point of a pin, the head of which is then to be held in the flame of
a candle until the wart is destroyed; it will drop off in a few days.
The remaining warts will then usually disappear.
(_f_) A touch of castor oil (the best) once a day. It is a slow
process, but, nevertheless, a sure remedy, and painless. Choose night
time just before going to bed, to rub in well a little castor-oil,
and then take a cloth or towel and rub any that remains off. Continue
it for a month or two, for it needs persevering in. In some cases
there will be no alteration for 2 months; but sooner or later they
all die away. Some die away and others can be taken off, as if they
had lost their roots.
SUPPLEMENTARY LITERATURE.
Spencer Thomson: ‘A Dictionary of Domestic Medicine and Household
Surgery: with a chapter on the Management of the Sickroom, by Dr.
Steele.’ London. 1883. 10_s._ 6_d._
John Gardner: ‘Household Medicine and Sickroom Guide: a familiar
description of diseases, remedies, methods of treatment, diet, &c.,
expressly adapted for family use.’ London. 1882. 12_s._ 6_d._
Charles J. Cullingworth: ‘A Manual of Nursing, Medical and Surgical.’
London. 1883. 3_s._ 6_d._
E. Symes Thompson: ‘Colds and Coughs; their causes and consequences.’
London, 1877. 1_s._
J. Milner Fothergill: ‘Food for the Invalid, the Convalescent, the
Dyspeptic, and the Gouty.’ London. 1880. 3_s._ 6_d._
Prosser James: ‘Sore Throat; its nature, varieties, and treatment.’
London. 1879. 6_s._ 6_d._
Edward John Waring: ‘Remarks on the Uses of some of the Bazaar
Medicines and Common Medical Plants of India, with a full index
of diseases, indicating their treatment by these and other agents
procurable throughout India, to which are added directions for
treatment in cases of drowning, snake-bites, &c.’ London, 1875. 5_s._
Gordon Holmes: ‘A Treatise on Vocal Physiology and Hygiene, with
especial reference to the Cultivation and Preservation of the Voice.’
London, 1881. 6_s._ 6_d._
W. H. Corfield: ‘Health.’ London, 1880. 6_s._
J. L. Milton: ‘The Hygiene of the Skin.’ London, 1877. 1_s._
James W. Allan: ‘Notes on Fever Nursing.’ London, 1879. 2_s._ 6_d._
John Beadnell Gill: ‘Indigestion; what it is, what it leads to, and a
new method of treating it.’ London, 1881. 4_s._ 6_d._
Erasmus Wilson: ‘Healthy Skin; a Popular Treatise on the Skin and
Hair, their Preservation and Management.’ London, 1876. 2_s._ 6_d._
Henry Thompson: ‘Cremation; the Treatment of the Body after Death.’
London, 1884. 1_s._
Florence Nightingale: ‘Notes on Nursing: what it is, and what it is
not.’ London, 1884. 2_s._
Henry C. Burdett: ‘Hints in Sickness: Where to go and what to do.’
London, 1883. 1_s._ 6_d._
William Henry Day: ‘Headaches: Their Nature, Causes, and Treatment.’
London, 1880. 6_s._ 6_d._
Mary Hooper: ‘Cookery for Invalids, Persons of Delicate Digestion,
and Children.’ London, 1883. 2_s._ 6_d._
E. Bibby: ‘Invalids Abroad; Hints on Travelling, Nursing, and
Cooking.’ London, 1879. 2_s._ 6_d._
Henry C. Angell: ‘The Sight, and how to preserve it.’ London, 1878.
1_s._ 6_d._
T. Wharton Jones: ‘Defects of Sight and Hearing; Their Nature,
Causes, Prevention, and General Management.’ London, 1877. 1_s._
Charles J. Cullingworth: ‘The Nurse’s Companion; a Manual of General
and Monthly Nursing.’ London. 2_s._ 6_d._
William Murrell: ‘What to do in Cases of Poisoning.’ London, 1884.
3_s._ 6_d._
Lionel S. Beale: ‘On Slight Ailments, including the Principles of
Treating Disease.’ London, 1887. 5_s._
M. Charteris: ‘Health Resorts at Home and Abroad; with a Section on
Sea Voyages.’ London, 1885. 4_s._ 6_d._
E. J. Domville: ‘Manual for Hospital Nurses.’ London. 2_s._ 6_d._
_THE BATHROOM._
BATHING IN GENERAL.
Bathing is of several kinds. There is the morning tub and the sea dip
which are taken to brace up the system; then there is the hot bath,
more for sanitary and cleansing purposes; and finally come hot-air
and vapour baths which are generally of a more or less medicinal
character. These will be considered in rotation.
_Cold Bathing._--All persons in health and of average strength may
use a cold bath daily, in summer at least. In winter, mornings of
extreme frost try the strongest constitution, and few are likely
to benefit by a plunge on these occasions. For the most part,
individuals of moderate powers and free from disease may carry the
cleanly practice of summer through the winter months. A word on the
bath itself. Those who take it should begin in summer, not winter,
and so become gradually accustomed to its lowest temperature. No one
should linger over it; 3-4 minutes are ample. After immersion, the
body should be quickly and well dried and rubbed before dressing.
Light gymnastic, dumb-bell, or club exercise, may occupy the next
few minutes, the clothes being partly on if the weather be cold, and
breakfast, or a cup of warm tea or coffee, should shortly follow, to
prevent chilling.
There are those whom a cold bath injures, instead of invigorating.
The readiest test of benefit is the glow of free surface-circulation,
or at least the absence of any decided sense of chill after
immersion. Some do not experience this. Among these are the subjects
of heart weakness, arising from whatever cause; it may be consequent
on organic disease of the heart, on old gout or rheumatism, or on
overwork and underfeeding, in which case it is a part of a general
debility. Again, there is in some a tendency to engorgement of one or
other deep-seated organ with blood, a kidney, the liver, &c. This is
commonly the result of a previous inflammatory attack, or of visceral
disease at the time existing. Surface-cold aggravates the congestive
tendency. Obviously, therefore, such persons, if they bathe, ought
to use tepid water; and, in renal disorders, this method is often
advantageous. In slight cases, cold is not injurious if the ablutions
be expeditiously gone through, and restricted to periods of summer
weather. The aged should avoid cold baths, and commonly do. Infants,
if ordinary despatch is used in bathing and in dressing, have no
reason to fear them. Their powers of reaction are excellent.
Cold baths chill down the feeble circulation of the badly nourished,
and provoke a physical torpor which is obstructive to the processes
of nutrition. They drive the blood from the surface of the body in
upon vascular organs, whose circulation is already sluggish from
general weakness. They thus produce discomforts which aggravate
existing languor, and enhance the feeling that food and drink ought
not to and therefore cannot be taken. A bath described as one “from
which the chill has been taken” is too cold for subjects under
medical advice who are in need of extra feeding.
In any case it is unwise to bathe out of doors when copious
perspiration has continued for some hour or more, unless the weather
be excessive or the sweating has been induced by loading with clothes
rather than by exertion. When much perspiration has been produced by
muscular exercise, it is unsafe to bathe, because the body is so
fatigued or exhausted that the reaction--that is, the return of the
momentarily displaced blood to the surface--cannot be ensured, and
the effect may be to congest the internal organs and notably the
nerve centres. From congestion of the nervous centres comes cramp, so
often fatal in bathing.
If the weather be “chilly,” or there be a cold wind so that the body
may be rapidly cooled at the surface while undressing, it is not safe
to bathe. Under such conditions the further chill of immersion in
cold water will take place at the precise moment when the reaction
consequent upon the chill of exposure by undressing ought to occur,
and this second chill will not only delay or altogether prevent the
reaction, but convert the bath from a mere stimulant to a depressant,
ending in the abstraction of a large amount of animal heat and
congestion of the internal organs and nerve centres. The actual
temperature of the water does not affect the question so much as its
relative temperature as compared with that of the surrounding air.
Practically, there ought to be a good deal of difference between
the two, the water being much lower than the air and the body
being--without great or long persisting perspiration--much warmer
than the water, of course, but not so much warmer than the atmosphere
as to be chilled by undressing. In short, the aim must be to avoid
two chills; first, from the air, and second, from the water, and to
make sure that the body is in such a condition as to secure a quick
reaction on emerging from the water, without relying too much on
the possible effect of friction by rubbing. It will be obvious that
both weather and wind must be carefully considered before bathing is
commenced, and that the state of the organism as regards fatigue and
the force of the circulation should also be considered, not merely as
regards the general habit, but the special condition when a bath is
to be taken. These precautions are eminently needful in the case of
the young or weakly.
Sea bathing is regarded, naturally, as more bracing in its character
than river bathing. The saltness of the water and the sharp air of
the sea together tend to invigorate us. As a rule, the bather can
remain longer, without injurious effect, in salt than in fresh water.
The sudden shock which results from a plunge into river or sea may
be attended by bad effects in the case of persons who are subject to
fits of any kind or to disturbance of the heart’s action. Another
highly important question in bathing has reference to the care of
the ears. Wherever any tendency to ear-ache or inflammation of the
ear exists, bathing must be cautiously indulged in. A dive has been
known to be followed by rupture of the “drum” of the ear, owing
to the sudden pressure to which this membrane has been subjected
in passing from the air under the water. Again, persons who have
suffered from discharges from the ears--common after scarlet fever,
for example--and in whom the drum of the ear may be perforated or
irritable, abscess of the brain may follow injury produced by the
sudden dive or by plunging the head beneath the water. Placing
cotton wool in the ears is a necessary precaution for any who have
tender ears, and a safe practice for all. Further, do not dive too
much and avoid swimming on the back, for from the position of the
ears the water gets into them a great deal more than even in diving.
When getting out, besides giving a good rub down with a rough towel,
always carefully wipe the ear and the glands behind the ear dry.
No child under 2 years of age ought, under any circumstances, to
be bathed in the open sea, and no one, child or adult, can enter
the sea without danger while under the influence of emotional
excitement. Under 2 years of age, a child’s body is too weak to
gain any benefit from the shock of immersion in the open sea. Its
nervous and circulating forces are too feeble for the development
of that vigorous reaction, without which sea-bathing is either
useless or hurtful. In the absence of strength for such reaction a
sea-bath tends to chill an infant’s body, and predispose to internal
congestion. At any age the shock of immersion in the sea brings
risk of danger, and even of death, when the emotions are powerfully
excited, and especially when the mind and body are dominated by that
most depressing of human emotions--fear. Infants are not always
bathed in the sea merely with the intention of making them strong.
There is an old seaside tradition that babies diligently bathed
become fearless in the water when they grow up. This notion is also
false. Than that infants gain courage by being plunged in the sea,
it is more probable that many a nervous child has acquired a dread
of bathing which no after-experience could remove, because it was
compelled in fear and trembling to plunge under water. If a child
be sufficiently robust to develop a good reaction, if it be over 2
years of age, and, above all, if it be not afraid, it may be bathed
in the sea with advantage. If any of these conditions be wanting,
sea-bathing for children is likely to be positively injurious.
(_Brit. Med. Jour._)
Attacks of cramp, to which even expert swimmers are liable, may
arise from many causes. Where special nervous diseases do not exist,
the so-called “cramp spasms” are, as likely as not, due to some
irregularity in digestion, or to some imprudence in bathing at wrong
times and seasons. Bathing after a full meal may induce so-called
“cramps,” and it is to be feared that many a fatal case of drowning,
attributed to some hidden nervous cause, has had a far simpler origin
in digestive disturbances reacting on the nervous system, and through
this system propagated to the muscles.
The ordinary rules--drawn up by the Royal Humane Society--which
should be observed by all bathers, whether in fresh or salt water,
and whether swimmers or not, are simple and readily borne in mind.
1. Never bathe within 2 hours after a meal.
2. Never bathe when exhausted or in ill-health. The practice of
plunging into the water after exercise is to be thoroughly condemned.
3. Never bathe when the body is cooling after perspiration.
4. A morning bathe may be taken by those who are strong and healthy
before breakfast on an empty stomach.
5. The young, or those who are delicate, should bathe 2-3 hours after
a meal, and in the forenoon, if possible.
6. The signs which forbid open-air bathing altogether are chilliness
and shivering after entering the water, numbness of hands and feet,
and deficient circulation generally.
7. When the body is warm, bathing may be indulged in, provided
undressing is quickly accomplished, and the body is not chilled
before entering the water.
8. On leaving the water, dry and dress _quickly_. Standing about
undressed, after leaving the water, is, under any circumstances,
injurious.
9. Rather cut short, than prolong, the bathe. Swimmers possess
the power of remaining in the water for a considerable time, in
consequence of their active movements. But even in their case injury
is often wrought by unduly extending the exercise. The slightest
feeling of chilliness should be taken as a sign to leave the water at
once.
It is a recognised fact that a sudden head douche of cold water
is apt to cause giddiness in many persons from its effect on the
brain-circulation, which forms in itself a peculiar part of the
blood-system. Cases of persistent headache, often accompanied by
giddiness and faintness, have followed sea and river bathing; these
effects having disappeared when the practice of plunging the head
below water was discontinued. Persons thus affected cannot do better
than omit the head from the bath, and, in shower baths, stoop forward
or lean backward and sidewise, so that the water shall fall on back,
chest, and shoulders, but not on the head.
_Hot Baths._--Concerning the bathroom, Edis remarks that whenever a
bath is provided, it is generally left open, and forms a receptacle
for dirt and dust, which is not always cleaned out when the bath is
filled. He suggests that the bath be slightly lowered into the floor,
and fitted with a hinged top, about seat-high from the floor, so as
to keep the bath clear of dirt, and when not in use make it answer
as a table or seat. A bathroom is often fitted up with cupboards for
linen, and if the hot-water cistern be placed in the room on the
floor level, or sufficiently high for use, or a coil of hot-water
pipes be carried through, the linen cupboard with lattice shelves
might easily be fitted over it, with closed doors of course, by which
the linen would always be kept properly aired; and if the room be
lined with tiles, there would be no fear of damp or moisture from
steam condensing on the walls. The bath should be formed in a recess,
with tile lining all round and overhead, and the recess might then
be fitted with cupboards over, and drawers and useful shelves at
one end, so as to provide storage-room for a large amount of spare
clothing and linen, which it is often so difficult to find room for.
A curtain drawn across the bath keeps it clean, and hides it from
view when not immediately required.
_Hot-air and Vapour Baths_, _Turkish Baths_, _&c._--The _Lancet_
expresses a strong objection to that form of bath which involves the
patient being in an erect or sitting posture, where the bath is used
to produce perspiration; it is always possible that some amount of
faintness or giddiness may be experienced by the bather even when
the blanket or tent-shaped envelope is so effectively applied as
to prevent the fumes rising to the mouth and being inspired. It is
always far better, and ought to be a rule, that the patient should be
in the recumbent position. With a properly constructed cradle-head,
the bed-clothes can be raised and the lamp placed safely in the bed
itself, the clothes being well tucked in round the neck and under the
chin, so that nothing may reach the mouth. In this way the patient
may enjoy the full benefit of a fairly high temperature without the
least fear of faintness. There are, nevertheless, certain precautions
which ought to be observed, and which are too commonly overlooked.
(_a_) A thermometer with a long stem ought to be so placed that the
bulb may be inside the clothes and the indicator-column visible
outside. Such a thermometer might with advantage be supplied with
the bath. It is always desirable to know the temperature of the
atmosphere to which the patient is subjected. (_b_) The moment
perspiration is induced there arises the question--How far ought it
to be carried? If the purpose of the bath be to eliminate fluid or
any product of tissue-waste from the body, there may be a need for
the maintenance of the cutaneous perspiration for some time: but
otherwise it is not, generally speaking, well to let the patient
remain in the heat for more than 10 minutes; otherwise, the result
can only be to saturate the bed-clothes with moisture, which will
begin to cool as soon as the lamp is removed, and after the lapse
of 20-30 minutes must place the patient in the perilous position of
lying, perhaps sleeping, in a damp bed. A hot-air bath for ordinary
purposes is better given in the morning than at night; or, if that
be impossible, the patient should be removed to a dry bed with hot
blankets. The body-heat can never be safely trusted to keep the
clothes, which have been saturated with moisture by a bath, warm
after the lamp is withdrawn. It is quite a different matter when
the perspiration has been raised by the heat of the body itself.
As a rule, the patient should be removed and wiped dry in about 20
minutes after the withdrawal of the lamp--that is, in ½ hour from
the commencement of the bath. If the perspiration be acid, it is
desirable to sponge the surface with hot water, in which about 1
dessertspoonful soda carbonate has been dissolved--say, in 1 qt.
water. (_c_) If the case be one of rheumatism or gout, it must be
recognised that by determining to the skin we are likely to get
increased stiffness and surface irritation after each bath until the
excrementitious material has been thoroughly eliminated. Overlooking
this fact, patients, and sometimes practitioners, fail to persevere
long enough with the baths, because, as it seems, each bath makes
matters worse.
A simple form of hot-air or steam-bath for home use may be made as
follows:--To the back of an ordinary wooden or cane-bottom chair fix
an upright piece of wood, and to this at the height at which the
neck of the sitter on the chair will be fix a hoop of cane or other
material sufficiently wide to keep the cloth to hang from the hoop
free from the shoulders of the sitter. Place beneath the chair a gas
or oil lamp or two, if one does not give sufficient heat. If, now, a
cloth be fixed round the ring sufficiently ample to reach the ground
and close all round the sitter, a tent will be formed from the top of
which the head of the sitter will project. Let the cloth overlap the
ring freely, so as to permit of being pulled close to the sitter’s
neck. Whilst taking this hot-air bath, the feet must be kept in a
basin of warm water. If there is danger of a headache, a cold wet
cloth on the head will prevent it. If a vapour bath is preferred,
place a pan of water over the lamp, so that the water may boil.
[Illustration: 127. Ellis’s Bath.]
Ellis & Co., of 47 Farringdon Road, London, have introduced a Cabinet
Turkish Bath, which dispenses with chair, lamp, sheets, and covers.
It is exceedingly simple, and consists of a neat cabinet (Fig. 127)
made of well-seasoned wood, taking up a floor space of only 2 ft. 5
in. by 2 ft. 8 in., and large enough to admit the person comfortably.
It is mounted upon castors, so that it may easily be moved from place
to place on the same floor; and it is light enough to be carried if
required. It is fitted with a foot-warmer, and with an adjustable
seat, so that it can be used by children and by adults of different
sizes. A book-rest is arranged conveniently, so that the time may be
pleasantly occupied, and small doors are provided through which the
hands may be passed in order to turn over the leaves of a book, or to
wipe the face, or to remove a cigar from the mouth, &c. The bath is
heated by gas, or by a special lamp in which spirit is burned. It may
be managed with the greatest ease without the aid of an attendant,
being, in fact, quite as simple as an ordinary sponge or sitz bath.
It is only necessary to fill the foot-warmer with hot water, covering
it with a piece of flannel, to light the lamp, and step into the bath
with a towel round the neck to prevent the heat escaping too readily.
Ample ventilation is allowed, so that the body is not exposed to
the action of vitiated air, since this is constantly being renewed
from outside. The bath constitutes, in fact, a small ventilated hot
chamber, the time spent in which may vary from 10 minutes to ½ hour,
according to pleasure. The prices of this bath range from 5_l._
10_s._, as made in best pine, to 9_l._, in black walnut.
MANAGEMENT OF HOT-WATER SYSTEM.
Before entering into the details of the management of a hot-water
system destined to supply baths, &c., it will be desirable to
acquaint the reader with the general plan and principle of an
apparatus, and to explain the cause of circulation, &c., as this will
convey some idea of the subject to be treated, for although many
possess an apparatus fitted in their residences, yet much practical
information cannot be gained from it, as a major portion of the work
is hidden from view.
[Illustration: 128. Hot-water System (Cylinder Form).]
Figs. 128 and 129 show two distinct forms of apparatus, both of which
are at present in general use, and both of which even now nearly
equally share the public favour, although No. 1 is the more modern
and has been proved to be practically superior to No. 2, and is now
nearly exclusively adopted by most firms who profess this work.
No. 1 is known as the cylinder system, and consists of a cylinder (a
square tank is sometimes used where the pressure of water is light,
tanks costing much less than cylinders of the same capacity) which is
placed at the nearest position to, but above the level of the boiler.
Two pipes connect the boiler with the cylinder, the upper pipe a
is termed the “flow,” and is carried from the upper surface of the
boiler to about 9 in. up the nearest side of the cylinder as shown,
and the lower pipe _b_, known as the “return,” is carried from a
lower position in the cylinder, under the “flow,” to within about 3
in. from the bottom of the boiler, either through the top, as shown,
or entering at the back or side.