Papers on Health Part 24

In adults the rate for males is from 70 to 75 beats per minute, and for females 75 to 80. In infants the healthy pulse may be at birth 130 to 140 per minute, diminishing with increase of age. In the case of any child under five and over one year, if the pulse beats, say, 108 in the minute, it is too fast. The pulse of an adult may go down as low as 60 or even 50 per minute, but there is then something wrong.

Cooling the head is always safe with high pulse and feverishness, and often this alone will ward off disease and restore the healthy condition. If the pulse be low, fomentations to the feet should be applied, along with cooling action elsewhere, if necessary.

Purple Spots on Skin.--These arise first as small swellings. The swellings fall, and leave purple patches behind, which, if the trouble continues, become so numerous as to spoil the appearance of the skin.

This especially occurs in children or young people, whose skin is exceptionally delicate. What has occurred is really much the same as the result of a blow or pinch, leaving the skin "black and blue." Some of the delicate vessels in the skin have given way, and dark blood collects on the spot.

The treatment is to sponge all over the body and limbs with warm CAYENNE "TEA" (_see_), only strong enough to cause a slight smarting.

It should never cause pain. If it does so, the tea is too strong, and should be diluted with warm water. The soapy LATHER (_see_) may also be used, and olive oil may with advantage be rubbed on as well. Milk and boiling water should be given to the patient every two hours during the day, with a few drops of the cayenne "tea" in it. This is a true stimulant, and worth all the whiskey in the world. The object of the treatment is to nurse the patient's strength, and stimulate the skin.

An intelligent study of many articles in this book will guide the thoughtful how to act.

Racks from Lifting.--_See_ Muscular Pains; Sprains.

Rash, or Hives.--Infants are often troubled with large red, angry-looking spots, breaking out over the body, and causing trouble by their heat and itching. These are commonly known as hives. If the water in which a child is washed be hard, it will sometimes cause the skin to inflame and become "hivey." If the soap has much soda in it, it will also cause this. What is called glycerine soap, and much of what is sold as peculiarly desirable, is utterly unsuitable for an infant's skin. Soda soap will cause serious outbreaks even worse than "hives,"

and will often not be suspected at all, as a cause.

Only M'Clinton's soap, which is made from the ash of plants, should be used on tender skins.

When the "hives" are not very troublesome, they are apt to be neglected; but this should not be, as in most cases this is the time they may be easily cured. The true element in cure is found in attention to the _skin_, as distinct from the stomach or blood.

M'Clinton's soap (_see_ Soap) applied as fine creamy lather will _cure_ hives, and will never, we think, fail to do so. We know of a nurse plastering an infant's body with this soap, so that it was blistered.

This is a totally wrong way of working. The right way is to work the soap and hot water as described in article Lather, and to apply it gently with the brush to the parts affected. After applying it with gentle rubbing for some time, and leaving some on the sore places, the infant will usually be soothed to sleep. Where over-cooling is feared, with a weak child, a little olive oil is gently rubbed on with the second coat of lather. In any case of itchiness the above treatment is almost certain to cure. Often the infant is suffering from too rich diet. (_See_ Children's Food.) In such cases, thinner milk, and a little fluid magnesia administered internally will effect a cure.

Remedy, Finding a.--It will sometimes occur, in the case of those endeavouring to cure on our system of treatment, that on applying what is thought to be the correct remedy, the trouble becomes worse. For example, where there are violent pains in the legs, a bran poultice is put on the lower back, and it is rubbed with oil. The pains become worse instead of better, and perhaps our whole system is abandoned and condemned. Now, all that is required here is to think and try until we find the _true_ remedy. If the pain in the legs is rheumatic, the hot poultice is all right. If it has been cramp, what is needed is a cold cloth on the lower back, instead of heat. In the example above given, what is needed is not to abandon the treatment, but to rectify the mistake, and apply cold instead of heat. In a great many forms of illness the same principle holds good. It is safer, where there is any doubt, to try heat first, but not in a very strong manner. If this gentle heating makes matters worse, gentle cooling may be tried. If the heat does good, it may be continued and increased, but never beyond the point of comfort. If the cold does good, it also may be continued on the same principle. What the patient feels relieving and comforting, is almost sure to be the cure for his trouble, if persisted in. _See_ Changing Treatment.

Rest.--In every person there is a certain amount only of force which is available for living. Also this force, or _vitality_, is _produced_ at only a certain definite rate. Where the rate is very low, only perfect quiet in bed for a time can bring down the expenditure far enough to enable the vital force gradually to acc.u.mulate, and a cure to be effected. Sitting, in such cases, may be serious overwork.

When rest is ordered, we are often met by the reply that it is impossible, as work cannot be given up. It is, however, often possible to get a great deal more than is taken. Every spare moment should be spent lying down in the most restful position. It is an important element in nursing to give such a comfortable rec.u.mbent position to a patient as const.i.tutes perfect rest, and the nurse who does so, does a great deal to cure.

There is with many a prejudice against rest. It is somehow believed that it is a weakening thing to lie still in bed. "You must get up and take exercise, and enjoy the fresh air." This is a very good order for a person who has the strength for bracing exercise and fresh air. But this is absent in a person truly ill. That person's vital force is low, and the organs that supply it are feeble in their action. The fresh air may enter the chest, but the lungs are not in a state to make good use of it. "Exercise and fresh air" only consume the sufferer. On the contrary, rest and fresh air allow the weak vital force to recruit. The sort of exercise which is wanted in such cases is given by others in ma.s.saging or such squeezing the muscles as stimulates the organic nerves without using vital force in the sufferer. We have repeatedly succeeded in giving new strength by some weeks in bed, when it could not have been given otherwise. It is all very well for a young, strong person, only a very little out of sorts, to take a cold sitz-bath for ten minutes, and then a walk of a mile or two in mountain or seash.o.r.e air. But this treatment would be death to one really ill. Perfect rest in bed, with an abundant supply of air through windows open night and day, would save the life which such "exercise and air" would send out of the world. It requires only a little common sense to see this. "He must be weakened by lying in bed so long." There is no such "must" in the nature of things. On the contrary, it may be absolutely necessary to his getting strength that he should lie still for weeks on end. You may, no doubt, give us instances in which a person was compelled to get up, and was thereby made to lose the delusion that he was not able to do so; but such instances in any number will not make one strong who is actually weak. Make sure first that vital energy is supplied, and when that supply rises to a certain degree it will not be easy to keep your patient in bed.

We would also note that true rest can never be had in a forced position. A limb bound down is not resting. The agonising desire to change its position shows this. True rest is found always in _freedom_ and _ease_. It may be necessary to put splints on a limb, but it must never be done where rest is aimed at. Usually there is a position of comfort to be found. Let the patient find and keep that. He will then have rest.

For instance, an exhausted patient is lying at full length in bed, but under the waist there is a hollow which is bridged over by the back.

This part of the back calls for a considerable amount of force to hold it over this hollow, but we get a pillow inserted under the back, the muscles relax, and the patient rests. In packing and fomenting an inflamed knee, for example, it is usually better done in a slightly _bent_ position, which is more restful than a straight one. Employ two or three small pillows to prop it comfortably. And so on, in mult.i.tudes of cases, the earnest healer will be guided by the patient's own restful feelings. _See also_ Noise; Veins.

Restlessness.--In slight cases, where the patient simply cannot sleep for tossing about in bed, a cold towel placed along the spine, with a dry one above, will usually relieve, especially if changed and cooled several times as it grows warm. If heat be specially in the head, then that may be cooled in the same manner till peace settles down in the brain.

But we must go on to consider those cases of restlessness in which there is no extra heat in either spine or brain. Tea may have been taken in a rather strong infusion, or so late that its peculiar influence may be the cause of the restlessness. It is necessary to avoid this beverage if such restlessness is to be escaped; still it will generally be found that in cases in which tea has caused serious wakefulness and restless tossing, that there is more than the mere effect of the herb, and that superabundant heat is present also; then the application already pointed out will give relief.

Now take an instance in which it seems to be the mind that causes the tossing rather than the body. Preachers after earnest preaching are in many cases sleepless and restless too; so are almost all persons when currents of exciting thoughts have been set agoing in their minds.

Then, no doubt, it is necessary to get at relief from the spiritual side, by means of thought fitted to calm down the excitement that has been raised. But it is never well to forget that in all such cases there is a material as well as a spiritual aspect of the experience.

Many preachers take a sitz-bath before going to bed after a day of service, and find that somehow when sitting in the cool water the over-driven brain begins to slacken pace. If from any cause you are restless and cannot lie still, even after the head and spine have been cooled as we have described, it is well to take a sitz-bath in cold water for a few minutes. Dry and wrap up well, and you will be quiet after. Certain forms of coughing apparently cause the most serious restlessness. A warm poultice should be placed between the shoulders, and cold cloths pressed gently on the breast.

If there is extreme shrinking from everything in the least degree cold, then you need to go a step back in your treatment. A sponging of the most gentle kind, with CAYENNE LOTION (_see_) and water, all over the body, given very carefully for three or four days, once a day, will put away the shrinking to which we refer. This should be done with tepid water at first, but as the skin freshens it will be found comfortable to do it with cool water. In tender cases the poultice or hot bag will need to be comfortably warm, and not hot. The cool cloth must not be wintry cold, nor even at first summer cold. It is, however, necessary to get at the hot and irritating surfaces that are causing the cough, with more or less that is cooling. We may do this ever so gradually, but we must do it, if we would succeed in giving rest from the cough.

In a strong person's case there is really no difficulty. It is an easy matter to put on cloth after cloth till the irritated part is reached and cooled. But when the patient is spent to all but a skeleton, and has restlessness from frequent coughing, it is a very different matter.

Still to the very last the irritating heat may be kept down, and long sleeps given, when otherwise it would be hard work indeed to get through the last stages of illness. We write thus because we know it is possible to give precious relief even when it is out of the question to save life. It is possible to make even the last night on earth comparatively a peaceful one, instead of its being so very restless as it often is. This is to be done just by cooling the parts that irritate, and these only. Generally, heat may be required rather than cold, but at the part which is irritating and keeping up the coughing, there must be cooling. The kind and capable nurse who can carry out this cooling is beyond all price. Those only can understand this who have been delivered from an all but incessant cough by means that produce no reaction. It is also well to remember that we now and again give life by means of rest when we had no idea of giving more than temporary comfort. We have repeatedly had cases in which there seemed no hope of doing anything further than giving relief, but that relief has turned out to be the commencement of cure.

Rheumatic Fever.--_See_ Fever, Rheumatic.

Rheumatism.--We feel urged, in first considering this sore and very common trouble, to quote the old adage that "prevention is better than cure." Many people laugh at wettings, and some foolish young ones even seek exposure. We would impress upon all such that the effects of exposure may be, and often are, c.u.mulative: that is, you may escape any direct effect for years, and then find your recklessness end in rheumatism for the rest of your life. Let care, then, be taken to avoid wettings, unless these lie in the way of duty. Change clothes as speedily as possible when they are wet, and encourage the skin to all healthy action by proper care and exercise. Even with the skin all right, a wise man will not act in a foolhardy way, but if he must get wet and chilled, he will probably not suffer very much.

We would strongly recommend the use of Kneipp linen underclothing (_see_ Underwear). It powerfully stimulates the skin, and, by conducting away the perspiration, prevents chills. We have known many who suffered severely from rheumatism being quite cured by the use of this material. It is as comfortable as it is hygienic.

But supposing the rheumatism does come on, it may be treated, in mild cases, by gradual and steady moist heating. For the method of applying this, _see_ Fomentation and Armchair Fomentation. If the case is comparatively a fresh one, there will be need for no more than this fomenting, repeated several times at intervals of two to four hours.

Where the nervous system has been seriously affected, the fomentation must be gradual, and the moist heat gently insinuated into the parts affected. Where narcotics have been used, these _must_ be given up if a cure is to be hoped for.

In certain chronic cases, which are very largely nervous in their origin, a powerful soothing influence is required. This is secured by the use of soap lather (_see_ Lather; Soap). Cover the back and head, piece by piece, with this, rubbing it on and off four or five times.

Cover the fifth application with a soft cloth, and leave it on for the day in the morning, and for the night in the evening, the patient being in bed. Hot olive oil or occasionally cold drawn oil of mustard is gently rubbed on the stiff parts; when this cloth is removed, gently knead or squeeze the oil into the muscles. If during the lathering the patient feels too cold, a little olive oil should be mixed with the lather. A change to a dry climate from a damp one sometimes does a patient good, but when that is not possible, great relief, and in many cases cure, is to be had by this treatment.

Ringworm.--This distressing and most infectious trouble is due to a small parasite. Where that settles in the skin, a reddish _ring_ soon appears, and gradually widens, leaving a leprous white patch of skin within it. Care should be taken at once to cure this, as, if it spreads widely, serious results follow. Fortunately it is slow in growth, and can easily be checked and cured. The method of cure is to soak the rings well with vinegar or weak acetic acid. Of strong acid use three tablespoonfuls to a quart of water. By even the first good soaking with this, the developed parasites are killed, but the eggs are not. These hatch out by degrees, so that renewed soaking and "dabbing" with the acid and a soft cloth are required. Each application may be continued for fifteen minutes. If the hair, as on the head, interferes, it may be cut closely, but need not be shaved. In a bad case the daily soaking with acid may not be sufficient. Then a poultice of potatoes and b.u.t.termilk (_see_ b.u.t.termilk Poultice) may be applied first, and afterwards the weak acid. Secure that there be felt, before the close of each application, a _slight smarting_, to show that the acid has really soaked in. It is not difficult to guard against its spreading in a family or school. All that need be done is, once a week or so, to see that the whole skin of those exposed to infection, head included, is freshened by a wash all over with vinegar, and then protected with a gentle rub of olive oil. If this is done we should have little fear of contagion. Such a weekly freshening would ward off other evils as well as this one.

Rose.--_See_ Erysipelas.

Rupture.--The abdomen is formed of a series of _rings_ containing the bowels, and holding them in proper position. If the muscles and tissues holding these rings _yield_ so as to permit them to separate a little, what is called "rupture" takes place. It may be caused by violent muscular efforts, heavy weight lifting, jumping from a height, etc., etc. The rings are not broken, but only displaced, and especially with young persons, the "rupture" can soon be brought all right, but even with the aged, in all cases it may be mitigated, if not cured, by proper treatment.

The first thing is to replace any part of the bowels which may have escaped through the opening of the rings. Lay the patient flat on his back. He must not be treated in any other att.i.tude. Then rub the swelling gently _downwards_. It _must not_ be rubbed upwards, or it will be made worse. This rubbing will soon bring the bowel into its proper place. Give some time and kindly care to this treatment, which is very important. Then get a surgical instrument maker to fit a proper truss. See that this really fits. If it hurts in any way when first put on, it does not fit well enough. Avoid for a considerable time any effort likely to strain the part. Take light and easily digested food; give up all alcoholic drinks and the use of tobacco.

Saliva.--_See_ Digestion; Nourishment.

Saltrome.--The disease known by this name in Canada breaks out in the hands, especially on the palms. The skin cracks open and refuses to heal up. Sometimes, if the hands do heal, the trouble comes out on other parts. It is probably due to the long-continued use of bad and strongly irritating soap in washing the hands and face, conjoined, in Canada, with the great dryness of the air.

The treatment for prevention is the regular use of M'Clinton's soap (_see_ Soap). Where the trouble has developed, the hands and face, if involved, should be packed in cloths soaked in b.u.t.termilk. Then over the packing we should foment with large hot flannel cloths (_see_ Fomentation). Renew, if necessary, the b.u.t.termilk packing, and after a thorough fomenting, leave the b.u.t.termilk cloths on all night, with dry ones on top. Then gently anoint with OLIVE OIL (_see_). This treatment, with some rest and the use of the above-mentioned soap, should soon effect a cure.

Santolina.--This plant is the _Chama Cyparissos_, or ground cypress. It is of the greatest value as a remedy for worms in the bowels (not tapeworm), and also acts as a stomach tonic of no small value. It is cut at the end of the season, made up in small bunches of six stalks or so, and hung up to dry. When required for worms, boil one of these bunches in three teacupfuls of water until it is reduced to two teacupfuls. Half-a-teacupful of this is given to a _child_ with worms, each morning before any food, for four days. In the evening of the fourth day an ordinary dose of liquorice powder is given to move the bowels. For a _grown-up person_ the quant.i.ty is a full teacupful each morning. If a child picks at his nostrils, or grinds his teeth while sleeping, the santolina will cure him, even if no other symptom of worms is noticed. It may with advantage be used in all cases where there is indication of the failure of the mucous membrane of the stomach and bowels.

Where required as a stomach tonic, santolina should be infused with boiling water, as tea is. About half-an-ounce of the dried herb is infused, and a small teacupful taken as hot as can easily be drunk about an hour after each meal. Half the quant.i.ty will do for young people under fourteen. Do this six days in succession. Then take none for six days. Then again take it for three days. This treatment may be repeated after a week.

Sciatica.--This is a severe pain in the lower back, shooting sharply down the back and calf of the leg. It arises from inflammation of the large nerve which supplies these parts of the leg with power. Most commonly it is caused by exposure of the hips or lower back to cold and damp, as by sitting on the gra.s.s or a stone seat.

The cure for it, in the earlier stages, is the application of the ARMCHAIR FOMENTATION (_see_). This may be applied for an hour, and renewed immediately for another hour if the patient can stand it, and then rest given for two hours, and the fomentation applied for two hours again, or at least for one, taking care to rub with oil and wrap up in comfortable flannels between and after the treatment. This may be done again on the second day. The fomentation may then be given once a day until the pain is removed.

Be quite sure that no trifling application will succeed with such a disease as this. It will not do to use less heat than will go through and through the haunches of the patient; and that amount of heat is not very small. You must have a good soft blanket if possible, your water must be boiling hot, and you must have plenty of it.

If the hot treatment causes increase of pain, this indicates that a stage has arrived in which _cold_ is to be applied instead of heat to the lower back, to subdue nerve irritation. Before or after this stage, cold application will do harm, so it is well always to try heat first, as in the great majority of cases that is what is required. When cold is applied, the patient _must be warm_, and if necessary the feet and legs should be fomented.