To prevent the cramp returning, means must be adopted to increase vital energy in the system. Entire mental rest for an hour after meals must be taken. If the patient says "I cannot get this," then he simply will soon have to give up all work, and perhaps narrowly escape a departure from this working world altogether.

Each morning before rising, the compress should be applied as above for a short time; the back should then be rubbed with hot olive oil before dressing. This treatment, and proper rest, will prevent return of the cramp. If the patient falls asleep on the compress, allow this sleep to continue unbroken: it is invaluable. So also is the avoidance of all anxious thought, which is best secured by complete trust in a loving God and Saviour.

Croup, Less Serious Form.—The less serious croup proceeds from a nervous closing of the windpipe, the attack being brought on by any causes of irritation in the nervous system. In this case, when the fit reaches a certain stage, the throat opens, and breathing proceeds as usual. This croup is a cramp of the windpipe; the cramp is caused by an irritation of the nerves controlling it, which are already in a condition to be easily irritated. The cure is to apply cooling cloths to the spine. Take the child warm in bed in the morning, and rub the little back with warm olive oil. Ring out a towel of cool, not quite cold, water; fold this into a narrow compress, and place it along the spine; place a dry towel above it and wrap up warm. Change for a fresh cool towel in two or three minutes. If the child falls asleep on this, leave him till he wakes voluntarily. Rub the back again with oil before dressing. The cooling may continue for an hour or so. If this treatment fail, the child may be given medicine to produce vomiting, which frequently relieves. Before putting to bed at night wash the child all over with plenty of M'Clinton's SOAP (see), dry and rub over with warm olive oil. Continue this treatment for some days.

Croup, More Serious Form.—This is caused by an accumulation of material in the windpipe, which is coughed up in pieces of pipe-like substance, and which, if not removed, threatens suffocation. For treatment, first give sips of hot water (distilled water is best) frequently. We have seen only five teaspoonfuls of this taken by a child followed by the throwing off of such a quantity of matter from the throat as had nearly caused suffocation. The further treatment is the bran poultice between the shoulders, and cold cloths on the chest, as prescribed in the article on Bronchitis. These may not cure in all cases, but will do so in many apparently otherwise hopeless. The moment the symptoms are perceived, treatment should be begun, as this disease is very rapid in its progress.

When an actual attack of croup of this kind comes on, and is severe, it is usual to put the child in a warm bath. If the water is a little below blood heat, and laved on the back, this will go far to relieve; but it will not have a tenth of the effect which a cold towel will have, if placed along the spine. It is indeed wonderful how spasms and the various forms of cramp give way to this. When a little warm olive oil is first rubbed on and then off, there is no danger of cold or of any bad effect (see Cramp in Stomach). If this croup is obstinate, there may be more serious disease of the throat, and good medical advice should be had.

Cures Losing their Effect.—After a fortnight's treatment often matters seem to come to a standstill in a case, and then the attendants are apt to despair. Such a state of things indicate only the need for some change in treatment, or perhaps for a rest from treatment for some days. Common sense must guide, and the case may be more keenly looked into: it may have changed its character in the time that has passed, and different treatment require to be given. It is well not to give up until all has been tried which in any way seems likely to suit the case. All the various articles bearing on it should be carefully read and pondered, and no doubt the way to change the treatment will open up. See Changing Treatment.

Cures, as Self-Applied.—Often young people in lodgings are in difficulty for want of some one to apply the necessary treatment in their own case. It is often, however, possible to treat oneself quite successfully by exercising care and common sense. Help should always be got if possible, but where it cannot, it may be done without. In the case of applying cold cloths to any part, when it is necessary to change these frequently, a basin of cold water may stand by the bedside so that the patient can wring out towels without getting up. A still better plan is to have several towels wrung out to begin with—these may be hung over a rail or chairs until required. When the first has been heated it must be hung over the rail or chair so as to be as much spread out as possible. Evaporation will then cool it sufficiently to be used when its turn comes again. Each towel is to be treated in a similar way in turn. Four towels will give an hour's cooling with very little trouble in this way. So a bran poultice may be prepared and laid on the bed, so that one can lie down on it, and with the cold towels handy, as above, most effective treatment given. Common sense is the guide here, as everywhere in our treatment, and a little thought will solve difficulties at first apparently insoluble.

Damp Beds.—An ordinary bed which has not been slept in for some weeks, although perfectly dry to begin with, will become damp, even in a dry house, and, unless properly dried, will be a great danger to its next occupant. This is a preventable danger, and all who entertain guests should see that they are not exposed to it. Many a fatal illness is due to the culpable carelessness of those who put a guest into such a bed. Ignorance in such a matter is shameful. All who have charge in a house should fully understand their responsibility in this matter.

But if you are put into such a bed it is infinitely better to rise and dress, and make the best of a night of discomfort, than to sleep among the damp. If, however, you have so slept, and feel the bad effect, the best cure will be the SOAPY BLANKET (see). If this cannot be had, a good hot footbath, with the heat kept just comfortable for half-an-hour or more, will do very well. This should be done at the earliest possible moment.

It will add greatly to the efficiency of such treatment if hot water can be had to drink in small quantities, and often. A few drops of cayenne "tea" in the water will act as a gentle stimulant. Old-fashioned folk place great confidence in a "hot drink" in such a case. This is all very well if they only keep the alcohol out of it: that destroys vital resources, but never supplies them. We have known cases in which all power was lost through a single night in a damp bed. Possibly in these cases it might not have been easy to restore the lost vitality by any amount of treatment; but we rather think that a speedy application of genial heat all over would have restored it. In some apparently hopeless instances it has done so.

Deafness.—See Hearing.

Decline.—See Consumption.

Declining Limb, A.—See Limbs, Drawn up.

Delirium in Fever.—The best way of treating this truly distressing symptom is by cooling and soothing applications to the head. We have seen in one case large cool cloths applied to the head for some time every three hours or so. An almost immediate cessation of the delirium followed this application, and it only returned a few minutes before the time for the next cooling. If the pulse becomes rather slow than rapid, and the body rather cool than hot, while delirium still continues, then hot cloths may be applied to the head. When either hot or cold appliances are removed, rub olive oil into the roots of the hair, and dry off.

An excellent treatment is also to cover the whole head with soap lather. See Head, Soaping.

It is to be noted that the state of the patient determines the treatment. If he is hot, cold treatment is required. If he is cool or chilly, then give the warm treatment. If he changes from hot to cold, then alter the treatment accordingly.

In some diseases delirium occurs, not because of fever, but because of poisonous elements in the blood supplied to the brain. This is the case in liver and kidney troubles, when waste products are not got rid of by these organs as they should be.

To get these organs to work, the best thing is to drink half a teacupful of hot water every ten minutes for two hours at a time. Do this once a day for two days. Probably it will cause purging, but that is part of the cure. If the case does not yield in any way to this, a large hot bran poultice should be placed over the whole of the right side under the arm, from the spine right round to the breast-bone (see Bran Poultice). This should be renewed if necessary, so as to keep up the heat for an hour. Next day place a similar poultice over all the lower part of the back, so as to help the kidneys and bowels. Dry after these poultices, and rub gently with warm olive oil. The delirium will usually yield to a few days of such treatment. We have seen the reason under such treatment return with a rapidity that astonished the medical attendant. He had given the patient three months to gain what was complete in less than one. See Fever.

Depression.—This is usually a bodily illness, though often regarded as mental only. It appears in loss of interest in all that otherwise would be most interesting. A mother loses interest in her children, a man in his business, and so on. Students, and children overpressed at lessons, are apt to suffer from it. It is simply the result of a drain of energy from the system, until the brain has an insufficient supply. Those who have the care of the young would do well to watch carefully against this state coming on. If it appears, all work should be given up, and as much play take its place as possible. No cramming of ideas into a weakening mind can ever be equal to the possession of health and energy, as a preparation for life.

Treatment should be such as to restore energy. The whole back should be fomented with a large blanket fomentation, being rubbed with olive oil before and after. Let this be done for an hour in the morning; in the evening give the ARMCHAIR FOMENTATION (see). Carry this on for a week, and then rest for another week, only rubbing the back with a little hot olive oil each night. Cultivate open-air life; sleep as much as possible—eight hours at least, or better nine. Carefully prepared and easily digested food should be given, and change of company, scene, and climate are most effective helps; but rest from work is the chief matter. See Restlessness and Worry.

Diabetes.—There are two more or less distinct stages of this serious trouble; the first stage is generally curable, the second stage generally incurable. Yet good natural means of cure will very much alleviate even the incurable stage. The earlier as well as the later stages are marked by extreme thirst. This, in the case of some poor sufferers, is enormous. Gallons of water are taken, and the more is taken the more is wanted. But this thirst is not the effect of heat, as fever thirst is. It cannot be quenched by means of cold cloths often changed over the stomach, as fever thirst can. A sufferer in this disease will set a large pitcher down at the bedside to serve for the night, and drink it all before morning; but there is no extra heat anywhere to account for this. The thirst is more like that which is caused by eating very salt food. It points to the character of the juices which are affecting the stomach, and not to any heated condition of the stomach itself. The drinking is a desperate effort to dilute these juices; and, at least by cold water, that cannot be done. A wineglassful of hot water taken every ten minutes for an hour, or two hours, or three, or ten hours, as is felt to be comfortable, will do wonders in the early stages of this disease. This water, when taken at the right heat, at once mixes with the strongly concentrated juices of the stomach, and causes them to be easily managed by that and other organs. It is truly wonderful what this very simple remedy will effect by itself alone. The next thing to be noticed is the excessive hunger. The food, whatever it may be, fails to quell this hunger. Here, again, it is clearly the stomach with which we have to do. When the hunger is developed we should think the case further advanced than when thirst alone is experienced. The hot water meets this symptom as it meets the other. It is also of the very greatest moment to give right food. Oatmeal and buttermilk steeped together for a time and then moderately boiled, a very little salt or sugar being added, produces a food which we do not expect to see excelled by the most costly that can be got anywhere. Wheaten meal, or barley meal, will do as well as, and perhaps in some cases better than, oatmeal, but these may be chosen according to taste. The chief thing is the ease with which this food is converted into a large supply of the best of blood for all purposes of nourishment. Food containing much starchy matter, as white bread, rice, and all sugar, must be forbidden. To make up for this, an abundance of fat should be consumed. The bowels should be kept open by a suitable diet and exercise.

Now we come to the excessive urinary discharge which is so strong a feature of this disease. The body seems as if it were melting away in this.

We can benefit the kidneys vastly through acting on the liver, as well as on themselves. By a large hot bran poultice over the liver we can add new life to that, and whatever does so tends to benefit the kidneys. After using this large poultice, with plenty of oil rubbed on before and after, say three or four times, place it over the kidneys and use it as often there. If the heat is well kept up for an hour at a time, one poultice a day would do, but, if the patient desires it, twice a day will be all the better. It is good to do the best that can be done with the skin. By means of soap and oil rubbing, and the cleansing effects of diluted acetic acid, very considerable help may be gained. Good can be done by a hot fomentation of the feet and legs to the knees, with oiling after, so as to have these extremities in a comfortable state. Tea, coffee, and sugar must be avoided.

Diarrhoea.—Sudden attacks of this, though in a mild form, are very troublesome. An enema of cold water is in such cases often an immediate cure. The first injection may be followed by even an excessive motion, but if a second cold injection be given this will cease. But in more troublesome cases, where the patient is an infant, or very weak, this is not applicable. For such cases, mix equal quantities of honey and lemon juice (one or two teaspoonfuls of each), and add enough boiling water to dilute it for taking. Give this three or even four times a day. It will usually and speedily cure, and is relished by infants.

Often the cause of diarrhoea in infants is the infection of milk by flies (see British Cholera), or from dirty feeding bottles. Bottles with tubes should never be used. The india-rubber teat should be smelt to see that it is perfectly sweet and clean before the bottle is filled. Unsuitable or too rich food will bring this trouble on.

A tablespoonful of blackberry (or brambleberry as it is also called) jelly may be given—it is a powerful and simple remedy. In adults, a dose of castor oil, with a few drops of laudanum in it, will probably remove all trouble, if it be due to nothing more than indigestible food. Where the cold enema is dreaded, one of hot thin starch, with fifteen drops of laudanum in it, may be used for adults.

Stale vegetable or animal food, also impure water, are fruitful sources of diarrhoea.

The mind has a great effect on this trouble, anxiety and worry are frequent causes. See Worry. A comfortable seat by the fire, and an interesting book, will often relieve.

When the diarrhoea is very serious, use the four-ply flannel bandage. See Bandage; British Cholera; Dysentery.

Diet.—The composition of different articles of food varies. A turnip is not the same as a piece of cheese. It is more watery, and has more fibre in it, and we speak of it as less nutritious. There are, however, in almost all foods certain chemical substances present which have different duties to perform in the body, and which are present in widely different proportions in the various articles we use for food.

Water is the most common of these substances. Soups, vegetables, fruits, puddings, are largely water. Some foods contain less of it than others, but on the whole a very large, if not the largest, part of all food consists of water. This large amount is needed. Water makes up two-thirds of the body, and nearly two quarts are given off daily in the various excretions and secretions. If enough be not taken the tissues get dry, and Nature indicates her want in thirst.

Another of these substances is starch, or its equivalent, sugar. Rice, bread, and vegetables in general, are largely made up of this starchy or sugary substance, which, as it contains a considerable quantity of carbon, we speak of as the carbonaceous element in food. This is the substance which goes to feed the muscles, replacing the waste from work done, just as fuel is required for the fires of an engine.

Yet another substance in food is fat. It may be animal, such as beef or mutton fat, and butter, or vegetable, as the oils in nuts, in the olive, etc. Fat, like carbonaceous food, also goes to feed the muscles, but both are required in a healthy diet.

Of the first importance, however, is the proteid element in food. Meat, milk, cheese, eggs, peas, etc., contain proteid in considerable quantities. Its use is to repair the exhausted tissues themselves. The muscles and nerves get worn out in their daily work, and require rebuilding. This is what proteid goes to do, and from this, its high import in animal economy, is called Proteid (protos—first). Finally, in all natural foods there are certain salts, which also build up, e.g., lime, which goes to make up bone. These salts may be seen in the ash of any common vegetable after being burnt.

These four kinds of food substance make up our daily food, and a certain amount of each substance is required to replace the daily expenditure, a proportion which varies, however, under different circumstances. See Food in Health.

As the relative amount of proteid, carbonaceous matter, water, and salts, may vary considerably in different articles, we rightly have combinations of food at our meals. A pudding of corn-flour and water contains no building material, hence we add milk and eggs, which do. A meal of meat and cheese requires bread and potatoes, etc., etc.

Appetite is a good test of the amount and also of the particular kind of food required, provided the appetite is in a healthy condition. If a healthy man refrain from carbonaceous foods for a day or so, he feels a great longing for them, a sign that the body really needs them. It is of immense importance, then, that the appetite should not be accustomed to over-indulgence, for then it is no guide in our selection of foods (see Appetite). If disease indicates such over-indulgence, food should be restricted till the appetite is accustomed to a smaller diet. Bilious people, for example, may have accustomed their appetite to desire more carbonaceous and fatty foods than necessary. On the contrary, badly-fed people often require a coaxing of the appetite to eat strengthening foods, such as oatmeal, cheese, and brown bread.

In order to regulate our diet, it is of importance to have some idea of the composition of common articles of food. We get our food, as everybody knows, from the vegetable and animal kingdoms. The majority of the Anglo-Saxon race live on a diet of animal and vegetable combined, but many exclude flesh from their diet. In Southern Asia, for example, the vast bulk of the people rarely, or never, touch meat. The vegetable kingdom supplies us largely with the carbonaceous or muscle-forming food, whereas the animal kingdom is rich in proteid, or tissue-forming food. Much proteid, however, can be obtained from the vegetable kingdom—peas, beans, lentils, dried fruits, and nuts being particularly rich in it. We should endeavour to cultivate an appetite for these vegetables containing proteid, as it is a great mistake to rely entirely for this element on meat, as so many of our race do. The animal products—such as cheese, milk, and eggs—will also form an efficient substitute for much flesh-food. This simple diet suits both the brain-worker and the athlete, though each will have to make a selection of those foods most required by him. Certainly much animal food is liable to produce kidney disease, gout, and kindred troubles. If we have a tendency to corpulence (and many have this in advancing years), to resort to an exclusive meat diet will produce these troubles. Far better abstain from vegetables, such as potatoes, and from sweet dishes, pastry, etc., and eat largely of the green-leaf vegetables and fruits with the articles of a simple diet which build but do not fatten the body. (See Diet and Corpulence; Diet for Middle Age, and the Aged.)

Fruit is a very useful article of food. The acid helps to keep the blood alkaline (which alkalinity is necessary for the normal performance of its functions). It prevents acidity of the stomach. The dried fruits, such as dates, figs, raisins, are very rich in proteid. Nuts also are rich in proteid and in fat; they require, however, careful mastication. Mills can be purchased cheaply for grinding nuts; the ground meal, either alone or made into a cream, forms a delicious adjunct to stewed fruit.

Green vegetables are a much neglected food. The salts they contain are very useful. They require careful cooking. A cabbage boiled in the ordinary way loses in the water its valuable salts. In case of flatulence arising from indigestion, the use of vegetables may, however, require to be restricted, at least for a time. Some vegetables are palatable raw, such as salads and celery. Indeed, raw vegetables have a tonic effect on the bowels.

Bread should never be too fresh, and should be thoroughly chewed. Zwieback (twice baked) can be recommended, especially for those who suffer from indigestion. It is made by cutting bread, preferably wheaten, in thin slices, and putting these in a slow oven till thoroughly dry and lightly browned. Wholemeal bread should always be present on the table, as its use prevents constipation. Indian corn can be made into a number of palatable cakes, and is a very nutritious food. Home-made jam and honey are digestible forms of sugar, but like all sugar foods should be consumed in moderation, especially by sedentary individuals. Condiments should be avoided, the healthy appetite is better without them, and they irritate the stomach.

Regarding animal foods, they are often spoilt by over-cooking, and it should be remembered that when lightly done they are easiest to digest. White fish, tender steak, or juicy joint and cutlet are superior to the oily fish, and kidney, liver, and heart. These internal organs should be avoided, as they contain even more than the rest of the animal certain extracts liable to produce URIC ACID (see). Milk, cheese, eggs, and butter are not open to these objections. Cheese is a food very rich in proteid. It requires careful chewing, and may with advantage be grated before use. Buttermilk is a valuable and strengthening food. A generation or so ago the Scotch peasants lived almost exclusively on buttermilk and oatmeal, and were a magnificent type of men in every respect. Whey is a pleasant drink, and may be made a substitute for tea where the latter is prohibited. It is also beneficial for the kidneys. Jellies are a pleasant addition to the diet of convalescents, but have little nutritive value.

We would strongly urge upon our readers the advantages of simple diet. We mean by this the avoidance of all those rich and spiced dishes which are made up in so many ways to tempt the appetite, of alcohol in every form, of meat to the extent often consumed by the well-to-do, of pastry and such indigestible food as heavy cakes, of fried food in general; and, on the other hand, the adoption of a diet largely consisting of milk, cheese, eggs, butter, cereals, root and green vegetables, fruits, and nuts. It will not be found an expensive diet; on the contrary, it is remarkably cheap; it will give little trouble, for but little cooking will be needed. It may require some little effort at first, and some breakings with social customs, but far less of both than will be imagined. Seeing that a large part of disease is ultimately traceable to a rich and stimulating diet, and to too much food in general, simplicity is imperative on all who seek for the preservation of health. Eat less, eat better (or more slowly, with perfect mastication), eat simpler foods at your meals, eat at these meals only when you require it, and never between your meals. Such eating will ensure good digestion, good assimilation, good blood, and good health.

Diet and Corpulence.—A tendency to obesity should always be carefully checked by attention to diet and exercise (see Exercise). The fattening foods are those which contain either fat or carbonaceous substances. Carbonaceous substances are found in bread, sugar, arrowroot, puddings in general, pastry, potatoes. The fats, such as butter, cream, and animal fat, should be much restricted in their use. As we have above indicated, however, it is not wise, as many corpulent people do in their efforts to get rid of this superabundance of fat, to make up for their restriction by an increase in the quantity of meat consumed. Cheese, peas, beans, buttermilk, and oatmeal might with advantage be drawn upon instead. At the same time, if the circulation is good it is well with such proteid diet to increase the amount of water drunk during the day, as this helps to eliminate the waste which would otherwise overtax the kidneys. Green vegetables and fruits should form a large part of the diet.

It must be remembered that it is dangerous to strike out at once all fattening foods from the diet; many have injured their health permanently by such injudicious haste, and brought on floating kidneys, etc. Remember, also, that exercise is a much safer reducer of fat than a very great reduction in diet, unless there has been a decided tendency to continually overeat. All alcoholic beverages must be strictly forbidden.

Diet for the Lean.—To a large extent the preceding article will suggest what is suitable here, remembering, however, that regular exercise will be also necessary in order to enable the muscles to increase in size. Green vegetables and fruits should be largely used in addition to the carbonaceous foods, as their FOOD SALTS (see) are necessary to keep the blood in a condition to allow of proper assimilation. In the case of nervous and consumptive patients, the more digestible forms of fat, such as cream and butter, are to be recommended. Some thin people do not seem able to assimilate much fat. These cases will do better on a smaller quantity. Remember always that it is not what is eaten, but what is assimilated, that goes to increase the weight, therefore if any particular food is found, after a careful trial, to constantly disagree, it must be accepted that for that one at all events, it is not a suitable article of diet.

Diet for Middle Age and the Aged.—In advancing years when less exercise is, as a rule, taken, a restriction in the amount of food consumed is highly desirable. The increasing corpulence, which often begins to show itself from 30 to 40, is far from being a healthy sign; indeed, is often the premonitory symptom of serious disease. It should be remembered that a lessening quantity of food is required from middle life on. This applies to all the elements of food. It is noticeable that a fat person seldom lives to old age, most octogenarians being thin and wiry, and almost all attribute their long life to increasing watchfulness over their health, and largely over what they eat.

When a person is young and taking active exercise, a good deal of surplus food can be worked off, and if the excess be too great, a bilious attack tends to prevent any more being taken, for a time at least.

But as we get on in life, the surplus food, if much is eaten, is deposited in various parts of the body as fatty or gouty accumulations. The liver becomes deranged, and loss of health and strength are at once apparent.

It is then, as Sir Henry Thompson has well pointed out, that the fond but foolish wife often does her husband incalculable harm by her efforts to "keep up his system." She urges and tempts him to take more food, fetching him, between meals, cups of beef-tea, soup, or cocoa, when he really would be greatly the better of total abstinence from all food for several days. What we have said about appetite being the best guide applies to the old especially, and if they could but realize what a very small quantity of food is necessary, they would not be perturbed to find that their appetite guided them to eat very much less than at a younger age.

Milk, which is the ideal food for the very young, is for that reason often undesirable for the old, and it is a great mistake for such to drink much of it with solid food.

Diet for the very aged becomes mainly a question of invalid diet, and it must be remembered that much should be granted to the individual's choice and liking. All foods for the aged should be light and easily digested, and careful attention paid to proper cooking.

A striking example of lost health recovered and life and activity prolonged to a great age, by strict temperance in food, is Cornaro, a Venetian nobleman of the sixteenth century, who lived over 100 years. He says:—"Our kind mother Nature, in order that old men may live to still greater age, has contrived matters so that they should be able to subsist on little, as I do, for large quantities of food cannot be digested by old and feeble stomachs. By always eating little, the stomach, not being much burdened, need not wait long to have an appetite. It is for this reason that dry bread relishes so well with me.... When one arrives at old age, he ought to divide that food of which he was accustomed to make but two meals into four, and as in his youth he made but two collations in a day, he should in his old age make four, provided he lessen the quantity as his years increase. And this is what I do, agreeably to my own experience; therefore my spirits, not oppressed by much food, but barely kept up, are always brisk, especially after eating, nor do I ever find myself the worse for writing immediately after meals, nor is my understanding ever clearer, or am I apt to be drowsy, the food I take being in too small a quantity to send up fumes to the brain. Oh, how advantageous it is for an old man to eat but little! Accordingly, I, who know it, eat but just enough to keep body and soul together."

Digestion.—Digestion is the process whereby the food we eat is turned into material fit to be assimilated by the blood. It begins in the mouth by the mechanical grinding and crushing of the food, and the chemical conversion of the starchy part into sugar, in which form alone it can be assimilated. This conversion is carried out by the saliva. Hence the necessity for thorough mastication, even of sloppy foods that do not seem to require it, and for attention to the teeth in order that they may thoroughly chew. Alcohol and tobacco, as they spoil the saliva, are very unfavourable to digestion, and should always be avoided. Twenty minutes longer to chew one's dinner is worth a whole box of pills, and no one need expect good digestion who neglects thorough chewing and salivation of the food. This may, with advantage, be increased to an extent which most people would think quite absurd. It has been proved that when all food is chewed until completely reduced to a liquid, its nutritive qualities are so increased that about half as much will suffice. This is of immense importance in all cases of weak digestion, or indeed whenever an absence of vigorous health renders the economy of vital energy important.



In the stomach the food meets with the gastric juice, which has the property of turning proteid (see Diet for the various substances contained in food) into material ready for assimilation. The walls of the stomach are muscular, and their contraction churns the food with the juice. The gastric juice is secreted by glands embedded in the walls of the stomach, and is poured out when food is taken.

The whole food, now in the form of a paste, passes into a pipe about 12 inches long (the Duodenum), into which pours the secretion of the pancreas and that of the liver (bile). The pancreatic juice acts upon the starch which has escaped the action of the saliva, and also continues the work of the stomach. It furthermore emulsifies the fat or divides it into extremely fine drops.

The food passes now into a long coiled pipe—the small intestine. This secretes the intestinal juice which further assists the pancreatic juice. Absorption has been proceeding from the stomach onwards (see Assimilation). The mass of undigested food is pushed along the small intestine by means of muscles in its walls and passes into the large intestine where a similar process to that of the small intestine goes on, the remains of the food ultimately reaching the vent in a semi solid form, consisting of the undigested part and the debris of digestion.

During this complex process much blood and energy is needed for the abdominal region, therefore hard work or exercise should not immediately follow a meal. It will be noticed that each stage of digestion prepares the food for the next stage e.g., the mouth prepares the food for the stomach. Now, as the food ceases to be under our control when it leaves the mouth, every effort should, as we have said, there be made to prepare the food for its reception by the stomach. Chew food dry as far as possible, for that excites saliva. It is best not to drink till after the meal. The digestive powers often become weakened in advancing years, but may be greatly preserved, and even restored to health after long debility, by careful attention to the above hints.

Drinks made of lemon juice or orange juice and water are often very good to help an invalid digestion, but nothing is better than sips of hot water for some time before a meal. Distilled water is especially a most valuable drink. Cooling applications to a fevered stomach and warm fomentations to a cold one will often promote digestion marvellously. The feet and legs may be fomented if cold while the cold cloth is pressed over the stomach, especially if the process be long continued. Where heat is necessary it should be gradually and cautiously applied, so that sickening the patient may be avoided. (See also Assimilation, Food in Health, Indigestion).

Diet, Economy in.—Dr. Hutchison, one of our greatest authorities on the subject of Dietetics, has well said—

"The dearest foods are by no means the best. 'Cheap and nasty' is not a phrase which can be applied to things which you eat. A pound of Stilton cheese at 1s. 2d. contains no more nutriment than a pound of American cheese at sixpence. A given weight of bloater will yield more building material than the same quantity of salmon or sole.

"The upper classes in this country eat too much. The labouring classes are insufficiently fed—much worse fed than their brethren in America. One of the chief consequences is an undue craving for alcoholic stimulants; another is that our poor are not properly armed against tuberculosis and epidemic disease.

"How can this be rectified? Anyone who knows anything about the poor man's budget knows that he already spends as much on food as he is able. As it is, 50 per cent. of a workman's wages are absorbed in its purchase, so that half the struggle for life is a struggle for food.

"The only remedy is to buy the things which are the most nourishing and which yield the most energy. Quite a good diet can be obtained for fourpence a day, yet the average working man spends sevenpence.

"I advise the buying of more vegetable foods, particularly peas, beans, and lentils, and the cheaper varieties of fish. The working classes should also be taught how to cook cheese, and thus make it more digestible, as the Italians do. Cheese contains much building material, and is therefore a valuable article of diet.

"I strongly recommend one good meal of oatmeal a day, instead of so much bread, butter, and tea, which is the staple diet of so many poor families, because it is easily prepared, and because of human laziness.

"Skimmed milk is better than no milk at all, for it contains all the original proteids, and has only lost its fat. More dripping and margarine should be eaten, instead of jam; margarine being quite as digestible and nourishing as butter."

Vegetable oils are, however, more digestible than animal fats. Cocoanut butter is a cheap and excellent substitute for margarine or butter. As it contains no water it will go much further.

Another instance of bad economy is the use of cod liver oil. Butter or even cream are quite as fattening and much more digestible.

Malt extract is much dearer than honey, which is superior to it in value as a food.

To supply a healthy man with the amount of proteid required by him daily in beef extracts would cost 7s., in milk (a comparatively expensive food) would only cost about 1s.

Diphtheria.—The most striking symptom of diphtheria is the growth of a substance in the upper part of the windpipe, which threatens to close it entirely. Good medical skill is of first importance here, yet much may be done where that is not available. We have often seen the swallowing of a little hot water and treacle enable the children to throw up the entire obstruction and make the breathing perfectly free. Mark at once whether the feet are cold or warm. If cold, oil them well with olive oil, and pack in a hot blanket fomentation to the knees. When the feet and knees are thoroughly warm in this, put a cold cloth on the back of the neck down between the shoulders. Change this as often as felt comfortable. The throat may be brushed out with a weak solution of Condy's Fluid, but a strong solution of common salt will do very well. Good white vinegar and water (see Acetic Acid) is perhaps best of all. We have never seen this fail in changing the character of such growths, and if the windpipe can be washed out repeatedly with it, we should feel sure of a desirable result. Now, we have seen a humble working man's wife wash out the throat of her son as well as any medical man could do it, using Condy's Fluid for the purpose with full success. When you can, have the help of a medical man, but when you are so placed that such help is impossible, you need not fear to try yourself. If there is much fever, cold cloths may be applied to the head to reduce the heat. As the disease is strongly infectious, care should be taken to isolate the patient, and attendants should avoid his breath. Abundance of fresh air and light should be allowed to enter the room, and one window at least should be open as far as possible.

Douche, Cold.—In its most powerful form this is a solid stream of water directed down on the patient's shoulders and spine. It may be applied either by an apparatus fixed up for the purpose, or by merely pouring from a watering-can without a rose. Its power depends on the great heating in the skin which springs up when it is withdrawn. This heating power again depends on the strong shock given to the system when it is applied. Thus it will be seen that what is called a "Spray" or "Spray Douche" is of little use for the same purpose, as it gives little or no primary shock. It is with this application as with many. The patient's feeling benefit is the great and true evidence of the treatment being right. When the douche issues in bodily comfort and cheering to the mind, all is right. If it issues in discomfort, then some other treatment must be tried.

"Downbearing."—This expression will cover many troubles especially common among women, where the weight of the internal organs becomes distressingly felt. These are usually supported without our being conscious of their weight at all. But in weakness, or after long fatigue and standing, it becomes felt as a severe downward pressure. This is often caused by the pressure of corset and skirts upon the waist. In cases where it is troublesome, much help will be derived by adopting some device for suspending the clothes from the shoulders. This may quite cure the trouble (see Tight Lacing). For more serious cases, take daily a short SITZ-BATH (see) in cold water, with the feet in hot water. Internal syringing is often required, which is best done with the "Fountain Enema," and very weak acetic acid and water (see Acetic Acid). A more powerful application is to have cold water poured over the front of the body while sitting in the sitz-bath, from a watering-can with a garden rose on the spout. This must be done gently at first, and afterwards more strongly and with colder water. This also prevents the troublesome "flooding" from the womb, which so often accompanies "down-bearing." The water employed in the douche must be cold, but it need not be icy cold. Ordinary cold tap water does very well. In serious cases medical advice should be sought, as the womb may be displaced. A golden rule for the prevention of this distressing ailment is to pass water frequently. If women would always do this before pushing heavy furniture, hanging up pictures, &c., many internal ailments would be prevented, as when the bladder is empty there is little danger of the womb being displaced.

After the system has been weakened by a miscarriage, this flooding often occurs. Apply the above treatment: it checks the flooding, and braces the parts.

Drinks, Refreshing.—This is a matter of great importance to the sick. Nor is anything more important to be said on them than this, that the foundation of all such drinks must be water. This water must be pure, and is best distilled, or boiled and filtered. Long boiling will spoil water, and half-an-hour is long enough to boil. To add to this pure water, we may take the juice of half a lemon, sweetened to taste. Few patients will fail to relish this. A whole orange may be used instead of half a lemon. A substitute may be made by taking half-a-teaspoonful of good white vinegar instead of the orange or lemon. Also in many cases where the cold drink is not relished, it may be taken warm.

Dropsy.—This trouble is rather a symptom than a disease. It rises from accumulation of watery waste in the body, owing to improper action of the skin, lungs, or kidneys, and sometimes follows scarlet or other fevers and lung affections. By far the greatest danger in such cases arises from fashionable medicines. It is of the last importance that nothing should be given to lessen life by injuring already weakened vital action. It is when this is done by metallic preparations that such cases become very grave and even hopeless. There is a prominent error in connection with all dropsical tendencies, which should be removed. That is the idea that the "water" which collects in such swellings is similar to good drinking water, and that giving the thirsty patient water to drink is increasing his illness. The so-called "water" which swells the face, or the feet, or any other part of the body, in dropsy, is used-up matter such as is, in good health, removed (imperceptibly, in greatest measure) by the organs fitted for that purpose.

Water, especially if given about blood heat, is at once used for most important vital purposes. This hot fresh water mingling with the poisonous "water" of dropsy dilutes it—renders it not only so much less injurious, but tends powerfully to its removal. The thirst of the patient is in perfect harmony with this truth, as all natural symptoms are ever in harmony with nature. If there are convulsive attacks, they are the result of used-up matter returning into the circulation, and reaching even the brain and central parts of the nervous system. The cure is gained when the defective organs are brought to act well. It is shortsighted action to deal with the kidneys alone in this trouble. They often fail because they are overloaded through the failure of lungs and skin to do their part. First, it is well to act on the lungs by gentle rubbing with hot olive oil between the shoulders and over all the back—done best in a warm room by the fire, or in bed. This may be continued for half-an-hour or more twice daily. The skin may be stimulated by a smart sponging with vinegar or weak acetic acid, and a rubbing all over with soap lather, and afterwards with hot olive oil. This lathering and rubbing to be done at another time from the first rubbing for the lungs. Then apply a large warm bran poultice to the lower part of the back behind the kidneys.

We have often found the following simple treatment effectual, where the patient is not very weak. If there are any signs of heart failure, do not use it. But if the patient is fairly strong, it is most beneficial. You have a case, say, of dropsy in the abdomen: put on two folds of soft flannel, wrung out of cold water; put two folds dry over the moist ones. Keep away all oiled silk and everything of the kind. You will very soon have an astonishing outflow of insensible perspiration, but it passes off through the soft porous flannel without any obstruction whatever. You will find that under this the swelling soon comes down, and even disappears entirely. It is necessary, in such treatment, to renew the bandage so as to keep all fresh and healthful, but your work is abundantly rewarded. In such a case as this the matter to be passed off is so great that a cotton or ordinary linen bandage may fail, as being too impervious, when a flannel bandage will succeed. A Kneipp linen bandage is perfectly porous, and will not irritate the skin as flannel often does. Worn-out underwear can be kept for this purpose.

If stronger heat seems to be needed, a soft cloth four-ply thick, large enough to cover the whole lower back, should be dipped in CAYENNE LOTION (see), slightly squeezed, and placed on the back. Over this a dry cloth should be placed, and the patient should lie down on a bran poultice or hot-water bag for an hour or two. Afterwards the back should be rubbed with olive oil, and a band of soft new flannel worn round the body.

Even if the swelling is caused by rupture this treatment is the best. The rupture must be reduced (see Rupture) and sustained by a proper truss, for which the patient should apply to a responsible surgical instrument maker. This treatment alone has cured many dropsical patients. Where failure of the heart's action complicates the trouble, this treatment will usually relieve the heart as well as kidneys. For drink in such cases see article Drinks. For food give whatever is most easily digested and passed into good blood. Wheaten-meal food, oatmeal jelly, etc., are good. See also Biscuits and Water.

Drowning.—Many valuable lives have been saved by an elementary knowledge of what to do in the case of one apparently suffocated or drowned.

Commence treatment immediately in the open air, with the face down, neck and chest exposed, and all tight clothing such as braces removed.

The points to be aimed at are—first and immediately, the Restoration of Breathing; and secondly, after breathing is restored, the promotion of Warmth and Circulation. The efforts to restore Breathing must be commenced immediately and energetically, and persevered in for one or two hours, or until a medical man has pronounced that life is extinct. Efforts to promote Warmth and Circulation beyond removing the wet clothes and drying the skin must not be made until the first appearance of natural breathing, for if circulation of the blood be induced before breathing has recommenced the restoration to life will be endangered.



First: Roll the patient over on his chest, with one of the arms under the forehead, when the water will readily leave the mouth. Second: If breathing does not recommence then, place him on his face, supporting the chest on a roll of clothing. Turn the body gently on the side, then briskly on the face repeating these movements, about 15 times in the minute. (By placing him on his chest the weight of the body forces the air out; when turned on the side air enters the chest). Five minutes is the longest that can be afforded to this treatment. Third: Turn him on his back, draw his tongue forward, keeping it forward by a band passing over it and under the chin, placing the roll of clothing under the shoulder blades. Then, kneeling at his head, grasp the arms just below the elbows, draw them above the head, keeping them stretched for about two seconds. Then turn down the arms and press them firmly for two seconds against the sides of the chest. (The outstretched position allows air to be drawn into the lungs, the other position allows it to be pressed out.)



When a spontaneous effort to respire is observed, proceed to induce Circulation and Warmth. This is accomplished by rubbing the limbs upwards with firm grasp and pressure underneath the warm blankets, or over the dry clothing which through bystanders or other means should have been already procured, apply hot flannels, hot water bottles, heated bricks, etc., to the pit of the stomach, the armpits, between the thighs and the soles of the feet.

Allow abundance of fresh air to play about the patient. Administer a teaspoonful of warm water, and then if the power of swallowing have returned, give hot milk, coffee, etc., in small quantities. The patient should be kept in bed and a disposition to sleep encouraged.

The above treatment should be persevered in for some hours, as it is an erroneous opinion that persons are irrecoverable because life does not soon make its appearance, persons having been restored after persevering for many hours. The appearances which generally accompany Death, are: Cessation of the heart's action, eyes half-closed, pupils dilated, tongue approaching to the inner edges of the lips, lips and nostrils covered with a frothy mucus. Coldness and pallor of surface increase.



Cautions: Prevent crowding, avoid rough usage; if the body is on the back have the tongue secured. Never hold up the body by the feet. Never place the body in a warm bath, unless under medical direction, and even then only momentarily.

Dwining.—We give this name to a trouble from which we have been able to save some patients, as expressing best the general failure and weakness which sometimes constitute a serious danger, even where all specific symptoms are wanting. Some cases of this kind we have cured, when they were supposed to be hopelessly dying, by the use of simple soap lather. The skin of the patient is usually dry, and the pulse feverish. In such a case take lather, made as directed in article Head, Soaping, and spread it gently all over the stomach and heart. Repeat this six or seven times, keeping the patient warm in bed. Then, after drying, do the same thing to the back. This does immense good. For the general skin stimulation, rub over with the mixture for NIGHT SWEATS (see). The skin is rubbed over with this five or six times, once a day.

Where there is no feverishness, but rather cold feelings, then use the warm lather as directed, and rub well all over afterwards with hot olive oil. This treatment alone we know to have cured many.

Dysentery.—This is an affection of the bowels of the nature of diarrhoea, but much worse, as in it blood accompanies the bowel discharge. It usually begins as diarrhoea, and at this stage may be cured by either warm vinegar and water or simple cold water injected into the bowel (see Diarrhoea). Where there is any reason to suspect the water supply, that should be boiled for half-an-hour and cooled before use. Attention to the diet, taking for a time milk diet alone, is also important. Nothing can be better than boiled bread and milk, giving no more than the sufferer feels he needs. When the diarrhoea has passed into true dysentery, with blood discharge, or the trouble begins as such, then enemas of weak acetic acid, or vinegar and water, given warm (i.e., a little over blood heat), must be used instead of cold water. As much vinegar should be used as will make the mixture (see Acetic Acid) very slightly smarting when applied to a tender part of the skin—say, to the corner of the eye. What is wanted is just as much acid as will act healingly on the injured vessels, and no more. An enema of this water mixed with acid may be repeated as long as required with perfect safety and good effect every time. Even if the disease has made very serious progress, this will tell upon it powerfully. These warm enemas should be very resolutely followed up as long as they give the least comfortable feeling. No one who has not felt their magical effect can conceive how powerful they are. We have seen a patient on the point of giving in and lying down as a helpless invalid made perfectly fit for work in less than an hour by this mode of treatment.

Where the trouble has passed into that stage where the patient is much weakened, in addition to this the ARMCHAIR FOMENTATION (see) should be employed; or if the patient be too weak, the fomentation may be properly wrapped round him in bed without rising. If the patient be too weak for wrapping round the body, he may be first wrapped round the legs, and so strengthened as to stand the stronger remedy. Olive oil must be rubbed on the skin before and after fomenting. The heat may be kept up for an hour. If too weak to stand even this, the feet and legs may be first fomented, and afterwards the body. This treatment has saved many cases from disaster. See also British Cholera; Diarrhoea.

Dyspepsia.—See Indigestion.

Earache.—In the common form this is purely neuralgic. The nerves are in shape and distribution like some tender plant, the root in the brain or spinal cord, and the ends of the branches in the organs supplied by them with nerve power. They are best affected, and most easily cured, by applications to the root rather than the branch ends. This is greatly the case with earache, which is a trouble of the nerves of the ear—not those of hearing, but the ordinary nerves supplying the part. The remedy is to press cold cloths on the back of the head and neck. This will often give instant relief. It is best done when the patient is thoroughly warm. If he be cold and clammy in feeling, the feet and legs must be well fomented before applying the cooling. Rub all parts treated with warm olive oil when the treatment is finished.

Ears, Running.—In this trouble there is indicated a failure somewhere of the clearance of waste from the body. This matter gathers locally in the ear, where suppuration and discharge take place. A cure must not be directed to the ear alone, but first the general waste-removing system should be stimulated with special reference to its service in the ear. Rubbing the back with hot olive oil and gentle pressure for a long time, say forty minutes daily, will go further to cure the ears than anything which can be done to themselves. Gatherings, by this treatment, are often quickly dissolved and dispersed.

Where actual waste matter runs out of the ear, the treatment is to have a round camel's-hair brush and soak the interior of the ear, using the brush, with warm weak vinegar, or weak acetic acid, just sour to the taste; then brush with a little fine almond oil, and wipe very gently as dry as possible.

Another way is to syringe the ears very gently with this dilute acetic acid; do not force the acid strongly against the internal parts of the ear, but rather let it soak in. It may be continued as long as is felt agreeable. Do this twice a day; have also a good warm bran poultice placed at the back of the head and neck for an hour each day, oiling the skin before and after. This is best done at bedtime. If this treatment be pursued carefully, the ears should soon come right.

Ears, Singing in the.—Partial deafness is often accompanied by noises in the ear, which are very annoying. This is caused by the internal state of the ear, and is often due especially to the state of the aural nerve. Similar noises are heard also when we place our fingers in our ears, or when we hold a shell or hollow vessel against one of them. In the latter case, what we hear is the rush of blood in the vessels of the ear. In this way, singing in the ears often arises in the course of the treatment recommended in the last article for running ears. If it become too loud, a cessation of the heating at the back of the head, and a brief cooling application, will relieve it. Therefore, in such cases, it is well to use COOLING IN HEATING (see).

Eczema.—Skin eruptions, known under this name, have very various causes. Treatment must vary accordingly.

Where the cause is a failure of the skin to act properly, the whole skin of the body, especially the chest and back, will be dry and hard. In this case apply SOAPY BLANKETS (see).

If the soapy blanket be too severe on the patient, then apply general lathering with M'Clinton's Soap. Use a badger's-hair shaving brush, and have the lather like whipped cream with no free water along with it. We have known a few of these applications cure a case of long standing.

Where general debility is present, along with the disease, use all means to increase the patient's vitality. Simple diet is best (see Diet, Saltcoats' Biscuits, Barley, Assimilation, Digestion), and abundance of fresh air, within and without the house, by night and by day.

Where the disease results from a parasite, some ointment should be used, and is best applied under the immediate direction of a specialist in Diseases of the Skin.

Elbow Joint.—See Armpit Swelling and Bone.

Enemas, Cold Water.—Prejudice often exists against cold treatment of any kind, but it must be overcome, unless the sick would lose some of the most precious means of relief which we possess. The Enema Syringe, or Fountain Enema, may be had from any druggist, and is used to inject liquid into the lower bowel. To inject cold water by this means is a most efficient method of relief for internal heat and irritation, as well as for DIARRHOEA (see). Sick headaches are also often instantly cured by this means. What we are here concerned with, however, is to say that this remedy is as safe as it is simple, so long as discomfort is not felt by the patient. Cold enemas may be given repeatedly, where they are felt to be comforting, without any danger whatever. If the bowels move after the first application, there is no need to be alarmed. Repeat the cold injection, and the diarrhoea will cease. The cold enema does not produce or aggravate constipation; on the contrary, it often relieves and cures the sluggish bowels. In cases where medicine has to be almost constantly taken, its use, and the disuse of the drugs, will often effect a complete cure. In many instances in which outward cooling cannot be borne, the thermometer will indicate that there is excessive internal heat, and the pulse will be quick also. In such cases it will be possible to give the most delightful relief by cautiously applied internal cold.

Fever that might be relieved by cold packing and sponging with vinegar, or some such means, will be far more speedily reduced by these cold injections, and fever which cannot be reduced by these means alone will give way when this is added.

There are cases in which a sort of paralysis of the lower bowel renders what is called "opening medicine" constantly necessary. The consequence of these continued doses is to produce greater and greater paralysis, and ultimately death itself; in these cases the cold enema is of great value. If there is lack of power in the bowel, it is well to increase it by a warm bran poultice, or hot bag on the back, and to brace the vessels and muscles within with the cold enema. (See Constipation.)

Epidemics.—The key to action in case of epidemics prevailing in the district is found, when we consider that always, many residing amid infection escape it. They do so in virtue of better resisting power, rather than because no seeds of disease ever reach them. In case of epidemic, then, besides daily sponging with acetic acid or vinegar, and scrupulous cleanliness, everything should be done to increase health and vitality in the household. Plenty of fresh air and sunlight, open windows day and night, and good plain food, are most powerful aids to resisting disease. The milk and water used in the household should all be boiled and allowed to cool before use, the boiling lasting half-an-hour. The family where all this is done may expect to escape infection, and therefore may maintain that calmness and freedom from fear which is itself a very important help against it.

Epilepsy.—The first sign of such an illness is a brief and slight attack of "absence." We notice once or twice that the person "loses himself" for a few moments, but recovers so speedily that we scarcely are sure whether anything of importance has occurred. He is perfectly unaware that he has so "lost himself" or been "absent" at all. That part of the brain on the activity of which consciousness depends has been for the moment inactive.

There is another symptom—that is, the "falling" which gives one of its titles to this malady. It is called "the falling sickness." There is a peculiarity in the falling of one who is affected in this way. In some cases consciousness partially remains, but the balancing power of the brain is lost. A patient in this case sees the ground rise till it strikes him violently on the forehead. We remember a friend telling us that he was walking along a railway, when all at once the rail seemed to rise and strike him in the face: he had fallen on the rail, and seriously wounded himself. The same thing occurs to the person who has taken enough alcohol to deprive him for the time of brain action for the usual balancing of his body. Just as there is a certain part of the brain which gives men consciousness, so is there a part which gives muscular control, such as we use in balancing the body, and there is a stream of vital action flowing from the nerve sources by which both are supplied. If this stream is diverted from these organs, "absence" and "falling" are the natural and necessary result.

There are many cases in which there are only "absence" and "falling," but in others, symptoms much more alarming appear. The next of these which we notice introduces us to a totally distinct element in our explanation. It is found in the "screaming" that follows instantly on unconsciousness, and precedes the "falling" generally. The sufferer is entirely unaware of all that occurs with him, and screams by no voluntary act on his part. The symptom is purely bodily, and expresses no thought or feeling, good or bad, though it is similar to the scream of terror, and makes the same impression on the uninformed hearer. The muscles are used in the scream of epilepsy, just as the muscles of ordinary movement are used in St. Vitus' Dance, but there is nothing of the mind whatever in the movement. The organ of the mind is unsupplied with vital action, but the organs of voice are over-supplied. It is beyond doubt this over-supply which shows itself in the scream, for there is nothing else to account for it.

The same thing is true of the movements of the jaw that are so terribly strong, and so sorely wound the tongue, in the case of those suffering in this way. The jaws open and shut with great force, and without the mind regulating their movement. All the motor nerves are convulsed with strong action, and the muscles they supply are wrought to the utmost, while all consciousness and control are entirely suspended. There is such an overwhelming supply of activity to the mere muscular system that the sources of that supply are soon exhausted, and the motion ceases for a time. Consciousness does not at once return fully, but the convulsions cease, and something like a sleep follows before the brain has its needed supply.

How is it that vital action seizes these mere motor nerves and leaves the brain? There is a symptom in cases of epilepsy which tends to throw some light on this question. It is seen in the extreme activity of the brain, indicated by the incessant talking of the patient before a series of convulsions come on, when taken along with the extreme depression and silence that follow such a series. During whole nights, even, the sufferer will talk, till every organ is exhausted; then comes a series of violent convulsions, then a season of perfect silence and bewilderment.

This explanation of the disease points to the remedy. That which will nurse the brain, and at the same time lessen nervous force in the system, will tend to cure the evil. Strong fomentations round the lower part of the body may be used. Soap in fine LATHER (see) should be made to cover the skin at bedtime, and washed off with weak ACETIC ACID (see) in the morning. Easily digested food should be taken, and all so-called stimulants strictly avoided. We should endeavour to secure the soothing of the spinal system of nerves. This is done in a degree that is incredible to those who have not actually witnessed it by a persevering use of the cold treatment of the back. The best time is early in the morning, after the patient has had a good night's sleep. For a whole hour spinal treatment should then be used. We have no faith in any royal road to success in such a cure, but we have faith in common sense and right good work. Taking three towels, and putting two of them in cold water, the "operator" is ready to begin. It will be well first to rub the patient's back gently with a little warm olive oil. This will obviate all danger of shock or shiver when the cold cloth is placed on the skin. Then wring out one of the cold towels thoroughly, so as to have it damp and not dripping; fold it lengthways eight ply. Put the one over the other, place both on the centre of the patient's back as he is sitting up in bed to receive them, keeping the damp towel next the skin. Adjust these cloths nicely, make the patient lie down upon them, and cover him snugly up with the bedclothes. So long as the feeling is nice, let well alone. When the towel becomes hot, wring out the second, and change it on the back. Carry this out for a full hour, and if the patient is disposed to go to sleep again, encourage him to do so.

Continued for weeks every morning this humble treatment, without any addition, has an incredibly soothing effect on an excitable system. But it will be well to add to it some nursing of the head and feet, so that every encouragement may be given to a diffusion of nerve action over the body. At night, before going to bed, the feet and legs should be bathed in hot water for a quarter of an hour, dried, rubbed gently with warm olive oil, and a pair of soft cotton stockings drawn on. While the patient is being treated, every possible wearing and irritation of the brain must be avoided, and when lying on the cold towel, the head should be soothingly rubbed by a gentle hand. If an actual violent attack comes on, loose all tight clothes, place a piece of cork between the patient's teeth to prevent biting the tongue, give plenty of fresh air, and keep the patient in a recumbent position.

Everything should be done, by training, to increase the patient's self-control, and all stimulants should be avoided as most injurious. See Head, Rubbing the.

It is important that those liable to these attacks should be kept employed. Nothing is so harmful as idleness. Everything tending to good health is of value, but the essentials of the treatment are found in soothing the spine as above, and stimulating the brain by the head rubbing. Unless in cases in which the very structure of the system has been, so to speak, altered by long-continued disease of this sort, we should look for good results from such treatment as this. Even in the worst cases it would be possible to mitigate the severity of the distress.

A difference in the focus of the eyes often causes a strain on the brain in the effort to adjust them. This sometimes causes epilepsy, and we have known many cases cured by the use of spectacles made to correct this inequality. In all cases of this disease, therefore, an optician should be consulted, to see if there is any defect in the eyes.

Other illnesses are sometimes mistaken for epilepsy: for example, the liver and kidneys in a defective state and impurities passing in the blood to the brain, will explain certain forms of that which passes as epilepsy. It is often easy to cure attacks of this nature by merely bringing the liver and kidneys into working order. If there is a yellowness of the skin, or other signs of the blood failing to be purified in a natural way, then that should first be dealt with, and the fits will often be removed as soon as good action is established in the purifying organs. But in all cases in which there is anything like real "fits," it will be found of great importance to study the over-and-under-actions of the nerve system as by far the most essential elements in the disease. See Jaundice.

Eruptions.—See Hives; "Outstrikes;" Saltrome, etc.

Erysipelas.—This troublesome disease is also known as St. Anthony's Fire, or the Rose. The skin becomes fiery red or even purplish in hue. A violent heat and pain in the part accompany this, and fever and general disturbance of the system follow in a severe case. Swelling of the parts follows, with much distress and danger. Air irritates violently the sore parts, and is usually excluded.

In curing the trouble, regard must be had to the cause, which is usually a general failure of strength from overwork, worry, or some other disease. If a cure is to be effected, rest of mind and body is necessary, and must be secured at any possible cost. For local application, the sore parts are thickly dusted with fine fresh flour, and covered with soft wadding or surgeon's lint. The air is excluded, and all is kept strictly dry. A waterproof covering over the lint will help this, but is not absolutely necessary.

But, now, is there nothing that can be done to quicken that inner action, the slowness of which has paved the way for all this mischief? This might be done in two ways. After the affected parts, say the face, have been secured in this pack of flour, it will be easy to place a hot blanket, soaked partly, but not at all wet, with boiling water, all round the head of the patient. As soon as the heat begins to enter the head, a sense of comfort will be experienced. Care must be taken to keep the inner cloths dry, and heat is best given by an india-rubber bag. When this cannot be had, however, the blanket may be used. At intervals, as the patient feels it desirable, this fomentation may be renewed. It will hasten recovery as well as arrest the spreading of the malady, while it will secure such recovery as will not readily dispose to a return of the evil. The feet and legs are likely to be cold. As the sufferer lies still in bed, but not when the other fomentation is on, these should be wrapped in a hot fomentation, allowed to lie in it for a good half-hour, taken out of it and dried, rubbed with warm olive oil, and covered with a pair of soft cotton stockings. If this treatment is at all well carried out, the feeling of comfort given will soon tell how it is working. Of course, if the feet and legs are the parts affected, the fomentation must be applied elsewhere, say on the back, or on the haunches.

Where erysipelas appears in connection with wounds or sores, the same treatment is to be pursued, as far as possible consistent with dressing the sores. These should be carefully cleansed, dusted with boric acid, and covered with a layer of wadding bandage. The limb should be raised to a horizontal position. Simple food should be given, and the sufferer kept quiet. In all cases of skin trouble, linen should be worn next the skin. See Underwear.

Exercise.—Where this is advised medically, it is often taken in a manner far from wise. For weakly people seeking strength, exercise should never be pursued to the extent of fatigue. Up to a certain point it does good; beyond that, harm. The beginning of harm is indicated by the feeling of weariness. At the same time it must be remembered that what is felt as weariness may be merely laziness. This must be energetically combated. There is no royal road to health any more than to learning.

In some cases this disinclination for exercise may arise from too much or too rich food, and a more sparing diet may remove it. See Appendix; Physical Culture.

When even walking is out of the question, a kind of exercise may be given by gently massaging the limbs while the patient is in bed. The back muscles should also be gently rubbed and kneaded, so as to cause them to move under the skin, without effort on the patient's part. But no fatigue must be caused. The amount may be gradually increased as the patient can stand it. See Brain Exercise; Massage.

Exhaustion.—Often very serious trouble takes the form of simple overwhelming weariness. The patient's system has been wrought down till it can no longer respond even to stimulus, and life itself seems ebbing away. In such cases treat as for DEPRESSION (see) avoiding too energetic treatment, and gradually infusing new life by massage and fomenting.

Expectoration.—What is commonly called a "cough and spit" is sometimes due to some serious trouble of the lungs, and in all cases a doctor should be consulted at once. Often, however, it is due to the failure of the skin or other organs duly to carry off the waste of the body, which then accumulates in the air tubes. If we get a good revivifying treatment of the skin, such cough and spit will speedily be cured. A mild vapour bath, with thorough SOAPING (see Soap) will usually be sufficient in a slight case.

Sometimes there is a sweating of the skin itself which does not cure expectoration, but which must itself be cured. That is the night or early morning sweating, which is very reducing. It is the insensible perspiration which is needed to remove the spit. Give one good sponging over the body with acetic acid; follow this the evening after with cayenne "tea," afterwards rubbing with warm olive oil. For two or three evenings repeat this treatment. There should then be a loosening of the phlegm, and a lessening of the flow through the lungs. The sufferer may be very weak, and yet these things may be so gently and kindly done, that no fatigue is experienced.

If above treatment does not cure, the SOAPY BLANKET (see) may be used once a week, with daily sponging with vinegar or weak acetic acid, and rubbing with warm olive oil. This should cure in a few weeks, where there is no real disease.

Eyes, Accidents to.—Three distinct classes of these are to be considered. They require very different treatment.

When the eyeball is cut or pierced, if the cut be deep or large, a surgeon must deal with it. But if small, a drop or two of castor oil let fall into the eye will often be all that is required. Where inflammation comes on, the tepid pouring recommended below for bad eyes will greatly help. If more severe, the treatment for inflamed eyes may be given. Perfect rest and thorough exclusion of light are very important.

If the eye is bruised, bathe with warm water, to which a little vinegar or boracic acid has been added. If after bathing, pain continues, drop in castor oil, and on the outside of the eyelid lay a pad dipped in a mixture of equal parts of laudanum and water. Change this cloth frequently until the pain is relieved.

Treat in this way also for insects stinging the eye.

When the eye is burned, either by sparks or by some burning chemical substance, cold cloths should be persistently applied to the eye. The softest rags or surgeon's lint should be cut up into small pieces that will just cover the eye. Dip these in the coldest water, and press it out a little, so that it will not run off. Place these little bits of wet cloth one after another on the eye or eyes affected. The patient will not be able to endure pressure further than the weight of the cloths themselves. These can be taken off and changed for cold ones as the feeling of the sufferer directs. After a time the cooling will be felt to have gone far enough, and the cloths may be allowed to lie; when they get too warm they can be taken off, or if the heat and pain return they can be renewed.

While this treatment is going on it will be necessary to open the eyelids at intervals, so as to let off the tears that collect in such cases and cause great distress. These will flow out when in the most gentle way you have laid one thumb on the upper eyebrow, and the other just below the lower eyelid, so that you can draw the lids just slightly open.

Eyes, Cataract on.—This disease has been arrested, and in earlier stages even cured, by the treatment described in, Eyes, failing sight. By means of this treatment we have seen a totally blind eye restored in a few weeks.

Eyes, Danger to Sight of.—Where inflammation has gone so far as to lead to suppuration, or even to ulceration of the eyes, there is grave danger of blindness, and this is often the case with infants and children who have been wrongly treated or neglected. In such a case, cease at once all irritating and painful treatment and drugs. First, wash the eyes by gently dropping over them distilled water, or boiled rain water which has been cooled. The water should be used about blood heat.

After an hour or so, have another warm bathing by means of gentle pouring over the eyes, but do not rub the eyelids. Let there be no friction beyond that of the soft and warm water running over the face in the bathing. Rather have patience till that washes all waste matter away than run any risk of irritating the eyeball. All this time watch what the sufferer evidently likes, and follow his likings—that is, as to warmer or colder water, and so on. It will not be very long before you have thoroughly cleaned the eyes, while at the same time you have infused fresh life into them. To the water used a little vinegar or acetic acid should next be added, or Condy's fluid may be used when it is convenient. But care must be taken that no great smarting is caused. See Acetic Acid.

As the discharge from ulcerated eyes is very infectious, care should be taken not to communicate it to other persons' eyes. Strict cleanliness should be observed, and all rags employed should be burnt, and disinfectants used to cleanse the patient's and nurse's hands, etc. Towels should be boiled for half-an-hour before being washed, after they have been used in such a case.

Now a most important matter must be attended to. Castor oil is the most soothing that can be used with the eyes. Fresh olive oil comes next, but it is usually just as easy to get the one as the other. With a feather, or fine camel's-hair brush, and as gently as possible, cover the eyelids with this oil heated to about blood heat. Do not try to force it on the eyeballs, but if the lids open so much as to let it in, allow it to lubricate the eyeball also. Rub it gently over the eyebrows and all round the eyes, and dry it gently off. Cover the eyes then with a soft covering, and let them have perfect rest.

It sometimes happens that a tiny piece of dust or iron may stick in the surface of the eye, and refuse to be washed away by the tears. Take a square inch of writing paper, curve one of the sides of it, and draw it lightly and quickly over the spot. Never use any sharp instrument or pin. Repeat the operation a few times if unsuccessful.

Diet as recommended in article Eyes, Hazy Sight.

Eyes, Failing Sight.—This often comes as the result simply of an over-wearied body and mind, without any pain or accident whatever. It appears as an inability to see small distant objects, or to see at all in dusky twilight. The sight is also variable—good when the patient is not wearied, and bad when he is tired. When this comes on under thirty years of age, the eyes have almost certainly been overworked, and need rest. Rest from all reading and other work trying for the eyes is the best cure. If this can be had, it should be taken, with much outdoor exercise. Fresh air is a fine tonic for the eyes. Where total rest cannot be had, take as much as possible, and nurse the failing nerves as follows. Apply the bran poultice, as directed for inflamed eyes, just as long as it is felt to be comforting—with one patient it will be longer, with another shorter. Now there is a cooling of the brow and of the eyes themselves, which is as important almost as the heating of the back of the head. We always find, as a matter of fact, that a cold application opposed to a hot one produces a vastly better result that two hot ones opposed, or one hot one by itself alone. So we find in the case of the eyes. We have now, as we write these lines, eyes under our care that are mending every day by means of a bran poultice at the back of the head and neck, and a cold cloth changed on the brow and eyes. They do not mend anything like so well if heat alone is used. Rub the back of the head and neck with hot olive oil before and after poulticing, and dry well. Do this for an hour at a time, twice, or if possible three times, a day. Continue for a fortnight, cease treatment for a week, and again treat for another fortnight. This should make such improvement as to encourage to further perseverance with the cure. Sometimes failing sight follows neuralgia. In this case the rubbing described in Eyes, Squinting, given twice a day for fifteen or twenty minutes each day, will be useful in addition to above treatment.

Even in cases in which "cataract" is fully formed, we find that the disease is arrested, and the patient at least gets no worse. But where this malady is only threatened the haze soon passes away. We most earnestly wish and pray that this simple treatment should be as widely known as there are failing eyes in this world of trial.

Eyes, Hazy Sight.—Frequently, after inflammation, and even when that has ceased, the sight is left in a hazy condition. The eyes may be in such cases rather cold than hot, and not amenable to the cooling applications. The whole system also lacks vital action. First, in such a case, wash the back thoroughly all over at night with hot water and SOAP (see). Dry well and rub hot olive oil into the skin until dry. In the morning rub the back for a few minutes with vinegar or weak ACETIC ACID (see) before getting out of bed, dry, and rub with warm olive oil. A strip of new flannel should be sewn on the underclothing, so as to cover the whole back. The feet and legs should be bathed (see Bathing Feet) twice a week. All alcoholic drinks, and most drugs, should be avoided, while only such food should be taken as can be converted into good blood. Half a teacupful of distilled water should be taken before each meal. The whole of this diet tends to produce healthy blood, which is the great means of dissolving all haziness in the lenses and humours of the eyes.

Every drop of alcohol does so much to reduce that action. We have heard this beautifully described by one of the foremost of living medical men. He began by stating, what no one can doubt, that a certain quantity of alcohol taken by the strongest man will kill that man as effectually as if he were shot through the head with a rifle bullet. Now a certain portion of alcohol takes a man's sight entirely away. Half that quantity will only render his vision "double"—that is, unfit him to see objects as they really are. Half that again will only perceptibly impair the power of the eyes; but the action of the smallest particle of the substance is the same in nature as that of the largest quantity. Hence that action is to reduce the very efficiency of the nerves of the eye, which it is of such immense importance to nurse to the uttermost. No mere dictum, however strongly expressed, can hold for a moment against this transparent reason. Hence, if a person must take alcoholic liquor, the cure of inflammation in his eyes, and of the thickening of the transparent portions of these organs, is simply out of the question unless the disease is comparatively slight, and his nervous constitution strong.

The very same reason holds good of tobacco. So of opium. So of every other narcotic, whatever it may be called. Hundreds of men lose their eyesight by the use of tobacco alone. We have seen their eyeballs gradually becoming sightless when no change could be detected in their eyes—only the optic nerve gradually lost its sensibility till they were entirely blind. We are perfectly aware that there are those who will scout the idea of such an effect, and prescribe these very narcotics largely in such cases; it is because such drugs are used and ordered that we are compelled thus to reason about them. In all cases of failing eyesight they should be carefully avoided. So should all foods which are not easily converted into healthful blood.

Eyes, Healthy.—Cheap, ill-printed literature is responsible for much eye trouble, and it is well worth while to pay, if possible, a little extra for books well printed, especially in the case of those who read much. When reading sit erect, with the back to the light, so that it falls over the shoulder. Too fine work, dim light, wrong diet, and want of exercise produce the dull and strained eye, which eventually becomes seriously diseased. Opening the eyes under cold water will help to strengthen them, and massaging the muscles of the eye by passing the finger and thumb round the socket (with scarcely any pressure on the ball itself) will be found of advantage.

Eyes, Inflamed.—For all kinds of burning inflammatory pain in the eyes, the following treatment is most effective. Place a hot BRAN POULTICE (see) beneath the back of the head and neck while the patient lies on the back. Press gently fresh cool damp cloths, frequently changed, all over the eyeballs and sockets, so as to draw out the heat. No one who has not seen this done can imagine how powerful a remedy it is. It may also be necessary, if the feet be cold, to foment up to the knees. This last fomentation is best done at bedtime, and the feet and legs should be rubbed with olive oil, and a pair of cotton stockings put on to sleep in, to keep the feet comfortable.