few drops of essence 
 of ginger, of peppermint, of cloves, or of cajuput at meal- 
 times are often serviceable. Pepsin and papain in large 
 doses are also good for flatulence. Soups, eggs, starches, 
 fruits, vegetables, should be eaten sparingly. A dry meat 
 diet is often best. 
 
 Waterbrash. This is a gush of acid fluid (chiefly saliva) 
 which comes into the mouth after an attack of pain in the 
 stomach. 
 
 Try the following mixture: Sodium bicarbonate, 15 
 grains; magnesium carbonate, 10 grains; compound carda- 
 
INFANT FEEDING 
 
 153 
 
 moms tincture, 1 drachm; aromatic spirit of ammonia, ^ 
 drachm; caraway water to one ounce. The draught to be 
 taken occasionally. 
 
 Flushing after meals. Take a one-grain pill of creosote 
 made with soap, after food, thrice daily. Or, a half minim 
 creosote pill. 
 
 Vomiting. The cachets of bismuth and charcoal above 
 mentioned are useful. 
 
 Foul breath. Sodium bicarbonate, 10 grains; carbonate 
 of bismuth, 5 grains; tincture of chiretta, 10 minims; in- 
 fusion of quassia, % ounce. Take this draught half an 
 hour before each meal, and look well to the state of mouth 
 and teeth. 
 
 Infant Feeding. No other one factor in the health of an 
 infant compares for a moment in importance with the man- 
 ner in which it is fed. Breast feeding may be more diffi- 
 cult to carry out than bottle feeding ; but according to Holt 
 the mortality of bottle-fed infants during the first year is 
 fully three times as great as that of those who are breast 
 fed. 
 
 Dr. Winter says that while very few breast-fed infants 
 die, the mortality of bottle-fed infants in tenements and 
 institutions may be as great as 59 to 93 per cent. 
 
 These figures apply to those cases where our modern 
 knowledge of artificial infant feeding is not applied. With 
 care these percentages can be much reduced ; but no matter 
 how perfect our methods of artificial feeding are they can 
 never equal, in their results, the effects of breast feeding. 
 
 Breast Feeding. During the first day the infant need 
 have nothing but water. 
 
 Little milk is secreted by the mother until the third day. 
 The number of daily nursings and the intervals are shown 
 by the following table (from Holt). 
 
 Period 
 
 Nursings in 
 24 hours 
 
 Interval by day 
 hours 
 
 Night nursing 
 
 (10 P.M. to 6 A.M.) 
 
 1st & 2nd day 
 
 4 
 
 6 
 
 1 
 
 3 days to 6 weeks . . . 
 6 weeks to 3 months . 
 3 to 5 months 
 5 to 12 months .... 
 
 10 
 
 8 
 7 
 6 
 
 2 
 
 2y 2 
 
 3 
 3 
 
 2 
 2 
 1 
 
 
154 
 
 ARTIFICIAL FEEDING 
 
 The mother should have a simple but generous diet with 
 plenty of fluids. Eggs, cereals, soups, vegetables, meat 
 once a day, gruel, milk, or cocoa at bedtime. 
 
 She should avoid worry, anxiety, fatigue, social dissipa- 
 tion, grief, excitement, fright and passion. 
 
 There is no objection, after the first few months, to sub- 
 stituting bottle feeding for some of the breast feedings. 
 Weaning should be begun gradually at nine or ten months 
 and completed at one year. 
 
 Artificial Feeding. Milk for artificial feeding should 
 come from healthy cows and be clean and fresh. 
 
 It is preferable if it is "certified," pasteurized, or both. 
 
 In making up the following formulas (according to Holt) 
 7 per cent, milk is used. This is obtained by removing 
 the upper half from a quart bottle of milk which has stood 
 at least four hours. It can also be obtained by mixing 
 three parts of milk and one part of ordinary (16 per cent.) 
 cream. 
 
 Nine formulas are employed for different periods of the 
 child's development. 
 
 They are made as follows : 
 
 
 1 
 
 II 
 
 III 
 
 IV 
 
 V 
 
 VI 
 
 VII 
 
 VIII 
 
 IX 
 
 
 oz. 
 
 oz. 
 
 oz. 
 
 oz. 
 
 oz. 
 
 oz. 
 
 oz. 
 
 oz. 
 
 oz. 
 
 7-per cent, milk 
 
 2 
 
 3 
 
 4 
 
 5 
 
 6 
 
 7 
 
 8 
 
 9 
 
 10 
 
 Milk sugar .... 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 Lime water .... 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 1 
 
 Boiled water . . 
 
 17 
 
 16 
 
 15 
 
 14 
 
 13 
 
 12 
 
 11 
 
 10 
 
 9 
 
 Totals 
 
 20 
 
 20 
 
 20 
 
 20 
 
 20 
 
 20 
 
 20 
 
 20 
 
 20 
 
 Formula I is begun on the second day; II on the fourth 
 day; III at ten to fourteen days; but after that the in- 
 crease is made more slowly. A healthy infant with good 
 digestion will be able to take formula V by the time it is 
 three or four weeks old. 
 
 Formulas from 7 per cent, milk can be continued until 
 the child is six or seven months old. Then a change should 
 gradually be made using whole milk. Instead of remov- 
 ing the upper 16 ounces, one may for two weeks remove the 
 upper 18 ounces. 
 
 For the next two weeks remove the upper 20 ounces and 
 for the next two weeks remove the upper 24 ounces. 
 
FEEDING 
 
 155 
 
 After this the bottle may be shaken up and the whole 
 milk used (Holt). 
 
 For artificial feeding of infants during the first year the 
 following table will be of service. 
 
 Age 
 
 Interval 
 
 between 
 meals by 
 
 Night 
 feedings 
 10 p. m. 
 
 No. of 
 feed- 
 ings 
 in 24 
 
 Quantity 
 for 
 one feeding 
 
 Quantity 
 for 
 24 hours 
 
 
 day 
 
 to 7 a. m. 
 
 hours 
 
 
 
 
 Hours 
 
 
 
 Ounces 
 
 Ounces 
 
 2nd to 7th day ... 
 
 2 
 
 2 
 
 10 
 
 l-ll/ 2 
 
 10-15 
 
 2nd & 3rd weeks . . 
 
 2 
 
 2 
 
 10 
 
 li/ 8 -3 
 
 15-30 
 
 4th & 5th weeks . . 
 
 2 
 
 1 
 
 10 
 
 2y 2 -3i/2 
 
 25-35 
 
 6th to 9th weeks . . 
 
 2y a 
 
 1 
 
 8 
 
 3-5 
 
 24-40 
 
 9th week to 5th mo. . 
 
 3 
 
 1 
 
 1 
 
 4-6 
 
 28-42 
 
 5th to 9th month . 
 
 3 
 
 
 
 6 
 
 5-7y 2 
 
 30-45 
 
 9th to 12th month . 
 
 4 
 
 
 
 5 
 
 7-9 
 
 35-45 
 
 The entire amount for the 24 hours should be made up at 
 one time, placed in bottles containing the exact amount for 
 a single feeding and pasteurized. 
 
 At the end of six months a little farinaceous food may 
 be added to the diet also a little beef juice, the white of 
 an egg and orange juice. 
 
 For vomiting the amount of milk must be reduced, or 
 the fat content of milk should be reduced and the lime 
 water increased. 
 
 For colic or constipation strengthen the formula, sub- 
 stitute milk of magnesia for lime water or replace milk 
 sugar by maltose. 
 
 For diarrhea diminish the fat content of the milk, boil 
 it and dilute it if undigested milk appears in the stools. 
 
 The best forms of pasteurizers are the Freeman and the 
 Walker-Gordon. 
 
 As soon as the bottles are emptied they should be rinsed 
 with cold water and allowed to stand filled with water to 
 which a little bicarbonate of soda has been added. Before 
 the milk is put into them they should be thoroughly washed 
 with a bottle brush and hot soap-suds and then placed for 
 twenty minutes in boiling water. 
 
 Feeding during the Second Year : 
 
 Five feedings a day should be given with milk at 10 
 p. M. if the child is awake, from the bottle. 
 
 The following are given until the fourteenth month 
 
156 INFANTILE PARALYSIS 
 
 milk with gruel, orange juice, beef juice, white of egg and 
 mutton or chicken broth. 
 
 From the fourteenth to the eighteenth month the follow- 
 ing are given: milk (warmed), fruit juice, oatmeal or 
 hominy with cream, dry toast, beef juice, egg, rice, broth 
 and scraped beef. 
 
 After this, until the end of the second year, may be 
 added beefsteak, mutton chop or roast beef, prune pulp or 
 baked apple. 
 
 Feeding during the Third Year : 
 
 The night feeding at 10 p. M. should be omitted. The 
 midday meal should be increased. Three regular meals 
 should be given and milk once besides. 
 
 To the second-year diet may be added baked white po- 
 tato, boiled rice or spaghetti, asparagus tips, string beans, 
 peas and spinach all cooked until soft and mashed. 
 
 Condensed milk and proprietary foods. If these foods 
 are used to correct symptoms of indigestion they should 
 be used for a few weeks only. 
 
 Most of them are low in fat and proteids and high in 
 sugar. 
 
 Children fed upon them for too long a time are liable to 
 develop rickets and sometimes scurvy. 
 
 Infantile Paralysis (Acute Anterior Poliomyelitis). 
 This is an acute disease characterized by the rapid onset 
 of paralysis with fever. While it is usually confined to 
 infants and children, adults may also contract it. It is 
 most prevalent in summer and has recently been occurring 
 in epidemic form. The paralysis is most common in one 
 or both legs, but the arms may be affected. After a mild 
 attack the paralysis may disappear entirely. In all cases 
 some of the paralysis disappears, but as a rule the paralysis 
 which remains is sufficient to cause considerable deformity 
 and disability. In addition to the paralysis and fever, 
 there may be pain and tenderness, headache, restlessness 
 and muscular twitching. Few cases die. 
 
 Infantile paralysis is a disease due to a germ so small 
 that it has never been seen, which attacks the spinal cord 
 and produces local injury there. 
 
 Early treatment consists of rest in bed, counter-irritation 
 over the spine and local antisepsis of the mucous membranes 
 of the mouth and nose. Later the services of an expert 
 physician are most necessary to prevent deformity by means 
 
INFLUENZA 157 
 
 of electricity, massage and the use of mechanical appli- 
 ances. 
 
 Since 1907 when the first large epidemic occurred in this 
 country in and near New York City the disease has been 
 spreading rapidly until during the past year there have 
 been epidemics in 31 states. 
 
 Prevention. As the disease is communicable and to some 
 extent contagious, all cases should be isolated for at least 
 a month as the disease germ has been found in the secre- 
 tions from several weeks to several months. 
 
 While the exact modes of transmission are not yet known 
 there is a suspicion that it may be caused by flies, fleas or 
 street dust. It may be carried by a person who has been 
 exposed even if not a sufferer. As the most common point 
 of entry of the germ into the body is the mucous membrane 
 of the nose, not only should all nasal and oral discharges of 
 the sufferers be disinfected and destroyed, but those ex- 
 posed (and we are all constantly exposed) should cleanse 
 their nasal cavities and mouths several times daily with 
 some mild antiseptic solution such as Liquor Antisepticus 
 Alkalinus. 
 
 While monkeys have been immunized, it has not yet be- 
 come practicable to immunize human beings. One attack 
 protects from subsequent ones. 
 
 Inflammation. (See "Abscess.") 
 
 Influenza is an epidemic fever, accompanied always by 
 catarrh of some part of the body or other. It begins about 
 a week after infection, and it begins suddenly, with a rapid 
 rise of temperature, which it needs no clinical thermom- 
 eter to prove. The feverishness lasts nearly a week in 
 ordinary cases, and ends suddenly in an attack of perspira- 
 tion. There are at least four quite different types of in- 
 fluenza, and the same poison, whatever it may be, seems 
 to cause them all. Everybody who catches influenza has 
 three symptoms feverishness; "cold" in the head, nose, 
 eyes, throat or chest; and extreme prostration. But some 
 people have other things added to these : for example, bron- 
 chitis and pneumonia; or palpitations, flushing, fainting, 
 sweating and gasping; or diarrhea, vomiting, jaundice; or 
 skin eruptions; or mental troubles. Everything depends 
 upon which part of the body is attacked. There is very 
 seldom a rash, but there may be a rose-rash which soon 
 fades. Nearly every case of influenza which is going to 
 
158 INSANITY 
 
 be serious is accompanied by dreadful pains in the head, 
 back and limbs. 
 
 Influenza is infectious and epidemic, and it is due to 
 a germ, which is coughed into the air and is inhaled by 
 sufferers. You may have numerous attacks; one attack 
 does not protect you from a second. Old and young, poor 
 and rich, all stand a good chance of being attacked during 
 an epidemic. 
 
 The first thing to do when you are seized with influenza 
 is to send for the doctor. He will know how to nip the 
 mischief in the bud, if it ever can be thus nipped, and the 
 earlier treatment is begun the better chance you will have 
 of escaping lightly. Only about one person in a hundred 
 cases dies of influenza, but many, very many, are left pros- 
 trate for weeks, if not months, afterwards, and many are 
 never the same again after an attack. So do not waste 
 precious hours in self-doctoring, or you may regret it all 
 your life. In middle-aged and elderly folks the attack is 
 only too likely to be complicated by pneumonia (inflamma- 
 tion of the lungs). In younger people, an attack of in- 
 fluenza is often trivial and recovery occurs in a few days. 
 But it will not do to presume too much on one's former 
 health and strength ; and relapses are quite common. 
 
 You must keep the patient in bed during the attack ; and 
 until the doctor comes you may give a teaspoonful of am- 
 moniated tincture of quinine every two hours, and some 
 strong beef tea and good cognac brandy in it. Do not let 
 him take antipyrin or any such strong medicine without 
 medical advice, lest you damage his heart, which will re- 
 quire all the power it possesses if complications should arise. 
 Afterwards, a tonic will be required. If possible a change 
 of air and a thorough rest should be undertaken. 
 
 Insanity. Not very many years ago a madman or mad- 
 woman got very little sympathy, and was locked up in an 
 insanitary madhouse, looked after by ignorant and often 
 brutal attendants, and hastened to death, or worse forms of 
 madness, by neglect, cruelty, starvation, or accident. If 
 the mad person were raving, noisy, and destructive, he was 
 tied down, confined in a dark room, or half -smothered with 
 clothes. If he believed himself persecuted by poisoners, 
 he would refuse all food, and then would probably be left 
 to starve. If he were depressed and melancholic, he would 
 be left alone, and shunned and neglected. If he were in- 
 
INSANITY 159 
 
 clined to commit suicide very little trouble was taken to 
 prevent his doing so, and sooner or later he generally suc- 
 ceeded. If he were homicidal, he would be chained up, 
 and, if he were a person of no importance, would probably 
 be utterly neglected, and die of some disease caused by 
 unhealthy surroundings. A great many cunning lunatics 
 were able to conceal their disorder, and keep out of asylum, 
 because of the ignorance of doctors, as well as of the public, 
 on the subject of mental disease. 
 
 In this way anyone who became so insane as to require to 
 be locked up, became at once a disgrace to the family a 
 skeleton in the cupboard whose existence was concealed at 
 any cost, and a stigma on all the relations. If a man had 
 cancer, or was a drunkard, he was pitied or despised; but 
 if his mind gave way, he was shunned, and ran the risk of 
 dying of neglect. He was thought by the ignorant pious 
 to be possessed of a devil, or to be a wizard or a witch. A 
 madman rarely recovered, for his unmerited sufferings in- 
 creased his madness, and to the tortures of mental pain 
 were added the unkindness (often ignorant rather than in- 
 tentional) of those sane and well. 
 
 At the present day the lot of the insane is very greatly 
 improved, and mental disease is a department of the study 
 of medicine in which very great progress is being made. 
 It is probably true that at no period of the world's history 
 have the needs of the mad been so well understood and 
 catered for as at the present day. Of late years the study 
 of madness has been recognized as the province of the 
 physician, and not of the lawyer, or clergyman, or mad- 
 house keeper. There are a great many things connected 
 with lunacy which are still in the hands of lawyers, and 
 plenty of instances where the attitude of the Law towards 
 criminals who are mad, rather than bad, or who are both 
 mad and bad, is manifestly unjust and wrong. Still, things 
 are improving, and it is the medical expert who generally 
 decides as to the alleged insanity of a criminal, though it 
 is the judge still who apportions the responsibility. 
 
 Just as in all other branches of the art of medicine, so in 
 the science of mental disease people who are quite igno- 
 rant of the subject are apt to express opinions about pa- 
 tients who are said to be mad. And the reason of this is 
 that madmen do not necessarily act on all occasions in a 
 different manner to the sane. You might easily pass 
 
160 INSANITY 
 
 through an asylum without chancing to see anyone at all 
 whom you would consider insane, and yet every one of the 
 patients there is mad. And there are a great many vari- 
 eties of the disorder, each with special signs, which you can 
 only recognize when you have been taught to do so. This 
 will explain how it is that madness requires special study, 
 and why it is that madmen must be kept for care and kind 
 treatment in a suitably-appointed asylum, and submitted 
 to the wholesome routine that is there carried out. Those 
 who have had absolutely no experience of either asylums 
 or the insane are very apt to think that it is terrible to 
 "lock up" an insane person in an asylum; but no kinder 
 thing can be done to a madman than that. And for these 
 reasons : 
 
 Nowadays asylums are all visited by officials of the 
 Government of the very highest standing, and it is their 
 duty to report on what they see in asylums for all the 
 world to know. At the head of every asylum is a physician 
 of special knowledge in the treatment of insanity. Under 
 him are other physicians, who assist him and train the 
 attendants, so that the patients shall not be in the care of 
 ignorant, and possibly unkind, men and women. 
 
 The utmost care is taken of the mad people, and the 
 physicians report on their condition regularly to the Govern- 
 ment. As soon as a madman recovers, and he is well 
 enough to be at large, he is discharged a free man. The 
 rooms and corridors are warmed, the food is excellent, and 
 the management of the patients is in skilled hands. So 
 you see that everything is done to alleviate the sadness of 
 madness. Entertainments are provided, and in some places 
 recovery is accelerated by giving all the patients suitable 
 work to do ; for work is the grandest thing to keep you in 
 good mental health. The lot of the insane person at the 
 present day is made as comfortable as possible; formerly, 
 as I have shown, the mad were ill-treated, as if they were 
 evil or criminal, and the treatment soon made them both. 
 
 But while we may congratulate ourselves on our growing 
 knowledge, wisdom and kindness towards the unfortunate, 
 we are possibly too lenient and forbearing not towards 
 poor suffering mad people, but towards the sane as well. 
 For a lunatic is not as other people are, even if he recovers ; 
 he is always liable to relapses, and yet when free of the 
 asylum he may marry and have children, and there is 
 
INSANITY 161 
 
 always a risk that he will transmit to them some taint or 
 other madness, alcoholism, or some other dread disease. 
 
 The Varieties of Madness. Insanity, or the state of mad- 
 ness, is the condition of unsoundness of mind which is the 
 opposite to sanity, which means that state of mind which 
 makes men and women able to carry out their duties to 
 their fellows, and to behave properly in their own interest. 
 There are cases of insanity of very different forms, and 
 they may be classed and considered in many ways. Infants 
 may be born mad, and are then called idiots; or insanity 
 may come on at every period of life, even in extreme old 
 age. Indeed, old age has a special form of madness, called 
 Dementia, or a return to a childish state of mind. Insanity 
 may be inherited or acquired. Madness certainly runs in 
 some families, and sometimes comes on about the same age 
 and in similar form in one generation after another. It 
 can be acquired by head injuries, by drunkenness, by de- 
 bauchery, by shocks to the mind, from extreme grief, and 
 from horror. Long-continued, severe pain and starvation 
 will also send people mad. A long series of epileptic -fits 
 may end in insanity. The usual forms of insanity which 
 occur in middle-life to persons who have been in good health 
 are three Mania, Melancholia, and Monomania. Mania 
 means madness in which violence predominates, or, at any 
 rate, the form in which patients have attacks of violence. 
 It is called raving madness. It is marked by loss of com- 
 mon sense and memory, with delirium, restlessness, and 
 sleeplessness, self -neglect, senseless anger, distrust of others, 
 shouting and howling for hours together. The maniac is 
 mischievous and destructive, and may attack others or kill 
 himself. Melancholia comes on gradually, with depression 
 of spirits, fear, and a sullen, morose state of mind. Such 
 patients seem unwilling to say or do anything, and sit for 
 hours vacant-minded or in mental agony. They sometimes 
 refuse food, and try to starve themselves, and may attempt 
 suicide in many ways. Melancholic persons may also de- 
 velop murderous tendencies, and sometimes try to set fire 
 to furniture and buildings. The worst cases of melan- 
 cholia are those which begin from extreme religious devo- 
 tion. Monomania is the name given to those forms of 
 madness in which the patient has some settled delusion or 
 mental crank, and may yet be able to speak and act sensibly 
 in ordinary matters. For example, monomaniacs may think 
 
162 PREVENTION OF INSANITY 
 
 themselves kings, or made of glass, or that they have some 
 divine work set them to do. 
 
 That form of insanity in which the sufferer has constant 
 fixed delusions is called paranoia. This is one of the com- 
 monest forms of insanity in this country. 
 
 Treatment. To conceal a person's insanity is to commit 
 an action which is both unkind to the patient and a crime 
 on the whole public. The earliest possible removal to an 
 asylum is of the utmost importance, and every day's delay 
 may diminish to some extent the chance of his restoration 
 to health. There is not much to be ashamed of in having 
 a mad person in the family as a drunkard, for instance ; 
 but, in any case, asylum treatment is his only chance of 
 recovery. 
 
 Prevention of Insanity. The importance of preventing 
 insanity is appreciated when it is realized how rapidly in- 
 sanity is increasing (104 per cent, during the last decade 
 in New York State, where one-sixth of the total expenditure 
 of the State is for the insane.) 
 
 Insanity is due, in a majority of cases, to causes which 
 are known and preventable. The 32,000 persons now in 
 hospitals for the insane in New York State might have 
 remained sane and lived useful and happy lives if they 
 had known certain facts and acted accordingly. 
 
 Of the preventable causes the following are the most 
 important : 
 
 Immoral living, alcohol and other poisons, certain physi- 
 cal diseases, bad mental habits and heredity. 
 
 Immoral living is extremely liable to result in the con- 
 traction of syphilis, which may produce, among other dis- 
 eases, softening of the brain the cause of 25 per cent, of 
 all insanity. Every man and boy should know that by 
 yielding to the temptation to go with immoral women he is 
 exposing himself to the probability of getting this disease, 
 which may result, years after, in incurable insanity. 
 
 Alcohol. Forty per cent, of all insane cases are due 
 directly or indirectly to alcohol even in ' ' moderate ' ' quanti- 
 ties not producing intoxication. 
 
 Other poisons capable of producing insanity are opium, 
 morphine and cocaine. 
 
 Physical diseases which may be followed by insanity are 
 typhoid fever, influenza, diphtheria, tuberculosis, and dis- 
 eases of the arteries, heart and kidneys. A person suffer- 
 
PREVENTION OF INSANITY 163 
 
 ing from these diseases should have good nursing, skilled 
 medical treatment, pleasant surroundings and freedom 
 from anxiety. Physical diseases may be prevented or con- 
 trolled by protection of food and water, temperance, health- 
 ful homes and factories. 
 
 Hard work alone rarely causes a nervous breakdown. 
 It only becomes a menace to health when associated with 
 worry, loss of sleep, etc. 
 
 Bad Mental Habits. The healthy state of mind is one 
 of satisfaction with life. This does not depend so much 
 upon our surroundings or how much money we have, as 
 upon the way in which we train ourselves to deal with 
 difficulties and troubles. " Stone walls do not a prison 
 make, nor iron bars a cage." 
 
 Anyone who departs too far from this state of satisfac- 
 tion must be regarded as tending towards an unhealthy 
 condition. 
 
 The average person little realizes the danger of brooding 
 over slights, injuries, disappointments, or misfortunes, or 
 of lack of frankness, or of an unnatural attitude towards 
 his fellowmen, shown by unusual sensitiveness or marked 
 suspicion. Yet all these unwholesome and painful trains 
 of thought may, if persisted in and unrelieved by healthy 
 interests and activities, tend toward insanity. Wholesome 
 work relieved by periods of rest and simple pleasures, and 
 an interest in the affairs of others, are important pre- 
 ventives of unwholesome ways of thinking. 
 
 We should train ourselves not to brood, but to honestly 
 face personal difficulties. We may not like even to admit 
 the existence of these difficulties, but they are often the 
 real cause of the brooding. To start doing something, to 
 change the situations about which we fret, is the healthiest 
 way to avoid aimless fretting. We should not hanker after 
 the impossible, but learn to get satisfaction from what is 
 at hand. We should not give ourselves up to day dreaming, 
 but try to do something, no matter how small it is. 
 
 Heredity. We cannot choose our parents, but we can 
 do much to insure the health of our offspring. On the 
 other hand we can accomplish much by not worrying un- 
 duly about insanity in our ancestors. Insanity is not di- 
 rectly inherited. One may inherit a greater or less tend- 
 ency toward insanity. Mental instability may be inherited 
 just as weak constitutions may be inherited. 
 
164 INSOMNIA 
 
 Those who have reason to believe that there was mental 
 disease in their ancestry should not be unduly alarmed. 
 The fact that some of their ancestors suffered from mental 
 trouble does not make it certain that they will suffer like- 
 wise. These tendencies towards insanity may lie dormant 
 during the whole lives of the individuals. But such per- 
 sons should take the proper precaution to prevent the 
 development of this tendency. As a weak constitution may 
 be built up by healthful habits, so may mental instability 
 be made stable by good mental and physical habits. The 
 individual whose family has bad mental trouble may often 
 escape the disease by proper surroundings, healthful and 
 temperate activities, and proper mental and physical habits. 
 The most important fact in heredity is that the vast ma- 
 jority of ancestors of every individual were normal. 
 
 Heredity tends, therefor, rather more strongly toward 
 health than toward disease. 
 
 The fact that heredity plays a part in the causation of 
 insanity, should create a public conscience regarding mar- 
 riage. Marriages should not be contracted by two persons 
 who have insanity or feeble-mindedness in their immediate 
 families, without first seeking the advice of a competent 
 physician. 
 
 Insomnia. (SLEEPLESSNESS.) No one can remain many 
 days without sleep, but many persons do not sleep so long 
 as they would like to, and many persons do not sleep as 
 much as their health needs. The doctors describe a special 
 form of disease named insomnia, which means wakefulness 
 occurring when sleep ought to be present. It may be due 
 to disease of the mind, or of the brain, or of the body, and 
 may itself give rise to other diseases. Absence of sleep 
 is very rarely complete even for twenty-four hours, but 
 want of quiet, restful, continuous sleep is a state from 
 which most people suffer at some time or other. It is very 
 well known that there are drugs which will produce sleep, 
 or, at any rate, will bring on insensibility, or a form of 
 sleep, and these drugs are called sedatives or narcotics. 
 It is, however, very bad policy to give any doses of such 
 medicines until you have tried the removal of all possible 
 causes for the wakeful state, because in most patients there 
 is some definite cause for it, and when the cause is taken 
 away the patient sleeps well. Sedative doses strong enough 
 to compel sleep should be avoided also because they dis- 
 
INSOMNIA 165 
 
 order the stomach, disturb the digestion, make the tongue 
 dry and coated, and cause an unnatural thirst ; the appetite 
 is also lost. Sleeplessness may show the presence of fever; 
 it may be due to pain, to shortness of 'breath, to palpitation 
 of the heart, or to delirium, especially the delirium of 
 drunkards. Simple sleeplessness does sometimes occur in 
 the absence of any of these serious causes; it may be due 
 to a state of worry or irritability of the mind, pointing to 
 a congestion of the brain. Some forms of indigestion will 
 cause it, and in this matter people vary very much, for some 
 cannot sleep after a heavy supper, while others lie awake 
 if they have an empty stomach. Persons who lead lives of 
 bodily work carried on in the open air generally sleep very 
 soundly, while persons who work in the close, unhealthy 
 rooms in factories often have restless nights. Over-fatigue 
 may cause restlessness, and so anxiety of mind can destroy 
 all chances of sleeping. Literary workers, and also persons 
 who lead useless, frivolous lives, often sleep very lightly, 
 and go to doctors for sedatives. 
 
 But all attempts at classifying the causes of sleeplessness 
 are very unsatisfactory, and the subject might be dealt 
 with adequately only in a couple of thick volumes. We 
 have mentioned above eight of the commonest causes of 
 sleeping badly. Others are cold feet, tea-drinking at bed- 
 time, lack of food, heart disease. The first thing to do, 
 then, if you sleep badly, is to find out why. Have your 
 room dark and quiet, and see that your feet are warmed. 
 (See also "Sleep, Hints on Obtaining," in this volume.) 
 
 When we come to consider drugs we tread on dangerous 
 ground. The people who suffer most from sleeplessness 
 are not those who do some work in life, and fill their hours 
 in some profitable way, but they are those who idle and 
 lounge, or live frivolously, and those who drink and eat 
 too much. These people are already self-indulgent, and to 
 tell them to drink a little alcohol, or to take a little narcotic 
 at bedtime, is only to give them an excuse for another bad 
 habit. Chloral, morphine, alcohol, and the rest, spoil a 
 good many lives from over-indulgence. The most harmless 
 sedatives are the bromides, which may be taken, if neces- 
 sary, for years. Thirty grains of bromide of ammonium 
 should be taken an hour before bedtime in mild cases of 
 sleeplessness, and until this plan has been given a good 
 trial, no other sedatives should be used. A very safe drug 
 
166 ITCHING 
 
 is bromural in a dose of 10 grains, taken in a little hot 
 water and sugar at bedtime. 
 
 Itch is a skin disease caused by the presence of a species 
 of mite which lives, male and female, on the skin, and 
 burrows into it. The female itch-insect leaves her eggs in 
 the burrows and they set up an intolerable itching and 
 irritation. The commonest places for these burrows are 
 the webs between the fingers and toes, the front of the 
 wrists, and women's breasts; and never are they seen on 
 the face, except sometimes on children in arms. There is 
 generally a little tiny pimple which marks the mouth of 
 each burrow, and a little track can generally be traced by 
 the thin line of dirt which fills it. So that almost anyone 
 can discover the signs of the presence of the insect. If you 
 rub weak sulphur ointment into the burrows so thoroughly 
 as to get into every cranny and nook, for a few days, the 
 insects will die, and the disease will be cured. But in 
 cases where the itch occurs on parts of the body which are 
 covered up, disinfection of the clothes must be undertaken, 
 and the patient must take baths, and use soaps and lotions 
 which must be ordered by the doctor according to the merits 
 of the particular case. So far, so good. But many people 
 who contract the itch scratch the skin wildly, and as the 
 finger-nails are not always clean, the scratched skin soon 
 has a number of sore places on it, all more or less "poi- 
 soned" by the patient himself, who very likely spreads the 
 disease all over his body by mere scratching. With regard 
 to the cure we must say that mere smearing of the ointment 
 on the place is of no use ; on the other hand, you need not 
 be so vigorous as to inflame the skin with it. If there is 
 only itch, you may cure it with stavesacre ointment, or weak 
 sulphur ointment, after a hot bath, in which use soft soap. 
 For the itching a lather of menthol soap is the best thing. 
 But where the skin has been rudely scratched, and is a mass 
 of tender places and sores and scabs, it is a case for the 
 personal attention of a doctor. 
 
 Itching of the Skin of Various Parts. There are two dis- 
 tinct ailments in which the sufferer complains of itching of 
 the skin. One is prurigo, a non-contagious skin-eruption 
 of small pimples, causing intense suffering, and very diffi- 
 cult to relieve. It has nothing to do with the disease called 
 the itch, and is really a disease of old age and caused in 
 some mysterious way by the slow * ' decay ' ' of the skin itself. 
 
ITCHING 167 
 
 This ailment we shall say no more about. The other ail- 
 ment, which must not be mixed up with prurigo, is called 
 pruritus, and means "an itching." 
 
 Pruritus is not a disease, nor is it a skin-eruption, but 
 only a sign or irritation of the skin caused by something 
 which it is the doctor's duty to find out before he can set 
 to work to relieve it. The causes of the itchiness of the 
 skin which we call pruritus are : 
 
 (a) Local causes 
 
 (1) Dirty habits; lack of washing. 
 
 (2) Lousiness (see "Lice"). 
 
 (3) Ringworm. 
 
 (4) Eczema. 
 
 (5) Irritating woolen underclothing. 
 
 (6) "Prickly heat" (a sweat eruption which some 
 people get in very hot weather) . 
 
 (b) General causes 
 
 (1) Diabetes (which see). 
 
 (2) Jaundice. 
 
 (3) Piles, which cause much itching at the anus. 
 
 (4) Diseases of the womb often cause itching due to 
 the irritating discharges. 
 
 (5) Pregnancy. Many women have terrible itching 
 towards the end of child-bearing. 
 
 (6) The change of life in women (see "Change of 
 Life"). 
 
 (7) Worms in the intestines. 
 
 Now, whatever be the cause of the itchiness, it gets worse 
 when the patient gets warm in bed. 
 
 Treatment. First, insist on thorough cleanliness and 
 bathing. Eczema, if present, wants special treatment (see 
 "Eczema"). Diabetic itching is relieved by sponging the 
 parts daily with Goulard lotion. Or the following may be 
 painted on with a brush menthol, 1 part ; olive oil, 5 parts. 
 
 Baths are especially comforting to itchy skins. The co- 
 nium and starch bath Extract of conium, 120 grains; 
 starch powder, lib.; hot water, 30 gallons. (After this 
 bath, sprinkle the skin with starch powder.) 
 
 The Sulphuret bath Sulphuret of potash, 4 ounces ; hot 
 water, 30 gallons. 
 
168 KIDNEY DISEASES 
 
 Caution. Not to be taken if there be sore places from 
 scratching. 
 
 Kidney Diseases. The kidneys are two organs lying in 
 the lower part of the back (the loins), and their duty is 
 to get rid of the waste matters in the blood. The water 
 which the kidneys secrete passes down two little tubes into 
 the bladder and remains in the bladder until that vessel 
 is uncomfortably full when it is passed away through the 
 urethra or pipe. 
 
 A healthy person passes about fifty ounces (two and a 
 half pints) of urine every day. In cold weather, more ; in 
 hot weather, less, because the skin gets rid of a lot of water 
 by perspiration. Healthy urine is pale amber-colored and 
 has no deposit. But let none of our readers pay too much 
 attention to the urine. It varies very much in color and 
 in quantity even in good health. A pinkish sediment in 
 urine that has been standing and has got cool in the cham- 
 ber, is very common, and is of no importance. It probably 
 means that you have a slight cold, or that you are eating 
 too much meat. Many medicines color the urine; rhubarb 
 makes it very yellow, asparagus makes it smell aromatic- 
 ally; and so on. If the state of your urine troubles you, 
 take a little bottle of it to a doctor and ask his opinion. 
 Don't take " kidney pills," or other self -prescribed medi- 
 cines. And don't run away with the idea that a pain in 
 the back necessarily means kidney disease, as certain ad- 
 vertisements try to make you believe. The pain may be 
 kidney trouble, but probably is not. (See also "Lum- 
 bago.") 
 
 The kidneys are subject to inflammations of various kinds. 
 The acute inflammations are serious acute illnesses, and 
 must be treated by the doctor. Nothing is to be gained by 
 a long description of these diseases. 
 
 Inflammation of the kidneys ( Bright 's disease) produces 
 certain signs and symptoms which the reader ought to know 
 something about. 
 
 (1) Smoky urine. When the urine looks as if it had 
 been mixed with smoke, it probably contains blood. Take 
 some of it to the doctor at once. 
 
 (2) Dropsy. The eyelids are puffy when the patient 
 rises from bed in the morning. The ankles are puffy at 
 bedtime. If the finger is pushed into this puffy swelling 
 it leaves a pit ; the flesh seems to be " boggy, ' ' and is water- 
 
KIDNEY DISEASES 169 
 
 logged, as the saying is. These signs, seen in a person who 
 has had scarlatina, means kidney trouble. In middle-aged 
 persons who have damaged their kidneys by drunkenness, 
 this dropsy is common. 
 
 (3) In kidney disease the heart and pulse beat hard and 
 strong, and the patient is liable to giddiness and vomit- 
 ing. 
 
 Chronic Bright 's Disease. This is of two chief varieties. 
 Persons who have had syphilis, or malaria or gout, and 
 those who work in lead, are especially liable to these forms 
 of kidney decay. But the chiefest cause of all chronic 
 kidney disease is intemperance. The early signs of chronic 
 kidney disease are anemia, loss of appetite, headaches, 
 sickness, general weakness, passing too much urine (es- 
 pecially having to get up in the night to pass it), and 
 dropsy, as before described. The disease generally pro- 
 gresses until the patient gets an attack of paralysis, or 
 several attacks, and then heart disease, and then death. 
 But much may be done by a doctor's careful treatment, 
 warm clothing, and especially by total abstinence from 
 alcohol. Alcohol, in fact, is a powerful poison when the 
 kidneys are diseased. Meat must be given up as far as 
 possible, and the diet be confined to milk and farinaceous 
 foods. 
 
 The treatment of some of the symptoms of chronic 
 Bright 's disease, or chronic nephritis (degeneration or de- 
 cay of the kidney tissues), is here given: 
 
 For sleeplessness 
 
 (1) Sulphonal, 20 grains, in cachet. (To be swal- 
 lowed at bedtime, and washed down with a half-pint of 
 hot water.) Or, 
 
 (2) Paraldehyde, 1 drachm; water, a wineglassful. 
 (At bedtime.) Or, 
 
 (3) Trional, 5 grains in cachet. (To be swallowed an 
 hour before retiring.) 
 
 Note. Chloral, opium and morphine must not be 
 taken. 
 
 For headache 
 
 (1) Caffeine, 5 grains; antipyrin, 2 grains. (To be 
 taken whenever the headache is violent.) 
 
170 LEAD POISONING 
 
 For smoky urine 
 
 (1) Nitrate of pilocarpine, 4 grains; vaseline, 12 
 ounces. (To make an ointment, about 3 ounces of which 
 are to be daily rubbed well into the skin and covered 
 with cotton wool, and bandage.) 
 
 For dropsy 
 
 General measures massage, hot-air baths, purgatives. 
 For vomiting 
 
 (1) Real buttermilk, 1 ounce; potash water, 7 ounces. 
 (To be taken as a draught occasionally.) 
 
 (2) Iced champagne. 
 
 Koumiss, Home-made. A stimulating, nourishing, and 
 refreshing food and drink for persons with diabetes, and 
 others with indigestion. // buttermilk can be got, mix two 
 pints of it thoroughly with three pints of milk, and add 
 five lumps of white sugar. Put the milk in a bowl, covered 
 with a clean towel, and let it stand in a warm corner for 
 24 hours. Then pour it into small bottles, cork them, and 
 tie down with corks. Leave the bottles in the kitchen three 
 days lying on their sides and shake them occasionally. 
 After this the koumiss is ready for use. 
 
 // buttermilk cannot be got. Boil enough fresh milk to 
 fill a few quart bottles when cold, not filling the bottles 
 completely, but leaving room to shake. Add to each bottle 
 half -ounce of castor sugar, and 20 grains of Vienna yeast ; 
 cork the bottles up with sound corks and tie down. Lay 
 the bottles horizontally on the floor in a warm corner, 
 and shake twice a day. The koumiss will be ready to 
 drink on the sixth day (sooner in hot weather and later 
 in cold.) Can be made thinner by using skimmed milk. 
 (Yeo.) 
 
 Lead Poisoning. This occurs chiefly among painters, 
 plumbers, compositors, type-founders, and factory-hands 
 in white lead factories and potteries. Those who drink 
 beer to excess are more liable than others. 
 
 Poisoning by lead may be known by attacks of colic, 
 ancemia, gouty attacks, a blue line on the gums, paralysis, 
 and headaches, and cramps and numbness, and, in women, 
 abortions. The colic attacks are very severe; the pain is 
 
LICE 171 
 
 relieved a little by pressure and a tight belt. The patient 
 is constipated, and often vomits before the colic begins. 
 The anaemia is often the first sign (see also "Anaemia"). 
 The "blue line" is not to be seen in persons who brush 
 the teeth regularly. The paralysis is in the form of wrist 
 drop the patient's hands hang down and he cannot raise 
 them. 
 
 The poisoning is curable, but will come on again if the 
 patient does not give up his unhealthy occupation. The 
 colic yields to opium, but a doctor must be consulted about 
 that. All the signs of poisoning will disappear at last if 
 the patient, having changed his employment, will take, for 
 three months, or more, as the case may be, some such medi- 
 cine as the following: Iodide of sodium, 40 grains; sul- 
 phate of magnesia, one ounce ; tincture of nux vomica, two 
 drachms ; cinnamon water to eight ounces. Take two table- 
 spoonfuls, on rising and at bedtime, for three months. 
 
 Lice (VERMIN) are not uncommon on the bodies or 
 among the hairs of persons who are not of cleanly habits. 
 A louse is a tiny insect looking a little like a tiny crab, 
 and, in fact, the word ' ' crab ' ' is often used to refer to such 
 lice. The louse lives on the skin and feeds on the blood of 
 the dirty person who harbors it. The presence of several 
 lice causes itching, and as the person scratches with dirty 
 finger-nails, he infects the little louse wounds with dirt, and 
 thus he gets a sort of skin disease. The whole business is 
 all the more disgusting because it could be entirely avoided 
 by keeping the skin clean. In a bad case, a neglected child 's 
 skin or scalp becomes covered with dirty sores and crusted 
 scabs; on the hairs near will be found "nits," tiny eggs, 
 which are glued to the hairs, and cannot be got off by or- 
 dinary washing. Later on the glands in the neighborhood 
 become swollen and form painful lumps, which may become 
 abscesses. 
 
 Whenever a child's head is always itching, and there 
 are scabs on it, and a few little lumps on the neck, the child 
 probably has lice, and we ought to look for the nits, which 
 are gummed to the hairs. First cut the hair short, and 
 burn it. Burn also the cap or hat that he has been wear- 
 ing, and send his towel and pillow-case to the wash. Then 
 rub into the scalp white precipitate ointment. 
 
 Vinegar and water will destroy nits, used as a lotion 
 after washing the head thoroughly. A good lotion for lice 
 
172 ARTIFICIAL LIGHTING 
 
 consists of 1 grain perchloride of mercury, 1 drachm spirits 
 of rosemary, and dilute acetic acid up to 1 ounce. 
 
 Elderly people of dirty habits often complain of an itch- 
 ing skin, and if the folds of the shirt or chemise near the 
 neck be closely examined, lice may be found. In such a 
 case the clothes must be disinfected as well as washed, and 
 that may be done by baking them. 
 
 Lighting. The illumination of a room is a matter greatly 
 affecting the comfort and, indirectly, the health of the 
 occupants, and is of especial importance to eyesight in 
 the case of factories, workshops and schools, where the 
 eyes are concentrated on small objects for many hours at 
 a time. 
 
 The difference between good lighting and darkness is 
 the difference between cheerfulness and gloom. It vastly 
 increases the efficiency of the worker; it obviates eyestrain 
 and the development of myopia. Good natural lighting 
 aids cleanliness, destroys germs and their dangerous prod- 
 ucts and influences directly the health of the body. Just 
 how light acts in this way is not definitely known but it 
 is a well-proven fact. Some direct evidence comes from 
 the recognized effect of ultra-violet rays and the Finsen 
 light on certain disease processes on the surface of the 
 body. 
 
 The best illuminant is sunlight. The best artificial illum- 
 inants are those which most closely resemble sunlight. 
 All sources of light should be shaded and the best form 
 of illumination is that known as the * ' indirect ' ' where light 
 is reflected from a broad light surface. 
 
 An important aid to the illumination of dark interiors by 
 natural light has been the recent introduction of panes or 
 plates of glass with a series of ridges or prisms, which re- 
 fract and diffuse throughout a room light which would 
 otherwise illuminate it but partially or not at all. 
 
 ARTIFICIAL LIGHTING of all the systems of arti- 
 ficial lighting in common use at the present time the in- 
 candescent electric light should be placed in the first rank, 
 followed next by the incandescent gas-light (Welsbach). 
 
 The Incandescent electric light presents the following 
 advantages over coal gas, oil and candles. There is no 
 consumption of oxygen, there are no products of com- 
 bustion to pollute the air, and the heat produced is rela- 
 tively slight. The light of the arc light is not yellow, but 
 
ARTIFICIAL LIGHTING 
 
 173 
 
 white. It precisely resembles solar light in being rich in 
 the violet and the ultra-violet rays. Plants grow and flower, 
 and fruit ripens, when exposed to this light, just as they 
 do in the sunlight; whilst photographs can be taken as 
 easily by the arc electric light as by daylight. 
 
 The arc light, while well adapted for lighting streets, 
 large halls and buildings, is extremely dazzling, and is 
 productive of injurious effects on the eyes of those who are 
 much exposed to its influence unless it is extremely well 
 shaded. 
 
 The incandescent lamps are best suited for domestic use. 
 The light is steady and agreeable, but should always be 
 shaded or used as a diffused indirect light. 
 
 Modern economical forms of electric lighting for work 
 rooms and halls are the mercury vapor tubes used in the 
 Cooper-Hewitt and the Moore systems. In the Cooper- 
 Hewitt light the red rays are absent and human beings 
 have the complexion of death. The light is a very good 
 one to work by, however. The Moore light has a more 
 agreeable yellow or pink rose color. 
 
 The Welsbach light is less productive of carbon dioxide 
 than the average oil lamp and consumes not quite one-half 
 less gas than the ordinary gas burners, giving rise, there- 
 fore, to the evolution of half the heat and half the amount 
 of carbon dioxide, while its illuminating power expressed 
 in candles is more than three times as great as the best 
 ordinary gas burners or incandescent electric light. 
 
 The important attributes of an illuminant, from the 
 health standpoint, are the following: amount of ogygen 
 removed from the air, the amount of carbon dioxide pro- 
 duced, the amount of heat produced and the degree of 
 vitiation of the atmosphere. 
 
 The following table shows these points for the com- 
 moner forms of illuminations : 
 
 
 Candle 
 power 
 
 Oxygen 
 removed 
 
 Carbon 
 dioxide 
 produced 
 
 Heat 
 calories 
 produced 
 
 Vitiation 
 equal to 
 adults 
 
 Tallow candle .... 
 Kerosene oil lamp . 
 Coal-gas burner . . 
 Welsbach burner .. 
 Electric incandes- 
 cent light 
 
 16 
 16 
 16 
 50 
 
 16 
 
 cu. ft. 
 10.7 
 5.9 
 6.5 
 4.1 
 
 0.0 
 
 cu. ft. 
 
 7.3 
 
 4.1 
 2.8 
 1.8 
 
 0.0 
 
 1400 
 1030 
 1194 
 763 
 
 37 
 
 12 
 7 
 5 
 3 
 
 0.0 
 
 
 
 
 
 
 
174 LIVER, DISEASES OF THE 
 
 Acetylene gas, generated by the action of carbide on 
 water, furnishes a powerful white light; but its use is not 
 unattended with danger, unless great care is exercised. 
 
 Coal gas gives a yellow or orange flame which is usually 
 steady and agreeable although there are certain drawbacks 
 connected with its use. It consumes much oxygen, pro- 
 duces carbon dioxide, produces much heat and vitiates the 
 atmosphere considerably. Leaky gas pipes are dangerous. 
 The products of combustion are injurious to health. The 
 combustion dries the air and the humidity is much lowered. 
 
 Each cubic foot of gas burnt per hour from ordinary 
 burners vitiates as much air as would be rendered impure 
 by the respiration of an individual. 
 
 Kerosene oil lamps are well fitted for use in rural com- 
 munities. The fuel is cheap and the light a steady one, 
 and agreeable if properly shaded. They vitiate the air 
 greatly and produce a great deal of heat, as well as consume 
 much oxygen and produce much carbon dioxide. Their use 
 is sometimes attended with danger from explosion and fire, 
 but modern lamps are made in which explosions are im- 
 possible, and there are lamps which become extinguished 
 automatically when they are upset. 
 
 Tallow candles are the poorest of the common forms 
 of illuminants. The light is flickering, weak, too yellow 
 and sooty. Much gas and heat are produced, the vitiation 
 of the air is great, much oxygen is consumed and the amount 
 of carbon dioxide produced is large. 
 
 Liver, Diseases of the. The liver, which is a very large 
 gland, lying chiefly on the right side, below the lung, and 
 beneath the lower ribs, has for its principal duty the for- 
 mation of a digestive fluid called bile or gall, which is stored 
 up in the gall-bladder on the under surface of the liver, 
 and is poured out drop by drop into the gut or bowel so 
 that it may mix with the food and digest it. To digest 
 food means to prepare it for absorption into the blood. 
 The liver has other work to do also, but the making of the 
 all-important bile is its chief industry. Now bile not only 
 helps in the digestion of the food, but it is a natural dis- 
 infectant, and a natural purgative, helping the lowest parts 
 of the bowel to get rid" of the waste matters. It is now 
 easy to see why a stoppage in the formation of bile leads 
 to costive bowels, and to indigestion. 
 
 Like every other part of the body, the liver is subject 
 
CIRRHOSIS OF THE LIVER 175 
 
 to congestion and inflammation. Acute inflammation of 
 the liver is caused by excess of alcoholic drinking, indis- 
 cretions in diet, etc., and requires rest in bed. The patient 
 is a little feverish, the liver is tender, the whites of the 
 eyes are yellowish, the motions are pale colored, the urine 
 high-colored, and he has a headache and languid feeling. 
 A light milk diet will be needed, and a three-grain dose 
 of calomel; and a hot linseed and mustard poultice must 
 be put on over the liver and replaced when cold by a thick 
 layer of cotton-wool. The attack generally lasts about a 
 week. 
 
 Chronic inflammation of the liver results from heart- 
 disease of certain kinds, and this is the patient's sad mis- 
 fortune; the chronic enlargement of the liver due to al- 
 coholic excess is more common and is the patient's fault. 
 Its cure depends very largely on the patient himself. The 
 chronic enlargement is called cirrhosis (pronounced sir- 
 rosis) of the liver. The symptoms of it are also those 
 of chronic indigestion caused by alcohol, because it is al- 
 ways accompanied by inflammation of the stomach. The 
 chief signs are trembling and coated tongue, shakiness of 
 the hands, enlarged veins over nose and cheeks, sickness on 
 rising in the morning, loss of appetite, a dry taste in the 
 mouth, sleeplessness. Later on, piles and blood-vomiting 
 (which see ) ; watery eyes, muddy complexion, fat body, 
 thin legs and arms. 
 
 Most of these drunkards, suffering thus from years of 
 folly and self-indulgence, are weakened from long absti- 
 nence from food, and a slight nutritious slop diet is one 
 of the first necessities. But Nature will recover herself 
 largely without much treatment if only the alcohol is given 
 up absolutely and at once. Change of occupation is of 
 vital importance for waiters, publicans, and barmaids who 
 have developed the disease. Outdoor labor should be 
 tried. 
 
 Cirrhosis of the Liver has very, very numerous, pain- 
 ful and distressing symptoms. We cannot here attempt 
 a thorough exposition of the treatment necessary. When 
 the disease is definitely developed the patient will require 
 continuous medical aid as well as his own efforts at keep- 
 ing sober. The following medicine will help him to resist 
 the craving for drink and will do his indigestion good: 
 Taraxacum juice, 2 ounces; dilute nitre-hydrochloric acid, 
 
176 LOCOMOTOR ATAXY 
 
 % ounce; tincture of mix vomica, 6 drachms; liquid ex- 
 tract of Cinchona bark, 4 drachms; water to 12 ounces. 
 Take a tablespoonful in a wineglassful of water before 
 meals. 
 
 Cancer of the Liver. This generally occurs in the in- 
 temperate, but a secondary growth in the liver may happen 
 to anybody with a cancer. (See "Cancer.") 
 
 Liver Colic. This is the pain caused by the passage of 
 a gallstone which is forced from the gall-bladder where it 
 was formed, through a narrow tube too small for it, into 
 the gut. The pain is sudden and intense and is felt in 
 the lower part of the chest, the right shoulder and back. 
 It is often so severe that the wretched man (or more often 
 woman) is bent double in agony and writhes about on the 
 floor, shivering, sweating and miserable. After a time the 
 pain becomes less, and dull and aching until it all sub- 
 sides or a fresh attack occurs. 
 
 Very often the patient gets yellow all over, jaundiced. 
 The whites of the eyes are the first to show the yellowness 
 and the last to lose it. If the gallstone passes into the 
 gut, the pain all goes away, the jaundice gets better and 
 the little stone is passed away in the motions. But the 
 stone may remain in the little tube, unable to get out. 
 
 The actual attack of pain must be treated by a medical 
 man. Afterwards the patient must take precautions against 
 the formation of another stone. The diet must be spare, 
 plenty of exercise must be taken and alkaline drinks must 
 be taken in large quantities always. Also the patient must 
 take a heaped-up teaspoonful of phosphate of soda in hot 
 water every morning. 
 
 Hot baths or hot poultices are useful for the attacks of 
 pain, until medical advice can be obtained. 
 
 Lockjaw. (See "Tetanus.") 
 
 Locomotor Ataxy. A nervous disease, chronic, progres- 
 sive, ending in death in a few years. Most common in 
 middle-aged men, especially fast men, who have had 
 syphilis, and who, in addition, are given to drinking alcohol 
 in excess. 
 
 There are three stages to the disease: 
 
 (1) The Pre-ataxic stage. (Ataxy means inability to 
 control muscular movements.) Some of the signs and 
 symptoms in this stage are: "lightning-pains" (acute, 
 severe and violent sudden pains lasting a few seconds) ; 
 
LUMBAGO 177 
 
 "girdle-pain," a sensation as if bound tight with a belt 
 or iron band. 
 
 (2) Ataxic stage. The first sign is often the tumbling 
 forward into the basin on closing the eyes during washing 
 in the morning, another is the difficulty in buttoning up 
 the collar. 
 
 The patient soon feels as if he were walking on wool 
 instead of on the pavement, and cannot turn round sud- 
 denly, or stand with his eyes shut. He has to look at his 
 feet when he walks. He is no weaker, however. Then he 
 may have vomiting, acidity, shortness of breath, inability 
 to pass his urine or to hold it sometimes. The skin is 
 dry; the nails crack, perhaps. The pupils of the eyes 
 are small. 
 
 (3) Paralytic stage. The patient becomes bed-ridden, 
 and sooner or later dies of pneumonia or some other serious 
 disease. The disease is probably always incurable, but some 
 cases caused by syphilis have recovered under treatment. 
 
 Lumbago. Rheumatic pains in the muscles of the loins 
 backache. This often comes on quite suddenly as a 
 violent pain in the back, like a stab with a dagger in the 
 loin muscles. It comes on again every time the sufferer 
 rises from lying down to the erect position, and also some- 
 times when he coughs or sneezes or laughs. 
 
 He is apt to imagine that he has some terrible kidney 
 disease but he probably has not. There are no signs of 
 illness, except the pain ; and it is not like the pain of either 
 kidney or liver colic. 
 
 When it is better, the back feels stiff and sore for a 
 long time. 
 
 Treatment. As in the treatment of all other pains, we 
 must try to relieve lumbago not only by local applications, 
 but must get at the root of the mischief by giving medicine 
 internally. 
 
 Local applications 
 
 (1) Hot fomentations, sprinkled with laudanum or 
 turpentine. 
 
 (2) Put a piece of brown paper over the loins and 
 then iron them with a heated flat-iron. 
 
 (3) Hot-air baths. 
 
 (4) "Baths" of warm medicated mud, such as 
 "fango," are very useful and comforting. 
 
178 LUNGS, DISEASES OF THE 
 
 (5) Rub in compound camphor liniment four times 
 a day, and let the patient wear a warm, wide, woolen 
 belt next his skin, around the loins and abdomen. 
 
 (6) Dry -cupping of the loins is very likely to give 
 relief to lumbago in robust and full-blooded persons. 
 This is a treatment which ought to be done by a doctor 
 or nurse, but as there are always a few people who like 
 to do things on their own responsibility, we describe the 
 process here. To dry-cup, take a thick glass tumbler, 
 and put into it a bit of blotting-paper sprinkled with 
 methylated spirit. Set fire to the paper, and just before 
 it has quite burnt out, clap the mouth of the glass on 
 to the loins of the patient. The heating of the air in 
 the glass has "rarified" it, and a vacuum is produced so 
 that the skin is sucked up into the glass and the blood 
 rushes to it, thus being drawn from the seat of the pain. 
 The glass is left on for 15 minutes. This can be re- 
 peated in several places. Wet-cupping is even more ef- 
 fectual, but it cannot be done by non-medical persons. 
 
 (7) If the patient with lumbago wants to move about, 
 he should wear a plaster made from equal parts of 
 belladonna plaster and opium plaster and spread on 
 leather. 
 
 (8) Many doctors get good results from puncture. 
 They rapidly insert a stout needle into the loins and 
 pull it out again, and repeat this in several places. It 
 is a somewhat painful proceeding at the time, but gives 
 relief directly afterwards. 
 
 (9) It may be necessary, if none of these methods give 
 relief, for the doctor to inject some medicine into the 
 loin with a syringe, through a fine, hollow needle. 
 
 (10) Very chronic cases of lumbago are relieved by 
 blistering freely. 
 
 (11) Electricity is used in some hospitals to relieve 
 pain. Internal remedies are such as these : 
 
 Aspirin, sodium salicylate or salicylate of colchicum. 
 
 Lungs, Diseases of the. The lungs are two elastic organs, 
 occupying the chest and sharing it with the heart, which lies 
 in a closed membranous bag between them. The chief 
 duties of the lungs are: to enable the blood which cir- 
 culates in the spongelike tissue, to come into contact with 
 the oxygen of the air ; and to give off carbonic acid gas in 
 
MADNESS, SYMPTOMS OF 179 
 
 the breath. The oxygen is required to purify the blood 
 which gets filled with carbonic acid gas in doing its work 
 of nourishing the tissues of the body. It will be seen that 
 the lungs are most important organs. Thus: 
 
 (1) If they are undeveloped, then the blood does not get 
 aerated and purified as well as it should; also it does not 
 give up its carbonic acid gas properly. So the whole nour- 
 ishment of the body suffers and the body remains stunted. 
 
 (2) If they are inflamed or diseased, then the blood 
 which is continually circulating through them carries im- 
 pure and used-up blood to the rest of the body, instead 
 of pure fresh blood. We shall refer again to this condition. 
 
 (3) If the lungs are too much developed blown-out, 
 as in many athletes, and asthmatics and bronchitic persons, 
 and glass-blowers, and wind-instrument players, then they 
 cannot expand and contract properly, and the blood never 
 gets properly aerated. The results are shortness of breath, 
 blueness or coldness of the hands and feet, and so on. 
 (See "Chest Deformities.") 
 
 (4) In people who suffer from Bright 's disease, and 
 heart disease, the lungs are apt to get dropsical or * ' water- 
 logged, " and hence the blood cannot be properly aerated. 
 
 The disease which is most important of all those which 
 affect the lungs themselves is one known as "Pneumonia." 
 This is also called "inflammation of the lungs," but as it 
 is in reality a disease of the whole body, involving the whole 
 of the respiratory organs and the digestive and other or- 
 gans as well (though the chief mischief is in the lungs), 
 we shall devote a separate article to it. (See "Pneu- 
 monia.") 
 
 The next most important lung disease is Broncho-Pneu- 
 monia, in which there is Bronchitis as well as Pneumonia. 
 It is commonest in children under five years of age, and is 
 very often fatal. Other lung diseases are Abscess of the 
 Lung, Gangrene of the Lung, and Tuberculous Disease of 
 the Lung, which is another name for our old enemy, Con- 
 sumption. Lastly, the lung may be affected with Cancer. 
 
 Madness, Symptoms of. The mental symptoms and signs 
 of unsoundness of mind are mainly three. Every insane 
 person has one or more of these symptoms, though it is 
 quite possible for anybody to have one or more of them 
 in a very slight degree, without being considered or treated 
 as insane. A very large number of persons are subject 
 
180 HALLUCINATION 
 
 to delusions; and as long as they are harmless delusions, 
 and as long as the patients know that they are probably 
 delusions, and do not act upon them, there is no need to 
 put them under care and restraint in an asylum or home. 
 These are the symptoms : 
 
 An hallucination is a disorder of one of the special senses 
 (seeing, hearing, smelling, tasting or feeling). That is to 
 say, the patient fancies that he hears voices, when there 
 are really no voices ; or that he has a bad taste in his mouth, 
 when there is nothing in his mouth and it is quite healthy 
 and clean; or that he sees persons, who are not there; or 
 that he smell onions, when there are no onions near. Cer- 
 tain very saintly people in the middle ages, particularly 
 half-fed and badly-treated nuns and monks, used to fancy 
 that they heard voices whether from heaven or hell tell- 
 ing them to do certain actions. So long as they kept com- 
 mon sense enough not to act upon the fancied voices, they 
 were sane; but as soon as they began to act upon the sug- 
 gestions (which, after all, came from their own brains) 
 then they were really insane. Unfortunately, no one in 
 those times had any really scientific knowledge about in- 
 sanity; and the result was that if these poor, half -starved 
 creatures acted piously as the result of the "heavenly'' 
 voices which they thought they heard, all went well with 
 them, and after death they were regarded as saints. But 
 if the voices made them act wrongly and commit crimes 
 instead, they were said to be "possessed of the devil," and 
 treated accordingly. Many a poor wretch, even at the 
 present day, commits crimes at the instigation of "voices" 
 which do not exist except in his own ears, and come from 
 his poor diseased brain. No one who confesses that he 
 hears "voices" talking to him, or about him, and saying 
 rude or slanderous things about him, is quite fit to be 
 trusted; at any time he or she may become quite insane 
 and irresponsible. The golden rule in all such cases is that 
 of securing medical advice as early in the development of 
 the ailment as may be possible. This practice, in fact, con- 
 stitutes the only hope of cure. 
 
 An illusion is a false perception of the senses that is to 
 say, the senses misinterpret what is seen or heard. A per- 
 son who has illusions, for example, sees an empty dressing- 
 gown hanging behind the door and believes it to be a 
 burglar concealing himself. Some persons have illusions 
 
MALARIA 181 
 
 too, but they do not act upon them, or at any rate, act 
 sensibly. A man who, seeing his beloved wife in the night 
 standing in the bedroom, believes her to be the devil, and 
 beats the life out with a poker is acting insanely, and is 
 certainly, if only temporarily, insane. We are all very 
 often obliged to doubt the evidence of our senses ; especially 
 in watching conjuring and sleight-of-hand tricks. But no 
 sane man would knock a conjurer down because he pounded 
 up his gold watch before his eyes; the man would know 
 quite well that he was under an illusion and would applaud 
 the cleverness of the conjurer. 
 
 The third mental sign of insanity is delusion. A delu- 
 sion is a disorder of consciousness. It is a false belief in 
 some fact (which nearly always concerns the patient per- 
 sonally) of the falsity of which he cannot be persuaded, 
 either by his own senses, knowledge or experience, or even 
 by the declarations of others whom he trusts. A man, for 
 instance, may believe that his legs are made of glass, and 
 that he cannot sit down without a risk of breaking them. 
 If he is insane, it is perfectly hopeless to prove to him 
 that his legs are flesh and blood and that they bleed when 
 pricked; it is a waste of time to argue with him. He is 
 insane, and he not only believes that his legs are of glass, 
 but he is terrified lest they should be broken. Of course, 
 he is not always quite consistent in his actions, but then 
 none of us are quite consistent, even when we are sane. 
 There are plenty of well-educated people who are under 
 delusions on certain subjects, such as table-turning, etc. 
 These are "sane delusions," or, more properly, erroneous 
 judgments. A perfectly logical and consistent sane man 
 would argue, if invisible spirits could be got to rap on 
 tables, and make them turn round in the dark, that they 
 might fairly be expected to do something useful and serv- 
 iceable also, such as dusting the furniture or cooking the 
 dinner! But no one with the "table-rapping" delusion 
 ever seems to expect a spirit to use his energy in a reason- 
 able and useful way ! 
 
 Malaria. This is the general term for diseases that have 
 been known for years as marsh-fever, coast-fever, ague, jun- 
 gle-fever. The whole subject of the study of malarial dis- 
 eases forms one of the most triumphant and interesting of 
 all those connected with the science of medicine. 
 
 Malaria consists of a series of periodical attacks of fever 
 
182 MALARIA 
 
 which come on regularly and almost exactly just when they 
 are expected. There are several types. Thus you may get 
 daily malarial fevers (quotidian), or an attack every other 
 day (tertian), or an attack every third day (quartan). 
 
 Cause. The cause is the presence in the blood of one of 
 three parasites, all very much alike and microscopically tiny. 
 The parasite is injected into the blood by mosquitoes which 
 have first chanced to bite someone else ill with malaria, and 
 have themselves become infected. It is believed that it is 
 impossible to catch malaria without being stung by a cer- 
 tain kind of mosquito, called the anopheles. The parasites 
 of malaria, thus injected into the body by an infected 
 mosquito, multiply rapidly in the blood, and it is the poison 
 generated by their presence which causes the feverish at- 
 tacks. 
 
 Before an attack of malarial fever, or ''ague fit" comes 
 on, the patient gets headaches and shiverings, but he may 
 be quite well. 
 
 The ague fit itself consists of about an hour of shivering 
 (when the patient gets to bed and piles clothes on him- 
 self, even in the hottest weather) ; then several hours of in- 
 tense heat and high fever (when he throws off the clothes 
 and vomits and has violent headache), and then a period of 
 sweating, which continues till he has gradually recovered 
 and feels quite well. The whole attack happens again next 
 day, or in two days, or in three days, and again and again, 
 unless he is properly treated. 
 
 Occasionally persons die in these attacks. 
 
 Now, even if the fever is neglected (and it often is), 
 sooner or later, if the person leaves the malarious country 
 and gets no more mosquito bites, the disease wears itself 
 out and gives no more trouble. But if it is more severe, 
 malaria becomes a chronic disease and leads to a chronic 
 state of ill-health, consisting of ancemia, yellow wasted skin, 
 enlarged liver and enlarged spleen. This is called by doc- 
 tors the "malarial cachexia." 
 
 The cure of malaria is accomplished by the use of quinine, 
 but every case needs special care ; and the same form or 
 preparation of quinine does not suit everybody. Moreover, 
 no two people thrive on exactly the same dosage. Overdoses 
 of quinine upset the digestion and cause giddiness and ring- 
 ing in the ears. 
 
 As a rule five grains of quinine taken three times a day, 
 
MASSAGE 183 
 
 in capsule or pill form, is sufficient to cure an acute attack 
 of malaria in an adult. The dosage must be continued 
 for several weeks, however, or the malarial attack may 
 return. 
 
 Prevention of Malaria. (See also "Mosquitoes.") As 
 the only method by which malaria can be contracted is 
 through the bite of a mosquito infected with malaria the 
 most rational way to prevent it is by destroying all mos- 
 quitoes in the neighborhood of one's residence. Details of 
 the methods for the destruction of mosquitoes are given 
 under the heading "Mosquitoes." 
 
 As mosquitoes can only obtain the malarial parasite from 
 a person suffering from malaria it stands to reason that 
 the best way is to keep mosquitoes away from the malarial 
 case by careful screening. 
 
 When living in a malarial country in which the develop- 
 ment of mosquitoes cannot be controlled, some protection 
 may be secured by taking quinine from time to time in 
 doses of ten or fifteen grains a day. 
 
 Malignant. This word is used by doctors to refer to any 
 form of disease which is more serious than the usual type 
 and almost certain to be fatal. Thus, we speak of malignant 
 smallpox, malignant typhoid, etc. The word is applied also 
 to the set of tumors called cancers, which include every form 
 of tumor which, if left alone, will ulcerate and kill the 
 patient by exhaustion, and which, even if removed, will 
 probably come back again, growing in another part of the 
 body. 
 
 Massage. This is the general term for the work done by 
 nurses who are skilled and certificated masseurs, or mas- 
 seuses (for both men and women do this work) . Their Eng- 
 lish name is "rubbers." Massage, or scientific medical 
 rubbing, can be learned from a book, by those who know 
 physiology; but no masseur is of any use until he under- 
 stands the meaning of the rubbing which he learns to do. 
 The movements included in Massage are called stabile and 
 labile. The stabile movements are pressing, pinching, 
 hacking, thrusting and tapping the skin and muscles, to 
 improve the circulation and stimulate the tissues. The 
 labile movements are stroking, rubbing and kneading. 
 Massage is useful in the following complaints : stiff joints 
 (unless they are "strumous" or "tuberculous," when they 
 must not be rubbed), inflammatory tough thickening, 
 
184 MEASLES 
 
 rheumatic stiff joints, and fractures, or broken bones, and 
 a few cases of slight paralysis and sprains. 
 
 Measles. A majority of us suffer from measles in child- 
 hood. But let it be remarked here that the ideas held by 
 many of the ignorant poor, that every child must have 
 measles, and that a child therefore might as well be put 
 in the same bed with a brother or sister who has the dis- 
 ease, are absolutely wrong, if, indeed, not criminal. Dr. 
 Alexander Gordon quotes the following experience: "A 
 boy of 14 had measles, and his mother, feeling sure that 
 the other children would catch the disease in any case, 
 took no precautions. Her six-months old baby died after 
 two days of measles, and her little girl of two years lost 
 the sight of both eyes. So much for the wickedness of the 
 superstition. ' ' 
 
 The disease is contagious, and infects the air round the 
 patient and the clothes which he wears, though to a less 
 degree than scarlet fever does. It is even more contagious 
 before the rash comes out than afterwards. Between the 
 day of catching the disease and the first signs of it, about 
 ten days elapse. It begins with feverishness, loss of appe- 
 tite, drowsiness, and chills, and in some children with 
 vomiting or fits. Then the eyes get red and watery, the 
 nose runs, and there is a cough because the air-tubes in 
 the lungs are also affected. On the fourth day of this 
 "bad cold" the rash comes out. (See "Rashes on the 
 Skin.") There are pink spots, round, and afterwards ir- 
 regular in shape, patches of redness with scalloped edges. 
 Only a doctor can distinguish between it and the rash of 
 scarlet fever. The rash is mostly on the face which gets 
 red and blotchy, but there are some patches on the body 
 and limbs, too. In three days it has reached its height and 
 then it begins to fade, leaving mottled, brownish patches 
 from which the skin is shed in tiny bran-like fragments. 
 This "peeling" is often hardly noticeable. The feverish- 
 ness is worse when the rash breaks out, and then begins to 
 subside. After about a week the patient begins to get well 
 again. 
 
 This is an ordinary mild case of measles without compli- 
 cations. But there are many possible complications. 
 Thus, the catarrh of the air-tubes may become a real severe 
 bronchitis, or the lung itself may share the inflammation 
 which then develops into a pneumonia. Then the voice- 
 
MEASLES 185 
 
 box or larynx may become inflamed too, and laryngitis 
 comes on, with a croupy cough and hoarseness. Other com- 
 plications are, inflammation of the eyes (ophthalmia), of 
 the mouth, of the bowels (causing diarrhea), and of the 
 ears. Enlarged tonsils, swollen glands and tuberculosis 
 and pleurisy are all apt to occur. 
 
 Treatment. When a child is 1 1 sickening " in the way 
 above described, the disease may turn out to be measles, 
 or German measles, or scarlet fever. It is wise to have the 
 child under medical supervision from the first in order 
 to name the disease correctly, to treat it correctly, and to 
 guard against complications. 
 
 No one can possibly cut short or ''cure" the disease all 
 at once. But a good doctor can point out how best to 
 guide and support the patient until the course of the dis- 
 ease is run, and how so avoid the terrible possible complica- 
 tions. Briefly, this is what to do (1) Isolate the child if 
 possible in a room with not a single piece of unnecessary 
 furniture. (2) Let the temperature of the sick-room be 
 not less than 60 and not more than 70. (3) Moisten 
 the air by boiling a kettle in the room and have plenty of 
 steam. It helps the patient to breathe. (4) Have two 
 beds in the room, one for day and one for night. Ventilate 
 it well with open window or door, using screens round the 
 bed itself. Plenty of fresh air, but no draughts. (5) 
 Have a subdued light in the room. (6) Disinfect freely. 
 Use a good disinfectant, and be sure to put some of it into 
 the bed-pan before and after use, and to rinse all vessels 
 in it which have been used by the patient. (7) Milk diet 
 is necessary, milk alone, or with lime water or soda water. 
 Barley-water and lemon juice or home-made lemonade may 
 be freely given. (8) If the fever is high the doctor may 
 direct you to sponge the body with tepid water. The cough 
 in ordinary cases needs no special medicine. (9) To ease 
 the feverishness at first, you may give a teaspoonful of this 
 mixture to any child with measles from 2 to 5 years of 
 age: Solution of acetate of ammonia, 2 ounces; spirit of 
 nitrous ether, 2 drachms; sirup, 1 ounce; distilled water 
 to 4 ounces: mix. Dose One teaspoonful every two or 
 three hours. (10) After a week, in ordinary cases the 
 child may get up from bed but not leave the room. In the 
 poorer classes children are generally allowed out too soon; 
 hundreds of cases of consumption and deafness and chest 
 
186 MEDICINE CHEST 
 
 troubles are due to this serious mistake. In the winter no 
 child ought to be allowed to run about in the open-air for 
 at least a month after the attack. "Serious complications 
 are more common after measles than after any other dis- 
 ease/' wrote Dr. Whitla. (11) During convalescence 
 tonics will be wanted, such as quinine and iron, to improve 
 the appetite. Whooping cough is very common after 
 measles. No case of either of these diseases should be 
 treated without medical advice. 
 
 Medicine Chest. Here follow a few suggestions for the 
 home medicine-chest. Bottles ought to be labeled with 
 large white labels, well written, and perfectly clear. 
 Poisons must have red as well as white labels, and they 
 ought to be in green or blue fluted bottles, so that they can 
 be picked out when the light is bad. On every bottle 
 there ought to be written the dose of the medicine, and, in 
 case of poisons, their uses. 
 
 A well-stocked home medicine chest should contain: 
 
 A pair of scales and drachm and grain weights. 
 
 A clinical thermometer (see notes below). 
 
 A glass measure, marked in drachms and ounces. 
 
 A minim measure, for small doses. 
 
 A medicine glass, marked in teaspoonfuls and table- 
 spoonfuls. 
 
 A feeding-cup. 
 
 A glass eye-bath. 
 
 Brushes for painting out the throat (no two persons 
 to use the same brush). 
 
 A piece of oiled silk, say a square yard, or a piece of 
 jaconet. 
 
 A roll of surgeon's lint. 
 
 A bottle of pastils (or tabloids or soloids) of corrosive 
 sublimate, for making lotions, for washing ulcers, 
 etc. 
 
 A cake of carbolic soap, 10 per cent. 
 
 A waterproof sheet, for confinements, etc. 
 
 A roll of adhesive plaster. 
 
 A glass ear-syringe: A Higginson syringe. 
 
 A bottle of household ammonia, for bites of insects, 
 stings, etc. 
 
 Bandages, assorted. A "wringer" (see "Fomenta- 
 tions," pp. 86-7). 
 
MEDICINE CHEST 187 
 
 For external application, in bottles marked POISON : 
 
 Liniment of iodine, two ounces (see notes below). 
 
 Glycerin of the subacetate of lead, four ounces. 
 
 Creosote, pure, two drachms. 
 
 Zinc sulphate, four ounces (see notes). 
 
 Carbolic acid lotion, 1 in 60, two pints. 
 
 Friar's balsam, four ounces. 
 
 A bottle of smelling salts. 
 
 Boric acid powder, one ounce. 
 
 Zinc ointment (one ounce). 
 
 Sulphur ointment (for the itch). 
 
 Hamamelis ointment (for piles). 
 
 For internal use (1) as purgatives: 
 
 Sirup of senna, two ounces. (Dose for children, one 
 
 drachm. ) 
 Epsom salts, half-a-pound. (Dose 30 grains to half- 
 
 ounce.) 
 
 Compound rhubarb pills, four grains in each. 
 Calomel, a bottle of tablets of a grain each. 
 Castor oil, four ounces. (Dose, about one ounce.) 
 
 (2) To relieve pain: 
 
 Laudanum, half a fluid ounce. (Dose, up to 30 
 
 minims. ) 
 Paregoric, two ounces. (Dose half to one drachm 
 
 [adult].) 
 Phenacetin and caffeine tablets, 25. 
 
 (3) To stop bleeding: 
 
 Alum powder, two ounces (see also notes below). 
 
 (4) To stop diarrhea: 
 
 Aromatic chalk powder. (Dose 10 grains to one 
 
 drachm. ) 
 
 Salol (five grain tablets), 25. 
 Gray powder (for children), an ounce. (Dose, % 
 
 grain. ) 
 
 (5) For coughs, etc.: 
 
 Ipecacuanha wine, two ounces. (Dose, 10 to 30 min- 
 ims.) 
 
 Sal volatile, two ounces. (Dose, one drachm in water.) 
 Pil. Ipecac, et Scillae. 
 
188 MEDICINES 
 
 (6) For feverish colds: 
 
 Quinine tablets of two grains each, 25. 
 Dover's powder tablets, five grains in each, 25. 
 Smelling salts. 
 
 NOTES ON THE FOREGOING MEDICINES, ETC. : 
 
 A clinical thermometer is marked from 95 to 107 
 Fahrenheit. It is used by placing the mercury bulb under 
 the tongue, closing the mouth, and leaving the thermometer 
 there for three minutes or less, according to the make of 
 the thermometer. A person in health varies from 96 to 
 98.4. Above 99 he is said to be feverish, and below 96 
 he is said to be subnormal, and may be in " collapse." 
 Some people prefer to "take the temperature" in the arm- 
 pit, which must be wiped dry before the bulb of the ther- 
 mometer is put there, and it must be left there about 15 
 minutes. After use, the mercury column is to be taken 
 down again by jerking. 
 
 The throat-brush must, of course, be used for nothing 
 else, and thoroughly washed every time. Each brush 
 should have a label gummed onto it, bearing the name of 
 the person who has used it. The brush must be dipped into 
 the glycerin of tannic acid (used for painting the throat) 
 in a saucer and not in the bottle. 
 
 Corrosive sublimate lotions. One part in 2,000 of water 
 is a strong enough antiseptic lotion for most purposes. 
 
 Carbolic soap. The hands ought to be washed with this 
 before any cuts, ulcers, or burns are attended to. 
 
 Bandages. A three-inch unbleached calico bandage can 
 be cut into two in its new rolled-up condition, by a sharp 
 knife, if finger bandages are wanted. 
 
 Liniment of iodine is good for painting on chilblains, and 
 for painting on the skin of the whole of the chest, back and 
 front, in cases of irritable and frequent cough. 
 
 Subacetate of Lead with glycerin is useful in eczemas, 
 especially if mixed with four parts of fresh milk and ap- 
 plied on lint. Goulard water is the name given to the 
 diluted solution of subacetate of lead, and it is used as a 
 lotion for sprains and bruises. Mixed with one-eighth of 
 its volume of laudanum, it becomes "lead and opium lo- 
 tion," and is useful for painful bruises and itchiness of the 
 skin. 
 
CASTOR OIL 189 
 
 Creosote is useful in toothache. One drop on a tiny piece 
 of cotton-wool, put into a hollow aching tooth will relieve 
 the pain. Oil of cloves would do as well. Two to five 
 drops swallowed in a bread pill will often stop seasickness. 
 
 Zinc sulphate. Externally, this is very useful. Ked lo- 
 tion, used for ulcers (see "Ulcers") is made of zinc sul- 
 phate, 20 grains; compound tincture of lavender, 150 
 minims; and water to half-a-pint. As an eye lotion for 
 inflamed eyes, use 30 grains to 10 ounces of pure water. 
 But zinc sulphate is an internal medicine also. Taken 
 internally in doses of from one to three grains (for an 
 adult) it is a good tonic, and in doses of from 10 to 30 
 grains it acts as an emetic and produces vomiting. It is 
 useful to have this drug, therefore, always in the house. 
 
 Friar's balsam (compound tincture of benzoin). This is 
 one of the most useful things in the chest. Externally it 
 is an excellent antiseptic soothing and healing application 
 for all cuts and wounds. A cut finger may be wrapped 
 round with a bit of clean lint dipped in balsam, and covered 
 with a piece of jaconet, and the dressing need not be re- 
 moved until the cut is healed. Of course, before applying 
 the balsam you must hold the cut under the tap for a time 
 to get the wound quite clean. 
 
 Internally, a good cough mixture may be made for a 
 hard, painful cough by putting an ounce of balsam into an 
 eight-ounce bottle and filling up with water. Dose, a table- 
 spoonful three or four times a day. Again, a teaspoonful 
 of the balsam in a jug of boiling water gives off a healing 
 vapor very useful in hoarseness and sore throat. 
 
 Boric acid powder, a clean, non-irritating antiseptic dust- 
 ing powder for all sorts of purposes. 
 
 Compound rhubarb pills are to be taken, say, one every 
 evening, by persons with costive bowels and furred tongue. 
 
 Calomel is a splendid liver stimulant. Bilious people, 
 who suffer from specks before the eyes and headaches, 
 should take a dose of calomel in the evening, occasionally, 
 and follow it up by a dose of Epsom salts next morning. 
 Calomel powder should be dusted on those ulcers on the 
 lower third of the leg occasionally, and on those mucous 
 red patches on the face, and on the privates of persons with 
 syphilis. 
 
 Castor oil. Besides being a purgative it is useful for the 
 eyes. One drop of castor oil when you have "grit in the 
 
190 MEDICINES 
 
 eye" gives almost instant relief. Every case of summer 
 diarrhea ought to be given a dose of castor oil first, to clear 
 the bowels out. 
 
 Laudanum is tincture of opium and poisonous. It is use- 
 ful in all cases of mysterious colic or pain of any kind if 
 the doctor cannot be had. It is useful as a local applica- 
 tion, too, especially for toothache, or to increase the action 
 of poultices. 
 
 Paregoric is compound tincture of camphor. It is useful 
 for children's coughs and restlessness and sleeplessness, 
 especially when combined with ipecacuanha wine. 
 
 Phenacetin with caffeine is very useful for migraine or 
 sick headache due to fatigue or too much reading; also for 
 feverish attacks. 
 
 Alum is an astringent, and useful for gargles in cases of 
 relaxed sore throat, especially if combined with an equal 
 quantity of chlorate of potash. A teaspoonful of each to 
 half-a-pint of water will make a strong gargle. 
 
 Alum will also stop bleeding from razor cuts. All bar- 
 bers keep blocks of it on their shelves. A teaspoonful of 
 alum in a very little water will often act as an emetic. 
 With four grains to the ounce of water may be made an 
 eye lotion for bloodshot eyes. A lotion of twice that 
 strength, as a vaginal douche, is useful for women who 
 suffer from ' ' whites. ' ' 
 
 Salol will not stop diarrhea of itself ; but it disinfects the 
 bowels and thus removes the irritating matters which are 
 causing the diarrhea. 
 
 Ipecacuanha wine is an emetic in doses of four to six 
 drachms, but in doses of 10 to 30 drops (adult) it is a 
 splendid expectorant, and makes a cough easier. 
 
 Quinine as well as phenacetin is "good for" feverishness, 
 but it is no use trying to knock down fever until the bowels 
 are acting freely. 
 
 Dover's powder (compound ipecacuanha powder, con- 
 taining also opium). It increases the action of the skin, 
 causing a healthy free perspiration in acute catarrhs; and 
 it checks diarrhea. For children it is almost the only safe 
 preparation of opium ; the dose is one grain for every year 
 of the child 's life. 
 
 Gray powder. This is mercury with chalk. It is of the 
 utmost use for children with diarrhea in doses of half-a- 
 grain, twice a day, especially for those puny, miserable 
 
MENSTRUATION 191 
 
 children who are of unhealthy parents and badly fed, and 
 are always having diarrhea with foul fetid motions. 
 
 Meningitis. This disease may be of tubercular origin, 
 occurring as a primary disease in children or in adults 
 secondary to tubercular infection elsewhere in the body. 
 
 Epidemic Cerebro-spinal Meningitis is an acute germ 
 disease caused by the meningocoecus, occurring most fre- 
 quently in the young, but not confined to any age. The 
 disease usually begins abruptly with a chill followed by 
 vomiting, excruciating pain in the head, back and limbs. 
 The head is bent back. 
 
 There is high fever and sensitiveness to light, sound and 
 touch. 
 
 Untreated or improperly treated, this disease usually 
 results in death; or if recovery takes place is very liable 
 to be followed by blindness, deafness, paralysis or imbecility. 
 
 A physician should be called at the earliest possible mo- 
 ment, for if antimeningococcus serum can be administered 
 early enough complete recovery takes place in the great 
 majority of cases. 
 
 Prevention. All cases should be promptly isolated. As 
 most cases occur in the presence of unhygienic conditions, 
 care should be taken to improve the sanitary conditions 
 where danger of infection threatens. 
 
 As infection is probably contracted through the mucous 
 membranes of the nose and mouth the hygiene of these 
 cavities should be carefully seen to by the use several times 
 a day of a mild antiseptic solution such as the official Liquor 
 Antisepticus Alkalinus. 
 
 For this purpose a nasal douche, such as may be had at 
 any drug store, is of service. 
 
 Menstruation. This is a natural function in every fe- 
 male. The discharge, which occurs about every twenty- 
 eight days and lasts from three to eight days, is accom- 
 panied, in many women, by feelings of tiredness, headache 
 and irritability ; and in some cases by severe pain and sick- 
 ness. In a few women the whole phenomenon is painless 
 and gives no trouble at all. This function of menstruation 
 begins, in temperate climates, between the ages of 14 and 
 16, and as soon as it has become established the girl is said 
 to have reached the ' ' age of puberty. ' ' 
 
 During pregnancy the process does not occur, and in 
 fact the sudden cessation of the flow is often the first sign 
 
192 MIDDLE-AGE 
 
 that a woman is about to bear a child. While suckling her 
 baby, the flow is still suspended, and, among the poor, 
 women often continue to suckle a child far beyond the 
 proper length of time (about six months) because they 
 wrongly suppose that a new pregnancy is impossible as 
 long as suckling is continued. 
 
 Disorders of Menstruation. (1) It occasionally happens 
 that menstruation ceases in a woman who is neither married 
 nor about to be a mother. This should not, in itself, cause 
 alarm. The reason is probably that she is anaemic, or poor- 
 blooded, and that Nature is trying to set matters right in 
 her own way. At the same time, the doctor ou^ht to be 
 consulted. 
 
 (2) In some women menstruation is accompanied by 
 much pain, headache, backache and languid feelings. This 
 may be due to neuralgia, inflammation, or some other cause. 
 For a woman who has never borne children or suffered from 
 any internal complaint requiring a medical examination, 
 the following medicine will be found useful : antipyrin, 
 30 grains; tincture of castoreum, 90 minims; liquor mor- 
 phine, 20 minims; spirit of chloroform, 40 minims; water 
 to 6 ounces. A fourth part to be taken every two hours 
 while the pain continues, but not more than four doses are 
 to be taken altogether, except by express medical advice, 
 because this medicine contains poison. Very often these 
 cases are benefited by surgical treatment in a hospital. 
 
 (3) In the few cases in which very large quantities of 
 blood are lost at each period, no home treatment ought to 
 be attempted, but medical advice obtained before severe 
 anaemia sets in. (See also "Change of Life/') 
 
 Middle-aged Man, The. " After the age of 50, the less a 
 man eats and drinks, the more healthy he is likely to be." 
 Let us see how and why this statement is true. In the 
 first place we all, or nearly all, eat a good deal more than 
 we need. We could almost certainly do all the work re- 
 quired of us on a very much smaller consumption of food, 
 and we could generally do it better without stimulants, 
 such as spirits. Now, of course, all food contains only 
 a certain amount of nourishment; the remainder of it is 
 waste matter, and has to be got rid of somehow, by kidneys, 
 and bowels, and skin, and breath. These are facts of very 
 elementary physiology, such as every child ought to be 
 
MIDDLE-AGE 193 
 
 taught at school; but, unfortunately, the majority are still 
 ignorant of them, and thoughtless about them. 
 
 While one is still young, the body will answer to almost 
 any strain that is put upon it, for a time ; and that is how 
 it is that excesses and unsuitable foods do not hurt as much 
 as might be expected. If one eats too much meat, or drinks 
 too much of that very unnecessary alcohol, the youthful 
 body strains a few points and gets over the trouble by 
 drawing on the reserve powers. In middle-age there is 
 less reserve power, and, especially in those who have been 
 careless or dissipated in youth, the body finds it difficult or 
 impossible to get rid of the waste matters in the food. 
 
 Again, in middle-age we are too ready to take less exer- 
 cise, to ride instead of walk, and, worst of all, to find our 
 chief pleasure in eating and drinking. We are apt to get 
 stout, and, as we grow more and more self-indulgent, we 
 get fatter still. This is so common that it is, unfortu- 
 nately, looked upon as quite "natural" to get fat in middle- 
 age. The French have a proverb which means, ' * To get fat 
 is to grow old," and it is often true. But the getting fat 
 is not the worst thing that may happen; and, as a fact, 
 many people admire fleshiness in middle-aged people. The 
 storage of waste matters, due to eating too much, in middle- 
 age especially the eating of much animal food, and the 
 drinking of sweetened alcoholic drinks leads to about half 
 the headaches, backaches, rheumatics, and gout of the 
 middle-aged. 
 
 By the time one reaches middle-age one ought to have 
 stored up a supply of energy enough to carry one on 
 through life. After 50, the only food taken ought to be 
 just enough to keep one going, and not so much as to leave 
 waste matters in the system, to produce headaches, and 
 rheumatism, and gout. Much meat and alcohol are the 
 two chief offenders. The middle-aged man or woman can- 
 not only do well with very little of them, but will actually 
 enjoy life better in every way with as little as possible of 
 them. He will have a clearer mind and more active body 
 if he takes only what he requires to keep up a fair weight. 
 Let those of our middle-aged readers who have tried this 
 plan bear witness to our truthfulness. 
 
 In conclusion, we warmly recommend all middle-aged 
 people, married or single, male or female, to read the valu- 
 
194 MILK 
 
 able book by Sir Henry Thompson, entitled, Diet in Rela- 
 tion to Age and Activity. 
 
 Milk, Of any one factor in the maintenance of the health 
 of a family, the milk supply is without doubt the most 
 important. It may be very good and an important fac- 
 tor in the growth of a healthy family. It may be very poor 
 and responsible for much disease and ill-health. 
 
 Cow's milk, containing all elements of nutrition, is an 
 ideal food. It is therefore destined to be almost univer- 
 sally consumed in vast quantities by man whatever his 
 environment or mode of living. But unfortunately milk 
 is also an unusually favorable soil for the growth of bac- 
 teria, the pathogenic varieties of which are man's most 
 insidious enemies, to be feared and fought as were the wild 
 beasts of the forest by our primeval ancestors. 
 
 In the various processes of handling and transportation 
 which milk for city supply undergoes between its produc- 
 tion and consumption there lurks the danger of contamina- 
 tion at every step, even assuming that the milk was free 
 from disease germs when drawn from the cow. Great as 
 is the danger under ordinary conditions, it has been enor- 
 mously increased by the progressive lengthening of the 
 time that elapses between production and consumption. 
 
 As our modern cities grew, the source of milk supply, 
 as of all food supply, was pushed out into wider and wider 
 encircling areas until now the inhabitants of a large urban 
 community must frequently wait a day and a half, or two 
 days after the milk is produced before it reaches their 
 tables. For it must be realized that the 2,000,000 quarts of 
 milk which New York City, for example, consumes a day, 
 comes from 44,000 farms situated in seven different States, 
 and some of this milk travels 400 miles before it reaches 
 the consumer. 
 
 The commoner diseases which may be transmitted by 
 milk are typhoid and scarlet fever, tuberculosis, diphtheria 
 and summer diarrhea. 
 
 The methods of avoiding diseases transmitted in this 
 way are by cleanliness and precautions at the dairy to pre- 
 vent the milk being contaminated; and destruction of the 
 germs in the milk a short time before it is consumed. 
 
 If a choice can be exercised in the source of a milk sup- 
 ply, procure milk from a dairy which is inspected properly 
 and kept in a sanitary condition. Milk should only be used 
 
MILK 195 
 
 from cow's proved to be free from tuberculosis by the 
 tuberculin test. Of milk from dairy supplies not so con- 
 trolled 10 per cent, is found to contain tubercle bacilli and 
 can produce tuberculosis in children. 
 
 Milk should be kept cooled from the time it is produced 
 until it is consumed, except during the few minutes when 
 it is being pasteurized. This is one of the most important 
 factors in preventing the growth of bacteria. Milk which 
 has been collected and handled under the best conditions 
 may have only 5,000 bacteria per cubic centimeter when 
 sold. 
 
 A bacterial count of 10,000 per cubic centimeter is very 
 good for bottled milk the average being from 10,000 to 
 100,000. The bacterial count for milk in cans runs from 
 100,000 to 40,000,000 per cubic centimeter. 
 
 The advantage of using bottled milk is therefore seen at 
 a glance. 
 
 When so many bacteria constantly occur in milk, and as 
 the danger is so great that among these numerous bacteria 
 some will be disease-producing ones, the only way to make 
 milk safe to drink is by pasteurizing it. Many large deal- 
 ers are now doing this by exposing milk in bulk to a tem- 
 perature of 140 F. for twenty minutes and bottling it 
 immediately in sterile bottles. All milk not thus treated 
 should be pasteurized at home. This can be done conven- 
 iently by the use of the Freeman pasteurizer by which 
 milk is maintained at a temperature of 75 C. for 30 min- 
 utes. This does not render the milk absolutely sterile or 
 kill all the spores, but it kills practically all the disease 
 germs and is sufficiently effective to check fermentation. 
 
 Pasteurized milk should not be kept more than 24 hours. 
 
 In the home milk should constantly be kept cool and in 
 sealed bottles to prevent the access of flies a most danger- 
 ous source of contamination. 
 
 Shun as you would poison milk which has been obtained 
 in small quantities from a can in a dirty retail grocery 
 store where little or no attempt has been made to keep the 
 milk iced or to prevent the access of flies. 
 
 Milk, Artificial Human. (See also "Infant Feeding.") 
 Every child ought to be breast-fed for the first six or eight 
 months of its life. For the first three days the milk is not 
 very good, but the child ought to be put to the breast both 
 because that stimulates the breast into action and because 
 
196 MIND FAILURE 
 
 the milk purges the child a little. No other food is neces- 
 sary or ought to be given. When the flow of milk is well 
 set up the baby ought to be put to the breast at regular 
 intervals of from two to three hours during the day, for 
 ten minutes at a time, and less frequently during the night. 
 No crying on baby 's part ought to make a difference in this. 
 But if the mother cannot suckle, the child must have a wet- 
 nurse, or artificial food. The milk of mares and asses most 
 nearly resemble the milk of women. Cow's milk pure 
 needs the addition of water, cream and sugar to make it 
 anything like human milk in digestibility. 
 
 The shape and make of baby's bottle are important. Two 
 bottles ought to be in use, and the one not in use ought to 
 be lying in concentrated boric acid solution, to "sterilize" 
 it free from all germs. The boat-shaped bottles are the 
 best; there must be no india rubber tube. The Ballin 
 baby's bottle is to be warmly recommended. It can be 
 obtained through any chemist. 
 
 Even if there is no epidemic of any sort about, milk, 
 even if obtained with the greatest precautions, may con- 
 tain some disease germs such as the typhoid or diphtheria 
 bacilli, the germs of tuberculosis, summer diarrhea or of 
 septicaemia. 
 
 Danger from all these sources is obviated if the milk 
 is pasteurized before it is given to the infant. It should 
 be pasteurized in small bottles sealed with cotton and served 
 in these same bottles as soon afterward as possible. 
 
 The Freeman pasteurizer is one of the simplest and most 
 practical. Many milk companies are now selling pasteur- 
 ized milk. 
 
 Mind Failure. All diseases of the mind and failures of 
 the intellect are becoming more common every year, and 
 although our present day medical men know more accu- 
 rately how to treat insane persons, yet our asylums become 
 more and more crowded, and extra asylums for lunatics 
 are built every year. There are two chief reasons given 
 for this increase of lunacy one is the high pressure at 
 which we now live (see "Simple Life"), and the other is 
 the widespread prevalence of intemperance. Nearly three- 
 quarters of all mad persons who have not inherited insanity 
 have drunk to excess. 
 
 A man may be said to be insane when his conduct con- 
 tinues to be markedly out of touch with his surroundings 
 
MISCARRIAGE, CAUSES OF 197 
 
 and with his neighbors' ways. Physicians are often able 
 to detect the signs of a coming attack of madness before 
 they are noticeable by other persons. It is not usual for 
 madness to appear quite suddenly, except when persons 
 mad with drink get delirium tremens, and then pass on 
 into the state of mania. Neglect of suitable treatment in 
 the early stages of insanity defers the time of recovery 
 in a very marked manner. Epileptic persons, after a long 
 course of fits, are very apt to drift into madness. 
 
 Insane persons fall into several classes, as, for example : 
 
 (1) Maniacs characterized by excitement, violence, and 
 passions, want of sleep, causeless attacks of anger, neglect 
 of duties, and distrust of relatives and friends ; disordered 
 reason and confusion of ideas. Such patients are often 
 mischievous, and will injure their friends and attendants. 
 
 (2) Melancholies. These are in a state of sadness and 
 gloom ; they despair of all things, often refuse food, will 
 not talk to others, and sit alone in solitude. (3) Demented 
 persons. These have lost whatever intellect and mental 
 power they may have had ; they are weak-minded, like chil- 
 dren ; have dirty habits, and cannot understand the common 
 decencies of life. Memory is lost, not so much of the great 
 events of their lives, but of the happenings of the last few 
 hours. (4) Monomaniacs, who have peculiar ideas, de- 
 sires and actions in some special direction. For example, 
 some think of nothing but religion, others only of love- 
 making; others, again, are possessed with the wish to set 
 fire to buildings ; others seek to kill men and women around 
 them; and a last class are suicidal. (5) The fifth class are 
 sufferers from paralytic insanity a disease which runs a 
 short course, and is shown by a gradual onset of palsy, 
 accompanied by insane thoughts and actions. In these 
 cases the sufferers are often full of self-esteem, and think 
 themselves gods, and kings, or millionaires; they lose the 
 power of speech, and in a gradual manner paralysis spreads 
 all over their limbs; they become mere animals, and sink 
 into death. (See also ''Madness.") 
 
 Miscarriage, Causes of. By miscarriage is popularly 
 meant the birth of a child long before its time, and before 
 the pregnancy is seven months old. 
 
 About 37 per cent, of child-bearing women miscarry be- 
 fore they are thirty ; and it is commonest before the fourth 
 month. The causes may be classified : 
 
198 MOSQUITOES 
 
 (1) Causes due to the father syphilis, malaria, etc.; 
 
 advanced age. 
 
 (2) Causes existing in the mother syphilis and fevers, 
 
 jaundice, albumin in urine (kidney disease), 
 severe morning sickness; too long suckling of 
 previous child ; severe rheumatism ; mental shock 
 or worry; diseases of the womb; heart or liver 
 disease ; direct violence. 
 
 (3) Causes in the unborn child its death ; its strangu- 
 
 lation in the womb. 
 
 Abortion. To "procure an abortion" is to cause a child 
 to be born before its due time ; and this is a serious crime, 
 whether committed by the mother who bears the child or 
 by any other person except the doctor. A properly quali- 
 fied medical man may induce premature labor, if, after 
 consultation with another medical man, he decides that to 
 allow pregnancy to continue until full term would prob- 
 ably or certainly prove fatal to the mother. But in any 
 case the proceeding is a violation of nature, and is very 
 often followed by chronic ill-health. There are certain 
 drugs sold by unscrupulous herbalists to women for the 
 purpose of abortion. Not only do they fail in their in- 
 tended effect, but they invariably produce local disturbance, 
 and sometimes even lifelong illness. The advertisements of 
 such unscrupulous and heartless quack medicine vendors 
 are easily recognized, as they generally profess to "remove 
 obstructions. ' ' 
 
 Mortification. (See ' ' Gangrene. ") 
 
 Mosquitoes. It has recently been discovered that certain 
 kinds of mosquitoes are the sole means of the transmission 
 of malaria. 
 
 Other diseases which they are capable of transmuting in 
 southern climates are yellow fever, break-bone fever, and 
 filariasis the cause of elephantiasis. 
 
 When we reflect how simple are the precautions necessary 
 to annihilate this pest, and how effective when carried out 
 properly, we realize that there is no excuse for anyone get- 
 ting malaria or these other diseases. 
 
 They may be gotten rid of by three methods drainage, 
 kerosene, or fish which devour their larvae. 
 
 Mosquitoes cannot breed except in water. Therefore, if 
 stagnant water is done away with there can be no mos- 
 
MUMPS 199 
 
 quitoes. The eggs are laid on the surface of the water 
 and hatch out as little black wrigglers which live in the 
 water for several weeks until they finally become trans- 
 formed into mosquitoes. 
 
 The following are the methods used to prevent their 
 breeding : 
 
 Ditching to drain stagnant pools, puddles or marshes. 
 Clear away old cans, pans which collect water, and repair 
 gutters in which water collects. Screen barrels, tanks 
 and cisterns. Weeds and shrubbery in which the mos- 
 quitoes can find a dark, cool place to hide during the hot 
 part of the day, or when the wind blows, should be cut 
 down. 
 
 When pools of water cannot be drained, it is an easy 
 matter to kill all young mosquitoes in them by pouring a 
 little kerosene on the water. If the kerosene is washed 
 away by rains it must be renewed in ten days, before any 
 mosquito eggs have been developed into adult mosquitoes. 
 
 Minnows, goldfish and other fish feed on the mosquito 
 larva?, so by introducing these into a pond the number of 
 mosquitoes that breed there may be greatly lessened. 
 
 Whenever a person is suffering from malaria or yellow 
 fever he should be screened so that he cannot be bitten by 
 mosquitoes which may become infected and later, by biting 
 other people, convey the disease to them. 
 
 Mothers 5 Marks. (See "Birthmarks.") 
 
 Mucous Membranes. The mucous membrane is practi- 
 cally to the inside of the body what the skin is to the 
 outside. It is the thin lining of the inside of the body, 
 of the inside of the mouth and lips and nostrils, and of 
 the rectum and of the urethra, and of the womb. It is 
 always moist, because it is lubricated with mucus; and 
 pink, because it is so thin that you can see the color of 
 the blood through it. (See "Polypus.") 
 
 Mumps. This is a very contagious ailment, occurring 
 only once in the same individual, as a rule about two or 
 three weeks after exposure to the infection. The patient 
 first feels "out of sorts," and has a rather sore throat. 
 Then comes swelling of the gland round and below the 
 lobe of the ear, and then of the glands beneath the jaw 
 on each side. There are feverishness and faceache too, 
 and the patient cannot chew or swallow properly. These 
 symptoms subside in about a week and then convalescence 
 
200 NERVOUS DEBILITY 
 
 begins ; but in some cases this stage is unpleasantly marked 
 by swelling of the testicles (in males), or of the breasts 
 and ovaries (in females), and rarely these temporary 
 swellings may result in atrophy (wasting away) of one of 
 the organs affected. 
 
 Patients with mumps ought to be isolated so that other 
 children do not catch the disease, and they must not be 
 allowed to mix with their companions again till after four 
 weeks have elapsed from the beginning of the disease. No 
 special treatment is required, except that dictated by 
 commonsense. Poultices may be needed to relieve the face- 
 ache, and a doctor should be called in if the testicles or 
 breasts become swollen. 
 
 Mussels. Unwholesome mussels may cause nausea, vom- 
 iting, and severe purging, leading to rapid exhaustion. 
 These poisonous effects may arise either from the mussels 
 being stale and decaying, or from their having been col- 
 lected out of water rendered impure by sewage contamina- 
 tion, or because they have grown upon timber containing 
 copper nails, or sheathed with copper as often occurs in 
 docks and locks. The poisonous material needs to be re- 
 moved by vomiting, so give emetics (see list) of ipecac- 
 uanha, zinc sulphate, mustard and water, and also a brisk 
 purgative dose when the sickness is over, such as castor oil 
 (two tablespoonfuls), or black draught of Epsom salts and 
 senna; if there is much collapse, brandy (a tablespoonful 
 in a little water, repeated in 15 minutes) will be needed. 
 
 Nervous Debility. A great number of people are always 
 complaining of being weak and nervous; indeed, the state 
 of nervous debility seems to be the most common of all 
 ailments nowadays, and the young, who ought to be strong, 
 seem to suffer more often than those who are past middle 
 life and might reasonably be expected to be feeling the 
 weakness of old age gradually coming on. 
 
 There are hundreds of quack medicines which are war- 
 ranted to cure this state of ill-health; but we fear that 
 they are not very successful. The symptoms of this nerv- 
 ous weakness as recounted in advertisements are general 
 weakness, and loss of appetite, headaches, and sleeplessness; 
 indigestion, flushings of heat in the face, and coldness of 
 the feet and hands; nervous tremblings, and a feeling 
 of timidity and bashfulness before strangers. This is a 
 long catalogue of very indefinite symptoms, and if you 
 
NETTLERASH 201 
 
 really are weak and nervous and have some of these symp- 
 toms, you can readily fancy all the others. Nervous per- 
 sons can fancy almost anything they hear spoken of, and 
 many people of that sort fancy they have heart disease 
 all their lives without having anything at all the matter 
 with their hearts. Such people generally have "wind in 
 the stomach, ' ' and they fancy that the pain comes from the 
 heart. Nervous debility can generally be cured more read- 
 ily by leading a simpler life, with a proper share of whole- 
 some food, ample open-air exercise, and cold baths than 
 by any tonic or medicine, however much advertised, pro- 
 vided the patient will avoid the pleasant dangers of drink- 
 ing and over-much smoking. Sensible people who have no 
 actual disease of any organs can be their own doctors, but 
 when there is actual organic disease sensible persons will 
 not attempt to treat themselves. If you feel nervous de- 
 bility, examine yourself, and consider what kind of life 
 you have led, and what has caused your weak state. Is it 
 from any excesses, or late hours, or want of fresh air? 
 Or is it from irregular meals, or from cigarette-smoking, 
 or from an unhealthy home ? Or is your weak state heredi- 
 tary has it come down to you from your parents? In 
 any case, remove the cause, if you can find it. Women 
 are often weak and ailing from drinking too much tea, or 
 from drinking tea habitually which has been made too long 
 before use, for in that case the hot water has soaked much 
 tannin out of the leaves, and tannin injures the coats of 
 the stomach, and lessens the appetite. There are occasions, 
 no doubt, when a short course of tonic medicines, such as 
 quassia, gentian, cinchona bark, and quinine, will do much 
 good; but do not rely on them too much, nor continue to 
 take them too long. Live as simply and naturally as pos- 
 sible, and avoid drugs as much as you can, and do not take 
 to drops of wine and spirits to keep you up, because they 
 will gradually make you worse than ever. Rest when you 
 can, and get a change of air and scene whenever possible, 
 and spend as much time as possible in the open air and 
 sunshine (see also "Neurasthenia"). 
 
 Nettlerash. The medical name for this form of skin 
 affection is Urticaria, from the Latin name for nettle, and 
 is so called because this peculiar skin rash resembles the 
 white marks which are caused on a person's skin by being 
 stung with the leaves of the nettle plant. 
 
202 NEURALGIA 
 
 Nettlerash may occur in healthy persons as well as in 
 invalids, and is generally found to have been caused by 
 some errors in diet, or by some unwholesome food, or by 
 chills. 
 
 The characteristic signs are the appearance of bright red 
 patches or wheals on the skin; these are slightly raised, 
 but smooth and flat, and have no pimples nor vesicles on 
 them, no sores, no discharge, and no scurfiness. 
 
 The wheals are red at first, and then change a little, be- 
 coming pale and white in the middle, with a ring of pink- 
 ness around them; and as the wheal subsides the edges 
 grow pale, and are pink in the center. They vary in shape, 
 and may be seen any size, from a threepenny piece to the 
 size of the palm. A patch may last only an hour, or per- 
 haps for a day, or even longer. The wheals burst out 
 quite suddenly, and are accompanied by a feeling of heat 
 and by itching. Scratching gives only momentary relief, 
 and in some cases fresh wheals show up wherever the skin 
 is scratched. 
 
 The attack may be quite local, or it may be accompanied 
 by feverishness. The rash may last for days, fresh crops 
 coming out every few hours. Chronic cases are sometimes 
 seen, in which there may be occasional crops of skin rash 
 every few days for months or years. 
 
 This disease occurs chiefly in persons of a nervous tem- 
 perament, and is often found to accompany asthmatic at- 
 tacks. Persons who are habitually intemperate frequently 
 suffer from it, and so do gouty persons. It is very com- 
 mon among infants. Violent emotions of the mind, pas- 
 sions, and terror may bring on an attack, especially in 
 children. Unwholesome food is, however, the usual cause; 
 tainted meat, high game, shellfish, such as mussels and 
 oysters, crabs and lobsters, and mushrooms, are among the 
 commonest irritants which disorder the stomach and in- 
 testines, and bring out a nettlerash; and, lastly, children 
 with worms often suffer. As to treatment, of course the 
 first necessity is to find out and remove the cause; if it 
 comes out directly after suspicious food, give an emetic; 
 if later, give a sharp purge of black draught. For some 
 days take low diet, and a rhubarb and soda mixture, and 
 apply eau-de-cologne as a lotion, or zinc ointment. 
 
 Neuralgia. "Neuralgia," said a wise physician, "is the 
 prayer of a nerve for healthy blood." From this we learn 
 
NEURALGIA 203 
 
 that the real cure for neuralgia lies in the improvement 
 of the general health of the body, and not in rubbing in 
 something to ease the pain though that is necessary- 
 enough sometimes. Neuralgia is not a disease, but a sign 
 of disease, of some organ or nerve. Every doctor does his 
 best to discover the cause of the neuralgia first. In the 
 meantime, until he has found it he relieves the pain as 
 much as he can. 
 
 Ancemia is a great cause of neuralgia. If a woman is 
 anemic, let her try the following medicine for her neuralgic 
 pains : Reduced iron, 4 grains ; arseniate of iron, y 8 grain ; 
 sulphate of quinine, 1% grains; ingredients for one pill. 
 Take one of these pills after each meal (thrice daily) and 
 two at bedtime. Continue this for a month or more. But 
 the bowels must be kept freely open every day all the time ; 
 otherwise the pills will be useless. 
 
 Gout, Rheumatism and Syphilis are very common causes 
 of neuralgia. Of course, they must be dealt with accord- 
 ing to their nature in each case. Lead poisoning is another 
 frequent cause. 
 
 The local treatment of neuralgia is important. We shall 
 give here several useful formulae, reminding the patient 
 once again that it is wise to consult a doctor first of all, 
 and find out from him what is likely to be the cause of the 
 neuralgia, and what steps ought to be taken. These re- 
 marks apply specially to the dentist as well. 
 
 The fact that there are hundreds of recognized medicines 
 in daily use (in treating neuralgia), as well as hundreds 
 of quack remedies which are all said to "cure" without 
 delay, will prove to the reader that the treatment of neu- 
 ralgia is difficult in very many cases. We hope that some- 
 thing in the following list may be useful to sufferers who 
 have failed to obtain relief from either doctors or quacks, 
 and who are willing to take the risks which must always 
 fall to the lot of those who "pour medicines, of which they 
 know little, into bodies of which they know less. ' ' 
 
 For Neuralgia of the face and brow. Morphine hydro- 
 chlorate, y$ grain; sulphate of quinine, 5 grains; chloride 
 of ammonium, 15 grains (contains poison). Mix, and 
 make a powder, to be swallowed in a cachet twice a day. 
 (Requires a doctor's prescription.) 
 
 For Neuralgia of the gums and jaws. Tincture of gel- 
 semium, 15 minims; water to one ounce. Make four such 
 
204 NEURASTHENIA 
 
 doses. Take two tablespoonfuls of the medicine every six 
 hours. (Should not be taken without a doctor's advice.) 
 
 For General Neuralgic or Rheumatic Pains. Fellowes' 
 sirup of the hypophosphites. Liniments to be rubbed into 
 the painful spot: Linimentum Aconiti (poisons if taken 
 internally) ; or, Menthol 3, chloroform 3, olive oil enough, 
 to 16 parts; or, compound camphor liniment (poison) ; or, 
 Baume Analgesique Bengue. 
 
 If all medicines fail, recourse may be had to (1) Elec- 
 tricity, the results are generally disappointing; or, (2) 
 Operation. The various operations which have been done 
 to relieve neuralgia include nerve-stretching, nerve-cutting 
 in different ways, nerve-tearing, and nerve-ligature (ty- 
 ing). Lastly, (3) Hypnotism. 
 
 Neurasthenia is a very common complaint nowadays. 
 It is the medical word for nerve exhaustion, and it is 
 caused in different ways. The tendency of the age is to- 
 wards brain work, and brain workers therefore have to 
 contend against enormous competition. The weak-nerved 
 among them therefore break down sometimes. Then comes 
 the abuse of stimulants alcohol and tobacco, which are 
 taken to whip up the tired brain and then comes nervous 
 breakdown. The neurasthenic man or woman has usually 
 been a hard, honest worker, and when the breakdown comes 
 he tries to hide it and does not ask for sympathy. Even 
 if the breakdown is due to excesses and debauchery instead 
 of to hard work he tries to hide it, and to overcome it. 
 With hysteria, it is different. She (it is generally, but not 
 always, a woman) is idle and probably plump and well- 
 nourished, and craves for sympathy ; in fact, she will stoop 
 to almost any deception to get the pity and sympathy she 
 craves. Her aches and pains and sleepless nights are 
 mostly imaginary, though she at last begins to deceive 
 even herself, and she pities and loves herself sincerely. 
 The neurasthenic man or woman suffers from a feeling of 
 oppression at the top of the head, a poor memory, sleep- 
 lessness, irritability, fear of being in open spaces in the 
 streets, and melancholy. He may be wasted in body. The 
 two diseases, neurasthenia and hysteria, are generally quite 
 distinct, but in women both may be present together. 
 When they are distinct they differ, as we have said, in the 
 attitude of the patients towards sympathizers ; and in this 
 that hysterical women are very difficult to cure because 
 
NEURITIS, ALCOHOLIC 205 
 
 they often do not really desire to be cured, whereas neuras- 
 thenic people wish with all their hearts to be cured so that 
 they may be able to resume their work. 
 
 The proper treatment of neurasthenia requires time. 
 First, there ought to be a complete change a change of 
 scene, of air, of occupation and of faces. This partly ful- 
 fills the second requirement, which is rest, which ought to 
 be absolute. There ought to be absolutely no business 
 worries, no business letters and nothing to do but idle the 
 time away. The third requirement is plenty of food and 
 fresh air. And this method of treatment which is so good 
 for the neurasthenic is the worst possible for the hysterical 
 person. (See ''Hysteria.") 
 
 Neuritis, Alcoholic. This is fairly common, especially in 
 women who drink spirits to excess in secret. It begins with 
 pains or cramps and tenderness of the muscles, especially 
 those of the calves of the legs; and the patients, who love 
 their pet vice, prefer to believe that the pain is rheumatism ; 
 and that it is not alcohol which is making them ill. In 
 fact, they drink more alcohol to relieve the pains! Then 
 come tingling and numbness, or burning pains in feet and 
 hands, and some weakness, which may or may not become 
 actual paralysis. If the patient will leave off drinking 
 she may recover completely, but otherwise the trouble will 
 increase; and she will become suspicious and disagreeable 
 and fretful, and believe ill of everybody, and fancy that 
 people are persecuting her. It often happens that in these 
 cases the relations and friends cannot imagine what is hap- 
 pening to the patient or what makes her so ill and disagree- 
 able. A doctor will often suspect a woman of secret drink- 
 ing for months or years before he is able to find her out. 
 He may feel sure all the time that her illness is caused by 
 the spirit-drinking, and yet be unable to make her confess 
 to it. A woman who drinks to excess is the worst of liars, 
 and there is hardly a depth of meanness or deception to 
 which she will not stoop to obtain and conceal the drink 
 which is poisoning her blood. 
 
 Treatment. The first thing to do is to deprive the pa- 
 tient at once of all alcoholic liquor. This is sound treat- 
 ment, though if terrible depression follows, or vomiting or 
 delirium takes place, the patient and her friends will very 
 likely attribute the new trouble to the sudden deprivation 
 of alcohol instead of to its real cause, the alcohol itself. 
 
206 NIGHTMARE 
 
 But even though the patient protests that she will die if 
 she doesn't get more drink it must be withheld or she will 
 not recover. 
 
 There are exceptions to this rule, however, which the 
 experience of a doctor only can decide. To allay the crav- 
 ing for drink which now begins with great fury, food must 
 be given by a firm nurse every hour, or thereabouts a 
 little liquid food of some kind in small quantities at short 
 intervals. Then a teaspoonful of the following medicine 
 should be given in soda-water every hour while the craving 
 is intense : Spirit aromatic of ammonia, 4 ounces ; tincture 
 of cinchona, 2 ounces; solution of hydrochloride of strych- 
 nine, 1 drachm; tincture of capsicum, 1 ounce. (Poison.) 
 
 Then, as to the local treatment of the neuritis, rest in 
 bed is necessary, and cocaine injections under the skin very 
 often give much relief. In bad cases the sufferer must lie 
 on a water-bed. Twice a day hot fomentations ought to be 
 applied to the most painful parts of the limb, and after 
 being dried well, the limb must be wrapped in cottonwool 
 or woodwool tissue. Warm baths are often comforting. 
 When the pain is better the wasted muscles need electrical 
 treatment or massage. Note. Neuritis is not caused only 
 by alcoholic excess, though that is by far the most common 
 cause ; nor does it occur only in women. Men are liable 
 to it also, and especially those whose work brings them in 
 contact with certain chemical poisons, such as arsenic, lead, 
 mercury, silver, etc., and those who are afflicted with gout, 
 gonorrhea, syphilis, influenza, beri-beri, diabetes. (See 
 also ' ' Lead-poisoning. ' ' ) 
 
 Neurosis. This word means a ' ' nervous ' ' condition which 
 is not caused by any discoverable alteration in the brain, 
 spinal cord, or nerves. Such diseases are hysteria, asthma, 
 neurasthenia. A family is said to be neurotic when there 
 is a family history of one of the neuroses. Madness in some 
 forms is a neurosis. 
 
 Nightmare. Horrible dreams, as of falling over a preci- 
 pice, being strangled, being crushed, and so on, are gen- 
 erally due, in adults, to too much supper or to such items 
 of diet as cucumber, pastry, mayonnaise, pickles and cheese. 
 We all remember how Scrooge, in that wonderful old story 
 of Dickens', believed that Marley's Ghost was nothing but 
 a nightmare, and told him that he (the Ghost) might be 
 nothing more than an undigested bit of beef. Some adults 
 
NOISES IN THE EARS 207 
 
 have these dreams only when they sleep on their backs, 
 and they should tie an empty cotton-reel around the waist 
 to prevent their being comfortable on their backs. 
 
 Night-Terrors. These occur in nervous and excitable 
 children, especially those of precocious intelligence, whose 
 active little brains give them vivid dreams. The doctor 
 must be consulted in every case of these "terrors" in chil- 
 dren. The cause must be looked for. It may be nothing 
 more serious than the irritation of the nervous system 
 caused by teething ; or by worms in the bowels ; or by indi- 
 gestion. But the terrors may be due to some foolhardy 
 and ignorant nurse-girl who tells the children ghost stories 
 or threatens absurd punishments for naughtiness. Chil- 
 dren who are very sensitive should not be put to bed in a 
 quite dark room there should always be a night-light. 
 Adenoid growths seem to "predispose" to night-terrors. 
 No medicine should be given in these cases without the ex- 
 press orders of the family doctor. 
 
 Night Sweats. Children with rickets often perspire very 
 much at nights, especially about the head and neck. The 
 treatment is the general treatment for rickets. 
 
 Persons with consumption of the lungs sometimes wake 
 up drenched with perspiration. This is very weakening if 
 it continues long. The following pill, given at bedtime, 
 will stop the sweating in many cases: Oxide of zinc, 2 
 grains ; extract of belladonna, % 6 grain ; extract of hyoscya- 
 mus, 1 grain. To make 12 pills. 
 
 If this fails, however, try picro toxin (see "Consump- 
 tion") or give five grains of sulphonal at bedtime instead. 
 If there is diarrhea as well as sweating the patient will 
 improve on 10 grain doses of calcium phosphate. 
 
 Noises in the Ears. The treatment of these must depend 
 upon the cause, which may be wax in the ear, a polypus, 
 catarrh, decayed teeth or some other unexpected condition. 
 We can only give a prescription or two in the hope of 
 relieving some who suffer from this distressing symptom. 
 First, however, let the sufferer get the ear well cleaned out 
 by syringing with boric acid lotion. (Also see "Ear Dis- 
 eases.") 
 
 (1) Apply a blister behind the ear; or, (2) rub veratrine 
 ointment into the skin round the ear; or, (3) take ten 
 minims of the tincture of digitalis in water every four 
 hours; or, (4) take fifteen grains each of ammonium bro- 
 
208 OYSTERS, RISK OF EATING 
 
 mide twice a day. (5) Fowler's solution, 1 drachm; 
 bromide of sodium, 2 ounces ; aromatic spirits of ammonia, 
 2 ounces; camphor water to 12 ounces. Take one table- 
 spoonful of the mixture thrice daily after meals. Of 
 course, before beginning with any of these medicines the 
 sufferer will make sure by getting the advice of an aurist 
 that there is no local curable condition. 
 
 Nose-Bleeding may occur from knocks or blows, or from 
 over-fullness of the blood vessels. In moderate quantity 
 it rarely does any harm, and is checked by bathing the 
 face with cold water, while the patient sits down quietly; 
 loosen the collar, and calm him, if alarmed. The sudden 
 application of cold, such as of a cold laundry iron, to the 
 bare back between the shoulder blades, often stops the 
 bleeding by giving a shock to the nervous system. Nose- 
 bleeding may occur in women instead of some other usual 
 loss of blood, and even in pregnancy, in a similar way. 
 Some persons are born with a special liability to bleed, 
 especially at the nose. After middle-age, nose-bleeding 
 often shows a dangerous state of internal congestion and 
 averts an attack of apoplexy. 
 
 Never allow a person with nose-bleeding to hang his head 
 over a basin. Keep the head high and apply cold to the 
 nape of the neck. When simple treatment fails to check 
 nose-bleeding, it is necessary to spray the inside of the 
 nostrils with an astringent lotion, such as alum in water 
 a teaspoonful to a tumbler. In cases of violent bleeding, 
 which you cannot stop, you may paint the inside of the 
 bleeding nostril with glycerine of tannin, by a long, fine, 
 soft brush, or blow powdered alum or tannin into the 
 nostrils from an india-rubber bag, or insert a cone of cotton- 
 wool, dipped in some alum or tannin solution, into the 
 nostrils with a probe. These modes of treatment, however, 
 require skilled hands and special apparatus, so a doctor 
 should be sent for. If all these fail, the surgeon will have 
 to plug the nostrils behind as well as in front by means 
 of a special instrument called a nasal sound. 
 
 Overlaying. (See "Babies Lost.") 
 
 Oysters, Eisk of Eating. Oysters are a very nutritious 
 food, and when eaten raw are very digestible, but when 
 cooked are not suitable for invalid diet. Oysters are grown 
 in shallow sea water at certain sandy places along our 
 coasts, and there is always the risk that they may have been 
 
PAIN 209 
 
 tainted with sewage. All sea-coast towns drain into the 
 sea and very often there are currents which carry foul 
 matters along the coasts instead of more directly into the 
 ocean. Contaminated oysters cannot be distinguished 
 either by sight or smell, but when eaten may give rise to 
 attacks of typhoid fever, which may end fatally; such at- 
 tacks may not show themselves for a week or two after 
 taking the poisoned oysters. 
 
 Pain. Students of human nature will probably agree 
 with almost complete unanimity that since the world began 
 mankind's greatest curse has been pain; yet, paradoxical 
 as it may seem, very casual consideration will prove con- 
 vincingly that this same specter pain is, in reality, the 
 greatest blessing ever bestowed upon mankind. 
 
 The power of pain to emphasize the appreciation of 
 pleasure (a dictum frequently dwelt upon by the old phi- 
 losophers) may be put aside for the present, for the impor- 
 tance of pain has a much more direct bearing upon the 
 subject here at hand. 
 
 It is pain which calls the attention of the human being, 
 no matter how low in the social order, to the fact that he 
 is experiencing some abnormal condition which if not 
 heeded and corrected may result in the cessation of his 
 earthly existence. Not infrequently it is pain alone which 
 stands between him and physical annihilation if this in- 
 dicator is not heeded. For without this symptom, in many 
 inflammatory conditions of vital organs, relief would not 
 be sought until the time had long passed when hope of 
 relief from medical or surgical agencies would be of avail. 
 
 The importance of pain as a symptom, then, having been 
 established, it becomes of the greatest importance to the 
 average human being to be able to appreciate what forms 
 of pain may be trivial and capable of relief by home meth- 
 ods, and what forms are serious and demand the quickest 
 possible relief by expert agencies. 
 
 On general principles it may be stated that pains in the 
 extremities rarely immediately threaten life and may be 
 temporized with ; while pains in the trunk or head may 
 indicate the involvement of a vital organ, and any tem- 
 porizing may have fatal consequences. Therefore, in at- 
 tempting relief of such pains, the average human being 
 should feel very sure of his ground before attempting to 
 relieve such pains without expert opinion as to its cause. 
 
210 PARALYSIS 
 
 Pains may be roughly divided into the following 
 forms : 
 
 Inflammatory, neuralgic, tumors, foreign bodies such as 
 stones, pressure pains (as e. g. aneurism), chemical poisons 
 and functional pains. 
 
 Functional and neuralgic pains should only be diagnosed 
 after a process of exclusion of other forms, and rarely 
 prove fatal. Any one of the other forms, however, may 
 indicate a condition capable of resulting fatally. 
 
 The causes and treatment of the various forms of pain 
 are best considered under the various disease headings. 
 The interpretation of many pains is so complex that only 
 a trained diagnostician is competent to adjudge them cor- 
 rectly. This is emphasized by the fact that many pains 
 are "referred pains" caused by a condition remote from 
 the apparent site of the pain. Moreover, the most serious 
 conditions are not always announced by the most severe 
 pain. 
 
 Therefore, unless a pain is thoroughly understood, do 
 not delay in having its cause determined by a competent 
 medical authority, and do not belittle this "God's great- 
 est gift to man. ' ' 
 
 Paralysis. The old-fashioned English name for paralysis 
 was palsy, but this word has gone very much out of use 
 of late years. It will be found in Bible stories. The word 
 means a state of disease in which there is a loss of muscular 
 action, a loss of power to move some part. Thus, for 
 example, there are facial palsies, in which the face muscles 
 have lost their uses, and the face on one side, or both, is 
 expressionless. Another variety is seen in painters and 
 others who have lead colic; in such patients we may find 
 a partly useless hand or a dropped wrist. The most com- 
 mon cases of paralysis are, first, those cases called Hemi- 
 plegia, in which one side of the body, one arm and leg, are 
 palsied, and, secondly, Paraplegia, in which both legs are 
 palsied, but not the arms. The first is due to brain mis- 
 chief, either softening of the brain or bleeding into the 
 brain; the second is caused by disease or injury to the 
 spine. Either of these diseases may be recovered from in 
 some cases, but in others a fatal result ensues. Simple 
 palsy of one side may last for years, and never improve; 
 some such cases remain bedridden all a lifetime. We can- 
 not say that any medicines have power to cure palsies, ex- 
 
PERSONAL HYGIENE 211 
 
 cept those caused by syphilis, and when cases recover it is 
 "Nature" which effects the cure. 
 
 Hemiplegia, or paralysis of one side, is generally of sud- 
 den onset, coming on with an apoplexy, commonly called 
 a fit, or a paralytic stroke. (See "Apoplexy.") In such 
 cases a blood vessel has burst in the brain. If of slow 
 onset, it is due to the "softening" or decay of some spot 
 in the brain. A sudden loss of the senses occurs often ac- 
 companied by a fall; the patient cannot be roused, as he 
 can from a faint ; also, instead of the pale face, seen in one 
 who has fainted, there is often a purple tint of face, with 
 difficult noisy breathing. One cheek hangs loose, and the 
 other cheek is drawn aside ; there may be a squint, and one 
 eyelid may drop uselessly. The patient is unable to speak, 
 from part of the tongue having lost its power ; saliva often 
 dribbles away. When the insensibility passes off it is 
 found that the arm and leg of one side cannot be volun- 
 tarily moved; they may be flabby or stiff. Some cases die 
 even in the moment of the fit ; others live for hours or days, 
 and die without regaining consciousness ; the result depends 
 upon the situation and amount of the brain mischief. 
 When this is slight the signs of recovery may come on very 
 soon, and complete disappearance of all the symptoms may 
 ensue in a few days or weeks. But in the majority of cases 
 some weakness (called Paresis) is left, even if there is no 
 definite palsy, and the patient is an invalid who has to 
 take great care of himself for the rest of his life. Elec- 
 tricity and massage may be necessary, but not very much 
 good is to be hoped from electrical treatment. Massage of 
 a paralyzed limb is always grateful to the sufferer. The 
 possibility of a second attack has to be borne always in 
 mind, and the patient should particularly avoid excess of 
 alcohol and should live on a very light diet. 
 
 Paraplegia is commonly the result of spinal disease, espe- 
 cially in children. And there is another type of paraplegia 
 (paralysis of the legs) with spasm added to it. Nothing 
 can be gained from dealing more fully with these subjects 
 in this book. (See also "General Paralysis.") 
 
 Pathology. This is the science which treats of the 
 changes produced in the body by disease. 
 
 Personal Hygiene. Man's health is maintained by car- 
 ing for the condition of his body and his environment. 
 To the latter the term sanitation is usually applied. 
 
212 PERSONAL HYGIENE 
 
 Hygiene implies a somewhat closer association with the 
 body, and by personal hygiene is meant care of the body 
 which will improve its physical condition and prevent the 
 contraction of disease. 
 
 Personal hygiene is a large subject and can be dealt with 
 fully only at great length; but there are a few rules of 
 right living which may be conveniently mentioned in brief 
 the observance of which would do much to diminish the 
 amount of sickness and ill health. 
 
 Skin. This is a protective against the entrance of germs 
 into the body and assists in the purification of the blood 
 and the regulation of the loss of heat from the body, mainly 
 by perspiration. 
 
 It is important to keep the skin clean because dirt in- 
 terferes with perspiration and the other skin functions, 
 favors skin blemishes, boils and abscesses, and the harbor- 
 ing of parasites and germs of disease. 
 
 To this end a daily cleansing bath of hot water with 
 soap is advised preferably at night. 
 
 Mouth. The mouth harbors many of the germs of dis- 
 ease even when the person feels perfectly well. If any- 
 thing occurs, however, to lower this person's resistance to 
 disease as e. g., chilling these germs may obtain a foot- 
 hold and cause disease. Therefore efforts should be made 
 to keep the mouth as germ free as possible by the use sev- 
 eral times daily of some pleasant mouth wash or antiseptic 
 such as listerine, glycothymoline, borine, alkalol, borolyptol 
 or alkaline antiseptic fluid of the pharmacopeia. 
 
 Lungs and Nose. The air of cities is full of germ-laden 
 dust. To prevent the entrance of this dust into the lungs 
 breathing should be done entirely through the nose where 
 there is a filtering apparatus capable of removing dust im- 
 purities from the inspired air. 
 
 The air thus inspired is also warmed before it reaches 
 the lungs. 
 
 Dust which is removed from the air by the nasal filter 
 should be removed from the nose at least twice a day by 
 the use of a nasal douche containing a weak antiseptic 
 solution such as dilute glycothymoline, alkalol or boracic 
 acid. 
 
 If the nasal passage is obstructed, the obstructions should 
 be removed. The commonest form of obstruction in the 
 naso-pharynx is lymphoid tissue or adenoids. 
 
PERSONAL HYGIENE 213 
 
 Signs of obstruction are open mouth, a vacant, unin- 
 telligent expression, snoring, frequent colds and nasal dis- 
 charge, mental dullness, deafness and cough. 
 
 For the proper development of the chest and lungs deep 
 breathing is strongly recommended. 
 
 Stomach and Intestines. The first great rule of diges- 
 tion is not to eat too much. The simple articles of diet 
 are the best. Temperance in the use of alcoholic drinks is 
 highly recommended. 
 
 The intestines should be emptied every day or two. 
 Laxatives may be necessary, but the natural means are 
 preferable. These consist in the use of articles of diet 
 which have a coarse residue and in exercising the abdom- 
 inal muscles. Enemas may prove a useful adjunct. 
 
 Digestive ferments to aid digestion are not recommended 
 for continuous use. Healthy out-of-door exercise is the 
 best appetizer. 
 
 Hair and Nails. Disease germs are readily harbored 
 beneath the nails. They should be kept short and cleaned 
 daily with a small sharpened piece of wood which is to be 
 immediately destroyed. 
 
 The hair is a prolific gatherer of germs. It should be 
 washed at least once a week and the scalp rubbed at the 
 same time. 
 
 Ringworm and lice are the two most common parasitic 
 diseases of the scalp and hair. The former requires treat- 
 ment by a physician. 
 
 To remove lice cut the hair short and apply a mixture 
 of equal parts of olive oil and kerosene twice a day for 
 several days. 
 
 Hearing. The most common causes of defective hearing 
 are adenoids, wax in the ears and inflammation or abscess 
 in the middle ear from inflammation or disease of the nose 
 or throat. Wax and adenoids should be removed. 
 
 Early attention to diseased throat and nose conditions 
 will often prevent permanent deafness. 
 
 Eyes and Vision. The eye conditions requiring atten- 
 tion are ophthalmia, trachoma, conjunctivitis, and func- 
 tional diseases from eye-strain. 
 
 Most ophthalmias occur at the time of birth and can be 
 prevented by dropping a drop of 1 per cent, solution of 
 silver nitrate into the eyes of the new-born child. 
 
 Trachoma is a contagious disease requiring medical 
 
214 BATHS 
 
 treatment. It can be avoided by avoiding people who are 
 suffering from it. 
 
 Conjunctivitis usually occurs from over-strain or from 
 dust which gets into the eyes. 
 
 Daily use of a % per cent, solution of boracic acid will 
 relieve it. 
 
 Eye-strain can be avoided by avoiding too continuous 
 eye work, fine and indistinct work, faulty lighting of the 
 room, and bad posture in reading or writing. 
 
 Nervous system. Hygiene of the nervous system is more 
 or less complex. It consists largely of avoiding worry and 
 strain and maintaining a good reserve force of the body. 
 The latter is accomplished by proper food, sufficient sleep, 
 exercise and daily baths, with occasional vacations. 
 
 Cheerfulness, happiness and avoidance of irritation are 
 great aids in the maintenance of a healthy nervous system. 
 
 Sleep and Rest. The amount of sleep required varies 
 with the person and his work. The child usually requires 
 from 10 to 12 hours of sleep ; the young adult about 9 ; 
 the adult of middle life usually finds 7 to 8 sufficient, while 
 old people can usually do with less. 
 
 Sound, refreshing sleep is favored by a well-ventilated 
 room (all the windows should be open), absolute quiet, 
 darkness and a warm bed. 
 
 Baths. Warm baths cleanse the skin and thus promote 
 its healthy functions. They may be taken weekly, bi- 
 weekly, or even once a day preferably always at night. 
 Warm baths have a temperature of 85 to 100 F. Hot 
 baths range from 100 to 110 F., and should usually be 
 followed by cold sponging or a cold shower. 
 
 Cold baths are not cleansing, but have a stimulating and 
 tonic effect and reduce the liability to catch colds. They 
 should be taken every morning. Cold shower baths are 
 more invigorating than cold tub baths. 
 
 Swimming baths provide physical exercise and promote 
 health. Salt water baths are usually more invigorating 
 than fresh water baths. 
 
 Turkish, Russian and hydro-therapeutic douches are ad- 
 mirable tonics though to be classed as luxuries. 
 
 Baths should not be taken too soon after meals, because 
 digestion may be lessened or entirely stopped by the blood 
 being called from the stomach to the skin and muscles. 
 In cold baths the head should be immersed first to avoid 
 
TEMPERANCE 215 
 
 increasing the blood pressure in the brain too greatly, 
 which might result if the body were gradually immersed 
 from the feet upward. 
 
 Clothing. The best rules for clothing are those which 
 ordinary intelligence dictates. Simple general rules are to 
 keep the head cool and the extremities warm; avoid tight 
 constricting bands; and wear cool clothing in summer and 
 warm clothing in winter. 
 
 For summer wear the light colors are preferable, and 
 cotton and linen fabrics will generally be found the coolest. 
 
 For winter wear wool, silk and fur are the warmest. 
 Underclothes of wool are the warmest and those introduced 
 by Jaeger are the most comfortable and serviceable. 
 
 The much condemned corset of women's wear is un- 
 doubtedly harmful if for no other reason than that it 
 interferes with free respiration as well as exerting pressure 
 on the abdominal viscera and producing constipation. 
 
 The most important sanitary precaution to preserve in 
 reference to clothing is that of cleanliness. While dark 
 clothing does not show dirt as well as light it accumulates 
 just as much, and should be cleaned just as often. The 
 greatest precautions in regard to cleanliness are required 
 in the case of those articles of clothing worn next to the 
 skin. 
 
 Exercise. (See "Exercise and Recreation.") 
 
 Temperance. The long-continued, immoderate use of 
 alcohol leads to degenerative changes, primarily in the 
 stomach and liver, and at a later period in the kidneys, 
 lungs, brain and blood vessels. The degeneration is char- 
 acterized by increased growth of interstitial fibrous tissue, 
 which in course of time shrinks and causes atrophy of 
 gland cells and loss of function. Chronic catarrh and 
 cirrhosis of the stomach with cirrhosis of the liver, followed 
 by dropsy and hemorrhage, are the well-recognized results 
 of alcoholic intemperance. 
 
 The effect of such intemperance in shortening life is now 
 universally recognized. Statistics bear overwhelming evi- 
 dence on this point. It may be stated generally that the 
 mortality of the intemperate is from four to five times 
 greater than that of the strictly temperate of the same 
 age and in the same class of life. 
 
 All evidence points to the fact that alcohol, except in 
 strict moderation, is injurious to men who are exposed to 
 
216 SEX HYGIENE 
 
 extremes of climate (great heat and great cold), or who 
 have to undergo great bodily or mental labor. Its effect 
 on the circulation is distinctly injurious to those engaged 
 in hard bodily work, for it causes the heart to do more 
 work without conferring any counterbalancing advantage. 
 
 In strictly moderate doses alcohol has not been proved 
 to do any harm; and, taken in the form of beer or wine, 
 many of the inhabitants of our large towns find it a useful 
 aid to digestion and assimilation. But it must be remem- 
 bered that there are idiosyncrasies as regards alcohol, and 
 that what is harmless to one individual may be injurious 
 to another. For thoroughly healthy people, alcohol in any 
 form presents no advantages, and for children and young 
 people it is decidedly injurious. 
 
 Worse than all other dangers from alcohol is the danger 
 of the alcohol habit. This invariably leads to loss of effi- 
 ciency, dependence, insanity or even worse. 
 
 Sex Hygiene. The defective or degenerate of the human 
 race should not be allowed to propagate. 
 
 To produce healthy children and ones not prone to dis- 
 ease, both parents should possess good constitutions, and 
 they should take great care not to weaken these by excess 
 of any kind, physical or mental. In this climate the proper 
 age for marriage is considered to be about twenty-four or 
 twenty-five for the man, and nineteen or twenty for the 
 woman. 
 
 A disease may be hereditary as syphilis or only a pre- 
 disposition may be hereditary, as in the case of tuberculosis. 
 
 Marriage between relatives is reprehensible the danger 
 increasing with the nearness of the relationship. 
 
 Before a marriage is contracted it should be a certainty 
 that neither party is suffering from syphilis or gonorrhea. 
 Other diseases which are very liable to reappear in the 
 offspring, especially if present in both parents, are scrofula, 
 gout, hysteria, epilepsy, insanity, some physical deformi- 
 ties and skin diseases and criminal tendencies of various 
 kinds. 
 
 Unhygienic Habits. There are certain unhygienic habits 
 which need but to be once called to the attention to be 
 discontinued. 
 
 Such are the following : 
 
 Putting articles into the mouth such as pencils, coins, 
 
PILES 217 
 
 candy, chewing gum or any other object that has been in 
 the mouth of another person. 
 
 Allowing the unwashed fingers to touch the face, eyes or 
 lips. 
 
 Spitting, or coughing and sneezing without protecting 
 the mouth with a handkerchief. 
 
 Washing the teeth in a wash basin which is used by 
 other people for washing purposes. 
 
 Allowing children to play in the dirt. 
 
 Careless disposal of excreta. 
 
 The use of a common drinking cup and the drinking of 
 impure water. 
 
 Kissing babies on the mouth. 
 
 Perspiration. (1) Offensive (sweating feet). The feet 
 of dyspeptic people often smell offensively, especially if 
 they have to stand a great deal. In these persons the arm- 
 pits also are apt to be very offensive. The digestion must 
 be attended to first; and the armpits and feet are to be 
 washed daily in a lotion made of carbolic acid 1 part and 
 water 39 parts. After drying well, dust the feet with 
 boric acid powder and starch, equal parts, or with talc 
 powder. The socks or stockings are to be wrung out of 
 a corrosive sublimate lotion, 1 in 2,000, and then dried, 
 before being worn. And, as the bacilli, or germs, which 
 cause the evil smell, flourish in the damp leather of boots, 
 the insides of the boots ought to be wiped out with a wet 
 rag dipped in the same lotion, occasionally. 
 
 (2) Excessive sweating. This is a sign of general de- 
 bility, and must be treated with tonics. (See "Night 
 Sweats of Consumption.") 
 
 Physiology. This is the science which deals with the 
 duties and functions of all the parts and organs of the 
 (human) body, when it is in a state of health. 
 
 Piles (called by doctors, "HEMORRHOIDS"). Piles are 
 varicose veins of the rectum or lower bowel. It is usual 
 to speak of external and internal piles. An internal pile 
 is a swollen vein in the inside of the bowel, just inside the 
 anus; and an external pile is one which, perhaps, was once 
 internal, but which has come out through the opening dur- 
 ing straining at the water-closet, and which has been 
 squeezed and bruised by the muscle which closes the open- 
 ing until it has become inflamed and bleeds. External 
 
218 PILES 
 
 piles tend to get well, and to leave behind ridges and tags 
 of hard skin hanging just outside the anus. 
 
 Causes. A sedentary life, constipation, sluggish liver, 
 overeating, alcoholic disease of stomach or liver, pregnancy. 
 
 Signs. A person may have external piles for years with- 
 out caring anything about them, though suffering much 
 discomfort when the bowels are costive. But when they 
 get inflamed, there is a feeling of weight and great soreness 
 at the anus, pain during the passage of motions, itching 
 and throbbing, and perhaps irritability of the bladder and 
 a frequent desire to pass water. When piles get really 
 inflamed and swollen the patient cannot even sit down in 
 comfort. Then the piles will suppurate and discharge pus. 
 This process is often Nature's way of bringing about a 
 cure ; the piles get filled up with blood clot and shrivel up. 
 
 Internal piles show their presence by bleeding, which, if 
 copious and too frequent, may be a danger to health. But, 
 generally, the loss of an ounce or two of blood by piles is a 
 good thing for the patient, and may save him headaches, 
 apoplectic strokes and attacks of illness. 
 
 Treatment. (1) Palliative. A spare diet, especially 
 avoiding alcoholic drinks, much meat, and spiced foods. 
 The bowels must be kept always a little loose, not with 
 strong purges, but with gentle laxatives like magnesia, con- 
 fection of senna, brimstone and treacle, castor oil, phenol 
 phthalein tablets, licorice powder and not calomel, aloes, 
 colocynth, jalap. 
 
 When piles are acutely inflamed. Take two grains of 
 calomel at bedtime and a dose of castor oil (half-an-ounce) 
 in the morning. Take hot hip baths or use hot fomenta- 
 tions. If an external pile, with a blood clot inside, is in- 
 flamed and tender, send for a doctor, who will probably 
 puncture it. 
 
 If you have internal piles, especially bleeding ones, which 
 come out every time you go to the closet, you must gently 
 press them back again, and use a collapsube of ointment 
 of galls and opium, or of hamamelis and cocaine, or of 
 ferric perchloride. Regular exercise is essential in all 
 these cases. Conium ointment is also an excellent soothing 
 application. 
 
 (2) Operative. The operations for piles are called " ex- 
 cision" and "ligature." Of course, they are entirely out- 
 side the province of home-doctoring. But it is quite 
 
PLEURISY 219 
 
 certain that many a man and woman whose piles are a 
 lifelong nuisance to them would be immensely relieved 
 by the simple and safe operation for the removal of their 
 piles. Such an operation would lay a patient up only for 
 about a week and the relief would be immediate. 
 
 Pleurisy. This is an inflammatory disease within the 
 chest. It is accompanied by fever in the acute form, but 
 may become chronic, and may last for weeks without any 
 fever being present. It is an inflammation of the pleura, 
 or serous membrane, which lines the inside of the chest, 
 and also covers the surface of the lungs, so that the two 
 surfaces of the membrane glide over each other with every 
 breath that is taken. These movements are quite unfelt in 
 a state of health, but when pleurisy has come on each 
 breath taken and every movement of the chest causes pain, 
 which in acute inflammation may be of a very acute nature. 
 In health the pleural surfaces are smooth and moist, but 
 when inflamed there is at first dryness, then roughness and 
 tenderness. After some hours of the disease a change oc- 
 curs and some fluid is poured out, and some flaky, white, 
 solid material is deposited. The fluid which is formed col- 
 lects in the chest cavity around the lung, and if the quan- 
 tity becomes great it compresses the lung more and more 
 and renders it unable to expand. At first this pleuric ef- 
 fusion is a clear, pale yellow, watery liquid, but if the 
 inflammation continues the clear effusion becomes opaque 
 and purulent, like the contents of a boil or an abscess. 
 This is called by doctors empyema. This is a very serious 
 state of disease and very often leads to early death. 
 Pleurisy is generally set up by catching cold from exposure 
 to cold and damp; in healthy persons attacks are usually 
 short and easily cured, but if pleurisy attacks a consump- 
 tive child or young person it is always a serious matter. 
 On the other hand, in a person who has consumption of 
 the lungs, local pleurisy is one of Nature's methods of try- 
 ing to localize and heal the mischief. 
 
 An attack of pleurisy begins with a feeling of chilliness 
 and a shivering fit, followed by flushes of heat and thirst, 
 headache and a burning skin ; there is acute pain somewhere 
 in the chest, most often in the side, and a dry cough, which 
 much increases the pain. Either one or both sides may be 
 affected. The pulse is hard and quick, and the breathing 
 is rapid ; there is restlessness, and a feeling of anxiety, and 
 
220 PNEUMONIA 
 
 the urine is scanty and high colored. As soon as these 
 symptoms are observed, the patient must give up and go 
 to bed, have a hot bath, and then lie between blankets, 
 take a sharp purgative, and put a hot linseed jacket 
 poultice, with a little mustard, on the painful part of the 
 chest. A doctor must take charge of the case at once. 
 (See "Poultices.") 
 
 Pneumonia. (See also "Lung Diseases.") Men, women 
 and children are all liable to pneumonia, in which the chief 
 trouble is inflammation of the lungs. The persons who 
 run most risk of it, and who are most liable to die of it, 
 are drunkards. It is slightly contagious. The disease be- 
 gins quite suddenly: the patient has a shivering fit, his 
 temperature runs up to 103 or 104 (the usual healthy 
 temperature is 98% and anything higher than that is 
 called "fever") ; his tongue is coated, his appetite is lost, 
 and he has a bad headache and shivering. Then he coughs 
 in a painful way, and spits up phlegm tinged with blood. 
 In a few hours more, he is propped up in bed with flushed 
 forehead and cheeks, bright eyes, and panting, gasping for 
 breath. He is very feverish, and his skin is dry. At night 
 he cannot sleep, but wanders in his mind and talks non- 
 sense. He gets worse and worse (and perhaps dies). 
 
 But suddenly, when he has been ill about eight days, 
 and is very bad indeed, he falls asleep ; his fever abates, 
 his pulse rate goes down, his breathing becomes easy, his 
 dry, brown tongue grows moist and he wakes up feeling 
 almost well ! From that time forward he slowly but surely 
 improves until he is all right again. Nearly all the cases 
 of pneumonia that recover end in this way. 
 
 Here, then, is a disease which is caused by a germ, which 
 runs its course, and which cannot be cut short. It is a 
 dangerous disease and its treatment demands much skill. 
 
 No sensible person without a medical training would care 
 to undertake the treatment of pneumonia on his own re- 
 sponsibility. The doctor will order a diet of milk, beef 
 tea or mutton broth given in small quantities, frequently; 
 and the patient may have a liberal amount of water to 
 drink. Large hot linseed-meal poultices may be wanted 
 (see "Poultices"). Leeches may be required. An ice bag 
 (a gutta-percha bag to hold fragments of ice) may be called 
 for. Alcoholic stimulants may be the only thing which 
 will keep life in the patient in the later stage before the 
 
POISONING 221 
 
 crisis as much as 8 to 12 or more ounces of good whisky 
 or brandy daily may have to be taken. (See "Drachms" 
 and "Ounces.") The sleeplessness requires special treat- 
 ment; the ice bag to the head is recommended by many 
 doctors, but chloral must not be given even if the patient 
 is accustomed to its use. 
 
 In recent years great emphasis has been laid upon the 
 importance of fresh air in the treatment of pneumonia. 
 Many cases are treated out of doors. Oxygen is freely 
 given in many cases. Serums seem to be of assistance in 
 some cases, but no specific has yet been discovered. The 
 chief danger in pneumonia is heart failure during the at- 
 tack and thrombosis and embolism, causing instant death, 
 during convalescence. Therefore a patient must be kept 
 absolutely quiet until all danger is past. 
 
 During convalescence a tonic will be required, followed 
 later, if possible, by a change of air to a temperate sunny 
 climate for a few weeks. 
 
 Prevention, As pneumonia is an exceedingly common 
 disease during winter and spring and as it so often results 
 fatally, it is important that all possible care be taken to 
 avoid contracting the disease. This is done first by in- 
 creasing the body resistance, and second by avoiding con- 
 tact with the infectious cause, or pneumococcus germ. 
 
 The body resistance is maintained by the following 
 means : 
 
 Exercise, cold morning bath, good nourishment, little 
 worry, little alcohol to drink and little tobacco smoking. 
 
 Avoidance of exposure to cold, draught, sudden changes 
 of temperature and wet feet. 
 
 Pneumococcus vaccine will increase the body resistance 
 to infection. 
 
 The infective agent is avoided by careful household 
 cleaning, avoiding close proximity to people who are cough- 
 ing, sneezing, or spitting in public places, or breathing 
 through the nose while in their presence. Frequent careful 
 cleaning of the mouth with antiseptic solution especially 
 in the morning, evening and after meals. 
 
 Poisoning. When a person has taken poison you must 
 send for the doctor at once. In the meantime, if you know 
 what poison he has taken, you may be able to save him; 
 if you do not know, you must await the doctor, but in the 
 meanwhile you need not be idle. 
 
222 POISONING 
 
 FIRST CASE. You know what poison has been taken. If 
 it is Prussic Acid or Cyanide of Potash the patient will 
 almost certainly die at once. There is no time to save him. 
 But if he is not yet dead, and lies insensible, pale, and 
 rigid : 
 
 (1) Give him a tablespoonful of mustard in a tumbler- 
 
 ful of warm water. If he vomits, it is well; if 
 not, put your finger to the back of his throat. 
 
 (2) When he has been sick, give him brandy or strong 
 
 beef tea or strong coffee. 
 
 (3) Pour cold water over his head, holding him over a 
 
 basin. 
 
 These two poisons are very powerful. They are used in 
 photography and are too easily obtained. 
 
 If the poison is Laudanum, the patient is first excited, 
 then depressed, then insensible. At first you can rouse 
 him, afterwards he becomes like one dead, with noisy 
 breathing, blue lips, and pale, ghastly face. 
 
 (1) Give him a tablespoonful of mustard in a tumbler- 
 
 ful of water. 
 
 (2) March him about, stimulate him, douche him, keep 
 
 him alive by worrying him in every way. If 
 you let him alone he will die, probably. 
 
 (3) Give him a pint of very hot strong black coffee, 
 
 injected into the rectum, or back passage, with 
 a glass or Higginson syringe. 
 
 If the poison is Oxalic Acid, make him swallow chalk, 
 lime or whiting, or plaster scraped from the wall, in large 
 quantities, washed down with water. Don't give an emetic. 
 Give him stimulants and castor oil. But the acid is irritant 
 and you cannot do much for a person whose whole mouth 
 and food tube are inflamed and corroded. 
 
 If the poison is White Arsenic, there will be very little 
 time. Give spoonful of magnesia and white of egg and 
 salad oil until the doctor comes. 
 
 If the poison is Carbolic Acid, give him : 
 
 (1) A tablespoonful of mustard in a tumblerful of 
 warm water. 
 
POLYPUS 223 
 
 (2) When he has been sick, give him half-an-ounce of 
 
 Epsom salts in a half -pint of cold water. 
 
 (3) Keep him warm, and give him stimulants. 
 
 Sometimes people take overdoses of sleeping draughts. 
 For an overdose of Chloral: 
 
 (1) Make him sick by tickling the back of the throat. 
 
 (2) Rouse him, stimulate him, flick him with wet 
 
 towels, force him to walk about, worry him. 
 
 (3) Inject a pint of hot coffee into the rectum. 
 
 SECOND CASE. You do not know what poison has been 
 taken. In this case you must use your wits and notice 
 what symptoms he has. 
 
 If he has Vomiting, Diarrhea, and Colic he may have 
 taken sugar of lead, phosphorus, arsenic, spirits of salts, 
 corrosive sublimate, sulphuric acid, Prussian blue, salts of 
 sorrel, or other irritant poison. 
 
 (1) Do NOT give an emetic, because you may injure 
 
 stomach by the vomiting. 
 
 (2) Give plenty of lime water, or milk, or magnesia, 
 
 or wall-plaster, or whitewash, or whiting, or 
 chalk, and plenty of milk and water to wash 
 them down. If he vomits them up, give him 
 more. 
 
 (3) When he becomes exhausted, give a tablespoonful 
 
 of brandy or whisky in milk or water, and put 
 hot-water bottle to his feet, until the doctor 
 comes. 
 
 Smell his breath. If he has taken carbolic acid or prussic 
 acid or laudanum or alcohol, you will know it by the smell. 
 Phosphorus (rat paste) smells of garlic. If he is quite 
 insensible, he may have taken opium, morphine, bella- 
 donna, laudanum, chloral, chloroform ; or he may be suffer- 
 ing from coal gas which has escaped into the room where 
 he slept. In all these cases stimulation of every kind is 
 desirable, though no special treatment can be undertaken 
 without medical advice. 
 
 Polypus. This is an old-fashioned Latin word, used to 
 mean a little tumor (or swelling) with a stalk, short or 
 
224 POLYPUS IN THE EAR 
 
 long, by which it is attached to the mucous membrane 
 somewhere in the nose, the throat, the ear, the rectum or 
 the womb. It is impossible to understand what a polypus 
 really is without knowing what a mucous membrane is, and 
 so you must first read the article on * * Mucous Membrane. ' ' 
 Now, when a mucous membrane is afflicted with catarrh 
 and inflammation (see "Abscess") for a long period, dur- 
 ing which pus, or matter, is always trickling over it, the 
 membrane gets into an irritable state and a polypus is 
 formed, which tends to drop off by its own weight, but may 
 remain attached by a stalk. 
 
 A nasal polypus is a red, soft, gelatinous, mucous tumor, 
 like a hanging pear-drop. If it gets big enough it blocks 
 up the nostril, and then it must be removed by a surgeon. 
 He passes a silver wire noose over it and twists it off. If the 
 catarrh continues, of course, there may be another there 
 very soon, growing on to the stalk of the old one. A nasal 
 polypus generally causes deafness. 
 
 Polypus in the ear is often one of the results of years 
 of the very common middle-ear disease, with its chronic 
 discharge. It must be removed, by an aural surgeon, with 
 a "snare." 
 
 These fibroid tumors, and fibroid polypi of the womb, 
 are very common among women in the middle period of 
 life so common that they are the real reason for the un- 
 fortunate stoutness of so many middle-aged women. When 
 a woman has dull, aching, throbbing pain in the abdomen, 
 with feelings of weight and * ' bearing down, ' ' piles, costive- 
 ness, and frequent attacks of bleeding, she very likely has, 
 in her womb, a fibroid tumor, which may or may not have 
 become a polypus already. By that time the surgeon will 
 be able to feel the tumor and will advise as to its removal. 
 Short of operation, the patient may control bleeding by 
 douches of hot water, and by taking this medicine in- 
 ternally: Ammonia sulphate of iron, 30-36 grains; dis- 
 tilled water, 8 ounces; mix. Take a sixth part every six 
 hours. Very hot water douches will generally stop the 
 bleeding, and give a sense of great comfort. But, if very 
 profuse, a solution of hemisine, or adrenalin, or supra- 
 renalin (liquid extract, 1 part, hot water, 10 parts) will 
 be necessary to check the hemorrhage. These three drugs, 
 which closely resemble each other, are the very latest and 
 
POULTICES 225 
 
 best agents for checking every kind of bleeding. Cheaper 
 drugs for the same purpose are turpentine, perchloride 
 or iron and alum. 
 
 The reader will now understand that when a patient 
 says that he or she has "a polypus," and wants a "cure" 
 for it, we can give no help. A polypus may occur any- 
 where where there is a mucous membrane, and its only 
 treatment is local, and requires skill. 
 
 Polypus of the Womb. The commonest sort of tumor 
 of the womb is a little hard, fibrous knob, which grows and 
 develops witjiin the substance of the womb itself. Most of 
 our readers know that the womb is the muscular bag in 
 which the unborn child lives and develops until it is ready 
 to be born. The little knob, growing in the muscular 
 substance (the "flesh") of the womb is gradually squeezed 
 out of it, and bulges either into the hollow inside of the 
 womb, or on the outside, among the coils of gut. In either 
 case, it drags the mucous membrane along with it and 
 when it is squeezed right out of the womb substance, it 
 remains hanging as a tumor with a stalk of mucous mem- 
 brane, either inside or outside the womb. The tumors, 
 which happen to be squeezed outside, and lie among the 
 coils of intestine, are not very dangerous, however large 
 they may grow; but those inside the womb (called polypi) 
 cause much pain and bleeding, and may have to be re- 
 moved by operation. 
 
 Poultices are rather old-fashioned applications for ap- 
 plying heat and moisture to inflamed parts. They are not 
 so cleanly as fomentations, and ought not to be used for 
 sores or anywhere where the skin is broken, because they 
 are not antiseptic and may even themselves contain the 
 germs of disease. 
 
 A poultice must only just be big enough to cover the 
 inflamed part; if it is bigger it makes the surrounding 
 parts sodden and helps to spread the inflammation. When 
 an abscess has discharged itself no more poultices must be 
 used; their time of usefulness is over. Before applying 
 a poultice to the chest of a young child or old person a 
 piece of warm flannel must be placed there first, and grad- 
 ually withdrawn after the hot poultice is in its place. 
 Thus the great heat of the poultice is brought gradually 
 and not suddenly to the child's notice. This is a little 
 
226 TO MAKE A POULTICE 
 
 nursing "tip" which few trained nurses know. After re- 
 moving a poultice, dry the skin and cover it with a layer of 
 cotton wool. 
 
 To make a poultice. Have everything quite ready before 
 beginning to make it, so that when it is made it may be ap- 
 plied without delay, as hot as possible ; test its heat by apply- 
 ing it first to your own cheek. A linseed poultice is thus 
 made. ' ' Into a basin, previously scalded, place the ground 
 linseed meal, enough for the size of poultice required. Pour 
 scalding water on it gradually, stirring with a table knife 
 or ivory paper knife. Spread the poultice on linen, old 
 flannel, or tow; the tow is then folded over the edge of the 
 meal and the poultice is ready. It is a better plan to pour 
 the water on the meal than to sprinkle the meal on the 
 water, unless a very large poultice is required. A bread 
 poultice is thus made: Stale white bread crumbs are 
 dropped into boiling water and the cup in which the poul- 
 tice is being made is then covered with a saucer and stood 
 upon the hob. The water is then drained away and the 
 pulp applied upon a piece of linen. A starch poultice is 
 soothing and retains the heat a long time, and is suitable 
 for inflamed skin eruptions. The starch is first mixed 
 with cold water and then boiling water is added until the 
 mess becomes of a proper consistence. A charcoal poultice 
 is a good antiseptic one. Finely-powdered vegetable char- 
 coal is mixed with bread or linseed meal and a little more 
 charcoal is sprinkled over the surface just before apply- 
 ing it. A mustard poultice is thus made: The mustard 
 powder is made into a thin paste with hot or tepid water 
 and spread in a thin layer on brown paper, and covered 
 over with a layer of muslin. It is kept on as long as 
 necessary, or as long as it can be borne, say fifteen minutes, 
 unless blistering of the skin is aimed at. An eau-de- 
 cologne poultice consists of an ordinary pocket handker- 
 chief saturated with eau-de-cologne, and applied to the 
 skin with a layer of oil silk over it. This is quite enough 
 to produce the redness of counterirritation on some skins 
 and the redness quickly disappears." 
 
 A hot boiled Spanish onion is a splendid poultice for 
 earache, as its pointed end fits into the ear, keeps the 
 heat a long time, and the juice is an antiseptic. Put a 
 large pad of cotton wool over it and bandage on it. (See 
 also * ' Fomentations. ' ' 
 
PREGNANCY, SIGNS OF 227 
 
 Pregnancy, Hygiene of. Pregnant women must have 
 plenty of fresh air and only moderate exercise. Walking 
 is better than riding. All fatigue to be avoided, also 
 crowded entertainments. Dress. Tight stays, garters and 
 collars are not to be worn. If the enlargement of the 
 abdomen is excessive, an obstetric belt must be worn. 
 Flannel drawers are advisable. 
 
 The bowels must be kept well open, with cascara or saline 
 purges if necessary. A warm bath ought to be taken 
 once weekly. If the breasts are painful they must be 
 bandaged or supported; the nipples must be hardened by 
 bathing with equal parts of whisky and water, or alum 
 lotion, night and morning. The nipples, if not prominent, 
 must be drawn out and kept out for a few minutes daily 
 by an elastic .ring placed round the bases of them. This 
 is most important, as also is this that in every pregnant 
 woman the urine ought to be analyzed at least twice during 
 the carrying of the child. 
 
 Lastly, at the periods which correspond to the courses 
 which would otherwise be in progress, great care and 
 caution is to be observed, as miscarriage is more apt to 
 occur then. 
 
 Pregnancy, Signs of. Wives are frequently doubtful as 
 to whether they are ' ' in the family way ' ' or not. In many 
 cases the skill and experience of a medical man are neces- 
 sary to decide the question, but very often there is no 
 difficulty in being sure, one way or the other, at an early 
 date. The ordinary signs of the pregnant condition are 
 here given, with comments: 
 
 (1) A woman, on becoming pregnant, at once ceases 
 her menstrual periods (see "Menstruation"). This is the 
 first sign, and is relied upon by most women for calculat- 
 ing when the baby will be born. Precise calculation is 
 impossible, as a rule, but the confinement may be expected 
 about 280 days from the first day of the last menstrual 
 period. 
 
 Fallacies. But the periods may cease, in any girl or 
 woman, because of anaemia, which must be treated by a 
 doctor. And, very often the fear of becoming pregnant 
 may cause the periods to cease for some weeks, and the 
 desire to become pregnant may stop them. In fact, any 
 nervous condition is enough to upset some women in this 
 way. Secondly, a woman may continue to menstruate for 
 
228 PSOEIASIS 
 
 three or four months, even though she is pregnant, be- 
 cause of a polypus or other disease of the womb. 
 
 (2) The breasts of a woman feel full and hard at a 
 very early stage of pregnancy. 
 
 (3) In the second month comes "morning sickness." 
 The expectant mother feels sick on getting up in the morn- 
 ing. This is a very common sign, but is occasionally quite 
 absent. Sometimes, however, the vomiting is a very serious 
 matter. Fallacy. Women who drink overnight, or who 
 tipple in secret, are often sick in the morning from catarrh 
 of the stomach. 
 
 (4) After the third month the dark circles round the 
 nipples of the breast become very dark red instead of a 
 rosy pink, and a drop of milk may sometimes be squeezed 
 out of the breast. But many blonde women show no sign 
 of this kind. 
 
 All the other signs are such as only a doctor can under- 
 stand or seek for. 
 
 Psoriasis. This has been called "the skin disease of the 
 healthy man," and it is true that most of those who have 
 this disease are otherwise quite healthy. Psoriasis con- 
 sists in a chronic inflammation of the skin, with raised 
 red patches, covered with silvery or yellowish-white dry 
 scales. No one knows the true cause of psoriasis. 
 
 Psoriasis often appears first in childhood and then goes 
 away again, and reappears occasionally. It occurs espe- 
 cially in gouty, rheumatic, and syphilitic families, and is 
 particularly noticeable in the spring of each year. It is 
 not infectious or contagious. The true psoriasis has silvery 
 scales, and when it occurs in a person who has had syphilis 
 the scales are much yellower. It can hardly be said, how- 
 ever, that syphilis has much to do with the causation of 
 the disease. 
 
 Psoriasis first appears on the back of the forearms and 
 elbows, and on the front of the knees. There are, in 
 the earliest stage, small pimples each capped with a little 
 dry scale, and the pimples grow or unite with others until 
 they form patches of two or three inches wide. Then 
 other parts of the body become affected. There is no pain 
 or itching. 
 
 Treatment. Of course, the first thing to do is to guess 
 at the probable cause of the disease and to deal with any 
 rheumatic or gouty taint that the person may have, A 
 
PSORIASIS 229 
 
 to diet, it is of very little real service, as a rule, to adopt 
 any special diet. But the writer has seen cases in which 
 a month or two's severely vegetarian diet worked wonders 
 in the cure for psoriasis. 
 
 The one medicine of all others which seeme to have in all 
 cases a certain amount of beneficial effect, is arsenic. But 
 arsenic, though a valuable medicine in the hands of a medi- 
 cal man, is yet a very powerful poison. The dose of it is 
 to be increased right up to the limit of toleration of the 
 patient; until, in fact, he gets redness round the eyes. 
 Then it is to be continued until the eruption has disap- 
 peared, and for three months after that, in gradually 
 diminishing doses. But at the very beginning of a first 
 attack of psoriasis arsenic is not to be given ; in that stage, 
 thyroid extract tablets may be given with advantage. 
 
 Psoriasis, then, is a disease which is not suitable in any 
 way for amateur treatment. Both arsenic and thyroid are 
 powerful medicines and require a doctor's prescription. 
 A celebrated physician recommends the patient with 
 psoriasis to swallow a 10-minim capsule of turpentine 
 three times a day; and he increases the dose up to 30- 
 minim doses. 
 
 Local treatment. This is much more important and more 
 easily manageable at home than the constitutional treat- 
 ment. The best application of all is chrysarobin ointment, 
 which must be rubbed well into the patches of the disease 
 but must not be allowed to touch the healthy skin round 
 about. The strength of the ointment may be, say, 15 
 grains to an ounce of vaseline. The ointment stains the 
 skin and bedclothes, and if applied to the face may make 
 the eyelids dropsical. But if it is rubbed into patches on 
 the body, some of it gets absorbed and does good at last 
 to the patches on the face. 
 
 In dealing with a patch of psoriasis it is of no use to 
 rub any ointment on it until you have rubbed off the 
 scales. Tar ointment is not so messy as chrysarobin, and 
 the detergent tar solution may be thought even more con- 
 venient. This solution acts well if applied to the patches 
 undiluted and allowed to dry on. 
 
 Hutchinson's excellent ointment for psoriasis is as fol- 
 lows: White precipitate, 10 grains; chrysarobin, 10 
 grains; creosote, 20 minims; detergent solution of tar, 10 
 minims; benzoated lard, 1 ounce (mix). 
 
230 PURGATIVES 
 
 If a patient finds it difficult to get off the scaliness, let 
 him apply to the patches for several hours, pads of lint 
 soaked in weak carbonate of soda solution and bandaged 
 on over a piece of oiled silk. 
 
 Purgatives. Medicines which act upon the bowels. The 
 following list of purges will be found to contain some- 
 thing in the way of medicine suitable for the relief of all 
 kinds of costiveness, sluggish liver, congestive headaches, 
 dropsy and blood poisoning. (See also "Dosage.") 
 
 (1) Laxatives. Medicines which cause Very gentle 
 purging, without griping, and with soft semi-fluid mo- 
 tions: Honey, figs (especially green figs), tamarinds, 
 prunes, brimstone and treacle, citrate of magnesia. 
 
 (2) Aperients produce more liquid motions and cause a 
 little griping: Black draught (compound senna draught), 
 white mixture (at all hospitals), extract of cascara sagrada 
 (adult dose, 2 to 4 grains), castor oil (adult dose, 1 fluid 
 ounce). 
 
 (3) Saline purgatives are especially good for gouty and 
 rheumatic people, and those with Bright 's disease, or liver 
 disease, or who suffer from headaches (see also "Head- 
 ache") : Phosphate of soda (dose, 2 drachms), Epsom 
 salts (y.to 1/2 an ounce), Seidlitz powders, cream of tar- 
 tar (1 to 3 drachms). 
 
 (4) Cholagogues especially stimulate the liver and move 
 the bowels: Blue pill, calomel, podophyllin. (Require a 
 medical man's prescription.) 
 
 (5) Drastic purgatives cause a violent and very watery 
 action of the bowels. They are required in cases of drunk- 
 enness, dropsy (unless the heart is feeble) : Colocynth, 
 jalap (compound jalap powder, 1 drachm), croton oil (dose, 
 1 to 3 drops, given rolled up in a bread pill). 
 
 A few additional purgative medicines for special cases 
 are now given: (1) For habitual costiveness and "wind 
 in the stomach": Sulphate of sodium, 2 drachms; dilute 
 sulphuric acid, 1 drachm; compound infusion of gentian, 
 to 6 ounces. (Take a small wineglassful of this mixture 
 after the two principal meals every day. ) (2) As a purga- 
 tive for persons with rheumatic gout: Sulphate of soda, 
 l!/2 ounces; flowers of sulphur, 2 ounces; (One teaspoon- 
 ful in a tumbler of milk on rising from bed every morn- 
 ing). (3) For anaemic women, with headaches, costive- 
 ness, and stoppage of the monthly flow: Granulated 
 
RASHES OF THE SKIN, ARTIFICIAL 231 
 
 sulphate of iron, 2 grains ; pill of aloes and myrrh, 3 grains. 
 (To make one pill. Let the patient take one such pill 
 thrice daily, after meals.) (4) To relieve the fullness of 
 dropsy: Podophyllin resin, 6 grains; ginger powder, 20 
 grains; extract of hyoscyamus, 24 grains. (Divide the 
 mass into 12 pills, and let the patient take 2 every other 
 night, at bedtime.) (5) A laxative for children with 
 costive bowels. A stock of this medicine to be kept in 
 cupboard at home: Rhubarb powder, 45 grains; mag- 
 nesium carbonate, 3 drachms ; dill water, 4% fluid ounces. 
 (Mix well and give the infant a teaspoonful every two 
 hours until the bowels are freely moved.) (6) Another 
 purge for persons with dropsy in any part of the body: 
 Elaterium, 1 grain; extract of gentian, 12 grains. (For 
 four pills. Let the patient take one every night.) 
 
 Quinsy. This means the abscess which forms in the back 
 of the throat sometimes as a result of inflammation of the 
 tonsils. It ought to be opened by the surgeon; if left to 
 itself, it will burst in time, but it may burst during sleep 
 and suffocate the patient. It ought not to be left un- 
 treated. (See also "Sore-Throat.") 
 
 Rashes on the Skin, Artificial. These eruptions are those 
 which are not due to some internal disease, such as scarlet 
 fever, but which are mostly caused by some substance ap- 
 plied to the skin. Soldiers and sailors, and others, such as 
 professional beggars and tramps, sometimes make them- 
 selves ill in this way in order to escape service or duty, 
 or to prey upon the sympathy and charity of the kind- 
 hearted. These sham eruptions come under two main 
 headings : 
 
 A. (1) Eruptions caused by external agents, (a) 
 Animals such as lice, fleas, bugs, jellyfish, gnats, mos- 
 quitoes, wasps, and the irritating discharge of ulcers, 
 carbuncles, and the urine in diabetes. (6) Vegetable 
 such as germs of some kinds, orange-peel juice, arnica, 
 poison-oak, poison-ivy, mustard. Most of these produce a 
 rash like that of eczema. 
 
 (2) Trade eruptions, among those who handle paraffin, 
 tar, sugar (grocer's itch), salt, lime, cotton oil, etc., and 
 such people as chemists, dyers, tanners, paperhangers, 
 bakers. 
 
 (3) The eruptions of beggars and tramps are often pro- 
 duced purposely by the patients themselves to excite pity. 
 
232 RASHES OF THE SKIN 
 
 The chief offenders are hysterical girls, who cannot get as 
 much attention paid to them as they desire; prisoners; 
 deserting soldiers and sailors; and lunatics. The sub- 
 stances used are such as croton oil, acids, turpentine, 
 iodine, mustard, Spanish fly, urine. A few of these 
 malingerers are very clever, but not quite clever enough 
 to deceive a doctor for very long, because they produce 
 rashes which are not seen in disease, and suggest ''art" 
 rather than "nature." In the French army the soldiers 
 use thapsia root, and sometimes get erysipelas from it. 
 Rogues of this kind will often inflict much pain on them- 
 selves. 
 
 B. The other type of artificial eruptions is produced 
 by drugs taken internally. The rash caused by too much 
 antipyrin, for example, is often like that of a certain dis- 
 ease, but there are generally ways of distinguishing it, and 
 doctors are generally on the alert for these drug rashes. 
 Bromides (given for sleeplessness or epilepsy) produce an 
 artificial eruption (in some people) like acne. So may 
 iodides, arsenic, chloral, mercury, belladonna, quinine, 
 opium and others. 
 
 RASHES ON THE SKIN. (1) A rash coming out in crops, 
 first on chest, stomach and neck, then on wrists and the 
 rest of the limbs, and accompanied by a sore throat and 
 feverishness which has lasted one day only, is likely to be 
 the rash of scarlet fever (scarlatina). Send for the doctor 
 at once. 
 
 (2) A rash appearing at the beginning of an illness or 
 without any feeling of illness, coming out in crops, on 
 the face, shoulders, back, and scalp, with tiny red pimples 
 which very soon become blebs is probably chicken-pox. 
 Send for the doctor at once. 
 
 (3) A rash, first seen on the face, of hard red pimples 
 which feel like shot embedded in the skin, and accom- 
 panied by pain in the bottom of the back, and fever and 
 headache and vomiting of three days' duration is the 
 rash of smallpox. Send for the doctor at once, or go to 
 the nearest vaccination station and get vaccinated. 
 
 (4) A rash of red patches with round scooped-out edges, 
 which appears on the fourth day of illness, and is seen 
 first on the face, then on the body, and then on the limbs, 
 and is accompanied by the signs of a bad cold in the head, 
 cough and feverishness is the rash of measles. Send for 
 
RED GTJM 233 
 
 the doctor and see that no other children go anywhere near 
 the diseased one. 
 
 (5) The rash of German measles is variable. 
 
 (6) Small red spots with deep-purple points in the cen- 
 ter of them are generally due to flea ~bites. Old flea bites 
 might be mistaken for a skin disease, but marks on the 
 linen and clothes will perhaps show what the spots are 
 caused by. 
 
 (7) Wheals on the skin with whitish middle parts and 
 a central blueish spot, are caused by bug bites. Bugs in- 
 ject a poison into the skin which makes it swell so that 
 the bug may have a better supply of blood to feed upon. 
 Toilet vinegar and lead lotion are both good for bug bites. 
 
 (8) See also "Lice.'; 
 
 (9) Sometimes a patient taking medicine by the doctor's 
 orders gets a skin eruption or rash, which ought to be re- 
 ported at once to the doctor. Some people are too sus- 
 ceptible to some medicines and the dose will require to be 
 regulated by him. 
 
 The commoner medicines which sometimes cause rashes 
 are ether, bromides, iodides, chloral, quinine, antipyrin 
 and belladonna. 
 
 (10) A rash of tiny blebs like drops of dew on the skin 
 is probably a rash due to too much perspiration. It should 
 be dusted with violet powder or fuller's earth. 
 
 (11) A rash which consists of wheals, flattened, and 
 feeling hard and firm ; at first red, then white and blood- 
 less with a bright pink edge; and surrounded by a red 
 halo is the rash of nettlerash. In bad cases the whole 
 skin is red and the wheals stand out in white patches 
 upon it. 
 
 It comes on quite suddenly and itches and burns, but 
 wherever the scratching is done fresh wheals appear. (See 
 "Nettlerash.") 
 
 (12) Rashes may be caused by various irritants, such 
 as the stings of wasps, jellyfish, and stinging nettles; of 
 gnats and mosquitoes, and of hairy caterpillars. (See 
 "Rashes, Artificial.") 
 
 Red Gum. This is a skin disease, seen only in babies, 
 and is associated with the cutting of the first teeth. It 
 is shown by pink pimples on the skin of face, body or 
 limbs, sometimes in patches, at other times in single 
 pimples. They do not last many days, often come and 
 
234 RHEUMATISM 
 
 go, and do not ulcerate; they may alternate with a loose- 
 ness of the bowels. Pay strict attention to diet, and avoid 
 all chills to the skin. Give a dose of rhubarb and soda, 
 in amount according to the age of the infant, and smear 
 a little zinc ointment over the spots. 
 
 Refuse Disposal. Refuse may be divided into three chief 
 classes house sweepings and ashes; garbage; and sewage 
 (see i l Sewage Disposal ") . The substances composing tho&e 
 three classes should be disposed of separately. 
 
 Ashes may be disposed of by the producer in the coun- 
 try for paths, roads or filling-in, or they may be collected 
 by municipal or town authorities to be disposed of as they 
 see fit. 
 
 Garbage should be collected in covered galvanized cans 
 which are emptied frequently (daily). 
 
 In the country garbage may be consumed by pigs, or 
 dumped on a garbage heap, which is disposed of at longer 
 intervals. Both garbage heap and pigpen should be 
 screened to prevent the access of flies, which find garbage 
 an ideal breeding ground. 
 
 The most sanitary method of garbage disposal for both 
 city and country is by the use of garbage destroyers or 
 incinerators. Small ones are now manufactured which 
 can be placed in kitchens, and garbage can thus be de- 
 stroyed as soon as it collects. 
 
 Garbage and refuse are collected in settled districts by 
 the municipalities or towns and are then best disposed of 
 by garbage crematories, furnaces or destructors. 
 
 Rheumatism. This disease occurs in several forms. The 
 most serious cases are those of acute rheumatism, also 
 called rheumatic fever (see " Acute"). Chronic rheu- 
 matism may be left behind in the joints when the acute 
 form passes off, and the" same name is also given to a similar 
 affection of the muscles. Rheumatism of the loins is com- 
 monly called lumbago, and when the pain goes down the 
 back of the thigh it is called sciatica. It may here be 
 remarked that all these terms are very inaccurately and 
 carelessly used. As a fact the pains in these cases are very 
 little understood even by doctors themselves. Hence much 
 difference of opinion. The muscles of the shoulders, ribs 
 and arms may also suffer. There is also a form of this 
 disease called rheumatic arthritis, in which the toes and 
 fingers become swollen, painful, and gradually so deformed 
 
RHEUMATIC FEVER 235 
 
 until they are useless. The chronic forms of rheumatism 
 are associated with great pain, but an absence of fever. 
 
 Rheumatic fever is a formidable disease, lasting some- 
 times for weeks. In it there are severe pains in several of 
 the large joints, high fever, great weakness, and an ex- 
 treme liability to have inflammation attacking the valves 
 inside the heart. It has been supposed that the disease 
 depends on the formation of a peculiar chemical compound 
 called lactic acid in the blood, and that this acid attacks 
 the fibrous structures of the joints, causing them to in- 
 flame, swell, and contain an excess of watery fluid. For 
 a long period it has been supposed that the immediate and 
 only cause of attacks were chills, exposure to cold and 
 damp, when the person is in a weak or unhealthy state. 
 But more recent arguments and researches seem to show 
 that rheumatism is, like most others, a germ disease. 
 
 The symptoms are shivering, malaise, nausea, and head- 
 ache, with restlessness, passing on into a state of fever; 
 next day there is an onset of painful stiffness in one or 
 more joints, often the knees or elbows, the hips or the 
 wrists; the fingers and toes rarely suffer. The patient 
 feeling great heat, with violent pain, is soon rendered a 
 pitiable spectacle of helpless suffering. He dare not move, 
 because each movement increases the pain, which becomes 
 agonizing, even the weight of the bedclothes can hardly be 
 borne, the skin becomes bathed in sweat of a peculiarly 
 offensive, sour smell ; the pulse is full and bounding ; there 
 may be constipation or diarrhea, the tongue is furred, and 
 the water is scanty and high-colored; the disease passes 
 from one joint to another, and relapses are common. 
 
 Treatment. Absolute rest in bed is necessary, lying be- 
 tween blankets on a hard hair mattress with the affected 
 joints wrapped in wool, or covered with warm fomenta- 
 tions. The most reliable modes of treatment are by the 
 salicylate of soda, aspirin, salicin, bicarbonate of potash, 
 and similar medicines. 
 
 The three different types of the medicinal treatment of 
 an acutely inflamed rheumatic joint (whether the case is 
 severe enough to call "rheumatic fever" or not) are: 
 (1) The salicylate treatment, (2) the opium and salicylate 
 treatment, (3) the alkaline treatment. The first is the 
 best, generally speaking, though some patients cannot take 
 enough salicylates, because of the humming noises they pro- 
 
236 RHEUMATISM, CHRONIC 
 
 duce in the head. It is certain that this medicine relieves 
 the pain in the joints, whether it cuts short the attack 
 or not. We give below two useful prescriptions: 
 Salicylate of soda, 3 drachms; syrup of ginger, 1 ounce; 
 water, 6 ounces. A tablespoonful to be taken every three 
 hours while the joints are hot and painful (for an adult). 
 Tincture of opium, 1 ounce ; potassium carbonate, % ounce ; 
 glycerin, 2 ounces; water, 12 ounces. To make a lotion; 
 to be applied on lint to the painful joint. (Poison not 
 to be taken.) 
 
 Diet in Acute Rheumatism. 
 
 FORBIDDEN ARTICLES OF FOOD. Beef tea, meat extracts, 
 pastry, sweets, sugar in all forms, alcoholic drinks of 
 every kind. 
 
 ALLOWED. While the joints are red and tender and 
 there is inflammation milk, milk and soda, peptonized 
 milk; fruit jellies, oatmeal gruel, barley water, home- 
 made lemonade, weak tea, malt extract. 
 
 When the fever has abated light clear soups and broths, 
 vegetables, chicken, light puddings, bread and milk, ar- 
 rowroot. 
 
 After a fortnight without fever Bread and butter, 
 eggs, white fish, chicken, pounded lean beef or mutton or 
 veal, stewed celery, spinach, potatoes, seakale, asparagus, 
 grapes. 
 
 Rheumatism, Chronic. Kheumatism in its chronic forms 
 and stages manifests itself in numerous ways; it is an ail- 
 ment that varies perhaps more than any other, both in 
 the parts affected and the severity of the pains. (See 
 " Acute.") 
 
 The disease may appear as lumbago, or pain, with stiff- 
 ness, may affect the neck, or any one of the joints; or it 
 may specially attack muscles, such as those between the 
 ribs, or over the shoulder, or the scalp of the head. 
 
 All these forms of rheumatism are worst in cold 
 weather, especially after exposure to wet and cold com- 
 bined; they are also often related to certain forms of in- 
 digestion, and in most rheumatic persons they can be 
 brought on by indulgence in beer. 
 
 Every attack which occurs renders the sufferer more 
 liable to further attacks, and many persons suffer from 
 rheumatism every few weeks from middle life to old age. 
 
 Repeated attacks are liable to lead to further changes, 
 
RHEUMATISM 237 
 
 for the muscles may waste and lose power, and the bones 
 of the joints may grow out that is, become enlarged and 
 deformed. 
 
 All rheumatic patients should pay great attention to 
 three points diet, warmth, and excretions (i. e., bowels 
 and urine) and perspiration. By these means attacks 
 may be seldom felt, while errors as to these points may 
 lead to much suffering at any time. It is wise to take a 
 saline purgative, such as a mixture of sulphate of mag- 
 nesia with bicarbonate of potash, in water, more or less 
 regularly, without waiting for symptoms of illness. The 
 skin also should be kept thoroughly and frequently 
 cleansed with warm baths. The action of the kidneys 
 should be sustained by an occasional dose of weak warm 
 gin and water at bedtime. 
 
 Chills must be avoided by wearing woolen clothing, 
 thick socks, and by the removal of wet boots at the earliest 
 possible moment. 
 
 The diet should be very simple, with only a small quan- 
 tity of meat; salted dry meats are especially to be 
 avoided. Very little sugar should be taken. All starchy 
 foods are likely to be harmless, as is milk, and also eggs, 
 so that a very excellent diet consists of boiled and baked 
 puddings of arrowfat, maizena, sago, tapioca, and 
 macaroni, made with good cow's milk and eggs. All 
 cooked vegetables will help to maintain the purity of the 
 blood, and many varieties of fruit, such as oranges, 
 lemons, bananas, pomegranates, cooked apples, and prunes, 
 may be taken with advantage. 
 
 As already said, beer almost always does harm, while 
 the French and German light wines, being of an acid 
 nature, are unsuitable. The safest drinks are soda or 
 potash water, to which a little malt whisky or good brandy 
 may be added, and these should be taken only with meals. 
 
 Medicines. (1) Powdered guaiacum resin, 1 drachm; 
 potassium iodide, 1 drachm; tincture of colchicum seeds, 
 3 drachms; syrup, 2 ounces; cinnamon water to 6 ounces. 
 A dessertspoonful of this mixture to be taken twice a day. 
 An excellent medicine for old chronic rheumatism of the 
 large joints. (2) Veratrine, 1 drachm; protoiodide of 
 mercury, 1 drachm ; vaselin, 1 ounce ; an ointment to be 
 gently rubbed into the joints. (3) Guaiacum powder, 1% 
 drachm; capsicum powder, 15 grains; pill aloes et asa- 
 
238 RHEUMATIC GOUT 
 
 foetida, 1% drachm. Divide mass into 60 pills. Take one 
 three times a day, if preferred to liquid medicine. 
 
 Rheumatic Gout (Rheumatic Arthritis), This is a name 
 applied to many cases of chronic, painful joint disease, 
 which differ from gout as much as from simple rheu- 
 matism. Rheumatic gout affects persons of middle age, 
 or old people, and is not seen in children. It is essentially 
 a chronic disease, and it tends to grow gradually worse 
 and worse, to last for years, and until death occurs from 
 some other disease. Both sexes suffer about equally. It 
 is essentially a disease of the joints, and it is not related 
 to rheumatism of the muscles so common in old age. Its 
 onset is generally slow and gradual, but in some cases 
 there are occasional feverish attacks. A man or woman 
 begins to feel unwell and weaker than before, easily 
 fatigued, loses appetite, and has vague pains in the head, 
 back, and limbs. The digestion is disordered, and the 
 bowels are irregular, and the urine often high-colored; 
 the sufferer is restless, uneasy, and sleeps badly. Soon 
 afterwards some of the joints become affected; pain is 
 present more or less continuously, and the joints are puffy 
 and enlarged, but not hot and burning with acute inflam- 
 mation. The joints are stiff, and can only be moved with 
 some difficulty and increase of pain; and so if the hip, 
 knee, or ankle is affected, the patient is rendered lame. 
 In some cases a peculiar sort of crackling or creaking 
 noise can be made by handling and rubbing the joint, 
 which, nevertheless, often seems to contain too great a 
 supply of oil within it. One joint becomes affected after 
 another, and this is often seen in the several joints of the 
 fingers and thumb. After causing mild suffering for 
 months or years, the joints become really enlarged with 
 hard, bony outgrowths, and the gristle part of the joint 
 becomes destroyed. In this way a joint becomes too large, 
 too hard, deformed and useless. Following this destruction 
 of the tissues forming the joint, the nerves of the parts 
 around become irritated, which gives rise to spasms and 
 cramps of the affected limb. All these troubles leading 
 to weary days and disturbed nights, break down the gen- 
 eral health gradually, and the patient becomes melan- 
 choly, and, on account of the debility, always feels chilled 
 and depressed; he catches cold easily, and so often suffers 
 from bronchitis; and such cases often end with conges- 
 
RICKETS 239 
 
 tion of the lungs. This is a very intractable disorder, for 
 while gout is more or less controlled by colchicum and 
 iodide of potassium, and rheumatism by the salicylate of 
 soda and bicarbonate of potash, this form of disease is 
 not checked by any drug known to medical science, and 
 the only hope of cure lies in the possibility of building up 
 the constitution with fresh air, change of climate, regular 
 exercise, with carefully-arranged diet. 
 
 Rickets. This is a disease which affects children, and 
 may be observed soon after birth, or not until the child 
 is several years of age. It is a form of weakness caused 
 by unsuitable and insufficient food, and the tendency to it 
 may be inherited from one or both parents who were af- 
 fected by rickets in their childhood, or it may be the 
 result of birth from parents who were delicate in health 
 from overwork or from scanty food at the time of the in- 
 fant's development and suckling. 
 
 Poverty of the suckling mother is the most certain 
 cause, as this is generally associated with unhealthy homes, 
 and often with overwork. It is most apt to occur in the 
 latter children of a family when the mother has had too 
 many children for her strength, or has had children too 
 fast, especially when the means of the father have not 
 improved with the passing years. 
 
 There can be no doubt that children with congenital 
 syphilis often develop rickets (see "Syphilis"). Some- 
 times it has seemed that a lack of lime salts in the food 
 has caused the onset of rickets, and so the cod-liver-oil 
 emulsion and the hypophosphite of lime mixtures sold by 
 chemists often do good. But not every case is cured by 
 lime salts. There is hardly a tissue in the body which is 
 not affected in the disease called rickets. 
 
 The bones are soft and bendable, because they are want- 
 ing in lime salts, and they do not develop in the usual 
 way. The chest of a rickety child is badly shaped, and 
 perhaps "pigeon-breasted." The ends of the ribs in front 
 are enlarged and feel like knobs under the skin. The 
 elbows, wrists, knees and ankles are too large and knobby, 
 and the legs get bow-legged because they are too weak to 
 bear the child's weight. The spine sometimes gives way 
 under the child's weight and may be bent forwards or 
 sideways. The skull is too big and bulgy, and so the face 
 looks too small; and the two soft places that you always 
 
240 SALISBURY TREATMENT 
 
 find on a child's head, and which generally "close up" in 
 a few months still remain "open" beneath the skin, and 
 soft for a year or two. A rickety baby often grows into 
 a deformed child, and dies of rheumatism, St. Vitus' 
 Dance, or some similar disease before reaching adult age. 
 The bony girdle at the hips may grow much out of shape 
 and give much trouble, if the child is a girl, when the time 
 comes for her to give birth to a baby. 
 
 The blood is poor in quality in rickets. The spleen and 
 liver are often too big. The results of the disease of the 
 tissues are to produce tenderness of the body of the child, so 
 that it cries when it is played with or rubbed. It throws 
 off the bedclothes at night. Its head is hot and perspir- 
 ing. Its stools (or motions) are green, pasty, watery, and 
 smell very badly. The child is very liable to spasms, fits, 
 convulsions, squinting. 
 
 No case of disease deserves more careful treatment, but 
 it is almost useless to lay down a routine of treatment, as 
 cases vary so much. The efforts of the child's parents 
 must be directed towards the improvement of the general 
 health, by fresh air, sunlight, and a life in the country, 
 or by the seaside. Plenty of milk, cream, and eggs are 
 wanted, and plenty of fresh fruit and vegetables. The 
 most useful medicines are cod-liver oil, saccharated solution 
 of lime, phosphates, quinine, iron, iodide of iron, and so on. 
 
 Ringworm. (See "Skin Diseases" V.) 
 
 Rupture. (See "Hernia.") 
 
 Salisbury Treatment, The. This is a system of treatment 
 chiefly useful for persons who are much too fat and who 
 are at the same time not in any way gouty. Gout and 
 Bright 's disease must not be treated by this system. The 
 Salisbury method is to feed the patient on an entirely meat 
 diet, giving him about three pounds of lean beef every 
 day and almost nothing else except plenty of hot water 
 to drink. After one week of treatment the patient goes 
 back to his ordinary diet for a time. The scientific value 
 of this method, according to the inventor of it, is that it 
 gets rid of all "fermentative" foods and that the large 
 quantity of hot water drunk acts beneficially by carrying 
 away the excess of uric acid which there is sure to be in 
 such a purely animal diet, and forces the kidneys, skin 
 and bowels to act most freely. The plan of treatment is 
 given in case any of our readers would like to try 
 
SALISBURY TREATMENT 241 
 
 this method at home. Persons with chronic indigestion, 
 dry red pointed tongue, and pain after food will very likely 
 derive benefit from the Salisbury method. Very fat people 
 may give it a trial too. Clearly understand that the Salis- 
 bury diet is not intended as a permanent diet. It is to be 
 continued "only while the necessity for it lasts/' 
 
 The Salisbury dietary is as follows : 
 
 (1) There are to be three meals a day. 
 
 (2) An hour and a half before each meal the patient 
 is to drink one pint of hot water about 100 F. or a little 
 hotter. It is to be sipped slowly. It may be flavored 
 with lemon juice, or a little tea or salt, according to taste. 
 
 (3) Mealtimes are to be 8 A. M., 1 p. M., and 6.30 P. M. 
 
 (4) The minced beef may be flavored with pepper, 
 or mustard, or Chutney, and the only vegetables allowed 
 are lettuce, watercress and celery (raw or cooked). The 
 least amount of mince taken with each meal is to be two 
 ounces, and the largest amount allowed at any one meal 
 is 16 ounces (one pound). If the patient is still hungry 
 then, he must take the whites of one or two eggs lightly 
 poached, between meals. He must not exceed six eggs 
 a day. The feeling of weakness that this diet produces 
 for a day or two will pass off. 
 
 (5) A little aperient medicine, such as cascara, may 
 be necessary occasionally. 
 
 (6) If after a long course of treatment the patient 
 is sick of beef-mince and beef cakes, he may have 
 (minced before being cooked) mutton, lamb, poultry, 
 well-boiled rice or macaroni, as additional food, but these 
 are not to replace the beef altogether. 
 
 (7) Instructions for making beef-mince. Cut slices 
 from the top side of a round of beef. Cut the meat into 
 strips and scrape away all fat and gristle. Put the meat 
 twice through the mincing-machine. Beat up the pulp 
 in a roomy saucepan with cold water, in the proportion 
 of one teaspoonful of water to one ounce of pulp. Add 
 black pepper and salt to taste. 
 
 Cook the mince slowly, stirring all the time, until the 
 red color disappears. This will take about twenty 
 minutes. 
 
 When finished, the mince should be a smooth, soft, 
 jpasty mass, without any lumps in it, aixd is .to be served 
 
242 SCARLET FEVER 
 
 in a hot basin and eaten from a teaspoon. The patient 
 may have a stick or two of raw celery if he wants some- 
 thing to chew with it. 
 
 (8) Instructions for making Salisbury beef cakes. 
 Take minced beef pulp prepared as already described 
 above, season it to taste, and turn it with two forks into 
 several flat round cakes, about half an inch thick, and 
 grill them over a clear moderate fire for about six minutes 
 each. 
 
 Scarlet Fever (Scarlatina) . This serious disease, to which 
 all are liable, though young children are most often attacked, 
 is a contagious fever, of which the most important charac- 
 ters are sore throat and a bright red rash on the skin ; and 
 the most important complication is inflammation of the 
 kidneys. (See also "Infection.") The poison of it clings 
 to clothing and articles that have been used for the sick, 
 sometimes for months, and often lying harmless for a long 
 time may suddenly start the disease again if it finds a per- 
 son who is weakly or susceptible. 
 
 As a rule, a person who has "caught" scarlet fever falls 
 ill within two days. He shivers, vomits, and complains of 
 headache and backache, and cannot eat or sleep. Then 
 comes a bad sore throat. On the second day appears a red 
 rash (see "Bashes on the Skin," No. 1). This rash begins 
 to fade about the sixth day of illness, and then begins 
 "peeling." The skin shreds off in tiny flakes, or even in 
 large flakes, and these little scales are very contagious. 
 This goes on sometimes for six weeks or more. As to the 
 throat, it is red, swollen, and painful and tender. The 
 tongue is bright red. The fever is high. In most cases 
 the disease is at its height about the sixth day of illness, and 
 after that the patient slowly gets better. In fatal cases 
 the patient dies from exhaustion after about five days of 
 severe illness. 
 
 The complications of scarlet fever may be terrible. The 
 tonsils and the palate may ulcerate; the glands under the 
 jaw may enlarge into a brawny hard swelling and undergo 
 mortification. This generally kills the patient. The mid- 
 dle ear (see "Ear Diseases") may become attacked, and 
 the patient will probably then be deaf and have a discharge 
 from the ears for the rest of his life. But the most seri- 
 ous of all are inflammation of the kidneys which may 
 
SCIATICA 243 
 
 come on during convalescence and lead to dropsy, etc., 
 and scarlatinal rheumatism, which may leave the patient 
 with heart disease. 
 
 Treatment. The general measures to be taken as to iso- 
 lation are described under the treatment of measles (which 
 see). A sheet dipped in and kept always wet with 1 in 100 
 carbolic acid lotion must be hung up to cut off the sick room 
 from the rest of the house. From the very first it is a good 
 plan to anoint the patient's body daily with 1 in 50 carbolic 
 oil. Washing the body daily with weak disinfectant lotions 
 is only to be done during convalescence. The medicines 
 must, of course, be left to the doctor in attendance. A 
 throat spray should always be used ; it lessens the risk of ear 
 complications. Such a spray is the following: Glycerin 
 of carbolic acid, 3 drachms ; glycerin of borax, 3 drachms ; 
 rose water to half-a-pint. Isolation must be kept up for at 
 least six weeks. It is of the very highest importance to 
 guard against chills during the convalescence. 
 
 Sciatica, This word means neuralgia (nerve pain) or 
 actual neuritis (nerve inflammation) of the sciatic nerve, 
 which lies under the muscles at the back of the thigh from 
 the buttocks to the heel. It is generally caused, in the first 
 place, by exposure to wet and cold, as by sitting on cold 
 stone, or lying on wet grass; and, once contracted, sciatica 
 is often very difficult to get rid of. Persons with sciatica 
 have pain more or less along the whole length of the nerve, 
 even down into the heel, and tender spots at various points 
 on the back of the thigh. If it goes on for a long time, 
 there is generally some wasting of the muscles and flesh of 
 the thigh. 
 
 Occasionally, sciatica is a sign of some spinal disease. 
 
 Acute sciatica, coming on suddenly after some indiscre- 
 tion, like sitting on a cold stone, should be treated thus: 
 Get the sufferer to bed, wrap him up warmly, and give him 
 two or three grains of calomel, followed by two Seidlitz 
 powders next morning. About the same time as the dose 
 of calomel, let him take 15 grains of Dover's powder. 
 (This is a pharmacopoeial, and not a patent medicine.) 
 
 Very chronic sciatica ought to be treated by a long rest 
 in bed and dry cupping over the course of the nerve, along 
 the thigh. Both acute and chronic sciatica will need spe- 
 cial medicines for the relief of pain, and morphine or co- 
 caine may have to be injected under the skin; of course, 
 
244 SCROFULA 
 
 these drugs can only be safely administered by a doctor. 
 Moreover, in most cases of sciatica, the patient is already 
 tainted with gout, or rheumatism, or alcoholism, or syphilis, 
 and the treatment proper to these diseases must also be 
 administered. Sufferers from sciatica might like to try one 
 of the following formulas : 
 
 (1) Phenacetin, 50 grains; salol, 50 grains; caffeine, 5 
 grains. Divide into 10 cachets, and take from two 
 to four cachets daily, in recent case of sciatica; or 
 
 (2) Spirit of turpentine, % ounce; pure honey, 1^2 
 ounce. Make a confection, and take a teaspoonful 
 night and morning; or 
 
 (3) Salophen, 10 to 40 grains, in cachets. Three or 
 more cachets to be taken daily in cases of sciatica 
 in rheumatic person. Aspirin has also had its ad- 
 vocates in 10 grain doses, thrice daily. 
 
 (4) Several liniments are in common use, but let the 
 sufferer remember that most cases of sciatica are 
 neuritis and not neuralgia alone. Hence the re- 
 lief obtained by rubbing liniments in is only tem- 
 porary. Good liniments for this purpose are 
 chloroform, belladonna, aconite of turpentine or 
 camphor liniments. 
 
 (5) Many cases of sciatica get relief from the injection 
 under the skin of pure water ; others like injections 
 of cocaine; others of chloroform. 
 
 (6) Leeches put on over the painful spot often give 
 much relief. 
 
 (7) Great heat, locally applied, as in the Sprague sys- 
 tem, often cures the neuritis altogether. 
 
 (8) Alcohol, one of the chief causes of neuritis, does 
 harm in all cases, and ought never to be taken. 
 
 Scrofula. A child or person is said to be scrofulous when 
 he or she suffers from a special liability to diseases caused 
 by the germ of tuberculosis or consumption ' ' the tubercle 
 bacillus." The word is dropping out of use nowadays. 
 There used to be an idea that there were only two types 
 of body which were especially liable to be attacked by 
 tubercle. But it is quite certain that there is no type of 
 individual which cannot become infected, though some 
 types are still recognized as being more prone than others 
 
SCURF 245 
 
 to the disease. The two "scrofulous" types are (1) 
 Those persons with coarse hair, coarse features and greasy 
 skins, of poor muscular development and long, flat chests, 
 and (2) those of somewhat delicate beauty, with pink and 
 white delicate skins, large eyes, soft dimpled flesh, downy 
 hair over the face, neck and arms, keen perceptions, lovable 
 dispositions, and bright intellect. The word struma means 
 much the same as scrofula. Old country doctors still 
 sometimes call only tuberculous disease of the lungs "con- 
 sumption"; tuberculous disease of a joint "scrofulous 
 joint"; and tuberculous infection of the glands "strumous 
 glands ' ' ; although as a fact the disease is the same in all 
 these cases caused by a deposit of "tuberculous matter" 
 in the part affected. (See "Tubercle.") 
 
 Scurf. This is a very different thing from scurvy, which 
 is a blood disease. Scurf is a disorder of the skin of the 
 head and hairy scalp. There are two chief varieties of 
 scurf (1) a greasy, oily scurfiness of the skin, with flakes 
 of reddish-brown scurf skin and red blotches, which may 
 spread from the scalp down on to the face; and (2) a dry- 
 ness of the scalp, with itching, and dry scales, which accu- 
 mulate on the collar of the coat during the day, and fall 
 in a shower when the hair is brushed. The first variety is 
 generally called scurf, and the second is named dandruff. 
 In the one case the skin glands are too active and too much 
 oil is made, so that the skin becomes sodden and sticky, and 
 in dandruff the hair, eyebrows, mustache and beard get 
 thin because there is not oil enough in the scalp. In both 
 cases the hair glands are in fault. Constipated persons 
 seem to be very liable to scurf on the head. Seeing that 
 people of all ages and of all classes, and of every way of 
 life, and under the most various circumstances of health 
 and quality of skin, suffer from scurf, we are sure to be 
 pretty right if we conclude that scurfiness is caused by the 
 presence of some parasite or other. But although animal- 
 culas of many different varieties have been found in the 
 scales from scurfy heads, no one can be sure yet what par- 
 ticular organism does the mischief. The importance of 
 all this to a non-medical reader is this that no one ought 
 to wear the cap or hat, or use the hair brushes or combs of 
 another person, and that brushes and combs ought to be 
 washed in disinfectants as well as with soap. In the house- 
 hold of the intelligent woman of the present day, disin- 
 
246 SCURVY 
 
 fectant solutions ought to be frequently in use for the pre- 
 vention of disease ; for prevention is better than cure. As 
 to what disinfectant to use, one may employ Sanitas Fluid . 
 or boric acid, or boroglyceride, or carbolic acid, or corrosive 
 sublimate. The last two are very powerful, and they are 
 also poisonous. But little bottles of tablets may easily be 
 obtained, and lotions of various strengths (according to the 
 purpose required, and prepared from the instructions on 
 the labels), may be made in a few minutes. 
 
 There is no doubt but that scurfiness prepares the way 
 for eczema in some persons and that it is sometimes diffi- 
 cult to decide where scurf leaves off and eczema begins. 
 All the more reason for keeping brushes and combs clean 
 and disinfected, and for not using other people's clothes 
 and for frequent washing of the scalp. 
 
 Now scurf is a local disease, and does not require "medi- 
 cines for the blood." The scaly masses ought to be got 
 away by gentle rubbing with a clean rag, dipped in spirit. 
 Then, at bedtime, in the case of dandruff, or dry scurf, rub 
 into the scalp (NOT the hair, but the skin) an ointment made 
 of precipitated sulphur, 1 part in 10 parts of cold cream. 
 Another good pomade is made of 5 grains of precipitated 
 sulphur to an ounce of lanolin. 
 
 In the other cases of scurf, where there is already too 
 much oiliness, first remove all greasy crusts and scabs and 
 scales, but gently, and without one of those abominable 
 little fine-tooth combs, which injure the skin and do harm. 
 Wash the scalp daily with Spiritus alkalinus saponis in 
 warm water for a week or so. Then when the scurfiness is 
 less, wash only once a week, and then use a new lotion made 
 of 20 grains of corrosive sublimate in 6 ounces of spirit and 
 2 pints of water. This is a poisonous preparation, and it 
 must be labeled poison and not left about. And, at last, 
 when there is no more scurf, to promote the growth of the 
 hair, use the following elegant pomade whenever necessary : 
 Precipitated sulphur, 2 drachms; castor oil, 4 drachms; 
 tincture of cantharides, 1 fluid drachm ; balsam of Peru, 10 
 drops or more ; cocoanut oil, 3 drachms. This will be found 
 a delightful preparation and may be continued throughout 
 life. (For other methods of treating Scurf, see "Skin Dis- 
 eases" IV.) 
 
 Scurvy. This is a blood disease caused by the absence of 
 sufficient vegetables in the diet. It is not to be confounded 
 
SELF-DOCTORING 247 
 
 with scurfiness or scurf, which is merely an unhealthy condi- 
 tion of the scalp of the head. The signs of scurvy are 
 weakness of gradual onset, sallowness, sunken eyes, pains all 
 over the body, tenderness of the gums, and foul breath. 
 Later, the gums bleed, the teeth fall out and bleeding takes 
 place from nose, rectum or vagina and even under the skin 
 (bruises) and in the whites of the eyes. The disease may 
 cause death at last. 
 
 Treatment. Scurvy can always be avoided by a sufficient 
 supply of fresh vegetables or fresh meat ; and the same rem- 
 edy will cure all but the very worst cases. 
 
 Seasickness. There are some people who, expecting to 
 be seasick when they go down to the quay, generally man- 
 age to feel so before they actually go on board by merely 
 watching the ship riding at her anchor. Others, expecting 
 to be sick, spoil the whole pleasure and interest by mere 
 apprehension. Some require no more than the gentle 
 plunging of a vessel at anchor ; some need a thorough shak- 
 ing-up in order to produce retching. As soon as a suscep- 
 tible patient gets on board a ship he should lie down flat on 
 his back and keep his eyes closed, and try to get a nap. 
 But, then, the susceptible man or woman ought never to at- 
 tempt a sea voyage without preparing themselves. The 
 nervous system of such a person requires soothing for a few 
 days before embarkation. Twenty grains of bromide of 
 sodium ought to be taken thrice daily for four days before 
 going on board. A light meal must then be taken three 
 hours before the ship starts. Some people only want a 
 little courage to help them fight against seasickness, and 
 iced champagne may very often supply the stimulus re- 
 quired to make Dutch courage. Chlorobrom is one of the 
 favorite remedies. It contains bromide of potash and other 
 things, and should be taken in the same way. Some people 
 like to suck extra strong peppermints all the time, and 
 there is no objection to them if the people near at hand do 
 not object. Before going on board attend well to the gen- 
 eral health. Eat nothing in the least bit indigestible, such 
 as pickles, cheese, nuts, rich soups, highly seasoned dishes, 
 and such-like. And, above all things, keep the bowels freely 
 open. 
 
 Self-Doctoring. This is only mentioned to be condemned. 
 No sensible man or woman will doctor himself or herself in 
 anything more than a passing ailment. Even a doctor will 
 
248 SEWAGE DISPOSAL 
 
 not doctor himself, because he knows how misleading sen- 
 sations can be. If you are ill, send for the best doctor 
 you can afford, and respect him, and put full faith in him. 
 Tell him everything, carry out his full directions and work 
 with him in every way. Even at the worst, his advice, 
 founded on skill and experience, must be better than your 
 unskilled guesswork; and this plan will be found to be 
 more economical in the end. 
 
 Sewage Disposal. There are few more common methods 
 for the transmission of disease than the improper disposal 
 of sewage. This comes about as a rule through the con- 
 tamination, through sewage, of water and milk supplies, 
 of baths, and of food supplies, largely through the agencies 
 of flies. Diseases transmitted in such ways are typhoid and 
 scarlet fever, cholera, diphtheria, tuberculosis, summer 
 diarrheas, and many others, including those due to the in- 
 testinal parasites. One of the gravest and most familiar 
 example of the last is the transmission of hook-worm 
 through sewage-contaminated soil. 
 
 This is a foot or skin infection and is prevented by wear- 
 ing shoes. 
 
 There are two main systems of sewage disposal the wet 
 and the dry systems. The wet system is only applicable 
 where there is a plentiful water supply, as in cities, or towns 
 and is therefore confined to thickly settled districts. 
 
 The methods most in use in the dry system are the pail 
 system, the earth closet and the privy vault. 
 
 The last method is usually objectionable as the contained 
 sewage is very liable to contaminate soil and water. 
 
 If used it should be lined with impervious material like 
 concrete or brick and emptied every week or two. It should 
 always be carefully screened from flies and the openings 
 should have hinged coverings. 
 
 In the pail system a pail is used of about two cubic feet 
 capacity. 
 
 These pails are removed as often as necessary neigh- 
 boring farmers being willing to remove them free of charge 
 on account of the value of this material as fertilizer. 
 
 In the earth-closet system about a pound and a half of 
 dry sifted loam or clay are immediately thrown upon the 
 dejecta, which are thus rendered inodorous and inoffensive. 
 Owing to the action of certain bacteria in the earth, all 
 trace of the peculiar nature of the organic compound is 
 
SEWAGE DISPOSAL 249 
 
 quickly destroyed, and the mixture soon becomes practi- 
 cally nothing but humus and is of some value as a fer- 
 tilizer. 
 
 The closet should not be on ground higher than the house ; 
 it should be tightly closed in and the openings in the seat 
 covered to keep out the flies. It should not be too far from 
 the house (about 150 feet) and not nearer to a well than 200 
 feet. Lime should be freely used, or even better are wood 
 ashes. Closets should be frequently cleaned and the matter 
 in them (if not used for fertilizing purposes) completely 
 buried or spread out on soil at some distance from the house 
 so that it will dry quickly. 
 
 Horse manure is best handled by placing immediately in 
 barrels which are covered or screened from flies (98 per 
 cent, of which breed in horse manure). 
 
 In the wet system of sewage disposal the chief points of 
 interest are the collection or plumbing and the disposal of 
 the sewage material. 
 
 The essentials of good plumbing are: 
 
 Enough water to flush and clean pipes. 
 
 A ventilation system to dilute and carry off gases. 
 
 Open plumbing to facilitate examination and repairs. 
 
 Traps to prevent entrance of sewer gas and micro- 
 organisms into the dwelling. 
 
 The following are the commoner methods of sewage dis- 
 posal, which concern not so much the householder as the 
 engineer planning city works: 
 
 Emptying into the sea at a distance from the shore. 
 
 Land irrigation, in which the sewage is distributed over 
 farms for fertilizing purposes. 
 
 Purification by chemical precipitation with subsequent 
 disposal of the sludge. 
 
 Biological purification by means of the septic tank or 
 contact beds. 
 
 Filtration. This is often combined with the previous 
 method. The filtrate contains very few bacteria after the 
 last three processes and may safely be emptied into a large 
 stream. 
 
 To empty untreated sewage into a stream is criminal, as 
 inhabitants on the banks lower down are certain to con- 
 tract such diseases as typhoid fever, diphtheria or cholera 
 if this water is drunk. 
 
 Cesspools, which are frequently used in the country to 
 
250 SIMPLE LIFE 
 
 temporarily collect and store large amounts of sewage, are 
 dangerous unless properly built. 
 
 They should be at least 50 feet away from a dwelling and 
 60 to 80 feet distant from a well, spring or stream. Their 
 walls and floors must be constructed of good brickwork in 
 cement, rendered inside with cement, and with a backing 
 of at least 9 inches of well-puddled clay around and beneath 
 the brickwork. The top of the cesspools must be arched 
 over and means of ventilation provided, which, at the same 
 time, are carefully screened from flies and insects. 
 
 The best method of emptying cesspools is by the pneu- 
 matic pressure method such as is commonly used in Paris 
 with the fosse permanente. 
 
 Simple Life, The. The papers, a short while ago, were 
 full of this expression: "Live the Simple Life!" What 
 does it mean? "The Simple Life" is the title of a won- 
 derful book by a German pastor named Wagner, in which 
 he finds just fault with all the artificiality of our present 
 empty civilization. He shows that most of the so-called 
 comforts we enjoy are not necessaries, but luxuries which 
 we should be happier without. Who can doubt it? The 
 arguments in this book chiefly hit the foolish expenses of a 
 certain rich class; but the working man is not exempted, 
 for does he not drink to the hurt and damage of his health 
 and happiness, the emptying of his purse, and the impov- 
 erishment of his family? What would life be, with all its 
 disappointments, without some of its convivial drinking, its 
 smoking, its cups of tea? the reader may ask. Well, as 
 life is at present in our towns, and with the fearful com- 
 petition, life would be dull indeed without some "dissipa- 
 tion," we are forced to admit. But, all the same, the Sim- 
 ple Life has its claims upon us. It does not mean that 
 to be happy and well we ought to forego all alcohol, all tea, 
 all tobacco, all gorgeous hats, smart boots and shoes, 
 feathers and luxuries. 
 
 It only means that the man, woman, or child is happy 
 and rich in proportion to the things he or she can do with- 
 out! The more simply we live, the happier and healthier 
 we shall be. The real Gospel of the Happy Life is to learn 
 to do without. We do need pictures, and travel, and books, 
 and clothes, and stimulants, in moderation. They help us 
 to develop the best that is in us. But we can and ought to 
 see pictures in the galleries, and they are better than most 
 
SINS AGAINST HEALTH 251 
 
 of us can buy; we can spend our savings on bicycles and 
 traveling tours ; we can dress suitably to our stations, and 
 for comfort rather than show ; and we only need stimulants 
 when we are not strong enough for the work we have to do. 
 The Simple Life saves our pocket money, and increases our 
 health and enjoyment. We are better citizens, better sons 
 and daughters, better sweethearts, better married folk, bet- 
 ter fathers and mothers, better old people, for having 
 learned to do without what we really do not need. It is in 
 the hands of women, to a great extent, to bring into effect 
 the advantages to be gained by the simpler way of living. 
 Let them scorn to keep company with the man who drinks 
 to excess, and let them refuse to marry as they are doing 
 more and more with men who are dissipated or selfish and 
 luxurious. And they themselves may set a good example 
 by dressing plainly, and discouraging extravagance. They 
 are very anxious to please and be pleasing ; so let the men, 
 in their turn, discourage over-fine dressing, excessive tea- 
 drinking, and encourage, as far as possible, the "Simple 
 Life" in their families. 
 
 Sins against Health Hygienic Misdemeanors. Under 
 these rather stern titles we refer to all those faults 
 which people commit, knowingly or unknowingly, against 
 their physical bodies or their minds. How is it that to-day 
 there is a mighty host of doctors trying to grapple with a 
 mass of disease and ill health; that there are hundreds of 
 patent medicines, all guaranteed to cure; that there is an 
 ever-increasing number of asylums for the unfortunate in- 
 sane; and that every year the hospitals are crying out for 
 funds, that they may enlarge the scope of their necessary 
 labors? Is not medical science wonderfully advanced? 
 Have we not sanitary boards, health officers, splendid san- 
 itation, and isolation of infectious disease? How many 
 families, reader, do you know of in which there is no one 
 sick, no one ever ailing? Has nearly every family, then, a 
 sick member? And this in America the most advanced, 
 civilized, and enlightened country in the wide world (ac- 
 cording to the American) ! The fact is, that we advanced, 
 wealthy, sensible, sturdy, plucky, enlightened and civilized, 
 as we are are living to-day an artificial, unwholesome, 
 and wearing life ; and it is the artificiality of our lives that 
 prevents so many of us from enjoying the birthright of 
 every living creature sound health. As long as an indi- 
 
252 SKIN DISEASES 
 
 vidual follows that inward voice which tells him what to 
 do and what not to do, he remains healthy in body and 
 mind. As soon as he begins to hear and do what others tell 
 him to do, he begins to find life complex, and to ail some- 
 thing. A young man is led to suppose something manly 
 in drinking and smoking; of himself, unless he be ill, he 
 would never drink except when thirsty; and of himself he 
 probably would never smoke. Why should he? He only 
 smokes in imitation of his fellows. The young girl is told: 
 that to tight-lace, wear high heels, or otherwise deform her- 
 self is to excite admiration in men. Of herself she would 
 probably prefer to breathe freely, and to live without adorn- 
 ment other than the roses of good health. Thus you see 
 what we mean by a hygienic misdemeanor it is really a sin 
 against health. You must realize that Nature is pitiless 
 and inevitable ; that as you sow, so must you reap. Every 
 excess must be followed by a reaction, a depression; every 
 sin brings its own punishment, sooner or later but sure as 
 death. No one can escape this law. And, in the same way r 
 it is possible to live righteously, from a hygienic point of 
 view to be moderate, temperate in eating, as well as in 
 drinking, and the result is just as certain, just as inevitable. 
 Years of drinking to excess, whether in the bar or in the 
 privacy of your bedroom, with the bottle hidden beneath 
 the mattress or up the chimney will tell upon you, ruin 
 your nerve, and spoil your health. And years of moderate 
 living, of hard work, of early hours, and of exercise in 
 fresh air, will have their due effect. Without accidents 
 or excesses many a man and woman lives to a hale and. 
 hearty hundred. Why not you? 
 
 Skin Diseases. I. This is a subject which does not lend 
 itself to easy comprehension by the non-medical person. 
 More, perhaps, than in any other branch of medicine is it 
 necessary to know the anatomy and physiology of the parts 
 under consideration, and to have experience of hundreds 
 of cases. We have, therefore, merely written a sketch of 
 the subject here, while for a few only of the commonest skin 
 diseases and their remedies, details are given under sepa- 
 rate headings (which see). 
 
 Almost all persons have some form of skin disease at one 
 time or another, and these affections often give rise to muck 
 discomfort and often to disfigurement. Some forms cause 
 
SKIN DISEASES ?53 
 
 great irritation, others are painful, and some give rise to 
 unpleasant discharges. 
 
 It must be remembered that many skin ailments are con- 
 tagious, especially those that are due to parasites or insects. 
 Some are attended by fever, and these are acutely infec- 
 tious, such as measles and scarlatina. 
 
 Some of these diseases are only observed in infancy, others 
 in childhood, while others again are only seen in middle life 
 or in aged persons. 
 
 Constitutional diseases of the nature of blood-poisoning 
 are often shown to exist by skin eruptions. The diseases 
 of the skin are shown by about nine different peculiarities 
 of the surface ; these may occur singly or may be observed 
 grouped together. These forms are smooth reddened 
 blushes, pimples, vesicles, blebs, pustules, wheals, stains, 
 scaliness, or scabs. 
 
 For example, erysipelas is shown by a blush only, but 
 smallpox goes through the stages of pimple, vesicle, pustule, 
 and scab ; while psoriasis is scaly only, as is one form of 
 ringworm or tetter. The red blush is seen in measles or 
 scarlatina. By pimple is meant a small, round, raised spot, 
 somewhat hard and solid. A vesicle is a similar spot, which 
 contains a drop of clear liquid. A pustule is a similar 
 raised spot, containing a drop of pus, or matter a 
 thick yellow liquid. Blebs are large vesicles like a blister 
 caused by a scald or burn. Wheals are temporary raised 
 pink patches; they rarely last many hours; they are seen 
 after nettle stings. 
 
 Scales of dry scurf are commonly seen on the scalp, but 
 some skin diseases cause large patches of scaly soreness on 
 the hands and arms. Stains of color, which are often hairy, 
 are generally formed before birth, but some patches of yel- 
 low or brown color may be due to parasites in the skin, or 
 some are caused by constitutional disease. 
 
 Scabs are the late stage of vesicles, blebs, and pustules, 
 after they have been broken, and arise from the surface dry- 
 ing into a hardened crust; but when a scab is pulled off 
 a raw sore place is found underneath. 
 
 Scabs being a dried, dead layer, it is not of the slightest 
 use to apply any ointment or lotion to them; the scabs 
 must be removed, and any curative treatment must be ap- 
 plied to the raw surface. Much disappointment is often 
 
254 CHILBLAINS 
 
 felt by a neglect of this precaution. To remove scabs it is 
 often necessary to apply one or more poultices of bread, 
 linseed meal, or mashed boiled turnip. 
 
 II. Chilblains, Cracks and Chaps. One of the most 
 common forms of skin disease in the cold weather is the 
 chilblain; this is caused by exposure to cold air, and is 
 often due to imperfect drying of the hands after washing 
 them ; it also attacks the feet, and in some persons the ears 
 suffer from exposure to cold winds. What are called chaps 
 are also caused by cold. Persons afflicted with a weak con- 
 stitution and a defective circulation of the blood suffer 
 most often. 
 
 Chilblains commence with a red blush on the skin, which 
 is very irritable, and becomes tender from rubbing. If 
 they are not soon cured they are apt to become broken in 
 small patches; that is to say, the inflamed surfaces become 
 raw, and require to be treated as an ulcer with healing 
 applications, such as zinc ointment. While unbroken they 
 need to be protected from the air, and require stimulating 
 liniments or spirituous paints, such as the tincture of 
 iodine. An excellent application is made by mixing 
 turpentine 12 parts, castor oil 6 parts, and collodion 30 
 parts ; this is painted on the chilblains with a brush. Com- 
 pound soap liniment or camphor liniment will cure many 
 cases. A favorite old domestic remedy was to take an 
 onion, cut it in half, dip it in salt, and rub the salted cut 
 surface on the chilblains. None of these applications must 
 be put on a broken chilblain. Inasmuch as this ailment 
 shows a state of feeble health, it is always wise to give 
 cod-liver oil for two or three weeks after meals and also 
 to take a mixture of quinine and iron half an hour before 
 the two principal meals each day. 
 
 Chaps and small cracks on the skin of the fingers may 
 be well treated by collodion, or by the above-described col- 
 lodion paint. Chafes are red patches of skin due to rub- 
 bing, and are also frequently found on the legs of infants, 
 where they are set up by their being kept tied up in wet 
 napkins, especially if they are not changed often enough. 
 These can be avoided by frequent bathing with warm water 
 and soap, and the parts carefully dried with a warm, soft 
 towel. When they have occurred they must be carefully 
 attended to in the same manner, and then dusted over with 
 a mixture of dry oxide of zinc and starch powder. If 
 
NETTLERASH 255 
 
 actual soreness has arisen, then apply zinc ointment twice 
 a day, and put a layer of clean lint smoothly over the part. 
 Fuller's earth is often applied by the poor to these tender, 
 sore patches on infants, but it often does harm, because 
 it is not ground sufficiently fine and smooth. Another 
 excellent dusting powder is named oleate of zinc; it is 
 extremely soft, and very soothing to inflamed skin. 
 
 III. Nettlerash, Freckles, Babies' Pimples, Erythema. 
 The ailment called nettlerash is not uncommon; it is al- 
 most always due to indigestion set up by excess of food, 
 or by unwholesome food, and attacks are particularly com- 
 mon after eating shellfish, crabs, lobsters, cockles, oysters, 
 or periwinkles. Eating cold pickles with hot meat is an- 
 other cause. A sudden chill on a perspiring skin may 
 bring it on. Persons who have had one attack often have 
 others subsequently. Nettlerash is a red blush, upon which 
 a paler patch soon appears; it does not last many hours, 
 but leads to much itching and irritation. Scratching and 
 rubbing this part should be avoided, and the irritation can 
 be subdued by lead lotion, zinc ointment, or by a lotion 
 of equal parts of sanitas and water. Epsom salts, taken 
 in water, is the best remedy for internal use. 
 
 Freckles are a form of skin disease, shown by small yel- 
 low or brown spots on the white skin of the face, arms and 
 hands. Most persons object to them, but there are a few 
 people who do not think them unbecoming. There are 
 hundreds of advertised quack remedies for freckles, but we 
 do not consider that there is any means of cure. They 
 often come out after exposure to bright, hot sunlight, and 
 may disappear of themselves. The cucumber ointment im- 
 ported from Paris is, perhaps, the most likely means of 
 cure. Or the following lotion may be tried : Fresh lemon- 
 juice, rose-water, rectified spirit equal parts. (Mix.) 
 Leave for 24 hours. Strain through muslin. Bathe the 
 face night and morning with the lotion after washing, and 
 dry lightly. 
 
 Red-gum and white-gum are the names of minute red 
 or white pimples seen on the skin of infants ; they appear 
 after free perspiration under their clothing; they are not 
 of much importance and do not last many days. A little 
 laxative medicine may be given, and lead lotion or zinc 
 ointment may be applied to the skin. 
 
 The group of pink, red, and purple skin rashes, which 
 
256 SCALP DISEASES 
 
 are accompanied by fever we refer to measles, scarlatina, 
 and erysipelas are serious diseases, and need medical care. 
 There is one other which may not be of much importance ; 
 this is called Erythema. In this disease there may be no 
 fever, and it is shown by the appearance of roundish pink 
 patches on the white skin, and these are often seen on the 
 front of the legs. They may be a little raised above the 
 skin around them; they may become more dusky in color 
 as they fade away; they last a few days. These patches 
 are also seen on the face and chest. The treatment is by 
 aperient medicines, such as sulphate of soda or sulphate of 
 magnesia, citrate of magnesia, or the tartarated soda; rhu- 
 barb, with bicarbonate of soda, is suitable for children and 
 infants. The diet for a few days must be light, consisting 
 of broths and farinaceous puddings, and fruit; lemonade 
 is the best drink to be taken. This skin rash is not con- 
 tagious. 
 
 IV. Scalp Diseases. The skin of the head is a part 
 which often gives rise to trouble. In health it should be 
 pale, smooth, free from scurf, and not too greasy, and the 
 hairs should stick firmly in it. 
 
 In disease it loses all these natural characters. The hair 
 may fall out generally, or in patches, and leave baldness. 
 There may be any variety of pimples, and pustules with 
 scabs, and the scalp may become scurfy, with either dry- 
 scales or a matted greasiness. Some forms are acutely 
 contagious; others cannot be caught by one persons from 
 another. 
 
 Loss of the hair may be due to ill health, and may result 
 from the violence of a fever, and the hair does become 
 gradually thinner during consumption and chronic ill- 
 nesses. In such cases, when recovery follows, the hair 
 generally takes on new growth. Loss of hair early in life 
 is very often an inherited peculiarity, and in such persons 
 neither medicines nor local applications will effect a cure. 
 When the loss of hair occurs in patches it becomes neces- 
 sary to decide whether the baldness is due to the growth 
 of a microscopic vegetable mold, or fungus, or to some fault 
 in the nerves of the spot. To decide this a physician is 
 necessary; he must scrape the surface, and examine the 
 scurf under powerful glasses ; if there is any mold growth, 
 the treatment is by applications which kill such fungi; if 
 not, the cure is by stimulating liniments and general tonics. 
 
RINGWORM 257 
 
 Scurfiness of the scalp is often a great annoyance; it 
 generally comes on from neglect of regular washing of the 
 scalp and brushing of the hair. Local treatment is neces- 
 sary. The scalp must be thoroughly washed with warm 
 water, with a nailbrush and a cake of 10 per cent, carbolic 
 soap, which a chemist can supply. Do this every other 
 night, three times. After this treatment, rub in every 
 night the following lotion, with a piece of flannel : Mix the 
 yolk of a small, fresh egg with half an ounce of spirit of 
 rosemary, and a half-pint of clean rain water. "When the 
 scurf is greasy, rub in this lotion instead: Take one 
 drachm each of powdered bicarbonate of soda, and borax, 
 half an ounce of eau-de-cologne, one ounce of rectified 
 spirit, and water half a pint ; mix and bottle. 
 
 Until lately it was considered very good practice to rub 
 pomatums, scented ointments, into the scalp almost daily, 
 but of late years doctors have considered that this custom 
 chokes up the pores of the skin, and does not nourish the 
 hair. The present plan is to stimulate the growth of the 
 hair by constant brushing of the hair and scalp. 
 
 V. A note on Ringworm. We come now to that most 
 persistent and troublesome ailment which is commonly 
 called tetter, or ringworm. It is a contagious disease, due 
 to the growth of a minute vegetable mold or fungus on the 
 skin, and in the roots of the hairs. It makes the hairs 
 brittle, and they break off, and makes them loose, and they 
 fall out. The disease may commence in one spot only, or 
 in many patches, almost at once. It causes irritation, and 
 so the sufferer scratches it, and so makes the skin red and 
 inflamed, and he infects one place after another. Patches 
 may begin anywhere among the hair on the scalp, or on 
 the neck where there is only a fine down growing. There 
 is a variety of ringworm which occurs on the skin of the 
 face, neck, arms, or body where there is no hair; this also 
 is parasitic, but it is much less troublesome and is gen- 
 erally easily cured by the ointment of ammoniated mer- 
 cury. The difficulty with children is to prevent them 
 scratching the spots, and so spreading the disease. 
 
 To return to ringworm of the scalp, if you see a patch 
 of about a week old which has not been treated there will 
 be a bare place, with a scurfy pink surface, the stumps 
 of the hairs visible; a few hairs not yet lost will be found 
 to be easily broken off by rubbing them; such a patch be- 
 
258 RINGWORM 
 
 comes red with scratching, and may soon be covered with 
 vesicles and little scabs ; ointments and paints which cause 
 irritation will produce the same result. The patch may 
 spread continuously, or other separate patches may appear, 
 and any or all of them may spread, until almost all the 
 hair of the head has been destroyed. 
 
 If a child be very healthy, and if the first patch be at 
 once treated in a scientific manner, there may be a chance 
 of cure in a month if there be no infection of other spots. 
 
 But in the majority of cases the disease spreads from its 
 first center and may run a course of many months, and 
 even years. 
 
 In order to effect a cure it is necessary to improve the 
 general health, to keep the spots free from dried scabs, 
 to apply paints or ointments which will kill the growth, 
 and then, with zinc or lead ointments, to heal up the in- 
 jured surfaces. The most difficult part is to find out when 
 the disease is killed, and the powerful applications may be 
 safely discontinued. If they are applied too long, they set 
 up unnecessary inflammation, ulceration, and scabbing; if 
 they are left off too soon, the work of killing the fungus 
 growth has to be begun again. Skilled medical attention 
 is necessary throughout the whole course of treatment. 
 Amateur doctoring is practically useless. "We give a few 
 good prescriptions for those who care to try them. 
 
 (1) For ringworm of the body. Ointment of the 
 iodide of sulphur, y drachm to 1 ounce of benzoated 
 lard. (For delicate skins.) 
 
 (2) For ringworm of the body (for farm laborers, 
 etc.). Ointment of the iodide of sulphur, 1 part; lard, 
 8 parts. (Should be made up a few days before re- 
 quired.) 
 
 (3) For scalp ringworm delicate skins. Oleate of 
 mercury ointment, 10 per cent. 
 
 (4) Pomade for the heads of children in a school or 
 home where ringworm has broken out. Boric acid 
 ointment, 2 ounces; eucalyptus ointment, 1 ounce; 
 cocoanut oil, 2 ounces ; oil of cloves, % drachm. 
 
 (5) Hutcliinson's plan. Cut off all the hair and 
 shave it close, where possible. Wash the scalp twice 
 a week with a lotion made of tar water, 1 drachm; 
 rain water, 1 pint; and rub in this ointment: 
 
SLEEP 259 
 
 Chrysarobin, 1 drachm ; ammon. hyd. chlor., 25 grains ; 
 lanolin, 1 drachm; benzoated lard, 6 drachms; tar 
 water, 10 drops. 
 
 The secret of success often lies in the patient con- 
 tinuance of the same remedy. 
 
 Sleep, Hints on Obtaining. (1) Let the room be well- 
 ventilated and cool. 
 
 (2) Let the feet be warm. Those who suffer from cold 
 feet should first try holding them in a basin of cold water 
 by the bedside, just before getting into bed, for about 
 two minutes or less, and then rubbing them fairly dry 
 with a rough towel. In persons with poor circulation, this 
 plan may fail ; then a hot-water bottle must be kept at the 
 end of the bed. Anything rather than cold feet. 
 
 (3) If hot when coming to bed, sit undressed long 
 enough to get moderately cool, and then get quietly into 
 bed. 
 
 (4) Have nothing to eat or drink for at least two hours 
 before bedtime. 
 
 (5) Once in bed, resolve to have done with thinking and 
 calculating. Once the bad habit of reviewing the day's 
 actions and events in bed is formed, it is very hard to 
 break. 
 
 (6) Get a dark blue globe for a night light or electric 
 light in the bedroom. Many persons can go to sleep better 
 in blue light than in any other, or in darkness. 
 
 (7) Try drinking half a pint or more clean cold water 
 on retiring. With some people this clears the blood, washes 
 irritating food out of the stomach, and promotes a feeling 
 of quietude which helps sleep. 
 
 (8) Brush the teeth, and wash out the mouth before 
 retiring. 
 
 (9) The following method, suggested by Mr. Martyn 
 Westcott, may prove as useful as it is interesting. "Lie 
 on the back, in an attitude of complete muscular relaxa- 
 tion. Let the feet be warm or make them so with a hot- 
 water bottle. Let the covering be of blankets only, and 
 not too many either; it is the lower half of the body which 
 especially needs to be kept warm at night. Now take a 
 long slow breath, without great effort and without hurry. 
 At the same time slowly and gradually open the eyes to 
 the full extent. At the end of the long breath the eyes 
 
260 SLEEPLESSNESS 
 
 ought to be widely open and the eyeballs looking upwards. 
 During these breaths the mind must be concentrated on 
 what you are doing; that is essential. Five such breaths 
 are to be taken leisurely, easily and the opening and 
 shutting of the eyes must keep time with them. Then take 
 ten such breaths with the eyes closed. Then five more 
 with the 'eye accompaniment'; then ten more without it. 
 Gradually you feel more and more sleepy, you lose count, 
 you do the eye-opening at last only in imagination, and 
 you drop off to sleep. A very little practice is required 
 to perfect this method, which is really one of auto-sugges- 
 tion." 
 
 Sleeplessness. It is during natural sleep that the waste 
 and wear and tear of the mind and body are replaced and 
 remedied. The brain it is which controls the whole organ- 
 ism, and it is the brain which knows when fatigue has 
 arrived and when the various parts of the body have done 
 as much work as they are fit for. It is the activity of the 
 brain which requires rest and renewal, and if that activity 
 is obliged to continue, if we are kept awake too long, the 
 whole body suffers. Whereas, as soon as the activity of 
 the brain ceases for a time during sleep, all the rest of the 
 body is able to repair and renew itself. Thus we see 
 the importance of sleep. When we dream it means that 
 only part of the brain is asleep, and that is why dreamy 
 sleep is so unrefreshing. That is the reason also why 
 dreams are so unreasonable, so unhappy, or so absurd ; only 
 a small part of the brain is at work, and there is no control 
 over the ideas as they dart in and out of the half -conscious 
 mind. 
 
 Want of sleep for long periods is often the cause of mad- 
 ness; or in many cases it would be true to say that the 
 cause of madness is also the cause of the sleeplessness, and 
 that if we cannot relieve the latter the patient may go mad 
 at last. 
 
 It follows that we should make sure of our due allowance 
 of sleep, and a small allowance will do for many people; 
 too much sleep makes one drowsy and dull-witted. We 
 should never take sleeping draughts if there is any other 
 way of dealing with the trouble. The principal causes of 
 want of sleep are worry, grief, exciting passions, indiges- 
 tion, heart disease, pain, cold feet, lack of nourishment. 
 
 We are often asked how much sleep should be taken. 
 
SLEEPLESSNESS 261 
 
 But we cannot answer the question. Every person must 
 find out for himself how much sleep he needs, and see that 
 he gets it, even if it means curtailing hours of pleasure 
 spent in dancing or amusement. "Six for a man," they 
 say, ''seven for a woman, and eight for a child." But 
 most men want more than six hours. 
 
 Sleep is produced by withdrawing blood from the head. 
 We mean, for instance, by putting hot-water bottles to the 
 feet. Many people cannot sleep because their feet are cold 
 and bloodless. 
 
 If you eat a hearty meal you will probably feel drowsy 
 after it, and that is because the stomach requires all the 
 blood it can get to help to deal with the food. You cannot 
 do brain work after a hearty meal because of this, and if 
 you attempt it you will get indigestion. 
 
 If you suffer from sleeplessness, then, the first thing to 
 do is to see if you are transgressing any of the ordinary 
 laws of health and hygiene. Attend to the ventilation of 
 your bedroom; do not eat heavy suppers, with pickles and 
 cheese; take enough exercise and try and put aside all 
 business worries as soon as you enter the bedroom. 
 
 A hard bed is always better than a soft one; a spring 
 mattress is the best of all for health; perfect quiet is not 
 always desirable ; some people cannot get off to sleep with- 
 out a clock ticking in their neighborhood; but habit is all- 
 important. Reading in bed is not to be encouraged; it 
 promotes slovenly habits of mind, though many sleepless 
 people read in bed to prevent their too active brains from 
 thinking and worrying. It would be better to get out of 
 bed and read at a table until too tired to sit up any longer. 
 A copious drink just before retiring will sometimes pro- 
 mote sleep ; with some people a hot drink, and with others 
 a cold one. 
 
 Many people go to sleep at once on retiring, and then, 
 after an hour or two, wake up and lie tossing and restless 
 until nearly morning. This is very often due to an un- 
 suitable or indigestible supper, and will come right of itself 
 as soon as the dieting is set right; but it may be due to 
 a lack of nourishment, and then a few biscuits and a glass 
 of milk taken in the night on waking will lead to a refresh- 
 ing sleep. As to the drugs and medicines which counter- 
 act sleeplessness, in each case which will not yield to simple 
 measures medical advice must be sought. The fear of ere- 
 
262 SMALLPOX 
 
 ating a habit which will enslave the sleepless one for the 
 rest of his life will be enough to deter unskilled persons 
 from recommending drugs for want of sleep. (See also 
 "Insomnia.") 
 
 Smallpox. This disease is always and only caused by 
 contagion; it is impossible for anyone to contract small- 
 pox without coming into personal contact with someone 
 who has the disease already, or with clothes, bedding, or 
 books which have been in the sick room. 
 
 It is most important to know that patients are contagious, 
 even before the rash comes out, and that the poison is given 
 off into the air even from the bodies of those who have died 
 of the disease. People of both sexes and at all ages are 
 liable to it; even the unborn child within the womb may 
 suffer from smallpox, and be born marked with the results. 
 At the present time smallpox is not common, and the num- 
 ber and severity of the epidemics have been reduced by 
 improved sanitary measures, by greater cleanliness, and, 
 above all, by efficient vaccination. Generally, the disease 
 occurs only once in the same person. 
 
 The disease begins suddenly, twelve days after catching 
 it, with a severe pain at the bottom of the back, shivering, 
 and fever; headache and vomiting. On the third day the 
 rash comes out. (See "Rashes on the Skin," number 3.) 
 There are several varieties of smallpox, named according to 
 the type which the rash assumes. When it occurs in those 
 who have been vaccinated years before, it is very mild, 
 and is called varioloid. 
 
 Treatment. Nowadays, when a case of smallpox occurs, 
 the patient is generally taken off to the nearest fever hos- 
 pital, where the treatment is, as a rule, excellent, and where 
 the patient will probably recover. Smallpox is apt to leave 
 behind some very disagreeable complications abscesses, 
 conjunctival inflammation (see "Eye Diseases"), middle- 
 ear disease (see "Ear Diseases"), bronchitis or paralysis. 
 Cases of varioloid generally make a good recovery. Cases 
 in which the spots (or pocks) run together, are more seri- 
 ous. These are called confluent smallpox. The general 
 principles of treatment are the same as for measles (see 
 "Measles"), namely, isolation, disinfection, and rest. 
 There is no method known which will, in every case, pre- 
 vent the scarring and pitting of the skin. (See also "Vac- 
 cination.") 
 
SORE THROAT 263 
 
 Sore Throat. There are very many forms of disease 
 which may affect the throat, and so we very often hear 
 persons say that the throat is sore or relaxed. Sore throats 
 may be considered in three groups. The first and most 
 common forms are those ailments due to catching cold from 
 exposure to cold and wet. The second group are those 
 cases of sore throat which accompany acute fevers, such as 
 scarlet fever and diphtheria; these are terribly infectious, 
 and are of a more serious nature. And the third sort are 
 truly ulcerated conditions of the throat, due to the ravages 
 of venereal disease. Cases of this last variety come in the 
 secondary stage after infection. (See "Syphilis.") The 
 soreness may last for months. The second group, those of 
 the infectious fevers and sewer-gas poisoning, are acutely 
 painful, and are accompanied by high fever. In scarlet 
 fever, unless very severe, the throat gets well in a week. 
 In diphtheria, which mostly affects the throat, nostrils and 
 windpipe, soreness is less painful, but even more danger- 
 ous, because there is a growth of false membranes in these 
 parts which may cause suffocation. There remains the 
 class of sore throats which arise from chills ; there is hardly 
 any more common accompaniment of a cold, or catarrh, 
 as doctors call it, and some persons have several attacks 
 each year; but they rarely last more than a week or ten 
 days. Three varieties may be mentioned first, a simple 
 relaxed throat, in which the mucous membrane is seen to 
 be red and somewhat swollen, wuh a long, puffy uvula (the 
 little ball which hangs in the center of the throat), and an 
 increased amount of secretion. The next form is more 
 violent ; there is a bright redness of the parts, with swelling 
 of the tonsils, pain and difficulty in swallowing, accom- 
 panied by thirst, heat of skin, and general f everishness ; 
 this sort of attack may pass off in three or four days. The 
 most severe form of sore throat is seen when the attack 
 beginning as last described ends in a definite inflammation 
 of one or both tonsils, passing on in the course of a week 
 into quinsy (see "Quinsy") ; and in such cases an abscess 
 forms on one or both sides of the throat, and then there is 
 no comfort until the abscess bursts or is opened by the 
 knife of the surgeon. 
 
 Treatment. In simple relaxed throat, where there is no 
 fever or inflammation, astringents are needed locally, either 
 as lozenges, or pastils, or jujubes, medicated with tannin, 
 
264 SPECIALISTS 
 
 rhatany, or catechu. Formamint lozenges are an excellent 
 remedy, because they disinfect the throat. Or gargles may 
 be used, containing alum, or sulphate of zinc. The chem- 
 ist will adjust the strength according to the age of the 
 patient. Some prefer to have the parts painted by a soft 
 brush dipped in glycerin of tannin, or a weak solution of 
 the chloride of zinc. All these remedies must be got prop- 
 erly made by a chemist of suitable strengths. Quinine and 
 iron tonic medicines will also be required to tone up the 
 system. 
 
 Tonsilitis. In acute inflammatory sore throat the pa- 
 tient would do well to knock off work as soon as the symp- 
 toms are developed, and to take to bed until the fever and 
 inflammation have passed away. Let him go to bed after 
 a hot bath if there be a convenient bath indoors and 
 take a good strong dose of saline purgative, with something 
 warm added to check pain ; such a dose as compound senna 
 mixture, or Epsom salts with essence of ginger. Put on 
 ample bedclothes, and try to produce a profuse perspira- 
 tion. Steaming the throat will give much relief, and put 
 on a warm poultice round the neck ; it may be made of hot 
 water with bread, or linseed meal, or boiled turnip. Dur- 
 ing the next two or three days the patient must take only 
 liquid nourishment gruel and broth no alcohol, and must 
 not smoke. When the acute illness has passed off the case 
 will need treating as for relaxed throat as already de- 
 scribed. In the more severe cases, when there is quinsy 
 (abscess), poultices on the neck will be much needed, and, 
 in addition to simple steaming of the throat, inhalations 
 medicated with compound tincture of benzoin (teaspoonful 
 to half-a-pint of hot water, repeated), and other drugs will 
 hasten the cure. Additional internal medicines, such as 
 aconite, antimony, or antipyrin, are commonly adminis- 
 tered every two or three hours, to combat the intensity of 
 the inflammation. These require a doctor's prescription. 
 Cases of quinsy require careful treatment by tonics and 
 local astringents for several weeks after the disease in the 
 tonsils has subsided. 
 
 Specialists. A specialist, in the medical sense, is a medi- 
 cal man who, having gone through the course of study 
 necessary for the training of every registered doctor, has 
 given up " general practice" in order to study and treat 
 special diseases or the diseases peculiar to one special or- 
 
SPECTACLES AND FAILING SIGHT 265 
 
 gan. There is no specialist who makes a profession of 
 dealing with only one disease such a man would not be 
 worth his salt. He is not necessarily better educated or 
 more highly trained than the family doctor, and in very 
 many instances he is not as skillful as the family doctor, 
 because he (the specialist) in studying his own specialty 
 is very apt to become narrow in his judgment, and to 
 tinker unnecessarily at the diseases or organs which he 
 knows most about. There are several recognized "special- 
 isms" in medicine and surgery. Such are diseases of 
 women, diseases of the nose, ear and throat; diseases of 
 the skin; diseases of the eyes; venereal diseases. It is 
 quite certain that as time goes on specialists will become 
 more and more numerous; but persons who can afford it 
 are too ready to run away to a specialist with diseases 
 which the family doctor is perfectly competent to treat. 
 Pew people are superior to the curious vanity of supposing 
 that their illness is unusual, rare, difficult to treat, and 
 requiring the special services of a specially-skilled person! 
 There are no such doctors as "specialists in rupture," vari- 
 cocele, asthma, bone diseases and so on. 
 
 Spectacles and Failing Sight. We refer in this article 
 to the failing sight of those persons of full age or advancing 
 old age, who have enjoyed good sight all their lives. Much 
 of this, however, will also be applicable to those who are 
 habitually short-sighted or too long-sighted. These two 
 faults depend upon a naturally badly-shaped eyeball, and 
 the vision is apt to fail earlier in life than it does in people 
 with well-formed eyes. The most common reasons for fail- 
 ing sight in adults are cataract, glaucoma, and amaurosis, 
 to which may be added opacities, clouds on the cornea 
 that is, the window front of the eye. These last arise from 
 injuries, or from ophthalmia, which means inflammation 
 of the eye surface, generally arising from injuries due to 
 irritating dust or other substances. (See also "Eye Dis- 
 eases.") 
 
 By cataract is meant slowly-growing opacity, or want of 
 transparency, affecting the lens within the eyeball. The 
 effect of this is to hinder the rays of light from passing 
 into and across the interior of the eyeball. A similar effect 
 is seen when a clear plate of glass is breathed upon, or is 
 dusted over with some fine powder; one can no longer see 
 clearly through it. Cataract is due to a slow deterioration 
 
266 SPINAL CURVATURE 
 
 of the structure of the lens a process of decay. No defi- 
 nite cause is known; all our organs may wear out, each in 
 its own peculiar way. Either one or both eyes may be 
 affected at once, or one may first suffer and then the other. 
 No curative medical treatment is known of, and the usual 
 practice is to await the stage of blindness, and then to 
 remove the offending lens by a surgical operation; if this 
 succeeds the patient will be able to see very well again, 
 with proper glasses. 
 
 Glaucoma is the second serious cause of blindness, and 
 is often a painful disease, which cataract is not. This is 
 a state due to obscure inflammation within the eyeball, by 
 which it becomes tense and hard from undue internal pres- 
 sure. It is more common in a chronic form, but it may 
 suddenly appear, with violent pain, as an acute disease, 
 which may very soon result in blindness. In some cases, 
 a greenish color is seen when looking into the eyeball, and 
 another symptom is the sudden onset of a state of long- 
 sightedness. 
 
 Amaurosis, the third form of disease is a slowly pro- 
 gressing failure of sight, due to disease to the nerve struc- 
 tures of the internal parts of the eye ; it is a sort of palsy 
 of the nerves of sight, and may result from diseases of the 
 brain, and may follow apoplexy. 
 
 Our sight is one of the most valuable gifts, and any dis- 
 order of vision should send a sufferer in all haste to an 
 ophthalmic surgeon, who makes diseases of the eye a special 
 study. 
 
 Spinal Curvature Deformed Back. There are several 
 varieties of deformity affecting the spinal column, and 
 these may be curable or incurable. They may be due to 
 .general debility and muscular weakness, or to bone disease. 
 
 The spine should be straight up and down when seen 
 from behind; but when seen from the side, it has special 
 curves in health. The natural curves may be lost, and 
 improper curves appear in delicate persons, from bad habits 
 of sitting, lounging, or working. Children at school often 
 sit very badly at their desks, and, of course, many trades 
 cause deformity from the continued necessity for occupy- 
 ing a constrained position, as in cobblers and tailors. 
 
 Near-sighted persons often have a bent neck and stooping 
 gait from the need to lower their eyes to their work. 
 Nurses may get a bent spine from long carrying of heavy 
 
SPINAL CURVATURE 267 
 
 babies. Blacksmiths, who use the right arm so much more 
 than the left, often get the spine somewhat curved. At- 
 tacks of pleurisy, by injuring one lung, often deform the 
 chest and back. Hip-joint disease and other ailments of 
 the leg and foot, by causing shortening of one leg, are 
 often followed by a spinal curvature. 
 
 All these deformed conditions are of gradual onset, and 
 of slow progress ; but once developed they are very difficult 
 to cure. 
 
 Persons who are most likely to suffer are those who are 
 born with a scrofulous constitution. (See "Scrofula" and 
 "Chest, Shape of.") They are generally thin, pale, sal- 
 low people, flabby of skin and muscles, and they have a 
 tendency to enlarged glands in the neck, large tonsils, 
 large bodies and thick lips. 
 
 Lateral curvatures are mostly from debility, and are 
 seen in girls and young women who have outgrown their 
 strength. One shoulder becomes higher than the other, 
 and the shoulder blades bulge out behind ; one hip projects 
 too much, and the other looks too small. The spine about 
 the middle of the ribs projects too much either right or 
 left. This deformity injures the lungs more or less and 
 displaces the heart, and so there may be pains in the chest 
 or back, or in the sides, and the breathing may be oppressed 
 and the digestion disordered. The opposite sort of curva- 
 ture from before back may arise from an injury or from 
 disease of the bones called vertebrae, which compose the 
 spine. In this form tuberculous or consumptive disease 
 may cause decay of one of the bones, so that instead of 
 its being firm and hard it will soften down into pus and 
 matter, and so form an abscess ; the body weight then bends 
 the spine at the spot thus destroyed by disease. The result 
 is an angular curvature, leading to hump-back. This dis- 
 ease is often fatal, although many cases recover health to 
 some extent, and even become robust, though always de- 
 formed. 
 
 In childhood bent backs can be treated with some hope 
 of success by means of mechanical appliances, but those 
 occurring in later life can rarely be treated successfully. 
 The great object is to improve the general health over a 
 period of years by means of good feeding, suitable exer- 
 cises, frequent changes of air, and by giving cod-liver oil, 
 maltine, and syrups of lime and iron. 
 
268 SQUINTING 
 
 Sprains. When a joint is sprained, there is at first a 
 little pain and much weakness. Then the patient lies down 
 and the pain grows worse, and, either at once, or very soon, 
 the joint begins to swell. The structures in the interior 
 of the joints have been violently treated and they soon 
 begin to bleed under the skin. That is called at home 
 ' ' black-and-blue " and is the result of a bruise. The very 
 first thing to do with a freshly-sprained joint is to hold it 
 under a stream of cold water from a tap for about ten 
 minutes. Then let the patient lie down and rest, and, if 
 the doctor has not yet arrived, put the sprained joint in a 
 thoroughly comfortable position, and wrap it in plenty of 
 cotton wool, and bandage it firmly and rather tightly. If 
 there is enough cotton wool, it will equalize the pressure 
 after a few minutes. It is not a good plan to poultice the 
 limb, even to relieve the pain, because the swelling is in- 
 creased in that way. 
 
 The greater part of the pain and loss of function after 
 a sprain results from the swelling, which is caused by the 
 escape of blood and serum into the tissues. Recently two 
 methods have been employed to prevent this, either to 
 "strap" the part with adhesive plaster, or to employ mas- 
 sage from the beginning. The latter is becoming the more 
 popular for small sprains. 
 
 In sprains of gouty and rheumatic and consumptive peo- 
 ple, constitutional medical treatment by a doctor must be 
 undertaken, or there is a serious risk that the joint may 
 become damaged for life. 
 
 Sometimes after a sprain there remains a good deal of 
 chronic thickening of the skin and structures of the joint. 
 In such cases people sometimes neglect them until it is 
 too late. Massage and the application of hot and cold 
 water douches alternately, are useful measures. 
 
 Squinting. This well-known deformity generally begins 
 in very early childhood, but in a few cases children are 
 actually born, if not with a squint, at all events with the 
 paralysis of one of the eye muscles which cause a squint 
 as soon as the eyes begin to see things. Squinting is 
 caused, then, by paralysis or weakness of one of the mus- 
 cles which turn the eyeball from side to side, or up and 
 down. The patient tries to look at the same point with 
 both eyes, but one eye cannot be brought to bear on the 
 right spot, and the patient then is said to squint. If one 
 
STAMMERING 269 
 
 eye, looking straight ahead, sees an object, and the other 
 eye looks in another direction, away from the sound eye, 
 then the second eye is partly paralyzed, and squints. This 
 is called divergent squint, because the lines of sight diverge 
 from one another. If, on the other hand, one eye looks 
 straight at an object, and the other eye looks across the 
 path of vision, then the squint is called a convergent 
 squint, because the lines of vision converge and cross each 
 other. Such a person is called cross-eyed. Sometimes the 
 squint is permanent; sometimes it happens only when the 
 eyes are tired; sometimes only one eye is paralyzed, and in 
 other cases both eyes squint. When the sight of both eyes 
 is good, and when the squinting is not caused by paralysis, 
 it is generally curable by operation. The causes of squint 
 are many and various. A baby may squint as the result 
 of irritation caused by worms in the bowels, or by irritation 
 of the nerves caused by teething; and the disease known 
 as "water on the brain," of which the proper name is 
 hydrocephalus. In the great majority of cases, however, 
 the optic nerves and eyeballs themselves are badly devel- 
 oped second-rate organs, generally smaller than they should 
 be, and badly shaped. The operation that is done is to cut 
 through the muscle which pulls the eyeball out of position, 
 and the muscle is left to attach itself to a more suitable 
 part of the eyeball. It may be necessary to operate twice, 
 or even thrice. The operation is often successful, but 
 sometimes is not. It can do no harm, if skillfully done, 
 even if it does no good. Squint caused by paralysis can- 
 not be cured in the majority of cases. 
 
 Stammering. We are frequently asked what to do with 
 a child who stammers. There are a few well-known meth- 
 ods of dealing with stammering, and some specialists claim 
 to be able always to cure the complaint. Boys at an ordi- 
 nary school who stammer are very heavily handicapped, 
 and their lives made almost unbearable by the thoughtless 
 teasing and wanton mischief of the other boys. In itself, 
 stammering is not caused by general debility; but stam- 
 mering often causes general debility, spoiled tempers, and 
 ruined dispositions. Boys who stammer are generally 
 backward in their education, because they cannot say their 
 lessons, even if they know them; and if they are lazy, 
 they shirk their work because they think their stammering 
 will cause it to be passed over. Masters cannot be blamed 
 
270 STOMACH DISEASES 
 
 for passing them over, either, as their time, and the time 
 of the whole class, cannot be wasted in waiting for a stam- 
 mering boy. Some masters, out of kindness, try and help 
 the boys; but the advice is often misguided, and makes 
 things worse. All this leads to the conclusion that a boy 
 who stammers ought to be taught only at a special school 
 for stammerers. The question of what to do with a boy 
 or girl who stammers is really a serious one, as we have 
 seen, if the stammerer is to earn a living in these days of 
 keen competition. There is no doubt that stammering is 
 a spasmodic nervous disorder, and the first need is for 
 medical treatment, directed towards quieting down a too 
 sensitive nervous system. It will be noticed that nobody 
 stammers when he sings; and so the best way for a stam- 
 merer to begin to cure himself is to say everything in a 
 sing-song way, and only very gradually to come to one 
 note, and then to ordinary speech. The stammerer finds 
 his greatest difficulty in the use of consonants as "f" and 
 "v" which entirely supersede the passage of air through 
 the nose, and where the necessity arises for firm contrac- 
 tion of parts of the mouth. But the real cure of stammer- 
 ing must be left to the specialists, only one or two of whom 
 are medical men. 
 
 Stomach Diseases. It is often a difficult matter to dis- 
 cover whether the stomach is diseased or not, because symp- 
 toms arising from upset stomach and disordered digestion 
 accompany almost all fevers and many other diseases as 
 well. True stomach pain is not very common, but stomach- 
 ache is the most usual name for all pains in the body lower 
 than the fifth ribs, so that the name has lost all accurate 
 meaning. Stomach-ache, in most cases, means a pain in 
 the intestines or bowels, due to either colic or the irritation 
 accompanying diarrhea. Most people speak of "stomach" 
 when they mean "belly" or "abdomen." Now, the stom- 
 ach itself is a hollow bag, with thin coats; its sides fall 
 together when empty; but when food and drink are taken 
 it will dilate so as to hold one or two quarts ; then it gradu- 
 ally shrinks as it empties itself during digestion, into the 
 bowels. Diseases of the stomach itself are of two kinds 
 organic, in which the coats of the stomach are diseased by 
 inflammation, ulceration, or cancer; and functional, in 
 which the action of the stomach as a digestive organ is 
 
DILATED STOMACH 271 
 
 alone impaired. The healthy stomach when it receives 
 food, pours out a liquid called gastric juice, which digests 
 the food, especially meat foods. During digestion the 
 stomach is in constant motion, though we are quite un- 
 conscious of it, churning up the chewed food and gastric 
 juice together. This process should be painless. It will be 
 obvious, when thought about, that if the internal coats of 
 the stomach are tender, sore, or inflamed, the movements 
 of the stomach will be painful ; and if the patient be in bad 
 health, the gastric juice will not be in a good condition, 
 and so the food is delayed in the stomach, imperfectly 
 digested. The results are that the food ferments, turns 
 sour, and causes nausea and sickness. Diarrhea often fol- 
 lows this state of indigestion, which doctors often call dys- 
 pepsia. The liver often " sympathizes" with an upset 
 stomach, and then the bile also becomes unhealthy, and 
 unable to perform its special duty of digesting fats in the 
 intestines. 
 
 Gastritis. Gastritis is the name for inflamed stomach. 
 Acute gastritis is not usual; it is due to poisons, caustics, 
 swallowing hot liquids, and violent spirit-drinking bouts. 
 Chronic gastritis is often associated with liver disease, im- 
 proper diet, free drinking, and especially with consumption 
 of the lungs. It is shown by nausea and sickness, pain 
 under the left ribs in front and side, some tenderness there, 
 water brash, heartburn, and disordered action of the 
 bowels. 
 
 Bilious Attacks. Gastric catarrh may come on as part 
 of a general cold or catarrh, or it may come on periodically, 
 especially in feeble persons, who generally call this ailment 
 by the common title of bilious attack. 
 
 Dilated Stomach. In some unfortunate persons the 
 stomach dilates with each meal, but fails to shrink back to 
 its naturally small, empty state; and after some months 
 of dilating, a state of chronic indigestion arises, because 
 the stomach is never quite emptied between meals, as it 
 should be. In this condition there are nausea and occa- 
 sional sickness, with loss of appetite and cramp-like pains 
 in the stomach; constipation is common, with much flatu- 
 lence. Vomited matters will be found dark, undigested, 
 and sour-smelling from having been delayed so long as to 
 have fermented. 
 
272 STONE IN THE BLADDER 
 
 Cancer of the stomach. Cancer of the stomach is most 
 often seen in men past middle age ; it is a very painful dis- 
 ease, and proceeds to a fatal issue. 
 
 Ulcer of Stomach. Ulcer of the coats of the stomach is 
 an ailment very common in young women, and this also 
 may be fatal, from accidental rupture of diseased blood 
 vessels. If a young woman complaining of want of appe- 
 tite, pain after eating, and general indigestion, is found 
 to become daily more pale and weak, the presence of an 
 ulcer in the stomach must be suspected. The ulcer is round 
 or oval, and on the inner aspect of the stomach coats, but 
 may be on the front or the back of the organ; according 
 to its position, the place where the pain is felt will vary. 
 The pain is worst after food for an hour or more; sour 
 liquids rise up in the throat, and slight vomitings are com- 
 mon. There is most danger when such an ulcer eats so 
 deeply into the coats of the stomach as to cause bleedings. 
 There may be only smears of blood on what is brought up 
 by vomiting, or there may be a tablespoonful or more of 
 blood, generally dark and clotted, and not frothy, as it is 
 when coughed up from the lungs. Of course, if an ulcer 
 eats into a large vein, the bleeding will be profuse, so great 
 even as to cause fainting; but the hemorrhage may be all 
 internal and give no sign of its occurrence. 
 
 Perforated Ulcer. An even more dangerous accident is 
 when the ulcer eats quite through the thin stomach walls, 
 and then the blood, liquid food, and gastric juice escape 
 into the general space within the body. Such an event 
 causes instant collapse, intense pain, and very often a sud- 
 den death. In that case the only chance of recovery is an 
 immediate surgical operation to sew up the perforation. 
 From these facts it will be obvious that cases of severe 
 indigestion should be watched by a doctor. In mild cases 
 of dyspepsia, domestic treatment should endeavor to regu- 
 late the bowels to one or two daily actions by means 
 of rhubarb, senna, or cascara. A dose of rhubarb, soda, 
 and ginger will often relieve stomach discomfort. Indiges- 
 tion should not be treated by giving spirits, because it is 
 easy to begin a habit of having recourse to strong drinks 
 to cure small ailments. (See "Indigestion.") 
 
 Stone in the Bladder. (See "Bladder Diseases.") The 
 signs of a stone in the bladder are pain in the region of 
 tjie, bladder, and in the bottom of the back, too frequent. 
 
STRONG, HOW TO BECOME 273 
 
 desire to pass water; the water passed often containing 
 blood (and looking "smoky") ; the passage sometimes of 
 pure blood; shivering fits. The pain is generally most 
 violent immediately after passing the last few drops of 
 water. 
 
 Strong, How to Become. (A warning!) This is too wide 
 a subject to deal with in much detail within the limits of 
 the short articles in this book. 
 
 Everyone nowadays realizes that to become physically 
 strong it is necessary to live steadily, purely, cleanly, and 
 to take sufficient and suitable exercise. The leisured man 
 gets his cricket, his football, his tennis, his golf, and his 
 hockey. The man of small means and small leisure time 
 must needs take his exercise in walking or in gymnastics. 
 The home-gymnastics method is now very largely catered 
 for. There is an ever-increasing crowd of "professors" 
 and "strong men" and "culture teachers" of more or less 
 ability. They nearly all have one serious fault. They 
 advertise that they can make anybody and everybody 
 "strong." They show photos and pictures of men of 
 enormous and unnatural muscular development, and they 
 try to make you believe, first, that it is desirable to have 
 such an excessive development, and secondly, that, whoever 
 you are, you can be made equally big and strong by their 
 particular method. Now, it is an undoubted fact that 
 thousands of people are lamentably undeveloped in every 
 way; that girls grow up flat-chested and narrow-hipped 
 all over the country. Hence the frequent advertisements 
 of bust developers, which aim only at increasing the fat 
 over the neck and breasts and at enabling a woman to 
 present a good appearance. Young men are to be seen in 
 plenty, round-shouldered and flabby in muscle. No one 
 will wish to deny that all these young people could be im- 
 proved by systematic development, and, if only the gym- 
 nastics employed are suitable to the individuals, all will go 
 well. With gradual muscle development comes renewed 
 health. 
 
 But the " let-me-make-you-strong " professor teaches that 
 anyone can attain a fine physical and muscular develop- 
 ment. This is not true. Doctors will tell you that very 
 numerous cases of damage done by injudicious muscular 
 exercise come to their notice every year. The physical 
 culture cranks, keep very quiet about the overstrained, 
 
274 SUMMER HOLIDAYS 
 
 hearts, and the muscular debility and the mental im- 
 poverishment produced in some of their customers. It is 
 so easy to go to excess in the ambition to become a Hercules 
 so easy to overtax a heart that would have been quite 
 adequate for all ordinary purposes. Not everyone has a 
 heart and vessels which will bear the strain of daily con- 
 centrated muscular exercise. Only the very few can ever 
 attain to the dimensions of a Samson. Once a person has 
 had rheumatism, for instance, his heart is forever unfit to 
 do much more than the ordinary routine demands. (See 
 "Exercise and Recreation.") 
 
 Struma. (See "Scrofula.") 
 
 Stun, (See "Concussion of Brain.") 
 
 Styes. A stye is inflammation, and, at last, abscess 
 round the root of an eyelash. The whole eyelash gets 
 red and swollen, and just as one stye is quieting down and 
 getting well another one begins. Styes are practically 
 boils of the eyelid. 
 
 Treatment. As soon as you see a stye, look at the eye- 
 lid through a magnifying glass, and with a fine pair of 
 forceps pull out the eyelash which is in the very center 
 of the reddest part of the inflammation. A tiny drop of 
 matter may come out then, and when it has been wiped 
 away with a clean bit of cotton wool, touch the place with 
 the blunt end of a needle which has been dipped in pure 
 carbolic acid. In those cases where styes are always com- 
 ing, owing to the weak state of health of the patient, it is 
 a good plan to apply weak yellow oxide of mercury oint- 
 ment along the edge of the eyelid twice a day. The 
 patient ought to ask his doctor to prescribe a tonic for him 
 also. 
 
 Summer Holidays. Now is the time to sound a note of 
 warning for those who are going to take a holiday the 
 one holiday, perhaps, of the whole year. What are the 
 benefits that we expect to derive from this yearly cessa- 
 tion from work? It is, firstly, a change of occupation for 
 the mind, and change of occupation means rest, and rest 
 means recuperation and refreshment. Secondly, it is a 
 change of habits, diet, and air for the body. The change 
 brings fresh zest to life, fresh enjoyment to mere eating, 
 drinking, and sleeping; and if a holiday is properly used, 
 the whole system is invigorated. But, just as there is a 
 right way and a wrong way in everything else, in holiday 
 
SYPHILIS 275 
 
 making it is possible to be foolish and thoughtless, and to 
 return from the annual outing in worse condition than 
 before. The artisan's wife and children go down to Ocean 
 Grove for a fortnight. The children (unless they are al- 
 lowed to paddle beneath a broiling sun and get sunstroke, 
 or else overeat themselves with fruit or ices and get 
 choleraic diarrhea) will very likely benefit greatly by the 
 change of air, by the exercise, the lack of restraint, and 
 the country food. But for the wife and mother herself the 
 holiday is too often but a period of extra anxiety and wor- 
 ries. The bother of getting suitable lodgings, of packing 
 for the family, of procuring and preparing victuals in un- 
 familiar and often unsuitable places, and the worry of 
 keeping an eye on the children, to see that they don't fall 
 into the sea, off the end of the pier, or over the side of 
 the Skylark, or get lost on the crowded sands all these 
 matters deprive the poor woman's holiday of a good deal 
 of its restfulness. Poorer and less fortunate people still 
 (and there are hosts of them in our great cities and else- 
 where) get, perhaps, only a few days, or a week, of holi- 
 days. It is no real holiday to scamper off to Ocean Grove 
 by the steamer for one day only. Thousands do it, and, 
 perhaps, the change does some of them good. But the 
 weakly ones only get tired out, and we have seen children 
 and adults in these crowds, at the end of the day, 
 thoroughly exhausted with unwonted excitement and 
 bustle. Holidays should be arranged with a view of rest- 
 fulness. If your holiday time be very short, don't go a 
 long way from home to a crowded place. Go into a quiet 
 country or seaside place ; sit about in the open air and 
 sunshine; don't "live" every minute of the time in the 
 silly, nervous, modern way, but just "exist," quietly 
 enjoying the calm beauty of the landscape, or the sea, or 
 whatever scenery there may be, and the inspiriting music 
 of the bands. Then, when you return to the busy hum of 
 city life, with its unending toil, you will feel that the 
 "holy calm," and perfect quiet and rest, have done you 
 some real good. (See also "Change of Air.") 
 
 Sunstroke. (See "Heatstroke.") 
 
 Sweating. ( See ' ' Perspiration. ' ' ) 
 
 Syphilis (The "Bad Disorder"). This is the most impor- 
 tant of the venereal diseases. Syphilis spoils the lives of 
 thousands every year. It is contagious, not only through 
 
276 CONGENITAL SYPHILIS 
 
 sexual congress, but even through kissing, or using the 
 pipe or cup of a contagious person. The disease is indeed 
 a dread one, and those who suffer from it may infect a 
 great many during the two or more years that the con- 
 tagiousness lasts. The man who contracts it, if untreated 
 or improperly treated, may suffer from it, or its complica- 
 tions, all his life; and symptoms may crop up as many as 
 thirty or more years after it was caught. Thousands of 
 wives suffer chronic ill health all their married life from 
 having caught syphilis from their husbands. Hundreds of 
 doctors suffer from blood-poisoning caught from patients 
 with syphilis which they have been treating and trying to 
 cure. And, worst of all, the sins of the parents are visited 
 on the children, even to the third and fourth generation; 
 for syphilis is the cause of a large proportion of all mis- 
 carriages, and hundreds of innocent children are born every 
 year, alive, but with ' ' hereditary " or ' ' congenital ' ' syphilis 
 in their bodies. 
 
 There are, then, two kinds of Syphilis the Congenital 
 and the Acquired. 
 
 (1) CONGENITAL SYPHILIS. Children born of parents 
 in the secondary stage will almost certainly in every case 
 be the victims of congenital syphilis. As a rule, when the 
 parents have arrived at the tertiary stage (see next section 
 " Acquired Syphilis") their child escapes the disease. 
 One attack of syphilis protects against a second; no one 
 gets syphilis twice. In a large majority of cases the 
 syphilitic child is born apparently quite healthy and looks 
 plump and well for about three or four weeks. Then it 
 gets "snuffles," a bad cold in the nose with a discharge 
 of pus and dirty crusts. Then comes a RASH on the skin, 
 on the thighs, back, buttocks, and belly. This eruption is 
 the color of raw lean ham, but it must not be confused with 
 another skin disease called intertrigo. Only a doctor can 
 distinguish them. 
 
 Then there may be pimples, blotches, sores all over the 
 poor little body, and the face of the child gets wrinkled 
 and like the face of a little old man or woman. 
 
 It must be borne in mind by parents that this disease is 
 very tractable if it is dealt with early enough, and the 
 careful treatment of a family physician will do much 
 towards converting a miserable, puny, diseased baby into 
 a crowing, laughing, healthy little person! 
 
ACQUIRED SYPHILIS 277 
 
 (2) ACQUIRED SYPHILIS. We shall follow a case of 
 syphilis through all its stages. 
 
 Firstly, inoculation. The poison is transferred by sexual 
 connection, or by kissing or other contact, to the healthy 
 skin, and enters it through a minute crack or scratch, 
 which is perhaps too small to be noticed. 
 
 Nothing happens for a period of from two to three weeks. 
 Then there comes at the infected spot, a red pimple, like 
 a hard, flat, dry button, called a "hard chancre." This 
 occurs on the skin. But if the mucous membrane be in- 
 fected instead, there is a sore instead of a button or pimple, 
 which, only after about ten days, seems to be situated on 
 a little disk of parchment slipped under the skin. This, 
 then, is the hard chancre, the "primary stage" of this 
 disease. 
 
 The writer imagines that no one with any such sore 
 would be foolish enough not to consult a doctor at once 
 about it. And it may be said at once, that if the doctor 
 decides that the sore is a " hard chancre, ' ' then the patient 
 has the disease called syphilis; he will be contagious, and 
 must at once start treatment for eighteen months or two 
 years under medical supervision. 
 
 The PRIMARY STAGE OP SYPHILIS, then, consists in the 
 presence of a sore at the place of inoculation. The nearest 
 lymphatic glands (generally in the groin) become hard 
 and lumpy and tender. In some cases, this stage is the 
 whole of the disease, and the victim is never troubled with 
 it again if he carefully carries out the whole two years' 
 treatment. In the majority of cases, however, four to six 
 weeks after the hardening of the chancre the second stage 
 begins. 
 
 SECONDARY STAGE. Note carefully that these "stages" 
 are only so called for convenience' sake. Nature does not 
 always arrange the disease exactly as here described. The 
 chief signs of secondary syphilis are as follow, but some of 
 them may be absent, and others may be present: 
 
 (1) Eruptions of the skin. These are raw ham or 
 coppery colored ; occur on both sides of the body ; do not 
 itch; do not leave scars; and are sometimes of every 
 possible variety pimples, blotches, blebs, abscesses, 
 patches, scales, wheals, nodules, scabs, etc. 
 
 (2) Moist patches very contagious indeed about the 
 mouth, nostrils, and back passage. 
 
278 TERTIARY SYPHILIS 
 
 (3) Sore throat, which often gets ulcerated, and if not 
 treated well may lead to scars which deform the throat 
 and spoil the voice of the sufferer. 
 
 (4) Enlarged glands in various parts. 
 
 (5) The hair comes out, and sometimes the nails are 
 shed also. 
 
 (6) Sometimes paralysis occurs. 
 
 Then comes a period of rest. The disease appears to be 
 gone for ever cured, and sometimes there is no more of 
 it. But in some people there comes an intermediate stage, 
 called "Reminders" stage. 
 
 "REMINDERS" of Syphilis. These may take dozens of 
 forms. Among them are scaly patches on the hands (called 
 psoriasis of the palms), and various eye troubles. 
 
 TERTIARY SYPHILIS. At last, at the end of about 
 eighteen months to two years after the chancre, the third 
 stage of the disease begins. There is no hard and fast line 
 between the secondary and tertiary stages, but when the 
 secondary symptoms have quite disappeared, and two years 
 have elapsed since the chancre, the tertiary stage is said 
 to have begun. As said above, not everyone gets any 
 symptoms in the third stage; but once the last secondary 
 symptom has gone, the disease is no longer contagious, and 
 though the patient may have to suffer himself, at any rate 
 he (generally) cannot make his wife suffer or give the 
 disease to his children. The symptoms of the tertiary stage 
 may be : 
 
 (1) Skin eruptions, scattered, affecting only one side 
 of the face or body, forming sores (ulcers), and leaving 
 deep scars. 
 
 (2) Lumps in any part of the body (called nodes), 
 on the surface, or in the bones, or in the organs. 
 
 (3) Tumors in any part of the body, such as the liver 
 or brain ; these are called gummata. 
 
 (4) Destruction of the testicles in men and ovaries in 
 women. 
 
 (5) Fits, convulsions, paralysis. 
 
 Now, the reader who has acquired syphilis and who has 
 read carefully all the foregoing is by this time probably 
 much alarmed at the prospect and severity of the disease. 
 He will ask, at this point, three questions : 
 
SYPHILIS 279 
 
 (1) How can any one be sure that he has contracted 
 syphilis ? 
 
 (2) How long, and in what manner, is a syphilitic 
 person dangerous to society? 
 
 (3) Can the disease be cured? 
 
 The answers are as follow: 
 
 There is only one way of deciding the presence or absence 
 of syphilis, and that is to consult a surgeon of repute, and 
 be guided in this very serious matter wholly by his ad- 
 vice. No one can keep the thing secret and get well. The 
 doctor must be taken into your confidence, and, cost what 
 it may, he must be consulted from time to time for the 
 next two years at least. 
 
 The answer to the question as to whether syphilis can 
 be quite cured turns on the meaning which is given to the 
 word cure. Some people seem to get " cured" very soon, 
 and are little the worse for the experience. Yet, if even 
 they decide to neglect the treatment, they will almost cer- 
 tainly suffer in later life. The disease becomes quiescent, 
 but no one can be sure that it will not break out again later 
 on. Whereas the man who continues treatment for about 
 two years is as safe as medicine can make him. 
 
 The drug which, by universal consent, is allowed to 
 have most influence in the cure of syphilis is mercury. If 
 given regularly and suitably from the first it modifies 
 and at last demolishes the disease. Mercury must be taken; 
 but as to how it is to be taken we can only say that this 
 must be decided by the doctor, according to the age, sex, 
 and habits of the patient, and the severity of the attack. 
 It is worse than useless to expect to get one prescription 
 which will suit all cases, or all stages of the same case. To 
 neglect medical advice in this matter is to run into danger 
 which may affect one's whole life. Syphilis is curable 
 in many cases, entirely so; in many others, the patient 
 must be content if he gets rid of all symptoms, and must 
 put up with, as inevitable, the weakness which, to some 
 extent, always remains. 
 
 In short, though signs of syphilis may be got rid of, 
 and a cure, in that sense, obtained, yet the patient is never 
 quite the same person again, but has been subjected to 
 a poison which may (or may not) give him trouble for the 
 rest of his life. His best chance of escaping the effects of 
 
280 TATTOO MARKS 
 
 the disease is to live a quiet life, and especially to avoid 
 alcoholic excess. Alcohol especially renders him liable to, 
 and aggravates, all the symptoms of the tertiary stage. 
 
 Recently a new preparation has been discovered, known 
 as "606," for the treatment of syphilis. This has been 
 found efficacious in a large number of cases, especially the 
 old resistant ones; but the technique of administration is 
 difficult and it can only be given by an experienced 
 physician. 
 
 Taller, How to Grow. Let it be noted that Nature seems 
 to have fixed an average height for the Anglo-Saxon 
 about 5 feet 8 inches and that she maintains it with con- 
 siderable persistency. If one's father and mother are 
 above the average height, one is most probably an inch or 
 so shorter than one's parents; if the parents are under- 
 sized the child is generally an inch or so taller. If the 
 mother is too short the sons tend to be too tall, and if the 
 father is undersized the daughters are probably taller than 
 the average. There are ways of increasing the height of 
 individuals, nevertheless. 
 
 Firstly, we nearly all stoop, and do not appear as tall 
 as we really are. This is the first thing to attend to, then, 
 to stand and sit upright, even at the office desk. The back 
 muscles need to be strengthened to bring about this re- 
 sult, and that can be done by using one of the "developers" 
 on the market all are equally good if intelligently used 
 or with dumb-bells. Indian-club exercise is an excel- 
 lent means of increasing the height. After thirty it is 
 well-nigh impossible to get taller, except by straighten- 
 ing out the back ; or to look taller, except by wearing eleva- 
 tors in the shoes and boots. 
 
 Secondly, there is a method used by the American 
 cavalrymen and others stand upright with back to a wall 
 until quite erect. Then take two paces forward away 
 from the wall. Eaise the arms slowly with the palms for- 
 ward, up, up, until the forefingers meet over the head. 
 Keep the arms unbent. Do this slowly, thirty times on 
 first rising in the morning, and thirty times, when un- 
 dressed, before going to bed at night. Thus can you add 
 about an inch to your stature, if you are not yet thirty 
 years of age. 
 
 Tattoo Marks. Let us urge the reader, whoever he or 
 she may be, not to submit to the wiles of the tattooer, 
 
TEETH, CARE OF 281 
 
 even for the sake of having the flag or a sweetheart's 
 name or initials tattooed on his arm or chest. In later 
 life everyone regrets these marks, for if tattooing is prop- 
 erly done, the marks never can be removed. Glycerin of 
 papain has been used to destroy tattoo marks, but in any 
 case a skin surgeon should be consulted if removal is de- 
 sired. 
 
 Teeth, Care of. Our teeth give us trouble from the 
 cradle to the grave. As infants, the growing and cutting 
 of our teeth of the first set cause pain, feverishness, and 
 often convulsions. No sooner are they all cut but they 
 begin to get loose and fall out, and very often they suffer 
 from decay as well. In some states of constitution these 
 teeth may be decayed even before they are cut. 
 
 Before all the first set of teeth is got rid of, the first 
 double teeth of the second set appear at five or six years 
 of age, followed by the front teeth, then the side ones, 
 and lastly the double ones behind the first great grinders. 
 This process may be finished at 12 years of age. The four 
 wisdom still remain, and they may not be fully through 
 the gums until 24 years of age, and sometimes they never 
 appear at all. 
 
 The cutting of the teeth of the second set may be fairly 
 painless, but the cutting of the final four wisdom teeth 
 may give rise to persistent neuralgia. 
 
 A man or woman is blest if born with a good constitu- 
 tion and a perfect set of strong, regularly placed teeth; 
 they escape hours of face-ache, and much indigestion, 
 which is sure to result from improperly masticated food. 
 There are some few people fortunate enough to preserve 
 all their teeth until they reach the age of three score and 
 ten, but they are very few; in olden days they were more 
 numerous, and among savages, uncontaminated by our 
 civilized habits of feeding, they are common still. 
 
 Very few of us have no decayed teeth, and many of us 
 lose some teeth almost every year from the time we get 
 them. This is no new ailment, for we know that the ancient 
 Egyptians suffered to some extent from decay of the 
 teeth, and we know that they had some priest dentists, for 
 teeth containing gold stoppings have been found in mum- 
 mies in Egypt. Some diseases, such as rickets, scrofula, and 
 tubercle, cause early decay of the teeth. But, apart from 
 these diseases, there is no doubt that cookery is largely 
 
282 TEETH, CARE OF 
 
 responsible for decay of the teeth; the more simple the 
 national diet the healthier are the teeth. Very hot drinks, 
 such as hot tea, and very cold food, like confectioners' 
 ices, play havoc with the teeth and crack the enamel. 
 Long ago, when races ate only vegetables, fruits, and nuts, 
 we believe decayed teeth were unknown ; even in the times 
 of the Old Testament food was much simpler than it is 
 now, and the word toothache does not occur in it. 
 
 It Has been said that wherever you find a toothbrush 
 you will find decayed teeth; and this is no doubt true; 
 but it would be silly to say the former caused the latter. 
 When a race becomes developed enough to indulge in 
 cookery, hot and cold foods, vinegar, etc., toothache be- 
 gins to be common, and doctors become common, and den- 
 tists, too, later on. Under these circumstances, it is wise 
 to adopt the use of the toothbrush, and also certain soft 
 powders and disinfectant liquids may be suitably used 
 with the brush. There is reason to fear, however, that 
 much of the tooth powder, consisting mainly of chalk, 
 which has been retailed the last fifty years, has been much 
 too gritty, and that although it may have made teeth look 
 clean, it may have worn away the enamel of the teeth in 
 places, and may have started spots of decay. 
 
 Liquid teeth washes, containing an antiseptic, such as 
 the preparations of carbolic acid, are the most safe. 
 Dental hospitals for the poor exist now in England, and 
 parish doctors will always look at decayed teeth, remove 
 them, or advise what is best to be done. Decayed teeth are 
 always liable to ache, and are a source of danger to health. 
 For instance, sickly children with decayed teeth rarely eat 
 freely, and do not eat enough, because the mouth is so 
 tender. 
 
 It is the fermentation of particles of food lying in the 
 spaces between the teeth which gives rise to acid juices, 
 which corrode the enamel surfaces of teeth, and lead to 
 spots of decay. Careful and frequent brushing removes 
 the source of mischief. An excellent plan is as follows: 
 At bedtime, put a teaspoonful of bicarbonate of soda in 
 the bedroom tumbler full of warm water. Soak some 
 pieces of white silk in it. Draw the strands of silk be- 
 tween the teeth, backwards and forwards until the dis- 
 colored patches are gone. Then brush the teeth with car- 
 bolic tooth powder. If a tooth is healthy when it is 
 
TETANUS 283 
 
 cut it does not decay from within, but from without in- 
 wards, because of the decay of the particles of food which 
 are caught in the cracks of the enamel. 
 
 The early stage is painless, but at last in each case there 
 comes a day when the erosion by decay opens into the 
 natural space within the tooth, exposes the delicate, sensi- 
 tive nerve, and toothache begins, and will continue to be 
 felt either continuously or at intervals until the whole of 
 the sensitive pulp is dead. 
 
 Even then the danger of toothache still exists, because 
 little abscesses may form at the deep-seated ends of the 
 fangs of the tooth, and it is then that the sufferers rush 
 at last to the doctor or the dentist for immediate relief by 
 extraction. 
 
 The teeth, then, are of so much value to health that 
 everyone should pay the utmost attention to them. 
 
 There is always an early stage, when the affected tooth 
 may be saved for a time, if carefully stopped by a dentist; 
 but this stage is easily passed by, and then there only re- 
 mains the cure of the pain by having the tooth taken out. 
 (See also "Dental Hygiene.' 7 ) 
 
 Tetanus (Lock-jaw). Tetanus is a disease which occurs 
 most commonly from Fourth of July accidents, and as a 
 result of wounds made with dirty or rusty instruments or 
 nails. 
 
 It is nhie to a germ found most commonly in the soil 
 and about stables, which enters the body through wounds 
 which may sometimes be so small they are hardly noticed. 
 The most dangerous wounds are the small deep ones, such 
 as those made by nails, and the wounds from firecrackers 
 and toy pistols. 
 
 The toxin manufactured by the tetanus germ is three 
 hundred times as strong as strychnine. It poisons the 
 nervous system and causes all the muscles to be thrown 
 into contraction. One of the first symptoms of tetanus is 
 a stiffness of the muscles of the jaw and neck. 
 
 When a wound is made by a dirty instrument a nail, 
 a firecracker or a toy pistol extraordinary precautions 
 should be taken to disinfect the wound, using peroxide 
 of hydrogen, potassium permanganate solution, followed 
 by bichloride of mercury solution. Copious bleeding of 
 a wound helps to wash out the poisonous products. 
 
 An antitoxin for tetanus has been prepared, but it is 
 
284 TOBACCO 
 
 of more use in preventing the disease than curing it. As 
 a result of the use of this antitoxin the deaths from tetanus, 
 following an almost equal number of Fourth of July in- 
 juries (about 4500), were reduced from 406 in 1903, to 
 62 in 1907. Observance of the "safe and sane" Fourth 
 in recent years has still further reduced the amount of 
 death and injury resulting at this time of the year. 
 
 Tobacco; Ought we to Smoke it? Let us say in answer 
 to our own question Yes. So long as we smoke in 
 moderation, and, at suitable times, and do not annoy other 
 people by our smoking, there seems no good reason why 
 we should not smoke. Given as a drug, tobacco does 
 weaken the heart and depress the nervous system. In 
 smaller doses it only quiets the heart and soothes the 
 nerves. So it has its uses, as everybody knows. No one 
 wishes to defend its abuse. If a young man finds he has 
 flabby, cold hands, he is very likely smoking too much; 
 but what may be excess for him may be only moderation 
 for somebody else. A smoke often makes one feel more 
 comfortable in mind and body, but the feeling of well- 
 being is not accompanied by a desire for activity (except 
 in a few people who write), but by a desire to stay as 
 long in the easy-chair as possible! So we ought to smoke 
 only when work is done. Many people who suffer from 
 ''sick headache," or migraine, as doctors call it, find that 
 tobacco is a wonderful means of getting relief; but others 
 do not get sick headache until they have smoked too much. 
 "What is one man's meat is another man's poison," says 
 the old proverb. People will certainly keep on smoking in 
 spite of cranks of all kinds, and in spite, even, of certain 
 scientific investigations which go to prove that it does no 
 one any particular good, and many people much harm. 
 The pipe is the best way of smoking tobacco, and the sea- 
 soned clay pipe is the sweetest smoke of all. Yet the 
 stem of the clay is hot, and, in certain people, leads to 
 ulcers and sores of the lips and tongue. The stronger the 
 man the stronger the tobacco he can stand; but, also, the 
 more he is likely to go to excess. After all, men will do 
 something or other to excess, and excess of smoking does 
 far less social damage than excess of alcohol. Cigarette 
 smoking is generally rather prejudicial, and all smoking is 
 likely to be harmful when inhaling is indulged in. Egypt- 
 
TOE-NAIL INGROWING 285 
 
 ian and Turkish cigarettes are apt to contain niter, to make 
 them taste strong. They often cause headaches. Cigars 
 of good quality are free from much objection, but few 
 can afford a good cigar. In tobacco-growing countries one 
 can get a good weed for about 2 cents, but here no cheap 
 cigar is worth smoking. Many cigars are innocent of to- 
 bacco, and are made of dock leaves, or rhubarb leaves, or 
 dandelion; and are flavored with tobacco juice. Such 
 cigars are smoked only for effect. They taste like what 
 they are imitation tobacco; and the buyer does not gen- 
 erally want to buy any more of them, if he can procure 
 tobacco in some other form. 
 
 Toe-Nail Ingrowing. This is a very painful and rather 
 troublesome affection, caused by wearing boots too narrow 
 across the toes. The soft flesh and skin at the side of 
 the big-toe nail is pressed upon by the boot and made to 
 overlap the edge of the nail. The nail does not grow into 
 the flesh, however, but causes a sore place where the flesh 
 is pressed against a sharp edge of the nail. The ulcer 
 formed is often troublesome when the feet have not been 
 kept clean. 
 
 In mild cases, a good plan is to scrape the nail down the 
 middle with a knife or piece of broken glass, until it is 
 hardly thicker than a sheet of paper. Then, all dirt or 
 horny skin should be removed from under the nail. Then, 
 a notch should be cut in the middle of the free edge. These 
 measures help the edges to curl up somewhat and take them 
 away from the flesh. But if tight boots are not worn, and 
 if the edge of the nail is not cut square, the toe-nail 
 trouble will never arise. The first essential, then, is to 
 wear roomy boots with squarish toes. 
 
 In very bad cases of ingrowing toe nails, there is only 
 one really satisfactory treatment, and that is removal of 
 the whole nail. This can be done by a surgeon, or at a 
 hospital. Short of this radical cure there are several modes 
 of treatment, of which we give two. One comes from Ger- 
 many. The plan is to put a fragment of cork under the 
 edge of the nail where it appears to be growing into the 
 flesh. Then pour ten drops of strong solution of ferric 
 chloride on to the ulcer and edge of the nail, let it dry 
 on, and repeat the process every day for five days. A 
 blackish crust forms and the nail becomes so brittle that it 
 
286 TONGUE, DISEASES OF 
 
 can be scraped away easily. Then the sore may be healed 
 up with a little iodoform ointment, and wider boots must 
 be worn. 
 
 The other plan is quicker and rather cleaner. Get a 50 
 per cent, solution of caustic potash (or caustic soda), warm 
 some of it, and moisten the nail with it. This softens the 
 nail and the soft part may be scraped away with a piece 
 of clean broken glass. Then drop a little more caustic 
 on to it and scrape away until the nail is as thin as paper. 
 Then the offending part of the nail may be easily removed 
 with nail scissors. This is a very good method when deal- 
 ing with old horny tough nails such as are found on the 
 feet of old men and women of the laboring class. 
 
 Tongue, Diseases of. The tongue has its own special dis- 
 eases, such as inflammation, ulceration, and cancer, and 
 may, of course, suffer from injuries, such as scalding, or 
 it may be bitten during fits, especially epileptic fits. 
 
 The tongue has its minor ailments also, and its appear- 
 ance varies so greatly from day to day during the course 
 of general diseases that it has been looked on from time 
 immemorial as the guide to a person's state of health. 
 Medical knowledge has made immense strides during the 
 last 50 years, but the state of the tongue still remains one 
 of the most important guides to the progress of a disease. 
 
 The tongue of a healthy person is pink, soft, moist, and 
 clean; that is to say, it is not covered with any "fur," 
 or deposit of a white, gray, or brown color. It is ex- 
 tremely important that the tongue should be moist, for 
 if it be dry it causes much discomfort, and sense of taste 
 is lost. 
 
 The tongue is discolored and covered with fur whenever 
 there is any form of indigestion, and also during all states 
 of fever. 
 
 Another tongue symptom is that of being in a state of 
 tremor; it trembles when it is put out, and the patient is 
 quite unable to hold it steady. This is one of the symptoms 
 of delirium tremens, and is the result of poisoning by 
 alcoholic drinks. The absinthe so much drunk in Paris is 
 especially liable to cause this ailment. 
 
 Palsy may also affect one-half or the whole of the 
 tongue, and this is usually one of the results of a severe 
 apoplectic attack, which brings on paralysis of either the 
 right, or left limbs. 
 
TOOTHACHE 287 
 
 Pallor of the tongue a loss of its rosy pink tint is 
 seen in the course of anaemia, so common in young women ; 
 and in debility the tongue becomes swollen, soft and flabby, 
 so that at its side you may see the marks where it lies 
 against the teeth. 
 
 White furred tongue is seen in rheumatic and other 
 fevers, also dyspepsia and congestion of the liver, and all 
 stomach ailments. All who drink too freely are liable to 
 have the tongue furred, and smokers generally have a 
 dirty white tongue. 
 
 A bright red tongue is seen in scarlatina, and red dry 
 tongue marks the end of fatal diseases, such as phthisis 
 and pyaemia. A dry brown tongue is a sign of great ex- 
 haustion, such as seen in typhoid and typhus fevers and in 
 cases of blood-poisoning. When patients are recovering, 
 the tongue gradually loses its fur, and regains its proper 
 color and moisture, much to the relief of the sufferer. 
 
 We may mention that in many illnesses in which the 
 tongue is furred it may be "cleaned" for a time, with bi- 
 carbonate of soda solution and a clean towel. This often 
 gives a great sense of comfort to the sick man. Lemon 
 juice may be used if soda fails to clean it. 
 
 Too Fat. (See "Corpulence.") 
 
 Toothache. This is a sign of some local trouble in one 
 or more of the teeth, or in the jaw, and must be dis- 
 tinguished from neuralgia of the face, though neuralgia 
 is often caused at first by the irritation of decayed teeth. 
 If the pain is made worse by hot or by cold water in the 
 mouth, probably the tooth is decayed and the nerve pulp is 
 exposed. The proper thing to do then is to syringe the hol- 
 low tooth out carefully and gently with warm water and 
 to put into it afterwards, without any pressure, a little 
 plug of cotton wool steeped in creosote, or oil of cloves, or 
 cocaine dissolved in oil of cloves. If the pain is due to 
 inflammation in the pulp cavity (i.e., inside a tooth) no 
 relief will be obtained till the pus can get out, and a visit 
 to the dentist should be made. 
 
 If all the gums around are swollen and tender, the neces- 
 sity of a dental surgeon's advice is all the greater. What- 
 ever you do, do not be beguiled into trying to "cure" 
 your toothache with any of the so-called "neuralgia cures." 
 They will be useless while the local state of things in the 
 mouth is unattended to. It would be difficult to overrate 
 
288 TRADE DISEASES 
 
 the importance of keeping the teeth in order. Decayed 
 teeth are really little nests of disease germs and may cause 
 consumption, enlarged glands, indigestion, ear disease, fits, 
 &c., &c. 
 
 Trade Diseases. There are certain trades and occupa- 
 tions which have important relations to certain diseases, 
 which are therefore grouped together here under the above 
 heading. 
 
 I. Lead poisoning. All workers in lead, such as fac- 
 tory hands in lead works, painters, compositors, plumbers, 
 glass and pottery polishers, and white lead makers, are 
 liable to suffer from a group of symptoms caused by the 
 absorption of lead into their systems. Lead may also be 
 taken into the body in poisonous quantities in drinking 
 water contaminated by lead pipes, in cider, or in tinned 
 fruits. 
 
 It is the lead glazers who chiefly are liable to lead poison- 
 ing, as they inhale dry lead salts. 
 
 Symptoms. Early signs are muscular weakness, debility, 
 and pallor of the skin. Then follow some or all of these 
 symptoms: A blue line along the gums, absent where the 
 teeth have fallen out and often absent in those who clean 
 the teeth regularly. Colic and constipation, generally very 
 painful indeed, and lasting, sometimes, several days. 
 Wrist-drop and foot-drop the muscles which should hold 
 up the wrist and foot respectively become paralyzed. Con- 
 vulsions and violent headaches may occur. Anosmia, and 
 all its consequences. Kidney disease, with scanty urine. 
 
 Treatment. In lead works the foremen generally know 
 what to do when there are signs of lead poisoning in any 
 of the workers. Colic is to be dealt with by hot fomenta- 
 tions and morphine injections, which the doctor will give 
 with his hypodermic syringe. (See also "Lead poison- 
 ing.") 
 
 II. Arsenic poisoning. Those who work at arsenic ore 
 smelting, and in factories of wall paper, and elsewhere, 
 all are liable to suffer from arsenic poisoning. The 
 symptoms are those of multiple neuritis vague pains and 
 tingling in the limbs, weakness and wasting away of the 
 calves and thighs, wrist-drop, and * ' dropped foot, ' ' hoarse- 
 ness, squinting, and tenderness of the calf muscles. In 
 addition to these there may be cough, diarrhea, eczema, 
 headache and trembling. 
 
TRAINING 289 
 
 If the patient gets away from the source of all the mis- 
 chief, namely, the arsenic, he will get well. Otherwise, he 
 will not. 
 
 III. Phosphorus poisoning. The fumes of phosphorus 
 are apt to affect those who work in match factories where 
 the yellow form of phosphorus is in use. 
 
 These workers are liable to have "phossy jaw," which 
 is a local disease of the jawbone due to the irritation of 
 phosphorus which has got in through a hollow decayed 
 tooth. All factory hands should take special care of their 
 teeth. Special medical treatment is necessary. 
 
 IV. Mercurial poisoning occasionally occurs in felt-hat 
 makers in which occupation mercury nitrate is often used. 
 Sometimes a man gets an inflamed mouth while dosing 
 himself with mercury for syphilis. The treatment for 
 this is to stop the mercury for a time and suck chlorate of 
 potash lozenges continually. 
 
 V. Among other diseases caused by occupations are 
 aneurism, to which laborers and porters are liable; 'bron- 
 chitis, emphysema and deafness, from which glass blowers 
 often suffer; sore throat of a special type, common among 
 the clergy; fibroid consumption of the lungs, set up by 
 irritating particles of metal, is common among flax-workers, 
 iron-workers, steel grinders and millers. 
 
 VI. Special forms of nervous cramps and paralysis 
 occur among typewriters, clerks, and telegraphists. Miners 
 are liable to suffer from jerkiness of the eyeballs, and 
 shoemakers and tailors and leather-workers sometimes get 
 wry-neck of a spasmodic kind from sitting too long in one 
 attitude. 
 
 Training. As our object in this book is to be of use to 
 as many of our readers as we possibly can, we feel it our 
 duty to say something on the subject of athletic training. 
 The object of training is to bring about the development 
 of the highest degree of activity and endurance and 
 strength possible to the human body. Some loss of stored- 
 up material (principally fat) always takes place in this 
 process; and so, if it be carried too far, the athlete is at 
 last weakened and is then said to be overtrained. 
 
 Training consists in a combination of dieting and ex- 
 ercise, and takes about six weeks to accomplish. The 
 muscles get harder, the whole skin improves in appear- 
 ance and the athlete feels more and more "fit" every 
 
290 TRAINING 
 
 day. The change from ordinary feeding to a training diet 
 should be gradual and not sudden. A diet consisting 
 largely of lean meat is necessary, but this reminds us 
 that no one ought to be allowed to undertake "training" 
 on these lines, or to enter for feats of endurance or 
 strength, if he is over 35 years of age, or if he is gouty 
 in tendency. But no really sensible man begins training 
 without having had himself "overhauled" first by the 
 family doctor. 
 
 The diet then is to be roast or grilled underdone beef 
 and mutton, with a moderate allowance of vegetables and 
 bread. All entrees and pastry and puddings and sweets 
 are absolutely forbidden. So are all sauces, condiments, 
 and pickles, for their only use is to increase artificial 
 appetite. 
 
 The drink allowance is to be limited, and there is to be 
 no allowance of spirits; occasionally, a very light dry 
 Rhenish wine may be taken. Toast-and-water, barley 
 water, cocoa, tea and coffee are to be the beverages. There 
 are to be three meals a day. We append below the schemes 
 of training which are adopted at Oxford and Cambridge 
 Universities for the inter-university boat race every sum- 
 mer. As to exercises, we can say little; no one will be 
 able to train quite satisfactorily without personal advice 
 from a trainer; we can only suggest the dietary. 
 
 A day's training for the boat races. (Summer.) (By 
 Dr. Maclaren) : 
 
 CAMBRIDGE 
 
 A run of 100 or 200 yards, as fast as possible. 
 Breakfast. Underdone meat, dry toast, two cups of 
 
 tea, watercress occasionally. 
 2 P. M. Meat as at breakfast, bread, potatoes, greens. 
 
 One pint of beer. Dessert, oranges, or biscuits 
 
 and figs, 1 vo glasses of wine. 
 "Rowing exercise during late afternoon. 
 8 :30 P. M. Cold meat, bread, lettuce or watercress, 
 
 one pint of beer. 
 10 P. M. Retire to bed. 
 
 OXFORD 
 
 7 A. M. Rise. A short walk or run. 
 8:30 Breakfast. Underdone meat, crust of bread or 
 dry toast, tea (as little to be drunk as possible). 
 
TUBERCLE 291 
 
 2 P. M. Dinner. Meat, bread, no vegetables (not 
 strictly adhered to), one pint of beer. 
 
 5 :30 Rowing exercise. 
 
 8:30 Supper. Cold meat, bread, sometimes water- 
 cress, one pint of beer. 
 
 10 P. M. Retire to bed. 
 
 It will be observed that at both the universities the un- 
 dergraduates take two pints of beer daily during train- 
 ing. Professional trainers and professional athletes are 
 mostly teetotal; and it yet remains to be proved whether, 
 even for young fellows, undergoing training for special 
 events like the boat race, it would not be much better if 
 they adopted a training diet which excluded alcohol alto- 
 gether. 
 
 Tubercle. A tubercle is a little tiny granule (in some 
 organ such as the lung), made of a collection of cells which 
 have gathered together to try and limit the poisonous 
 effects of one or more tubercle bacilli, or germs, which oc- 
 cupy the center of the tubercle. The bacilli are breathed 
 into the lungs (for example), find that there is a suitable 
 place for them to grow in, and begin to multiply as fast 
 as they can. From that moment the person becomes 
 "tuberculous." But his resisting power may be so great 
 that the germs are surrounded by cells which soon cut 
 them off from all nourishment, and then they die ; and the 
 place where they had found a temporary lodging turns 
 into a sort of cheesy mass which is harmless. Then the 
 person is said to be cured of his tuberculous disease. Too 
 frequently, however, there are some bacilli left, which only 
 await their opportunity to start a fresh patch of disease, 
 whenever the person gets run down. There are hundreds 
 and thousands of people who are exposed to the tubercle 
 bacilli in the air every day of their lives. Hundreds of 
 them become infected over and over again, and get rid 
 of it by a natural cure. Many a person with a bad cough 
 has a small infection of tubercle, which he will presently 
 get cured of. Every person with even bad tuberculous 
 disease may hope that he will get into a stage of quiescence, 
 which is about the best that can be hoped for. If a case 
 of tuberculous disease is taken early and treated well, there 
 may be a complete cure; but, too often, the damage done 
 to the organ affected only admits of "quieting" and not 
 curing the disease. 
 
292 TYPHOID FEVER 
 
 Tumor. The word tumor means a swelling, and nothing 
 more than that. But the word is applied not so much to 
 diffuse and generalized swelling (such as occurs on a 
 shoulder after a severe bruising, for instance), but to 
 "lumps" or "knobs" of any sort caused by inflammation 
 or by the growth of "new tissue," such as cancer. A 
 tumor which, if it were removed, would not be replaced by 
 another of the same type, is called a benign tumor. Such 
 are fatty tumors, birth-marks or naevi, bony knobs, cysts 
 (wens), and fibrous growths, like warts. 
 
 A tumor which, if removed, would only be replaced by 
 another of the same type, and which, if left alone, would 
 ulcerate and cause the patient's death, is called a malignant 
 tumor. Such are all the forms of cancerous, and sarcoma- 
 tous growths. 
 
 Typhoid Fever. Although this disease is less often found 
 in an epidemic form than it used to be, before the drain- 
 age of our towns was carried out so efficiently, yet it is 
 still a very common ailment in solitary cases. It is gen- 
 erally spread through the contamination of drinking water, 
 or milk, or oysters, or by the rise of sewer gases from 
 drains or sinks into our dwelling houses. It is but very 
 slightly infectious in ordinary ways, and cannot be caught 
 from the breath of a patient, and only from touching a 
 sufferer when the skin has been soiled by discharges. Even 
 those who nurse cases of this disease very rarely become 
 infected. 
 
 Cases of typhoid fever vary very much in severity; a 
 few persons are able to keep up most of the time, but the 
 majority of those who have it need to remain in bed for 
 four or more weeks. Children seem to suffer less severely 
 than adults; both sexes are affected, and young adults 
 generally have the most severe attacks. It attacks rich 
 and poor almost equally, and it may so lower the vitality 
 that although a patient may recover from it, he often, 
 soon after, goes off into consumption. On the other 
 hand, many people, on recovering from typhoid fever, get 
 better and stronger than they ever were before; and some 
 consumptives get quite cured of their consumption by an 
 attack of typhoid fever. This disease is sometimes called 
 enteric fever, because it causes local affections in the bowels. 
 It is in our times the great scourge of armies, especially 
 in war-time. In this country it is most prevalent in the 
 
TYPHOID FEVER 293 
 
 autumn of the year and wet seasons. When one case is 
 caught from another, a period of 10 to 14 days elapses be- 
 fore the onset of symptoms. This is called the incubation 
 period of the disease. It is slow in developing, unseen 
 and generally unsuspected. It is a disease attended by a 
 form of fever, continuous, but generally not of a violent 
 type. 
 
 The ailment begins with a period of debility and languor, 
 with loss of appetite and nausea, then follow headache, chills, 
 thirst, and pains in the back and limbs, with a tendency to 
 diarrhea without much colic pain; about two degrees of 
 fever in the mornings and three to four degrees in the 
 evenings. The patient is restless, and often sleepless. This 
 fever may continue for three weeks, and in such cases the 
 weakness becomes extreme, the tongue dry and brown, and 
 there may be extreme diarrhea, and even blood may be 
 passed, which comes from ulcerations of the bowels. In 
 a considerable number of cases there is a slight rash of 
 pink dots on the skin of the chest and body. These rosy 
 spots are most noticeable on the belly, and come out in 
 crops, some fading while others are appearing. These 
 symptoms may gradually pass off, and recovery will follow, 
 but in severe cases they lead on to fatal exhaustion, ac- 
 companied by delirium, insensibility, and convulsions. No 
 drug has any power to cure the disease, and the doctor can 
 only give medicines to relieve serious symptoms as they 
 arise. 
 
 But it is useless to attempt to treat the disease without 
 medical aid. It has been well studied and is well under- 
 stood. A large proportion of all cases recover. The chief 
 hope of the patient is in the excellence of the nursing. 
 The nurse must daily examine the "stools" (the matter 
 passed by the bowels), and must be on the look-out for un- 
 digested lumps of curdled milk. The diet must be milk 
 (if it agrees), chicken broth, barley water, and so on. 
 Beef tea is not much use, especially as it tends to bring 
 on diarrhea. Alcohol may be needed in the later stages 
 when the heart is weak. 
 
 The disease, as we have said, requires real skill and 
 medical treatment; the nurse must have, always ready, 
 broken ice, hot water, castor oil, a water-bed for the patient 
 to lie on; and she must be on the look-out for bedsores, 
 which are very apt to form. (See ' ' Bedsores. ' ' ) Lastly and 
 
294 ULCERS 
 
 most important, she must keep a plentiful supply of dis- 
 infectants and put some into every stool and every vessel 
 used by the patient. (See "Infection.") 
 
 Note that no solid food must be given to any typhoid 
 patient till the temperature of the body has been normal 
 for at least a week or ten days. To give solid food other- 
 wise is to kill the patient. 
 
 Prevention of Typhoid Fever. Typhoid fever can be pre- 
 vented in one of three ways (the three combined are prefer- 
 able) : 
 
 1st. Destroy the infectious agent at its source. 
 
 2nd. Destroy the means of transmission. 
 
 3rd. Avoid infection. 
 
 (1)^ The infectious agent always proceeds from a case of 
 typhoid fever. Therefore disinfect all secretions and ex- 
 cretions from a typhoid case by the use of freshly slaked 
 lime or chloride of lime. Dispose of these in such a way 
 that they cannot contaminate a water or milk supply. Do 
 not allow utensils or furnishings in a typhoid case's room 
 to be used by anyone else until they have been thoroughly 
 sterilized or disinfected. 
 
 Remember there is danger of a "typhoid carrier's" trans- 
 mitting the disease through excretions a long time after 
 recovery from the disease. Absence of the germ from the 
 excretions can only be determined by a bacteriological ex- 
 amination. 
 
 (2) Pasteurize all milk drunk and filter or boil all water. 
 Destroy flies or prevent their breeding. Do not empty raw 
 sewage into water supplies used for drinking or bathing. 
 
 (3) Avoid infection by having yourself immunized 
 against typhoid by preventive inoculation. Any first class 
 physician can do this. 
 
 Do not drink any but pasteurized milk unless you know 
 its source to be free from danger of typhoid. (Very few 
 are.) 
 
 Do not eat any but deep-sea oysters, unless cooked. 
 
 Prevent the access of flies to your food. 
 
 Do not bathe in sewage-polluted water. 
 
 Keep your body in robust condition. 
 
 Ulcers. The common word for ulcer is "sore," and, of 
 course, there are a very great many varieties of sore. (For 
 ulcer of stomach and perforated ulcer, see "Stomach Dis- 
 eases"; ulcer of back, see "Bedsores"; ulcerated throat, 
 
ULCERS 295 
 
 see "Sore Throat"; syphilitic ulcer, see " Syphilis"; scrofu- 
 lous ulcer, see "Tubercle" and "Consumption"; eczema- 
 tous ulcer, see "Eczema.") The treatment of every 
 different type of ulcer is different, and this fact makes it 
 necessary for us to describe each of the more common kinds 
 of ulcer, so that the reader may know what sort of ulcer he 
 has before he begins to treat it. We hope that these re- 
 marks will be of the highest value to our poorer readers 
 who suffer so much from ulcerated legs, who grudge the 
 money that the advice of a good medical man naturally 
 costs, and who are too apt to waste their money in buying 
 ointments which are said to cure all ulcerated legs! No 
 one ointment can possibly be good for all the different 
 kinds of ulcers, and some ulcers want no ointment at all. 
 
 (1) The Healthy ulcer. The skin round it is not swollen 
 or boggy, or discolored; there is no change in it beyond a 
 ring of pinkness immediately round the sore. The edges 
 of the sore are rounded, shelving gently down to the sore, 
 and are opaque white at the very margin, bluish nearer to 
 the middle and dark red at the center of the sore. The dis- 
 charge, if any, is like white of egg in appearance. There 
 is no pain, no tenderness. It is the object of our treatment 
 to bring all ulcers to this condition. 
 
 Treatment. Rest, and any cleanly dressing are all that 
 are needed. The ulcer will heal of itself in good time. 
 
 Now with regard to REST, we must say that it is the most 
 important thing of all in the treatment of every kind of 
 ulcer. Few people will take to bed for the sake of healing 
 a small sore which is giving little trouble, but many a 
 woman's whole life's misery would have been saved if she 
 had only treated her ulcerated leg with rest in bed while 
 it was not a serious matter! By those who can afford a 
 proper surgical dressing for the ulcer, the following in- 
 structions may be followed: A piece of perfectly clean 
 lint, exactly the size of the sore, is moistened with a con- 
 centrated solution of boric acid and laid on the ulcer. It 
 is covered with a piece of oiled silk which overlaps the lint 
 all round; uniform pressure is applied by a bandage and 
 the dressing is changed once a day. 
 
 Whatever mode of treatment be adopted for an ulcer on 
 the leg, rest in bed, with the limb raised, has more influence 
 than any other condition in hastening the cure. 
 
 Sometimes, even in a healthy ulcer, there is so much loss 
 
296 ULCERS 
 
 of tissue, that if we are to wait " until it skins over" we 
 shall have to wait a very long time. In these cases sur- 
 geons graft some flakes of skin from other parts of the body, 
 and the transplanted skin grows well in its new situation. 
 
 (2) The weak ulcer. This is often the result of too much 
 watery poulticing. The edges are not definite and the ulcer 
 has no opalescent blue ring like the healing ulcer has. The 
 granulations (the pinkish granular flesh of the sore) are 
 pale, flabby and exuberant, and have a watery discharge. 
 Old nurses call the ulcer " proud flesh." 
 
 Treatment. This is, in one word, stimulation. The pa- 
 tient wants nourishing food, rest in bed, pure air, and a 
 tonic. The ulcer has to be dressed often, washed with red 
 wash, and a little piece of lint the same size as the ulcer 
 is to be dipped in the wash and always kept on the ulcer. 
 The flabby, pale little granules are to be lightly touched 
 with a stick of lunar caustic from time to time. 
 
 (3) The callous or indolent ulcer. The edges of this 
 ulcer are raised, irregular and hard. The surrounding skin 
 is hard, discolored, and brownish-red and brawny. The 
 surface of the sore is smooth and yellowish, and there are 
 no granulations because there is no healing going on. Such 
 ulcers are seen mostly on the outer side of the leg, between 
 the ankle and the calf, in persons of middle age. They are 
 painless, and callous, and not tender to the touch. 
 
 Treatment. First, of all, try the pressure method. Ap- 
 ply a Martin's india-rubber bandage to the ulcer, without 
 any dressing, every morning before getting out of bed; 
 keep it on all day, wearing it not too tightly. At bedtime, 
 wash the ulcer with warm water (using a piece of cotton 
 wool or rag never use a sponge in surgery!) and put over 
 the ulcer a pad of lint soaked in rectified spirit, and apply 
 an ordinary calico bandage. The india-rubber bandage 
 ought to be dipped or kept in some disinfectant during the 
 night. 
 
 If this plan of treatment does not bring the ulcer into a 
 healthy condition a surgeon must be called, to strap it, or 
 to incise it. There remains, however, one of Unna's meth- 
 ods of treating these ulcers; it is this: Paint the ulcer 
 itself and all the surrounding skin with Unna zinc-ichthyol 
 gelatin, cover the whole with clean lint, bandage it and 
 leave it three days, and then renew the treatment. 
 
 (4) The irritable ulcer. This is commonest in elderly 
 
VARICOSE ULCER 297 
 
 people and is generally situated behind the ankle. The 
 surrounding skin is often purplish, hard, and discolored. 
 The edges of the ulcer are raised and irregular. The sore 
 itself is dark red or covered with a "slough," and a thin 
 scanty discharge issues from it. The pain of it is terrible 
 and keeps the patient awake at night, bringing him to a 
 severe condition of exhaustion. The sore is acutely tender 
 to the touch. Absolute rest in bed is the first essential. 
 The bowels must be moved occasionally with half-a-drop of 
 croton oil swallowed in a bread-crumb pill. During the day, 
 if the ulcer is very painful, let the sufferer take five grains 
 of antipyrin and thirty grains of bicarbonate of soda, four- 
 hourly. At night, to procure sleep, some form of opium 
 will probably be necessary, but it must be prescribed to suit 
 the special case by a doctor. 
 
 The treatment of the ulcer itself is not easy. A good 
 plan is to paint it over with a 10 per cent, solution of 
 cocaine; ten minutes later, to rub it gently all over with 
 lunar caustic so as to form a slough; and then to dress it 
 with boric acid ointment on lint. After a day or two the 
 slough separates and comes away, and a healthy sore ought 
 to remain, which is treated as under (1). If the ulcer does 
 not look healthy yet, this plan may be repeated. 
 
 (5) The inflamed ulcer. This is the sort of ulcer that 
 drunkards are especially liable to have. The surrounding 
 skin is red, swollen, hot and tender. Note, that any ulcer 
 may become an "inflamed" one, if neglected. The edges 
 are sharply cut. The sore itself is generally covered with 
 a slough, and there is a blood-stained discharge from it. 
 Or it may be quite dry and covered with a scab. 
 
 Treatment. The patient will be all the better for a good 
 purging, and he may have to be treated for gout. After 
 two grains of calomel at bedtime, the patient should take, 
 next day, three times during the day, a drachm of Epsom 
 salts in an ounce of infusion of quassia. Very hot fomenta- 
 tions made with boric lint and sprinkled with a few drops 
 of laudanum, make very good local applications to the sore. 
 But the important things in the treatment of these ulcers 
 are rest in bed, abstinence from alcohol, and purging. 
 
 (6) Varicose ulcer. These are very common among 
 middle-aged and elderly women of the poorer class. The 
 patient has varicose veins, and as a result of them, the skin 
 of the leg, somewhere between the calf and the ankle, be- 
 
298 URINARY TROUBLES 
 
 comes badly nourished, purplish in color, and shiny in ap- 
 pearance. Such shiny, discolored skin is very easily dam- 
 aged by very slight injuries and a sore is very liable to 
 form. This sore as it spreads is all too likely to eat into 
 one of the dilated twisting varicose veins ; and at any time, 
 in a few seconds, the patient may lose as much as a pint 
 of blood (see " Bleeding from Varicose Veins"). 
 
 Treatment. No local treatment will be of much good 
 until the pressure of the column of blood in the dilated 
 veins is taken off the part where the ulcer is. This must 
 be done by wearing an elastic stocking or elastic bandage 
 during the daytime. At night, hazeline ointment may be 
 applied on lint to the sore. But the only radical treatment 
 is by operation on the varicose veins which are causing the 
 trouble. 
 
 Urinary Troubles. The troubles connected with the pass- 
 ing of water from the body may be described under two 
 main headings : 
 
 A. Incontinence of urine. Inability to hold water in 
 the bladder 
 
 (1) True incontinence is caused by paralysis of the 
 muscle, called the sphincter, which lies at the entrance 
 to the bladder. This paralysis is probably caused by 
 spinal cord disease or injury and may or may not be 
 curable. 
 
 (2) Incontinence occurs in men sometimes as the 
 result of sexual excesses. Rest and tonics raid whole- 
 some living will cure it. 
 
 (3) Hysterical incontinence occurs in young girls 
 sometimes. 
 
 (4) Nocturnal or night incontinence, or bed- wetting, 
 occurs in children of all ages; it may be due to a long 
 foreskin, which requires circumcision, or to a stone in 
 the bladder, or to bad bringing up. (See No. 7.) 
 
 (5) False incontinence is the word used to express 
 the overflow from an over-full bladder in a paralyzed 
 patient. 
 
 (6) Women after childbirth sometimes cannot hold 
 their water because of the bruising of the parts during 
 the delivery of the child. 
 
 (7) Epileptic attacks are often accompanied by the 
 dribbling away of urine. Many epileptic children wet 
 
DEPOSITS IN URINE 299 
 
 the bed without knowing it, and ought to be treated 
 for epilepsy. 
 
 (8) Fright sometimes causes a child to wet the bed. 
 
 B. Retention of urine. This means a condition in which 
 the patient cannot pass his water though the bladder is 
 quite full. It is a very painful affection. It may be due 
 either to some obstruction or to paralysis of the bladder 
 
 (1) In old men the obstruction may be an enlarged 
 prostate gland. This is often relievable, but hardly 
 curable. 
 
 (2) In adult men, the obstruction may be a stric- 
 ture; congestion, due to gout; a little stone lodged in 
 the passage. 
 
 (3) In children, the foreskin may be too tight to 
 allow the water to pass freely. 
 
 (4) In women, a tumor in the abdomen, or the head 
 of a yet unborn child may press upon the passage and 
 prevent the passing of the urine. 
 
 C. Frequent desire to pass water. This may occur in 
 one of two different sets of circumstances. Some people 
 are always wanting to urinate because their bladder seems 
 to be always full, and in fact, does fill up very quickly. 
 This occurs with 
 
 (1) Diabetes. 
 
 (2) Chronic B right's disease. 
 
 (3) Hysteria in women. 
 
 (4) Chronic drunkards. 
 
 Other people are continually wanting to pass water be- 
 cause the bladder is so irritable that it will not tolerate the 
 presence of even a few drops of water in it. This occurs 
 in 
 
 (1) Inflammation of the bladder. 
 
 (2) Inflamed prostate gland. 
 
 (3) Enlarged prostate gland (in old men chiefly). 
 
 (4) A stone in kidney or bladder. 
 
 D. Deposits in urine. The man who worries himself 
 about his health so much as to look at his tongue in the 
 
300 VACCINATION 
 
 glass every morning, and to examine the color of his urine, 
 often frightens himself quite unnecessarily. The deposits 
 which may be seen in the urine are very numerous, and 
 most of them indicate something seriously wrong with the 
 individual. But there are other deposits which are less 
 important, or unimportant and far more common. Quite 
 normal, healthy urine is clear and amber-colored when 
 passed. But urine may be turbid when passed, and that 
 turbidity is generally caused by eating too much meat, or 
 by a little catarrh of the bladder caused by catching cold. 
 After a heavy meal there is sometimes a brick-dust sort of 
 deposit, reddish-yellow, pink, or red. It is of no impor- 
 tance, but suggests that you have been eating too much 
 meat, or that you have a bad cold, or that you are feverish. 
 
 In short, a little knowledge of the urine is really a dan- 
 gerous thing to all who are unduly nervous. The only good 
 reason for examining the urine passed is to enable you to 
 report it truly to the doctor, and not to enable you to 
 doctor yourself without understanding the subject. 
 
 Vaccination. We of to-day little realize how enormous 
 the destruction of life from smallpox was up to a hundred 
 years ago when control was obtained over it by means of 
 the process known as vaccination. 
 
 During the 18th century 60,000,000 of the inhabitants 
 of Europe died from smallpox and there were few who 
 escaped having the disease some time during their life. 
 
 Since the introduction of vaccination the reduction of the 
 amount of smallpox has been so great that there can be no 
 doubt of its infinite value. 
 
 The death rate in Sweden per million has been reduced 
 from 2,050 before the vaccination era to 2 in 1894. In 
 1897 there were only 5 deaths from smallpox in the entire 
 German Empire of 54,000,000 people. In Russia, where 
 vaccination is neglected, there are still over 50,000 cases a 
 year. 
 
 If a person is vaccinated in infancy and again at the 
 end of childhood he is practically safe from smallpox. He 
 is absolutely safe if he is revaccinated every ten years. 
 
 There is no danger from vaccination. The vaccine is 
 now manufactured in an absolutely pure condition and 
 there is no possibility of contracting any disease through 
 vaccination. The reaction is slight and never lasts more 
 than a day or two. 
 
VARJCOCELE 301 
 
 Every child should be compelled to be vaccinated before 
 one year of age and again when a pupil of a private or 
 public school at 9 or 10 years of age. 
 
 We should not be lulled into a sense of false security by 
 the practical absence of smallpox in this country at the 
 present time. If we should relax our precautions and dis- 
 continue vaccination smallpox would soon become almost 
 as common now as it was 100 years ago. 
 
 The disfigurement of the face from smallpox known as 
 pock marking or pitting is permanent. Without vaccina- 
 tion you can never feel that you are free from this danger. 
 
 Vaccination is a very simple procedure; but should be 
 done by a physician. 
 
 Varicella. This is the medical name of chickenpox 
 (which see). Chickenpox and smallpox (variola) are 
 quite distinct diseases, because chickenpox occurs in chil- 
 dren whether vaccinated or not, and an attack of it does 
 not protect from smallpox. 
 
 Varicocele. A varicocele is a little bunch of dilated and 
 knotted veins in the "purse" or scrotum of a man. It is 
 the result and not the cause of that ' ' loss of manly vigor, ' ' 
 that "diminished sexual power," and that "debility," 
 which figure so largely in the advertisements relating to the 
 cure of varicocele. We beg to remind our readers that no 
 registered doctor, surgeon, or physician in America is al- 
 lowed to advertise, and that if he does so, he runs a risk 
 of losing his position as a member of the honorable faculty 
 of medicine. 
 
 The youth, then, who, as the result of fast living or bad 
 habits, begins to wonder why he is weak and wretched is 
 only too apt to believe advertisements when they tell him 
 that varicocele is at the root of all his trouble, and that 
 the cure or removal of the varicocele will restore all his 
 power. That is not true. Restoration of virility and man- 
 liness will take place at once (though slowly), on the re- 
 sumption of a clean mode of life early hours, hard work, 
 and not too much food. The varicocele may or may not be 
 cured. It is not half as dangerous, even when it is large, 
 as a varicose vein of the leg, which may ulcerate and bleed 
 you to death ! 
 
 We now come to the surgery of this subject. 
 
 A varicocele is a little bunch of twisted and knotted veins 
 inside the scrotum, or fleshy bag which contains the testi- 
 
302 VARICOCELE 
 
 cles. The swelling may be very small, or so large as to be 
 a nuisance. It is greater when the man stands up, and 
 gets smaller when he lies down. It increases for a time 
 after coughing or exertion. Sometimes it may be compli- 
 cated by a " rupture" or hernia, and for that reason no 
 young man ought to bother himself about his varicocele or 
 buy bandages for its treatment until he has consulted a 
 surgeon, who will tell him exactly what is wrong. If only 
 young men would go to respectable family doctors and ask 
 about all private natural matters which they don't under- 
 stand, how much heart-burning might be saved! Some- 
 times a varicocele is attended with a sensation of weight and 
 aching, especially if it is large and unsupported by a ban- 
 dage. Sometimes the neuralgic pain of it is very great. 
 Occasionally, but rarely, a vein " bursts," and the scrotum 
 fills up with blood. 
 
 Treatment. There are two ways of treating a varicocele, 
 if, indeed, it is large enough to cause any annoyance. One 
 is the palliative treatment. This consists in attending to 
 the general health by tonics and exercise and by living a 
 cleaner and more moral life, and by wearing a suspensory 
 bandage which supports the varicocele and soon relieves 
 the pains, and by bathing the parts with cold water night 
 and morning. The other way of treating a varicocele 
 is the radical method. This consists of a little surgical 
 operation for the tying, or tying and removal of the whole 
 bunch of enlarged veins. The little operation is free from 
 danger and is done quite painlessly. The testicle is not 
 touched or in any way damaged, and it does not waste 
 away afterwards, except in a few cases when it was already 
 wasting from a poor blood supply. But even if the testicle 
 of the left side (and varicocele is nearly always on the left 
 side) does waste away, there is still one left; and a man is 
 just as well able to procreate children with one as with 
 two. These remarks will be appreciated by all those who 
 are continually sending letters to the medical editors of 
 papers asking for information on these subjects. 
 
 The circumstances for which radical cure of a varicocele 
 is generally undertaken are these : 
 
 1. When the existence of a varicocele disqualifies a man 
 for admission to the public services. 
 
 2. Great discomfort and neuralgic pain from a very large 
 varieocele. 
 
VARICOSE VEINS 303 
 
 3. Those cases of young, well-educated and sedentary 
 men, who worry about themselves, fidget about the local 
 condition which they can see and feel for themselves, and 
 suffer from amorous dreams and uncomfortable sensa- 
 tions. 
 
 Varicose Ulcer. Many people have varicose veins of the 
 legs, especially women who have borne many children. 
 Sometimes a vein, if unsupported by an elastic stocking, 
 gives way and bleeds. When the bleeding has been stopped, 
 a little sore remains which is all too apt to become a regular 
 chronic ulcer of the leg. Rest in bed is the first essential. 
 (See "Ulcers.") 
 
 Varicose Veins. This name is applied to a dilated and 
 tortuous condition of the veins, most common in the legs, 
 and usually due to long standing, severe muscular exertion, 
 pressure from a tumor or some intra-abdominal condition, 
 or an organic affection of the heart. Hereditary disease 
 such as gout may predispose to this condition by a weaken- 
 ing of the walls of the veins. 
 
 The appearance of the tortuous vein meandering up the 
 leg cannot be mistaken. 
 
 It is usually accompanied by a feeling of fatigue and a 
 sense of fullness of the limb after exercise or long standing. 
 
 The circulation may become so poor that the tissues be- 
 come poorly nourished, congested, inflamed (varicose ec- 
 zema), or may die, producing a varicose ulcer. These com- 
 plications are usually intractable and require the help of 
 a physician to heal. 
 
 The palliative treatment of a varicose vein consists in 
 supporting it by an elastic stocking and reducing the hours 
 of standing. 
 
 The radical treatment consists in the excision of a greater 
 or less portion of the dilated vein with ligation to force 
 the blood back through the deeper veins of the leg. The 
 radical method is recommended in aggravated cases or 
 cases with intractable ulcers or eczema. 
 
 Vegetarianism. Real vegetarian diet consists only of 
 fruits, nuts and vegetable produce of every kind. There 
 are few real vegetarians because they very soon discover 
 that to take enough vegetarian diet to work upon, they need 
 absurdly large quantities of it. Moreover, vegetables all 
 contain a very high percentage of water in their composi- 
 tion, and sooner or later the bowels get out of order. 
 
304 VEGETARIANISM 
 
 A rational and altogether satisfactory diet (from the 
 health point of view) is the modified vegetarian diet that 
 is, one which admits eggs, milk and cheese in moderation. 
 This fleshless diet is, of course, not a purely vegetarian one ; 
 for eggs and milk are highly concentrated animal foods. 
 But there is no doubt that thousands of us would be all the 
 better if we ate no flesh. The man who eats no meat or 
 very little meat, soon gets to care very little for alcoholic 
 drinks, and soon finds that his pocket benefits, and that his 
 health is better. It is the " fumes" of a flesh diet which 
 give rise to thirst; and the large amount of waste matter 
 in flesh food and the difficulty of getting rid of it by the 
 kidneys are the causes of the craving for stimulants. It is 
 not to be expected that people will give up their joints of 
 roast beef ; and perhaps the nation would lose much of its 
 fighting propensity if they did. But, nevertheless, the 
 middle-aged man who wants to feel young still, who wants 
 to avoid rheumatic pains and gouty attacks, and who 
 doesn't want to be a soldier, or to take part in any amuse- 
 ments which depend upon brute strength and animal 
 powers, may do much worse than restrict his animal diet, 
 or do without flesh altogether. The acid properties of a 
 half-pound of fillet of beef, washed down with a pint of 
 beer, make a man feel at peace with the world and send 
 him (where possible) to the armchair for a smoke and an- 
 other glass of stimulant. But if he is middle-aged, and 
 especially if he has no manual labor to do, he has eaten a 
 meal far in excess of his requirements, and of a nature dif- 
 ferent from that which he needs for brain work. It is 
 lucky for him if years of this kind of ''solid feeding" don't 
 provide a future for him of gout, rheumatism or apoplexy ! 
 This doctrine is not as "cranky" as some may suppose. 
 We do not find fault with the hearty meals of the youth 
 who has to work and play hard. But we strenuously main- 
 tain that brain-workers and business men would drink less, 
 work harder, and be more clear-headed on a fleshless diet 
 than on either a full-flesh or a vegetarian diet. The experi- 
 ment, in any case, would not only cost a man nothing, but 
 would save money for him, for meat is an expensive item; 
 and the experimenter would find himself fresh and brisk 
 in the mornings, indifferent to continual and stupid 
 ' * liquoring-up, ' ' and free from most of the aches and pains 
 that we call rheumatic. Age, sex and occupation, of course, 
 
VENEREAL DISEASES 305 
 
 produce great variations in our food requirements. Per- 
 sons much exposed to the weather require fats and sugars 
 and starches. Children require much meat, or, rather, 
 milk, eggs and cheese ; whereas old people, if they want to 
 live long, will have to eat sparingly, especially of animal 
 foods. In conclusion, we recommend to the notice of all 
 our middle-aged and elderly readers the wise little book of 
 Sir Henry Thompson, entitled Diet in Relation to Age and 
 Activity, which can be ordered through any bookseller. It 
 is not a work on vegetarianism, however. 
 
 Venereal Diseases. (See also "Syphilis" and "Gonor- 
 rhea.") Until very recently it has not been realized what 
 a vast amount of venereal disease there is in this country. 
 One reason has been because these diseases, syphilis and 
 gonorrhea, rarely appear in our mortality statistics and 
 because we have never taken the trouble to tabulate the 
 simple cases. But many of these cases produce more seri- 
 ous conditions and it is by determining the results of these 
 diseases that we know how abundant they must be and what 
 enormous damage they are doing. 
 
 Syphilis is a cause of a large part of the following fatal 
 diseases: General paralysis, locomotor ataxia, paraplegia, 
 softening of the brain, arteriosclerosis, aneurism and still 
 births. 
 
 Gonorrhea is responsible for 80 per cent, of the deaths 
 due to inflammatory diseases peculiar to women. It is the 
 cause of many of the cases of rheumatism and most of the 
 cases of blindness in infancy. 
 
 These diseases are sometimes contracted innocently as, 
 e. g., an innocent wife from a "fast" husband; but most 
 of them come as the direct result of immorality. 
 
 It is doubtful whether laws will ever aid much in con- 
 trolling this evil. 
 
 It is certain, however, that moral teaching can do much 
 especially when backed up by the facts of what suffer- 
 ing, sorrow, and disease may result from a departure from 
 moral methods of living. It is a question how old children 
 should be before they are educated on the "social evil"; 
 but such education should certainly be given before a child 
 is sent off to school or college, or freed from home re- 
 straints. 
 
 If syphilis or gonorrhea should ever be contracted by any- 
 one they should place themselves at the earliest possible 
 
306 VENTILATION 
 
 moment under the care of a physician and absolutely avoid 
 all possibility of transmitting the disease until they have 
 been pronounced cured and free from infection. 
 
 Ventilation. The idea of human beings living steeped in 
 their own excretions is not a pleasant one to dwell upon; 
 yet this is just what countless people in shops and houses 
 are doing when they breathe air not sufficiently renewed 
 by ventilation. 
 
 When we realize that there are many buildings in New 
 York City where several thousand people spend their days 
 on a ground area of 100 x 100 feet; that the streets be- 
 tween are narrow and dark and the spaces between are 
 cistern-like and filled with stagnant, lifeless air we can 
 understand the headache, depression, anaemia and impaired 
 health which many of the " sky-scraper" denizens feel. 
 
 Of the importance of ventilation we as a nation are as 
 yet almost totally ignorant. We appreciate how much bet- 
 ter we all feel out-of-doors, but we don't seem to realize 
 that the reason we feel less well in-doors is because we 
 breathe air which is shut up in rooms inadequately circu- 
 lated and inadequately renewed. 
 
 Ventilation is required to rid the air of its gaseous im- 
 purities and the watery vapor which result from the respi- 
 ration and transpiration of human beings, and to reduce 
 these to such an extent that the air of inhabited rooms shall 
 not be detrimental to health. Solids, as dust, microorgan- 
 isms, etc., are not removed by the ordinary means used for 
 ventilation, and the circulation of fresh air through an 
 apartment cannot, therefore, take the place of methods of 
 cleaning. 
 
 The amount of fresh air required for each person per 
 hour is 3,000 cubic feet. As air cannot be changed com- 
 fortably, without producing some feeling of draught, more 
 than three times an hour, each person in a house should 
 have at least 1,000 cubic feet of air space. The legal mini- 
 mum for shops and factories in most states is 250 cubic 
 feet by day and 400 cubic feet by night. Each gas burner 
 consumes 4 cubic feet of gas per hour and requires 4,800 
 cubic feet of fresh air an hour. This must be added to the 
 air required by people in a room. Electric lights do not 
 consume any air. 
 
 The ideal scheme of ventilation is one in which the air 
 is derived from a pure source some feet above the ground, 
 
VENTILATION 307 
 
 washed and filtered free of dust and impurities, given a 
 proper degree of humidity and temperature, forced into 
 each individual room, sucked out through a pipe and ex- 
 pelled out of doors. 
 
 This is known as the artificial method of ventilation. 
 The natural method depends upon diffusion, wind, and tem- 
 perature to cause a circulation of air and is largely a mat- 
 ter of luck. Wind and temperature cause warmed air to 
 go up the chimney and it is hoped that fresh air to replace 
 this will get in somehow. 
 
 Diffusion stirs up the air and dilutes the impure air with 
 air not yet used. 
 
 The advantages of the artificial over the natural methods 
 are its constancy under all conditions and the facilities 
 which it affords for regulating the source and amount of 
 fresh air, and the preparatory treatment as to temperature, 
 moisture and purification. 
 
 In any scheme of ventilation regard must be had to the 
 following practical points : 
 
 1. When air is heated it expands and tends to rise; when 
 air is cooled it contracts and tends to fall. 
 
 2. The inlet provision for fresh air should average 24 
 square inches for each individual; the provision of inlet 
 areas somewhat larger than those of exit tends to immunize 
 draughts. 
 
 3. Inlets should be low in the room and incoming air 
 should be directed upwards if cold and downwards if warm. 
 
 4. There is a tendency for fresh air to take a direct 
 course to the outlets, and this must be counterbalanced by 
 a judicious selection of the relative positions of inlets and 
 outlets. 
 
 5. With less than 250 cubic feet of space per head, no 
 ventilation can be satisfactory which is not aided by me- 
 chanical force. 
 
 6. The source of the incoming air should be considered. 
 It should not be borrowed from adjoining rooms, but taken 
 direct from the outside. 
 
 7. If warmed air is forced into a room, it should only 
 be raised to a temperature sufficient to prevent a feeling of 
 cold (about 60 F.). More highly heated air is often felt 
 to be overdry and unpleasant. 
 
 8. Mechanical methods of ventilation are essential in 
 all office and public buildings, factories and theaters. It 
 
308 WAETS 
 
 is advisable in all apartment houses and homes unless the 
 expense of installation and maintenance is prohibitory. 
 
 Warts. Everybody knows what a wart is, but everybody 
 does not know that a wart is something between a mere 
 thickening of the skin and a cancerous tumor. A cancer 
 growing from the skin (called an epithelioma) is practically 
 a wart of a certain type a wart which, if left alone, will 
 at last ulcerate, cause swollen cancerous glands in the arm- 
 pit and perhaps, also, cancerous growths in internal organs 
 such as the womb or liver. Of course, most warts are, and 
 probably will always remain harmless; but as no one can 
 tell exactly whether a wart is going to become cancerous or 
 not, it is always worth while to get it removed. 
 
 Children's warts are found chiefly on the fingers or 
 knuckles, and are tough, flat, circular knobs of hardened 
 skin, ingrained with brownish dirt, and apt to bleed if the 
 topmost layer of skin is knocked off. They may come in 
 crops whenever the child is a little out of health. They can 
 be destroyed by caustics such as ethylate of soda, lunar 
 caustic, nitric acid pure, or caustic potash. A little of the 
 caustic is applied daily, from the end of a wooden match, 
 care being taken to touch only the wart and not the skin 
 surrounding, and to let it dry on. Little by little the tough 
 hard skin shreds off and the wart is gone. A little lime 
 water taken after food daily is said to assist in causing 
 warts to disappear. Sea water has also been used. 
 
 Pigmented warts. Colored warts are the ones which 
 should certainly be removed, for they are always apt to 
 grow into malignant tumors as the person gets on in years. 
 
 Tuberculous warts are common on the hands of students, 
 post-mortem room porters and funeral officials. They must 
 be cut out by a surgeon. 
 
 Cancer developing from a wart is of very rare occurrence 
 before middle age. About that time (say 45) and after, 
 the continual smoking of a hot-stemmed clay pipe is apt 
 to cause cancer of the lip. Chimney sweeps are liable to 
 cancerous warts of the skin on the scrotum, caused by the 
 irritation of soot, and by lack of cleanliness. The continual 
 drinking of bad spirits certainly makes a man more liable 
 to cancer of the stomach. 
 
 Note. Neither warts nor cancers are easily caught by one 
 person from another. But there is something in the idea 
 that the blood of a wart will sometimes produce another 
 
WATER 309 
 
 wart if rubbed on healthy skin. And as to cancers, it is 
 undeniable that there are houses in which person after 
 person, for generations, gets the disease from merely living 
 in them. Such are called "cancer houses," and ought to 
 be avoided. It has also been noticed that the husband of 
 a wife with cancer of the womb, or the breasts, frequently 
 develops cancer himself later on. 
 
 Water, There is no greater necessity of life than an 
 ample supply of pure water, especially for drinking pur- 
 poses. But the amount we drink is very small compared 
 to the amount which must be provided per head for the 
 inhabitants of a town. Allowance has to be made for ordi- 
 nary washing and personal cleanliness, for the baths and 
 domestic washing, for closets and for cooking, and for street 
 cleansing and for use in gardens. 
 
 In some towns sea water is used in the streets and for 
 the sewers, and in many places rain water is used for wash- 
 ing. In solitary cottages and small villages water is gen- 
 erally obtained from shallow wells, and this supply may 
 be pure enough for use when the population is small and 
 scattered. Shallow wells are, however, very liable to pollu- 
 tion from surface drainage, and from this reason the water 
 may be seriously contaminated. As villages grow into 
 towns a supply of drinking water has to be fetched from 
 hills at a distance, and conveyed through canals or under- 
 ground pipes. In some districts it is found possible to 
 obtain a supply of water by boring very deeply with iron 
 pipes in short lengths until a water-bearing stratum is 
 reached; these are called artesian wells. Such water is 
 generally very pure, but may be too hard. A water is said 
 to be hard when it has dissolved in it too much lime ab- 
 sorbed from the soil. Sea water is useless for drinking or 
 for domestic use, being too salt. 
 
 Rain water, although very pure, if collected away among 
 mountains or very far from dwellings, is both dirty and 
 impure when collected in towns. The air of towns is con- 
 taminated with carbonic acid and sulphur, dust of a thou- 
 sand sorts, emanations from the skin and germs of infection, 
 and rain in falling through it becomes dirty, impure, and 
 unfit to drink. 
 
 All towns now have a public water supply. This may be 
 of two sorts one in which the pipes supplying each street 
 and house are kept constantly full of water, under full 
 
310 WATER 
 
 pressure, at all hours; and on the other mode of supply 
 each house has to have a tank for storing water, because 
 the supply under pressure is only turned on for an hour 
 or two each day. This latter plan is more common than 
 the first, which is better. Under the constant supply more 
 water runs to waste, but with the occasional system there 
 is always a risk to health from cisterns which may be kept 
 in a dirty state or may get rubbish thrown into them. 
 
 Unless a person has seen a drop of dirty water exhibited 
 under a microscope, it is difficult to believe what a collec- 
 tion of very minute living beings may be contained in it. 
 Many of these are, no doubt, harmless, but, on the other 
 hand, many are germs of different diseases. These micro- 
 scopic germs, bacteria, and bacilli multiply with amazing 
 rapidity, especially in water which lies stagnant. 
 
 They get into the water from the rain, or from the soil 
 through which the water has run, and may fall into the 
 water in our cisterns if not well covered. Many diseases 
 are known to be spread by water containing the special 
 germs of the disease, and this is especially the case with 
 typhoid fever. Slops may be thrown away in gardens, or 
 sewage from infected houses may soak through the ground 
 and find its way into the water of shallow wells, and so 
 one case may lead to the occurrence of many other cases. 
 In this way typhoid fever is always common among soldiers 
 in camps, especially during war time, when it is so difficult 
 to secure sanitary conditions. In a war typhoid fever al- 
 ways kills more men than the guns of the enemy. Drinking 
 water kept in tanks may be wholesome enough if great 
 care is taken to keep tanks clean and covered, and if a full 
 supply is added daily, while a certain amount is drawn 
 away every day for use. But in poor districts it is always 
 found to be very difficult for landlords to keep the cisterns 
 clean. Of course, many landlords are very careless, and 
 pay but little attention to the needs of poor tenants; and 
 when a landlord does his best, poor tenants are apt to be 
 grossly careless and dirty in their habits. They leave cov- 
 ers off, or let children play in the tanks, and but rarely 
 watch that the water in them is clean. Cisterns are often 
 badly situated in dwelling houses; they should be as far 
 as possible from the closets, and should be placed so as to 
 be frequently inspected; they should be scrubbed out at 
 least every three months. Pure, wholesome water should 
 
WATER PURIFICATION 311 
 
 be clear, sparkling, and colorless, without the faintest smell 
 or taste, and should not be too hard with dissolved lime. 
 Impure water sets up diarrheal colic, sore throat, nausea, 
 and loss of appetite. Life is never safe without a pure 
 water supply. 
 
 Water Purification. So many of the infectious diseases 
 may be contracted through a polluted water supply that it 
 is advisable as a routine measure to avoid all chance of 
 contracting disease in this way by drinking only water 
 which has been purified. 
 
 Some city water supplies are filtered before being dis- 
 tributed. 
 
 Others are not. Whether the city water is filtered or not, 
 home measures for purification are advisable. 
 
 The chief measures for purification are boiling, filtra- 
 tion, distillation and chemical treatment. 
 
 Boiling destroys bacteria and removes temporary hard- 
 ness. This is one of the safest ways of purifying water, 
 but it may taste flat unless the air which has been removed 
 by boiling is replaced by aeration. 
 
 Distillation is the most universally applicable mode of 
 purification, and even sea water can be utilized in this way. 
 
 The process of distillation is a slow one, however, and the 
 water may taste flat from want of natural salts and air. 
 
 Filtration is a very good method of home water purifi- 
 cation provided good filters are used and kept in good order. 
 
 The best filters are the Berkefeld and the Pasteur-Cham- 
 berland, which can be applied to the water tap. 
 
 Every few days the filter-candle should be removed from 
 these filters, and thoroughly scrubbed and boiled before 
 being replaced. 
 
 Chemical processes are used, for the most part, in the 
 removal of inorganic impurities especially lime. This is 
 best done in connection with filtration, and many large 
 filters are provided with an arrangement by which the lime 
 is precipitated out of the water as it passes through the 
 filter by means of alum. 
 
 The purest water supplies are those which come origi- 
 nally from mountain springs, deep-driven wells and prop- 
 erly-filtered city water. 
 
 Water Brash is a clear alkaline fluid, much like saliva (or 
 spittle) in appearance, which comes into the mouth in 
 gushes, and has to be spat out, generally in the early morn- 
 
312 WHITE LEG 
 
 ing. Sometimes it comes up without any trouble, some- 
 times it is vomited up with painful retching. It is actually 
 spittle, from the mouth, which has been swallowed during 
 the night and comes up again in the morning. It is a sign 
 of chronic inflammation of the stomach, and is probably 
 caused by over-indulgence in alcoholic liquors. (See also 
 "Indigestion.") 
 
 Watercress AND ITS DANGERS. If watercress is grown in 
 a stream of clear water it is a most valuable salad, and is 
 well suited for eating with bread and butter at meals when 
 tea is drunk. It is very purifying to the blood, containing 
 potash with vegetable acids. There is, however, a risk of 
 being infected with typhoid fever, and, perhaps, also, of 
 swallowing the eggs of worms which may breed in the 
 bowels, if the water is foul, stagnant or has become soiled 
 with sewage materials draining from the fields or gutters. 
 All watercress should be pulled to pieces and thoroughly 
 washed by water running from a tap, or with several lots 
 of water in a bowl. 
 
 Water-on-the-Brain. This is the popular name for menin- 
 gitis, or inflammation of the membranes of the brain, called 
 in novels, "brain-fever." It is generally due to tubercu- 
 lous disease. Children are sometimes born with water-on- 
 the-brain, which has swelled up their heads, and which 
 crushes their brains and makes them more or less idiotic. 
 
 Weir-Mitchell Treatment. This is an expensive treatment 
 for neurasthenia (which see). It consists of complete rest 
 in bed, without letters or newspapers, or worrying visitors ; 
 overfeeding and massage to take the place of muscular 
 exercise. The patient is allowed to see no one except the 
 doctor and the nurse. It is a splendid treatment for ex- 
 haustion and brain-fag. 
 
 Wens. A wen is a cyst of the skin caused by blockage 
 of the mouth of a little gland; it is full of a cheesy sub- 
 stance called sebum, and occurs commonly on the scalp or 
 neck. Doctors call wens sebaceous cysts. They are round, 
 dome-like, semi-fluid tumors, but quite harmless. They may 
 be easily removed under cocaine without pain, by any sur- 
 geon. 
 
 White Leg. A swelling of the whole of one leg, occur- 
 ring, sometimes, in women after childbirth, also in con- 
 valescence from pneumonia or typhoid fever. 
 
 Symptoms. For a few days, pain and tenderness of one 
 
WHITLOW 313 
 
 thigh, and feverishness. The limb swells slowly, and in a 
 few days will be very white, hard, and shining, like a hard 
 bolster in a white pillowslip. The veins can be felt as hard 
 as whipcord down the leg. The swelling begins to go down 
 again in about ten days and the leg may recover altogether. 
 But very often some degree of weakness and aching remain 
 in the leg for months or years. 
 
 Treatment. Rest in bed, and quiet, with the limb raised 
 on a pillow. At the onset, give the patient a pill contain- 
 ing two grains of quinine and % grain of opium every six 
 hours. But before that, administer a sharp purge like a 
 drachm or more of compound jalap powder. Do not move 
 the leg about, or poultice it, or rub it; everything depends 
 on its being kept still. Every time it is moved there is a 
 risk that a piece of blood clot from one of the inflamed veins 
 may be dislodged and carried by the blood stream to some 
 distant part, such as the brain or lungs, and cause fright- 
 ful damage, or even death. This mischief is called em- 
 bolism. 
 
 White Swelling. This is the name given to tuberculous 
 disease of a joint, especially of the knee, but it should not 
 be used by those who care for accuracy. 
 
 Whitlow. This is a name given to almost any kind of 
 inflammation of the fingers. The inflammation is caused 
 by a germ or a mixture of different germs, which get into 
 the blood through any crack or tiny sore on the fingers, 
 especially at the edge of the nails. 
 
 Symptoms. Throbbing pain in a finger, made worse by 
 hanging the hand down, relieved by raising the arm. 
 Swelling and redness and tenderness and pain, especially 
 at one spot. 
 
 In the least severe kind of whitlow the skin rises like a 
 blister over it and then, if the blister be pricked or cut, 
 matter will escape and the whitlow will soon be well. The 
 second and more severe type is when the inflammation is 
 right in the soft pulp of the flesh of the finger, especially 
 likely to occur after getting a splinter into the finger. This 
 kind of whitlow is to be continuously fomented or held in 
 hot water. Presently the matter comes to the surface, 
 bursts through, and the inflammation gradually subsides. 
 The third and really serious kind of whitlow may develop 
 from the others if they are neglected. The inflammation 
 goes right down to the tendon of the finger, gives intense 
 
314 WHOOPING COUGH 
 
 pain, swelling and tenderness all up the arm, swollen glands 
 in the armpit and a general feeling of illness. If neglected, 
 this whitlow may cause loss of a finger, or even of a hand 
 or arm. The treatment must be left to the skill of a sur- 
 geon. 
 
 Whooping Cough. This is a very contagious disease, 
 which attacks children so readily that very few children 
 grow up without suffering from it. The infection of the 
 disease seems to be in the air, and we suppose that the out- 
 breathed air and the phlegm of those who are suffering 
 from it spread the poison which starts other cases, but as 
 yet the scientific observers, with their microscopes, have not 
 been able to discover any definite germs. The disease occa- 
 sionally appears as an epidemic, attacking a large number 
 at once in the same locality, but, in general, each new case 
 is infected separately from a previous case. For example, 
 a child may get the infection from sitting in an omnibus 
 opposite to a child who has a severe fit of the cough. 
 Whooping cough is called Pertussis by doctors, and an old 
 English name was Chin-cough. It rarely occurs more than 
 once to anyone. 
 
 It generally begins as a common cold, passing on to a 
 cough, with a little f everishness ; and then after a week or 
 more, the cough changes its character; it tends more and 
 more to come on in fits of coughing, with free intervals. 
 There may be only two or three fits of coughing in a day, 
 or as many in an hour. The cough develops a peculiar 
 quality of a shrill sound or whoop, which, once recognized, 
 is hardly ever mistaken. It occurs at the end of a fit of 
 coughing, when the patient is almost strangled by the length 
 of time the cough has lasted. These coughing fits may end 
 in vomiting or in nose-bleeding, and a child suffers so much 
 in them that he dreads each onset. Directly after a fit, 
 however, the patient seems to regain courage, and if sick- 
 ness has occurred, he soon gets hungry again. Cases gen- 
 erally last three weeks, but children may continue to whoop 
 for three months. It is a very disagreeable disease for 
 nurses and patients, but its great dangers lie in the com- 
 plications which are so apt to develop. Measles occasion- 
 ally occurs with whooping cough, and makes the child even 
 more ill, and increases the danger. Bronchitis and pleu- 
 risy, and also pneumonia and congestion of the lungs, are 
 the most common and most dangerous diseases which ac- 
 
WHOOPING COUGH 315 
 
 company whooping cough, and when there are any symp- 
 toms of either of these, medical aid must be sought for at 
 once. The severe cough is also liable to injure the ears, 
 and may cause bleeding behind the whites of the eyes ; and 
 even convulsions are occasionally set up, and cause great 
 danger. 
 
 Treatment. Isolation is the first question to be dealt 
 with. As the disease will last for eight to ten weeks or 
 more, it is no use to begin a system in a half-hearted way. 
 If possible, where there is more than one child in a house, 
 the sick one should be sent away ; and if he is too sick, then 
 the other children must be sent away. The child ought 
 really to have two rooms to use, but in any case, from the 
 rooms which it uses everything that can be damaged by 
 disinfectants must be removed, because the rooms will have 
 to be disinfected afterwards. The child must be warmly 
 clothed, but must have plenty of fresh air and not be cod- 
 dled. When we come to mention medicines we find our- 
 selves in a fix : there are so many different ways af treating 
 the disease. We always discountenance the treatment of a 
 disease which may be so serious as whooping cough, with- 
 out a doctor, and we know that most doctors have their 
 routine way of dealing with it. Yet a few remarks may be 
 useful. The disease generally runs its course; very little 
 can be done with medicines, and a great deal can be done 
 by good nursing. The following is a very good prescrip- 
 tion for a two-year-old child with whooping cough : Phena- 
 zonum, 1 drachm; ammonium and sodium bromides, of 
 each 1 drachm; syrup of chloral, 6 drachms; chloroform 
 water to 4 ounces. Give a teaspoonful every three hours. 
 Caution. This contains poisons and must be given only in 
 measured doses. 
 
 Additional recipes for use in whooping cough : 
 
 (1) Yeo's inhalation method of treating whooping 
 cough. An iron dripping-spoon is kept on the fire and 
 carbolic acid is dropped on to it and evaporated until 
 the air of the room is full of carbolic fumes. The 
 throat of the child to be painted with glycerin of car- 
 bolic acid. The following lotion to be sprayed in front 
 of the child's face (with eyes shut) from time to time 
 Glycerin of carbolic acid, 1 drachm; bicarbonate 
 soda, 10 grains ; hot water, 1 ounce. 
 
316 WOEMS 
 
 (2) Instead of carbolic, eucalyptus or terebene may 
 be used. 
 
 (3) Resorcin (2 per cent.) solution may be both 
 sprayed into the room and painted in the throat. 
 
 (4) Ipecacuanha wine, 4 fluid drachms; ammonium 
 bromide, 3 drachms ; paregoric, 4 fluid drachms ; syrup 
 of tolu, 1 fluid ounce; chloroform water, to 4 fluid 
 ounces. A child of seven years may be given a tea- 
 spoonful of this in a wineglassful of water three times 
 a day. A good prescription. 
 
 (5) Another useful one is: Ammonium chloride, 
 25 grains ; bicarbonate of soda, 40 grains ; sodium ben- 
 zoate, 70 grains ; chloroform water, 1 fluid ounce ; anise 
 water, to 3 fluid ounces. A teaspoonful may be given 
 to a child of four, every four hours. 
 
 Winter-Cough.. There is no cough peculiar to the winter. 
 This name means chronic bronchitis, which is worse in the 
 cold and damp weather and better in the warm weather. 
 (See "Cough" and "Bronchitis.") 
 
 Worms. Under this heading we describe briefly the 
 principal worms which are sometimes found in the bodies 
 of human beings, especially in the bowels of children. 
 
 The TAPEWORM is a flat, long worm, whitish, like a piece 
 of tape and consisting of a tiny head, with suckers which 
 enable the worm to attach itself to the inside lining of the 
 bowel and to draw its nourishment from thence; a thin 
 tapering neck like a piece of white thread ; and a long body 
 of several separate segments or divisions. The body may 
 be as long as a yard or more, and the whole worm lies coiled 
 up in the bowel. Bits of it get broken off from time to 
 time, and appear in the motions, but so long as the head 
 holds fast, the worm does not die, but keeps on adding seg- 
 ments to itself. 
 
 Cause. The tapeworms are taken into the body by eat- 
 ing the flesh of pigs or cattle which have harbored them. 
 Pork with worms in it is called "measly pork," and is not 
 uncommon among the poorer class of butchers' shops. 
 There is a little tapeworm also, which is sometimes caught 
 from pet dogs. The dog picks up garbage and rubs its nose 
 in the filth of the gutter and then may communicate worms 
 to anyone who allows it to lick his face or touch his food. 
 
 Signs of worms. Children with tapeworm generally have 
 
THREADWORM 317 
 
 enormous appetites, diarrhea alternating with costiveness, 
 headaches and even fits or convulsions. From time to time 
 you can see several inches or feet of tapeworm in the mo- 
 tions. 
 
 Treatment. (1) Keep the child in bed. 
 
 (2) Give, for three days, a very spare and light diet 
 and a tabloid or two of cascara sagrada every night. This 
 gets the bowels free from much solid residue of food, and 
 makes the other treatment much more likely to succeed 
 the first time, 
 
 (3) On the fourth day, at nine in the morning, give 
 patient a capsule of ten minims of the extract of male 
 fern; another similar dose half-an-hour later; another 
 again at ten o'clock. Then, at eleven o'clock, a fluid 
 ounce of compound senna mixture, or an ounce of castor 
 oil. When the bowels have acted, give some breakfast. 
 The reason for these repeated doses is that if only a 
 single dose is given it may pass quickly over the worm 
 and fail to kill it. 
 
 (4) When the bowels do act, the motion ought to be 
 passed into a bedpan with a piece of black thin crape or 
 cloth over it. Then the white neck and head of the worm 
 may easily be found. 
 
 Until the head has been found, the cure cannot be 
 considered to have been accomplished. It is very small, 
 hardly bigger than a pin's head. 
 
 THREADWORM. The threadworm is about a quarter of 
 an inch long, white, and threadlike. These worms live in 
 the lower bowel or rectum. 
 
 Signs of threadworm. Diarrhea, nervous irritability, 
 and even fits ; picking of the nose, scratching of the funda- 
 ment, grinding of the teeth during sleep and bed-wetting. 
 
 Treatment. The irritation at the back passage may be 
 relieved by applying weak, white, precipitate ointment. In- 
 ternally the child should have one santonin lozenge, at bed- 
 time, every night, for a week, and a small dose of castor oil 
 in the morning; also injections of warm salt water or sea 
 water into the back passage. 
 
 BOUND WORM. The roundworm looks something like an 
 ordinary garden worm, only pale yellowish in color. It is 
 about ten inches long. These worms live in the bowels and 
 
318 WRY-NECK 
 
 feed there ; but sometimes one wanders into the stomach and 
 is vomited up, or into the nose, and may even try and get 
 through the nostril. These worms are fond of getting into 
 round openings. They cause a too-great appetite, varied 
 sometimes by a complete loss of appetite, and sometimes 
 diarrhea, and pain in the belly. 
 
 Treatment. To a child give 5 grains of santonin in one 
 dose, at bedtime, and a large dose of castor oil in the morn- 
 ing. 
 
 Wry-Neck. In wry-neck the head is twisted to one side. 
 It may be caused by the scars of a burn, or of operations 
 for swollen glands, which drag the head over to one side. 
 But by far the most common sort of wry-neck is caused by a 
 spasm or cramp of the muscle called sterno-mastoid which 
 jerks the head to one side, often in a very painful fashion. 
 Tailors and shoemakers are very liable to the complaint. 
 Infants during birth, when the delivery has been difficult, 
 are apt to suffer from a rupture of the sterno-mastoid mus- 
 cle, so that the one on the other side drags the head over to 
 that side. 
 
 The cure of every case of wry-neck must depend entirely 
 on its own merits and its causes. We can give no help in 
 these pages. 
 
 THE END 
 
INDEX 
 
 Topics printed in small capitals are found also in their regular 
 alphabetical place in the body of the book. 
 
 abortion, 198 
 
 ABSCESS, 1 
 
 abscess of the lung, 179 
 
 absinthe, 286 
 
 acetylene gas, 174 
 
 aconite, in fevers, 110; for sore 
 throat, 264 
 
 ACIDITY (Sour Stomach, Heart- 
 burn), 2 
 
 ACNE. (See BLACKHEADS) 
 
 acquired syphilis, 277 
 
 ADENOIDS, 3 
 
 adenoids, 207, 212 
 
 adhesive plaster, in medicine 
 chest, 186 
 
 adrenaline, for bleeding, 224 
 
 advertising, 273, 301 
 
 AGE AND WEIGHT, 4 
 
 ague, 182 
 
 ALCOHOL, ACUTE POISONING BY, 5 
 
 alcohol, as skin antiseptic, 12; 
 as food, 25; for sponging in 
 fevers, 110; a cause of in- 
 sanity, 162; in insomnia, 
 165; unnecessary drink, 193; 
 secret abuse of, 204; ex- 
 cesses, 215, 221, 244; in ty- 
 phoid, 293 
 
 ALCOHOLIC DRINKS, MODERATION 
 IN, 5 
 
 alcoholic drinks, 5; abuse of, 6; 
 moderation, 7 ; amount in 
 health, 8; not to be admin- 
 istered for apoplexy, 13, 236 
 
 alcoholic paralysis, 116 
 
 alkaline bath, formula for, 22; 
 soap, 125 
 
 alkaline, mouth wash, 78; tooth 
 powders best, 78 
 
 alkaloe, 12, 212 
 
 aloe, 218 
 
 aloe, belladonna and strychnine 
 
 pill, 69 
 alum, lotion for feet, 29; for 
 
 bleeding, 20S, 225, 227; for 
 
 sore throat, 264 
 alum powder, in medicine chest, 
 
 187, 190 
 
 aluminium acetate, for abscess, 1 
 amaurosis, 265, 266 
 ammonia, for stings, 26 
 ammonium acetate, in fevers, 110 
 ammonium bromide, 208 
 ammonia, in medicine chest, 186 
 arnputation ? 117 
 
 ANAEMIA, 8 
 
 anemia, 132, 133, 149, 203, 227, 
 287, 306 
 
 ANAESTHETICS, 10 
 
 anasarca ( see DROPSY ) , 89 
 
 ANEURISM, 10 
 
 aneurism, 289, 305 
 
 ANGINA PECTORIS, 11 
 
 anise, 57 
 
 antinomy, for eczema, 96; for 
 
 sore throat, 204 
 
 antipyrin, 110, 132, 158, 264, 297 
 ANTISEPTICS, 11; list of, 112 
 antitoxin, diphtheria, 73, 84 
 anus, the, 217 
 anyl nitrate, for angina pectoris, 
 
 11 
 
 apenta water, 69 
 APOPLEXY, 12 
 apoplexy, 211 
 
 APPENDICITIS, 13 
 
 APPETITE GOOD, BAD AND INDIF- 
 FERENT, 14 
 
 319 
 
320 
 
 INDEX 
 
 aristoe, antiseptic powder, 12 
 
 armpits, lotion for, 217 
 
 arnica, tincture of, for stings, 
 
 26; not to be used for gout, 
 
 123 
 aromatic chalk powder, in medi- 
 
 chine chest, 187 
 Arsenic for boils, 31; for eczema, 
 
 96, 223; in psoriasis, 229; 
 
 poisoning, 288 
 arterio-sclerosis, 305 
 artificial feeding, 154; lighting, 
 
 172 
 
 arthritis, 234, 238 
 artificial respiration, 90 
 ASCITES, 16 
 ashes. 234 
 aspirin, for lumbago, 178; for 
 
 rheumatism, 235 
 asses' milk, 196 
 ASTHMA, 16 
 asthma, 206 
 asthma powders, 17 
 asylums, 160 
 
 BABIES LOST BY OVERLAYING IN 
 
 BED, 18 
 BACKACHE, 19 
 
 bacon, 64. (See also DIETS) 
 bacteria, in milk, 194-5 
 ballin bottle, 196 
 bandages, in medicine chest, 186, 
 
 188 
 bandage, for bleeding in varicose 
 
 veins, 29; for abscess of 
 
 breast, 31 
 
 BANTING, 20 
 
 banting, 67 
 
 BARBERS' ITCH, 21 
 
 BARLEY WATER FOR INVALIDS, 21 
 
 barley water, 48; in measles, 185 
 
 BARRENNESS, 20 
 
 BATHING, THE IMPORTANCE OF, 
 22 
 
 baths, 214; conium, 167; sul- 
 
 phuret, 167 
 Baume AnalgSsique Bengue 1 , for 
 
 gout, 123 
 
 beans, in diabetes, 80 
 BED CASE ; 23 
 
 BEDSORE, 23 
 
 bedsores, 293 
 
 BEEF TEA, HOW TO MAKE, 23 
 
 beef juice, 48; tea, for influenza, 
 
 158 
 
 beer, 25, 216 
 
 belching, false relief of, 152 
 belladonna, for bruises, 34 
 benzoin, 189; for tonsils, 264 
 
 BEVERAGES, 24 
 
 bicarbonate of potash, in rheu- 
 matism, 235, 239 
 
 bicarbonate of soda, for teeth, 
 282; for tongue, 287, 297 
 
 bichloride of mercury, 28 
 
 bichloride of mercury (corrosive 
 sublimate), for cuts, 29; 
 for boils, 31; for abscess, 1; 
 as antiseptic, 12; as disin- 
 fectant, 86 
 
 bicycles, for reducing, 67 
 
 bilious attacks, 271 
 
 birthmarks, 25, 292 
 
 bismuth, 144 
 
 BITES AND STINGS, 26 
 BITES OF DOGS, 26 
 
 black and blue, 268 
 
 BLACK-EYE, 27 
 BLACKHEADS, 27 
 BLADDER, DISEASES OF, 28 
 
 bladder, 299 
 blankets, 235 
 
 Blaud's pills, for anaemia, 10 
 blebs, 253 
 
 bleeding, in scurvy, 247; wash- 
 ing wounds, 283 
 
 BLEEDING FROM VARICOSE VEINS, 
 28 
 
 blister, for ear noises, 207 
 blistering, for lumbago, 178 
 blood-poisoning, 230, 253, 287 
 
 BLOOD- SPITTING, 30 
 BLOOD-VOMITING, 30 
 
 blue mass, in fevers, 110 
 
 blood, in rickets, 240 
 
 blue pill, for liverishness, 69 
 
 BOILS, 30 
 
 Boracic acid, as antiseptic, 12, 
 
 212 
 boric acid for eczema, 97 ; for 
 
 barbers, 26 ; for shingles, 
 
 144; in scurf, 246 
 boric acid powder, in medicine 
 
 chest, 187, 189 
 boric lint, 40, 297 
 
INDEX 
 
 321 
 
 boric lotion, for black eye, 27; 
 
 ointment for housemaid's 
 
 knee, 146 
 
 borine, as toilet antiseptic, 12 
 /boroglyceride, 246 
 borolyptol, as toilet antiseptic, 
 
 12 
 
 bottles, for feeding, 196 
 bowels, 192, 203; in pregnancy, 
 
 227; in rheumatism, 237; 
 
 with ulcers, 297, 307 
 
 BRANDY AND EGG MIXTURE, 31 
 
 brandy, amount of alcohol in, 25 ; 
 for diarrhoea, 48; in col- 
 lapse, 200; after poisoning, 
 222 
 
 bread poultice, 226, 264 
 
 break-bone fever, 198 
 
 BREAST, ABSCESS OF, 31 
 
 breast feeding, 195 
 
 breasts, bandaged in pregnancy, 
 
 227 
 breath, 153, 192 
 
 BREATH, UNPLEASANT OR FOUL, 
 32 
 
 breath, shortness of, 32 
 
 breathing, exercises for bust de- 
 velopment, 36 
 
 BRIGHT'S DISEASE, 32, 168, 230, 
 299 
 
 brimstone, 218 
 
 BROKEN BONES, 32 
 
 bromide of sodium, for seasick- 
 ness, 247 
 bromides, 165 
 bromine, for epilepsy, 101 
 bromural, for insomnia, 166 
 BRONCHITIS, 33 
 bronchitis, 184, 289, 314 
 BRUISES, 34 
 brushes, 186 
 brushes and combs, 245 
 brush, throat, 188 
 BUBO, 34 
 bubo, 120 
 bug bites, 233 
 BUNION, 35 
 
 BURNS, 35 
 
 BUST DEVELOPMENT, 36 
 
 buttermilk, substitute for, 170 
 
 cachous, useless, 32 
 
 caffeine, 132; in medicine chest, 
 
 187 
 
 calamine lotion, for eczema, 95 
 calcium phosphate, 207 
 calomel, for boils, 31; for gall 
 
 stones, 117; in medicine 
 
 chest, 187, 189; for piles, 
 
 218; in sciatica, 243; for ul- 
 cers, 297 
 
 camphor liniment, 178 
 camphor, water, in chicken pox, 
 
 45; for chilblains, 46 
 CANCER, 37 
 cancer of the liver, 176; of the 
 
 stomach, 272; tongue, 286, 
 
 292, 308 
 
 candle light, 173 
 carbolic acid, 12; in chicken pox, 
 
 45; poisoning from, 222; 
 
 disinfectant, 246; for stye, 
 
 274 
 carbolic acid lotion, in medicine 
 
 chest, 187 
 carbolic oil, for catheter, 40; for 
 
 barbers, 126; for scurfiness, 
 
 257 
 carbolic soap, 40; in medicine 
 
 chest, 186, 188 
 carbolic tooth powder, 282 
 carbonate of soda, for scaliness, 
 
 230 
 
 CARBUNCLE. (See also GLANDS) 
 carre" ammonia process, 139 
 carron oil, for burns, 36 
 carrots, in diabetes, 80. (See 
 
 DIETS) 
 
 cascara, 10, 69 
 
 cascara sagrada, 227, 230, 317 
 castor oil, for eczema, 96 ; in 
 
 medicine chest, 187; for 
 
 poisoning, 200; in piles, 
 
 218; as purge, 230, 293 
 cataract, 265, 266 
 
 CATARACT. (See EYE DISEASES) 
 CATARRH. (See COLD IN THE 
 HEAD) 
 
 catarrh, 74, 263 
 
 catarrh of the stomach, 215 
 
 catechu, for sore throat, 264 
 
 CATHETER, 39 
 
 cauliflower, in diabetes, 80. (See 
 
 DIETS) 
 caustic potash, 286, 308 
 
322 
 
 INDEX 
 
 celery, avoid in asthma, 17 
 champagne, for tonic, 39 
 CHANCRE, 40 
 chancre, 277, 278 
 
 CHANGE OF AIR, 41 
 
 CHANGE OF AIR AS A REMEDY, 42 
 
 CHANGE OF LIFE, 43 
 
 cheese, to be avoided in asthma, 
 17; in consumption, 64. 
 (See also DIETS) 
 
 cheese cloth, for filtering air, 92 
 
 cess pools, 249 
 
 chaps, 254 
 
 charcoal poultice, 226 
 
 CHEST, DEFORMITIES OF, 44 
 CHICKEN POX, 45 
 
 chicken pox, 232, 300 
 
 CHILBLAINS, 45 
 
 chilblains, 254 
 
 childbirth, 298 
 
 child crowing, 46 
 
 chills, in scarlet fever, 243 
 
 chloral, 227 
 
 chloral, overindulgence, 165 
 
 chlorate of potash lozenges, 289 
 
 chloride of lime, 86 
 
 chloride of zinc for sore throat, 
 
 264 
 
 chlorobrom, in seasickness, 247 
 chloroform, as anaesthetic, 10 
 chlorosis, 9 
 chocolate, 25 
 CHOKING, 46 
 cholalogues, 230 
 
 CHOLERA, 47 
 
 cholera, 248 
 
 Christian Science, not for broken 
 bones, 33; chancre or syph- 
 ilis, 41 
 
 chrysarolin ointment, 229 
 
 cider, 25 
 
 cigars, 285 
 
 cigarette smoking, 201, 284 
 
 CIRCUMCISION, 48 
 
 circumcision, 111, 298 
 
 cirrhosis of the liver, 175, 215; 
 stomach, 215 
 
 citrate of magnesia, 69, 230 
 
 claret, 25 
 
 Clark, Sir Andrew, 9 
 
 CLEANING, 48 
 
 cleanliness, for blackheads, 3 
 
 CLIMATE FOR INVALIDS, 50 
 
 clothing, 215 
 
 cloves, oil of, 287 
 
 coal gas, 173 
 
 cocoa, 25 
 
 cocaine, 10; and bismuth oint- 
 ment, 69; for ulcers, 297, 
 312 
 
 codeine, in diabetes, 81 
 
 codliver oil, for acne 33; chil- 
 blains, 45; for consumptives, 
 64; for coughs, 71; for rick- 
 ets, 239; for spine disease, 
 267 
 
 coffee, antidote for opium pois- 
 oning, 25; for headaches in 
 anaemia, 133 
 
 coffee, after poisoning, 222 
 
 colchicum, in fevers, 110; wine 
 for gout. 123, 178 1 ; for gout, 
 239 
 
 cold baths. (See BATHING) 
 
 cold cream, 27 
 
 COLD IN THE HEAD (Nasal Ca- 
 tarrh), 56 
 
 cold in the lip, 144 
 
 COLD-ON-THE-LIP, 57 
 
 colds, 214 
 COLIC, 57 
 colic, 155, 223 
 collapse, 58 
 colocynth, 218, 230 
 cologne poultice, 226 
 coma, in diabetes, 80 
 COMA, 58 
 
 CONCUSSION OF THE BRAIN 
 
 (Stun), 58 
 confinement, calculation for, 227 
 
 CONFINEMENT, 59 
 
 congenital syphilis, 276 
 conium ointment, for piles, 218 
 conjunctiva (see EYE DISEASES), 
 
 105, 214 
 
 constipation, 69, 218 
 CONSUMPTION, 59 
 consumption, 64, 245, 289, 292 
 convulsions (see FITS), 111 
 Cooper-Hewitt light, 173 
 cornea, clouds on, 265 
 cornea (see EYE DISEASES), 106 
 corn plasters, 66 
 corn solvents, 66 
 
INDEX 
 
 323 
 
 CORNS AND BUNIONS, 66 
 CORPULENCE OR OBESITY, 66 
 
 corrosive sublimate, in catheter- 
 ization, 40; (see also bi- 
 chloride of mercury) for 
 barbers, 126, 223 
 
 corsets, 215 
 
 COSTIVE BOWELS, 68 
 
 costiveness, 230 
 cotton wool, for stings, 26 
 country, superior vitality in, 42; 
 good for children, 43 
 
 CRACKED NIPPLES, 71 
 
 CRAMP IN THE CALF OF THE LEG, 
 
 cramps, 71 
 
 cream of tartar, 230 
 
 CREMATION, 71 
 
 creosote, in medicine chest, 187 
 189, 287 
 
 CRETINISM, 72 
 
 cricket, 273 
 
 cross-eyes, 269 
 
 croton oil, for ulcers, 297 
 
 croup, 72 
 
 cubeb cigarettes, 17 
 
 curly hair, 128 
 
 cut throat, 73 
 
 cyanide of potash, 222 
 
 cystitis (see BLADDER), 28 
 
 dandruff, 245 
 
 DEAFNESS, 73 
 
 deafness, 289 
 
 DEATH, SUDDENj 75 
 DELIRIUM TREMENS, 76 
 
 delirium tremens, "D. TVs," 5, 
 
 77, 197, 286 
 demented persons, 197 
 dental hospitals, 282 
 
 DENTAL HYGIENE, 77 
 
 depilatory, 129 
 dermatol, 12 
 DIABETES, 78 
 diabetes, 299 
 
 DIARRHEA, 81 
 DIARRHEA IN BABIES, 82 
 
 diarrhea, in children, 2; in con- 
 sumptives, 64; infants, 155; 
 summer, 194, 196; rickets, 
 207 ; poisoning, 233, 248, 270 
 
 Diet 
 
 for consumptives, 64 
 
 for constipation, 69 
 
 diabetes, 80 
 
 epilepsy, 101 
 
 gall stones, 117 
 
 gout, 124 
 
 milking mothers, 154 
 
 infants, 155 
 
 pneumonia, 220 
 
 rheumatism, 236 
 
 rickets, 240 
 
 seasickness, 247 
 
 teeth, 282 
 
 athletic training, 290 
 
 typhoid, 293 
 
 vegetarian, 303 
 
 modified vegetarianism, 304 
 Diet in relation to age avid ac- 
 tivity, 194, 305 
 
 DIGESTIBILITY, 83 
 
 digitalis, for the ear, 207 
 dilated stomach, 271 
 dill water, 57 
 
 DIPHTHERIA, 83 
 
 diphtheria, 110, 162, 194, 196, 
 248, 263 
 
 DIPSOMANIA, 84 
 
 disinfectants, in typhoid, 294 
 
 DISINFECTION, 80 
 DISLOCATION, 86 
 DOSAGE, 86 
 
 Dover's powders, 110, 188, 190, 
 243 
 
 DRACHMS AND OUNCES, 87 
 
 drainage, for mosquitoes, 198 
 
 DREAMS, 88 
 
 dress, in pregnancy, 227 
 
 DRINKING CUP, 88 
 
 dropsy, 230, 243 
 DROPSY, 89 
 DROWNING, 89 
 drunkards, 299 
 drunkenness, 230 
 dry cupping, 178 
 Dunbar's pollantin, for hay fever, 
 131 
 
 DUST, 91 
 
 DYSPEPSIA (866 INDIGESTION), 93 
 
 EAR DISEASES, 93 
 
 ear, the, 224, 242 
 
324 
 
 INDEX 
 
 ear syringe, 186 
 
 earth closet, 248 
 
 ECZEMA, 94 
 
 eggs, 69, 83. (See also DIETS) 
 
 egg julep, for baldness, 20 
 
 egg-nogg, formula for, 31 
 
 elastic ulcer, 303 
 
 electric light, 172 
 
 electricity, 204, 211 
 
 electrolysis, for birthmarks, 25; 
 
 superfluous hair, 129 
 elephantiasis, 198 
 embolism, 221 
 emetics, 200 
 EMETICS, 98 
 emphysema, 289 
 empyema, 219 
 ENEMA, 98* 
 enteric fever, 292 
 epileptics, 197 
 EPILEPSY, 99 
 epilepsy, 111, 216, 298 
 epithelioma, 308 
 epsom salts, 187, 189, 200, 230, 
 
 297 
 epsom salts, in fever, 110; after 
 
 poisoning, 223 
 eruptions, of beggars and tramps, 
 
 231; from external agents, 
 
 231; in syphilis, 277, 288 
 
 ERYSIPELAS, 102 
 
 erysipelas, 253 
 
 ether, anaesthetic, 10; compound 
 spirits of, for hiccough, 144 
 ethyl chloride, 10 
 ethylate of soda, 308 
 eucaine, 10 
 eucalyptol, for toilet use, 12 
 
 EXERCISE AND RECREATION, 103 
 
 eye bath, 1S6 
 
 EYE DISEASES, 105 
 
 eye-strain, 214 
 eyes, 213 
 eythema, 255 
 
 FAINTING, 108 
 
 fasting, 152 
 
 fat, 193 
 
 feather duster, to 'be avoided, 49 
 
 feeding cup, 186 
 
 feeding, for children, 153-156 
 
 feet, lotion for sweating, 217 
 
 femoral hernia, 140 
 
 ferric chloride for ingrowing toe 
 
 nails, 285 
 
 ferric perchloride, 218 
 FEVEB, 109 
 feverish colds, 188 
 figs, 230 
 filariasis, 198 
 filters, 311 
 fireplaces, 138 
 first aid, drowning, 90 
 fish, 64. (See also DIETS) 
 FITS, 111 
 fits, 13, 278 
 flatulence, 152 
 flies, 195, 294 
 FLIES, 112 
 fly paper, 114 
 
 FOMENTATIONS, 114 
 
 fomentations, better than poul- 
 tices, 225 
 
 FOODSTUFFS EXPOSED TO STREET 
 DUST AND DIRT, 115 
 
 football, 273 
 
 foreskin, too tight, 28; cleanli- 
 ness in, 48; tightness, 299 
 
 formaldehyde gas, 8*5 
 
 Formamint lozenges, for sore 
 throat, 264 
 
 freckles, 255 
 
 Freeman's pasteurized, 155, 196 
 
 fresh air, for cholera, 47 
 
 Friar's balsam, 46: in medicine 
 chest, 187, 189 
 
 fruit jellies, 236 
 
 fruits, 303. (See DIETS) 
 
 GAIT AND APPEARANCE, 116 
 
 gallstone, 176 
 
 GALLSTONES, 117 
 
 galls and opium ointment, 218 
 game, 202. (See DIETS) 
 
 GANGRENE, Or MORTIFICATION, 117 
 
 gangrene of the lung, 179 
 garbage, 114, 234 
 gastritis, 271 
 
 GENERAL PARALYSIS, 117 
 
 gentian, tonic, 201 
 German measles, 185, 233 
 GIDDINESS, 118 
 gin, 25 
 gingerbread, 69 
 
 GLANDS, SWOLLEN, 119 
 
 glaucoma, 265, 266 
 
INDEX 
 
 325 
 
 glycerine, for cracked nipples, 71 
 glycerine of the subacetate of 
 
 lead, 187, 188 
 glycerine of tannin, for nose 
 
 bleeding, 208 
 glycerine suppository for piles, 
 
 69 
 
 glycothymoline, 212 
 goat's milk, 111 
 
 GOITER, OB DERBYSHIRE NECK (see 
 
 also CRETINISM), 120 
 gold fish, 199 
 
 GONORRHEA, 121 
 
 gonorrhea, 120, 216, 305 
 
 Gordon, Alexander, 184 
 
 GOUT, 122 
 
 gout, 9, 11, 17, 216, 228, 244, 
 
 297, 299, 303 
 granular lids, 107 
 grates, as ventilators, 137 
 gray hair, 128 
 gray powder, 187, 190 
 grease, on hair, 127 
 
 GROG BLOSSOMS, 124 
 GUMBOIL, 125 
 
 gummata, 278 
 gut, the, 13 
 gymnastics, 273 
 
 Hahnemann, 145 
 
 hair, the, 64, 213; loss of, 256 
 
 HAIRDRESSERS, HINTS TO, 125 
 HAIR, HOW TO TAKE CARE OF, 127 
 HAIR, LOSS OF ( S66 BALDNESS ) , 
 
 129 
 hair wash, a, 20 
 
 HAIRS, SUPERFLUOUS, 129 
 
 hallucination, 180 
 hamamelis and cocaine, 218 
 hamamelis ointment, 187 
 
 HANGING, 129 
 
 HANGNAIL, 130 
 
 HARELIP, 130 
 
 HAY FEVER, 130 
 
 HEADACHE (VARIETIES OF), 131 
 
 headache, 169, 193 
 
 HEALTH RESORTS. (See CLIMATE 
 
 FOR INVALIDS) 
 HEARTBURN, 133 
 
 heartburn, 152 
 
 HEART DISEASE, 133 
 
 HEATING, 136 
 
 HEATSTROKE (SUNSTROKE), 139 
 
 hematocele, 143 
 hemiplegia, 210 
 hemisine, for bleeding, 224 
 hemorrhoids, 217 
 
 HERNIA, OR RUPTURE, 140 
 HERPES, 143 
 HICCOUGH, 144 
 
 Higginson Syringe, 99, 186, 222 
 hip baths, 28; for piles, 218 1 
 
 HIP-JOINT DISEASE, 144 
 
 hip-joint, 116 
 hockey, 273 
 holidays, 275 
 
 Holt, 153; formula for modified 
 milk, 154 
 
 HOMEOPATHY, 145 
 
 honey, 69, 230. (See DIETS) 
 
 hook-worm, 248 
 
 hot-water bottle, 223 
 
 HOUSEMAID'S KNEE, 146 
 
 humidity, in heating, 138 
 
 Hunyadi Janos, 69 
 
 Hutchinson, ointment for psori- 
 asis, 229 ; plan for ring- 
 worm, 258 
 
 hydrobromic acid, 101 
 
 hydrocele, 142 
 
 HYDROCELE, 146 
 
 hydrophobia ( see BITES OF DOGS ) , 
 
 26 
 
 hydrothorax (see DROPSY), 89 
 hydrotherapeutic baths, 214 
 hypnotism, 204 
 
 HYPOCHONDRIASIS OR NEURAS- 
 THENIA,, 147 
 
 hysteria, 132, 204, 206, 216, 299 
 
 HYSTERIA, 148 
 
 ice, for consumptives, 62 
 ice bag, for appendicitis, 14, 220 
 ichthyol, for chilblains, 46; for 
 red nose, 125 
 
 IDIOSYNCRASY, 150 
 
 illusion, 180 
 
 IMPERIAL DRINK, 151 
 IMPOTENCE, 151 
 
 incinerators, 234 
 incontinence of urine, 298 
 incubation, periods of in fevers, 
 
 109 
 
 incubation, typhoid, 298 
 Indian clubs, 280 
 
 INDIGESTION, 151 
 
326 
 
 INDEX 
 
 INFANT FEEDING, 153 
 INFANTILE PARALYSIS, 156 
 INFLAMMATION. (See ABSCESS) 
 INFLUENZA, 157 
 
 influenza, 162 
 inguinal hernia, 140 
 inhaling cigarettes, 284 
 INSANITY, 158 
 insanity, 196, 216 
 
 INSOMNIA, 164 
 
 intertrigo, 276 
 
 intestines, 213 
 
 iodide of potassium, 150 ? 239 
 
 iodide of sodium, for asthma, 17 
 
 iodine, for chilblains, 46; for 
 
 housemaid's knee, 146, 187 
 iodine, tincture of, as skin anti- 
 septic, 12 
 
 iodoform, antiseptic powder, 12 
 ipecacuanha, as emetic, 200 
 ipecacuanha wine, in medicine 
 
 chest, 187, 190 
 
 iron, for anaemia, 9; for boils, 
 31; for bleeding, 225; for 
 sore throat, 264; syrup of, 
 267 
 
 ironing lumbago, 177 
 iron tonics, for hysteria, 150 
 ITCH, 166 
 ITCHING OF THE SKIN OF VARIOUS 
 
 PARTS, 166 
 
 jalap, 218, 230 
 Japanese furniture polish, 49 
 jaundice, 198 
 
 jellies, for consumptives, 64. 
 (See DIETS) 
 
 kerosene, 173; for m( 
 198; for lice, 213 
 
 KIDNEY DISEASES, 168 
 
 kidneys, disease of, a cause of 
 anaemia, 9; of apoplexy, 12; 
 in diabetes, 15, 19, 111; in 
 gout, 122, 198; alcoholic, 
 215; in rheumatism, 237; in 
 Salisbury treatment, 240; in 
 scarlet fever, 242 
 
 KOUMISS, HOME-MADE, 170 
 
 Lady Webster pill, 69 
 lanolin, for black eye, 27 
 
 laudanum, 190; for poisoning, 
 
 222; for ulcers, 297 
 laxative salts, 31 
 laxatives, 69, 218 
 
 LEAD POISONING, 170 
 
 lead poisoning, 203, 288 
 leeches, 93, 220 
 lemon juice for tongue, 287 
 lemonade, in measles, 185; in 
 
 rheumatism, 236 
 lemon water, 56 
 lens (see EYE DISEASES), 106 
 lice, 213 
 LICE, 171 
 licorice, 218 
 licorice powder, 69 
 LIGHTING, 172 
 lime, as disinfectant, 113, 249; 
 
 syrup of, 267; in typhoid, 
 
 294 
 
 lime water, 223, 308 
 liniments, 204 
 linseed jacket poultice, 220 
 linseed poultice, 226 
 linseed meal poultice, for sore 
 
 throat, 264 
 lint, 186, 230 
 
 liquor antisepticus alkalimis, 191 
 Lister, Lord, 102 
 listerine, 12 
 liver, congestion of, 287 
 
 LIVER, DISEASES OF THE, 174 
 
 liver, the, gO, 81, 218, 230, 240, 
 
 278 
 
 liver colic, 176 
 lobelia, 17 
 
 LOCKJAW. (See TETANUS) 
 lockjaw, 283 
 locomotor ataxy, 116, 305 
 
 LOCOMOTOR ATAXY, 176 
 
 lotion, for eczema, 97; for lice, 
 
 171; for scurfmess, 257 
 lumbago, 234, 236 
 LUMBAGO, 177 
 lunar caustic, 308 
 lungs, 212, 220 
 
 LUNGS, DISEASES OF THE, 178 
 
 lymphatic glands, in syphilis, 277 
 
 MADNESS, SYMPTOMS OF, 179 
 
 magnesia, 218, 223, 256 
 maize, 69 
 malaria, 198 
 
INDEX 
 
 327 
 
 male fern, extract of, for worms, 
 317 
 
 MALIGNANT, 183 
 
 malt, for chilblains, 45; for 
 
 cough, 71 
 malt extract, 64; in rheumatism, 
 
 236 
 
 maltine, 64, 267 
 maniacs, 197 
 
 manure piles, breed flies, 112 
 mare's milk, 196 
 marriage, cure for hysteria, 132, 
 
 216 
 
 MASSAGE, 183 
 
 massage, for cramps, 71; for 
 paralysis, 211; for sprains, 
 268 
 
 masturbation, 149 
 
 MEASLES, 184 
 
 measles, 232, 253 
 
 measure, 186 
 
 meats, 83 
 
 meat extracts, 236. (See DIETS) 
 
 MEDICINE CHEST, 186 
 
 medicines, avoid, unless recom- 
 mended by doctors, 151 
 melancholies, 197 
 Menire's disease, 119 
 meningitis, 312 
 
 MENINGITIS, 191 
 MENSTRUATION, 191 
 
 menstruation, 227 
 
 methylated spirits, for bedsore, 
 
 23 
 
 mercury, for syphilis, 279 
 mercurial poisoning, 289 
 
 MIDDLE-AGED MAN, The, 192 
 
 migraine, 132 
 
 MILK, 194 
 
 milk, in constipation, 69; modi- 
 fied by Holt's formula, 154; 
 in measles, 185; as antidote, 
 223; in rheumatism, 236 
 
 MELK, ARTIFICIAL HUMAN, 195 
 
 milk diet, for appendicitis, 14; 
 for asthma, 17; milk foods 
 in constipation, 164 
 
 MIND FAILURE, 196 
 
 mineral waters, for gallstones, 
 117 
 
 MISCARRIAGE, CAUSES OF, 197 
 
 miscarriages, 276 
 monomaniacs, 197 
 
 Moore system, 173 
 morning sickness, 228 
 morphine, for lead poisoning, 288 
 morphine, in sleeplessness, 165 
 
 MORTIFICATION. ( See GANGRENE ) 
 MOSQUITOES, 198 
 
 mosquitoes, 183 
 
 MOTHER'S MARKS. (See BIRTH- 
 MARKS ) 
 mouth, the, 212 
 
 MUCOUS MEMBRANES, 199 
 
 mud baths, 177 
 
 MUMPS, 199 
 
 mushrooms, 202 
 
 MUSSELS, 200 
 
 mustard, in warm water, for al- 
 coholic poisoning, 5; bath, 
 prescription for, 22, 57 
 
 mustard poultice, 226 
 
 mustard and water, emetic, 200, 
 222 
 
 muzzling dogs, 27 
 
 nails, 213 
 
 nasal sound, 208 
 
 naso pharynx, 212 
 
 NERVOUS DEBILITY, 200 
 NETTLERASH, 201 
 
 nettlerash, 233, 255 
 
 NEURALGIA, 202 
 
 neuralgia, 17 
 neuralgia- jaw, 287 
 
 NEURASTHENIA, 204 
 
 neurasthenia, 312 
 
 NEURITIS, ALCOHOLIC, 205 
 NEUROSIS, 206 
 NIGHTMARE, 206 
 NIGHT-TERRORS, 207 
 NIGHT SWEATS, 207 
 
 nipples, in pregnancy, 227, 228 
 niter, spirits of, in fever, 110 
 nitrate of potash, for asthma, 17 
 nitric acid, 308 
 nitrous oxide gas, 10 
 nodes, 278 
 
 NOISES IN THE EAR, 207 
 
 nose, 212 
 
 NOSE-BLEEDING, 208 
 
 nuts, bad for asthma, 17, 303. 
 (See DIETS) 
 
 oatmeal, in rheumatism, 236 
 observation, 116 
 
328 
 
 INDEX 
 
 obstetric belt, 227 
 
 oedema ( see DROPSY ) , 89 
 
 Oertel system, 67 
 
 oiled silk, 186, 230 
 
 olive oil, 64 ; for eczema, 97 ; for 
 
 lice, 213 
 
 onion juice, for stings, 26 
 onion poultice, 226 
 open air, cure for colds, 42; for 
 
 consumption, 63, 201 
 operation, for neuralgia, 204; for 
 
 piles, 218; for cross-eyes, 
 
 269; varicocele, 302 
 ophthalmia (see EYE DISEASES), 
 
 106, 213 
 opium, in diabetes, 80; for 
 
 eczema, 96; for ulcer, 297 
 ovaries, in mumps, 200; in 
 
 syphilis, 278 
 overeating, 218 
 
 OVERLAYING. (See BABIES LOST) 
 
 overwork, 118 
 oxalic acid, poisoning, 222 
 oxide of mercury ointment, 274 
 oxygen, 179; in pneumonia, 221 
 oysters, digestibility of, 83, 287. 
 (See also DIETS) 
 
 OYSTERS, RISK OF EATING, 208 
 
 pail system, the, 248 
 
 PAIN, 209 
 
 palsy, 286 
 
 paralysis, 12, 278, 298, 305 
 
 PARALYSIS, 210 
 
 paralytic insanity, 197 
 
 paranoia, 162 
 
 paraplegia, 210, 211, 305 
 
 paregoric, in medicine chest, 187, 
 
 190 
 
 paresis, 211 
 Pasteur treatment, 27 
 Pasteurized milk, 195, 294 
 pastils, 186 
 pastries, 17, 64, 236. (See also 
 
 DIETS ) 
 
 PATHOLOGY, 211 
 
 peas, in diabetes, 80. (See also 
 
 DIETS ) 
 
 peeling, in scarlet fever, 242 
 peppermints, for seasickness, 247 
 pepsin, in consumption, 64 
 perchloride, for bleeding, 223 
 
 perchloride of iron, for erysip- 
 elas, 103 
 
 perforated ulcer, 272 
 
 peroxide of hydrogen, 3; anti- 
 septic, 12; for cuts, 29; for 
 bruises, 34; for tetanus, 283 
 
 PERSONAL HYGIENE, 211 
 PERSPIRATION, 217 
 
 phenacetine, 132; in medicine 
 
 chest, 187, 190 
 phenol, 218 
 
 phosphate of soda, 230 
 phosphorus, 133, 223 
 phosphorus poisoning, 289 
 phthisis, 287 
 
 PHYSIOLOGY, 217 
 
 pickles, avoid in asthma, 17. 
 
 (See also DIETS) 
 
 picrotoxin, for night sweats, 207 
 piles, 9, 187 
 PILES, 217 
 pimples, 27-28, 253 
 pipes, best for smoking, 284 
 plastermulls, 97 
 Platt's Chlorides, 86 
 plenum system, 138 
 
 PLEURISY, 219 
 
 plug, for epileptics' jaws, 102 
 
 plumbing, good, 249 
 
 PNEUMONIA, 220 
 
 pneumonia, 184, 314 
 
 podophyllin, for gallstones, 117 
 
 poison, 150, 186 
 
 POISONING, 221 
 
 pollatin, Dunbar's, 131 
 
 polypus, 207 
 
 POLYPUS, 223 
 
 pomatum, on hair, 127 
 
 Poplar charcoal, 152 
 
 poppy-heads, fomentations of, for 
 black eye, 27 
 
 pork, bad for asthma, 17. (See 
 also DIETS) 
 
 porter, bad for asthma, 17. (See 
 also DIETS) 
 
 potassium permanganate, in te- 
 tanus, 283 
 
 potassium permanganate, as anti- 
 septic, 12 
 
 potatoes, in diabetes, 80. (See 
 also DIETS) 
 
 POULTICES, 225 
 
INDEX 
 
 329 
 
 poultices, for appendicitis, 14; 
 
 for black eye, 27; not for 
 
 gout, 123; in mumps, 200. 
 
 ( See also FOMENTATIONS, 
 
 114) 
 pregnancy, 191, 208, 218 
 
 PREGNANCY, HYGIENE OF, 227 
 
 prescriptions,, for colds, 34, 56; 
 for the skin, 37 ; for cholera 
 morbus, 48; for cough, 57. 
 (See also RECIPES) 
 
 prevention of disease, v-vi, 162, 
 192, 294 
 
 PREVENTION OF INSANITY^ 162 
 
 privates, itching of in diabetes, 
 8*0 
 
 privy vaults, 114 
 
 prostrate gland (see BLADDER), 
 28, 299 
 
 proud flesh, 296 
 
 prunes, 69, 230. ( See also DIETS ) 
 
 prurigo, 166 
 
 pruritus, 167 
 
 Prussian blue, 223 
 
 Prussic acid, 222 
 
 psoriasis, 253, 278 
 
 PSORIASIS, 228 
 
 pulse, in pleurisy, 219 
 
 puncture, for lumbago, 178 
 
 pupil (see EYE DISEASES), 105 
 
 purgatives, for acne, 3 ; not for 
 appendicitis, 14; for head- 
 aches, 133, 187. (See also 
 DIETS ) 
 
 PURGATIVES, 230 
 
 pus, 1, 3 
 
 pustule, 253 
 
 pyaemia, 287 
 
 pyridine, for asthma, 17 
 
 quack medicines, 200 
 
 quarantine, after fevers, 110 
 
 quassia, 201, 297 
 
 quinine, for eczema, 96; for tem- 
 perature, 110; for malaria, 
 182, 188, 201; for sore 
 throat, 264 
 
 quinine, ammoniated tincture of, 
 for influenza, 158 
 
 quinsy, 264 
 
 QUINSY, 231 
 
 rabies, 26 
 
 rash, 110, 232, 242, 276 
 
 RASHES ON THE SKIN, ARTIFICIAL, 
 
 231 
 
 RECIPES 
 
 consumption, 64 
 
 cough s ; 70 
 
 tooth powder, 78 
 
 diarrhea, 82 
 
 disinfectant, 85 
 
 eczema powder, 96 
 
 eczema cold cream, 97 
 
 various emetics, QS 
 
 enema, 99 
 
 ophthalmia, 106 
 
 gout, 124 
 
 for barbers, 126, 127 
 
 scanty hair, 127 
 
 superfluous hairs, 129 
 
 flatulence, 152 
 
 water brash, 152 
 
 foul breath, 153 
 
 conium baths, 167 
 
 lead poisoning, 171 
 
 drunkenness, 175 
 
 measles, 185 
 
 neuralgia, 203, 204 
 
 neuritis, 206 
 
 sweating in consumption, 207 
 
 polypus in womb, 224 
 
 wind in the stomach, 230 
 
 purge in rheumatic gout, 230 
 
 anaemia, 230 
 
 purge in dropsy, 230 
 
 laxative for children, 231 
 
 rheumatism, 237 
 
 sore throat, 243 
 
 sciatica, 244 
 
 dandruff, 246 
 
 scurf, 246 
 
 painful menstruation, 192 
 
 stomach discomfort, 272 
 
 white leg, 313 
 
 whooping cough, 315 
 rectum, the, 217, 222, 223 
 red gum, 255 
 RED GUM, 233 
 
 REFUSE DISPOSAL, 234 
 
 retention of urine, 299 
 retina (see EYE DISEASES), 106 
 rhatany, for sore throat, 264 
 rheumatic fever, 134, 235, 287 
 
330 
 
 INDEX 
 
 RHEUMATIC GOUT (RHEUMATIC 
 
 ARTHRITIS), 238 
 RHEUMATISM, 234 
 
 rheumatism, 198, 203, 228, 244, 
 274, 305 
 
 RHEUMATISM, CHRONIC, 236 
 
 rhubarb pills, in medicine chest, 
 
 187, 189 
 rhubarb and soda, in red gum, 
 
 234 
 
 rhubarb, 258 
 RICKETS, 239 
 rickets, 207 
 ringworm, 213, 257 
 
 RINGWORM. ( See SKIN DISEASES ) 
 
 Robinson's Barley Water, for 
 
 baldness, 21 
 
 Rochelle salts, in fever, 110 
 rose cold, 130 
 roundworm, 317 
 rum, amount of alcohol in, 25 
 rupture, 302 
 
 RUPTURE. (See HERNIA) 
 
 Russian baths, 214 
 
 Saint Vitus's dance, 116, 240 
 sal hepatica, 69 
 salicin, for rheumatism, 235 
 salicylate of soda, for cramps, 7, 
 
 239 
 
 salicylate treatment, 235 
 salicylates, in fevers, 110 
 saline cathartics, 110 
 saline purges, in pregnancy, 227 
 
 SALISBURY TREATMENT, The, 240 
 
 Salisbury treatment for fat, 67 
 salol, for gallstones, 117, 187, 
 
 190 
 
 salt water baths, 214 
 salts, 223 
 sal volatile, in medicine chest, 
 
 187 
 
 sanitas fluid, 246 
 sarcoma, 292 
 sardines, 17, 64. (See also 
 
 DIETS) 
 scabs, 253 
 scales (see MEDICINE CHEST), 
 
 186 
 
 scalp diseases, 256 
 scarlatina, 253, 287 
 
 SCARLET FEVER (SCARLATINA), 
 
 242 
 
 scarlet fever, 194, 248, 263 
 
 SCIATICA, 243 
 
 sciatica, 234 
 
 scratching, 202 
 
 screens, 114 
 
 SCROFULA, 244 
 
 scrofula, 15, 216 
 
 scrotum, the, 146, 301, 308 
 
 SCURF, 245 
 
 scurfiness of scalp, 257 
 
 SCURVY, 246 
 
 sea air, 50 
 
 sea-kale, 80 
 
 SEASICKNESS, 247 
 
 secondary syphilis, 277 
 Seidlitz powders, 3 ; 230, 243 
 
 SELF-DOCTORING, 247 
 
 senna, in medicine chest, 20, 187, 
 
 218, 230, 317 
 
 senna mixture, for worms, 317 
 septicaemia, 196 
 serums, 221 
 
 SEWAGE DISPOSAL, 248 
 
 sexual excesses, 149, 298 
 
 sex hygiene, 151, 216 
 
 sexual power, loss of in diabetes, 
 
 80; varicocele, 301 
 shampoo, 128 
 shaving brushes, 126 
 shellfish, 64, 202. (See also 
 
 DIETS ) 
 
 shingles, 143 
 shoes, 66 
 silver nitrate, for ophthalmia, 7, 
 
 z!3 
 SIMPLE LIFE, The, 250 
 
 SINS AGAINST HEALTH HYGIENIC 
 MISDEMEANORS, 251 
 
 Six hundred and six ("606"), 
 
 280 
 skin, 192, 212 
 
 SKIN DISEASES, 252 
 
 SLEEP, HINTS ON OBTAINING, 259 
 
 sleeping draughts, 260 
 
 SLEEPLESSNESS, 260 
 
 sleeplessness, 169 
 
 SMALLPOX, 262 
 
 smallpox, 232, 300 
 
 smelling salts, 187 
 
 smoking, 252, 284 
 
 soap, dry, for feet, 29; eczema, 
 
 97; hang nails, 130 
 Social evil, the, 305 
 
INDEX 
 
 331 
 
 sodium phosphate, 69; for gall- 
 stones, 117 
 
 sodium salicylate, 178 
 softening of the brain, 305 
 
 SORE THROAT, 263 
 
 sore throat in syphilis, 278 
 sorrel, 223 
 sour stomach, 2 
 Spanish onions, 69 
 SPECIALISTS, 264 
 
 SPECTACLES AND FAILING SIGHT, 
 
 265 
 
 SPINAL CURVATURE DEFORMED 
 
 BACK, 266 
 
 spiritus alkalinus saponis, in 
 
 scurf, 246 
 
 spleen, in rickets, 240 
 splint, 32 
 
 sponge, avoid in surgery, 296 
 SPRAINS, 268 
 SQUINTING, 268 
 
 STAMMERING, 269 
 
 Standard floor dressing, 49 
 starch, in diabetes, 80. (See 
 
 also DIETS) 
 starch poultice, 226 
 starchy foods, not for infants, 
 
 111. (See DIETS) 
 Stavesacre ointment, 166 
 stays (corsets), 227 
 steak, raw, for black eye, 27 
 steam heat, 137 
 sterile gauge, 29 
 sterno-mastoid muscle, 318 
 stethoscope, the, 135 
 stewed fruits, 69. (See DIETS) 
 still births, 305 
 stomach, the, 9, 213, 215 
 
 STOMACH DISEASES, 270 
 
 stomach pump, improvised, 98 
 
 STONE IN THE BLADDER, 272 
 
 stone, 298, 299 
 stoves, 138 
 stricture, 122, 299 
 stramonium, for asthma, 17 
 stroke, apoplectic, 12 
 
 STRONG, HOW TO BECOME, 273 
 
 struma, 245 
 
 STRUMS. (See SCROFULA) 
 
 STUN. (See CONCUSSION OF 
 
 BRAIN ) 
 STYES, 274 
 
 suckling, too long, 198. (See 
 
 PREGNANCY) 
 
 sugar, 80. (See also DIETS) 
 
 sugar of lead, 223 
 
 sulphate of magnesia, for giddi- 
 ness, 119 
 
 sulphate of soda, for erythema, 
 256 
 
 sulphate of sodium, 230 
 
 sulphate of zinc, for sore throat, 
 264 
 
 sulphide of calcium, 31 
 
 sulphonal, 217 
 
 sulphur, as disinfectant, 86 
 
 sulphur bath, formula for, 23 
 
 sulphur ointment, 166 
 
 sulphuric acid, 223 
 
 SUMMER HOLIDAYS, 274 
 
 sunlight, 172 
 
 SUNSTROKE. (See HEATSTROKE) 
 
 suprarenal extract, 131 
 suprarenalin, for bleeding, 224 
 SWEATING. (See PERSPIRATION) 
 sweets, 236. (See DIETS) 
 swimming, 214 
 SYPHILIS (The "BAD DISORDER"), 
 
 275 
 syphilis, 9, 11, 118, 120, 162, 
 
 176, 189, 198, 203, 211, 216, 
 
 228, 239, 244, 305 
 syringes, for deafness, 74 
 syringing, for ears, 94 
 
 table-rapping, 181 
 
 tablespoonfuls, 186 
 
 taller., how to grow, 28*0 
 
 tamarinds, 230 
 
 tannic acid, for cracked nipples, 
 
 71 
 
 tannin, for sore throat, 263 
 tapeworm, 15, 316 
 tapioca, 69. (See DIETS) 
 tar ointment, 229 
 tar water, for colds, 34 
 
 TATTOO MARKS, 280 
 
 tea, 25, 236, 252. (See also 
 
 DIETS) 
 
 teaspoonfuls, 186 
 tea drinking, 201, 252 
 teeth, care of, 281 
 teething, 112, 207 
 teetotalism, 5, 6 
 temperance, 5 
 
INDEX 
 
 temperature (see FEVER), 108; 
 in health, 220 
 
 tennis, 273 
 
 tertiary syphilis, 278 
 
 testicles, 142; in hydrocele, 146; 
 in mumps, 200; in syphilis, 
 278; one sufficient for pro- 
 creation, 302 
 
 TETANUS (LOCK-JAW), 283 
 
 thermic fever, 140 
 
 thermometer ( see MEDICINE 
 CHEST), 186, 188 
 
 Thompson, Sir Henry, 194, 305 
 
 thread worm, 317 
 
 throat, 242. (See also DIPHTHE- 
 RIA, SCARLET FEVER, SYPH- 
 ILIS) 
 
 thrombosis, 221 
 
 thymol ointment, for stings, 26 
 
 thyroid gland of sheep, for 
 
 goiter, 121 
 thyroid, 229 
 tight lacing, a cause of death, 
 
 75 
 
 tinned foods, 64 
 TOBACCO: OUGHT WE TO SMOKE 
 
 IT?, 284 
 tobacco, 204 
 toe-nail ingrowing, 285 
 
 TONGUE, DISEASES OF, 286 
 
 tongue, the, in scarlet fever, 
 
 242 
 
 tonsils, 242 
 tonsilitis, 264 
 TOO FAT (see CORPULENCE), 287 
 
 TOOTHACHE, 287 
 
 toothbrush, 282 
 trachoma, 217 
 
 TRADE DISEASES, 288 
 
 trade eruptions, 231 
 
 TRAINING, 289 
 treacle, 69, 218 
 triplex, 69 
 trusses, 142, 147 
 
 TUBERCLE, 291 
 
 tubercle bacilli, 112 
 tuberculosis, 162, 194, 196, 248, 
 
 267 
 
 tumor, 299 
 TUMOR, 292 
 Turkey figs, 69 
 Turkish baths, 214 
 turnips, in diabetes, 80 
 
 turnip poultice, 264 
 turpentine, for bleeding, 225; in 
 psoriasis, 229 
 
 TYPHOID FEVER, 292 
 
 typhoid fever, 112, 162, 194, 196, 
 
 209, 248, 287, 312 
 typhoid germs, 112 
 
 ulcer of the stomach, 272 
 
 ULCERS, 294 
 
 umbilical hernia, 140 
 
 Unna, Professor, 97 
 
 Unna's method for ulcers, 296 
 
 urethra, the, 121 
 
 uric acid, 240 
 
 URINARY TROUBLES, 298 
 
 urine, quantities per day, 168; 
 
 analysis in pregnancy, 227, 
 
 273 
 
 urotropin, for gallstones, 117 
 urticaria, 201 
 
 VACCINATION, 300 
 
 vaccination, 111 
 
 vaccine treatment for boils, 31; 
 
 for consumption, 63 
 vacuum cleaning, 49 
 valerianate of zinc, 133 
 
 VARICELLA, 301 
 
 varicocele, 142 
 
 VARICOCELE, 301 
 
 varicose ulcer, 297 
 
 VARICOSE ULCER, 303 
 
 varicose veins, 217 
 
 VARICOSE VEINS, 303 
 
 varioloid, 262 
 
 vaseline, 27, 229 
 
 vegetables, 69, 83, 236. (See 
 
 also DIET) 
 vegetarian diet, 229 
 
 VEGETARIANISM, 303 
 
 venereal disease, 263, 275 
 
 VENEREAL DISEASES, 305 
 VENTILATION, 306 
 
 ventral hernia, 141 
 
 veratrine ointment, 207 
 
 vermin, 171 
 
 vertigo (see GIDDINESS), 118 
 
 vesicle, 253 
 
 vinegar, for black eye, 27; not 
 
 for consumptives, 64 
 vinegar and water, for lice, 171 
 vomiting, 153, 223 
 
INDEX 
 
 333 
 
 Walker-Gordon pasteurizer, 155 
 wall plaster, 223 
 WARTS, 308 
 
 WATER, 309 
 
 WATER ON THE BRAIN, 312 
 
 water brash, 152 
 
 WATER BRASH, 311 
 WATER CRESS, 312 
 
 water, for sleeplessness, 259 
 waterproof sheet, 186 
 
 WATER PURIFICATION, 311 
 
 weights, in medicine chest, 186 
 
 WEIR-MITCHELL TREATMENT, 312 
 
 Walsbach, 173 
 
 WENS, 312 
 
 Westcott, Martyn, remedy for 
 
 sleeplessness, 259 
 wheals, 253 
 whiskey, 25, 223, 227 
 white arsenic, 222 
 WHITE LEG, 312 
 white mixture, 230 
 white swelling, 313 
 whitewash, 86, 223 
 whiting, 223 
 
 WHITLOW, 313 
 WHOOPING COUGH, 314 
 wholemeal bread, 69 
 wine, 216. (See also DIETS) 
 
 WINTER COUGH, 316 
 
 Winter, Doctor, 153 
 
 womb, diseases of in miscarriage, 
 
 198; polypus, 225 
 wood ashes, as disinfectant, 249 
 WORMS, 316 
 worms, 15, 207, 269 
 
 WRY-NECK, 318 
 
 X-ray, in diagnosis, 33; not a 
 cure for cancer, 38 
 
 yellow fever, 198 
 Yeo's method, whooping cough, 
 315 
 
 zinc lotion, for black eye, 27 
 zinc ointment, 144, 187, 202 
 zinc oxide, for trusses, 142 
 zinc sulphate, 187, 189, 200 
 
YB 79659