be, when coffined, surrounded with sawdust, in which these solutions
have been placed. Carbolic sanitas powders also present effective
means whereby disinfection of the dead body may be performed when
coffined; and nitrous acid fumes form the best disinfectant for
mortuaries or apartments in which the dead have lain for some time.
Room and Contents.
The room, having been vacated by the patient, should first be
fumigated by burning sulphur. This fumigation should be done under
the supervision of the physician or some other intelligent person.
Nothing should be removed from the room until this is completed,
unless it has been disinfected in the manner already described.
Everything to be fumigated should be so opened and exposed that the
sulphur fumes can come in contact with all portions thereof. All
cracks of doors and windows, fire-places, or other channels by which
the gas may escape should be tightly closed, using cotton wadding
when necessary. For a room 10 ft. in all its dimensions--that is,
one containing 1000 cub. ft. of air space--2 lb. broken sulphur
and 1 lb. flowers of sulphur should be provided, and an increased
amount for larger rooms, in the same proportion. This quantity is
important, as less will not so efficiently accomplish the desired
disinfection. The sulphur should be put in an iron pot, and this
placed on bricks in a large washtub half filled with water, or in a
large coal-scuttle containing wet ashes. This precaution is necessary
to prevent setting fire to the floor, which would occur if the pot
were placed directly on the floor or carpet. The vessel containing
the sulphur should not be one with soldered joints, as the intense
heat would melt the solder. A pot capable of holding 1 gal. is about
the right capacity for 3 lb. sulphur. The pot should be placed in the
centre of the room; if the room is a large one, containing several
thousand cub. ft. of air space, several pots should be provided,
distributed at different points. Everything being in readiness,
sufficient alcohol to moisten the sulphur should be poured on it, a
lighted match applied, and when it is seen that the sulphur is well
ignited, the room should be left and the door shut, and all cracks
outside, including the key-hole, closed by paper, cotton, or other
material. At the end of 10 hours the fumigation is completed. Great
care should be exercised in emptying the room of the sulphur fumes,
as these cannot be safely breathed, and are excessively irritating to
the eyes and throat. If possible, a window should be opened from the
outside, and through this the fumes permitted to escape; if this is
impracticable, all the windows and doors of adjoining rooms should be
opened, and then the door of the fumigated room, and through these
outlets the fumes allowed to find an exit. Thorough airing will
remove the slight odour which remains.
The fumigation being completed, all woodwork, as of floors, windows,
and door, and the walls and other surfaces, should be washed over
with solution of chlorinated soda, particular attention being paid to
cracks, crevices, and out of the way places, in which dirt ordinarily
finds a lodgment and from which it is with difficulty removed.
A subsequent washing with hot water and soap will complete the
cleansing process, and the room may be considered again habitable.
(_a_) While occupied, wash all surfaces with:--
(1) Mercuric chloride in solution, 1 in 1000. The blue solution
containing sulphate of copper may be used.
(2) Chloride of lime in solution, 1 per cent.
(3) Carbolic acid in solution, 2 per cent.
(_b_) When vacated:--
Fumigate with sulphur dioxide as described in the next paragraph.
A pleasant disinfectant for rooms is 20 parts camphor, 50 each
hypochlorite of lime, alcohol, and water, 1 each eucalyptus and clove
oils. The ingredients must be mixed slowly in a spacious vessel kept
cool. A few drops on a plate will suffice to disinfect a chamber
pleasantly.
Carbolic acid, when combined with water and boiled, evaporates with
the steam in a constant ratio, and the steam contains the same
relative quantity of the acid as the water from which it evaporates.
Pour 20-40 drops of a mixture of equal parts turpentine and carbolic
acid into a kettle of water, which keep simmering over a slow fire,
so that the air of the sick room will be constantly impregnated with
the odour. An excellent vaporiser for disinfecting purposes is made
by Savory and Moore.
To purify the air in a sickroom, place in the bed a small basket or
other porous article, containing wood charcoal, for the purpose of
absorbing the foul air which, if diffused throughout the surrounding
atmosphere, would be constantly returned to the lungs.
In a sickroom in which infants are sleeping, put a box or basket
containing a piece of quicklime and some wood charcoal, for the
purpose of fixing the carbonic acid exhaled from the lungs, and of
absorbing all the foul air generated in the system, and given off by
exhalation from the skin or otherwise.
Cellars, yards, stables, gutters, privies, cesspools, water-closets,
drains, sewers, &c., should be frequently and liberally treated with
copperas (sulphate of iron) solution. The copperas solution is easily
prepared by hanging a basket containing about 60 lb. copperas in a
barrel of water, or say 1½ lb. per gal. It stains linen.
Another good solution is made thus. Dissolve ½ dr. nitrate of lead in
1 pint boiling water; dissolve 2 dr. common salt in a pail of cold
water. Pour the two solutions together, and allow the sediment to
subside. Areas, dustbins, heaps of refuse, w.c.’s, or close rooms are
all alike benefited by this mixture, which has the advantage of being
without smell. Cloths dipped in the solution and hung up in a room
will sweeten a fetid atmosphere immediately. It is cheap, nitrate of
lead being procurable at about 6_d._ a lb.
_Rheumatism._--This common ailment is essentially due to damp or
being chilled. One of the easiest and most satisfactory means of
treatment is to apply a flannel bandage, pretty tightly, round the
chest, in order to restrain the movements of the chest wall. Soothing
liniments may also be laid on the side, such as belladonna and
chloroform liniments, mixed in equal proportions, or the liniment of
turpentine, or cajeput oil mixed with olive oil. Some of the popular
domestic remedies for lumbago (rheumatism in the back), are not to
be despised, such as ironing with a hot smoothing iron (with the
interposition of a double layer of flannel between the skin and the
iron), the efficacy of which is heightened by wrapping the flannel
round the hot iron, and moistening the flannel with vinegar. The
iron, thus guarded, is left in contact with the skin for ¼ minute, at
various points. Another good remedy is the application of turpentine,
effected by taking a doubled piece of flannel, say 12-14 in. long
by 8-10 in. wide, and dipping it into boiling water. It is then
wrung firmly, and turpentine is sprinkled liberally over it. This is
applied to the loins, and kept on for 20-30 minutes. When removed,
cotton-wool is applied to the skin. At the outset a strong effective
purge ought to be taken.
A good hot bath (104° F.) is very beneficial, and it may be
advantageous to make it alkaline, by adding about 6 oz. carbonate
of soda (washing soda) to the bath before entering it; this will
be specially efficacious in stiffness of the joints or muscles. Of
the many drugs which have the effect of inducing free perspiration,
solution of acetate of ammonia may most safely be used in
tablespoonful (adults) doses freely diluted with water. The bowels
may be opened by a mild aperient, preferably saline, taken largely
diluted in hot water, and early in the morning. The action of the
kidneys ought to be kept up by diuretics, the simplest being water,
say a tumblerful drunk slowly in the morning, while dressing, or it
may be rendered more energetic by the addition of 1 teaspoonful cream
of tartar.
Diet ought to be restricted to light forms of solid food, e.g.,
fish, soups, chicken, puddings, vegetables, fruit, milk. Beer and
wines should be avoided; ærated waters may be taken freely; smoking
is prejudicial. Finally, persons who suffer from rheumatism ought
always to wear flannel next the skin, and encourage perspiration.
Most alkalies are useful in relieving rheumatism. Potash, or soda
bicarbonate may be freely used in doses of ½ teaspoonful, in ½
tumbler of ærated water, twice daily, for 3-4 weeks at a time.
_Sea-sickness._--Many people, as soon as sea-sickness commences,
have recourse to oranges, lemons, &c. Oranges are very much to be
avoided, on account of their bilious tendency, and even the juice of
a lemon should only be allowed in cases of extreme nausea. Champagne,
too, is a very common remedy, and, without doubt, in many cases does
good; but this appears to be chiefly due to its exhilarating effects,
as, if it be discontinued, the result is bad, and a great amount of
prostration follows. Creosote is an old, but still good, remedy,
and, in cases accompanied by great prostration, is very useful; but
if given in the early stages of sea-sickness, it is often followed
by very bad results, and even increases the nausea. Bicarbonate of
soda is useful in slight cases, as it relieves nausea, and checks
the frequent eructations which often follow attacks of sea-sickness;
but in severe cases it is absolutely useless, and, in fact, it very
often prolongs the retching. A very good remedy in the earlier stages
of sea-sickness is a teaspoonful of Worcester sauce; it relieves the
symptoms, and renders the patient easier. Its action is probably
of a stimulant nature. Hydrocyanic acid is of very little service,
and most acid mixtures are to be avoided, except that perhaps for
drinking purposes, when it is best to acidulate the water with a
small quantity of hydrochloric acid. Of all drugs the most effectual
is sodium bromide. When sodium bromide is given in doses of 10 gr., 3
times a day, the attacks entirely subside, the appetite improves, and
the patient is able to walk about with comfort. In sea-sickness it is
very desirable that the patient should take sufficient food, so that
at all times the stomach may be comfortably full, for by this means
over-straining during fits of retching is prevented, and the amount
of nausea is diminished. The practice of taking small pieces of dry
biscuit is not of much use, as although the biscuit is retained by
the stomach, yet the amount taken is never sufficient to comfortably
fill the stomach. Soups, milk-puddings, and sweets are to be avoided,
as they increase the desire to be sick, and are followed by sickening
eructations. Fat bacon is easily borne, and does much good, if only
the patient can conquer his aversion to it. When taken in moderate
quantity it acts as a charm, and is followed by very good results. Of
all food, curry is the most useful in sea-sickness, and is retained
by the stomach when all other food has been rejected. Next to curry
come small sandwiches of cold beef, as they look nice on the plate,
and are usually retained by the stomach. Brandy should be used very
sparingly, as, in many cases, it induces sea-sickness; and its chief
use is confined to those cases where the prostration is very great,
and even then champagne is more effectual. (Dr. Kendall, _Brit. Med.
Jour._)
_Skin complaints._--Many of these are of a character to demand the
early attention of the doctor, but there are others which can readily
be combated by home treatment.
Pimple (Acne).--These are a frequent trouble in young people and
may be very disfiguring. They arise from inefficient action in the
fat (sebaceous) glands of the skin. Generally they can be dislodged
by squeezing with the thumb nails. To promote healthy action of the
glands and prevent formation of the pimples, Dr. Liveing recommends
the following plan.
(_a_) Steam the face every night by holding it over a basin of hot
water for a few minutes. (_b_) Rub the skin for 5-10 minutes with
soap (preferably terebene) and flannel, or with a soft nailbrush;
then sponge off the soap with warm water. (_c_) When the face has
been dried, a lotion should be thoroughly applied, composed as
follows: ½ oz. precipitated sulphur, 2 dr. glycerine, 1 oz. spirits
of wine, with 3 oz. each rose-water and lime-water. This is allowed
to dry on the skin and to remain on all night. In the morning the
face is cleansed with warm oatmeal and water or weak gruel. If, for
any reason, an ointment seems preferable to a lotion, a combination
of precipitated sulphur and vaseline is very useful. The treatment
must be modified or suspended for 2 or 3 nights if the skin becomes
sensitive and somewhat tender. If this plan be unsuccessful, try
application of potash soap in the form of a lotion. The lotion is
composed of 1 oz. each soft soap and rectified spirits of wine, and
7 oz. rose (or distilled) water. This should be rubbed in vigorously
with a piece of flannel for a short time, taking care not to make the
skin sore. According to Dr. Liveing, the worst cases of acne will
yield to the soft soap treatment if practised with necessary caution.
Something is often required to be done during the daytime to pacify
the heat and throbbing, which are part of the usual history of acne.
An excellent lotion is made by combining oxide of zinc, calamine,
prepared chalk, lead lotion, and lime-water, to which may be added a
small quantity of glycerine. Let the bottle containing this be gently
waved about so as to diffuse the materials, which are only held in
suspension; then pour a little into a saucer, and with a sponge
(reserved for the purpose) sprinkle the face from time to time. Wipe
off, when necessary, with a bit of fine muslin the powder which
remains on the skin after the evaporation of the fluid, and the face
may be washed occasionally with a little starch gruel. The cases are
not a few in which it is better not to use any kind of soap as part
of the evening ceremonial. After the face has been steamed, put on a
medicated jelly composed of zinc oxide, gelatine, and glycerine. It
must be liquefied by putting the vessel that holds it into hot water,
and then applied with a brush. Some sensitive skins are intolerant
of sulphur in any guise. When this is so, try combinations of lead,
chalk and zinc, blended as a quasi-ointment with the finest vaseline.
Dr. McCall Anderson’s formula of bismuth oleate with vaseline and
white wax has been aptly described as “one of the most healing of
salves.” Sometimes nothing agrees better than the old-fashioned
but capital substance called Kirkland’s “neutral cerate,” which is
composed essentially of lead plaster and olive oil.
Nettlerash.--A form of nettlerash seen in little children, showing
itself as slightly raised red blotches, worst in the night, is
referred to “teething,” and that is thought sufficient reason for
neglecting it. The best treatment is strict attention to cleanliness
and diet. The child should get a tepid bath night and morning. Take
care that no part of the dress irritates the skin, flannel not
being allowed to touch it; and let the patient enjoy fresh air and
sunshine. If itching continues, instead of a simple tepid or warm
bath at night, an alkaline bath should be given in this bath: in 8-10
gal. water as warm as the hand; dissolve 1-2 oz. soda bicarbonate.
Bathe the child for a few minutes, do not be too exact in drying,
and put to bed immediately. Nettlerash in adults requires medical
treatment.
Eczema.--Of this skin disease there are many forms, all arising more
or less from a disordered state of the blood, and demanding medical
advice. As a general rule, the patient should avoid soap in washing,
using oatmeal instead. Starchy food, such as potatoes, are deemed
unsuitable, while plenty of green vegetables and fruit should be
taken. Clean linen is essential, and the patient’s towel should not
be used by any one but himself.
Itching.--This troublesome affection may be cured by the use of the
following:--(_a_) 500 grm. milk of almonds; ¼ grm. each corrosive
sublimate and ammonium chloride. (_b_) 60 grm. glycerine of starch; 5
grm. bismuth subnitrate; 5 grm. zinc oxide. (_c_) 1 litre infusion of
mallow; 50 grm. cherry-laurel water (filtered); 10 grm. borax. (_d_)
Vaseline often gives relief.
Ringworm.--Whenever the disease is observed, efficient measures
should be taken to cure it, instead of wasting time with feeble
popular remedies, such as ink, permitting the affection to spread
and become established. The hair should be cut for ½ in. round each
patch of ringworm. Get a small camel-hair brush, and a solution of
the following composition: 30 gr. iodine; 2 drm. colourless oil of
tar. Apply the solution carefully with the brush to the diseased part
only. Repeat the application in a week. Strong carbolic ointment may
be applied _around_ the patch. It is a most obstinate disease, and
requires the exercise of great patience. Children suffering from
ringworm should not be much confined in the house, and it is a good
rule to give them cod-liver oil, or steel wine, or both.
_Sweating_ (excessive).--_(a)_ In the Michigan _Medical News_, Dr.
Currie recommends in sweats, from whatever cause, 1 pint alcohol, 1
drm. sulphate quinine. Wet a small sponge with it, and bathe the body
and limbs, a small surface at a time, care being taken not to expose
the body to a draught of air in doing it.
(_b_) For sweating of the feet, Dr. Meierhof, in the _Maryland
Medical Journal_, directs the patient to immerse his feet morning and
night for about 10 minutes, in warm water at 115°-120° F. in which
a teaspoonful (1 dr.) powdered commercial soda (impure carbonate of
soda) is dissolved. The feet are then thoroughly dried, after which
they are painted all over with a coating of compound tincture of
benzoin, which acts as an antiseptic astringent and by its mechanical
presence on the skin. This treatment is continued for about 10 days,
after which it is practised once daily, or every other day, as the
necessities of the case may require.
(_c_) M. Vieusse, principal medical officer at the Military
Hospital at Oran, states that excessive sweating of the feet,
under whatever form it appears (whether as mere super-secretion
accompanied by severe pain, or with fœtidity), can be quickly cured
by carefully-conducted frictions with bismuth subnitrate; and even
in the few cases where this suppresses the abundant sweating only
temporarily, it still removes the severe pain and the noxious odour
which often accompany the secretion. He had never found any ill
consequence follow the suppression of the sweating.
(_d_) Napthol has been recommended as an effective remedy against
excessive sweating of the palms of the hands, foot-soles, and
arm-pits. These places should be moistened once or twice daily, with
a mixture of 5 pt. naphthol, 10 pt. glycerine, 100 pt. of alcohol,
and afterwards dusted, either with pure starch or with a mixture of
2 pt. naphthol, 100 pt. starch. In the case of sweating feet, small
pellets of antiseptic cotton are dipped in the powder and placed
between the toes.
_Tooth Troubles._--To preserve the teeth, rinse the mouth after
every meal. If the gums are naturally irritable and tender, a few
drops of tincture of myrrh in water should be used to rinse out the
mouth, twice or thrice daily. The first tooth brush should be used
as soon as there are teeth to use it upon. An ideal tooth powder
should be alkaline, since acids dissolve the tooth substance; finely
pulverised, that it may not mechanically abrade; antiseptic, to
prevent decomposition of food lodged between the teeth, and perhaps
to destroy the microbes which are always found choking the tubules
of carious dentine; it should contain nothing irritating to the
gums; and, lastly, it should be pleasant to the taste, or it will
not be used. Fluid dentifrices do not, as a rule, clean the teeth
effectually, unless they contain some ingredient which acts upon the
enamel itself; and those preparations which are eulogised as making
teeth white or preventing deposit of tartar, should be avoided.
Charcoal was at one time a very popular form of dentifrice, and is
even now largely used, but from the amount of silica it contains it
will rapidly wear away teeth that are not of exceptional hardness;
and moreover, the gums in some instances become tattooed in a curious
manner from absorption of minute particles. Pumice-powder, again, is
too gritty; and camphorated chalk is said to make the gums spongy.
Precipitated chalk forms the best basis for a tooth powder, to the
base of which may be added pulv. saponis and ol. eucalypt., 1 dr. of
each; and if there is no objection to the taste, ½ dr. carbolic acid.
(_Lancet._)
The tooth brush, which should be used night and morning, should be
small, and have its not too stiff bristles arranged in separate
bundles (in order that they may pass readily between the teeth and
into the natural depression). The outer and inner surfaces of both
front and back teeth should be brushed. The direction of the brushing
should be from the gums; that is, downwards for the upper teeth, and
upwards for the lower. This mode of cleaning the teeth is the best
preventive against decay, which causes toothache, and also against
the accumulation of tartar, which makes the breath foul, and in
course of time causes the teeth to loosen and fall out.
Toothache.--(_a_) The following is a formula recommended by Prof.
Babaieff in the _British Medical Journal_:--Melt 2 parts white wax
or spermaceti, and when melted, add 1 part carbolic acid crystals,
and 2 parts chloral hydrate crystals; stir well till dissolved. While
still liquid, immerse thin layers of carbolised absorbent cotton
wool, and allow them to dry. When required for use, a small piece
may be snipped off, and slightly warmed, when it can be inserted in
the hollow tooth, where it will solidify. The ease produced by this
simple method is really very great.
(_b_) The following remedy is given by a dentist of great
reputation:--First wash the mouth well with warm water, then use the
following tincture: 10 gr. tannin, ½ dr. mastic, 10 drops carbolic
acid, dissolve in ½ oz. sulphuric ether.
(_c_) Dr. Dyce Duckworth says toothache may be relieved by holding in
the mouth a solution of bicarbonate of soda, say ½ dr. in 1 oz. water.
(_d_) A correspondent of the _Electrician_ gives the following as an
instant remedy for toothache:--With a small piece of zinc and a bit
of silver (any silver coin will do), the zinc placed on one side of
the afflicted gum, and the silver on the other, by bringing the edges
together, the small current of electricity generated, immediately and
painlessly stops the toothache.
(_e_) Equal parts carbolic acid and collodion applied on a pledger of
wadding and thrust into the hollow tooth. Apt to cauterise the mouth
somewhat. The saliva must not be swallowed.
(_f_) Anæsthetic in dentistry: 6 dr. pulv. camphor, 1 oz. æther.
sulphur. Apply this to the gum surrounding the tooth to be removed,
until the gum turns white, when the tooth can be extracted with
scarcely any pain.
_Warts._--(_a_) Apply a little nitric acid (aqua fortis) very
carefully. Take a small stick--a lucifer match--dip it into the
acid, and so apply a tiny drop to the top of the wart. It soon
becomes yellow, and in a few days the top can be picked off. Repeated
applications in the same way are necessary.
(_b_) Light a match or taper and apply the flame for a second, till
you feel a sting, to the top of each wart, for 3 days in succession,
when a watery blister will form round each wart, which you must
burst, and throw all the warts away, which will be found to be quite
loose, causing no pain; they will never return again, and no trace of
them will be left after a short time.
(_c_) Prof. Unna recommends the continuous application of mercurial
ointment containing 5 per cent. arsenic or a plaster containing in
each 8 sq. in. 154 gr. arsenic and 77 gr. mercury.
(_d_) A plaster of black soap, applied each night for a fortnight,
according to Vidal, will soften a wart so that it may be scraped off.