Papers on Health Part 17

There are many who speak most carelessly, even wickedly, to those in trouble. They think it a duty to dash their hopes and predict gloomy things. Such should never enter a sick-room, and should, indeed, change entirely their manner of speech. To go about the world sowing doubt and gloom in men's hearts is a sorry occupation, and one that will have to be accounted for to Him who is emphatically the "G.o.d of hope."

Look, then, in treatment for every least sign of improvement.

Discourage all doubts and encourage all hopes, and you will make what would be a really hopeless case, if the patient were left to despair, one that can be comparatively easily cured. "A word to the wise is enough."

Hot Flushings.--_See_ Flushings.

Hot-water Bags.--The flat rubber bags of various shapes, to be had from all rubber shops, make excellent subst.i.tutes for poultice or fomentation; but care must be taken to have two or more ply of _moist_ flannel between the bag and the skin of the patient. This ensures a supply of moist heat, which is in almost every case the best.

Housemaid's Knee.--To cure a swelling on the knee-joint is, as a rule, easy. _Rest_ is a first and paramount necessity. Bathing with hot water, not too hot for comfort, for at least an hour each day is usually sufficient. If the knee has been blistered, or leeched, it is more difficult to cure; but a cure may be expected if the bathing be continued for a long enough time. It is best done by wrapping a cloth dipped in vinegar round the knee, and placing the foot in a bath, then pouring hot water on the bandaged knee, lifting it from the bath in a jug.

When pain in bending is felt in the very centre of the knee-joint, this hot pouring may be needed for a month, or even longer. During the intervals of pouring a large cold compress should be worn, first well oiling the knee. Cover the compress with oiled silk. This will soften even a very stiff knee, so as at least to bring about ability to bend without pain. Of course, if there is any disjointing, good surgical aid must be had, if possible, to replace the bones in their natural position.

Hydrocele.--_See_ Dropsy.

Hysteria.--This is usually brought on by some excessive strain upon the brain nerves, and may show itself either in the violent or in the fainting form; it may even pa.s.s from the one to the other, fainting alternating with violent movements and cries. It may often be checked by plunging the patient's hands into _cold_ water.

In the silent stage, where sometimes unconsciousness continues for hours, a dry blanket should be laid on a bed, and another blanket must be rolled up and prepared with hot water as directed in Fomentation.

Fold this until it is the size and shape of the patient's back, and lay her down on it, so that the whole back is well fomented. Take care not to burn the patient: soothing heat, not irritation, is required.

Consciousness will usually return almost immediately. All except attendants should be excluded from the room. Allow the patient to rest in this comfortable warmth until signs of discomfort appear, then gently rub the back with hot olive oil, dry, and leave to rest or sleep if possible. Do all with great _steadiness of temper and kindness_; such a condition in the nurse is especially essential in these cases.

Where the fit is violent, apply every mental soothing influence available, and remove from the room all excited persons. Then apply cold cloths to the spine to soothe the irritated nerves and brain. Two may gently and kindly hold the patient, while a third presses on the cooling cloths. In about half-an-hour the fit should be overcome. A difficulty in treating such cases is the terrifying effect of the violent movements, or unconsciousness; but these should not create fear. As a rule, a little patience and treatment as above remove all distress. Where there is a hysterical tendency, give abundance of good food, and let the patient live as much in the open-air as possible.

The patient should be kept employed. G.o.d made us all to be workers, and this sad affliction is frequently the punishment of idleness. No one has any excuse for this, for the world is full of those who are overworked and whose burden could be lightened. The girl whose only task is to exchange her armful of novels at the library will never know what true happiness is, nor deserve to. _See_ Imaginary Troubles.

Illness, The Root of.--In treating any trouble it is well to get to the root of it. On one occasion a patient complained that the doctor never struck at the _root_ of his illness. The doctor lifted his walking-stick and smashed the brandy bottle which stood on the table, remarking that his patient would not have to say that again. This will ill.u.s.trate what we mean. Liquor drinking must be given up: it is the root of mult.i.tudinous ills; so must excessive tea drinking. Tobacco is one of the most insidious of poisons in its effects on the nerves, and is to be absolutely given up if a cure is expected in nervous cases.

Chloral, laudanum, and opium in other forms, may give temporary relief; but they are deadly poisons, paralysing the nerves and ultimately completely wrecking the system. The continued use of digitalis for heart disease is a dreadful danger. We mention these by name as most common, to ill.u.s.trate the truth that it is vain to treat a patient while the _cause_ of his illness is allowed to act. If any evil habit of indulgence has given rise to trouble, that habit must be given up; a hard fight may have to be fought, but the victory is sure to those who persevere. Often dangerous symptoms appear, but these must be faced: to relieve them by a return to drugs is to fasten the chains more surely on the patient. It is better to suffer a little than to be all one's life a slave.

Imaginary Troubles.--These are of two kinds, the one purely imaginary, the other where bodily trouble is mixed with the imagined. In the first case the patient is in agony with a pain, when nothing wrong can be discovered in the part, or even elsewhere, to account for it. In such a case, proper treatment of the BRAIN or SPINE (_see_) will often relieve. Again, a patient has set up such a standard of health that what would not trouble any ordinary person at all, gives him much distress. An intermitting pulse often is a source of great anxiety; but we have known people with intermitting pulses continuing in good health for forty years, and living to old age. So with many other heart symptoms that need give no concern at all. Sprains to some muscles are often taken for serious internal inflammation, and a slight cough and spit are taken for consumption. Care must be taken to resist all such fancies, and if not otherwise removable, _thoroughly competent_ medical advice will often put the patient right. In such a case a medical man of undoubted high standing is best consulted, for an inferior pract.i.tioner may nearly kill the patient by arousing needless fears, which are afterwards difficult to remove. _See_ Hysteria.

It must be remembered that diseases of the imagination are as actually painful to the patient as if they really were organic troubles. It is, therefore, useless to laugh at or pooh pooh the trouble, or suggest that the sufferer is only humbugging. Attention must be paid to diet, exercise, and to material, mental, and moral surroundings, so as in every way to relieve the patient from those apparent troubles that so annoy him. Great gentleness, firmness, hopefulness, and sympathy will often bring about an almost unconscious cure. If the trouble has been brought about by over-work and worry, complete rest will often be needed. If there is something in the surroundings that jars, a change may be advisable.

Indigestion.--(See also Digestion; a.s.similation.) This subject leads naturally to a consideration of _food_ in relation to it. The trouble usually is that food easily enough digested by others causes distress to the patient. Here we at once see that _cooking_ plays a most important part. Potatoes, for example, when steeped for half-an-hour in hot water, which is changed before they are boiled, are much more easy of digestion. The water in which they have been steeped is found _green_ with unripe sap, which is all removed. Where _unripe_ juice is present in any root, this method of cookery is a good one. Eggs placed in boiling water, and allowed to remain so till the water is getting cool--say _half-an-hour_--are often found to be much more easily digested than as usually prepared. What we aim at in these ill.u.s.trations is to show that digestion depends on the _relation of the food taken to the juices of the stomach which are to dissolve it_. It must be brought into a digestible state if weak stomachs are to deal with it.

Greasy, heavy dishes must always be avoided. Also unripe fruit. The diet should be spare, as very often indigestion proceeds simply from the stomach having had too much to do.

A very easily digested food is fine jelly of oatmeal made in the following way:--Take a good handful of the meal and put it in a basin with hot water, sufficient to make the mixture rather thin. Let it steep for half-an-hour. Strain out all the rough particles, and boil the milky substance till it is a jelly, with a very little salt. To an exceedingly weak patient you give only a dessertspoonful, and no more for half-an-hour. If the patient is not so weak you may give a tablespoonful, but nothing more for half-an-hour. In that time the very small amount of gastric juice which the stomach provides has done its work with the very small amount of food given. Really good blood, though only very little, has been formed. The step you have taken is a small one, but it is real. You proceed in this way throughout the whole day. The patient should not swallow it at once, but retain it in the mouth for a considerable time, so that it may mix with the saliva.

By this, or by porridge made from wheaten meal, you may secure good digestion when the gastric juice is scanty and poor; but we should not like to be restricted to that. We want a stomach that will not fight shy of any wholesome thing. We must treat it so that when suitable food is offered it may be comfortably digested.

Now, there is an exceedingly simple means for putting the glands in order when they are not so. About half-an-hour before taking any food, take half a teacupful of water as hot as you can sip it comfortably.

This has a truly wonderful effect. Before food is taken, the mucous membrane is pale and nearly dry, on account of the contracted state of the arteries. In many cases the glands that secrete the gastric juice are feeble; in others they seem cramped, and far from ready to act when food is presented. The hot water has the same effect on them as it has everywhere else on the body--that of stimulating the circulation and bringing about natural action. It looks a very frail remedy; but when we can, as it were, see these glands opening and filling with arterial blood the instant they are bathed in this same water, and see how ready they become to supply gastric juice for digestion, the remedy does not look so insignificant.

We have, in scores of cases, seen its effects in the most delightful way. Persons who have to our knowledge been ill and miserable with their stomachs for years have become perfectly well from doing nothing but taking half a teacupful of hot water regularly before taking any food. It is true that great good is effected in cases of this kind by giving the weakened organ light work to do for a time. Wonders are done by feeding with wheaten-meal biscuits and water for some time, beginning with a very small allowance, and seeing that every mouthful is thoroughly chewed. Great things, too, are accomplished with such wheaten-meal porridge as we have already mentioned. But we feel disposed to regard the half-teacupful of hot water regularly before eating as the chief means of cure. It is wonderfully cheap: it goes hard with the druggist if his customers need nothing but a little hot water. Still, from what we have seen, and from what some of the very highest authorities have told us, we come more and more to look to this simple remedy as about all that is required inwardly to cure the worst cases of indigestion.

A little pepsin added to the hot water may be of use; also in cases of acidity a few drops of white vinegar mixed with the water will be found beneficial.

Soda, iron, lime, charcoal, even tar pills are used as remedies for indigestion; but none of them do much good, and some are highly injurious. If used at all, their use should be temporary, and under good medical advice.

If pain is felt, the stomach may be greatly soothed by soft fine lather (_see_ Lather and Soap). It acts in such cases like a charm. Spread it gently over the stomach, and wipe it off with a soft cloth. Cover again with fresh lather. Do this five or six times, and cover up the last coat with a soft cloth.

All indulgences which tend to weaken the stomach are to be avoided.

Alcohol and tobacco must be given up. Over-excitement must be avoided, and abundance of fresh air breathed, if a cure is to be expected.

Where sudden and violent pain comes on after meals, a poultice or hot fomentation applied directly over the stomach is the best remedy at the time. _See_ Flatulence.

Infant Nursing.--A mother who has had strength to bear a child is, as a rule, quite strong enough to nurse it. Suckling is natural, and usually most beneficial to health. Many women have better health and appet.i.te at such a time than at any other. Every mother ought, therefore, unless her health forbids it, to nurse her own child; no other food is so good for it as that which nature provides. We cannot too strongly condemn the mother who from indolence or love of pleasure shirks this sacred duty. By so doing she violates the laws of nature, which can never be done with impunity. Many troubles follow, and her const.i.tution is seriously injured. Alas that we should ever have to say, with Jeremiah: "Even the sea monsters draw out the breast, they give suck to their young ones; the daughter of my people is become cruel, like the ostriches in the wilderness."

If a wet-nurse must be employed, great care should be exercised in choosing a healthy person with a child as near as possible to the age of the infant.

Let mothers remember that there is great _variety_ in milk. Not only does one mother's milk differ from another, but the same mother's milk varies from time to time. Variation in health and diet affects the milk very much. Many cases of infant trouble are traceable to the mother's milk, which should not be overlooked as a possible cause.

Again, an _abundance_ of milk is not always good. An infant may thrive better on a scanty supply of good milk than on an abundance of bad milk. Milk derived from drinking ale, porter, or alcoholic drinks of any kind, though abundant, is very far indeed from good, that produced by plain and simple diet is always best.

Again, the _state of the mother's mind_ has a great deal to do with the quality of her milk. A fright, or continued worry, may transform good milk into most injurious food for the child.

There need be no fear caused by these ideas: it is only in exceptional cases that nursing need be given up; the natural way is always the best. But where necessary there need be no hesitation in putting an infant on the bottle. The milk of a healthy cow, or condensed milk of first-rate brand, is much to be preferred to that of a wearied, worn-out, and worried mother.

Infants' Food.--For infants who cannot be nursed at the breast, cows'

milk in the "bottle" is the best subst.i.tute. But all milk used from the cow should be sterilised and cooled before use. That is unless it is found on trial that the child thrives better on unsterilised milk. It is not necessary to have "one cow's milk;" but it is important to have the milk adapted in strength to the infant's need. If the milk be too rich, the infant will often break out into spots, or will vomit. A little more boiling water in the bottle mixture will remedy this, and often prevent serious trouble. The same proportion of water and milk will not always do. One dairy's milk, and even one cow's milk, differs from another; and so does the digestive power of infants. We have to find out that strength of milk to suit our own baby, and not be led astray by the advice of other mothers. In health the young infant does not require food oftener than every two hours, sometimes even every three. It may cry because of cold, wet, or discomfort, not from want of food. To overload the stomach with food is harmful and leads to serious disorders. Its food requires a certain time for digestion, even in an infant, and as the child grows, the intervals between meals ought to be increased.

A good mixture is two parts of cow's milk to one of water. To every pint of this add four teaspoonfuls of sugar, and a tablespoonful of cream. Barley water may be used instead of common water. The water should be boiling, and should be poured into the milk. The bottle should be thoroughly cleansed, and boiled in boiling water before re-filling. It must be remembered that the saliva does not possess the property of turning starch into sugar till the child is six months old; therefore starchy food, such as bread, arrowroot, etc., should on no account be given before that age. Preparations for weaning may then begin, by giving the child _small_ quant.i.ties of oatmeal jelly and milk, or even of porridge and milk, so that the weaning comes on gradually. The time of nursing should not exceed nine months. If, however, a child afterwards be ill, there is no harm in going back for a time to the bottle, even at two years old. Common sense must guide, and not hard-and-fast rule. Easily a.s.similated food must ever be chosen; and as a food for children, oatmeal porridge, well boiled, holds the first place--far before bread sops. If porridge be not easily digested, try oatmeal jelly. Most of the infant foods so largely advertised cannot be recommended.

It is now suspected that tuberculosis is transmitted to children mainly from the milk of cows affected with this disease. Cows are exceedingly liable to tuberculous disease of the udder. It is therefore very difficult to get milk guaranteed free from the tubercle bacillus, and recent examinations of that coming into Manchester and Liverpool showed that from 18 to 29 per cent. contained this deadly germ. (Strange to say, tubercular disease of the mother's breast is practically unknown, and children never derive the disease from their mother's milk.) It is therefore of the greatest importance that only the milk of cows proved free from this disease should be used. The disease is easily detected, and if a demand were created for milk guaranteed free from the germs, dairymen would soon supply it.

Unless it is _absolutely certain_ the cows supplying the milk are free from disease, the milk should be sterilised by heating to near boiling point, and then cooling _rapidly_. If kept twelve hours, the boiled taste goes off it, and children soon get to like it. Though sterilised milk will keep for some time without getting sour, it should be sterilised each day, specially if for infant use.

This treatment makes the milk keep without the use of preservatives, such as boric acid. We regret to say the use of these is not illegal, and they are largely used in preserving milk, b.u.t.ter, hams, etc. We have seen very serious illnesses produced in children (and adults too) by the heavy doses they have got when both the farmer and milk vendor have added these preservatives. This they often do at the season when the milk easily turns sour. Every care should therefore be taken to get milk guaranteed free from these noxious drugs; and if this is impossible, condensed milk should be used instead. As there is a great variety of brands of condensed milk in the market, always choose one which guarantees that the milk taken has been whole milk, and also unsweetened.

Infants' Sleep.--_See_ Children's Sleep.

Infection.--Few things have so great and distressing effect as the fear of infection in disease. As a rule this fear is not justified by the facts, where ordinary precautions are taken. These precautions, too, need not be costly, and involve in many cases little more than some careful work. Where scarlet fever has shown itself in any household, the very first thing is to see to the continuous freshening of the air in the sick-room and in all the house. Ventilation is, indeed, the first and most important method of disinfection. Chloride of lime and other disinfecting fluids will decompose the offensive and noxious odours, but pure air will sweep the organisms of disease themselves away. Fresh air kills the microbes of certain diseases, _e.g._, consumption, and is hostile to all disease. The stools of typhoid patients should be disinfected, and great care taken that no water or other fluid is contaminated by them through imperfect sanitation, etc.

(_see_ Fever, Typhoid). Seeing that the seeds of disease are all around us, the best method of warding off their attacks is to keep the body in a state to resist their inroads by strict attention to diet, exercise and ventilation. Let all be done also, by fires if necessary, to thoroughly _dry_ the room and house. See that all the family breathe fresh air by night as well as by day; have open windows where and when possible.

Acetic acid is as powerful a disinfectant as carbolic acid, in proportion to its strength, and has the advantage of being harmless, unless in the glacial form.