upon them. Growths may occur in the ear from the custom of wearing
ear-rings, and especially when of base metal, although gold ones
sometimes give rise to the same. Such may require removal by the
surgeon’s knife. Inflammation may be set up in the lobe after
piercing it for wearing ear-rings, should a portion of gristle happen
to be transfixed by the needle, and all the more likely should
that be a dirty or rusty one. The best thing to do is to bathe it
frequently with hot water. The silly habit of pulling children’s ears
is very liable to cause disease and injury. Never “pick” the ears
with any sharp implement. For removing excess of wax, syringe gently
with warm water, softening it first, if necessary, by dropping a
little glycerine and water or soda dissolved in water, into the ear
for a night or two. Any foreign body (including insects) accidentally
getting into the outer ear can generally be removed by dropping a
little warm water or salad oil into the ear, and then inclining the
head. The popular dread of their getting into the brain is utterly
unfounded: the drum head of the ear is an effectual stop. Dr. Jacobi
remarks that closing the mouths of infants and children and simply
blowing into the nose is often a very valuable method of relieving
earache, the cause of the trouble probably being a catarrhal
affection of the Eustachian tube. Perhaps even better is the method
of inflating the ear by blowing into it gently, while the mouth and
nose are held closed, and syringing the ear with warm water. Much
harm has been done by putting oil, chloroform, laudanum, the heart
of roasted onion, and similarly improper things into the ears of
children.
_Eye complaints._--In every case skilled advice should at once
be sought. The following remarks relate only to what should be
done in urgent cases ere professional assistance can be obtained.
In inflammation, simple bathing with water (either cold or tepid
as the sensations may direct) is the safest remedy, and no other
application should be had recourse to, till sanctioned by the doctor.
The practice of applying poultices, common bread and water, bread
and milk, tea-leaves, porridge, &c., to an inflamed or injured eye
is totally wrong, often endangering the sight. Keeping wet cloths
applied to the eye, and bandaging up an inflamed eye, may also be
productive of much mischief, and should never be employed without
orders.
A particle of foreign matter entering the eye will often produce
such a flood of tears that it is soon washed out, especially if the
eye be kept closed and not rubbed for a few minutes; but sometimes
the irritating substance finds its way under the upper eyelid,
and remains fixed there by the pressure of the lid. In some cases
plunging the face into cold water and opening the eyes under the
water will suffice to remove it, but generally the eyelid requires
to be turned inside out, and the offending body picked off with a
feather; or the upper eyelid drawn forwards off the eye by means of
the eyelashes, and the lower eyelid pushed up under it: when the
eyelids are released, the eyelashes of the lower lid will brush over
the inner surface of the upper lid, and almost certainly remove any
substance that may lodge there. To evert the lid, lay a bodkin or
pencil along it, and turn it up by taking hold of the eyelashes about
the middle, the patient meanwhile looking down. Should such simple
means fail, the eye may be tied up with a pad of cotton wool over
it, so as to prevent the eyelid moving till professional advice be
secured.
Serious damage is frequently occasioned by lime or other caustic
substance getting into the eye. Wash the eye as quickly as possible
thoroughly with cold water or vinegar very much diluted with water
(say 1 teaspoonful vinegar in 2 oz. warm water), a stream being
allowed to course across the opened eye, while any particle of
caustic substance that remains should be carefully removed. A drop
of castor oil or olive oil applied every half-hour to the inside of
the eye will greatly allay irritation. Never bandage or poultice. In
all cases of injury the less done at home the better. A light pad
of cotton wool applied over the closed lids and kept in position by
a handkerchief or a pledget of cotton wool soaked in _cold_ water
reapplied _cold_ at least every 5 minutes, may be employed till the
doctor comes.
Dr. Louis Fitzpatrick says he has never seen a single instance in
which a stye continued to develop after the following treatment
had been resorted to: The lids should be held apart by the thumb
and index finger of the left hand, or a lid retractor, if such be
at hand, while tincture of iodine is painted over the inflamed
papilla with a fine camel’s-hair pencil. The lids should not be
allowed to come in contact until the part touched is dry. A few such
applications in the 24 hours are sufficient. (_Lancet._)
_Hair complaints._--Ladies should undo their hair at night, unplait
the hair, and wear it loosely in a net. In this way the nourishment
of the hair is duly provided for. Night-caps should always be
light. When forced to remain in bed for long periods, through
illness, have the hair oiled and combed with a coarse comb daily; if
circumstances permit, the head may be washed twice a week with soap
and water, warm, lukewarm, or cold, as taste or health directs. In
long-continued illness, it is often advisable to cut the hair, so as
to reduce its length by about a third, not merely from considerations
connected with the cleanliness of the hair, but also that stronger
aftergrowth may be encouraged. Few realise the injurious effects of
curling-irons and hair-dyes.
Ordinary baldness may be constitutional or local. The former is a
matter for the medical man. For persistent daily loss of hair, the
following remedy is recommended by Pincus:--15 gr. soda bicarbonate
dissolved in 1 oz. water; a little to be well rubbed into the scalp
daily, and persisted in. Sir Erasmus Wilson says that a lotion
composed of 1 oz. each spirits of hartshorn, chloroform, and sweet
almond oil, added to 5 oz. spirits of rosemary, and well rubbed into
the roots of the hair after brushing, is effective; it may be used
half-strength, diluted with eau-de-cologne. Other lotions are:--(_a_)
2 dr. tincture of Spanish flies, ½ oz. tincture of nux vomica, 1
dr. tincture of capsicum, 1½ oz. castor oil, 2 oz. eau-de-cologne;
apply night and morning with a sponge to the roots of the hair after
brushing. (_b_) 2 oz. spirit minderus, ½ dr. ammonia carbonate, ½
oz. glycerine, ½ oz. castor oil, 5 oz. bay rum; apply as in (_a_).
These will be found serviceable in the treatment of commencing
general baldness, where the whole scalp is parting with its hair.
Singeing the hair is not of the slightest use for hair stimulation,
and the frequent use of the “curling-tongs” cannot but be detrimental
to the health of the head-covering. When the hair demands a tonic
application, the following--which any chemist will compound--may
be tried:--1 oz. tincture of red cinchona bark, 2 dr. tincture of
nux vomica, ½ dr. tincture of cantharides, add eau-de-cologne and
coconut oil to make up 4 oz.; apply to the roots of the hair with a
soft sponge night and morning. Where means are being taken to restore
the health in cases of sudden or premature greyness of hair, Dr.
Leonard recommends the following application:--2 oz. coconut oil, 3
dr. tincture of nux vomica, 1 oz. bay rum, 20 drops oil of bergamot.
Washing with egg yolk is highly commended in such cases.
The common trouble known as dandriff (dandruff) frequently occurs
in strumous (scrofulous) individuals who are anæmic (poor-blooded)
and have a sluggish circulation, marked by cold hands and feet.
Adolescence is its peculiar time of appearance, and chlorotic
(greenish skinned) young girls are apt to be annoyed by it. It is
an attendant upon chronic debilitating diseases, as rheumatism,
syphilis, phthisis, and the like, and comes on after profound
disturbances of the constitution, such as fevers and parturition.
Dyspepsia and constipation are very common exciting causes or
aggravants of the disease. Improper care of the scalp, the use of the
fine-toothed comb, and of pomades, hair “tonics,” and hair-dyes will
give rises to disorder.
A good deal in the way of prevention, according to Dr. Jackson, can
be accomplished by proper care of the scalp and general health. The
brush should have its bristles well set into the back, placed in
little clumps at regular distances and rather far apart, and those
in each clump should be of unequal length and arranged so that the
longest ones are in the centre of the group. It is well to have two
brushes, one stiff enough to warm the scalp when used with vigour,
and one quite soft. The comb should be made with large teeth set wide
apart; held up to the light the teeth should show no roughness or
inequality of surface. The fine-toothed comb should be banished from
the toilet table, as it is an active agent in producing inflammatory
conditions of the scalp. In the morning the hair should be thoroughly
opened up in all directions with the comb, and it and the scalp
brushed vigorously with the stiff brush. Then the soft brush should
be used in parting the hair, in polishing it, and in subsequent
brushings during the day.
Do not wash the head too much. The so-commonly practised daily
sousing of the head in water is hurtful to the hair and scalp,
especially if they are not carefully and properly dried afterwards,
and a little oil or a vaseline rubbed into the scalp. It is not the
daily sousing which is objectionable, but the insufficient aftercare.
Water renders the hair dry, and the daily sousing only washes the
head superficially. A good shampoo every week or ten days for those
persons exposed to a good deal of dust, and every 2-3 weeks for
other people, is sufficient for cleanliness. For the shampoo, soap
and water, borax and water, or the yolk of an egg beaten up in lime
water, are all simple and good, but it must not be forgotten to wash
out these materials with plenty of clean water, and to thoroughly dry
the hair and scalp.
Patent hair “tonics,” pomades, washes, and dyes are to be avoided.
None of these dressings is needed by the healthy scalp, and proper
care will preserve the hair in better condition than they will.
The nearer the body can be kept to the standard of perfect health
by means of bathing, exercise, and good diet, the less likely is
dandruff to develop. When, therefore, the disease has appeared, first
inquiries should be concerning the general health, and first efforts
addressed to remedying anything found to be wrong.
If the case presents itself with a decided accumulation of scales, or
if crusts are present, saturate with sweet almond oil, before going
to bed, and place over the head a flannel cloth soaked in the oil,
and outside of all an oiled silk cap. Next morning shampoo thoroughly
with soap and water, using by preference the tincture of green soap,
and wash out the soap with plenty of water. The scalp is then to
be dried by vigorous rubbing with a coarse towel, and the hair by
pulling it through a soft towel. If the crusts by this method are
not completely removed, the oil should be kept on during the day,
the head again soaked at night, and washed with the soap and water
in the morning. If the scalp should appear very hyperæmic after
the crusts are removed, anoint the head with red vaseline or some
simple ointment, as rose ointment, until lessened. When the crusts
are removed and the hyperæemia overcome, have an ointment composed
of 1 dr. sulphur loti to 1 oz. vaseline, applied every morning to
the scalp. If the scales form rapidly, apply every night, and the
sulphur ointment every morning, and wash the head every second or
third day. As soon as scaling is lessened stop the use of the oil,
but continue the ointment, at first using it every second morning,
then gradually reducing its application to once a week. Throughout
this plan of treatment the head should be shampooed about once a week
with a tincture of green soap, borax and water, or the yolks of 3
eggs beaten up in 1 pint lime water, to which ½ oz. alcohol is added.
Another excellent ointment for these cases is composed as follows:--
℞ Hydrarg. ammon. gr. xx.
Hydrarg. chlor. mitis. gr. xi.
Petrolati 1 oz.
This applied once or twice a day has yielded admirable results in a
number of cases of simple dandruff. Its consistence, being that of
a salad dressing, renders it an elegant pomade for private practice.
Its use should be combined with the occasional shampoo as directed
above.
The persistent and systematic use of either of the two plans of
treatment, together with a proper oversight over the general health,
should cure every case of dandruff. But be prepared for occasional
relapses.
_Headaches._--Headaches vary much in degree and in kind. Their causes
may be grouped under 3 types--(1) when the blood-supply of brain and
body is at fault; (2) when some distant organ (such as stomach or
liver), with which the brain is in sympathy, is out of order; and (3)
when there is some affection of the nervous system, and especially of
the brain: or “circulation,” “digestive,” and “nervous” headaches.
Circulation headaches arise from the condition known technically as
_anæmia_ (bloodlessness) of the brain, in which the mental powers are
weakened, and much brain-work will result in headache. Chief among
its causes are a feeble heart and excessive drain on the system,
especially among women, the evil frequently lying in the excessive
use of purgative medicines. Hyperæmia (excessive blood supply) may
also give rise to headache in those who use the brain to such an
extent as to cause excessive waste, to repair which an increased flow
of blood to the head takes place, and may be so great as to overwhelm
the nerve-centres. This is often aggravated by an irregular mode of
life and too much stimulants. Interference with the blood return to
the heart may be due to causes within the chest, such as chronic
bronchitis or heart obstruction, to swellings in the glands of the
neck pressing on veins which convey the blood back to the heart, and
improper dress, such as tight stays, or tight collars and cravats.
In the bilious or dyspeptic headache, also known as the “sick
headache,” the brain sympathises with the stomach or liver in its
affliction, and thus is due to those errors of diet which lead to
indigestion or dyspepsia, e.g., unwholesome food, late suppers, hasty
and inefficient mastication, and continuous drinking and wine-bibbing.
The nervous system itself seems to be chiefly at fault in organic,
nervous, and neuralgic headaches. The organic headache often precedes
insanity. The nervous headache, more commonly known from the nausea
and vomiting which occur during an attack, as “sick headache,” is
due to various exciting causes, such as brooding over unpleasant
thoughts, bodily fatigue, dietetic errors, too little exercise,
overstraining of vision, loud noises of a disagreeable character,
unpleasant smells, and even disturbances of the weather; it is often
inherited. The attack may sometimes be warded off by the application
of atropine; the tendency to attack has been got rid of by the use
of a proper pair of spectacles. The neuralgic headache is a form of
tic douloureux, has its seat in one or other of the nerves of the
head, and may be excited by decayed teeth, exposure to cold, and
similar causes. It rarely occurs, even in those conditions, unless
the nervous system is lowered in tone. Many people have decayed
teeth without suffering the slightest ache so long as they keep
their health at par. Too much work, bodily or mental, or exposure to
conditions which act injuriously on the health, result in a neuralgic
headache.
Any irregularity in the mode of life, such as errors in diet and
drink, must be particularly shunned by those who are liable to any
form of headache. Where alcohol is found to do good, it should be
taken only in small quantities and with the meals. All worry and
excitement must be avoided. Sleep in sufficiency, as well as moderate
exercise, is essential. When headaches continue to burden the frame
and to make life miserable, change of air or scene, prolonged absence
from business, pleasant society, music, and other enjoyments may help
to get rid of them. Sometimes all that is wanted may be cod-liver
oil, or some other nutrient and tonic medicine. During the paroxysms
of sick headache, complete rest on sofa or bed in a darkened room is
found by many to be the only thing which gives relief; while others
believe they are assisted to endure by drinking cups of strong tea
or coffee. Those who suffer from this tendency, and disorders of
vision, should consult an oculist regarding the condition of their
eyes. (Dr. Maxwell Rose.)
_Indigestion._--Indigestion may be due to the food or condition of
the stomach. The food may be defective in quality. There may be
excess or deficiency of the normal ingredients, saccharine, starchy,
albuminous, or fatty, or some of the natural indigestible materials
which form a part of all food. The food may be introduced in an
indigestible form on account of defects in the cooking of it, or
imperfect mastication, or from its having undergone putrefaction or
fermentation, which arrests the functions of the stomach. Imperfect
mastication of food is a very common cause of indigestion. Eating
too much is probably the most common of all causes of indigestion.
The secretion of the gastric juice in the stomach seems to be
proportioned to the amount of material required for the nourishment
of the system. Food taken in excess of this amount acts as a foreign
substance undergoing fermentation and putrefaction, and occasioning
much disturbance in the system. Much may be done for the cure of
indigestion by eating very abstemiously of suitable food, thoroughly
masticated, taking exercise in the open air, breathing pure air, and
observing the laws of health generally. The amount of food should be
reduced until the quantity is reached which the stomach can digest
without evincing any symptoms of indigestion.
Hot water of a temperature varying from 110° F. to 150° F., has been
found highly serviceable in relieving painful conditions induced by
improper feeding. This beverage, diluting the ordinary fluids and
secretions of the digestive system, effects the work of the liver
and kidneys, and produces the happiest results. Dr. Cutter, of New
York, has summarised the methods of using hot water. He tells us that
the water must be really hot, and not merely lukewarm. If lukewarm,
it will only excite vomiting; whereas, when really hot, it appears
to soothe the irritable lining membrane of the stomach and bowels.
The quantity of hot water to be taken at a draught, according to
Dr. Salisbury, varies from ½ pint to 1 pint or more at a drinking.
The test of benefit being derived from the use of hot water is said
to be that derived from the kidney-secretion, which should be pure,
free from odour and deposit. Regarding the times at which hot water
should be taken, 1-2 hours before each meal, and ½ hour before
retiring to rest, are stated as the periods most suitable for its
administration; while the water must be sipped, and not taken so fast
as to cause distension of the stomach. Dr. Cutter says that ¼-½ hour
may be consumed in the draught of hot water. This form of hydropathic
treatment, according to the authorities just named, should be
practised in cases of digestive troubles for a period of 6 months
or thereabouts. Regarding the amount of liquid to be taken with a
meal, not more than 8 oz. has been prescribed as the regulation
quantity; a larger amount tends to dilute the gastric juice to too
great an extent. Various additions may be made to hot water by way of
rendering it palatable, although persons accustomed to drink it in
time learn to like it.
Dr. Milner Fothergill made some experiments with our ordinary native
fruits, to test the value of correcting the acid by means of alkali
to render the fruit more suitable for dyspeptics. The result was
that the amount of bicarbonate potash required for each lb. of fruit
was found to be about as much as would lie upon a shilling. With
all fairly ripe fruit this is just sufficient to neutralise the
acidity, and bring out the natural sweetness; indeed, the resultant
product was quite sweet enough for most adult palates. Such stewed
fruit can be eaten alone, or with milk puddings, cream, or Swiss
milk; gooseberries, currants, apples and plums are excellent when
so prepared. With dark fruits, as the black plum, the colour is
impaired by the alkali, and the fruit is less attractive to the eye
than is that of the ordinary stewed fruit, which is of a deep clear
crimson. A little cochineal will give the desired colour. Where there
is no natural sweetness, to neutralise the acid completely by an
alkali leaves nothing, simply a cold mass, to which the palate is
indifferent. Such is the case with rhubarb. Here it is well to use
half or all the amount of alkali with some sugar. The same is the
case with early gooseberries before they have any natural sweetness;
no sugar formed in them. Here the full quantity of alkali should
be used, and the remaining acidity be met by sugar. When ¾ lb. of
sugar is required to sweeten 1 lb. of fruit, only ¼ lb. of sugar is
necessary after the alkali has been added. The sour-sweet taste is
thus secured, which is toothsome. In these two instances the stewed
fruit is only rendered less objectionable to the stomach plagued with
acidity, not made quite inoffensive.
_Infectious Diseases._--All infectious (catching) diseases have
several features in common. They begin with a period of dormancy
(“latency” or “incubation,”) during which the poison is actively
developing. The duration of this period in smallpox is 12 days; in
typhus fever, 8-14 days; in typhoid fever, 14-21 days; in scarlet
fever, 3-6 days; measles about 4 days, at the termination of which
the sickness is said to begin, though its distinctive characters may
not appear for some days longer. These diseases (fevers) all commence
with a marked, and sometimes sudden, elevation of bodily temperature,
which, with variations, continues during the course of the illness.
Characteristic eruptions appear in scarlatina on the 2nd, smallpox
on the 3rd, measles on the 4th day, and so on; with them begins
the infection, and increases with the activity of the disease. The
following table, modified from that given by Domville in his ‘Manual
for Hospital Nurses,’ is exceedingly useful:--