Nervous Prostration.—Persons suffering from nervous prostration have probably allowed the urgency of seeming duty to drive them on in work till the vital energies have been fairly exhausted. At last they are completely broken down, and the very fountains of life are dried up. The brain itself has become incapable of giving sleep, or sound thought. But there is no need for despondency: this trouble is perfectly curable, only the right means must be employed.

In every case of real "nervous prostration," our question must be—How shall we enable this vital element to recreate itself? The answer is, with heat. Here we may detail the process which we know to be successful. Dip a four-ply cotton cloth in cayenne lotion, and lightly wring out. Lay this gently over the stomach and bowels, and over this an india-rubber bag full of hot water. All must be only hot enough to be comfortable. This application may remain on for two hours without any change, then it is repeated. Where no bag can be had, a good thick fomentation should be used instead. See Nerves, Shaken; Nerves, Troubled, and all articles on nervous trouble.

Much depends on consideration of the individual case, and careful thought and strong sense are needed on the part of all dealing with such cases. (See Changing Treatment.)

Dessertspoonfuls of light food should be given every half-hour, and increased in quantity as the patient can bear it. Avoid alcohol and all narcotics.

Nettle Rash.—This is an eruption on the skin, often coming suddenly and going off again, but sometimes of long standing. It resembles in appearance the sting of a nettle—hence the name. It is accompanied by an intolerable itching, and is a very sore trouble where it continues, or frequently recurs. Its cause is usually defective digestion. We should not depend on drugs for a cure, but treat first the whole spinal system. Rub the whole back smartly with vinegar. Wipe this off, and rub again with gentle pressure and warm olive oil. Put on the soapy cloth (see Soap) with the lather very finely wrought (see Lather), and free from excess of moisture. Over this lathered cloth put a good blanket Fomentation (see), changing it once or twice, so as to keep up the heat for half-an-hour. When all this is taken off, we should rub again with vinegar and oil, as at first. If the case is a sudden attack, we may soak the worst parts of the eruption with weak vinegar; but if a chronic one, the rash is better left untouched. The treatment to the spine may be continued daily. If the rash has been irritated into running, scabby scores by scratching, it may be cleaned with weak vinegar. A little cream of tartar or powdered rhubarb and carbonate of soda mixed in equal parts may be taken internally after meals—say about one-fourth of a teaspoonful in a little water. If this quantity exercise too great a cooling effect, smaller doses will produce very good results. Kneipp Linen Underwear will in many cases of such skin trouble give great relief.

Neuralgia.—This is severe pain in one part or other of the body, sometimes followed by swelling of the painful part, but frequently without much sign of anything wrong at that point. It is, as the name implies, a trouble affecting the nerves which are connected with the painful part, and usually there is nothing whatever wrong where the pain is felt. Where, however, violent pain in the head or jaws results from chill, there is an altogether different trouble, though it is often called by the same name.

We have seen a man who had been in agony all night with pain all over his head. We took a large piece of flannel, about the size of a small blanket, rolled it up so as to get about a quart of boiling water poured into the heart of the roll. We kneaded the whole for a little time, to have the heat and moisture well diffused through the flannel. We now placed a large towel fourfold on the pillow under the patient's head, so that it could be brought as a good covering over the hot blanket when that was on. We opened up the blanket steaming hot and laid the head in the heart of it, bringing it carefully up all round, then brought the large towel over all, and tucked him tidily in about the shoulders. In less than two minutes he exclaimed, "I'm in Paradise!" The pain was all gone, and in its place was a positive sensation of delight. There was nothing here but a chilled skull to deal with, and as soon as it felt the heat and relaxed, the man was perfectly relieved. Then came the question as to how what had been got was to be secured, so that he might continue well. After he lay about three-quarters of an hour in this hot fomentation of the head, we took it off, and rubbed gently some warm olive oil into the roots of the hair, and all around the head and neck. We then gave all a good dry rubbing with a hard towel, and covered up his head carefully, and kept it covered for a day or two. He required no more treatment of any kind.

But when this treatment increases the pain, or fails altogether to remove it, we have a trouble which calls for the very opposite treatment. Then we have true neuralgia, which may be in any part of the body, and which is relieved by cooling the roots of the nerves which supply that part. For the face and jaws, cold must be applied to the back of the head, neck, or brain generally. For pains in arms, cold is to be applied to the upper, and for pain in legs to the lower part of the spine; for pain in the body, cool the whole length of the spine. The cooling is done by cloths moistened in cold water and well wrung out, pressed on gently over the part, and renewed as they grow warm. If the patient feels chilly, foment or bathe the feet and legs up to the knees during the process of cooling. This may require to be done for an hour. Finish by rubbing the parts cooled with hot vinegar and olive oil, and wiping off.

Even young people are exposed to a great deal of suffering from this source, and we feel sure that every one of these may be at once relieved and cured by the vigorous use of the cold compress. When the patient is warm in bed, the cold compress is one of the most delightful of applications; and the warm olive oil, to keep what has been got, make up a real blessing for the sufferer.

We have seen cases in which the cold compress has been applied up and down the spine, but not with that full effect which could be desired. Somehow it has not power enough in the hands applying it to reach the roots of the evil. The want in such a case is generally of a person sufficiently skilful in the use of the cold towel. There is a way of pressing it gently over all the parts under which the affected nerves lie, which secures the cooling of those roots very effectually. But such skill is not always at hand when needed. Well, mustard is spread over the surface of the cold towel, and the compress, thus increased in power, is placed all along the centre of the back. We find that very soon the pain begins to moderate, and ere long it has ceased. If it has to be applied more than once, cayenne is greatly to be preferred. The pepper does not hurt the skin, the mustard very soon does. A cold damp towel, folded at least four-ply, and placed properly, after being sprinkled well with cayenne, has an excellent effect.

In wild toothache, or bad nerve pain in the head, massage all over the head for a considerable time will often cure. We know cases in which agonising pain was thus removed years ago, and it has never returned. There was first rubbing, in a gentle soothing way, over the whole head. At a certain point, that began to lose its soothing influence. The cold towel was then wrapped round the head, and gently pressed. As soon as it warmed it was changed. This was done for perhaps three or four minutes, and the rubbing repeated. The whole was kept up for about an hour. All pain and uneasiness were then gone, and there was no return of either.

It will be seen that it is essential properly to distinguish between the pain requiring heat and that requiring cold for treatment. In any case it is safe first to try the heat. Failing relief with this, the cold may be tried. Sometimes the cooling of the head and spine succeeds in driving off several attacks, but eventually fails to relieve. If in such a case the cold is applied over the stomach, there is frequently almost instant relief. Where the attacks can be traced to indigestion, or come on always a certain time after a meal, this is the proper method from the first. Where a decayed tooth is the cause of pain, of course go to the dentist.

Night Coughs.—These frequently remain as the so-called dregs of some illness, and are found very persistent. They are also frequently very alarming, as they are thought to indicate some trouble in the lungs, and as immediate steps should be taken to check this, it is well to consult a good doctor. But, though coughing at night does of course accompany lung disease, it is by no means a chief symptom. Also, it is evident that the treatment applicable to bronchitis and other chest inflammations will often fail to relieve a night cough, because the night cough in question is due to nervous irritation or indigestion. Narcotics are useless and hurtful. Great relief is frequently found from inhaling the smoke of burning nitre or saltpetre. Blotting paper may be soaked in a solution of saltpetre, dried and lighted. Place the burning substance near enough the patient for him to inhale the smoke, but not so near as to interfere with easy breathing, especially in cases where there is great weakness.

When patients are fairly strong the back should be rubbed with warm olive oil for ten minutes or so in the morning before getting out of bed. Then apply a cold towel, well wrung out, folded lengthwise along the spine, and over it a dry one. Let the patient lie on this, and renew it when heated, continuing altogether for fifteen minutes or so. Give another fifteen minutes' rubbing with the hot oil before dressing. If the patient feels chilly during the cooling, foment the feet and legs at the same time.

Nightmare.—In serious cases of this trouble, the patient awakes some time before he gains any power whatever to move, feeling held as in a vice. But in common instances, the attack is entirely during sleep, and accompanied by frightful dreams. A heavily-loaded stomach, pressing on the solar plexus of the nerves, is a very common cause. The burdened nerves partially cease action, and this gives rise to the trouble. Anything similarly affecting these organic nerves will cause it also; but if the stomach be at fault, reduce the food and let the last meal be light and not later than six o'clock. This followed by a cup of hot water, before going to bed, will work a perfect cure. When it is feared there may be an attack, lying on the face in bed will often prevent it, even if the patient so lies for a very short time, and then turns on the side again.

When students, or school children, are over-driven (see Children, various articles), nightmare, very persistent, is one of the symptoms. In such cases, there is urgent need of rest, or most serious consequences may follow. Treat as recommended in Depression, and if any nervous troubles show themselves, treat as in various articles on nerve affections. Bad dreams, especially with children, are a sure sign of something wrong with the health, and should always lead to investigation, that their cause may be found and removed.

Night Pains.—If these are of the nature of cramps, which come on while lying in bed, the treatment is similar to that given above as morning treatment for Night Coughs, only the cooling must be continued for three-quarters of an hour or longer, fomenting the legs if any chilliness is felt. Cold towels may also be wrung out before going to bed, and put within reach. These may be applied when the cramps come on. They will usually relieve speedily.

Spasmodic asthma may be relieved by the same treatment. It often comes on when lying down, and cold towels applied as above directed will generally relieve. Fomentations must be given to the feet and legs, if any feeling of chill is felt.

Where there is difficulty in breathing on lying down, usually the heart is at fault. Sometimes the heart is all right, and this hard breathing is nervous, caused by too sudden lying down. To lie down, propped up with pillows, which may be removed one by one, is often sufficient to cure it. The treatment in the morning as in Night Coughs will also greatly help.

Another set of night troubles are such as arise from unwise use of foods or drinks before going to bed. Tea taken at or near bedtime will often cause sleeplessness, and will be apt also to give spasmodic asthma; so will all indigestible foods. These overpower weary organs that need rest and sleep, and not food. Most people will do well to take their last meal four hours before retiring. Taking supper is a habit, and in many cases a very bad one.

Night Sweats.—This distressing symptom, which accompanies various illnesses, can in most cases be easily cured. The whole skin is to be sponged over at bedtime with CAYENNE LOTION (see). This is best done under the bed-clothes. Acetic acid, the effective essence in vinegar, has an astonishing power in healing and stimulating the skin. When it is assisted by cayenne its healing power is very great indeed. The nerves are stimulated, the too open pores closed, the skin cleansed, and the whole system invigorated by such a mixture, and as a result the night sweats disappear. Even where the case is hopeless, much suffering may be prevented by the use of this mixture. In conjunction with other treatment, its use may even turn the scale towards recovery.

Noise and Disease.—Perhaps nothing shows more the lack of human feeling in many people than the manner in which they inflict sore distress on the sick and dying by means of noise. Moreover, recovery is retarded, and has sometimes been wholly prevented, by nothing but a noise. It must be understood that talking, and also singing, which are delightful to some, become intolerable pain to the delicate and weak. They really are worn out by them. And the wearing out is real: it is a destruction of nerve substance, when the nerve of the patient is already too feeble. Shutting doors violently, and the endless "house noises," must be avoided. Even a long, loud prayer at the bedside of the sick is utterly out of place. It may become necessary, in order to prevent such abuses, to exclude from the sick-room some who will be greatly offended thereby; but courage to defend a patient against well-meaning intruders is one essential qualification of a good nurse. Oil doors that squeak, fasten windows that rattle, but above all keep quiet the tongues that clatter. Let all whispering in the sick one's hearing be avoided. Speak quietly but distinctly, so that the patient may not think you are hiding anything from him. Wrap the coals in pieces of paper, so that they can be put on the fire by hand, avoiding the noise of shovel or tongs.

No one has a right to do what distresses others, and especially when they are sick. This principle should guide action. Acting thus will give untold rest and ease to the troubled.

Nostrils, The.—The disease called Polypus, affecting the mouth or nostril with growths which are usually removed by force, is one of those troubles curable by proper use of vinegar or weak acetic acid. The extraction of the Polypi is painful, and we have ourselves seen them so completely cured, that it is a pity not to make very widely known a method of avoiding extraction. A small glass syringe or a "nasal douche" (rubber is best) should be got, such as may easily be used for syringing the nostrils, or gums, if the growth be on these. Syringe the growths well with vinegar or ACETIC ACID (see), so diluted with water as only very slightly to smart when it is applied. Use this slightly warm, and force it well up the nostril, so that it goes even back into the throat. This should be done for a considerable time: not so as to feel painful, but long enough to produce a decided effect, which remains on ceasing. Dry the nostrils with a little soft lint or clean rag, and force in a little fine almond oil. Do all this twice a day for a fortnight at least. In a bad case, a BRAN POULTICE (see) may be applied to the back of the head and neck, coming down over the spine between the shoulders.

Similar growths on other membranes, if accessible, may be cured by acid in a similar way.

This treatment is excellent for an ordinary cold in the head.

Nourishment.—Nothing is more required in healing than properly to nourish the enfeebled body. In its commencement proper nourishment demands a proper mixture of food and saliva. In fever, if there be little or no saliva present, food requiring much saliva to fit it for digestion only injures. This is the case with so-called rich foods, especially. Excessive thirst usually marks this deficiency of saliva. Always consider carefully the flow of saliva before feeding a patient in a weak state. Get the mouth to "water" somewhat before giving food. We have seen a cold cloth changed several times over the stomach start the flow of saliva almost miraculously, relieving the thirst, and prepare for nourishment which could not be taken before.

Going further into the matter, we see that very likely the stomach requires assistance to dispose of even well-salivated food. There may be a lack of gastric juice. In this case, frequent and small quantities of hot water supplied to the stomach will greatly help it. A wineglassful of hot water taken every ten minutes for two, four, or ten hours will be sufficient (see Digestion; Indigestion). It is well to think ten times of the readiness of the system to digest, for once of the food to be taken. If the stomach be either burning hot or cold and chilly, let it be cooled or warmed, as the case may be. Either use cold towels or give hot water as above, as the case demands. When it is brought into something like a natural state of feeling, you may then give food. The hot water will often not only prepare the stomach, but will start the flow of saliva in the mouth, and that even when the cooling cloth has failed to do so.

A medical man will, at times, forbid water, however thirsty the patient may be. He is not unlikely to be labouring under a serious mistake. It may be just the want of water which is causing the very symptoms which he thinks to cure by withholding it. We never saw anything but suffering arise from withholding water from the thirsty.

Milk is a prime element in nourishing the weak. Mixed with its own bulk of boiling water, or even with twice as much, it is immensely more easy to digest. The simple water is of vast importance, and the milk mixed with boiling water is quite a different substance for digestion from the fresh pure milk. It is better to have a teaspoonful of milk and water really digested than a pint of rich milk overloading the stomach.

Many persons put lime-water into the milk to make it digestible. In doing so they put a difficulty in the way, in the shape of the lime. If one tries to wash his hands in "hard" water, he sees how unfit that water is to do the proper work of water in the blood and tissues of the body. Now, it is not difficult to meet this evil where the only water to be had has a great deal of lime in solution. Boiling this water makes it deposit much of its lime. If a very, very small bit of soda is mixed with it in the boiling, it lets down its lime more quickly and completely.

Alcoholic drinks—wine, porter, or ale—are often given as means of nourishment. They are hurtful in the extreme, as the spirit contained in them spoils, so far as it acts, both the saliva and the gastric juice. Rum and milk, sack whey, and other such preparations are equally bad, and have killed many a patient.

While suitable nourishment is necessary for the sick, great care should be taken to avoid giving too much. Often the amount of food the patient requires or can assimilate is exceedingly small. Injudicious attempts to "keep up the strength" by forcing down food that cannot be digested often destroy the little that remains, and remove the only hope of cure. (See also Assimilation; Biscuits and Water; Blood; Bread; Buttermilk; Child-Bearing; Constipation; Diet; Drinks; Dyspepsia; Foods; Heartburn; Infants' Food.)

Nourishment, Cold in.—If a person is in fever, and is burning with internal heat, a little bit of ice, sucked in the mouth, gives great relief. The relief is got in this way: the melted ice, in the form of water, is little in bulk in proportion to the heat which is absorbed in melting it. To absorb the same heat by means of merely cold water, would imply a great amount of water, and an inconvenient filling of the stomach. The heat used up in melting the small bit of ice is great, and the amount of water exceedingly small. This gives benefit without inconvenience; hence, to suck a bit of ice is to be much preferred in such a case to taking a drink of cold water.

Within proper limits, beyond all question, cold is, in certain cases, essential to nourishment. For example, in a case of thirst such as we have noticed, the heat of the stomach extending to the mouth is drying up all the juices that should go to secure digestion and assimilation. The saliva is dried up, and the gastric juice equally so. Cold is applied to the pit of the stomach (not ice, but a moderate degree of repeated cold), and the result is, these juices begin to flow. Nourishment is the consequence, and very clearly, in such a case, it is the consequence of cold. In other words, it is the result of reducing the excessive internal heat, and leaving something like the proper degree behind.

The place which cold has in nourishing is, so to speak, negative—that is, it is useful only in reducing overheating. But when we remember how a frosty morning sharpens appetites and makes the cheeks glow with ruddy health, we see that such reduction of overheat is not infrequently required.

Nourishment, Heat in.—Heat is absorbed in building up the bodily tissues, and given off when they are disintegrated. To rightly understand this is of great importance in all treatment. When a living substance is growing, it demands heat. An illustration of this is the sun's heat causing what we call "growing weather." Again, where substances are breaking up, as in burning wood, heat is given out. In the stomach, a certain amount of heat is needed during digestion. If it is not given, indigestion ensues. To swallow ice, where the stomach has already insufficient heat, is then great folly. On the other hand, to take hot water is to do the very thing which gives the stomach what it needs, and so to relieve the indigestion. Many times, when the stomach simply stands still from lack of energy, it will move immediately on getting a glass of hot water to help it. Similarly, a little genial heat assists other failing organs. As we have shown how cold diminishes the excessive action of inflammation and fever, so we now point out that if you can find out what organs are feeble and acting insufficiently, and stimulate them with gentle heat, you are on the way to a cure.

Nursing Over.—Few vital processes are more remarkable than that by which food fitted for adults becomes in the mother's breast food fit for the little infant. In nursing it is well to remember that all food is not equally fit to be so changed. Well-boiled porridge, of either oat or wheaten meal, is probably as good as can be got. Malt liquor, though causing a large flow of milk, most seriously deteriorates its quality, and should be entirely avoided. But in this article we think chiefly of the mother, and of the necessary drain of blood and vital force which she bears in nursing. In most cases this drain is easily borne, in others the child is fed at the mother's expense. The supply of power, in such cases, is not equal to the loss of it in feeding the child, and the reserve in the mother's body is slowly used up. She becomes thin and pale, and her nervous system begins to suffer. When this is the case, either means must be used to increase her vital power, or nursing must at once be given up. Of course, where she may have had insufficient or unsuitable food, a change of diet may work a cure; but, as a rule, the drain of nursing will have to be stopped. To help her restoration, whether she ceases to nurse or not, use the following mixture and treatment: Boil a stick of best liquorice for half-an-hour in a quart of good soft water. Add one quarter of an ounce of camomile flowers, and boil for another half-hour. Keep the water up to the quantity by adding boiling water as required. Strain the mixture, and give a dessertspoonful thrice a day before meals. If the dessertspoonful be found too much, a teaspoonful may be taken. The patient, if any heart trouble is felt, should go to bed early, and have the feet and legs fomented, and cold cloths pressed over the heart. This may be done for three or four nights. After this, each night for a fortnight the back should be well washed with SOAP (see) and hot water, and rubbed with vinegar and hot olive oil. Let each be dried off before the other is applied.

Oil, Olive.—A little oil only should be applied to the skin at once. Any such smearing as dirties the clothes or bedclothes is quite unnecessary.

Since the first edition of these papers was published, the use of oil in the "massage" treatment has become so widely known that methods of rubbing are better understood, and its results more appreciated. Hence it is now easier to procure pure oil, and our readers should be able to get it cheaply at any first-class grocer's.

Opium.—See Narcotics.

Oranges.—Some things regarding this useful fruit require to be noted by those using them in sickness. To eat the whole substance of an orange except the outer rind is to give the digestive system some hard work. We have known most serious stomach disturbance caused to the healthy by doing so. Some parts of the inner rind and partitions of the fruit act almost like poison. These should always be rejected. The juice is most beneficial. It is best given to patients by squeezing the orange into a glass, and straining it through muslin into another glass. Add its own bulk of water and a teaspoonful of sugar, if liked. This may be taken warm or cold, and will do where even milk and water cannot be taken. (See Drinks).

"Outstrikes."—These appear on the skin from various causes. In the case of infants, they often appear on the head and face during teething.

An experienced medical man is cautious in the extreme of quickly healing the distressed skin. He is afraid of "driving in" the eruption on the brain. Perhaps he refuses to do anything whatever to heal the head. From what we have seen, however, even in the worst cases, when head and face and neck were one great sore, we feel assured that there is no need why this distress should be continued at all. It may be, at least in many cases, safely and not very slowly healed.

The whole skin of the infant must be brought into vigorous and healthy action. The head at first need not be touched; but the entire skin not affected should be sponged with warm vinegar, and then dried, rubbed with warm olive oil, and this wiped off carefully and gently, so far as it does not adhere to the skin under the soft dry towel. Quite enough remains to do all the good required; and if more is left on, a chilliness and nastiness are felt, which prejudice many against the use of it altogether.

It is well, in many cases, not to touch the child with water or soap. The vinegar and oil cleanse the skin and do all that is required. Then vinegar very much diluted should be used warm to apply with a soft rag to the sores. Take a teaspoonful of vinegar in a breakfastcupful of warm water. If this causes the child to cry when applied, then dilute still further. Vinegar weak enough to cause hardly any feeling when it touches the sore, will heal; stronger vinegar will injure.

We have known a nurse try to heal an outstricken face by means of good vinegar at its full strength. She was instructed to use the vinegar very much diluted, but fancied it would heal faster if much stronger. She might just as well have fancied that it is better to put one's cold hands into the fire than to hold them at some distance when wishing to warm them. The child's face was made greatly worse, of course, and the cure abandoned. It is therefore necessary to urge that a strength of acid which secures only the most gentle sensation of smarting is essential to cure. The weak vinegar is first applied to the outer and less fiery parts of the outstrike. Try to heal from this inwards, by gradual advances from day to day. On the less affected parts the weak acid may be applied twice a day; on the sorer parts only when itching is so distressing as to demand it.

We have seen a child whose head, face, and neck were one distressing sore; we have taken the cloth with the diluted vinegar and daubed a square inch or so of the skin on which the fiery eruption was so full, and in less than two minutes we have seen the colour change into a healthy pink, and remain that colour when the olive oil was applied. The child's sores yielded gradually, till the whole illness was removed.

Sometimes such eruptions, in adults as well as children, arise from suppressed perspiration, or from the perspiration being of an acrid and irritating nature. It is sometimes apparently the result of the rubbing off of a little of the skin, or it comes on without any known accident. For a time it seems scarcely worth noticing, and is consequently neglected; but gradually it spreads on the surface and gives uneasiness, especially after the patient has been some time in bed. It goes on till a large portion of the skin from the knee to the ankle is reddened and roughened with a moist eruption. Now remedies of various kinds are tried, but the evil gets worse and worse. The person affected is often a struggling mother or widow, who has to keep on her feet all day in anxious toil, and neither gets very good food during the day nor proper rest during the night. Month after month goes past, and no relief comes. The positive agony which such persons suffer is incredible to those who have not experienced anything of the kind.

Here the great difficulty often is to get the patient the very chief condition for cure—that is, perfect rest for the affected limb. If this can in any way be secured, all else is comparatively plain sailing. But this is sometimes impossible: the children may not be in a position to be left, or the little business cannot be allowed to die, as it would in a month's time if not attended to, or some other hindrance is in the way. We must just do the best in the circumstances. We shall say that we are compelled to do without the rest, probably also without certain other things. Rest is very desirable, and so is a gentle rubbing all over the body, first with warm vinegar and then with olive oil, but there is perhaps no one capable of doing such a thing whose services can be secured. It is easy to "order" very useful processes, but among many who would not be exactly called "poor people" it is not easy to have the "order" carried out. We must often do without this double rubbing, and yet cure the diseased skin of the afflicted limb. Let the reader remember that it is no matter of choice that we dispense with the rest and the rubbing. If they are possible, by all means let them be taken advantage of to the utmost.

For treatment, unless distinct running sores are formed, bathe the limb with warm water and M'Clinton's Soap, which will remove all crusts, scabs, &c. Then apply zinc ointment. Do not bathe or poultice after the first time. All secretion can be removed by a piece of cotton wool dipped in warm olive oil. If deep running sores have formed, then we must have a water-tight box of rough deal in which the whole leg up to the knee can be bathed for an hour in hot water. We see no reason why it should cost much over a shilling to get this, and it would be a sore want if it could not be procured. It is so made that the leg and foot can rest easily in it while it is nearly full of hot water. It need not be wider than just to hold the limb easily. Some good-hearted joiner will put five small boards together so as to meet this want. We shall suppose that it is supplied. Now for a few cloths, such as will cover the diseased parts, about three-ply all round. Then for vinegar or acetic acid, so diluted with water that it will just cause a slight smarting when heated and touching the affected skin. It must not be so strong as to cause burning, nor so weak as to give no sense of its presence at all, but between these extremes. It can be tried when too weak, and vinegar or other acetic acid added till a gentle smarting is felt. The cloths are dipped in the diluted and heated vinegar, allowed to drip till no more falls off, and then laid tenderly all round the sore. A strip of dry cloth may then be wound round so as to keep these on, and the leg thus dressed placed in the bath. It should be kept there, with now and again a gentle movement, and the strong comfortable heat of the water kept up for an hour, unless the patient should feel sickness before that time. If this comes on, the water is too hot; but, instead of merely cooling it, the bath may cease for the time, and water not so hot may be tried on a second occasion. Whether the hour has been reached or not, good has been done. The leg is taken out of the hot water and gently dried—not rubbed, but dried without rubbing. Then as much cloth as will go twice round all is dipped in warm olive oil, and this is pressed out a little, so that it may not run. The oiled cloth is wrapped all round the limb. Some dry cloth is also wrapped round, and the first treatment is completed. This should be repeated every night before going to bed, for a week at least. It may be required for a fortnight if the case is bad and no rest at all can be had during the day. We should say the cure may fail for want of this rest, but this is not likely. In the morning as soon as convenient, the diseased skin should be soaked with a warm vinegar cloth, so that it shall smart just a little. It should then be dressed again with the warm olive oil. If at any time during the day or night it gets irritated and troublesome, this morning dressing may be repeated. It will not be very long before the one leg is as good as the other. The general health, too, of the patient will be sensibly improved.

It is scarcely necessary to point out that a similar treatment to this will cure "outstrikings" of the same sort in the arms and other parts of the body, as well as upon the legs. There is required only some such modification of the appliances as may meet the particular case. For example, we have seen the outstriking between the shoulders, so that it could not be reached by bathing, unless by appliances utterly out of the question in the circumstances. But dressing with hot vinegar cloths, allowing these to remain on for twenty minutes or so, and then dressing with warm olive oil, allowing this to remain for two or three hours, is quite possible to any one who is so affected; and this will usually be sufficient for a cure.

You have, perhaps, been cured temporarily more than once with arsenic, and the evil has returned worse and worse. In that case you may require all the more patience and the longer application of the above treatment; but, once cured in this way, you will not, so far as a good long experience enables us to judge, be likely to have any relapse. In very bad cases we have seen poultices of mashed potatoes made with buttermilk cleanse the diseased parts most effectually, and then the acid takes healing effect very speedily. In these cases ordinary medical treatment had utterly and hopelessly failed.

Pain, Severe, in Limbs.—This is often not due to any trouble in the joint itself, but to some disorder in the large nerves which have their roots in the lower part of the back. In the case of severe pains in the back of the leg, ankle, or knee, when a chill to the large limb nerves has been the cause, and has raised inflammation, the patient should be put warm in bed. Take two large towels, thoroughly wrung out of cold water. Fold one six or eight ply thick. Gently press this, avoiding cold shock to the patient, over the lower part of the back. When this towel gets hot, spread it out to cool, and apply the other. Continue this with each towel alternately, and when finished, or after an hour, rub the skin with warm olive oil and cover up with new flannel. Similar cold applications to the upper part of the spine will cure such pains in the wrists. If the cold application intensifies or fails to relieve the pain, it is well to try the ARMCHAIR FOMENTATION (see).

Sometimes light pressure in the form of squeezing the muscles of the lower back is very useful. A very gentle pressure on the right parts is most pleasant to the sufferer. At first it simply relieves in some degree the weary feeling of the limbs. When it is at all well done, it soon raises a gentle heat, which slowly passes down the limbs, even to the very toes. This is just life itself communicated to the limb. But we must not confine our treatment to the spinal cord. The squeezing, or gentle pressure, must be carried down the limb; and when new life has been infused so far, it will be well to apply the pressure between the hands to the swollen and painful part. See Massage.

Palpitation.—Ordinarily we are not aware of the beating of the heart, enormous as is the work it does; but in certain cases this beating becomes distressingly violent, especially on lying down flat or in ascending hills or stairs. The latter cases are the more serious, yet both kinds we have found quite curable. In treatment, fomentation must be avoided, and so must doses of the nerve-damaging drug, digitalis. The best way is to cool the heart, and thus relieve its superabundant action. But care must be taken that cold be not applied to a feeble heart, but only where action is evidently superabundant. It is usually easy to distinguish the two kinds of palpitation. The cooling can be done by pressing towels wrung out of cold water all over the heart region of the left side. Then rub the part so cooled with olive oil, dry off, and let the patient rest. This may be done in the morning before rising. In cases where the heart is feeble, the following treatment should be carried out instead of the cold towels:—Begin at bedtime with a cloth covered with creamy soap lather, and placed quite warm all over the body of the patient. It should be fastened on with the body of a dress, or thin vest, so that it may be kept close to the skin during the night. In the morning the back should be gently washed with hot vinegar, dried, and gently rubbed with warm olive oil. In those cases where the palpitation is only part of a general nervousness, which causes great distress and sleeplessness at night, the back should be lathered all over with soap (see Lather and Soap) at bedtime, and the cloth with lather left on all night. In the morning, dry off, rub gently with hot vinegar, and then with hot olive oil. If the palpitation resists this treatment, then cold towels should be gently pressed to the spine, until the whole system is quieted. The back should then be rubbed with warm olive oil. So far as this restless action is concerned, this is all that is required for complete cure. We are writing thus in view of cases declared hopeless, but the patients are now in perfect health. We remember one at this moment in which the heart's action was so bad that the head could not be raised from the pillow, but the person was in a few weeks as well as any one could wish to be.

No one who has not seen how readily the surplus vital action passes out of the system when simple cold is rightly applied, can imagine how easily such cases are cured. It seems to us absurd to speak of "heart disease" in many of the cases in which people talk of it and set the case down as hopeless. It is absurd, simply because it is not heart disease, but only a little more action than is comfortable, and which is reduced in a few minutes by a cold towel. No doubt care and willingness to work a little are required, if one would relieve a sufferer in such a case as this, but that care and energy are sure to have the best of all rewards.

Palpitation often arises from indigestion, in which case see Indigestion.

Palsy.—See Paralysis.

Paralysis.—This serious trouble in slighter forms affects one side of the face, or even one eye only. More serious attacks involve the arm, and even an entire half of the body. It may come suddenly, or may creep slowly over the frame. In very old persons the case is usually hopeless, as life itself is fading. In earlier life, and in less serious cases, a cure is to be expected from proper treatment. Cupping, blistering, or opiates must be avoided, as all tending to reduce vital energy. Treatment must aim at increasing this, not reducing it. Take first the case of paralysis slightly affecting the face. When the patient is warm in bed, place a BRAN POULTICE (see) not too hot, on the back of the head and neck. Let the patient lie on it, first rubbing the neck and back of head with olive oil. Do this for an hour each day. At another time wash the back of head and neck with SOAP (see) and water, then with vinegar, and finally rub with hot olive oil. Keep the parts warm with good flannel always.

If the whole side be affected, foment strongly the whole spine, and treat it in a similar way to the back of the head, as prescribed above. We have known cases of comparatively speedy cure by this simple means. The heat simply vitalises the partially dead nerves. For paralysis of the lower limbs, the treatment is applied to the lower part of the spine principally, but also to the whole spinal system. There is no fear of injuring the patient in this treatment, and we know of many cases of most delightful cure secured by it. What is called the ARMCHAIR FOMENTATION (see) is an excellent method of dealing with paralysis of the lower limbs or any part of them, and may be resorted to if the above treatment fails. Care must be taken in any case to avoid a chill after fomenting, which might make matters worse than at first.

Perspiration.—By this term we mean not only the sensible perspiration which is felt as a distinct wetness on the skin during exertion or heat, or in some illnesses, but also, and chiefly, the constant insensible perspiration. This latter is far more important than the former. No one could live many hours without it, for by its means several pounds weight of waste is got rid of every day. Its importance we saw lately in the case of a child greatly swollen in dropsy. A flannel BANDAGE (see) wrung out of warm water, placed round the body, reduced this swelling completely, without any sensible sign of excretion. A very gentle treatment, increasing this insensible sweating, will often cure without weakening, where violent perspiring medicines or treatment cause great weakness. A damp flannel bandage placed round the lower half of the body all night for a few nights will produce a remarkable increase of insensible perspiration, and in many case forms a good substitute for sweating drugs. Along with this the soapy lather may be used at bedtime all over the skin (see Lather and Soap). We have seen a swelling of the hand, which made a medical man talk of amputation, cured by these means. Acetic acid, or white-wine vinegar, rubbed over the skin, produces a similar increase of insensible perspiration, and may be used without fear of injury. This done once a week will go far to reduce sensitiveness to cold. Indeed, the use of M'Clinton's soap and water, along with good acetic acid sponging once a week, will prevent many serious ills by securing a constant gentle excretion of hurtful waste through the stimulated skin.

Piles.—This very common trouble is caused by one or more of the veins in the lower bowel losing their elasticity, so as to protrude more or less from the anus, especially when the stress of a motion of the bowels forces them out. When no blood proceeds from this swollen vein, it is sometimes called a blind pile. If blood comes, it is called a bleeding one.

There are few illnesses more prevalent than this, few that seem to be less rationally dealt with, and yet few that are more easily cured.

It is distressing to think of what some poor people have to suffer from this disease, while they are still compelled to go on working, and even walking, in the most depressing sufferings. It is still more distressing to think of the painful operations which some have to undergo in having the relaxed portions of these veins cut out. Even when the piles have got to a very advanced stage it is not difficult to cure. It will generally be found that there is Constipation (see), so first of all, the bowels must be regulated. This may be done by means of liquorice and senna mixture, and strict attention to diet and exercise. Then the nerve action in the lower back is to be stimulated by applying to the back below the waist a large BRAN POULTICE (see). Rub the back after this with hot vinegar, dry, rub with olive oil, and wipe off the oil gently. Do this at bedtime. Into the bowels may be injected (with the fountain enema) first one or two injections of warm water; then an injection of warm water and white-wine vinegar. Be particular to have this mixture not too strong. A trial may be made with one tablespoonful of vinegar to a pint of water. If any pain is caused, inject simple lukewarm water and use the vinegar and water next time weaker. A very weak mixture has a wonderfully healing effect. After one pint of this mixture has been injected, an injection of cool water (but not cold) should follow. The vinegar should be so weak that it will cause no pain, properly speaking,—only just the slightest sensation of smarting. It will be possible to use the water colder and the vinegar stronger as you get on with the cure, but in both, your own feelings and good sense will guide you. This direction will suit other cases of internal syringing, in which membranes have got relaxed, and need to be braced with cold and weak acid. In all such troubles it should be remembered that the warm or tepid water is used at first only because the cold might be felt uncomfortable till the surfaces are prepared for it. It is the cold that does the good. After this, protruding piles may be gently manipulated by the fingers and pushed back into their place. During this the patient must press outwards, as if to discharge faeces from the bowel. The anus will then open and permit of the piles being pressed in. The injecting treatment may be given twice a day. If too painful, even bathing the parts with the vinegar and cold water has great healing power.

Let the sufferer, if at all possible, have entire rest for a fortnight during the treatment, and lie down as much as convenient.

In mild cases, simply bathe the piles with cold water and press them back into their places. A daily wash of the anus with SOAP (see) and warm water, followed by a cold sponging, will do much to prevent piles.

Pimples on the Face.—See Face.

Pleurisy.—The pleura is the tender double web, or membrane, which lines the inside of the chest on the one side and covers the lung, or rather encloses the lung with its other fold. Each of the two lungs has its pleura in which it works, and each side of the chest is lined by one side of this sensitive organ. The slender lining passes round the greater part of one whole side of the body with one-fold, and round the whole of the lung with the other. Let us suppose (which often takes place) that the front of the body is defended with what is called a "chest protector," but the sides and back are exposed to a chilling atmosphere. Part of the pleura, and that part which is farthest from the surface, is sheltered, but the greater part of it, and that nearest the surface, has no such protection. In the case especially of women this is the state of things. It seems as if people thought that they only need to keep a few inches of the breast warm—that is keeping the chest all right—though the sides just under the arms, and the back under the shoulder-blades, are of far greater importance. The throat is even muffled, and a "respirator" worn, so that fresh air is not allowed to get inside the lungs, while the pleura is exposed to chill at the back. The consequence of this is that vital action is so abstracted from the pleura that the tension of its small vessels is relaxed, and blood is admitted as it is not intended it should be.

Severe pain is felt on one or both sides, and round under the shoulder-blade. A painful cough arises, and great fever is produced. In such a case the treatment is on the same principle as that given in Lungs, Inflammation of the, which should be read. The inflamed part must be cooled by applying towels well wrung out of cold water round the side, applying a fresh one when that on the part becomes warm. If the pain does not leave in half-an-hour of this treatment, or if the patient be weak to begin with, or if any chilliness is felt, pack the feet and legs in a large hot fomentation. The cooling of the side may then go on safely until a curative effect is produced. We may not be able to give the theory of action of this treatment, but we know that in many cases it has perfectly and very speedily been successful, and that it leaves no bad results, as blistering and drugging are apt to do. We know of one case in which it took twenty-four hours' constant treatment to effect a cure. But it did effect it. Two friends took "shifts," and saw that all was thoroughly done. This will give an idea of the proper way to go about the matter.

Poisoning.—The following are the antidotes and remedies for some of the more common forms of poisoning.

Alcohol.—The patient is quite helpless, and there is usually a strong smell of alcohol. If the patient is intoxicated at the time give an emetic. If there is evident prostration from a long bout, keep him quiet and warm. Hot tea not too strong may be given.

Alkalis (e.g., ammonia, soda or potash).—Give dilute vinegar, followed by white of egg.

Arsenic.—Emetic, followed by white of egg. Keep very warm.

Carbolic.—Readily identified by smell of tar or carbolic. Wash mouth well with oil. Give an emetic.

Chloral.—Emetic; warm coffee, and even an enema of coffee. Artificial respiration (see Drowning) may be necessary if breathing gets very low.

Chloroform or Ether (inhaled).—Fresh air. Pull tongue forward, and begin artificial respiration. If heart has stopped, strike chest two or three times over region of heart.

Chloroform or Ether (swallowed).—Emetic; enema of hot coffee; keep awake. If necessary, artificial respiration.

Copper.—Emetic, white of egg to follow.

Laudanum.—There is intense drowsiness and contraction of pupils of eye. Give an emetic and plenty of strong coffee. Walk patient up and down. On no account allow him to give way to the desire for sleep.

Mineral Acids and Glacial Acetic.—If any neutralising agent, such, e.g., as lime, chalk, soda, or calcined magnesia, is at hand, give it at once. Or give an emetic, followed by oil or milk and water.

Mushrooms.—Emetic; castor oil and enema.

Nicotine (tobacco).—Emetic; stimulate and keep warm; keep patient lying down.

Oxalic Acid.—Neutralise by chalk or lime water, but not by soda or any alkali. Give plenty of water; apply hot fomentations to loins.

Phosphorus.—Often caused by children sucking matches. There is a burning in the throat, and often vomiting. Give an emetic. After this some barley water or milk may be given.

Prussic Acid.—Almost hopeless. Emetic; artificial respiration.

Snake Bite.—Suck the wound, and apply a drop or two of strong ammonia to the bite. Ammonia may be also inhaled. Artificial respiration often necessary.

Strychnine.—Emetic; keep quiet and darken the room. Chloral or bromide of potassium may be given. If spasms threaten respiration, artificial respiration is necessary.

Tartar Emetic or other Antimonial Poisons.—If vomiting is not present, induce it by an emetic. Give doses of strong tea. Keep very warm by hot blankets.

Good domestic emetics are a teaspoonful of mustard in a tumblerful of water, or a tablespoonful of salt in the same quantity of water.

Poisoning, Blood.—Where this arises from a more or less putrid wound, what is aimed at in the treatment is to stop the manufacture of the poison in the wound by cleansing and healing it. This done, the other symptoms will subside. The wound should be carefully brushed with a camel's-hair brush and vinegar or dilute ACETIC ACID (see). This should be followed up with a poultice of boiled potatoes or turnips, beaten up with the same weak acid. Leave this on all night. Brush again well with the acid in the morning. In the matter of diet eat what will produce healthy blood, and by open-air exercise seek the same end. But the daily brushing and poulticing, or even twice daily if necessary, will work wonders on the poisoned wound. Care should be taken where any cut or wound has been made in the flesh, that it is carefully washed, and any dirt or foreign matter removed. Especially is this to be attended to if a rusty nail or penknife has inflicted the injury.

Polypus.—See Nostrils.

Potato Poultice.—Potatoes boiled and beaten up with buttermilk, spread out in the usual way, make this useful poultice. Weak acid or vinegar may also be used instead of buttermilk. The potatoes should be boiled as recommended below.

Potato, The.—The proper cooking of this root is so important for health, owing to its universal use, that we here give directions which, if followed out, make potatoes a dish acceptable to even a very delicate stomach. Difficulty of digestion often arises from the potatoes not ripening properly, especially in cold soil, and since disease has become so widespread. Their unripe juice is positively poisonous, and when they are merely boiled is not completely expelled. The potatoes should be steeped in warm water for an hour before they are boiled. The water in which they have been steeped will be greenish with bad juice, and must be thrown away, and the roots boiled in fresh water as usual, giving a thorough drying after the boiling water is poured or strained off. So prepared, the potatoes make a very digestible dish.

Poultice, Bran.—See Bran Poultice.

Prostration, Nervous.—The various articles under Nerves and Nervousness should be read. Here we give simply the treatment for failure in the digestion and bowel action. This arises from failure in the great nerve centres near the middle of the body. External treatment may be given as follows:—Dip a cotton cloth, four-ply thick, and large enough to cover the stomach and bowels, into cayenne Lotion (see), and lightly wring it. Lay this gently over the stomach and bowels. Over this an india-rubber bag of hot water is laid. Take care that the heat is not too great or the mixture too strong. All must be just hot enough to be comfortable. This application may remain on for two hours, and then be repeated. The cayenne is greatly to be preferred to mustard for many reasons. Give the most easily assimilated food possible. A teaspoonful of gruel each half-hour, increased to a dessertspoonful, if the digestion will bear it, and preceded in all cases by a tablespoonful of hot water. This should be continued for twenty-four hours. Proceed very cautiously then to increase the nourishment, on the lines of Assimilation, Diet, Digestion, etc., giving oatmeal jelly, wheaten porridge, Saltcoats biscuits, and such diet, gradually bringing the patient back to ordinary food.

Pulse, Counting the.—Most valuable information as to the nature and progress of disease is derivable from the pulse. Every one should learn to count it, and to distinguish the broad differences in the rapidity and nature of the beat. Such a distinction as that between BRONCHITIS and ASTHMA (see these articles), which require almost directly opposite treatment, is at once discerned from the pulse. In bronchitis it beats much too quickly, in asthma it is natural or too slow. In many cases we have seen asthma, which in cough and spit is very like bronchitis, treated as bronchitis, with bad results. These would all have been avoided if the pulse had been intelligently counted. Count the pulse, if at all possible, for half-a-minute. This multiplied by two will give the rate per minute, by which it is judged. If this rate per minute be above 100, there is a good deal of feverish or inflammatory action somewhere. If below 60, there is considerable lack of vital power, requiring rest and food to restore it.

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

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

Purple Spots on Skin.—These arise first as small swellings. The swellings fall, and leave purple patches behind, which, if the trouble continues, become so numerous as to spoil the appearance of the skin. This especially occurs in children or young people, whose skin is exceptionally delicate. What has occurred is really much the same as the result of a blow or pinch, leaving the skin "black and blue." Some of the delicate vessels in the skin have given way, and dark blood collects on the spot.

The treatment is to sponge all over the body and limbs with warm CAYENNE "TEA" (see), only strong enough to cause a slight smarting. It should never cause pain. If it does so, the tea is too strong, and should be diluted with warm water. The soapy LATHER (see) may also be used, and olive oil may with advantage be rubbed on as well. Milk and boiling water should be given to the patient every two hours during the day, with a few drops of the cayenne "tea" in it. This is a true stimulant, and worth all the whiskey in the world. The object of the treatment is to nurse the patient's strength, and stimulate the skin. An intelligent study of many articles in this book will guide the thoughtful how to act.

Racks from Lifting.—See Muscular Pains; Sprains.

Rash, or Hives.—Infants are often troubled with large red, angry-looking spots, breaking out over the body, and causing trouble by their heat and itching. These are commonly known as hives. If the water in which a child is washed be hard, it will sometimes cause the skin to inflame and become "hivey." If the soap has much soda in it, it will also cause this. What is called glycerine soap, and much of what is sold as peculiarly desirable, is utterly unsuitable for an infant's skin. Soda soap will cause serious outbreaks even worse than "hives," and will often not be suspected at all, as a cause.

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

When the "hives" are not very troublesome, they are apt to be neglected; but this should not be, as in most cases this is the time they may be easily cured. The true element in cure is found in attention to the skin, as distinct from the stomach or blood. M'Clinton's soap (see Soap) applied as fine creamy lather will cure hives, and will never, we think, fail to do so. We know of a nurse plastering an infant's body with this soap, so that it was blistered. This is a totally wrong way of working. The right way is to work the soap and hot water as described in article Lather, and to apply it gently with the brush to the parts affected. After applying it with gentle rubbing for some time, and leaving some on the sore places, the infant will usually be soothed to sleep. Where over-cooling is feared, with a weak child, a little olive oil is gently rubbed on with the second coat of lather. In any case of itchiness the above treatment is almost certain to cure. Often the infant is suffering from too rich diet. (See Children's Food.) In such cases, thinner milk, and a little fluid magnesia administered internally will effect a cure.

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

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

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

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

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

For instance, an exhausted patient is lying at full length in bed, but under the waist there is a hollow which is bridged over by the back. This part of the back calls for a considerable amount of force to hold it over this hollow, but we get a pillow inserted under the back, the muscles relax, and the patient rests. In packing and fomenting an inflamed knee, for example, it is usually better done in a slightly bent position, which is more restful than a straight one. Employ two or three small pillows to prop it comfortably. And so on, in multitudes of cases, the earnest healer will be guided by the patient's own restful feelings. See also Noise; Veins.

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

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

Now take an instance in which it seems to be the mind that causes the tossing rather than the body. Preachers after earnest preaching are in many cases sleepless and restless too; so are almost all persons when currents of exciting thoughts have been set agoing in their minds. Then, no doubt, it is necessary to get at relief from the spiritual side, by means of thought fitted to calm down the excitement that has been raised. But it is never well to forget that in all such cases there is a material as well as a spiritual aspect of the experience. Many preachers take a sitz-bath before going to bed after a day of service, and find that somehow when sitting in the cool water the over-driven brain begins to slacken pace. If from any cause you are restless and cannot lie still, even after the head and spine have been cooled as we have described, it is well to take a sitz-bath in cold water for a few minutes. Dry and wrap up well, and you will be quiet after. Certain forms of coughing apparently cause the most serious restlessness. A warm poultice should be placed between the shoulders, and cold cloths pressed gently on the breast.

If there is extreme shrinking from everything in the least degree cold, then you need to go a step back in your treatment. A sponging of the most gentle kind, with CAYENNE LOTION (see) and water, all over the body, given very carefully for three or four days, once a day, will put away the shrinking to which we refer. This should be done with tepid water at first, but as the skin freshens it will be found comfortable to do it with cool water. In tender cases the poultice or hot bag will need to be comfortably warm, and not hot. The cool cloth must not be wintry cold, nor even at first summer cold. It is, however, necessary to get at the hot and irritating surfaces that are causing the cough, with more or less that is cooling. We may do this ever so gradually, but we must do it, if we would succeed in giving rest from the cough. In a strong person's case there is really no difficulty. It is an easy matter to put on cloth after cloth till the irritated part is reached and cooled. But when the patient is spent to all but a skeleton, and has restlessness from frequent coughing, it is a very different matter. Still to the very last the irritating heat may be kept down, and long sleeps given, when otherwise it would be hard work indeed to get through the last stages of illness. We write thus because we know it is possible to give precious relief even when it is out of the question to save life. It is possible to make even the last night on earth comparatively a peaceful one, instead of its being so very restless as it often is. This is to be done just by cooling the parts that irritate, and these only. Generally, heat may be required rather than cold, but at the part which is irritating and keeping up the coughing, there must be cooling. The kind and capable nurse who can carry out this cooling is beyond all price. Those only can understand this who have been delivered from an all but incessant cough by means that produce no reaction. It is also well to remember that we now and again give life by means of rest when we had no idea of giving more than temporary comfort. We have repeatedly had cases in which there seemed no hope of doing anything further than giving relief, but that relief has turned out to be the commencement of cure.

Rheumatic Fever.—See Fever, Rheumatic.

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

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

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

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

In certain chronic cases, which are very largely nervous in their origin, a powerful soothing influence is required. This is secured by the use of soap lather (see Lather; Soap). Cover the back and head, piece by piece, with this, rubbing it on and off four or five times. Cover the fifth application with a soft cloth, and leave it on for the day in the morning, and for the night in the evening, the patient being in bed. Hot olive oil or occasionally cold drawn oil of mustard is gently rubbed on the stiff parts; when this cloth is removed, gently knead or squeeze the oil into the muscles. If during the lathering the patient feels too cold, a little olive oil should be mixed with the lather. A change to a dry climate from a damp one sometimes does a patient good, but when that is not possible, great relief, and in many cases cure, is to be had by this treatment.

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

Rose.—See Erysipelas.

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

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

Saliva.—See Digestion; Nourishment.

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

The treatment for prevention is the regular use of M'Clinton's soap (see Soap). Where the trouble has developed, the hands and face, if involved, should be packed in cloths soaked in buttermilk. Then over the packing we should foment with large hot flannel cloths (see Fomentation). Renew, if necessary, the buttermilk packing, and after a thorough fomenting, leave the buttermilk cloths on all night, with dry ones on top. Then gently anoint with OLIVE OIL (see). This treatment, with some rest and the use of the above-mentioned soap, should soon effect a cure.

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

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

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

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

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

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

To keep what is got either by the soothing influence of cold or by the stimulating power of heat, it is good to rub with hot olive oil, and to dry this off well in finishing, and also to wear a good broad band of new flannel round the lower part of the body. This band ought not to be so tight as to confine the perspiration. See Changing Treatment; Remedy, Finding a.

Scrofula.—The treatment under Glands, Swollen, should be followed. But besides, the whole membranous system of the glands must be stimulated. Daily rubbing briskly over the whole body with the cold-drawn oil of mustard for a quarter-of-an-hour will have this effect, and even by itself may cure.

Good, easily digested food must be taken (see Abscess; Assimilation; Diet; Nourishment), and overwork avoided. Continued work, as with a child at school, may quite prevent a cure, while if the work ceases, the cure will be rapid. It is better to have health and holidays than sickness and school. Where there is a family tendency to scrofula, care should be taken to treat promptly any case of glandular swelling.

Scurvy.—Is a disease springing from disordered digestion, and caused sometimes by partial starvation, but more frequently by a deficiency of vegetable acid in the food. It often manifests itself in skin eruptions, the skin peeling off in scales. To ward off or cure this disease, fresh food should always be used, and salted or tinned foods avoided. Especially should abundance of green vegetables and fruit be used, and where such cannot be obtained in sufficient quantity, lemon juice is valuable. Too much exposure, fatigue, and impure air, aided by a wrong diet, are the causes that formerly made scurvy so prevalent in the navy. It has almost disappeared since a regular allowance of vegetable acid has been served out.

Seamill Sanatorium and Hydropathic.—Very soon after the appearance of these "Papers on Health," the need was felt for some establishment where the treatment expounded here could be given by trained attendants under Dr. Kirk's personal supervision. The site was fixed on the Ayrshire coast, in the parish of West Kilbride. This region was chosen because special advantages of soil, climate, and scenery recommended it. The soil along the shore is almost pure sand, and dries rapidly after rain. The climate is extremely mild, high hills sheltering the whole region from north and east winds, and the Arran mountains, intervening some sixteen miles over the sea to the west, collect much of the rain. Hence, although near some very rainy districts, the Seamill neighbourhood is peculiarly sunny and dry. In winter the sun reflected from the water, and beating on the face of the hills, makes the shore climate most genial, and when other places only a few miles away are encased in ice, flowers will be blooming in the gardens at Seamill. In the very best part of this district a villa was secured in 1880 by some gentlemen interested in the treatment, with grounds abutting on the sand of the seashore.

Here treatment was carried on with great success, until it became evident that larger premises were needed. In 1882 Mr. James Newbigging was secured by Dr. Kirk as manager and head-bathman, and worked under Dr. Kirk until the latter's death in 1886.

Mr. Newbigging then bought the establishment. Since that time, it has constantly increased in size and efficiency until it now accommodates close on a hundred patients.

Very many have come to Seamill almost or quite hopeless, and have left it with health restored and vigour renewed.

It ought to be mentioned here that in all his dealings with this establishment Dr. Kirk never had any pecuniary interest in it, always giving his services free. Nor has the writer, or any of Dr. Kirk's family, any pecuniary connection with the place. All information as to the establishment may be had by writing to the Proprietor or Manager, Seamill Sanatorium, West Kilbride, Scotland.

Sea-Sickness.—The cause of this is a nervous derangement of the internal organs, by which the bile passes into the stomach instead of, as it normally does, passing down into the intestines. A tight bandage round the middle of the body, so as to oppose resistance to this, will help so far. When the sickness has come on, a teacupful of hot water, at intervals, will very largely mitigate, and will often cure it. Even half a teacupful or a tablespoonful will prove sufficient in many cases where the teacupful cannot be taken. If this small quantity of hot water be taken every ten minutes, the worst effects of sea-sickness will not be felt, and far more relief obtained than most people will believe until they have tried it.